Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK

The following manuscript has just been accepted for publication.
Hegarty, N., Titterington, J., McLeod, S., Taggart, L. (2018, in press June). Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK. International Journal of Language and Communication Disorders.

It forms part of Natalie Hegarty's PhD (She is studying at the Ulster University and I am co-supervisor). Congratulations Natalie

Here is the abstract

Background Across the world, research has shown that intervention for children with phonological impairment can be both effective and efficient. However, research has also raised concerns about the translation of this evidence to practice, highlighting questions around clinician knowledge and understanding of approaches, and the intensity of intervention provided within real-life clinical contexts.
Aim To investigate the clinical management of phonological impairment by speech and language therapists (SLTs) in the United Kingdom (UK).
Methods & Procedures An anonymous, UK-wide, online survey was developed using Qualtrics. The target audience were UK-based SLTs who worked with children with phonological impairment. The following topics were explored: (1) SLTs’ understanding of intervention approaches, (2) SLTs’ use of intervention approaches to treat phonological impairment, (3) SLTs’ provision of intervention intensity for children with phonological impairment.
Outcomes & Results A total of 166 responses were analysed. To remediate phonological impairment, SLTs most commonly used speech discrimination (79.5%), conventional minimal pairs (77.3%), phonological awareness therapy (75.6%) and traditional articulation therapy (48.4%). Participants least frequently used the complexity approaches targeting the empty set (82.9%) and 2/3-element clusters (75%) as well as the cycles approach (75.6%). Results also showed that some SLTs were uncertain of what the empty set and 2/3-element clusters approaches entailed. In terms of intervention intensity, participants predominantly provided intervention once per week (69%) for a total of 9-12 sessions (ranging from 5-30 sessions, 71.5%) and elicited targets 10-30 times in single words per session (59.4%) in sessions lasting 21-30 minutes (41.4%).
Conclusions & Implications The most commonly used intervention approaches identified in the current survey (i.e., speech discrimination, conventional minimal pairs and phonological awareness therapy) may be used eclectically by SLTs, which could impact upon the effectiveness and efficiency of treatment for phonological impairment. The current study also highlighted that almost half of participants always/often used traditional articulation therapy to remediate phonological impairment, even though this approach has been found to be less effective for this difficulty. Additionally, it appears that the currently provided intervention intensity for phonological impairment in the UK is significantly lower than what is indicated in the literature. Therefore, a research-practice gap exists for SLTs in the UK working with children with phonological impairment.

Ben Phạm's PhD submission

Today Ben Phạm submitted her PhD. Four years ago she was awarded an Australian Awards scholarship to move to Australia to undertake her PhD. Her dissertation titled "Children’s acquisition of consonants, semivowels, vowels, and tones in Northern Viet Nam" is the culmination of her hard work and dedication. I am very proud to have been her supervisor and wish her all the best for her examination. Ben was also supervised by A/Prof Jane McCormack during the first year and Prof Linda Harrison.

Her PhD includes the following publications:

• PAPER 1: Phạm, B. & McLeod, S. (2016). Consonants, vowels and tones across Vietnamese dialects. International Journal of Speech-Language Pathology, 18(2), 122-134. doi:10.3109/17549507.2015.1101162.
• PAPER 2: Phạm, B. & McLeod, S. (2017, in press). Tone languages and communication disorders. In M. J. Ball & J. S. Damico (Eds.), Encyclopedia of human communication science and disorders. Thousand Oaks, CA: Sage.
• PAPER 3: Phạm, B., McLeod, S., & Le, X. T. T. (2016). Development of the Vietnamese Speech Assessment. Journal of Clinical Practice in Speech-Language Pathology, 18(3), 126-130.
• PAPER 4: Phạm, B. & McLeod, S. (2017). Vietnamese-speaking children’s acquisition of consonants, semivowels, vowels, and tones in Northern Viet Nam. Manuscript in submission.
• PAPER 5: Phạm, B., McLeod, S., & Harrison, L. J. (2017). Validation and norming of the Intelligibility in Context Scale in Northern Viet Nam. Clinical Linguistics and Phonetics, 31(7-9), 665-681. doi:10.1080/02699206.2017.1306110.

Ben, Ninh and Sharynne submitting her PhD online

Dr Audrey Wang, Ben Pham and Prof Sharynne McLeod

Overjoyed!

Ben submitting her PhD thesis to Associate Dean Research Peter Simmons

Here is the abstract:

The purpose of this doctoral research was to describe the speech acquisition of typically-developing Northern Vietnamese-speaking children. To achieve this overarching purpose, five aims were addressed: (1) to identify the consonants, semivowels, vowels/diphthongs, and tones of the Northern dialect compared with the Standard, Central, and Southern dialects of Vietnamese, (2) to present an overview of tone languages, (3) to develop a speech assessment to elicit speech samples from Vietnamese-speaking children, (4) to investigate children’s acquisition of Northern Vietnamese phonemes (speech accuracy, phoneme acquisition, non-adult realisations, and phonological patterns/processes), and (5) to investigate Northern Vietnamese-speaking children’s intelligibility. 

This doctoral research contained two parts and was presented in nine chapters, five of which were publications (one encyclopaedia entry and four journal articles). Part 1 included three comprehensive literature reviews. The first provided a review of phonological differences in the Northern Vietnamese dialect in comparison with the Standard, Central, and Southern Vietnamese dialects (Paper 1). The second provided an overview of tone languages (Paper 2). The third reviewed policy and literature about Vietnamese education and the speech-language pathology profession.

Part 2 commenced with a review of definitions of typical speech acquisition, phonological theories, and research design and methods for studying speech acquisition that informed the methodology of this doctoral research. Paper 3 described the conceptualisation and operationalisation of the Vietnamese Speech Assessment (VSA, Phạm, Le, & McLeod, 2016) used to elicit speech samples during data collection. The main findings of this doctoral research were presented in Papers 4 and 5.

Paper 4 described speech acquisition of 195 typically developing Northern Vietnamese children aged 2;2-5;11 years. Relational analyses were used to measure speech accuracy, phoneme acquisition, non-adult realisations, and phonological patterns/processes that resulted in four main findings. First, the accuracy scores of consonants, semivowels, vowels, and tones for Northern Vietnamese-speaking children were higher as age increased demonstrating the improvement of speech production accuracy with age. Second, by the age of 5;5-5;11, these Northern Vietnamese-speaking children had acquired all Vietnamese consonants, semivowels, vowels, and tones, with the exception of the initial-syllable consonants /ɲ, s, z, x/, the within syllable semivowel /w/, tone 3 (creaky thanh ngã), and tone 4 (dipping-rising thanh hỏi). Third, typical non-adult realisations of Northern Vietnamese consonants, semivowels, and tones were identified and variability of non-adult productions decreased in the older age groups. Fourth, common phonological patterns for younger children were fronting, stopping, deaspiration, aspiration, and semivowel deletion, and for older children were fronting and deaspiration. The children’s age and maternal education but not sex were found to influence the children’s speech accuracy. 

Paper 5 described parent-reported data regarding intelligibility of 181 Northern Vietnamese-speaking children aged 2;0-5;11 years and included validation of the Intelligibility in Context Scale: Vietnamese (ICS-VN, McLeod, Harrison, & McCormack, 2012). The mean ICS-VN score of Northern Vietnamese-speaking children was 4.43 (out of maximum 5.00) indicating that these children were “usually” to “always” intelligible. The ICS-VN scores were rated as significantly different between communication partners (higher ICS scores for family members and lower for strangers) and between children whose parents were and were not concerned about their speech and language skills (higher ICS scores for children with no concern). Additionally, factors significantly influencing the ICS-VN scores of Northern Vietnamese-speaking children were children’s age, parents’ occupation level, and mothers’ educational level but not children’s sex or fathers’ educational level.

The findings of this doctoral research provide emerging evidence about Northern Vietnamese-speaking children’s typical speech acquisition to inform policy and practice regarding the Vietnamese Government’s Developmental Standard 15 “Trẻ biết sử dụng lời nói để giao tiếp” (The child uses speech to communicate), Item 65 “Nói rõ ràng” (To speak clearly) and Item 70 “Kể về một sự việc hoặc hiện tượng nào đó để người khác hiểu được” (To narrate an event or a fact intelligibly to others). The findings also provide emerging evidence for professionals in Viet Nam and other countries to assist with the identification of children with speech sound disorders. The doctoral research introduces and validates two assessment tools (VSA and ICS-VN) for clinical and research use with Northern Vietnamese-speaking children. The study presented in this doctoral research is aligned with other international studies about speech acquisition providing a reference for future researchers in Viet Nam.

School of Teacher Education research

I am the Chair of the School of Teacher Education (SOTE) Research Committee. This week we have overtaken three SOTE noticeboards to showcase 50+ journal articles published by SOTE researchers 2017 and 2018 (see attached photos). We are now working on another noticeboard to feature the books written by SOTE staff and students. We are a prolific group researching many important issues.

SOTE Head of School, Carol Burgess with one of the SOTE research noticeboards

Communication rights presentation to CSU Centre for Law and Justice

Today I gave an invited seminar at the CSU Centre for Law and Justice titled:'Communication rights: Celebrating the 70th anniversary of the Universal Declaration of Human Rights'. The presentation was attended by people in Bathurst as well as online across the country. I profiled the special issue of the International Journal of Speech-Language Pathology on communication rights, including the paper by Emily Howie titled "Protecting the human right to freedom of expression in international law".

Attendees at the CSU Centre for Law and Justice presentation
(the people who joined virtually are not pictured)

Investigating new approaches to child assessment and educator reflection

This week Sandie Wong presented a paper at the World Organization for Early Childhood Education Conference (OMEP) on behalf of our team who is investigating new approaches to child assessment and educator reflection for children under 3 in early childhood education and care settings:
Janus, M., Harrison, L., Wong, S., McLeod, S., Elwick, S., Alexander, W., Mulhearn, G., & Williams, K. (2018, June). Investigating new approaches to child assessment and educator reflection on practice in early childhood education and care services for children under 3. Paper presented at World Organization for Early Childhood Education Conference, Prague, Czech Republic.

The paper described the two tools being developed/validated by the team:

• Infant & Young Child Development-Educator Version (IYCD-E) (based on the World Health Organization's IYCD) 
• Observing, Reflecting, Improving Children’s Learning (ORICL)

Media release about our VietSpeech project

CSU Media published a media release about our VietSpeech project today: http://news.csu.edu.au/latest-news/education/teacher-education/vietspeech-project-to-deliver-for-australia

• Questionnaire for people in Australia with Vietnamese heritage here:
• English version: https://www.research.net/r/VietSpeech
• Vietnamese version: https://www.research.net/r/VietSpeech-Viet

• VietSpeech Details about the project here: https://www.csu.edu.au/research/vietspeech

Ben Phạm's last PhD meeting

Ben Phạm arrived in Australia in June 2014 to begin her prestigious 4-year Australia Awards PhD scholarship. We have had a wonderful 4 years together, and today was her last PhD meeting before she will submit her PhD on Friday. Ben has calculated that over the 4 years we have had an average of 36 formal meetings per year (total = 143) with agendas and minutes (+ many more informal meetings). I am so proud of Ben's accomplishments over the 4 years and look forward to working with her for many years into the future.

Welcome Michelle Brown - our new postdoc

Today we received the news that Michelle Brown will officially join our team as a postdoctoral scholar, commencing on 1st August 2018. She will be with us part-time for two years. Michelle's postdoc will be funded by my CSU Senior Research Fellowship and she will be supporting the research of our team as well as continuing her PhD research into early literacy:

• Brown, M. I., Westerveld, M. F., & Gillon, G. T. (2017). Early storybook reading with babies and young children: Parents’ opinions and home reading practices. Australasian Journal of Early Childhood, 42(2), 69-77. doi:10.23965/AJEC.42.2.09 
• Brown, M. I., Westerveld, M. F., Trembath, D., & Gillon, G. T. (2017). Promoting language and social communication development in babies through an early storybook reading intervention. International Journal of Speech-Language Pathology. Advance online publication doi:10.1080/17549507.2017.1406988 

Michelle had the opportunity to meet with our team at the Speech Pathology Australia National Conference in Adelaide in May. We are delighted she will be working with us over the next two years. 

A video of Michelle discussing her work is here: "Improving language and social skill outcomes for very young children through early storybook reading". Evidence Bites recordings from the 2017 Speech Pathology Australia National conference. 

Michelle Brown (on the left) with our team after the SPA conference

United Nations NGO Accreditation Status for Speech Pathology Australia

Following on from our work to celebrate communication rights and the 70th anniversary of the Universal Declaration of Human Rights, Speech Pathology Australia has just been granted NGO Accreditation Status by the United Nations.

Here is the announcement on Facebook by Speech Pathology Australia:

Speech Pathology Australia has just been granted NGO (Non-Government Organisation) Accreditation Status by the United Nations! The Association’s application for new NGO accreditation to the Conference of States Parties to the CRPD (Convention on the Rights of Persons with Disability) was recently approved by consensus at the first meeting at the CoSP 11th session on 12 June in New York.
What this means is that Speech Pathology Australia can send delegations to the CRPD Conference of State Parties and participate in UN meetings and the Civil Society forum concerning the implementation of the Convention. The Association can now also host a side event at future CRPD Conferences of States Parties. Such a proposition has been under active consideration by the International Communication Project, as well as the Australian Department of Foreign Affairs and Trade and the Australian Human Rights Commission.
It is pleasing that the RCSLT has also just been granted accreditation status, providing further support for possible future ICP activities to promote communication as a human right. Additionally, the Association is aiming to apply for Consultative Status with United Nations Department of Economic and Social Affairs, which will provide further opportunities for consultation at this global level.
Gail Mulcair Chief Executive Officer

Charles Sturt University Senior Research Fellowship

Today, Charles Sturt University announced the recipients of 6 Senior Research Fellowships and 9 Research Fellowships. I am fortunate to have received one of the Senior Research Fellowships, a position I will hold for 2 years. Here is the description of the Fellowships

The Research Fellowships and Senior Research Fellowships are intended to boost research capacity within the university by supporting dedicated research time and providing additional research resources for a number of high-performing individuals.

Here is the announcement on What's New and News.

The recent call for Research and Senior Research Fellowships received 37 eligible applications and was highly competitive... Up to six Senior Research Fellowships were available and awarded with two dedicated to each Research Sphere within the Research Narrative. Up to ten Research Fellowships were available across the Research Narrative, and nine Research Fellowships were awarded.

Resilient People research sphere entitled Walanbang mayiny which means very strong people:
Senior Research Fellowships
* Prof. Sharynne McLeod, Faculty of Arts and Education
* Prof. Jade Forwood, Faculty of Science
Research Fellowships
* A/Prof. Karen Bell, Faculty of Arts & Education
* Dr. Tamara Cumming, Faculty of Arts & Education
* A/Prof. Peter Denyer-Simmons, Faculty of Arts and Education
* Dr. Danielle Ryan, Faculty of Science

Flourishing Communities research sphere entitled Ngumbadal-ngilanha which translates as united:
Senior Research Fellowships
* A/Prof. Oliver Burmeister, Faculty of Business, Justice and Behavioural Sciences
* A/Prof. Dominic O'Sullivan, Faculty of Arts and Education
Research Fellowships
* A/Prof. Zahid Islam, Faculty of Business, Justice and Behavioural Sciences
* A/Prof. Manoranjan Paul, Faculty of Business, Justice and Behavioural Sciences

Sustainable Environments research sphere entitled Gulbali ngurambang meaning to understand country:
Senior Research Fellowships
* A/Prof. Shokoofeh Shamsi, Faculty of Science
* Prof. Shane Raidal. Faculty of Science.
Research Fellowships
 * Dr. Andrew Clark, Faculty of Science
* Dr. Melanie Massaro, Faculty of Science
* Dr. Lihong Zheng, Faculty of Business, Justice and Behavioural Sciences

Please join me in congratulating all of the Fellowships recipients...
Kind regards Mary
Prof. Mary T Kelly DVC RDI

Research summary slide

I have been invited to create a Powerpoint slide to summarise my 2018 research for the upcoming CSU Faculty of Arts and Education Research Forum. Here is my slide:

The ICF framework: Considering individuals from a perspective of health and wellness

The following article has been accepted for publication.

Blake, H. L. & McLeod, S. (2018, in press June). The ICF framework: Considering individuals from a perspective of health and wellness. Perspectives of the ASHA Special Interest Groups (SIG17: Global issues in Communication Sciences and Related Disorders).

It will be published in a special issue on the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), and forms part of Helen's PhD.
Here is the abstract:

This paper describes the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) and its application to speech, language, and hearing. The ICF framework was developed to present a holistic person-centered approach for people of all ages, across all nations, health care disciplines, services, and time from a perspective of health and wellness. Therefore, it is an appropriate framework for the professions of speech-language pathology and audiology for use with people in relation to their communication and/or hearing. This paper describes the ICF, its purpose, development, contents, and coding. It also discusses how the framework is being used by speech-language pathologists and audiologists in clinical practice and research to investigate body structures and their functions and any restrictions these may place on an individual’s ability to participate in activities. The acceptance of the ICF as a biopsychosocial framework for practice and research marks a transition in thinking from the professions’ previous focus on handicap to a focus instead that considers individuals and society from a perspective of health and wellness.

United Nations Multilingual Video Collection

Dr Suzanne Hopf, is in Fiji and has added her voice to the United Nations Multilingual Video Collection reading Article 19 of the Universal Declaration of Human Rights: https://youtu.be/XlfonR_aQaQ #SpeakUp4CommRights #StandUp4HumanRights
Add your voice here: https://www.un.org/en/udhr-video/

Vietnamese langauge maintenance survey

We need at least 300 people with Vietnamese heritage to answer a questionnaire about Vietnamese language maintenance. We are interested in hearing from people with Vietnamese heritage who speak Vietnamese, Vietnamese and English, English only, or other languages. The VietSpeech questionnaire will take about 20-30 minutes to complete.

Please share this link with anyone you know who has Vietnamese heritage, lives in Australia and is over 18 https://www.research.net/r/VietSpeech

The research has ethical approval. The findings of this project will provide useful information to the Vietnamese-Australian community, educators, speech pathologists, and policy makers about supporting language maintenance.

This VietSpeech study is funded by an Australian Research Council Discovery Grant and conducted through Charles Sturt University. More details about the project are here: https://www.csu.edu.au/research/vietspeech/overview

We plan to have a Vietnamese version of the questionnaire available in the next few weeks, so please let us know if you are interested in accessing that version.

Thank you for completing the questionnaire (if you are eligible) and for sharing the link with others who may be interested.

Speech Pathology Australia's support for communication as a human right

Gaenor Dixon (President, SPA), Gail Mulcair (CEO, SPA), Prof Kirrie Ballard (Editor, IJSLP), Prof Sharynne McLeod (Guest Editor, IJSLP). Photo credit: Louise Hutchinson

At the Speech Pathology Australia (SPA) National Conference we celebrated the 70th anniversary of the Universal Declaration of Human Rights, focusing on communication as a human right. The photograph of the audience showing their support for communication rights is below. I was the editor of the special issue of the International Journal of Speech-Language Pathology (volume 20, issue 1) that contains 31 open access papers discussing communication as a human right is available here. The foreword is written by Alastair McEwan (Australian Disability Discrimination Commissioner) and Ed Santow (Australian Human Rights Commissioner) and is titled "The importance of the human right to communication".

Speech Pathology Australia delegates celebrating 70th anniversary of the Universal Declaration of Human Rights and communication as a human right (Article 19). Photo credit: Louise Hutchinson

Authors and editors of the special issue of IJSLP celebrating communication as a human right L-R: A/Prof Jane McCormack, Prof Sharynne McLeod (Guest Editor, IJSLP), Gail Mulcair (CEO, SPA), Hayley Tancredi, Prof Kirrie Ballard (Editor, IJSLP), Prof Bronwyn Hemsley, Prof Lindy McAllister, A/Prof Deborah Hersh, Dr Bea Staley. Photo credit: Louise Hutchinson

Natalie Davall (Taylor & Francis), A/Prof Anne Whitworth (Editor, IJSLP), Prof Kirrie Ballard (Editor, IJSLP), Prof Sharynne McLeod (Guest Editor, IJSLP), A/Prof Deborah Hersh (author), Hayley Tancredi (author). Photo credit: Louise Hutchinson