Monthly Archives: May 2019

Factors Influencing The Functional Communication Skills of Pre-School Children with Language Difficulties: How Does Socio-Emotional-Behavioural and Language Profiles Interact With Functional Communication?

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Here is the abstract from Louise Bulman’s final year research project, supervised by Dr Cristina McKean and Ana Trebacz (Post Graduate Research student)

Factors Influencing The Functional Communication Skills of Pre-School Children with Language Difficulties: How Does Socio-Emotional-Behavioural and Language Profiles Interact With Functional Communication?

Background: Functional communication is now a vital part of diagnosing developmental language delay (DLD). Currently there is a lack of research into the factors that may impact functional communication, which leaves professionals unable to identify children that may be at risk of experiencing functional communication difficulties, which could lead to a diagnosis of DLD.

Aims: The aim of the current study is to identify how socio-emotional-behavioural (SEB) difficulties impact on functional communication in pre-school age children, and if there are differences in functional communication between children with differing language profiles (expressive, receptive or mixed).

Methods & Procedures: The current cross-sectional observation study is nested within a larger therapy efficacy study, where 27 participants were recruited from schools (matched based on socio-economic-status), with expressive, receptive or mixed language difficulty profiles. Functional communication and SEB difficulties were measured, and analysed using correlations and statistical analysis.

Outcomes & Results: Significant correlations were found between (teacher reported) SEB difficulties and (teacher and parent reported) internalising difficulties with functional communication. Indicating that higher overall SEB difficulties and internalising difficulties are associated with poorer functional communication. No significant difference was found between children with differing language profiles on functional communication.

Conclusions & Implications: The findings give preliminary evidence to suggest that SEB, with particular strength to internalising difficulties are associated with poorer functional communication outcomes. Additionally, no evidence was found to suggest that functional communication is impacted by an expressive, receptive or mixed language difficulty profile.

Keywords: Functional Communication, Developmental Language Disorder, Socio-emotional-behavioural difficulties, expressive-receptive language

Exploring the Relationships Between Underpinning Theory and Intervention Choice for Children with Developmental Language Disorders:  Interpreting Data from a Practitioner Questionnaire Carried Out in 39 Countries

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Here is the abstract from Rachel Forsythe’s final year research project, supervised by Professor James Law and Dr Carolyn Letts.

Exploring the Relationships Between Underpinning Theory and Intervention Choice for Children with Developmental Language Disorders:  Interpreting Data from a Practitioner Questionnaire Carried Out in 39 Countries

Children with Developmental Language Disorder (DLD) have impairments in their understanding and use of language. Speech and Language Therapy interventions can be effective for DLD but there is limited research into practitioner-reported interventions, especially across countries. Therefore, it is important to investigate the current use of intervention approaches alongside rationales and scientific evidence across a diverse range of countries.

Practitioner-reported questionnaires were distributed online in 39 COST Action countries. The participants were 2408 practitioners. Analysis included thematic analysis, coding qualitative data and statistical exploration.

A wide range of intervention approaches and rationales were reported. Most responses included a client-centred factor. Participants were more likely to use the client’s level of functioning as a rationale if they reported a severe impairment. Participants with University level education were less likely to report basing intervention on client-centred factors. Overall there was limited use of scientific evidence. Specific interventions were used across countries. The key themes of intervention had varying levels of scientific evidence.

Certain client and practitioner characteristics could have an impact on the intervention approaches and rationales used across countries. Limited numbers of practitioners reporting use of scientific evidence suggest that there should be more initiatives to encourage scientific evidence-based practice.

Key words: Developmental Language Disorders, Language Intervention for Children, Qualitative Data analysis, Quantitative Data analysis

Enablers and barriers to the use of high-tech AAC in the specialist classroom

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Here is the abstract from Catherine Morrison’s final year research project, supervised by Dr Carolyn Letts and Kate Laws.

Enablers and barriers to the use of high-tech AAC in the specialist classroom

Numerous factors interact with alternative and augmentative communication (AAC) use in the specialist classroom. Despite this, there are no studies known to the researcher in the UK which consider the enablers and barriers to high-tech AAC in this setting. This project specifically aims to discover the enablers and barriers to communication via high-tech AAC in the specialist classroom. Qualitative methods of five classroom observations and thirteen interviews with speech and language therapists, teachers and learning support assistants were used to gather data. Thematic analysis was conducted to reveal key enablers and barriers to high-tech AAC use. A wide range of factors were identified under the themes of those relating high-tech AAC use and the student’s capabilities, external factors and the attitudes of staff/students. Factors, including communication partner behaviour, vocabulary on the device and perception of purpose of the device, were perceived as enablers and barriers, varying between classroom situations. Implications include that considering the potential enablers and barriers to use should be part of the assessment process during high-tech AAC provision. Once barriers are identified strategies to minimise the impact of these if possible, should be incorporated into interventions used so students are encouraged to reach their communicative potential.

Key words: Qualitative Data analysis, Alternative and augmentative communication

 

Comparing Interactions of Children with Autism with their Parents and Learning Support Assistants

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Here is the abstract from Lucy Dempster’s final year research project, supervised by Dr Faye Smith and Professor Helen McConachie.

Comparing Interactions of Children with Autism with their Parents and Learning Support Assistants

Children with autism have difficulties initiating interactions and generalising skills across contexts.  Therefore, providing intervention in both home and school contexts may be beneficial.  The aim of this study was to compare the baseline level of adult synchrony and child initiations to see if there were any differences between parents and LSAs.  Participants were 77 children with autism with a parent and LSA from the PACT-G trial who were filmed interacting separately with each adult. Adult communication acts were coded according to synchrony and child communication acts were coded as initiations or responses.  A synchronous communication act follows the child’s attention, and a child initiation starts an interaction.  No significant differences were found between the proportion of parents’ and LSAs’ synchronous responses or between the proportion of child initiations with parents and LSAs.  There was no correlation at baseline between adult synchrony and child initiations.  The results of this study indicate that when interacting with a child with autism, parents and LSAs have very similar interaction styles and the children interacted similarly with both adults.  This indicates that both adults could benefit from intervention to increase synchrony as this has been associated with increased child initiations.

Key words: Language Intervention for Children, autism

Listen, we have something to say: Developing methods for eliciting, analysing and understanding children’s stories about themselves

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Here is the abstract from Emma Higgins’ final year research project, supervised by Dr Cristina McKean and Dr Carolyn Letts.

Listen, we have something to say: Developing methods for eliciting, analysing and understanding children’s stories about themselves

This study aimed to evaluate methods of eliciting and analysing typically developing children’s personal narratives to inform the development of a method for assessing the personal narratives of children with developmental language disorder (DLD).  To do this, it evaluated, using ten-year-old children, the elicitation method for children’s personal narratives designed by the IALP Child Language Committee.  It also evaluated two methods for analysing children’s personal narratives, a structural focused analysis method and a coherence focused analysis method, in relation to children with DLD.  It found the elicitation method enabled children of a range of abilities to tell a range of personal narratives.  It also found, with development of both approaches, a combination of the two analysis methods has potential to provide a reliable and sensitive analysis method providing useful information for the diagnosis of and intervention planning in DLD.

Key words: Developmental Language Disorders, Qualitative Data analysis, Quantitative Data analysis

 

Long-term Functional Outcomes Following Transoral Robotic Surgery for Patients with Hypopharyngeal Cancer

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Here is the abstract from Holly Bocock’s final year research project, supervised by Dr Nicole Lallini and Diane Goff (Newcastle upon Tyne Hospitals NHS Foundation Trust).

Long-term Functional Outcomes Following Transoral Robotic Surgery for Patients with Hypopharyngeal Cancer

This study aimed to evaluate the long-term functional swallow outcomes following transoral robotic surgery (TORS) for patients with hypopharyngeal cancer.

Outcome measures of physical swallow function, diet modifications and dysphagia-related quality of life were gathered by retrospectively analysing scores on the Water Swallow Test (WST), Performance Status Scale (PSS) for normalcy of diet and M.D. Anderson Dysphagia Inventory (MDADI) obtained prior to TORS, at three-months post-surgery and after a year.

Twelve patients (10 male), mean age 64.9years, were included. Participants most commonly had T2 staging (58.3%) with no nodal involvement (N0=50%). Survival to the time of study was 50%. WST revealed reduced swallow capacity and speed one-year post-TORS, but no statistically significant change. Four of six patients were able to eat a normal diet after one year, no statistical difference in PSS scores was found over time. Comparative analysis was not possible for MDADI scores due to limited data, however 50% fell within the ‘optimal’ category (>80 points), and 50% within the ‘adequate’ category (76-79).

For patients with hypopharyngeal cancer, TORS was shown to provide encouraging long-term functional outcomes, with no significant difference in physical swallow ability, adaptations to diet or self-perceived swallow function found from pre-TORS to one-year post-TORS.

Key Words: Quantitative Data analysis, Dysphagia, Head and neck cancer

Exploring Prosody in Depressive Speech and The Relationship Between Therapist and Patient Prosodic Features in the Therapeutic Setting

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Here is the abstract from Hannah Grime’s  final year research project, supervised by Dr Laurence White.

Exploring Prosody in Depressive Speech and The Relationship Between Therapist and Patient Prosodic Features in the Therapeutic Setting

To investigate the relationship between prosody and depression severity and compare patient and therapist prosodic variables, the speech of 32 people with depression and eight therapists was analysed. Articulation rate, F0 range, and median F0 were measured within (early/late) and across (first/last) sessions. Quantitative speech analysis, answered three research questions: 1. What is the relationship between severity of depression and prosodic variables, articulation rate, F0 range, and median pitch? 2. Do patient’s prosodic features change within sessions and over the course of therapy? 3. Does the relationship between patient and therapist prosodic features change within sessions and over the course of therapy? There was no relationship between prosodic features and depression severity. There was an interaction effect of chunk and session on patient articulation rate. Comparing patient and therapist prosodic features showed no differences within or between sessions. In female-female pairs, therapists had higher articulation rate and median F0, female-female pairs showed signs of converging articulation rate.
Many findings in the current study differ from previous findings, possible reasons for differences are discussed. These findings suggest that accounting for gender and gender pairings is important when investigating depression speech and the relationship between prosody in depressed and non-depressed speakers.

Keywords: depressive speech, vocal prosody, convergence, articulation rate, F0 range

 

Bilingualism in Children with Special Educational Needs and Disabilities: A Study of Primary School Educational Staffs Training, Opinions and Experiences

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Here is the abstract from Sannah Qurban’s final year research project, supervised by Dr Carol Moxam.

Bilingualism in Children with Special Educational Needs and Disabilities: A Study of Primary School Educational Staffs Training, Opinions and Experiences

This study explores the training, attitudes and experiences of primary school educational staff in the North East of England with regards to bilingualism in children with special educational needs and disabilities (SEND). A questionnaire was created through the process of focus and pilot groups prior to distribution. The final paper questionnaire was distributed to specialist and mainstream provisions in the region. Data collected from 43 participants was quantitatively analysed using descriptive and inferential statistics alongside qualitative data analysis. The findings suggest despite extensive training on SEND there is a gap in training on bilingualism, yet professionals are keen to receive more training on identified areas of uncertainty. Despite attitudes being generally positive it was clear that participants were uncertain about the impact of bilingualism on communication skills, in pupils with SEND. Furthermore, differences between the current integration of bilingualism for children with SEND and priorities was identified between provisions. Additionally, this study found a majority of participants had experienced working with a bilingual SEND pupil in the classroom, which further highlights the need for further training and research with this population. The study concludes by emphasising the need for further research into the knowledge held by professionals and the current practises of bilingual staff working with the population.

Key words:
Special Educational Needs and Disabilities (SEND), bilingualism, specialist provisions, mainstream provisions, English as an Additional Language (EAL), Autistic Spectrum Disorder (ASD), Down Syndrome, Cerebral Palsy, Global Developmental Delay

Applying Behaviour Change Theory to Speech and Language Therapy Intervention for Inducible Laryngeal Obstruction: An Investigation for Service Improvement

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Here is the abstract from Hannah Asbridge’s final year research project, supervised by Dr Helen Stringer and Jen Murphy (Newcastle upon Tyne Hospitals NHS Foundation Trust)

Applying Behaviour Change Theory to Speech and Language Therapy Intervention for Inducible Laryngeal Obstruction: An Investigation for Service Improvement

Summary: This study provides the exploratory stages of using Behaviour Change Theory (BCT) to characterise Speech and Language Therapy (SLT) intervention for Inducible Laryngeal Obstruction (ILO). The study aimed to review literature using a BCT framework and compare this to observations of current practice. The study aims to develop research tools using BCT to facilitate future investigation.

Methods: The investigation comprised three phases: a literature review; development of a questionnaire for Speech and Language Therapists and development of a questionnaire for patients.

Results: A paucity of detailed literature was identified concerning SLT intervention for ILO. BCT was used to identify a subset of specific Behaviour Change Techniques relevant to this intervention from literature and current practice. Using these findings, questionnaires for patients and Speech and Language Therapists respectively were developed using the BCT framework.

Conclusions: BCT proved to be a useful and relevant framework for characterising this intervention. The research tools developed can be used to underpin future data gathering with BCT. This approach shows significant clinical implications for developing an effective complex intervention for this disorder. Future research should continue beyond the scope of this study to pursue a more comprehensive analysis of this intervention using BCT.

Key Words: Qualitative Data analysis, Intervention Analysis for Service Improvement

Are children with autism included in mainstream provisions? Perspectives from neurotypical 7-11 year olds in the North East of England.

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Here is the abstract from Emily Erceylan’s final year research project, supervised by Dr Carol Moxam.

Are children with autism included in mainstream provisions? Perspectives from neurotypical 7-11 year olds in the North East of England.

Neurotypical peer-exclusion of children with autism in mainstream provisions is a current issue, which has detrimental consequences for those with autism (APPGA, 2017). This study reports 77 neurotypical children’s perspectives towards inclusion of children with autism, in the North East of England. Participants completed a questionnaire in relation to a hypothetical child (character) from a vignette, with four variations of characters: 1) neurotypical male; 2) neurotypical female; 3) male with autism; 4) female with autism. Participants were randomly assigned to one of the four conditions.

Data from the questionnaire measured participant perspectives towards inclusion of the character. Three variables were investigated on participant responses: 1) Character autism status; 2) Character gender; 3) Participant gender. 5-point Likert scales obtained quantitative data which measured perspectives towards inclusion; analysed statistically. Comment boxes obtained qualitative data and provided insight into quantitative findings; analysed with deductive Thematic Analysis (Braun & Clarke, 2006).

Findings confirmed that characters with autism were perceived to be less included by participants than neurotypical characters, to a highly statistically significant level. The influence of character or participant gender were not statistically significant. Although, qualitative data found that female characters received more positive comments, and, found that female participants provided slightly more positive ratings than male participants.

Overall, findings confirm claims from APPGA (2017); neurotypical children hold negative perspectives towards inclusion of children with autism. Thus, findings suggest that mainstream schools, concerned about peer-inclusion of children with autism, should attempt to change perspectives of neurotypical pupils, through teaching autism awareness (NAS, 2019e).

Key words: Autism, neurotypical, mainstream primary education, inclusion, perspectives.