Tackling the High-Intensity-Practice Challenge in SSD - Guest lecture from Prof Kirrie Ballard

Today we were very honoured to host Prof Kirrie Ballard at Charles Sturt University in Bathurst. She presented a hybrid workshop titled "Tackling the High-Intensity-Practice Challenge in SSD".

Overview of the session • Your client with SSD is now stimulable for their target sound/s • Now, research says they need high intensity practice 3 or more times a week to master this • You can't see clients that often • You give them homework but have no idea how much gets done • Could your clients be improving faster? • In this session we'll discuss your biggest challenges to implementing evidence-based practice and brainstorm ideas you can take back to your clinics and try. We'll get hands-on experience with the one tool, the Say Bananas app, that we designed specifically for this problem. • BYO tablet (iPAD or Android). We will have some extras for those who don't bring one. Note that the Say Bananas app is not available for phones/laptops.

Say Bananas YouTube video - https://www.youtube.com/watch?v=MYvRJzDCmQM

Visiting The University of Sydney

Yesterday I had the opportunity to visit Professor Leanne Togher at the School of Health Sciences, Faculty of Medicine and Health at The University of Sydney. I really enjoyed catching up on our lives and research and sharing advice about grant writing and mentoring. I also had a chance to chat with Dr Liss Brunner and Dr Rebecca Sutherland.

This was the first time I had been invited to visit since I left in 1999. Over the past few years the department has moved from their campus in Lidcombe to the Broadway campus. I visited the new Susan Wakil Building and had a chance to view the 5th floor containing staff and student hotdesks and lockers (it is an open-plan building), simulation suite, and on-campus clinic. 

Sharynne, Leanne Togher and the painting of Elinor Wray, the first director of the first speech therapy course in Australia. This painting used to be by my office door when I worked at The University of Sydney.

Simulation hospital ward

Simulation baby

Staff lockers

Staff hotdesks

Chatting with Dr Liss Brunner.
Leanne and I found our PhDs on the shelf in the department

Professor Leanne Togher holds many roles: 

• Professor of Communication Disorders Following Traumatic Brain Injury 
• Senior NHMRC Elizabeth Blackburn Research Fellow 
• Supervisor, Communication Sciences 
• Executive Leadership Team, Brain and Mind Centre 
• Director, speechBITE www.speechbite.com 
• Director, Acquired Brain Injury Communication Lab 
• Chief investigator, NHMRC Centre of Research Excellence in Aphasia Rehabilitation 
• Board of Governors, International Brain Injury Association
  
• International Board member, Journals Board, American Speech Language and Hearing Association (ASHA) 
• Development Group Member for TBI, World Health Organization 
• Chair, Editorial Board, Brain Impairment

Vale Diana Maloney

Last week I attended the memorial service to honour my colleague and friend Di Maloney.

Diana Maloney in 2020

Di was my lecturer for my undergraduate degree and became a close colleague in my years of working at The University of Sydney. We co-authored a book with Lindy McAllister and Michelle Lincoln titled "Facilitating Learning in Clinical Settings".

Prof Michelle Lincoln (UC), Prof Lindy McAllister (USyd), Prof Sharynne McLeod (CSU)

Her memorial service was attended by many people from across her life, including a large group of speech pathologists. Di had a key role in the Australian speech pathology profession as the President of the Australian Association of Speech and Hearing and the Head of the Program of Speech Therapy. Her wisdom, kindness, and insights will be missed.

Standing: Maree Doble, Michelle Lincoln, Jan van Doorn, Caroline Slater, Lindy McAllister, Alison Purcell, Chris Sheard, Tricia McCabe, Cate Madill, Eva Nemeth
Seated: Gwyn Burns, Hilary Roberts, Joan Rosenthal, Sharynne McLeod

Thank you to my early career mentors

This week I had the opportunity to say thank you to two of my early career mentors: Joan Rosenthal and Mark Onslow. Joan and Mark were my lecturers for my undergraduate degree at Cumberland College of Health Sciences (later The University of Sydney). Joan taught me phonetics and clinical education. She was my masters' thesis supervisor where she taught me how to think, write, use APA formatting and play Scrabble. Mark taught me stuttering, clinical processes, and later when I worked at The University of Sydney I worked with him to establish the honours program in speech pathology.  They continue to inspire me.

Joan Rosenthal and Sharynne

Prof Mark Onslow and Sharynne at the Australian Stuttering Research Centre, University of Technology Sydney

What kind of public good is language maintenance?

Yesterday (5th December), Dr Van Tran, Dr Suzanne Hopf and I were able to attend the Michael Clyne lecture given by Professor Jo Lo Bianco at The University of Sydney. The lecture was titled: "What kind of public good is language maintenance?" It was an honour to hear Prof Lo Bianco speak, since he has had such an influence on language policy throughout Australia for so many years.  It was also interesting to listen to him speak about  language rights and to hear about the Salzburg Statement for a Multilingual World (2017).

He ended by saying "...there is a potentially deep conceptual change underway, involving a radical reconfiguring of what counts as normal communication". I believe that the work undertaken with multilingual and multimodal children and families by our SLM team in Australia, Fiji, Vietnam, Denmark, The Netherlands, UK, and other countries is contributing to this "radical reconfiguring of what counts as normal communication"

Prof Jo Lo Bianco

Dr Van Tran, Sharynne, Dr Suzanne Hopf

 Here is the description of the event from the Sydney Institute of Community Languages Education site:

Joseph Lo Bianco, Professor of Language and Literacy Education at the University of Melbourne joins the SICLE Seminar Series to deliver its annual Michael Clyne lecture. Professor Lo Bianco is author of Australia’s formal language policy, the National Policy on Languages, adopted in 1987, the first multilingual language policy in an English-speaking country.
In this year’s Michael Clyne lecture, Professor Lo Bianco will be looking at how the term ‘language education’ has a diverse range of activities whose essential differences are often overlooked by policy makers and even researchers. The teaching of languages foreign to their learners is a radically different activity from efforts to maintain spoken community languages across generations. Sociologically and therefore pedagogically, socio-linguistically and therefore in identity terms, teaching and maintaining a community language has its own unique value which needs to be considered in a broader context.
Using a multidisciplinary approach, this lecture draws upon thinking from public good theory in economics, restorative justice reasoning in ethics and law, as well from pedagogical efficiency and equity rationales, to develop a robust account of why Australian language education efforts should make intergenerational language maintenance a central feature of language policy. Should it be a right to learn one’s heritage language? Professor Lo Bianco will also distinguish a case for language rights and discuss the evolution of language rights thinking in international instruments. Specific reference will be made to the turbulent history of indigenous bilingual education for language maintenance of languages spoken by children in the Northern Territory, and the case of language reclamation by urban Aboriginal people, and intergenerational maintenance of immigrant community languages.
The lecture will be followed by a Q&A session. Please join us explore and discuss current themes in the world of community languages education.

Cluster randomized controlled trial evaluating the effectiveness of computer-assisted intervention

The latest Sound Start Study article has just been published:

McLeod, S., Baker, E., McCormack, J., Wren, Y., Roulstone, S. Crowe, K., Masso, S., White, P., & Howland, C. (2017). Cluster randomized controlled trial evaluating the effectiveness of computer-assisted intervention delivered by educators for children with speech sound disorders. Journal of Speech, Language, and Hearing Research. Advance online publication doi:10.1044/2017_JSLHR-S-16-0385 http://jslhr.pubs.asha.org/article.aspx?articleid=2643351

Members of the Sound Start Study Team (+Yvonne Wren and Paul White)

Here are the details of our other Sound Start Study publications: 

Crowe, K., Cumming, T., McCormack, J., Baker, E., McLeod, S., Wren, Y., Roulstone, S., & Masso, S. (2017, in press). Educators’ perspectives on facilitating computer-assisted speech intervention in early childhood settings. Child Language Teaching and Therapy. doi:10.1177/0265659017717437

Masso, S., Baker, E., McLeod, S., & Wang, C. (2017). Polysyllable speech accuracy and predictors of later literacy development in preschool children with speech sound disorders. Journal of Speech, Language, and Hearing Research. Advance online publication doi:10.1044/2017_JSLHR-S-16-0171 http://jslhr.pubs.asha.org/article.aspx?articleid=2639744

Masso, S., McLeod, S., Baker, E., & McCormack, J. (2016). Polysyllable productions in preschool children with speech sound disorders: Error categories and the Framework of Polysyllable Maturity. International Journal of Speech-Language Pathology, 18(3), 272-287. doi:10.3109/17549507.2016.1168483 http://www.tandfonline.com/doi/abs/10.3109/17549507.2016.1168483?journalCode=iasl20

Masso, S., McLeod, S., Wang, A. & Baker, E., & McCormack, J. (2017). Longitudinal changes in polysyllable maturity of preschool children with speech sound disorders. Clinical Linguistics and Phonetics, 31(6), 424-439. doi:10.1080/02699206.2017.1305450
http://www.tandfonline.com/eprint/hnFtnIR6iTvXn4IQNAV5/full

McCormack, J., Baker, E., Crowe, K., Masso, S., McLeod, S., Wren, Y., & Roulstone, S. (2017). Implementation fidelity of a computer-assisted intervention for children with speech sound disorders. International Journal of Speech-Language Pathology, 19(3), 265-276. doi:10.1080/17549507.2017.1293160
http://www.tandfonline.com/eprint/JjWu9TGPwWahCX53IuMM/full

McLeod, S., Crowe, K., & Shahaeian, A. (2015). Intelligibility in Context Scale: Normative and validation data for English-speaking preschoolers. Language, Speech, and Hearing Services in Schools, 46(3), 266-276. doi:10.1044/2015_LSHSS-14-0120 http://lshss.pubs.asha.org/article.aspx?articleid=2290674

McLeod, S., Crowe, K., Masso, S., Baker, E., McCormack, J., Wren, Y., Roulstone, S., & Howland, C. (2017). Profile of Australian preschoolers with speech sound disorders at risk for literacy difficulties. Australian Journal of Learning Difficulties. Advance online publication doi:10.1080/19404158.2017.1287105 http://www.tandfonline.com/doi/abs/10.1080/19404158.2017.1287105?journalCode=rald20

McLeod, S., Crowe, K., McCormack, J., White, P., Wren, Y., Baker, E., Masso, S., Roulstone, S. (2017). Preschool children’s communication, motor and social development: What concerns parents and educators? International Journal of Speech-Language Pathology. Advance online publication doi:10.1080/17549507.2017.1309065 http://www.tandfonline.com/doi/abs/10.1080/17549507.2017.1309065?journalCode=iasl20

Wren, Y., McCormack, J., Masso, S., McLeod, S., Baker, E. & Crowe, K. (2016, in press). Digital tools to support children’s speech and language skill. In S. Danby, M. Fleer, C. Davidson & M. Hatzigianni (Eds). Digital childhoods: Technologies in children’s everyday lives. Dordrecht, Germany: Springer.

Congratulations Sarah M - postdoctoral position

Sarah Masso will be starting as one of two Faculty of Health Sciences Early Career Development Fellows at The University of Sydney in June. Congratulations Sarah!

Celebrating the end of the Sound Start Study

On 30th June, the investigators on the Sound Start Study submitted our final report to the Australian Research Council. We celebrated the official end of the Sound Start Study at CSU Olympic Park on Monday; however, we are in the midst of finalising many journal articles, book chapters, and conference presentations reporting the findings of our research.

Sarah Masso, Elise Baker, Kate Crowe, Adelaide, and Sharynne

Here in an excerpt from the report:

SUMMARY: DP130102545 (Sound Start Study) was a large-scale clustered randomized controlled trial (RCT) examining the speech and pre-literacy skills of Australian preschoolers. It was completed as planned, on budget, and on time. The project involved mass screening of preschoolers (target n=1250; actual n=1205) in early childhood centers (hereafter sites) throughout Sydney (target n=18 sites; actual n=45 sites from 77 invitations); comprehensive assessment of preschoolers whose parents or teachers were concerned about their preschooler’s speech (target n=250; actual n=275); the development of an Australian version of innovative computer-based technology designed to target preschoolers’ speech and pre-literacy skills (Phoneme Factory Sound Sorter [PFSS]); RCT of PFSS over 9 weeks (each year) involving preschoolers with speech impairment (target n=128, actual n=123) randomly assigned to PFSS (target n=64; actual n=63) or control (target 64; actual n=57); comprehensive follow-up assessments evaluating the skills of each preschooler, immediately (target n=128; actual n=114) then 6-8 weeks after PFSS (target n=128; actual n=115), and interviews with early childhood educators (n=22) about their experience of using PFSS. A central aspect of DP130102545 was the RCT involving PFSS—technology previously shown to hold promise in improving children’s speech when delivered by a speech pathologist. In the RCT, an alternate service delivery model was tested with PFSS being delivered to preschoolers with speech impairment by early childhood educators at their early childhood centre.

RESULTS: From screening and assessments, more parents (35.1%) and early childhood educators (36.8%) were concerned about their preschoolers’ speech and language than any other aspect of development. Their concerns aligned with clinical testing, underscoring the importance of parents and educators seeking advice when they have concerns. For the RCT, a statistically significant improvement was found between time points (pre PFSS, immediate post and follow-up) for both PFSS and control groups on measures of pre-literacy skills (Aim 1a), speech (Aim 1b), underlying phonological processing (Aim 1c), and wellbeing (Aim 1d); however, there was no statistically significant interaction between group and time. That is, PFSS administered by early childhood educators, was not more effective than typical classroom practices. Considerable variability was evident within each group—some preschoolers showed impressive change in speech/pre-literacy over time; others showed little change, suggesting that specialized support delivered by speech pathologists is still needed for preschoolers with speech impairment to achieve optimal outcomes before school. Child- and family-related variables were explored to identify variables associated with change in pre-literacy and speech production status. Preschoolers who had difficulty producing polysyllabic (long) words had significantly poorer pre-literacy and phonological processing skills (Aim 2); preschoolers who had more difficulty producing polysyllabic words, and had a positive family history of speech difficulties were less likely to improve (Aim 3). Facilitators and barriers to PFSS implementation were also identified encompassing personal, environmental, and PFSS-specific issues.

BENEFITS: DP130102545 has provided new insights into parents’/educators’ concern about preschoolers’ development, the relationship between speech and pre-literacy skills, the identification of preschoolers with speech impairment most at risk for on-going speech and future literacy difficulties, and the implementation of support programs for preschoolers in early childhood settings. A large dataset has been created that will be mined to address future research on preschoolers with speech impairment, their families, and the role of early childhood centres.

OUTCOMES: This research has addressed all of the proposed objectives, and resulted in the production of 2 books; 8 book chapters; 4 peer reviewed journal articles; and 32 (including 5 invited) conference presentations across 7 countries including Australia (VIC, ACT, WA), Canada, England, Ireland, New Zealand, Sweden, United States). A further 3 book chapters and 11 journal articles are in preparation/submission at the time of this report. The PhD student employed throughout the project is due to submit her thesis (comprising 6 publications) in August 2016, and another student achieved 1^st class honours for her thesis, based on DP130102545 data.

IMPACT:  A submission was made to the Australian Government Senate Inquiry Prevalence of different types of speech, language and communication disorders and speech pathology services in Australia based on DP130102545; and CI-McLeod contributed to the Education and Employment References Committee: Students with disability in the school system, referring to data from DP130102545 (Hansard 25/9/15).

Sound Start Study symposium at Speech Pathology Australia 2016

The Sound Start Study, our Australian Research Council Discovery Grant (DP1030102545) is coming to a close, so it was a privilege to present five papers within a symposium session to share some of our findings.

• 

  L-R: Elise Baker, Sarah Masso, Pam Enderby (keynote speaker at the conference),
  Kate Crowe, Charlotte Howland, Sharynne McLeod

Here is the abstract from the first paper in the symposium

Speech sound disorders (SSD) affect many Australian preschoolers and if it persists into the school years between 30% to 77% will have reading difficulties. Without support services, these children face increased risk of life-long social, educational, occupational limitations; however, demand for speech pathology services exceeds supply. The Sound Start Study was designed to determine if the Phoneme Factory Sound Sorter (PFSS) (Wren & Roulstone, 2013) computer software can be used enhance preschoolers' speech and pre-literacy skills. The Sound Start Study was conducted in 6 stages per year, repeated over 3 years. In stage 1, 1205 children were screened via parent and teacher questionnaire. In stage 2, children whose parents and teachers had concerns about speech were assessed (n = 275). In stage 3, children who had a phonological impairment with no known cause (n = 133) underwent additional assessment of their speech, pre-literacy and phonological processing skills. In stage 4, 123 children were eligible and randomized into a control group or intervention group. The intervention group received PFSS administered by preschool staff over 9 weeks. This innovative computer program was designed using a psycholinguistic framework to target children's perception and representations of their phonological patterns via phonemic awareness tasks. In stages 5 and 6, children were re-assessed by speech pathologists blinded to the first assessment and intervention condition. These immediate and 3-month post-intervention assessments were undertaken to determine whether the intervention improved the children’s speech and pre-literacy skills.  

Here are the titles of our presentations:

• Randomised controlled trial of software to enhance preschoolers' speech and pre-literacy skills (Presenter - Sharynne McLeod)
• Implementation of a computer-assisted intervention for children with speech sound disorders in Australian preschools (Presenter - Kate Crowe)
• The print knowledge of preschool children with speech sound disorders before and after intervention targetting speech and pre-literacy abilities (Presenter - Elise Baker)
• The relationship between polysyllable production and emergent literacy in preschool-aged children with speech sound disorders (Presenter - Sarah Masso) 
• Realization of grammatical morphemes by children with speech sound disorders (Presenter - Charlotte Howland)

We were very pleased with the large number of people in the audience and the number of people who have commented, asked questions, and contacted us about our work after the presentation. More information about all of our presentations at SPA 2016 is here and information about Charlotte's award is here.

Congratulations Charlotte: Speech Pathology Australia Outstanding Student Award

Last night at the Speech Pathology Australia Annual General Meeting and Awards Night Charlotte Howland was congratulated by SPA President Gaenor Dixon for receiving the SPA Student Award for being the most outstanding academically and clinically within the Bachelor of Applied Science (Sp Path) program at The University of Sydney. While undertaking her studies Charlotte was our research assistant on the Sound Start Study and completed her honours program using some of the data from the study. Congratulations Charlotte!

SPA President Gaenor Dixon and Charlotte Howland

While at the conference, Charlotte presented a paper based on her honours research to a large and receptive audience:
Howland, C., Baker, E., McLeod, S., & Munro, N. - Sound Start Study: Realization of grammatical morphemes by children with speech sound disorders. 

Charlotte presenting her honours research during the Sound Start Study symposium

Charlotte's last day with the Sound Start Study

Today was Charlotte’s last day on the Sound Start Study. She has been working hard with us for the last two years – and working particularly hard over the last 3 months. She has been an invaluable member of the Sound Start team and has shown incredible initiative since her first day with us. Charlotte has been a pleasure to work with and has remained as cool as a cucumber despite varying levels of stress, workload and scanning (!!). She has finished a mountain of work over these last few weeks...Charlotte has been offered an incredible position as a speech pathologist at one of the large teaching hospitals in Sydney and will definitely be an asset to her new team.
CONGRATULATIONS CHARLOTTE! Congratulations on an amazing time with us, an amazing honours result and an amazing job opportunity. What a way to start a new, exciting year. Sound Start wouldn’t have been the same without you. (Written by Sarah Masso)

Congratulations Charlotte

Today Charlotte learned that she achieved first class honours. Congratulations Charlotte!

Congratulations Charlotte on your honours thesis submission

Today Charlotte Howland submitted her honours thesis to The University of Sydney. Charlotte has been working as our research assistant on the Sound Start Study for the past two years while she has been studying speech pathology at The University of Sydney. Her honours thesis incorporated data from the Sound Start Study and she was supervised by Dr Elise Baker, Dr Natalie Munro and myself.
The title of her thesis was: Played, jumped and shouted: Realization of grammatical morphemes by children with phonological impairment.

Charlotte Howland and Dr Elise Baker at The University of Sydney

Charlotte and Sharynne celebrating at CSU

Sound Start Study 2014

The Sound Start Study has had another extremely productive year.
During 2014 the team have seen 585 children, with more than 60 being involved in all six different stages of the study:

• Stage 1 = 585 children received screening assessments
• Stage 2 = 144 children received diagnostic assessments
• Stage 3 = 77 children received in-depth assessments
• Stage 4 = 69 children were randomised to either the intervention or control groups
• Stage 5 = 67 children received post-assessment 1
• Stage 6 = 65 children received post-assessment 2

Thank you to Kate Crowe and Sarah Masso who have completed these assessments with all of the children and Charlotte Howland, our research assistant who has assisted with data entry.
The Sound Start Study chief investigators and principle investigators are: Sharynne McLeod, Elise Baker, Jane McCormack, Yvonne Wren, Sue Roulstone and the research has been funded by an Australian Research Council Discovery Grant with support from the NSW Department of Education and Communities.

We have one more year of data collection to go, then can find out whether the Phoneme Factory Sound Sorter computer program is a successful intervention for children with phonologically-based speech sound disorders.

Sarah Masso, Mike Tom (Department of Education and Communities),
Kate Crowe, Charlotte Howland, Sharynne McLeod

Sound Start meetings in Sydney

Over the past 2 days we have had research meetings regarding the Sound Start Study in Sydney. We have traveled to be together to have a face-to-face meeting to discuss our progress, future plans, and to begin writing papers together. In attendance were Professor Sue Roulstone from (University of the West of England), A/Prof  Jane McCormack (CSU, Albury), Dr Elise Baker (University of Sydney), Prof Sharynne McLeod (CSU Bathurst), Dr Kate Crowe (CSU Homebush), Sarah Masso (CSU Homebush), Charlotte Howland (CSU Homebush/U of Syd) and Tamara Cumming (CSU Homebush). Dr Yvonne Wren (Bristol Speech and Language Therapy Research Unit) has been with us via Skype. It has been a productive two days.

Sound Start Team: Elise Baker, Kate Crowe, Charlotte Howland, Sharynne McLeod, Tamara Cumming, Sue Roulstone, Sarah Masso, Jane McCormack

Sound Start team meeting at CSU Homebush

A Sound Start is about to start

Last year we were awarded the following Australian Research Council (ARC) Discovery Grant: A sound start: Innovative technology to promote speech and pre-literacy skills in at-risk preschoolers (DP130102545).

Here is an overview of the project:

Speech impairment affects one in five Australian preschoolers. If the problem persists into the school years between 30% to 77% of these children will have reading difficulties. Without specialist services, these children face increased risk of life-long social, educational, vocational limitations. Three challenges exist: identification of preschoolers most at risk, development of strategies for targeting both speech and pre-literacy skills, and provision of appropriate specialist services. This project will determine if an innovative computer-based service, delivered within preschools, can address these challenges by promoting age-appropriate speech and pre-literacy skills in children with identified risk of reading difficulties. 

The project team are:

• Chief Investigators: Sharynne McLeod (CSU), Elise Baker (University of Sydney), Jane McCormack (CSU)
• Partner Investigators: Yvonne Wren and Sue Roulstone (University of the West of England)
• Project Officer: Kate Crowe
• PhD Student: Sarah Masso

The project will run from 2013 - 2015. The team met in Sydney on Thursday and Friday to plan for the project to commence in March. There is a lot to organise; however, we are looking forward to the challenges and anticipate outcomes that will be of benefit to children with speech difficulties.

Kate Crowe, Sarah Masso, Sharynne McLeod, Jane McCormack, Elise Baker