Thinking in Action: Strengthening Clinical Reasoning to Deliver High-Impact, Individualized Interventions

Today our Children's Voices Centre Visiting Scholar - Professor Lynn Williams  - presented a whole day workshop titled "Thinking in Action: Strengthening Clinical Reasoning to Deliver High-Impact, Individualized Interventions".

We had 16 people attend in person in Bathurst, 65 people attend session 1 online, 96 people attend session 2 online, and 62 people attend session 3 online!   

9:30-11:30 | Session 1: Thinking in Action: Strengthening Clinical Reasoning to Deliver High-Impact, Individualized Interventions (2 hours)
11:30-12:00 | COFFEE BREAK
12:00-1:00 | Session 2: The Evolution of the Multiple Oppositions Approach: From Theory to Global Practice (1 hour)
1:00-2:00 | LUNCH (Own expense at CSU café or BYO) 
2:00-3:00 | Session 3: Thinking in Action (1 hour)

Professor A. Lynn Williams, PhD, CCC-SLP 
A. Lynn Williams is Professor in the Department of Audiology and Speech-Language Pathology at East Tennessee State University (ETSU), USA. She was founding Dean of ETSU’s College of Health Sciences, and 2021 President of the American Speech-Language-Hearing Association (ASHA). An internationally recognized expert in speech sound disorders, she has led innovative interprofessional education initiatives and currently serves as Vice President of the National Academies of Practice, advancing collaboration to improve education, research, and patient care.

Sessions 1 and 3: 
Thinking in Action: Strengthening Clinical Reasoning to Deliver High-Impact, Individualized Interventions
Clinical reasoning is the bridge between research and real-world practice that allows clinicians to honour evidence-based interventions while adapting to each client’s needs. These interactive sessions will explore how clinical reasoning guides moment-to-moment decision-making during intervention, particularly in modifying teaching moments such as cues and feedback, and how clinicians may “tailor it, mix it, or wing it.” Using case examples, we will unpack the critical differences between tailoring, hybrid methods, and eclecticism, and their impact on treatment fidelity and outcomes. Attendees will gain practical strategies to strengthen their clinical reasoning skills, maintain intervention fidelity, and elevate confidence in delivering effective, individualized care.

Session 2: 
The Evolution of the Multiple Oppositions Approach: From Theory to Global Practice
First described in Williams (2000), the Multiple Oppositions approach offers a contrastive intervention for children with severe speech sound disorders. Grounded in systemic phonology, it targets multiple error sounds simultaneously to maximize change in a child’s speech system. This one-hour presentation will chart its development over 25 years from theoretical origins to adoption across languages. Participants will gain practical insights into applying the approach to improve intelligibility and participation for children.
Williams, A. L. (2000). Multiple oppositions: Theoretical foundations for an alternative contrastive intervention approach. American Journal of Speech-Language Pathology, 9, 282–288. https://doi.org/10.1044/1058-0360.0904.282

Some of the online audience

Speech-language pathologists brought along their books for Lynn to sign

Thank you DVC-R for your support

I appreciate having monthly check-in meetings with the Deputy Vice Chancellor Research, Neena Mitter to discuss the wonderful progress of the Children's Voices Centre. 

 

Creative gifts for The Beehive and The Treehouse

Today we had "welcome home soup" at The Treehouse with the Children's Voices Centre staff, Prof Lynn Williams and Camilla Porsanger. Lynn had brought some special gifts from USA to decorate The Beehive, the room where she is working while visiting Charles Sturt University. Thank you Lynn we love the creativity of your friends and colleagues in the US!

Prof Lynn Williams, Prof Sharynne  McLeod, Camilla Porsanger, A/Prof Tamara Cumming, Lorraine Bennett

Sharing welcome home soup at The Treehouse

 

Continuiing to renovate and decoarate The Treehouse

The Children's Voices Centre moved into The Treehouse (Building 1451 on the Bathurst campus of Charles Sturt University) in June 2025. Over the past few months we have worked hard to renovate and decorate the building to become a welcoming space for children, families, professionals, and researchers.

Last week at The Treehouse we hosted our first research event for children:  the children's advisory panel for our  Children Draw Health. This week we hosted our first event for professionals: Professor Lynn Williams' workshops.

We have just received a new refrigerator, new AV equipment, new bathroom taps, and boxes of books to go into my office. The renovation continues.

The Beehive for visiting scholars

The Billabong includes Lorraine's office

We look forward to updating our kitchen

Lorraine found our new refrigerator

 

Multilingual Speech Assessment: Using an Implementation Science Framework to Explore Acceptability of the Speech Assessment of Children’s Home Language(s) (SACHL)

Congratulations Kate Margetson who has just had the following manuscript accepted for publication that was written during her postdoc It is the next step in the research about the Speech Assessment of Children’s Home Language(s) (SACHL)

Margetson, K. & McLeod, S. (2025). Multilingual speech assessment: Using an implementation science framework to explore acceptability of the Speech Assessment of Children’s Home Language(s) (SACHL). American Journal of Speech-Language Pathology. Advance online publication. 
 

Here is the abstract

Purpose: The Speech Assessment of Children’s Home Language(s) (SACHL) offers a new, evidence-based clinical protocol for speech-language pathologists (SLPs) to assess speech in unfamiliar languages. This study used implementation science to investigate SLPs’ current multilingual speech assessment practices, determine the prospective acceptability of the SACHL, and compare current confidence to prospective confidence with the SACHL.
Method: The Consolidated Framework for Implementation Research (CFIR) and Theoretical Framework of Acceptability (TFA) were used to explore innovation deliverers’ (SLPs’ and student SLPs) prospective acceptability of the innovation (SACHL). Attendees at in-person and online SACHL presentations were invited to participate. 360 participants commenced an online questionnaire exploring current practices, transcription skills, confidence and acceptability of the SACHL. Statistical tests compared attendees at different presentations, SLPs and students SLPs, and monolingual and multilingual participants. 
Results: The majority of participants indicated low current confidence in assessing multilingual children. Most SLPs assessed, transcribed, and analyzed multilingual children’s speech in English; but rarely or never applied these practices in children’s home language(s). The majority of participants rated the SACHL as being culturally responsive, well-designed, easy to understand, and that it would increase diagnostic accuracy. There were concerns around the time burden in using the SACHL. Most (87.45%) indicated they would like to use the SACHL in clinical practice, and there was a statistically significant improvement between current confidence and prospective confidence.
Conclusions: The SACHL was evaluated by SLPs and student SLPs to be an acceptable clinical protocol to assess children’s speech in unfamiliar languages.

A beautiful Spring day in Bathurst

Today was a beautiful Spring Saturday in Bathurst, so we showed Prof Lynn Williams, Camilla Porsanger and their families around. We met a very friendly possum and sampled Annie's Icecream.

Planning for Lucy to come back to CVC

This afternoon I met online with Lucy Rodgers (UK) to discuss her next grant application so that she can come back to the Children's Voices Centre. We really enjoyed Lucy's visit earlier this year, so look forward to her coming again.

 

Commissioning Indigenous artwork for the Children's Voices Centre

Meleisa Cox is a Wiradjuri artist and early childhood educator. I purchased two of her artworks in 2022 for my personal use (pictured here) and today had the privilege of discussing artwork for the Children's Voices Centre. Thank you Meleisa for your interest in CVC. 

Sharynne and Meleisa

Here is Meleisa's Facebook page: https://www.facebook.com/MeleisaCox/

Interprofessional Leadership in Health and Higher Education

Today our visiting scholar, Professor A. Lynn Williams. presented a seminar titled "Interprofessional Leadership in Health and Higher Education": An interactive seminar for academic leaders and staff highlighting collaborative and distributed leadership approaches in health and higher education. The seminar was both online and face-to-face and we had attendees in Bathurst, across the CSU footprint, and in Fiji and Vietnam! 

Here is Prof Williams' bio:

Professor A. Lynn Williams, PhD, CCC-SLP is Professor in the Department of Audiology and Speech-Language Pathology at East Tennessee State University (ETSU), USA. She was founding Dean of ETSU’s College of Health Sciences, and 2021 President of the American Speech-Language-Hearing Association (ASHA). An internationally recognized expert in speech sound disorders, she has led innovative interprofessional education initiatives and currently serves as Vice President of the National Academies of Practice, advancing collaboration to improve education, research, and patient care.

Discussing the SACHL with Prof Lynn WIlliams

Prof Lynn Williams has spent 1.5 days with with Dr Kate Margetson discussing the Speech Assessment in Children's Home Languages (SACHL). Last week they met at the Charles Sturt University North Sydney campus and this week online. Her insights have been invaluable.

Children Draw Health: Children's advisory group week 1

Each Wednesday in September our Children Draw Health Advisory Group are considering the 100+ drawings from 17 countries we have received in our research. They are thinking about what the children of the world have shared. They analysed a sample of drawings to determine themes (food, doctors, hospitals, rainbows, friends, workout and sports), added their own ideas and came up with the following themes and answers to these questions:

1. What makes you healthy? Doctors, food, hospitals, Workout and sports
2. Who helps you be healthy? Mom, Dad, friends, doctors, hospital, therapist
3. Where do you go to get healthy? Hospital, doctor
4. What would your ideal healthcare setting look like? Rainbows, friends, nature

Stay tuned for next weeks' analysis...

A fun way to work out which themes answered which questions

At the beginning we considered each of the drawings and the artists' explanations

At the beginning we considered each of the drawings and the artists' explanations

At the end everyone demonstrated the thematic groups

Belinda's PhD - the final step

I was thrilled to receive a copy of Belinda Downey's bound PhD thesis today. What a significant moment - to hold the final product. Congratulations Belinda. Here is the link to the online version of her thesis titled "Staying in Early Childhood: Struggle, Hope and Connection": https://researchoutput.csu.edu.au/en/publications/staying-in-early-childhood-struggle-hope-and-connection

 

Welcome to The Treehouse Camilla

Today we welcomed Camilla Porsanger to The Treehouse. She is studying her PhD at Nord University and has a scholarship to visit Australia. She is a visitor of the School of Indigenous Australian Studies and the Children's Voices Centre.

Camilla and Prof Lynn Williams both were welcomed at CVC today

 Camilla's family brought a Sami flag for the CVC and we discussed Wiradjuri land.

Camilla's children wearing Sami dress (photos shared with permission)

Welcome Prof Lynn Williams - Visiting Scholar to CVC

Today we welcomed Prof Lynn Williams our Visiting Scholar to the Children's Voices Centre. She will be based at The Treehouse in Bathurst during September. Today she met the CVC staff and students, discussed future grants and research, and noticed the arrival of spring on campus with the blossoms.  We look forward to a very productive month of collaboration.

Welcome to the Bathurst campus of CSU

Welcome to the CVC!

 

 

 At the end of Lynn's first day on the Bathurst campus she was welcomed by a local kangaroo! 

 

Incremental changes at The Treehouse

We moved into The Treehouse in June. There is still work to do for The Treehouse to be finished. This week we have new AV and microphones, new taps and toilet seats, newly framed pictures, boxes of books and speech tests from my old office (still to be unpacked), etc etc. Thank you to Lorraine and Tamara for all of your work with the teams across CSU.