Here are some posts about my contribution:
Sharynne McLeod is Professor of Speech and Language Acquisition at Charles Sturt University, Australia. This blog was designed to record the work of her team to support multilingual children's speech acquisition throughout the world. The associated Multilingual Children's Speech website contains resources for over 60 languages: http://www.csu.edu.au/research/multilingual-speech
Here are some posts about my contribution:
|Kelly (US), Sharynne (Australia), Marie (US), Kate (Poland)|
|Early Childhood Research Group Dr Tamara Cumming (Chair) and Prof Sharynne McLeod (Deputy Chair)|
|Dr Tamika Heiden's workshop on Implementation Science|
|Participants in Bathurst|
|Some of the online participants: Sarah Verdon, Kate Margetson, Van Tran, Nicole McGill, |
(Michelle Brown, Mandy Cooke, etc.)
They taught us that the vowels are pronounced in the following way: a = ah, e = eh, i = e, o = o, ö = ur, u = u
|Prof Sharynne McLeod|
|Dr Michelle Brown|
|Celebrations at the moment of submission|
|In person: Nicole and Luke McGill, Prof Sharynne McLeod, Dr Sarah Verdon, Dr Cathy Easton, Dr Linda Wilson|
Online: Dr Suzanne Hopf (in Fiji), Dr Kate Crowe (in Iceland at 4am), Dr Helen Blake, Anna Cronin
|Suzanne celebrating by the pool in Fiji|
Throughout the world, some children with communication and swallowing needs must wait for support, since there are not enough speech and language services to meet demand. While waiting, children miss the benefits of early intervention and their caregivers may feel fearful, stressed, and disempowered. There is limited knowledge about waiting for speech and language services, solutions for managing waiting lists, and provision of support to those who are waiting. Consequently, this doctoral research explored current perspectives, experiences, and solutions regarding waiting for speech and language services across stakeholder groups (e.g., consumers, professionals), client populations, service contexts, and countries. This doctoral research, known as the Wait-Lifting Study, consisted of a four-phase program of research: (1) thematic analysis of stakeholders’ written submissions to a government Senate Inquiry (n = 133); (2) quantitative and qualitative analysis of SLPs’ questionnaire responses (n = 264); (3) a mixed methods study informing the design of an evidence-based active waiting website via an evaluation of existing sites (n = 25), and consultation with members of the public via a questionnaire (n = 119) and focus groups (n = 16); and (4) a randomised controlled trial evaluating active (provision of the website) versus passive waiting (control group) by children and families (n = 97). Two theoretical frameworks were applied: (1) the International Classification of Functioning, Disability, and Health: Children and Youth Version (ICF-CY), and (2) the theory of preparative waiting. This doctoral research was presented as a series of six journal articles and an exegesis in three parts.
Understanding the status quo: SLPs indicated that waiting duration for both assessment and intervention ranged from 0-42 months. Overall, children most often waited for assessments only (referral → wait → assessment → therapy; n = 67, 33.8%) but could follow a multitude of care pathways depending on their needs or the service they are referred to (e.g., referral → triage → assessment → therapy). Although passive strategies were evident, many consumers and professionals engaged in active strategies to address waiting lists and their consequences. Consumer actions included conducting their own research and relocating to a larger city. Professional actions related to service delivery (e.g., parent information, use of technology), workplace processes and policies (e.g., prioritisation policies), and the workforce (e.g., recruiting more SLPs). Young children and children with feeding and stuttering needs were most often high priority for speech and language services. Severity of communication/swallowing disorder and availability of resources (e.g., funding, staff) were considered the most important prioritisation factors.
Designing and evaluating solutions: A waiting for speech-language pathology website was proposed and evidence-based resources about strategies to implement with children, readable information, and simple web architecture were recommended. A randomised controlled trial comparing active waiting (provision of the website) and passive waiting (control group) by children and caregivers found no statistically significant changes between active and passive waiting groups, indicating that those on waiting lists may require more support than can be provided by a website.
Conclusions and contributions: Waiting lists can have significant consequences for consumers, professionals, and society, including physical, psychological, financial, and ethical burdens. Implicit decision-making, variation, and a lack of clear evidence guiding waiting list practices were apparent. Evidence-building in real-world clinical settings may guide professionals regarding effective waiting list management practices, including creation of care pathways. Transparent and collaborative actions at local and systemic levels are needed to reimagine service provision and access, and optimise outcomes for children and their families.
|Celebrating in Albury: Dr Michelle Smith-Tamaray, Sharynne McLeod, Nicole McGill, Dr Sarah Verdon|
|More celebrating in Albury: Sharynne, Nicole and Dr Lisa Brown|
Objective: To evaluate how the practice of specialist speech-language pathologists (SLPs) working with young children with cleft palate ± cleft lip (CP±L) maps onto the International Classification of Functioning, Disability and Health (ICF-CY) and consider the functionality of the categories of the ICF-CY for this specialist area of practice.
Design: Cross-sectional, qualitative study.
Setting: Semi-structured face-to-face interviews were conducted with SLPs working in tertiary level hospitals, universities, private and public clinics.
Participants: Six specialist SLPs with 17-39 years of experience working with young children with CP±L as researchers and clinicians in Australia, Brazil, Denmark, Ireland, New Zealand, and USA.
Main Outcome Measure(s): Specialists’ practices were captured using in-depth, semi-structured interviews. Data collected were analyzed by directed content analysis applying the ICF-CY coding schema.
Results: In total 4,077 data points were coded. Most mapped onto Body Structures (684, 16.8%), Body Functions (906, 22.2%) and Environmental Factors (1626, 39.9%). A “best fit” approach was taken to topics that did not map exactly onto categories of the ICF-CY (e.g., velopharyngeal insufficiency; VPI); however, there was not always an ideally suitable category available.
Conclusions: The current study revealed challenges in categorizing key aspects of practice with children with CP±L, including collaboration with parents and significant others, specificity around speech, language and articulation, and the different types of VPI within the ICF-CY. Therefore, future discussion around how best to use the framework with children with CP±L is needed.
|SOTE staff - February 2020|
|Belinda, Lana, Stacey, Helen, Andi, Tamara, Sharynne, Rahul, Jessica (Brian not pictured)|
|Conversation with Prof Lesley Olswang|
Purpose: To compare children’s speech, language and early literacy outcomes, and caregiver empowerment and satisfaction following provision of: 12 sessions of direct intervention (therapy), or face-to-face advice, or a purpose-built website (device) while waiting for therapy.
Method: A 4-stage randomised controlled trial was undertaken involving 3- to 6-year-old children referred to speech-language pathology waiting lists at two Australian community health centres over 8 months (n = 222). Stage 1 (screening): 149 were eligible to participate. Stage 2 (pre-assessment): 117 were assessed. Stage 3 (intervention): 110 were randomised to advice (33), device (39), or therapy (38). Stage 4 (post-assessment): 101 were re-assessed by a speech-language pathologist blinded to the intervention condition.
Result: After controlling for baseline levels, children’s speech (percentage of consonants correct) was significantly higher in the therapy group compared to the advice and device conditions. Caregivers’ satisfaction was also significantly higher in the therapy condition compared to the device condition. There were no significant differences between the three conditions for children’s intelligibility, language, and early literacy or caregivers’ empowerment.
Conclusion: Therapy resulted in significantly higher speech outcomes than the advice and device conditions and was associated with significantly greater caregiver satisfaction. Provision of a website containing evidence-based materials or a single session of advice may be a viable alternative while children wait for therapy targeting intelligibility, language, and early literacy, and to empower caregivers.
|Emily Davis, Angela Roberts, Sharynne McLeod, Jon Preston, Lauren after Jon's presentation|
|Sharynne and Jon comparing notes about electropalatography and ultrasound|
I’m really pleased you are going to experience Australia today. As you travel, think about our big country, small population, and the continuing challenges of fires, floods, drought etc. Then look at the map of the whole of Australia and notice that Bathurst actually is extremely close to Sydney - in fact on a number of measures we are not even considered to be “rural” and we definitely are not “remote”. Then overlay those thoughts with being a family with communication disorders/other issues...
|Skype meeting with Hang Nguyen, Vấn Phạm, and Dr Ben Phạm in Viet Nam|