Recent Submissions

  • The right advice at the right time: The role of health visiting teams in children's communication

    McDonald, David; Meredith, Lara (2020)
    This article will reflect on the importance of health visiting teams for supporting the speech, language and communication development of all children, including those with speech, language and communication needs (SLCNs). It will outline the national focus on early identification and intervention for children with SLCNs, and some ways in which health visiting and speech and language therapy teams can work together to boost children's communication. It will go on to highlight evidence-based messages about learning two languages and new online resources health visiting teams can share with parents and carers to support children's early speech, language and communication development.
  • What are the experiences of speech and language therapists implementing a staff development approach in early years settings to enhance good communication practices?

    McDonald, Sarah (2020)
    Interventions designed to improve communication environments and the quality of adult?child interactions in early years (EY) settings are an important part of facilitating children?s communication skills both for children with identified Speech, Language and Communication Needs (SLCN) and children without SLCN. One such intervention devised and delivered by speech and language therapists (SLTs) in Nottinghamshire is the Language Lead Approach (LLA), where SLTs deliver a formalized but flexible package of support and training to EY practitioners who go on to become Language Leads (LLs) for their setting. Nine SLTs delivering the LLA were interviewed to explore their perspectives on the implementation and impacts of the LLA. Interviews were analysed thematically. Three key themes were identified, the first of which related to factors internal to the setting and included aspects relating to the nature of initial and sustained engagement with an LL and the setting manager, time pressures and the impact of different setting organizational cultures. The second theme which emerged related to the individual qualities and characteristics of the LL, as SLTs noted that the response of LLs to the role varied considerably and was influenced by their confidence, experience and leadership capacity, as well as the degree of autonomy in the role. The final theme, external influences on implementation, reflected the SLTs own working practices and workload. Overall, SLTs felt the LLA was effective and could be implemented alongside their daily workload. SLTs reflected on their lack of training to implement such interventions, the challenges to sustaining the LLA at the setting and County level, and the challenges of evidencing effectiveness. This research has implications for those designing and evaluating training and mentoring approaches as well as for those SLTs who are seeking to develop the effectiveness of their consultative working with Early Years Educators (EYEs).
  • Parent-implemented language intervention delivered by therapy assistants for two-year-olds at risk of language difficulties: A case series

    McDonald, David; Colmer, Sarah; Guest, Susan; Humber, Dawn; Ward, Charlotte; Young, Jane (2019)
    The aims of this small-scale study were to explore the feasibility and outcomes of a parent-implemented intervention for two-year-olds at risk of language difficulties, and to explore the implications for the public health model of speech and language therapy (SLT). This adds to limited research into targeted SLT public health interventions. It is the first study to investigate early language intervention delivered by trained therapy assistants (TAs) rather than clinicians. Nine children aged between 26 and 31 months took part. Seven (78%) completed the six-session intervention. The outcome measure was the Words subscale of the Language Use Inventory. The gross motor subscale of the Ages and Stages Questionnaire was used as a control measure. Children’s skills were assessed twice before intervention and once afterwards. At baseline, six participants had expressive language delay and no wider speech, language and communication needs (SLCNs). Five of this subgroup showed language use skills within the typical range following intervention. At baseline, three participants had expressive language delay and previously undetected receptive language and/or social interaction difficulties. None of this sub-group showed improved age-adjusted language use skills following intervention. All nine participants had gross motor skills in the typical range at each time point. These exploratory findings suggest this targeted intervention is feasible. This study presents no evidence of short-term impact of this intervention for two-year-olds with expressive language delay and wider SLCNs. These findings suggest this targeted language intervention for two-year-olds may be associated with accelerated language development for some two-year-olds at risk of language difficulties because of expressive language delay; and may help identify two-year-olds with previously undetected wider SLCNs, and therefore facilitate early access to specialist support. We highlight limitations in the study size, design and outcome measures, and identify how these preliminary findings can inform future research.
  • Growth in syntactic complexity between four years and adulthood: Evidence from a narrative task

    McDonald, David (2018)
    Studies examining productive syntax have used varying elicitation methods and have tended to focus on either young children or adolescents/adults, so we lack an account of syntactic development throughout middle childhood. We describe here the results of an analysis of clause complexity in narratives produced by 354 speakers aged from four years to adulthood using the Expressive, Receptive, and Recall of Narrative Instrument (ERRNI). We show that the number of clauses per utterance increased steadily through this age range. However, the distribution of clause types depended on which of two stories was narrated, even though both stories were designed to have a similar story structure. In addition, clausal complexity was remarkably similar regardless of whether the speaker described a narrative from pictures, or whether the same narrative was recalled from memory. Finally, our findings with the youngest children showed that the task of generating a narrative from pictures may underestimate syntactic competence in those aged below five years.
  • Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia

    Haworth, Helen (2012)
    Objective: The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. Design: A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Setting: Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Subjects: Of 511 people with aphasia identified, 105 had low mood and were recruited. Interventions: Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Main measures: Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales ‘sad’ item, and Visual Analogue Self-Esteem Scale. Results: Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), visual analogue ‘sad’ (P = 0.03), and Visual Analogue Self-Esteem Scale (P < 0.01). At six months, group alone was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), and remained significant when baseline values were controlled for (P = 0.02). Mean Stroke Aphasic Depression Questionnaire 10-item hospital version scores decreased from baseline to six months by six points in the intervention group as compared with an increase of 1.9 points in the control group.
  • A comparison of three approaches to delivering a speech and language therapy service to people with learning disabilities

    Money, Della (1997)
    This research aimed to compare three different approaches to delivering a speech and language therapy service to people with learning disabilities, in order to make recommendations for future service delivery. The three approaches all involved working with key communication partners in the environment. They were: (i) working directly on a one-to-one basis with the person and partner; (ii) working indirectly by providing teaching for partners; and (iii) a combination of these two approaches. A teaching course called 'Talkabout' was used. Talkabout aims for staff to reach a recognised level of knowledge and competence in communication skills, thus facilitating the communication skills of their service users. The results indicated that whilst communication changed in all three approaches, overall changes were greater in the combination approach. Only the combination approach demonstrated statistically significant differences following intervention, in terms of staff initiations, service user responses, and their use of additional modalities.;
  • Without words--meaningful information for people with high individual communication needs

    Thurman, Sue (2005)
    The provision of appropriate accessible or easy information has been recognized as a right for people with learning difficulties (Department of Health 2001 a). However, there is a large and growing group of people with learning difficulties whose needs cannot be met by the use of techniques such as short sentences and appropriate pictures or technological support. People with high individual communication needs do not use formal methods of communication such as speech, writing or symbols. They communicate in their own unique way through their bodies, facial expressions, sounds, eye gaze or pointing. This paper stresses the importance of individual and person centred approaches which respect and respond to the individual's form of communication. It presents seven principles which will help those around the individual to understand them, the way they communicate, where they communicate best and which encourages supporters only to provide information that is relevant. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
  • The challenges of translating the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) Into British Sign Language

    Evans, Chris (2013)
    This article discusses translation issues arising during the production of a British Sign Language (BSL) version of the psychological outcome measure “Clinical Outcomes in Routine Evaluation–Outcome Measure” (CORE-OM). The process included forward translation, meeting with a team of translators, producing a second draft of the BSL version and back translating into English. Further modifications were made to the BSL version before piloting it with d/Deaf populations. Details of the translation process are addressed, including (a) the implications of translating between modalities (written text to visual language); (b) clarity of frequency anchors: analog versus digital encoding; (c) pronouns and the direction of signing; and (iv) the influence of the on-screen format. The discussion of item-specific issues encountered when producing a BSL version of the CORE-OM includes the expression of precise emotional states in a language that uses visual modifiers, problems associated with iconic signs, and the influence of Deaf world knowledge when interpreting specific statements. Finally, it addresses the extent to which lessons learned through this translation process are generalizable to other signed languages and spoken language translations of standardized instruments. Despite the challenges, a BSL version of the CORE-OM has been produced and found to be reliable.
  • Speech therapy and rehabilitation

    Robinson, H. Fiona (2012)
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  • Addendum to 'Increasing early childhood educators' use of communication-facilitating and language-modelling strategies: Brief speech and language therapy training'

    McDonald, David; Proctor, Penny; Heaven, Sue; Marr, Jane; Young, Jane (2015)
    This addendum article originally appeared in Child Language Teaching and Therapy, 2015, Oct vol 31 [3], 305-322. The purpose of this addendum is to include within our discussion the findings of Girolametto et al. (2007), a randomized controlled trial of Teacher Talk training, an adapted version of Learning Language and Loving It (LLLI). Teacher Talk does not include the coaching and video feedback elements of LLLI. Girolametto et al. report a statistically significant increase in the modeling of some, but not all, types of abstract language by a group of early years educators (ECEs) following training. The authors report individual variation in responses to training, in that six ECEs increased their use of strategies for modeling abstract language, while two ECEs did not. Overall, this RCT shows that ECE training that does not include coaching or video feedback can have some positive impact on ECEs’ skills at modeling abstract language. The following abstract of the original article appeared in (see record 2015-47121-005). Intensive Speech and Language Therapy (SLT) training courses for Early Childhood Educators (ECEs) can have a positive effect on their use of interaction strategies that support children’s communication skills. The impact of brief SLT training courses is not yet clearly understood. The aims of these two studies were to assess the impact of a brief SLT training course on ECEs’ interaction behaviour, and to explore ECEs’ views and experiences of the course. In Study 1, eight ECEs took part in a multiple-baseline study of a brief SLT training course. Video-recordings of interactions with children were used to evaluate ECEs’ interaction behaviour using the Conversational Responsiveness Assessment and Fidelity Tool. In Study 2, seven ECEs took part in semi-structured interviews about this training course. Template analysis was used to identify key themes. In Study 1, the group of trained ECEs showed a statistically significant increase in their use of one communication-facilitating strategy (using comments to cue turn-taking) and a statistically significant decrease in their use of one conversation-hindering behaviour (asking yes/no, testing or rhetorical questions). Analysis at the individual level showed a modest increase in some ECEs’ use of language-modelling strategies and a more generalized decrease in conversation-hindering behaviours. In Study 2, ECEs more consistently reported learning and using communication-facilitating strategies than language-modelling strategies. ECEs identified several features of the training course that facilitated learning: the practical, interactive nature of the group training sessions, the use of video feedback, and the repetition of key strategies in several training sessions. We conclude that brief SLT training for ECEs can lead to increased use of some interaction strategies that help children’s communication skills develop. Further research is needed to evaluate brief SLT training more thoroughly. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
  • Increasing early childhood educators’ use of communication-facilitating and language-modelling strategies: Brief speech and language therapy training

    McDonald, David; Proctor, Penny; Heaven, Sue; Marr, Jane; Young, Jane (2015)
    Intensive Speech and Language Therapy (SLT) training courses for Early Childhood Educators (ECEs) can have a positive effect on their use of interaction strategies that support children’s communication skills. The impact of brief SLT training courses is not yet clearly understood. The aims of these two studies were to assess the impact of a brief SLT training course on ECEs’ interaction behaviour, and to explore ECEs’ views and experiences of the course. In Study 1, eight ECEs took part in a multiple-baseline study of a brief SLT training course. Video-recordings of interactions with children were used to evaluate ECEs’ interaction behaviour using the Conversational Responsiveness Assessment and Fidelity Tool. In Study 2, seven ECEs took part in semi-structured interviews about this training course. Template analysis was used to identify key themes. In Study 1, the group of trained ECEs showed a statistically significant increase in their use of one communication-facilitating strategy (using comments to cue turn-taking) and a statistically significant decrease in their use of one conversation-hindering behaviour (asking yes/no, testing or rhetorical questions). Analysis at the individual level showed a modest increase in some ECEs’ use of language-modelling strategies and a more generalized decrease in conversation-hindering behaviours. In Study 2, ECEs more consistently reported learning and using communication-facilitating strategies than language-modelling strategies. ECEs identified several features of the training course that facilitated learning: the practical, interactive nature of the group training sessions, the use of video feedback, and the repetition of key strategies in several training sessions. We conclude that brief SLT training for ECEs can lead to increased use of some interaction strategies that help children’s communication skills develop. Further research is needed to evaluate brief SLT training more thoroughly.
  • Theory of mind ability in children with specific language impairment

    Gillott, Alinda (2004)
    Whilst evidence of theory of mind impairments in children with autism is well established, possible impairments in children with language disorder have only recently been investigated. Children with specific language impairment aged between eight and 12 years were matched by age and gender to high functioning children with autism and normally developing peers. The theory of mind abilities of the groups were compared using the strange stories task. Both the children with specific language impairment and the children with autism gave fewer correct mental state answers than normally developing children, but whereas the children with autism gave more inappropriate mental state answers than the children who were developing normally, the children who were developing normally and the children with language disorders did not differ in this respect. These findings are discussed within the context of theory of mind issues in autism and the classification of language disorders. © Arnold 2004.