Tuesday, October 5, 2021

The Effects of Different Sources of Stuttering Disclosure on the Perceptions of a Child Who Stutters

Snyder, G., Williams, M. G., Adams, C., & Blanchet, P. (2020). The Effects of Different Sources of Stuttering Disclosure on the Perceptions of a Child Who Stutters. Language, Speech & Hearing Services in Schools, 51(3), 745–760. https://doi.org/10.1044/2020_LSHSS-19-00059

 

Stuttering is a speech disorder involving disruptions, or ‘disfluencies’ in a person’s speech. People who stutter are often subject unfounded prejudice and negative stereotypes. People who stutter are often perceived to be quiet, guarded, anxious, and poor communicators. There is growing recognition of the therapeutic role of self-advocacy in stuttering treatment. One such strategy is stuttering self-disclosure, the act of telling someone else that you stutter. Self-disclosure has been found to have positive effects on a stutterer’s quality of life. Telling someone you stutter can be very challenging for a stutterer. Positive impacts have also been reported when a mother or teacher provides the stuttering disclosure on a child’s behalf. Past research has specifically addressed oral stuttering disclosure, but the current study focused on written disclosure.

There were 4 groups in this study: (1) Control participants viewed a 55 second video speech sample of a child who stuttered; the remaining participants view a written statement prior to the video either from the (2) child, (3) mother, or (4) teacher. Participants were then asked to rate the child’s speech skills and personality characteristics. Overall, few effects were found. Ease of listening was rated ‘easier’ when mothers or teachers disclosed. As well, ratings of more ‘calmness’ were found in the case of child or mother disclosure; and ratings of more ‘relaxed’ were found in the case of mother disclosure.

In this study, there was no direct comparison to an oral disclosure condition. As well, the disclosure statement did not provide any information other than stating the person in the video was a stutterer and stuttering might be observed in the video. It is possible that the disclosure statement may not have appeared authentic as something a child would say.

The authors suggest that a written disclosure statement may be used in stuttering treatment as a ‘stepping stone’ towards oral disclosure. For example, a child might write the statement, share it with advocates, practice reciting the statement orally, and then begin sharing it with others orally.



                          


Blogger: This article was reviewed by David Liu, a first year student at Western and a volunteer in the Language and Working Memory Lab. You can read more about David’s journey navigating stuttering on the Canadian Stuttering Association website: https://stutter.ca/articles/personal-stories/708-breaking-free-one-word-at-a-time.html

Thursday, September 23, 2021

The Contribution of Vocabulary, Grammar, and Phonological Awareness Across a Continuum of Narrative Ability Levels in Young Children

Khan, K. S., Logan, J., Justice, L. M., Bowles, R. P., & Piasta, S. B. (2021). The Contribution of Vocabulary, Grammar, and Phonological Awareness Across a Continuum of Narrative Ability Levels in Young Children. Journal of Speech, Language, and Hearing Research, 1-15.

 

Storytelling, or narrative ability, is a complex task that relies on many linguistic and cognitive skills. Oral language skills such as vocabulary, grammar, and phonological awareness support a child’s ability to both construct a story and retell a story. As these lower-level language components (i.e., vocabulary, grammar, phonological awareness) develop, increases are seen in the complexity of a child’s narrative language skills. Prior research has demonstrated strong associations between vocabulary, grammar, phonological awareness, and narrative skills. However, what is less known about the relationship is what unique contribution to narrative ability comes from each vocabulary, grammar, and phonological awareness and if specific associations among these lower-level skills vary at different points along the range of narrative ability.

 

In this study, 336 preschool and school age children completed an assessment battery to evaluate narrative ability, vocabulary, grammar, and phonological awareness. A narrative index was derived to reflect narrative skill while controlling for differences in age. Results demonstrated that combined vocabulary, grammar, and phonological awareness contributed to 13% of the variance in the narrative index. To understand any specific associations between the lower-level skills and the range of narrative ability, the authors looked at these associations for children preforming below average, at average, and above average on the narrative index. They found interesting differences across profile. For below average profiles, phonological awareness and vocabulary accounted for significant variance in narrative scores. For average profiles, grammar and vocabulary accounted for significant variance, and for above average profiles, only vocabulary accounted for a significant amount of the variance in narrative scores.

 

Clinically, it is interesting to note that different lower-level language skills accounted for a significant amount of the variance in narrative ability at differing skill levels. Further research has the potential to enhance our understanding for identifying specific targets in therapy depending on skill level. These findings also highlight the importance of vocabulary knowledge at any skill level. This research increases our understanding of the relationship between lower-level language skills and narrative ability.



                          

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.

Thursday, July 8, 2021

Tiered Approaches to Rehabilitation Services in Education Settings: Towards Developing an Explanatory Programme Theory

VanderKaay, S., Dix, L., Rivard, L., Missiuna, C., Ng, S., Pollock, N., Whalen, S. S., Eisen, I., Kyte, C., Phoenix, M., Bennett, S., Specht, J., Kennedy, J., McCauley, D., & Campbell, W. (2021). Tiered Approaches to Rehabilitation Services in Education Settings: Towards Developing an Explanatory Programme Theory. International Journal of Disability, Development and Education, 1-22.

Rehabilitation disciplines (i.e., speech-language pathology, occupational therapy, physiotherapy) often use a range of approaches with increasing support as required (called tiered approaches) to provide interventions in education settings. In a Response to Intervention (RTI) or tiered approach, tier 1 services are provided at a classroom-wide level, tier 2 services are provided to students who require some additional support, and tier 3 services are provided to students who require individualized and more intensive services. There are several benefits to using a tiered approach to services including early identification of difficulties, reduction in waitlist times, etc. Some barriers include insufficient resources and lack of clarity regarding professional roles at different tiers. Although much is known about the outcomes of using a tiered approach to intervention services, there is a lack of specific explanatory theories related to tiered rehabilitation service delivery in education.

One way to develop a theory is to use Realist Evaluation. Using realist evaluation allows for the development of a theory that answers “how, why, for whom, to what extent and in what context”. Realist Evaluation allows for the identification and examination of variables that impact the outcome of a program. Realist Evaluation outlines that the outcomes of the program are impacted by both mechanisms (i.e., how individuals in the program respond to the program) and contexts (i.e., setting, structure, environments).

In this study, the authors identified that their main goal was to develop the first theory for tiered rehabilitation services in education settings. As a first step in achieving this goal, the authors completed a realist synthesis of the literature to identify the relevant contexts, mechanisms, and outcomes from articles collected in their literature review. The realist synthesis identified 52 articles that reported on tiered rehabilitation services in education. From these articles the authors summarized the findings relating to outcomes, context, and mechanisms. Within outcomes three factors were identified and themes were included within each category: children and youth (e.g., greater sense of inclusion), parents and professionals (e.g., increase knowledge and skill), and systems (e.g., timely intervention). Three different contexts were identified including the macro-level (e.g., high-quality, universal curriculum), meso-level (e.g., clear guidelines for tiered approaches), and micro-level (e.g., rehabilitation professionals with relevant skills). Three different categories were identified in mechanism including collaborative relationships (e.g., common frameworks), authentic services (e.g., services are fluid and flexible), and building capacity (e.g., give and take of ideas).

These results are a first step in building a theory for tiered rehabilitation services in education. Future work from these authors will look at the relationship between the contexts and mechanisms and the influence on the outcomes of a program. The results of this work will be useful for reflecting on the current use of tiered services and future application of this approach to service.



                          

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.

Tuesday, June 1, 2021

Learning with and without feedback in children with developmental language disorder

Arbel, Y., Fitzpatrick, I., & He, X. (2021). Learning with and without feedback in children with developmental language disorder. Journal of Speech, Language, and Hearing Research, 64(5), 1696–1711. https://doi.org/10.1044/2021_JSLHR-20-00499

When a child says, ‘tup’, and we reply, ‘no, that’s a cup. Say cup’, we’re providing feedback that we expect will help the child learn the correct form. This feedback is considered to provide an avenue for ‘explicit learning’, that is, the conscious effort to learn the right form. This type of learning requires the child to monitor and evaluate feedback, so it places demands on working memory and executive functioning. On the other hand, when a child says, ‘tup’, and we say, ‘yes, that’s a cup. Let’s have a drink’, we’re creating opportunities for ‘implicit learning’, that is, the unconscious learning of patterns. This type of learning without feedback does not require self-monitoring, and so does not place demands on working memory and executive functioning.

The ability to learn from feedback is also tied to certain brain regions such as the frontal cortex and basal ganglia. Prior work suggest that feedback processing may be impaired in children with developmental language disorders (DLD) due to poor working memory skills and brain abnormalities. It would follow that children with DLD may learn better if they can bypass feedback processing.

In this study, 14 typically developing (TD) children and 13 children with DLD learned new words. During the learning session, children learned the names of novel objects and EEG data was recorded. On each trial, children saw two images and heard a name. In the feedback trials, participants had to decide which object matched with the name followed by feedback. Green checkmarks indicated correct responses while red Xs indicated incorrect responses. In the no feedback trials, correct responses were highlighted with a green box around the object and participants did not have to respond. During immediate and delayed (1-week later) testing, children had to decide which of the two objects matched a name and no feedback was provided. As expected, TD children performed better than DLD children overall. Interestingly, for both groups of children, learning was better without feedback than with feedback when tested immediately and after a delay. Further, when learning from feedback, both groups of children were more likely to benefit from positive feedback (repeat a correct response) than change after negative feedback (switch to the correct response). The EEG data showed that TD children were more sensitive to negative feedback than children with DLD.

It is interesting to consider how the effect of feedback, or lack thereof in this case, fits into clinical practice. This might be one way to reduce working memory demands, that is, to prioritize the learning of new information by minimizing the need to process feedback simultaneously. The findings also suggest the importance of positive feedback. More broadly, the findings regarding feedback were surprising, and further replication and study of feedback in DLD is important.



Blogger: Theresa Pham is a student in the combined SLP MClSc/PhD program, supervised by Dr. Lisa Archibald

Thursday, April 29, 2021

Reducing low-value practices: a functional-contextual consideration to aid in de-implementation efforts

Farmer, R.L., Zaheer, I., Duhon, G.J., & Ghazal, S. (2020). Reducing low-value practices: a functional-contextual consideration to aid in de-implementation efforts. Canadian Journal of School Psychology. https://doi.org/10.1177/0829573520974915

Low-value practices are practices that are either unproven or discredited by evidence. Low-value practices sometimes persist in practice, and may interfere with implementation efforts for competing strategies. The de-implementation of low-values practices may be a necessary step in an implementation science approach to the adoption of evidence-based practices. Steps in de-implementation include identifying a low-value practice to be reduced, evaluating variables that may affect the de-implementation process, determining and using strategies that should reduce or eliminate the practice, and evaluation of the effects of de-implementation. Strategies for de-implementation could include policy change at the system level or ‘unlearning’ at the individual.

The authors of this paper consider how applied behaviour analysis could inform de-implementation due to the focus on functional relationships between context and future behaviour (i.e., functional-contextual lens). Briefly, the authors explain that the likelihood of a behaviour can be altered by changing the reinforcement, salience of contextual cues, or effort to engage in the behaviour. Through this lens, the authors suggest that low-value practices viewed as behaviours have little consequences and are rather rule governed behaviours. Behaviour reduction strategies are described including extinction through removal of reinforcement, differential reinforcement where extinction is paired with targeting of alternate behaviour, increasing response effort by requiring approvals or extra paperwork to use a behaviour, and punishment involving the addition or removal of stimulus when engaged in behaviour. The authors argue that these behavioural reduction strategies have the potential to assist in de-implementation of low-value practices but stress the importance of pairing this goal with efforts to implement evidence-based practices. 

The focus on the persistent use of low-value practices as a barrier to implementation of evidence-based practice is interesting. When implementing a new evidence-based practice, clinicians would do well to consider how it fits in with existing practice and any need for change.


Blogger: Lisa Archibald

Thursday, April 22, 2021

Relearn faster and retain longer: Along with practice, sleep makes perfect

Mazza, S., Gerbier, E., Gustin, M., Kasikci, Z., Koenig, O., Toppino, T., & Magnin, M. (2016). Relearn faster and retain longer: Along with practice, sleep makes perfect. Psychological Science, 27(10), 1321–1330. https://doi.org/10.1177/0956797616659930

Two of the most effective study techniques are spaced learning and sleep. Spaced learning (or distributed practice) is when learning is spaced out over multiple sessions rather than presented in one long session. Sleep, on the other hand, has many learning benefits. After sleep, newly learned information becomes more stable thereby enhancing learning. The goal of the current study was to determine if combining both strategies could lead to better learning.

The study had 3 parts, the studying session, relearning session, and delayed testing (1 week and 6 months later). In the studying session, participants read 16 Swahili-French word pairs (nyanya-tomate) and then studied each word (given nyanya-____, what is the French translation?). For words they recalled incorrectly, the correct translation was shown, and participants practiced until they got all 16 correct. The relearning session happened 12 hours later and proceeded in a similar way. Delayed testing occurred 1 week and 6 months later. Participants were divided into 3 groups: (i) sleep group: studied at 9 pm, slept, and then relearned at 9 am the next day; (ii) no sleep group: studied at 9 am and relearned at 9 pm on the same day; and, (iii) control group: studied at 9 pm, slept, and then completed a recall-only session at 9 am the next day. Findings revealed that sleeping after learning (sleep and control groups) led to better retention the next day than not sleeping (no sleep group). Further, the sleep group required fewer trials to successfully recall all 16 pairs correctly than the no sleep group (i.e., relearning happened faster). Strikingly, the benefits of sleep and relearning were amplified 1-week later and were maintained 6-months later: only the sleep group remembered significantly more word pairs than both the no sleep and control group.

The results suggest that sleeping after learning is a good strategy but additional learning after sleep is especially beneficial to long-term memory. It would follow from these findings that it would be beneficial to children’s learning if a clinician could introduce new learning in therapy one day and then incorporated a re-learning phase (perhaps with home practice materials) after sleep the next day.




Blogger: Theresa Pham is a student in the combined SLP MClSc/PhD program, supervised by Dr. Lisa Archibald

Saturday, April 10, 2021

Semantic effects in sentence recall: The contribution of immediate vs delayed recall in language assessment

Polišenská, K., Chiat, S., Comer, A., & McKenzie, K. (2014). Semantic effects in sentence recall: The contribution of immediate vs delayed recall in language assessment. Journal of Communication Disorders, 52, 65–77. https://doi.org/10.1016/j.jcomdis.2014.08.002

Sentence recall, the immediate repetition of spoken sentences, is used clinically to assess language skills. This seemingly easy task draws on different types of language and memory skills. For instance, phonological (speech sound) skills support the remembering of the word form itself. Semantic skills (knowledge of meaning) aid in remembering the meaning of the sentence. Typically, sentence repetition is tested by having the person repeat the sentence immediately after hearing it (immediate recall). The ability to recall a sentence after a delay (delayed recall) is usually not tested. The goal of this study was to understand the skills involved in immediate and delayed sentence recall.

Across two studies, participants completed immediate and delayed sentence recall. In study 1 involving adult participants, a distracting task was completed prior to delayed recall: either counting backwards from 10 (less demanding) or naming a series of images (more demanding). In study 2 with children, the task was either waiting quietly for 10 s (less demanding) or counting from 1 to 10 (more demanding). Further, sentences were either semantically plausible (The red bus was late so we drove by car) or implausible (The red grass was brave so we spoke to jam) with the idea that more familiar and meaningful sentences would benefit recall. The results were similar across both studies. Immediate sentence recall was better than delayed recall. Plausible sentences were recalled more accurately than implausible sentences. Finally, the more demanding the distracting task, the more participants relied on the semantics of the sentence to support recall (i.e., accuracy declined more steeply for implausible than plausible sentences).

Overall, results suggest that sentence recall draws on both phonological and semantic knowledge, but their contributions may differ. Phonology has a relatively greater role in immediate recall, whereas semantics has a relatively greater role in delayed recall. As well, familiar information supports memory overall. Clinicians who have a good understand about the language and memory skills involved in sentence recall will be in a better position to interpret their assessment findings. Further, there may be a need to incorporate delayed testing into practice.




Blogger: Theresa Pham is a student in the combined SLP MClSc/PhD program, supervised by Dr. Lisa Archibald

Thursday, February 25, 2021

Exploring mentorship as a strategy to build capacity for knowledge translation research and practice: A scoping systematic review

Gagliardi, A. R., Webster, F., Perrier, L., Bell, M., & Straus, S. (2014). Exploring mentorship as a strategy to build capacity for knowledge translation research and practice: A scoping systematic review. Implementation Science9(1), 1-10.

Knowledge translation (KT) refers to the movement of research knowledge into practice. It improves healthcare outcomes by promoting the use of new findings in clinical settings, management settings, and decision-making regarding healthcare policies. Within KT there is knowledge transfer which is the movement of new knowledge from research to practice, and knowledge exchange which is the multidirectional movement of knowledge between researchers and knowledge users (i.e., clinicians, decision makers, policy makers). Engaging in KT is a complex process and for these approaches to be successful the appropriate knowledge of KT, infrastructure for KT, and incentive to engage in KT need to be in place. 


It has been identified that those involved in KT would benefit from receiving support to build their KT capacity. In the past, building KT capacity involved KT training for those involved in a KT project. The current authors were interested in the use of mentorship to increase KT capacity. Mentorship provides the chance for an interactive experience and a partnership between the mentor and mentee to promote learning and development of KT. 


In this study the authors completed a scoping review to examine the effectiveness of mentorships as a way to support the development of job-related knowledge. They were interested in understanding the components that support a successful mentorship (e.g., design of mentorship, goals of mentorship). The scoping review identified 13 articles that reported on the use of mentorships to increase job-related knowledge. Results revealed that in 12/13 studies those in the mentorship self-reported that they achieved their goals related to the mentorship. In most studies the mentorships were formally established, mentees were specifically matched with mentors, and most mentorships were hierarchical. Some barriers faced in mentorships included issues if specific goals were not laid out by mentorship program, and if the mentee felt that their mentor was untrustworthy. 

 

These results provide insight into the importance of preparing, educating and supporting those who are engaging in a new project. Mentorships are an interactive way to support the development of new knowledge and skill. This scoping review was the first step in understanding what components are necessary for a successful mentorship. As more researchers and knowledge users begin to engage in KT approaches, understanding how best to prepare and support those involved in the process will be important for project success.   



                          

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.

Monday, February 8, 2021

Language repetition and short-term memory: an integrative framework

Majerus, S. (2013). Language repetition and short-term memory: an integrative framework. Frontiers in Human Neuroscience, 7, 357–357. https://doi.org/10.3389/fnhum.2013.00357

Tasks such as repeating words and sentences likely rely on both language skills and verbal short-term memory (the ability to temporarily hold verbal information in mind). To capture the interaction between language knowledge and verbal short-term memory, this paper proposes a three-component framework consisting of:

1.   Item information: This is the knowledge associated with ‘knowing a word’ including phonological (speech sounds that form the word), semantic (meaning-based information), and syntactic information (grammar). All these different types of knowledge are said to be immediately activated upon encountering a (familiar) word. 

2.    Serial order information: Order information refers to keeping information in the exact order as it was presented. Think of learning a new word like kipser. Because you likely know nothing about the word, prior knowledge would not support learning. Instead, it is important to keep the order of the speech sounds in mind in order to retain it. Serial order is also important when trying to remember a phone number, for example.

3.   Attention: Attention is the ability to focus on what matters and keep that information active in mind until the end of a task. As the task becomes more difficult, more attention is needed to keep items in mind. Attention is also important in coordinating and maintaining both item and order information during language tasks.

Measuring brain activity during language tasks has been a helpful way to understand how these three domains interact with each other to support verbal short-term memory. Language pathways in the front (ventral) and back (dorsal) of the brain maintain phonological and semantic information, respectively. In addition to these language pathways, more difficult tasks like new word learning and recalling complex sentences also activate brain areas tied to serial order and attention processes. There is a network in the right front-parietal region of the brain that is important for maintaining serial order information. The left fronto-parietal network, on the other hand, is important for actively maintaining items in the focus of attention. 

This framework shows the importance of recognizing that some language tasks used in clinical assessments may be as much a measure of language skills as verbal short-term memory. Interpreting children’s performance should take into account task demands related to linguistic knowledge (or lack thereof), efficiency of serial order processing, and attention. 


Blogger: Theresa Pham is a student in the combined SLP MClSc/PhD program, supervised by Dr. Lisa Archibald.


Wednesday, December 9, 2020

Using a Design-Based Research Approach to Develop and Study a Web-Based Tool to Support Collaborative Learning

Lyons, K. M., Lobczowski, N. G., Greene, J. A., Whitley, J., & McLaughlin, J. E. (2020). Using a design-based research approach to develop and study a web-based tool to support collaborative learning. Computers & Education, 104064.

Engaging in collaborative learning is beneficial for students as it creates supportive learning environments. Difficulties in collaborative learning can arise when conflicts in the group are not dealt with in productive ways. Theories of social regulation of learning suggest that successful collaborative learning includes students monitoring and regulating their own and their groups’ cognition, motivation and emotions. To support students in successful collaborative learning, researchers have developed and implemented web-based tools focusing on 3 principles for group regulation (promoting metacognitive awareness of the learning process, supporting externalization of the learning process and promoting the acquisition and activation of regulation process). 

 

The current article identified the need for a comprehensive web-based tool that included all 3 principles and additionally addressed the need to scaffold students’ metacognitive knowledge of how to use these principles. A design-based research approach was used to develop a comprehensive tool to foster social regulation of learning. Design-based research is an approach to research that takes an iterative and systematic approach to investigate the design and implementation of a tool in a specific learning environment. 

 

In this study, authors developed and implemented the tool, Collabucate, over two design-based cycles. Each cycle included the following phases: focus on the problem, understand the problem, determine existing solutions, define the current goal, conceive the solution, build the solution, test the solution, and understand results. Cycle 1 involved 29 participants who completed the tool twice a week for six weeks. Results included data from their weekly submissions and qualitative data from a survey and focus group. Students identified advantages (e.g., increased metacognitive awareness) and disadvantages (e.g., the need for a group discussion surrounding strategy implementation) of the tool that were considered in cycle 2. In the second iteration, disadvantages of the tool were addressed by creating a new section in the web-based tool and making the tool visually appealing. Cycle 2 involved 83 participants and results revealed that students indicated previously seen disadvantages were now advantages for the tool. 

 

These results support the use of a web-based tool that aids in social regulation of learning within collaborative learning environments. Additionally, this study demonstrates the iterative nature of design-based research and describes the different phases involved in developing a tool suited to a specific learning environment. This project reveals both the complexity and success that can come from design-research.


                          

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.