FULL TEXT - Canadian Centre for Knowledge Mobilisation

Transcription

Volume 30, No. 1
Young Children’s
Responses to
Maximum
Performance Tasks:
Preliminary Data
and
Recommendations
The Phonetic
Notation System of
Melville Bell and its
Role in the History of
Phonetics
Introducing a
Speech-Language
Pathology
Outcomes Measure
in Manitoba
Predicting Reading
Abilities from Oral
Language Skills: A
Critical Review of
the Literature
Published by the
Canadian Association of
Speech-Language
Pathologists and
Audiologists
Publiée par l'Association
canadienne des
orthophonistes et
audiologistes
Spring Printemps 2006
Southern California, Los Angeles County
SPEECH - LANGUAGE PATHOLOGI STS
Alhambra Unified School District has an average daily enrollment of 20,000
Kindergarten through grade 12 students. Eight miles northeast of Los Angeles,
Alhambra stands at the gateway to the San Gabriel Valley. Within one and one-half
hours driving distance from the mountains to the north, the Pacific Ocean to the
west, the Mojave desert to the east, and the Mexican border to the south. We are
proud of our 13 elementary schools having received the honor of “Distinguished
School”. Our five high schools are eligible for the honor this year.
We are seeking speech-language pathologists that possess Canadian certification
equivalent to a California Clinical Rehab Credential or the California credential.
Must be eligible for visa.
Our benefits package includes District-paid medical for employee and eligible
dependents; District-paid life insurance in a $50,000 group term policy with an
additional $50,000 for accidental death or dismemberment; District-paid dental for
employee with dependent coverage available; District-paid vision insurance for
employee. Salary is $46,350-$75,001 annually (depending on training and
experience)
Contact the Human Resources Office by calling, writing, or emailing Carla Glenn,
Certificated Human Resources Analyst, at the address and phone number below.
Email address is [email protected]. Applications are also available
on our website.
Human Resources Division
Laura Tellez, Assistant Superintendent, Human Resources
15 West Alhambra Road
Alhambra, CA 91801
(626) 308-2231
(626) 308-1762 (Fax)
www.alhambra.k12.ca.us
JOURNAL OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
Purpose and Scope
The Canadian Association of Speech-Language
Pathologists and Audiologists (CASLPA) is the
recognized national professional association of
speech-language pathologists and audiologists in
Canada. The association was founded in 1964,
incorporated under federal charter in 1975 and is
committed to fostering the highest quality of
service to communicatively impaired individuals
and members of their families. It began its
periodical publications program in 1973.
Indexing
JSLPA is indexed by:
• CINAHL - Cumulative Index to Nursing and
Allied Health Literature
• CSA - Cambridge Scientific Abstracts Linguistics and Language Behavior Abstracts
• Elsevier Bibliographic Databases
• ERIC Clearinghouse on Disabilities and Gifted
Education
• PsycInfo
JSLPA Reviewers
The purpose of the Journal of Speech-Language
Pathology and Audiology (JSLPA) is to
disseminate contemporary knowledge pertaining
to normal human communication and related
disorders of communication that influence
speech, language, and hearing processes. The
scope of the Journal is broadly defined so as to
provide the most inclusive venue for work in
human communication and its disorders. JSLPA
publishes both applied and basic research, reports
of clinical and laboratory inquiry, as well as
educational articles related to normal and
disordered speech, language, and hearing in all age
groups. Classes of manuscripts suitable for
publication consideration in JSLPA include
tutorials, traditional research or review articles,
clinical, field, and brief reports, research notes,
and letters to the editor (see Information to
Contributors). JSLPA seeks to publish articles
that reflect the broad range of interests in speechlanguage pathology and audiology, speech sciences,
hearing science, and that of related professions.
The Journal also publishes book reviews, as well
as independent reviews of commercially available
clinical materials and resources.
Subscriptions/Advertising
Nonmember and institution subscriptions are
available. For a subscription order form, including
orders of individual issues, please contact: CASLPA,
200 Elgin Street, Suite 401, Ottawa, Ontario K2P
1L5. Tel.: (800) 259-8519, (613) 567-9968; Fax:
(613) 567-2859; E-mail: [email protected]
Internet: www.caslpa.ca/english/resources/
jslpasubscriptions.asp.
All inquiries concerning the placement of
advertisements in JSLPA should be directed to
[email protected]. The contents of all material and
advertisements which appear in JSLPA are not
necessarily endorsed by the Canadian Association
of Speech-Language Pathologists and Audiologists.
Lisa Avery, Barbara Bernhardt, Sandi Bojm,
Carol Boliek, V.J. Boucher, Tim Bressman,
David Brown, Melanie Campbell, Arlene
Carson, Margaret Cheesman, Gloria ChiFishman, Patricia Cleave, Pierre Cormier, Luc
de Nil, Margaret Dohan, Philip Doyle,
Christopher Dromey, Wendy Duke, Andrée
Durieux-Smith, Diane Frome Loeb, JeanPierre Gagné, Bryan Gick, Ralph Gilbert, Luigi
Girolametto, Carla Hanak, Elizabeth Haynes,
Steve Heath, Lynne Hewitt, Jonathan Irish,
Marlene Jacobson, Mary Beth Jennings,
Andrew Johnson, Benoît Jutras, Elizabeth
Kay-Rainingbird, Michael Kiefte, Inge
Kirchberger, Robert Kroll, Guylaine Le Dorze,
Tony Leroux, Nonie Lesaux, Ian MacKay,
Heather MacLean, Heather Maessen, Angela
Mandich, Virginia Martin, Deborah Maund,
Alison McVittie, Barbara Meissner Fishbein,
George Mencher, Kathy Meyer, Robert Mullen,
Elena Nicoladis, Greg Noel, J.B. Orange,
Johanne Paradis, Carole Peterson, Michel
Picard, Kathy Pichora-Fuller, Karen Pollock,
Moneca Price, Jana Rieger, Danielle Ripich,
Kathryn Ritter, Elizabeth Rochon, Todd
Rogers, Christine Santilli, Susan Scollie,
Richard Seewald, Barbara Shadden, Ravi
Sockalingham, David Stapells, Catriona Steele,
Nancy Thomas-Stonell, Anne van Kleeck,
Ted Venema, Susan Wagner, Linda Walsh,
Jian Wang, Genese Warr Leeper, Penny
Webster, Richard Welland, S. P. Whiteside,
Connie Zalmanowitz
Vol. 30, No. 1
Spring 2006
Editor
Phyllis Schneider, PhD
University of Alberta
Managing Editor/Layout
Judith Gallant
Manager of Communications
Angie D’Aoust
Associate Editors
Marilyn Kertoy
University of Western Ontario
(Language, English submissions)
Tim Bressmann
University of Toronto
(Speech, English submissions)
Rachel Caissie
Dalhousie University
(Audiology, English submissions)
Patricia Roberts, PhD
University of Ottawa
(Speech & Language, French
submissions)
Tony Leroux, PhD
Université de Montréal
(Audiology, French submissions)
Assistant Editor
Vacant
(Material & Resource Reviews)
Assistant Editor
Vacant
(Book Reviews)
Cover illustration
Andrew Young
Review of translation
Tony Leroux, PhD
Translation
Smartcom Inc.
ISSN 0848-1970
Canada Post
Publications Mail
# 40036109
JSLPA is published quarterly by the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA). Publications
Agreement Number: # 40036109. Return undeliverable Canadian addresses to: CASLPA, 200 Elgin Street, Suite 401, Ottawa, Ontario
K2P 1L5. Address changes should be sent to CASLPA by e-mail [email protected] or to the above-mentioned address.
Revue d’orthophonie et d’audiologie - Vol. 30, No 1, Printemps 2006
1
REVUE D’ORTHOPHONIE ET D’AUDIOLOGIE
Objet et Portée
L’Association canadienne des orthophonistes et
audiologistes (ACOA) est l’association
professionnelle nationale reconnue des
orthophonistes et des audiologistes du Canada.
L’Association a été fondée en 1964 et incorporée
en vertu de la charte fédérale en 1975. L’Association
s’engage à favoriser la meilleure qualité de services
aux personnes atteintes de troubles de la communication et à leurs familles. Dans ce but,
l’Association entend, entre autres, contribuer au
corpus de connaissances dans le domaine des
communications humaines et des troubles qui s’y
rapportent. L’Association a mis sur pied son
programme de publications en 1973.
L’objet de la Revue d’orthophonie et
d’audiologie (ROA) est de diffuser des
connaissances relatives à la communication
humaine et aux troubles de la communication qui
influencent la parole, le langage et l’audition. La
portée de la Revue est plutôt générale de manière
à offrir un véhicule des plus compréhensifs pour
la recherche effectuée sur la communication
humaine et les troubles qui s’y rapportent. La ROA
publie à la fois les ouvrages de recherche appliquée
et fondamentale, les comptes rendus de recherche
clinique et en laboratoire, ainsi que des articles
éducatifs portant sur la parole, le langage et
l’audition normaux ou désordonnés pour tous les
groupes d’âge. Les catégories de manuscrits
susceptibles d’être publiés dans la ROA
comprennent les tutoriels, les articles de recherche
conventionnelle ou de synthèse, les comptes
rendus cliniques, pratiques et sommaires, les notes
de recherche, et les courriers des lecteurs (voir
Renseignements à l’intention des collaborateurs).
La ROA cherche à publier des articles qui reflètent
une vaste gamme d’intérêts en orthophonie et en
audiologie, en sciences de la parole, en science de
l’audition et en diverses professions connexes. La
Revue publie également des critiques de livres ainsi
que des critiques indépendantes de matériel et de
ressources cliniques offerts commercialement.
Abonnements/Publicité
Vol. 30, No 1
Printemps 2006
Inscription au Répertoire
ROA est répertoriée dans:
• CINAHL - Cumulative Index to Nursing and
Allied Health Literature
• CSA - Cambridge Scientific Abstracts Linguistics and Language Behavior Abstracts
• Elsevier Bibliographic Databases
• ERIC Clearinghouse on Disabilities and Gifted
Education
• PsycInfo
Réviseurs de la ROA
Lisa Avery, Barbara Bernhardt, Sandi Bojm,
Carol Boliek, V.J. Boucher, Tim Bressman,
David Brown, Melanie Campbell, Arlene
Carson, Margaret Cheesman, Gloria ChiFishman, Patricia Cleave, Pierre Cormier, Luc
de Nil, Margaret Dohan, Philip Doyle, Christopher Dromey, Wendy Duke, Andrée
Durieux-Smith, Diane Frome Loeb, JeanPierre Gagné, Bryan Gick, Ralph Gilbert, Luigi
Girolametto, Carla Hanak, Elizabeth Haynes,
Steve Heath, Lynne Hewitt, Jonathan Irish,
Marlene Jacobson, Mary Beth Jennings, Andrew Johnson, Benoît Jutras, Elizabeth KayRainingbird, Michael Kiefte, Inge Kirchberger,
Robert Kroll, Guylaine Le Dorze, Tony Leroux,
Nonie Lesaux, Ian MacKay, Heather MacLean,
Heather Maessen, Angela Mandich, Virginia
Martin, Deborah Maund, Alison McVittie,
Barbara Meissner Fishbein, George Mencher,
Kathy Meyer, Robert Mullen, Elena Nicoladis,
Greg Noel, J.B. Orange, Johanne Paradis,
Carole Peterson, Michel Picard, Kathy PichoraFuller, Karen Pollock, Moneca Price, Jana
Rieger, Danielle Ripich, Kathryn Ritter, Elizabeth Rochon, Todd Rogers, Christine Santilli,
Susan Scollie, Richard Seewald, Barbara
Shadden, Ravi Sockalingham, David Stapells,
Catriona Steele, Nancy Thomas-Stonell, Anne
van Kleeck, Ted Venema, Susan Wagner,
Linda Walsh, Jian Wang, Genese Warr Leeper,
Penny Webster, Richard Welland, S. P.
Whiteside, Connie Zalmanowitz
Les membres de l’ACOA reçoivent la Revue à ce
titre. Les non-membres et institutions peuvent
s’abonner Les demandes d’abonnement à la ROA
ou de copies individuelles doivent être envoyées à:
ACOA, 200, rue Elgin, bureau 401, Ottawa
(Ontario) K2P 1L5. Tél. : (800) 259-8519, (613)
567-9968; Téléc. : (613) 567-2859 Courriel :
[email protected]; Internet : www.caslpa.ca/
francais/resources/jslpa-asp.
Toutes les demandes visant à faire paraître de la
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Bureau national. Les articles, éditoriaux et
publicités qui paraissent dans la ROA ne sont pas
nécessairement avalisés par l’Association
canadienne des orthophonistes et audiologistes.
REVUE
D’ORTHOPHONIE ET
D’AUDIOLOGIE
Rédactrice en chef
Phyllis Schneider, Ph.D.
Directrice de la rédaction /
mise en page
Judith Gallant
Directrice des communications
Angie Friend
Rédacteurs en chef adjoints
Marilyn Kertoy
University of Western Ontario
(Orthophonie, soumissions
en anglais)
Tim Bressmann
University of Toronto
en anglais)
Rachel Caissie
Dalhousie University
(Audiologie, soumissions
en anglais)
Patricia Roberts, Ph.D.
Université d’Ottawa
en français)
Tony Leroux, Ph.D.
(Audiologie, soumissions
en français)
Rédacteur adjoint
Libre
(Évaluation des ressources)
Rédacteur adjoint
Libre
(Évaluation des ouvrages écrits)
Révision de la traduction
Tony Leroux, Ph.D
Illustration (couverture)
Andrew Young
Traduction
Smartcom Inc.
ISSN0848-1970
Postes Canada
Envoi publications
# 40036109
La ROA est publiée quatre fois l’an par l’Association canadienne des orthophonistes et audiologistes (ACOA). Numéro de publication:
#40036109. Faire parvenir tous les envois avec adresses canadiennes non reçus au 200, rue Elgin, bureau 401, Ottawa (Ontario)
K2P 1L5. Faire parvenir tout changement à l’ACOA au courriel [email protected] ou à l’adresse indiquée ci-dessus.
2
Journal of Speech-Language Pathology and Audiology - Vol. 30, No. 1, Spring 2006
Table of Contents
Table des matières
From the Editor
Spring Issue
4
De la rédactrice en chef
Numéro du Printemps
5
Article
Young Children’s Responses to Maximum
Performance Tasks: Preliminary Data and
Recommendations
Susan Rvachew, Alyssa Ohberg and Robert Savage
6
Article
The Phonetic Notation System of Melville Bell and
its Role in the History of Phonetics
Judith Felson Duchan
14
Article
Article
Réactions des jeunes enfants aux tâches de durée
maximale d’exécution : données préliminaires et
recommandations
Susan Rvachew, Megan Hodge et Alyssa Ohberg
6
Article
Le système de notation phonétique de Melville Bell
et son rôle dans l’histoire de la phonétique
14
Article
* Introducing a Speech-Language Pathology
Outcomes Measure in Manitoba
Sheri-Lynn Skwarchuk, Mark Robertson and
Darlene Devlin
18
*Introduction à la Mesure des résultats en
orthophonie du Manitoba
Sheri-Lynn Skwarchuk, Mark Robertson et
Darlene Devlin
18
Article
* Predicting Reading Abilities from Oral Language
Skills: A Critical Review of the Literature
Elizabeth Ekins and Phyllis Schneider
26
Book Review
46
Article
*Prévoir les aptitudes à la lecture à partir des
capacités langagières : un compte rendu
documentaire
Elizabeth Ekins et Phyllis Schneider
26
Évaluation de ressource écrit
46
Resource Review
50
Énoncé de position sur l’utilisation de la
télépratique par les orthophonistes et les
audiologistes membres de l’ACOA
54
Position Paper on the use of Telepractice for
CASLPA Audiologists and Speech-Language
Pathologists
51
Renseignements à l’intention des collaborateurs
77
Information for Contributors
75
* The review of these manuscripts was coordinated by
Philip C. Doyle, PhD
* La révision de ces articles a été coordonnée par
Philip C. Doyle, Ph.D.
3
From the Editor
Spring Issue
The first article in this issue provides follow-up information to the special issue on technology that constituted the
previous issue of JSLPA. In their contribution to the special issue, Susan Rvachew, Megan Hodge, and Alyssa Ohberg
presented a tutorial on obtaining and interpreting Maximum Performance Task (MPT) data from children using the
TOCS+™ MPT Recorder© ver. 1 (Hodge & Daniels, 2004). MPT data can assist clinicians in diagnosing motor speech
impairment in children. The authors showed how the software can facilitate the recording of children’s responses
directly to digital computer files. In the article in the current issue, Susan Rvachew, Alyssa Ohberg, and Robert Savage
present and discuss pilot data with 4 to 6-year-old children. Based on these data, the authors make recommendations
for using MPT tasks in the diagnosis of dyspraxia and dysarthria in this age group.
The second article in this issue also has a connection to a previous issue. Judith Duchan has been studying the
history of speech pathology for a number of years. An article by Dr. Duchan was published in Volume 29, issue number
2 on the subject of Alexander Graham Bell’s contributions to the field of “elocutionary teaching” in the development
of therapy techniques for use with individuals with communication disorders. In the current issue, Dr. Duchan discusses
the contributions of Alexander Melville Bell, Graham Bell’s father. Melville Bell invented a phonetic system that could
be used for transcribing the speech sounds of any language. His “Visible Speech” was used by the predecessors of speechlanguage therapists; his system had a lasting impact on phonetics, in particular on the representation of vowel sounds.
In our third article, Sheri-Lynn Skwarchuk, Mark Robertson and Darlene Devlin discuss the development of
the Manitoba Speech-Language Pathology Outcomes Measure. Beginning with models from several other sites,
clinicians across Manitoba collaborated to develop the outcomes measure, which permits the cataloguing and storing
of severity and priority rating information on clients receiving intervention in the province. The authors discuss issues
that had to be addressed in developing the database and make recommendations to others who may be considering
development of such a tool in their own regions.
Our fourth article is a critical review of the research literature on language measures that predict literacy. As
noted by the authors, identification of language predictors of later literacy skills would be potentially useful in detecting
and perhaps avoiding difficulties in academic achievement related to language. The various measures of language skills
are discussed along with details of selected research articles.
The current issue also includes two book reviews and one resource review. In the first book review, Jeanne
Claessen, a clinical educator, discusses Clinical Education in Speech-Language Pathology, by Lindy McAllister &
Michelle Lincoln. Our second book review is by Susan Rvachew, who reviews Gail T. Gillon’s book, Phonological
awareness: From research to practice. Finally, Lu-Anne McFarlane presents a review of the Pre-Reading Inventory of
Phonological Awareness (PIPA), by B. Dodd, S. Crosbie, B. McIntosh, T. Teitzel, and A. Ozanne.
Reference:
Hodge, M.M. & Daniels, J.D. (2004). TOCS+™ MPT Recorder© ver. 1. [computer software]. University of Alberta,
Edmonton, AB
Phyllis Schneider
Editor
[email protected]
4
De la rédactrice en chef
Numéro du printemps
Le premier article de ce numéro fournit un complément d’information au numéro précédent de la Revue
d’orthophonie et d’audiologie (ROA) consacré à la technologie. Dans leur article de ce numéro spécial, Susan Rvachew,
Megan Hodge et Alyssa Ohberg présentaient un tutoriel sur l’obtention et l’interprétation des durées maximales
d’exécution chez les enfants à l’aide du logiciel TOCS+™ MPT Recorder© ver. 1 (Hodge et Daniels, 2004). Les données
sur les durées maximales d’exécution peuvent aider le diagnostic d’un trouble moteur de la parole chez les enfants. Les
auteurs montraient comment le logiciel peut faciliter l’enregistrement des réponses des enfants dans des fichiers
informatiques. Dans l’article du présent numéro, Susan Rvachew, Alyssa Ohberg et Robert Savage présentent et
examinent les données pilotes obtenues auprès d’enfants de 4 à 6 ans. En se fondant sur ces données, les auteurs formulent
des recommandations sur l’utilisation des tâches de durée maximale d’exécution pour diagnostiquer la dyspraxie ou
la dysarthrie chez un enfant de ce groupe d’âge.
Le deuxième article de ce numéro est également relié à un numéro précédent. Judith Duchan étudie l’histoire
de l’orthophonie depuis un certain nombre d’années. Un article de Dr Duchan paru dans le numéro 2 du volume 29
abordait les contributions d’Alexander Graham Bell, dans le domaine de « l’enseignement de l’élocution », à
l’élaboration des techniques de rééducation destinées aux personnes ayant des troubles de la communication. Dans ce
numéro, Dr Duchan discute des contributions d’Alexander Melville Bell, le père de Graham Bell. Melville Bell a inventé
un alphabet phonétique que l’on peut utiliser pour transcrire les phonèmes de n’importe quelle langue. Son « langage
visible » a été utilisé par les précurseurs des orthophonistes; son alphabet a eu un effet durable sur la phonétique,
notamment sur la représentation des voyelles.
Dans notre troisième article, Sheri-Lynn Skwarchuk, Mark Robertson et Darlene Devlin discutent de l’élaboration
de la Mesure des résultats en orthophonie du Manitoba. À partir des modèles de plusieurs autres sites, des cliniciens de
partout au Manitoba ont collaboré à l’élaboration de la mesure des résultats, qui permet de classer et de stocker des
données sur la gravité et le degré de priorité des clients suivis dans la province. Les auteurs débattent des questions qu’il
a fallu aborder lors de l’élaboration de la base de données et font des recommandations à ceux qui envisagent de
concevoir un tel outil dans leur propre région.
Notre quatrième article fait un compte rendu des rapports de recherche sur les mesures des capacités langagières
qui permettent de prédire le niveau d’alphabétisme. Comme les auteurs le font remarquer, il pourrait être utile de
dégager les indices permettant de prédire les capacités de lecture et d’écriture pour dépister et peut-être éviter les
difficultés à scolaires liées au langage. Ils discutent des différentes mesures des capacités langagières présentées dans
quelques articles de recherche.
Le dernier numéro comprend aussi deux comptes rendus de livre et un compte rendu de ressource. Dans le
premier compte rendu de livre, Jeanne Claessen, agente de formation clinique, discute de Clinical Education in SpeechLanguage Pathology, par Lindy McAllister et Michelle Lincoln. Notre second compte rendu de livre est de Susan
Rvachew, qui a lu Phonological awareness: From research to practice de Gail T. Gillon. En dernier lieu, Lu-Anne
McFarlane présente un compte rendu de Pre-Reading Inventory of Phonological Awareness (PIPA), par B. Dodd, S.
Crosbie, B. McIntosh, T. Teitzel et A. Ozanne.
Référence:
Hodge, M.M. & Daniels, J.D. (2004). TOCS+™ MPT Recorder© ver. 1. [logiciel d’ordinateur]. University of Alberta,
Edmonton, AB
Phyllis Schneider
Rédactrice en chef
[email protected]
5
Young Children’s Responses
Young Children’s Responses to Maximum Performance
Tasks: Preliminary Data and Recommendations
Réactions des jeunes enfants aux tâches de durée maximale
d’exécution : données préliminaires et recommandations
Susan Rvachew
Alyssa Ohberg
Robert Savage
Abstract
The purpose of this study was to examine the ability of 4- to 6-year-old children with typical speech
to perform certain maximum performance tasks, with a view to developing diagnostic criteria for
identifying dyspraxia and dysarthria in this age group. Twenty children were asked to prolong [a],
[mama], [f], [s], and [z] for as long as they could. They were also asked to repeat the syllables [pa],
[ta], and [ka] and the trisyllabic sequence [pataka] as fast they could. The children’s responses to
the prolongation tasks were highly variable within and across children. Using traditional elicitation
methods, these measurements do not appear to be good potential indicators of dysarthria or
dyspraxia in this age group. In contrast, repetition rates were much more stable within and across
children. All but one child repeated monosyllables at a rate of at least 3.4 syllables per second. Every
child achieved a correct repetition of [pataka] at a rate of at least 3.4 syllables per second.
Recommendations for interpreting young children’s performance on these tasks are provided.
Abrégé
La présente étude porte sur des enfants de 4 à 6 ans dont la parole est typique et examine leur capacité
à exécuter des tâches de durée maximale d’exécution dans le but d’élaborer des critères de diagnostic
pour la dyspraxie et la dysarthrie chez ce groupe d’âge. Nous avons demandé à vingt enfants
d’allonger les séquences [a], [mama], [f], [s] et [z] aussi longtemps qu’ils le pouvaient. Nous leur
avons aussi demandé de répéter les syllabes [pa], [ta] et [ka] et la séquence trisyllabique [pataka]
aussi rapidement que possible. Les réponses des enfants à la tâche de prolongation ont donné des
résultats très variables pour chaque enfant et entre les enfants. À partir des méthodes habituelles
de d’évocation, ces mesures ne semblent pas être de bons indicateurs de la dyspraxie ou de la
dysarthrie chez ce groupe d’âge. En revanche, la fréquence de répétition était beaucoup plus stable.
À l’exception d’un seul enfant, tous ont répété les monosyllabes a une fréquence d’au moins 3,4
syllabes la seconde. Chaque enfant a réussi à répéter correctement [pataka] a une fréquence d’au
moins 3,4 syllabes la seconde. L’article formule des recommandations pour interpréter la
performance des jeunes enfants à ces tâches.
Susan Rvachew
Ph.D., S-LP(C)
McGill University
Montreal, QC Canada
Alyssa Ohberg
McGill University
Montreal, QC Canada
Robert Savage
McGill University
Montreal, QC Canada
6
Key Words: speech sound disorders, speech development, maximum performance tasks
S
peech-language pathologists are expected to conduct an oral-peripheral
examination as a part of their standard assessment procedures, even when
the client is a young child (e.g., see Bliele, 2002; Hodson, Sherz, & Strattman,
2002; Miccio, 2002; Tyler & Tolbert, 2002). Textbooks about speech sound disorders
include specific instructions for conducting such an examination (Bauman-Waengler,
2004; Bernthal & Bankson, 2004; Creaghead, Newman, & Secord, 1989). Asking the
child to prolong certain sounds for as long as possible and to repeat certain syllables
as quickly as possible is a central part of this assessment procedure. These tasks are
administered in order to identify problems with speech motor function that may
contribute to the child’s speech sound disorder.
Having administered the procedures, the challenge of
interpreting the child’s responses remains. Thoonen,
Maassen, Wit, Gabreels, and Schreuder (1996) developed
some criteria for diagnosing dysarthria and dyspraxia by
integrating information about the child’s responses to
maximum performance tasks (MPTs), specifically
maximum phonation and fricative durations and
repetition rates for single syllables and the standard
trisyllabic sequence [pataka]. These criteria were derived
from the responses of children aged 6 to 10 years of age,
some with normally developing speech and some with
clinically diagnosed dyspraxia or dysarthria. Briefly,
children with dysarthria were found to produce short
phonation durations and slow monosyllabic repetition
rates; children with dyspraxia produced slow trisyllabic
repetition rates and short fricative durations (the specific
criteria are described later in this paper).
Later, these criteria were cross-validated with new
samples of school-aged children, this time including a
sample of children with a developmental phonological
disorder with no known motoric component. It was shown
that these tasks could be used to identify dysarthria with
89% sensitivity and 100% specificity. In other words, 89%
of the children with clinically diagnosed dysarthria were
identified as dysarthric on the basis of their responses on
the MPTs (sensitivity). Furthermore, none of the children
who were not dysarthric by clinical criteria were falsely
identified as dysarthric on the basis of their responses to
the MPTs (specificity). Dyspraxia was identified from
MPT responses with 100% sensitivity and 91% specificity.
Overall, diagnostic accuracy was excellent with 95%
correct classification of 41 children as presenting with
normally developing speech, developmental phonological
delay, childhood apraxia of speech, or dysarthria. Of
particular interest was the finding that children with a
developmental phonological disorder performed these
tasks in a qualitatively and quantitatively different manner
from children with dysarthria or dyspraxia. Children
with dyspraxia were often unable to produce a correct
trisyllabic sequence. Children with a developmental
phonological disorder were usually able to produce the
sequence accurately but only after an unusual number of
unsuccessful attempts. Overall, the performance of the
children with developmental phonological disorders was
intermediate between the dysarthric and dyspraxic groups
and the normally developing control group.
Although the procedures described by Thoonen et al.
(1996, 1999) appear to be very useful for the diagnosis of
dyspraxia and dysarthria in school-aged children, these
researchers concluded that the criteria that they described
could not be validly applied to children younger than the
age of 6 years. The purpose of the present study was to
examine the normal range of performance on sound
prolongation and syllable repetition tasks for a sample of
4- to 6-year-old children with typical speech development
with a view to developing criteria that will be valid with
younger children.
Method
Participants
The children were recruited from inner-city and
suburban daycares and suburban kindergarten classrooms
in the Montreal area. These preschool settings had EnglishFrench bilingual programs. Parents were asked to
volunteer their children to participate in a comprehensive
study of oral language and early literacy development,
involving two to three assessment sessions, each lasting
approximately 45 minutes. Only those aspects of the
assessment procedures and the resulting data that are
relevant to the children’s maximum performance task
will be described here.
A parent questionnaire was used to obtain
information about the child’s language background and
developmental history and family socio-economic status.
The Peabody Picture Vocabulary Test (PPVT; Dunn &
Dunn, 1997) and the Goldman-Fristoe Test of
Articulation-Second Edition (GFTA; Goldman & Fristoe,
2000) were used to screen for speech and language delay.
Of the 29 children whose parents volunteered them to
participate in this study, 23 were selected on the basis of
the following criteria: proficient speakers of English; aged
4 to 6 years; receptive vocabulary and articulation skills
within the normal range; no known developmental delays;
no known sensory disorders such as hearing or visual
impairment; no known primary medical or
developmental conditions that might impact speech and
language development.
For the first 5 children to be enrolled in the study,
their responses on the MPTs were recorded using a digital
minidisk player. These children either did not complete
the entire test protocol or did so reluctantly and only with
much coaxing and multiple visits to their daycares. Their
responses will not be described in this report. At this point
in the study, the TOCS+™ MPT Recorder© software was
developed and then employed to record the children’s
performance, as described below. With the aid of this
software, 20 additional children completed the test
protocol without any extraordinary effort. Only the
results recorded from these 20 children will be described
in this report. An additional 4 children were recruited but
did not complete the assessment due to scheduling
problems.
This group of 20 children was comprised of 10 girls
and 10 boys with a mean age of 69 months (SD = 7.8). All
participants either had English as a native language or
were judged to be proficient in English. English proficiency
was determined by teacher report, examiner’s impression,
and receptive vocabulary skills as measured by the PPVT.
All of the children’s mothers had either college diplomas
or university degrees with the exception of one mother
whose highest level of education was secondary school
completion. The children’s mean percentile ranking on
the GFTA was 37.60 (SD = 17.92), and their mean standard
score on the PPVT was 104 (SD = 12.22). One child scored
slightly below normal limits on the GFTA but his only
7
speech sound error (dental distortion of /s/ and /z/) was
judged to be developmentally acceptable and thus this
child was included as a participant.
Procedure
The standardized tests and the MPTs were
administered by the third author (Alyssa Ohberg) during
two separate test sessions. These sessions included tests
relating to a different study of emergent literacy
development and thus each session lasted approximately
45 minutes but the MPTs themselves required only 20
minutes on average.
Administering the MPTs. The child was asked to
prolong the sounds [a], [mama], [f], [s], and [z] for as
long as possible on a single expiration. The child was given
one practice trial and three test trials for each of these
tasks. Then the child was asked to repeat the syllables [pa],
[ta], and [ka] and the syllable sequence [pataka], in each
case as fast as possible on a single expiration. The child was
given one practice trial and three test trials for each
repetition task. For the trisyllabic sequence repetition
task only, the child was allowed as many as three additional
attempts, as necessary, to obtain an accurate repetition of
the sequence.
The TOCS+™ MPT Recorder© software was used to
administer the assessment protocol and record the child’s
responses. As described in detail elsewhere (Rvachew,
Hodge, & Ohberg, 2005), this software facilitates the
recording of the child’s responses directly to digital .wav
files using a computer. The software also ensures
standardized administration of the protocol as the
instructions are available to the child and clinician on a
task-by-task basis. The software provides an auditory and
visual prompt to the child to begin producing the desired
response for each trial.
Measurement of durations and repetition rates. The
time needed to measure all of the durations and repetition
rates obtained from each child was 10 to 15 minutes. The
waveform function of TFR (Avaaz Innovations, Inc.), a
speech analysis program, was used to measure the
durations of each prolongation of [a], [mama], [f], [s],
and [z], using visual inspection of the waveform and the
partial playback function to identify and mark the
beginning and end of each prolonged sound, the duration
of which was provided by the TFR software. For the
repetition of single syllables, visual inspection of the
waveform and the partial playback function was used to
identify an uninterrupted sequence of 10 syllables produced
on a single expiration, excluding the first and last syllable
produced. The duration of this sequence of 10 syllables
was provided by the software and then the examiner
calculated the number of repetitions produced per second.
For the trisyllable repetitions, the duration of 4 repetitions
of [pataka] was measured and then the number of syllables
produced per second was calculated.
Summary statistics. These measurements were then
reduced to a number of summary statistics as follows:
Maximum Phonation Duration (MPD) = the mean of the
8
durations of the longest [a] and the longest [mama]
prolongation; Maximum Fricative Duration (MFD) =
the mean of the longest prolongation of [f], the longest
prolongation of [s], and the longest prolongation of [z];
Maximum Repetition Rate for single syllables
(MRRmono) = the average repetition rate for the fastest
repetition of [pa], the fastest repetition of [ta], and the
fastest repetition of [ka]; Maximum Repetition Rate for
the trisyllabic sequence (MRRtri) = number of syllables
per second produced during the fastest accurate repetition
of the sequence [pataka]; Sequence = 1 if the child produced
a correct repetition of the sequence and 0 if the child did
not succeed in producing a correct sequence; Attempts =
the number of additional attempts (beyond the first three)
that were required for the child to achieve a correct
repetition of the sequence.
Interpretation. First, the children’s scores for each
summary statistic were interpreted in relation to the
criteria for identifying dyspraxia and dysarthria as
described by Thoonen et al. (1999) for children aged 6 to
10 years of age. Then, scatter plots of the children’s
responses were examined to identify criteria that might be
more appropriate to the younger children that were
assessed for this study.
Results
Table 1 shows each participant’s longest durations
for each prolongation task, fastest repetition rate for each
repetition task, and the final score for each of the summary
statistics described above. Prolongation durations were
highly variable across children, with MPD ranging from
4.25 to 13.94 and MFD ranging from 4.74 to 13.26 seconds.
Repetition rates were less variable across children, with
MRRmono ranging from 3.03 to 5.11 syllables per second
and MRRtri ranging from 3.42 to 6.74 syllables per second.
Table 2 shows that stability within subjects was also greater
for repetition rates than for prolongations, although
reliability across trials was more than adequate for every
task except prolongation of [mama].
As described in the introduction, Thoonen et al.
(1996, 1999) validated certain criteria for assigning
dysarthria scores of 0, 1, or 2 and dyspraxia scores of 0, 1,
or 2. Scores of 0 on either scale indicate an absence of the
condition while scores of 2 indicate the presence of the
condition in children aged 6 to 10 years of age. Thoonen
et al.’s criteria are shown in Table 3. All 11 of the control
group children with normally developing speech assessed
by Thoonen et al. (1999) received dysarthria scores of 0.
All but one of these children also received dyspraxia scores
of 0. The one control participant who received a dyspraxia
score of 2 received speech therapy at a later age after
referral by the classroom teacher. We applied these same
criteria to the younger children assessed in this study. The
result is shown in Table 3 as the proportion of children
meeting the criteria for each possible dysarthria or
dyspraxia score.
Thoonen et al.’s (1999) criterion for ruling out
dysarthria is MRRmono greater than 3.5 syllables per
Table 1
M axim um Perform ance Task results obtained from 4-, 5-, and 6-year-old children
P#
A ge
GFTA
[a]
[mama]
MPD
[f]
[s]
[z]
MFD
[pa]
[ta]
[ka]
(months)
MRR
MRR
mono
tri
S eq
Attempts
27
49
84
9.73
9.75
9.74
3.65
15.13
11.48
10.1
3.79
3.89
3.6
3.76
3.98
1
1
25
56
50
14.8
8.48
11.6
7.96
4.96
6.73
6.55
4.65
4.59
4.1
4.45
4.67
1
0
28
59
73
7.71
6.46
7.09
11.22
12.4
11.88
11.8
4.27
3.88
3.56
3.90
3.99
1
0
29
65
30
13.49
8.7
11.1
11.92
11.83
13.35
12.4
4.19
4.16
3.78
4.04
3.95
1
0
6
66
30
9.52
9.17
9.35
4.86
5.28
7.23
5.79
5.28
4.76
5.29
5.11
6.74
1
1
24
66
37
12.12
10.87
11.5
17.8
6.47
13.83
12.7
5.13
4.83
4.45
4.80
6.08
1
0
26
66
32
6.22
11.62
8.95
7.65
7.3
7.73
7.56
4.33
4.12
3.86
4.10
4.18
1
0
7
68
30
8.35
12.35
10.4
5.03
7.88
16.97
9.96
4.05
4.24
3.97
4.09
4.78
1
0
12
68
37
6.57
8.37
7.47
10.1
4.46
9.31
7.96
4.48
4.3
3.76
4.18
3.72
1
0
11
69
27
7.9
11.14
9.52
8.5
7.98
10.78
9.09
5.2
4.92
4.51
4.88
4.24
1
0
9
71
20
15.93
11.95
13.9
6.85
7.79
8.12
7.59
4.57
4.82
4.01
4.47
3.64
1
0
10
71
27
4.29
4.21
4.25
3.48
5.28
5.47
4.74
3.04
2.97
3.09
3.03
3.42
1
3
19
72
48
4.16
8.23
6.2
2.39
8.41
8.01
6.27
4.65
4.53
4.16
4.45
3.99
1
0
21
72
22
12.02
10.88
11.5
8.42
6.68
8.48
7.86
4.56
3.46
4.55
4.19
3.77
1
1
22
72
22
8.55
6.91
7.73
6.08
6.19
8.53
6.93
4.93
4.93
4.57
4.81
3.82
1
3
13
74
52
6.15
5.96
6.06
5.86
6.68
8.11
6.88
4.89
5.06
4.39
4.78
4.59
1
0
15
75
31
10.91
9.17
10
13.62
12.8
13.36
13.3
4.76
4.23
3.85
4.28
3.49
1
0
20
77
14
5.44
5.74
5.59
10.6
13.09
9.58
11.1
4.79
4.81
3.77
4.46
5.05
1
1
17
79
56
7.56
7.17
7.37
3.11
9.04
11.18
7.78
4.7
4.73
4.59
4.67
4.74
1
0
23
83
30
10.11
8.14
9.13
6.53
6.11
11.51
8.05
4.97
5.65
4.5
5.04
4.77
1
1
M
68.90
37.60
9.08
8.76
8.92
7.78
8.29
10.08
8.72
4.56
4.44
4.12
4.37
4.38
1.00
0.55
SD
7.85
17.92
3.34
2.26
2.44
3.90
3.11
2.86
2.47
0.53
0.61
0.49
0.49
0.85
0.00
0.94
Min
49.00
14.00
4.16
4.21
4.25
2.39
4.46
5.47
4.74
3.04
2.97
3.09
3.03
3.42
1.00
0.00
Max
83.00
84.00 15.93
13.94 17.80
15.13
16.97
13.26
5.28
5.65
5.29
5.11
6.74
1.00
3.00
12.35
Note: GFTA scores expressed as percentile ranks. Longest of 3 trials is shown for [a], [mama], [f], [s], and [z]. Fastest of 3 trials is shown for
[pa], [ta], and [ka] repetitions.
9
second while a MRRmono less than 3 syllables per second
leads directly to a diagnosis of dysarthria. These criteria
seem to be appropriate even with these younger normally
developing children. All but one of the normally
developing 4- to 6-year olds enrolled in this study achieved
a MRRmono greater than 3.5 syllables per second and no
child produced a MRRmono of less than 3 syllables per
second. However, monosyllable repetition rates between
3 and 3.5, when accompanied by MPD of less than 7.5
seconds, also lead to a diagnosis of dysarthria when
applying the Thoonen et al. (1999) criteria. The one child
whose MRRmono was in the borderline range between 3.0
and 3.5 produced a very short MPD and thus received a
dysarthria score of 2. However, inspection of the
scatterplot shown in Figure 1 reveals that 35% of these
young children failed to achieve a MPD that exceeded 7.5.
Therefore, these data confirm previous reports that
maximum phonation durations are difficult to obtain
from children younger than age 6 years (Kent et al., 1987;
Thoonen et al., 1996; 1999). However, the expectation
that children should achieve a MRRmono that is greater
than 3.4 seems appropriate even for these very young
children.
Table 2
Within subject stability represented as the
intraclass correlation coefficient (ICC) for
each task across 3 trials.
Task
ICC
Prolong [a]
.71
Prolong [mama]
.47
Prolong [f]
.88
Prolong [s]
.81
Prolong [z]
.84
Repeat [pa]
.91
Repeat [ta]
.94
Repeat [ka]
.83
Repeat [pataka]
.93
Note: All ICCs are significantly different from
0 with the p values being equal to or less
than .001 in each case, except the ICC =.47
in which case p =.047.
Table 3
Proportion of Twenty 4- to 6-year old children m eeting the criteria established by Thoonen et
al. (1999) for assigning dysarthria and dyspraxia scores to 6- to 10-year-old children
Score
Classification
Criteria
Proportion
of Children
Dysarthria Scores
0
Not dysarthric
MRRmono > 3.5
.95
1
Undefined
MRRmono 3.0 <> 3.5 and MPD > 7.5
.00
2
Dysarthric
MRRmono < 3.0, or
.05
MRRmono 3.0 <> 3.5 and MPD < 7.5
Dyspraxia Scores
10
0
Not dyspraxic
MRRtri > 4.4 syllables/second
.40
1
Undefined
MRRtr 3.4 <> 4.4 syllables/second and
MFD > 11 seconds, or
MRRtr 3.4 <> 4.4 syllables/second and
additional attempts < 3
.15
2
Dyspraxic
MRRtri < 3.4 syllables/second, or
unable to produce a correct sequence,
or fails to meet criteria for scores 0 or 1
.45
Figure 1
Maximum repetition rate for monosyllables (MRRmono) plotted against maximum phonation
duration (MPD) for each child.
Figure 2
Maximum repetition rate for trisyllables (MRRtri) plotted against maximum fricative duration
(MFD) for each child.
11
Thoonen et al.’s (1999) criterion for ruling out
dyspraxia is MRRtri greater than 4.4 syllables per second.
As shown in Table 3, only 40% of this sample of normally
developing 4- to 6-year-olds met this criterion. Thoonen
et al.’s most straightforward criteria for diagnosing
dyspraxia are MRRtri less than 3.4 or a failure to produce
any correct repetition of [pataka] within 6 trials. Every
child enrolled in this study produced a correct sequence
and no child produced it a rate slower than 3.4 syllables
per second. However, inspection of the scatterplot in
Figure 2 reveals that 60% of the children produced a
MRRtri that was within the borderline range from 3.4 to
4.4. Nine of these children with borderline MRRtri results
were assigned a dyspraxia score of 2 because they required
three additional attempts (2 children) and/or their MFD
was less than 11 seconds (9 children). However,
considering the total group, only 4 children achieved a
MFD that was greater than 11 seconds, as shown in Figure
2. With respect to the dyspraxia scores, these younger
children are clearly not achieving the minimum
expectations for older children with respect to MRRtri or
MFD.
Discussion
The first conclusion to be drawn is that 4- to 6-yearold children can participate in maximum performance
tasks. When using the TOCS+™ MPT Recorder© ver. 1,
complete data was obtained from 20 young children
within a reasonable time period and without undue effort
on the part of the examiner to engage the child in the
procedures.
The second conclusion, not surprisingly, is that the
criteria for diagnosing dysarthria and dyspraxia in
children older than 6 years cannot be validly applied to
children younger than 6 years. However, it does appear
that the criteria could be adjusted to yield valid diagnoses
with younger children.
With respect to the diagnosis of dysarthria, these
children achieved repetition rates for monosyllables that
were very similar to those obtained from older children.
Specifically, all but one child’s MRRmono was greater
than 3.4 and no child produced a MRRmono that was less
than 3 syllables per second. These findings are consistent
with other normative studies of syllable repetition rates
(Robbins, 1987; Williams & Stackhouse, 2000). However,
maximum phonation durations were considerably shorter
than those obtained by Thoonen et al. (1996; 1999) for
older children. The use of the MPD to adjudicate the one
borderline MRRmono resulted in this young normally
developing child receiving a dysarthria classification. One
possible solution would be to modify the criteria and the
procedure so that MPD is not obtained from children
younger than 6 years or used in the diagnosis of motor
speech disorders with this population. The criteria could
be adjusted to involve only MRRmono as follows: Assign
a dysarthria score of 0 (not dysarthric) if MRRmono is
greater than 3.4; assign a dysarthria score of 1 (undefined)
12
if MRRmono is between 3.0 and 3.4; assign a dysarthria
score of 2 (dysarthric) if the MRRmono is less than 3.0
syllables per second. These criteria would result in 95%
‘not dysarthric’ and 5% ‘undefined’ diagnoses for the
normally developing children described in this report.
With respect to the diagnosis of childhood apraxia of
speech, only 40% of our younger sample met the
expectation for older children of a trisyllabic rate greater
than 4.4 syllables per second, yielding an unambiguous
classification of ‘not dyspraxic’. However, no child
produced a MRRtri less than 3.4 and every child achieved
a correct repetition of the sequence [pataka] and thus no
children received an unambiguous ‘dyspraxic’
classification. The use of the MFD to make a decision
about children achieving a MRRtri between 3.4 and 4.4
was clearly inappropriate since the range of MFD scores
was great and only one-fifth of the sample was able to
prolong a fricative for longer than 11 seconds. Again, the
criteria could be adjusted so that only the MRRtri is taken
into account, as follows: Assign dyspraxia score of 0 (not
dyspraxic) if MRRtri is greater than 3.4 seconds; assign
dyspraxia score of 1 (undefined) if MRRtri is between 3.0
and 3.4; assign dyspraxia score of 2 (dyspraxic) if MRRtri
is less than 3 syllables per second. These criteria would
result in 100% ‘not dyspraxic’ diagnoses for the normally
developing children described in this report.
More research is required to cross-validate these
recommended criteria with a different and larger sample
of 4-to 6-year-old children. Validation of these criteria
with children who have clinical diagnoses of dysarthria,
childhood apraxia of speech, and phonological disorder
of unknown origin is also required.
Further research to develop a procedure to obtain
valid maximum phonation and maximum fricative
durations from young children would also be valuable. It
seems unlikely that normally developing preschoolers are
physically unable to sustain a vowel or fricative for longer
than 4 seconds. However, they do sometimes have difficulty
understanding the instruction to do so. They also seem to
require more time to learn to consciously control the
coordination of respiration and speech production. They
may not be sufficiently motivated to sustain a single sound
for periods longer than 4 or 5 seconds. The availability of
software to provide visual real-time feedback to children
about the prolongation performance may help them to
learn this task more quickly and motivate them to achieve
the goal of sustaining a vowel or fricative for at least the
criterion duration.
In the meantime, the practice of asking children to
quickly repeat monosyllables and trisyllabic sequences is
a valuable part of the assessment and diagnostic process
for children with suspected speech sound disorders. Even
children as young as four can be expected to repeat
monosyllables and trisyllables accurately and at rates
exceeding 3 syllables per second.
Acknowledgments
Development of the TOCS+™ MPT Recorder© ver. 1
was supported by a grant to Dr. Megan Hodge from the
Canadian Language and Literacy Research Network
(www.cllrnet.ca) and uses the Universal Sound Server©
software developed for the TOCS+ Project
(www.Tocs.plus.ualberta.ca) at the University of Alberta
by Tim Young. Readers interested in using the TOCS+™
MPT Recorder© can contact Megan Hodge
([email protected]) to obtain a copy of the
software. This study was also supported by a research
grant to Dr. Susan Rvachew from the Canadian Language
and Literacy Research Network and by a research grant to
Dr. Robert Savage from the Social Sciences and Humanities
Research Council and by a studentship awarded to Alyssa
Ohberg by the Natural Sciences and Engineering Research
Council of Canada. This study is one component of Alyssa
Ohberg’s master’s thesis research.
Author Note
Address correspondence to Dr. Susan Rvachew,
School of Communication Sciences and Disorders, McGill
University, 1266 Pine Avenue West, Montréal, Québec
H3G 1A8.
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Manuscript received: November 29, 2004
Accepted: August 8, 2005
13
Phonetic Notation System of M. Bell
The Phonetic Notation System of Melville Bell and its Role
in the History of Phonetics
Le système de notation phonétique de Melville Bell et son
rôle dans l’histoire de la phonétique
Abstract
Alexander Melville Bell was an inventor, like his son Alexander Graham Bell. In 1867, Melville Bell
invented the first universal phonetic alphabetic system, one that he called “Visible Speech.” Visible
Speech was also used by elocutionists of the time to teach speech production to the deaf and to people
with stuttering and articulatory problems. Some aspects of Melville Bell’s phonetics contribution
had a lasting impact on the science of phonetics, especially in its representation of vowels. Other
aspects, such as the notation system he used, were lost to posterity. This article argues that Melville
Bell’s work can offer a case study, of sorts, to illustrate that one cannot assume today’s practices
will be long lasting ones.
Abrégé
Alexander Melville Bell était inventeur, comme son fils Alexander Graham Bell. En 1867, Melville Bell
a inventé le premier alphabet phonétique universel, qu’il a baptisé « Visible Speech » (le langage
visible). Les professeurs d’élocution de l’époque ont également utilisé le langage visible pour enseigner
la production de sons aux sourds et aux gens ayant des problèmes de bégaiement et d’articulation.
Certains volets de la contribution de Melville Bell à la phonétique ont eu un effet durable sur la science
de la phonétique, notamment dans sa représentation des voyelles. D’autres volets, tel le système de
notation qu’il employait, n’ont pas passé à la postérité. Cet article soutient que les travaux de Melville
Bell peuvent servir d’étude de cas, en quelque sorte, pour illustrer le fait qu’on ne peut pas supposer
que les pratiques d’aujourd’hui perdureront.
Key Words: history, phonetics, visible speech, phonetic alphabet
U
State University of New
York at Buffalo
Buffalo, New York USA
14
nlike psychologists, linguists, or deaf educators, those in the field of speechlanguage pathology have tended to ignore their historical origins. This
historical nearsightedness can lead to a lack of appreciation of how much
therapeutic practices depend upon the times in which they originate. We can see from
the evolution of Melville Bell’s notation system that knowledge and practices that are
taken as established today may either be forgotten or have lasting relevance to later
generations.
Among the first people in Canada to carry out speech therapy practices was
Alexander Melville Bell. While he is best known today as the father of Alexander Graham
Bell, Melville Bell deserves more recognition for his own invention—a universal
phonetic alphabet. Melville called his alphabet “Visible Speech” and designed it to
depict sounds from many languages, as well as vocal noises such as coughing and
sneezing. As described by an anonymous contemporary of Melville Bell’s in 1865:
“The symbols represent the most elementary actions of the organs: put together they
produce compounds. A full sneeze, for example, is a complex operation: it comes among
what are called inarticulate sounds; but Mr. Bell writes it down, and, for aught we know,
could undertake to furnish every member of the house of Commons with a symbol
representative of his own particular sneeze, as distinguished from those of all his
colleagues” (Cited in A. M. Bell, 1867, p. 29).
Melville Bell worked as an elocutionist and as a college lecturer first in Edinburgh,
Scotland, then in Brantford and Kingston, Ontario, and finally, in Boston, Massachusetts.
He lectured to young college students and provided elocution lessons to public speakers,
deaf speakers, and people who had articulation and
stuttering difficulties. He, like his son, performed a version
of what we know today as speech therapy.
Early in his work Melville Bell became interested in
phonetics and the physiology of speech. It was around
1850 when he began developing his alphabet that was to
be regarded as the first successful attempt to create a
universal system of phonetics.
Melville Bell’s Phonetic Alphabet
Melville Bell’s phonetic notation system, like the
phonetic alphabets that preceded and followed it,
portrayed articulation in terms of place, manner, and
voicing (e.g., Ellis, 1848; Holder, 1669; Sweet, 1877). But
Melville Bell did not use traditional orthography from
letters of the alphabet. Instead, he used characters that
were iconic representations of the activity of the
articulators.
The chart in Figure 1 was used by Graham Bell to teach
how his father’s system portrayed consonant placement
(A. G. Bell, 1906, p. 41). The large curved lines on the
lower lip and tongue represent the lower articulators
(which the Bells saw as the active ones) and the smaller
curved lines on the palate and upper lip represent more
passive articulators, the contact point for the active
articulators.
Figure 1
straight lines to represent articulatory closure (which he
called “shut”) that produced stops ( l ). Fricatives were
depicted through the use of two small semi-circles that
look like a backwardly curved capital E ( ). This was in
keeping with Melville Bell’s thinking that the air passes
through two sides of the mouth for fricatives. The nasal
S ) to represent the shape
indicator was shaped like an s (S
of the uvula, an articulator whose position is associated
with nasality.
The voice-voiceless distinction in Melville Bell’s
phonetic alphabet was portrayed using two symbols: a
— ), and an
horizontal line for voiced (a closed glottis) (—
elliptical circle (an open glottis) or absence of a vertical
0 ).
line for voicelessness (0
Other features, such as aspiration ( > ) and trilling
( ), were also indicated in ways that were reminiscent of
a salient aspect of physical production of the sound.
The full notation system involved combining
indicators of place, manner, voicing and modifying
features such as aspiration. For example, in Figure 2 the
left-most symbol represents “p” and is comprised of a
circle closed at the right showing lip involvement, a vertical
line showing articulatory closure (stop), and a right
bracket showing aspiration. The second symbol in Figure
2 represents a “b”, combining features that Melville
described as “lips shut” and voicing. The third symbol is
an “f” showing the “lip divided aperture” and the fourth
a “v” adding voicing to the features used to represent the
“f”.
Figure 2
In order to serve as phonetic symbols for speech
sounds, the curve representing larger element or active
place of articulation for a sound was separated from the
drawing. For example, the curve on the lower lip, a
semicircle open at the left, was used to depict labials ( ),
the curve on the tongue tip was used to represent alveolars
( ), and the curve on the back of the tongue was used to
represent velars ( ).
The curves depicting the place of articulation were
combined with other symbols that show manner and
voicing features of sounds. Like those for place, markings
for manner and voice were derived from movements
involved in articulation. For example, Melville Bell used
Melville Bell’s combination of place, manner, and
voicing indicators to form single speech sounds is
reminiscent of what was later to be dubbed a distinctive
feature approach. (See Fromkin & Ladefoged [1981] for
a history of distinctive features.)
Vowels in Melville Bell’s system are also straight
vertical lines with dots strategically placed on the line to
signify where in the mouth the tongue is most constricted.
.
A dot on the right side of the line is a front vowel (| ), and
.
one on the left side of the line is a back vowel ( |. ). Dots
placed at the top of the line are high vowels ( | ); those
low on the line are low vowels ( | . ).
Recommended Uses for Visible Speech Alphabet
Melville and Graham Bell argued in their various
publications for a wide variety of uses for Visible Speech
(see Table 1). The Bells saw Visible Speech as a means to
enhance speaking, reading, and writing for various
populations and as a way to aid in learning foreign
15
languages. Melville Bell also aimed to have his Visible
Speech alphabet used by linguists, phoneticians, and
language teachers as a standard for pronunciation of
sounds in different languages.
Table 1. Uses of Visible Speech and Sample Sources
Where the Uses are Described and Elaborated
Teaching children to read (A.M. Bell, 1858)
Offering science a universal alphabet (A.M. Bell, 1867)
Teaching the blind to read (A.M. Bell, 1867)
Teaching oratory to preachers, actors, or anyone with normal
speech who wants to improve upon it (A.M. Bell, 1868)
Providing a written language for the blind (A.G. Bell, 1872)
Teaching illiterate adults to read (A.G. Bell, 1872)
Teaching speech to children who are deaf (A.G. Bell, 1872)
Capturing the sounds of unwritten language (A.G. Bell, 1872)
Comparing the phonetic systems of different languages
(A.G. Bell, 1872)
Improving the speech of children with articulatory disorders
and children and adults who stutter (A.M. Bell, 1878)
Teacher training (A.M. Bell, 1883)
The Visible Speech system was most often used by the
Bells to teach speech to those with communication
disabilities. Graham Bell concentrated his efforts for
many years on devising ways to use his father’s alphabet
for teaching oral language to his deaf students in the UK,
Canada, and the US. Graham Bell also used it to provide
speech therapy to students in his practice who stuttered or
had articulatory problems (Duchan, 2005).
The Scientific Impact of Melville Bell’s
Invention
In the mid 19th century, when Melville Bell published
his alphabet, many others in Europe and America were
working to develop notation systems for depicting
pronounced speech. These scientists came to the phonetic
enterprise with different backgrounds and interests. Some,
such as Samuel Johnson and Noah Webster, were
lexicographers with an interest in capturing standard
sound pronunciations. Others, such as George Bernard
Shaw and Benjamin Franklin, were spelling reformers
looking to standardize, rationalize, and simplify spelling
practices. Elocutionists such as Andrew Comstock and
Melville and Graham Bell came to the study of phonetics
through their interest in oratory and speech therapy.
Melville Bell’s Visible Speech notation system was
seen by his contemporaries as being an advance over other
efforts because it was more precise, it captured sounds of
16
all languages, and it offered a conceptual system for
understanding vowels. Bell’s classification of vowels into
horizontal (high vs. low) and vertical (front vs. back)
dimensions was further developed and popularized by
Henry Sweet in 1877. The combined work on vowels of the
two men came to be called the Bell-Sweet model of vowel
production (Catford, 1981) and is still seen as a viable way
of representing the articulation of vowels across languages.
Melville Bell’s vowel system was to have an impact on
the development of the International Phonetics Alphabet,
first issued in Paris in 1889 by the International Phonetic
Association. The IPA, as it is now called, was an amalgam
of different alphabets that existed at the time and was
based on the following set of principles (International
Phonetic Association, 1999).
· There should be a separate sign for each distinctive
sound, that is, for each sound which, being used instead
of another, in the same language, can change the
meaning of the word.
· When any sound is found in several languages, the
same sign should be used in all. This applies also to very
similar shades of sound.
· The alphabet should consist as much as possible of the
ordinary letters of the Roman alphabet, as few new
letters as possible being used.
· In assigning values to the Roman letters, international
usage should decide.
· The new letters should be suggestive of the sounds they
represent, by their resemblance to the old ones.
· Diacritic marks should be avoided, being trying for the
eyes and troublesome to write.
It was on the third criterion, having to do with making
the letters in the phonetic alphabet look like ordinary
letters of the Roman alphabet, that Melville Bell’s Visible
Speech alphabet failed. Those hoping to use Melville
Bell’s Visible Speech system found it difficult to learn and
remember because the notations were unlike anything
they had seen previously (Gordon, 1892). It was also
difficult because many of the characters looked alike.
Therefore, although Melville Bell’s phonetic studies and
notation system preceded the development of the IPA, it
was eventually forgotten and replaced by a more familiar,
transparent, and therefore more learnable alphabet.
Melville Bell’s alphabet is seen by today’s phoneticians
as being significant historically because it was the first
alphabet that allowed them to depict the sounds of speech
independent of the choice of particular language or dialect
and because it offered a rational system for understanding
and depicting vowels (Catford, 1981).
Melville Bell’s Visible Speech system is relevant not
only for what it successfully contributed to later
generations, but for what did not get passed on. In
particular, Melville Bell’s effort to create a notation system
whose symbols looked liked articulators ended up being
too difficult to learn, especially for those unacquainted
with the anatomy involved in speech production.
Knowing which of Melville’s contributions lasted and
which ones did not has significance to us today. It not only
helps us learn about the origins of current practices, but
it also helps us understand why the tools and practices
considered to be the best in one generation of practitioners
may not fit the next. Perhaps the most important lesson
to be learned from history is humility.
References
Bell, A. G. (1872). Visible Speech as a means of communication articulation to deafmutes. American Annals of the Deaf and Dumb, 17, 1-21.
Bell, A. G. (1906). Lectures upon the mechanism of speech. NY: Funk & Wagnalls.
Bell, A. M. (1867). Visible Speech: The science of universal alphabetics, or selfinterpreting physiological letters, for the writing of all languages in one alphabet
(Inaugural edition). London: Simpkin, Marshall & Co.
Bell, A. M. (1858). Letters and sounds. A nursery and school book. Salem, MA:
James P. Burbank.
Bell, A. M. (1868). English Visible Speech for the million. Salem MA: James P.
Burbank.
Bell, A. M. (1878). Principles of speech and vocal physiology and dictionary of
sounds. Salem, MA: James P. Burbank.
Bell, A. M. (1883). Visible Speech reader, for the nursery and primary school,
requiring no preparatory knowledge of Visible Speech on the part of the teacher.
Cambridge, MA: M. King.
Catford, J. C. (1981). Observations on the recent history of vowel classification.
In R. Asher & E. Henderson (Eds.), Towards a history of phonetics (pp. 19-32).
Edinburgh: The University Press.
Duchan, J. (2005). The phonetically-based speech therapy methods of Alexander
Graham Bell. Journal of Speech Language Pathology and Audiology, 29, 70-72.
Ellis, A. (1848) The essentials of phonetics. London: Pitman.
Fromkin, V. & Ladefoged, P. (1981). Early views of distinctive features. In R. Asher
& E. Henderson (Eds.), Towards a history of phonetics (pp. 3-8). Edinburgh, Scotland:
Edinburgh University Press.
Gordon, J. (1892). Education of deaf children: Evidence of Edward Miner Gallaudet
and Alexander Graham Bell, presented to the Royal Commission of the United Kingdom
on the condition of the blind, the deaf and dumb, etc. Washington, D. C.: Volta Bureau.
Holder, W. (1669) The elements of speech. London: Scholar Press. Facsimile
reprint, 1967.
International Phonetic Association (1999). Handbook of the International Phonetic
Association. Cambridge, England: Cambridge University Press.
Sweet, H. (1877). A handbook of phonetics. Oxford: Clarendon Press.
Author Note
Correspondence concerning this article should be
addressed to Judith Duchan, Department of Communicative
Disorders and Sciences, State University of New York at
Buffalo, 130 Jewett Parkway, Buffalo, NY 14215,
[email protected]
Received: September 18, 2004
Accepted: May 9, 2005
17
Speech-Language Pathology Outcomes Measures
Introducing a Speech-Language Pathology Outcomes
Measure in Manitoba
Introduction à la Mesure des résultats en orthophonie du
Manitoba
Sheri-Lynn Skwarchuk
Mark Robertson
Darlene Devlin
Abstract
The Manitoba Speech-Language Pathology Outcomes Measure is a standardized severity and
priority rating scale contained on a centralized database. The purpose of the database is to catalogue
and store information on individuals aged 0-21 years who receive intervention services by
participating speech-language pathologists (S-LPs) in the province of Manitoba. The measure was
developed and piloted by a team of clinicians to aid in caseload management, to document the
prevalence and severity of specific communication disorders, and to facilitate communication
across different programs and regions offering services in speech-language pathology in Manitoba.
Information regarding the severity level of an individual’s functional communication, variables
affecting priority for intervention, service provider(s), and other demographic information is
entered onto a secure website. The information and resulting treatment outcome(s) for the goal
area(s) of each individual is calculated and displayed on the website. Aggregate information is
available on caseloads for individual speech-language pathologists, for school divisions or health
regions, and at a provincial level for participating clinicians.
The Manitoba Speech-Language Pathology outcomes measure was piloted in 1999/2000 with the
caseloads of three regional groups of speech-language pathologists. It was expanded in the 2000/
2001 academic school year to include most speech-language pathologists in Manitoba. The database
is used currently by approximately 141 clinicians and contains outcome information for over 9,300
individuals from across the province. The purpose of this field report is to describe the process of
developing the measure in Manitoba. This paper has implications for other jurisdictions developing
and implementing other outcomes measures.
Abrégé
Sheri-Lynn Skwarchuk,
Ph.D.
University of Winnipeg
Winnipeg, MB Canada
Mark Robertson, M.S.
Manitoba Education,
Citizenship and Youth
Winnipeg, MB Canada
Darlene Devlin, M.S.
Interlake Regional Health
Authority
Gimli, MB Canada
La Mesure des résultats en orthophonie du Manitoba définit une échelle normalisée de classement
de la gravité et de la priorité des cas et s’appuie sur une base de données. La base de données a pour
but de classer et de stocker des renseignements sur des personnes de la naissance à 21 ans qui ont été
suivies par un orthophoniste participant dans la province du Manitoba. Une équipe de cliniciens a
élaboré et vérifié la mesure afin d’aider la prise en charge des cas, de documenter la prévalence et la
gravité de troubles de communication précis et de faciliter la communication entre les responsables
de programmes et les régions du Manitoba qui offrent des services d’orthophonie. On verse dans
un site Web sécurisé les données relatives à la gravité du trouble de communication fonctionnelle,
aux variables ayant un effet sur la priorité d’une intervention, aux fournisseurs de services ainsi que
d’autres données démographiques. On compile et affiche sur le site Web les données et les résultats
du traitement qui s’ensuit en fonction des objectifs fixés pour chaque personne. Il est possible de
consulter des données sur l’ensemble des cas d’un orthophoniste clinicien participant, d’une
administration scolaire, d’une région sanitaire et d’une province.
La Mesure des résultats en orthophonie du Manitoba a fait l’objet d’un projet pilote en 1999–2000
portant sur les cas de trois groupes régionaux d’orthophonistes. L’essai s’est étendu à la plupart des
orthophonistes du Manitoba durant l’année scolaire 2000–2001. Environ 141 cliniciens utilisent
actuellement la base de données, qui contient les résultats du suivi de plus de 9 300 personnes dans
toute la province. Ce rapport d’utilisation a pour but de décrire le processus d’élaboration de la
mesure au Manitoba. Ce travail aura des répercussions sur l’élaboration et la mise en application
de mesures des résultats dans d’autres provinces ou territoires.
Key Words: outcome, database, severity, priority, functional communication measure
18
Introducing a Speech-Language Pathology
Outcomes Measure in Manitoba
Given the increased demand for clinical and
therapeutic support services in various public jurisdictions
(e.g., Proactive Information Services, 1998), clinicians are
feeling pressure to provide high-quality services for children
and their families in an efficient manner. Complicating
clinicians’ responses to increased demands are factors such as
service overload, recruitment and retention, and funding. In
many cases, resource-limited funding models (Weber, 1994)
prevent optimal service delivery for those who require it.
Consequently, waiting lists for most publicly-delivered and
some privately-delivered clinical services are long. Direct
assessment and intervention by a specialist, such as a speechlanguage pathologist (S-LP), are limited, and therapy
becomes focused more on intervention than prevention
strategies, all of which raises concern over the effectiveness of
current service delivery models. As a result, clinicians have
been involved in the process of finding solutions to these
problems to alleviate workload and caseload stress, and
ultimately to enhance service delivery (Schooling, 2000).
Research indicates that in addition to concerns over
working conditions, due in part to increased caseloads,
clinicians are feeling increased pressures to be accountable
for the services they provide (Schooling, 2000). This pressure
to ensure accountability has been highlighted recently in the
field of special education. Accountability is necessary to
ensure that individualized programming efforts are effective,
to justify the high cost of special needs programming, and to
combat the growing number of students referred for service
in a resource-limited model (Proactive Information Services,
1998). Furthermore, since specialized educational services in
areas such as speech-language pathology are often housed in
separate, periphery departments in school divisions, the
large budgets needed to sustain these specialized services can
become a target for cutbacks in times of fiscal restraint
(Weber, 1994).
The policies and procedures in place to ensure
accountability of teachers, principals, and schools are clear.
Curricular documents are available (e.g., Manitoba
Education and Training, 1997a, 1998; Western Canadian
Protocol, 1996, 1998) and academic standards are
documented within them to ensure that students are exposed
to certain materials and topics in school. There also are
guidelines established for reporting on student progress and
achievement (Manitoba Education and Training, 1997b). In
most Canadian provincial and territorial jurisdictions,
students also complete a locally developed standardized
exam at various grade levels (Skwarchuk, 2004) to ensure
they are meeting academic expectations (Manitoba
Education and Training, 1999). Descriptions of effective
teaching strategies are available from provincial education
departments such as Manitoba Education and Training
(1996). Guidelines for appropriate professional practice are
available from professional teaching organizations such as
the Manitoba Teachers’ Society (2003).
Perhaps due to the specialty and individualized nature
of the service provided, there are few publicly documented
guidelines and expectations set for the delivery of special
education and clinical services, such as the profession of
speech-language pathology. Consequently, clinicians are
left to their own wisdom and professional expertise to act in
the best interest of the individuals they serve. Furthermore,
since most of the work in speech-language pathology is
conducted at the individual level, S-LPs work to assess and
provide programming on a case-by-case basis. The optimal
distribution of such services to individuals and the efficient
delivery of those services in the most cost-effective manner is
yet to be determined. However, in a recent review of the
Special Education services in Manitoba conducted by an
independent research firm, a recommendation was put forth
that the province develop a mechanism for tracking students
receiving special services in general, including speechlanguage pathology, and documenting the services provided
(Proactive Information Services, 1998). The provincial
outcomes measure was not mentioned in the review because
it had not yet been developed.
One method of addressing increasing concerns over
accountability is to document caseload size and measure
intervention success by tracking pre- and post-intervention
data, and then measuring the outcome(s) or amount of
change after a period of intervention (Swigert, 1997). In these
designs, it is preferable to have a control group (Cozby,
1993), but in applied research settings, a suitable control
group is not always available. This information often has
been tabulated in databases developed by professional
organizations or governing agencies worldwide that are
interested in the caseload makeup of an entire region, the
collective effectiveness of the various interventions used in
the field, the equitable prioritization of individuals, and the
overall job satisfaction and well-being of the service providers
(Gallagher, Swigert, & Baum, 1998). For example, the United
Kingdom has developed the Therapy Outcome Measure
(Enderby, 1997) to provide S-LPs with a “practical tool to
measure outcomes of care by providing a quick and simple
measure which can be used over time” (John & Enderby,
2000, p. 287). Similarly, the American Speech-LanguageHearing Association has endorsed the National Outcomes
Measurement System (American Speech-Language-Hearing
Association, 1996, 1997) “to assist its members in the
collection of outcome data” (Schooling, 2000, p. 4). Canadian
efforts include the Priority Rating Scale (PRS), developed by
clinicians in New Brunswick in 1997 (Eval-Plan Consulting,
1998), and a document written in 1993 by Alberta Health,
outlining structural standards (i.e., serving the target
population effectively), process standards (i.e., competent
and acceptable delivery of services) and outcomes standards
(i.e., ensuring that program objectives are met, using a
priority rating scale) of professional practice.
In addition to providing data for accountability
purposes, a system for keeping track of pre- and postintervention data would be helpful for clinicians. The data
can serve to identify the size of individual caseloads, including
the prevalence of frequently and infrequently occurring
speech- and language-related disorders within the province
for participating clinicians, and as a function of each school
19
or region. Data entered would also reveal the percentage of
time devoted to direct versus indirect service delivery or
group versus individual intervention, and the related
effectiveness of the intervention. Furthermore, these data
would be helpful in improving clinicians’ understanding of
interventions and simplifying report writing.
Communication across regions and jurisdictions of S-LPs
could be improved if all clinicians used the same data recordkeeping and data-tracking system. Finally, the data collection
would be meaningful in terms of explaining the goals and
outcomes of programs and the time required to deliver
programs effectively, thus globally substantiating the
importance of the speech-language pathology profession to
the general public.
The success of implementing these programs is highly
dependent upon marketing the tool effectively. Stakeholders
will support outcomes programs because, among other
reasons, they address increasing concerns over
accountability, they determine best educational practices in
speech-language intervention, and they ensure cost-efficient
service delivery models (Gallagher, Swigert, & Baum, 1998).
Clinicians can be encouraged to support outcomes programs
if they are user-friendly, save time and minimize paperwork,
provide reliable and valid information, and more globally,
can be used in discussions concerning the overall worth of the
speech-language pathology profession. These outcome
programs also must sustain durability due to changes in
political priorities, government cutbacks, and coordination
between ministries and/or departments of education and
health (Law, Lindsay, Peacey, Gascoigne, Soloff, Radford, &
Band, 2001). Consequently, despite their strengths and
educational potential, the aforementioned Canadian
outcomes projects in both Alberta and New Brunswick were
not considered to be educational priorities and have since
been discontinued.
The reasons for the development of an outcomes
measure in several countries and regions are similar to the
reasons for developing a measure in Manitoba. Global
pressures concerning accountability in education (e.g.,
Reeves, 2002) and health-related fields, in combination with
the increasing demand for services and the associated increase
in costs of these perceived ancillary costs to the general public,
provide a rationale for the development of such measures.
The Manitoba project, however, was not a product of a
professional organization or government mandate. The
project was unique in that it was initiated by a group of
practicing clinicians who were interested in understanding
and improving their individual and collective service delivery.
The fact that the project met several of the global concerns
contributed to its appeal and provided time and resources
for the measure to be developed further. The future success
of its implementation is dependent upon continuing to
establish consensus within the field to design and implement
a measure, ensuring that the measure actually aids in
alleviating caseload stress, endorsement of the measure from
an overarching agency or agencies, strong collaboration
among team players to ensure face validity, and establishing
procedures to ensure reliability. The purpose of this paper
20
is to describe the process through which the measure was
developed.
The Manitoba Project
The Manitoba Speech-Language Pathology Outcomes
Measure project evolved over three phases as a grassroots
endeavor. Initial meetings were held to develop a tool for
measuring treatment outcomes with a group of S-LPs
practicing in the Interlake region of the province. The
Interlake region is a rural geographical area north of
Winnipeg, between Lake Winnipeg and Lake Manitoba.
These meetings were then expanded to include the South
Central regional group of S-LPs, another rural group of
clinicians practicing south west of Winnipeg, and to provide
further expertise and diversity to the working group. In the
second phase of the project, S-LPs in the South East region of
the province were invited to participate and review the initial
draft of the measure. The final phase involved expanding the
project to all geographical regions in Manitoba. The process
of developing the project with respect to these three phases is
described in detail below.
Phase 1 — Developing Ideas
Given the reported importance of implementing
outcomes measures in other provincial and international
jurisdictions and the perceived benefits of using such measures,
two regional groups of S-LPs met along with Manitoba
Education, Citizenship and Youth personnel to develop a
measure for use in Manitoba. The working group represented
a diverse range of S-LPs working in the education, family
services and health care professions. Initial meetings focused
on researching available outcomes measures used in Canada
and the United States. The group discussed the relative merits
of each measurement scale as it would apply to service
delivery in Manitoba. Each scale was evaluated in terms of
ease of use, comprehensiveness with regard to diverse work
settings, populations served, assumptions regarding service
delivery models, face validity, and the inherent ability to
capture change. Based on this review and clinicians’ field
experiences, the working group decided to draft a new
measure that: 1) incorporated the combined strengths of
the ASHA NOMs, New Brunswick Priority Rating Scale, and
the outcomes prescribed by Alberta Health (1993); and 2)
focused more positively on functional status rather than
impairment.
The portions of the reviewed outcome measures that
accurately described Manitoba caseloads were incorporated
into the outcomes measure. Portions that needed to describe
current caseloads more accurately than text that was already
available were written by subcommittees, reviewed by the
group, and then incorporated into the Manitoba measure.
For example, the team felt that the prioritization system used
in the Alberta measure was innovative and seemed to capture
the variables required in prioritizing individuals receiving
speech-language pathology services. Consequently, members
combined the Alberta prioritization system with Prognosis
and Related Factors elements from the New Brunswick system
into a working model for prioritizing caseloads and treatment
in Manitoba. The team members also felt the severity ratings
of the functional communication measures from the ASHA
NOMs were user friendly, had broad applicability, and were
relatively concise. Thus, permission was sought from ASHA
to adapt the severity ratings for the functional communication
measures as described in the ASHA NOMs. However, since
the Manitoba team valued a unified system of data entry,
coding, and analysis, the ASHA school-aged and preschool
NOMs descriptors (which are separate in their outcomes
model) were combined to provide the same severity rating
scale of the functional communication measures for all
individuals aged 0 to 21 years. Manitoba clinicians also
incorporated some unique features (i.e., addressing concerns
related to augmentative communication, expanding on the
description of all severity levels to ensure reliable coding, and
incorporating recent developments in the areas of
phonological awareness and word finding into the severity
rating scale) to capture the essence of a case. Finally, the team
reviewed descriptions of each functional communication
measure to ensure that each specific level in each of the scales
was functionally-based and would be sensitive enough to
capture improvements in an individual’s ability to function
at home, school, work, or play.
Broadly stated, the provincial outcomes measure was
designed:
· to document the prevalence and severity of specific
communication disorders, treatment priorities, and
outcomes from the interventions for individuals
serviced by S-LPs up to and including the age of 21 years
across the province of Manitoba;
· to summarize information on caseloads and treatment
provisions for individuals receiving speech-language
intervention across the province in schools, health
regions, and family service and housing regions; and
· to facilitate communication across different programs
and regions offering services in Manitoba, and to
improve consistency in description of service delivery.
The working group developed a manual for
implementation and a standard form for reporting caseload
summaries. This manual has since been revised and a current
version is available on the Manitoba Education, Citizenship
and Youth (2003a) website: www.edu.gov.mb.ca/ks4/
specedu/slp/manual.html. The current version of The
Manitoba Speech-Language Pathology Implementation
Manual (2003a) contains information on the developmental
history and purposes of the project, instructions on
completing the treatment summary form on an individual,
descriptions of the 12 functional communication measures
(FCMs) used in the outcomes measure, information on
scoring the four levels of the severity variable, and the four
categories (severity, urgency, related factors, and prognosis)
associated with the priority variable. The manual also
contains several case study examples, a list of concomitant
factors affecting S-LP intervention (e.g., spina bifida), a set of
variables that can affect treatment outcomes (e.g., level of
support), and a glossary.
In the next phase of the project, the same group of
regional clinicians evaluated the preliminary measure by
piloting it with case studies. Disagreements in coding and
ambiguities in the measures were resolved through discussion.
Discussions continued until consensus was reached. In some
cases, the discussions led to development of new terminology
with a standard definition to eliminate individual
interpretations of previously used terms. For example,
although some clinicians used the terminology “consultative
collaborative” to indicate a broad range of S-LP involvement,
the term was redefined provincially to refer to cases where the
S-LP was involved in the assessment and recommendations
of treatment and periodic follow-ups to review program and
carry-over goals. Several practice sessions focused on applying
the outcomes measure to individuals receiving treatment
from actual caseloads in the field and trouble shooting
problems.
Phase 2 -- Piloting the Project in the Interlake,
South Central, and South East Regions of
Manitoba
Efforts were made to expand the project into another
region of Manitoba after a working copy of the manual was
completed. The development team wanted to ensure adequate
content validity and applicability in the field. The South East
region of S-LPs was chosen because it represented another
geographically distinct region in Manitoba, the S-LPs in the
region were within driving distance of the other group for
ease of facilitating meetings, the S-LPs represented a diverse
group comprised of both new and experienced clinicians,
and the demographics of the individuals receiving the S-LP
services were diverse. The new region expanded on the range
of ages served and the cultural demographics of individuals
served, and represented a variety of service delivery models.
The three groups of S-LPs met and the manual was
revised to eliminate any concerns. Specifically, several
functional communication measures were collapsed or
moved to concomitant factors. The revisions were made
to ensure that the communication measures were as
functional as possible (i.e., they focused on clear
descriptions of the individual’s current performance
capabilities), they were hierarchical in nature, and they
represented areas that were sensitive to change. Several
changes were introduced. For example, the functional
communication measure for Hearing Sensitivity was
removed because it was determined that a functional
communication measure based on severity of hearing loss
would not be remediated by treatment but would be a
significant concomitant factor affecting outcome. As a
result, hearing sensitivity was removed as a functional
communication measure and Deaf/Hard of Hearing was
added as a concomitant factor. The functional
communication measure of Central Auditory Processing
was also changed to a concomitant factor. Functional
communication measures in the areas of Cognitive
Orientation, Pragmatics, Language Comprehension,
Language Production, and Fluency/Rate/Rhythm were
adapted significantly through group input and consensus
to make the individual scales easier than the original
version for understanding, interpreting, and capturing
functional change.
21
Clinician data was initially collected on a Treatment
Outcome Summary Form and submitted to central support
personnel. The computer software program Excel was used
to generate caseload outcomes and reports. Due to a perceived
increase in the availability of computer services and constant
technological upgrades in internet access, the working group
decided to mount the outcomes database on a secure website.
A website would ensure that the information could be entered
and accessed in almost any location and would facilitate data
entry. The website was designed to be user friendly and
included flip-down windows with options to select required
information, thereby minimizing the amount of information
to be entered individually. A database developer was hired
to develop the website and organize it in ways that would be
beneficial to S-LPs, their regional directors, and other
governing agencies. Clinicians were asked to access the website
and enter data for each individual on their caseload, including
identifying information, severity level of functional
communication and a rating of variables affecting priority.
Support personnel were available to help clinicians with the
initial stage of data entry if required. Each clinician entered
a password and received access only to his or her own
individual caseload. Clinicians assigned each individual a
unique identification code to prevent the duplication of
individual entries. In this respect, they could access individual
case files at the times of assessment and reassessment. The
website provided opportunity to review and edit all data,
enabling any errors in data entry to be easily changed. Some
provisions were created within the database to ensure that
only certain characters and certain numbers of characters
could be entered to the various data fields, limiting the
number of data entry errors. School student service
coordinators and regional program directors also could
obtain a password to access aggregate data on their school
division/facility, including the types of services provided and
the treatment outcomes. The website was also organized so
that this aggregate information was available on the caseloads
of participating clinicians for the purpose of creating
summaries of prevalence rates, priority ratings, and
treatment outcomes.
Phase 3 — Expanding the Project into All Areas
of the Province
To expand the use of the measure to all areas of the
province, the project was described at regional workshops
conducted by the provincial S-LP consultant. S-LP
participants received a copy of the implementation manual
before the session. The workshops focused on accessing and
using the website, examining cases to establish reliability in
using the codes, and practicing using the manual and website
with an actual case. The same government representative
presented the measure to all S-LPs to ensure the delivery of
consistent information.
Addressing Reliability and Validity Issues from
an Action-Based Research Model
In developing a measurement scale, researchers and
educators often are concerned with establishing acceptable
22
levels of reliability and validity (Gay & Airasian, 1996; John
& Enderby, 2000). The reliability of a measure is concerned
with establishing consistency in data measurement, and
good reliability represents less error in data interpretation.
The reliability of a measure may be established by obtaining
the same score for an individual by using different testing
instruments, using different raters or establishing the same
rating over a period of time. Validity, on the other hand, is
concerned with whether the score measures what it is intended
to measure, and whether the assessment is appropriate and
meaningful to its users (Gronlund & Cameron, 2004). There
are different types of reliability and validity described in the
testing literature and formal measures for assessing them.
Since the project started at a grassroots level with S-LPs
participating from all areas of the province to develop a
system of classification that would work for them, there was
no initial intent to gather information formally on reliability
and validity. A rigorous developmental process was
implemented to ensure that reliability and validity issues
were established in a general and informal sense. The project
operated from a qualitative, action research perspective.
Thus, the reliability and validity of the measure was grounded
in the clinical expertise of its developers.
Under the assumptions of a qualitative research
paradigm (e.g., Johnson & Christensen, 2000), the following
factors were considered in the discussions of reliability and
validity. First, the data were collected over a long period of
time (one year of pilot testing and two subsequent years of
provincial data collection), involving a large number of
individuals (i.e., currently 9,300 individuals) from across the
province. Developers made the assumption that any inherent
and obvious problems associated with the validity and
reliability of the measure would be identified by its users
during this pilot phase of the project.
Consensus also was established on the terminology to be
used, even if it meant redefining certain phrases and keywords
to establish continuity within the provincial field. Findings
were triangulated by cross-checking information and
conclusions through a number of sources (e.g., the working
group of clinicians, case examples, and comparisons of scores
with those obtained in other outcomes measures). Discussions
also were held to review disparate cases and resolve any
tentative explanations in the data. These discussions
incorporated the perspectives of multiple S-LPs from rural
and urban areas who were employed in a variety of settings
to ensure that the findings were representative and that the
tool made sense to clinicians working in the field. Regular
meetings and peer review sessions were held with the initial
developmental team and other clinicians across the province
to conduct critical reflections and eliminate potential biases
that may have affected the developmental process of the tool.
Finally, presentation, review, and support for S-LPs
using the measure was completed by the same consultant. To
ensure ongoing development of the measure, a committee of
practicing S-LPs from across the province has been formed.
The committee, in response to S-LP input, reviews, revises
and expands the current applicability and utility of the
measure.
In summary, concerns over reliability were minimized
informally by having a large number of S-LPs score clinical
interpretations from a large number of diverse cases. These
clinicians worked with one provincial consultant who then
trained all additional S-LPs, to ensure that the training was
consistent for SLPs using the measure. In terms of establishing
validity, a wide range of S-LPs representing diverse
background experiences and working environments were
involved in developing the measure and scoring resulting
cases. A rigorous review process was used to ensure that scales
were meaningful and reflected the collective experiences of
S-LPs working in the province. This rigorous developmental
process would ensure that future formal studies of reliability
and validity would not lead to disappointing results.
Positive and Negative Experiences in the
Development and Implementation Process
The process of developing, organizing, and
implementing an outcomes measure for use at a provincial
level has been rewarding and challenging. The next section
will focus on the positive and negative aspects of developing
the measure with grassroots clinicians.
Positive Experiences
Important for the development of such a measure is the
mandate and support from a governing body or institution
to facilitate change. The goals and focus of the project aligned
with recommendations to improve service delivery in a
recent review of Special Education services in Manitoba
(Proactive Information Services, 1998). Consequently, it
received strong governmental approval and support. In fact,
the project was highlighted as an area of priority in a
governmental discussion paper released in March of 2001,
and it was cited as an area of best educational research
practice by Manitoba Education, Citizenship and Youth.
From the onset, the project was coordinated by one
consultant. This person completed the background research
for the project, networked with personnel in other
jurisdictions to obtain information on other initiatives, and
served as a contact person and supporter for clinicians using
the measure. This same contact person was responsible for
providing supervisory support to all new school clinicians.
The consultant has developed close working relationships
with most new clinicians in the province over the last six years.
The development of these relationships was beneficial in
terms of gaining compliance to try the measure and providing
ongoing on-site support, especially for clinicians practicing
in remote rural communities and settings.
The Manitoba outcomes project was strongly supported
by a grassroots effort of clinicians. The project was initiated
by a front line S-LP concerned with the need to describe
caseloads and intervention outcomes in a functional way for
S-LPs and administrators. During the developmental stages,
collaboration was required from three governmental
department jurisdictions responsible for S-LP intervention.
Despite discrepancies in service delivery models and issues
that could ensue in times of limited resources, the team
worked collaboratively to develop a system that would work
for them. Lengthy discussions resulted in group consensus on
issues of content, terminology and implementation.
Clinicians held discussion groups after hours, tested the
various outcomes scales on individuals on their caseload,
and assisted in any way possible to facilitate the development
of the measure. The appeal to use the measure came from the
fact that clinicians could use the results from the database to
make decisions, instead of relying on gut feelings.
Finally, for the first time ever, an attempt has been made
to obtain aggregate data at a regional and provincial level on
prevalence rates, service delivery and outcomes based on
gender, age, grade, priority variables and severity levels of
communication disorders (Manitoba Education and Youth,
2003b). The aggregate data collected to date have been used
to plan for some current and future service delivery in speechlanguage pathology.
Challenges
The developmental team worked to address concerns in
three general areas: technological difficulties, clinician
acceptance and support, and end-result test score
interpretation. These three areas of concern are discussed in
more detail below, both in terms of how they were viewed as
problems and how they were addressed.
When the project was first initiated, clinicians commented
that they wanted a user-friendly, easily accessible system.
Program developers were hired to design the interface,
allowing for the efficient storage and retrieval of the data on
the internet. However, due to technological difficulties
associated with internet access, speed, and system
incompatibility, some clinicians experienced difficulties with
this set-up. To preserve confidentiality and anonymity for
individuals on their caseload, S-LPs had to be careful when
working on a computer system with multiple users such as in
a school computer lab. Furthermore, since many people
were involved in entering data on the website, incompatible
conventions in data entry occurred. Finally, technical
difficulties with the database required assistance from the
system developer.
Although clinicians support the outcomes measure,
concerns have been raised over time commitments and
associated benefits of a new data collection system. To
address these concerns, government personnel have
promoted the tool by offering follow-up sessions on data
entry short-cuts, profile interpretation, and ways of marketing
the measure to employers. Discussions have been held to
circumvent any problems that have occurred with on-line
data entry. In addition, some changes have been made to
improve the storage and retrieval of information contained
on the database in order to enhance access to the database for
the purposes of conducting additional statistical analyses. It
is important to have support consultants available to focus
on naturally occurring glitches as soon they are identified.
Finally, in the development and use of the Manitoba
Speech-Language Pathology Outcomes Measure, clinicians
expressed concern over using different standardized tests,
making conclusions from those test score results, and then
using the outcomes measure to summarize results (e. g., two
23
different S-LPs could obtain the same score for an individual
based on the administration and interpretation of different
tests). To address this problem, some clinicians felt that S-LPs
should use the same assessment tools to establish consistency
in scoring. Discussions were held and it was decided that these
concerns were related to the entire speech-language
pathology profession as opposed to the Manitoba SLP
Outcomes Measure per se. The developmental team decided
not to mandate certain assessments as this inflexibility would
undermine the clinical training and expertise of those persons
using the measure.
In the initial stages of the project, clinician concerns over
the potential data to be used in evaluating the individual
performance of clinicians was identified and acknowledged
by the group as a risk factor in the implementation of the
Manitoba measure. The group agreed that comparisons and
evaluations of individual clinicians currently occur without
the benefit of formal standardized data. It was agreed that
clinicians would be empowered by bringing standardized
data on the nature of their caseloads and services provided,
to the administration and to the general public. Overall, the
group felt that the benefits of standardized data and informed
decision making outweighed any risk involved.
Recommendations and Conclusions
During times of budgetary restrictions, clinician
shortages, and overextended caseloads, service providers are
searching for efficient ways of delivering speech-language
pathology services. The Manitoba Speech-Language
Pathology Outcomes Measure enables clinicians to
document the size and severity level of their caseload, assess
the treatment priority of their individuals, and determine
the kinds of interventions provided. For the most part, the
implementation of the measure has been perceived positively
in the field and it is currently being used voluntarily by most
pediatric S-LPs in the province. Some agencies mandated to
provide evaluation of their programs have chosen to use the
Manitoba measure. Despite its success, the project
experienced growing pains. Based on our experiences in
developing and implementing the measure, we suggest the
following recommendations for others involved in creating
similar measures:
Establishing Connections in the Field. Establishing
personal connections with clinicians in the field was essential
to facilitating communication about the project. The close
connection between the provincial consultant and individual
clinicians implementing the measure ensured that problems
could be detected early and circumvented. Frequently held
regional team meetings also improved the morale and
commitment of clinicians to the project by giving them a
sense that they were working on a new, innovative project
together, and by providing opportunities for problem solving
to further develop the measure.
Marketing the Tool. Discussions regarding the benefits
of developing and implementing an outcomes measure
should be held with all stakeholders (i.e., clinicians, regional
directors, government staff, and provincial and national
24
professional organizations). For the Manitoba project, these
discussions were facilitated by the provincial consultant who
traveled to different regions, held dialogues with the involved
parties, drafted reports on the progress of the measure, and
in general, served as an advocate for the outcomes measure.
Developers of the ASHA NOMs scale have made similar
recommendations with respect to marketing their measure
(Goldberg, 1997).
Working with Technological Difficulties. The software
for the database should be chosen carefully, considering not
only the ease of inputting data and the storage and retrieval
of information at different hierarchical levels (i.e., clinician,
region, province), but also the set-up of the data in terms of
conducting statistical analyses. The organization of the
database should only permit data to be entered in one
format. Furthermore, considerations should be made for
ensuring individual/clinician confidentiality. Finally,
although mounting the database on the internet had
accessibility appeal, many clinicians became frustrated with
the speed of the dial up internet system that resulted in slow
data entry.
Providing Training and Ongoing Professional
Development. It is important that all users receive consistent
training on using the measure. For the Manitoba project, this
training initially included sessions on how to access the
database, enter individual information, and print reports.
Subsequent sessions outlined shortcuts for data entry,
reviewed methods for understanding and presenting results
to employers, and identified methods to interpret results.
The development of a provincial speech-language
pathology outcomes measure has been an exciting challenge
for many stakeholders who have sought to improve service
delivery. It is anticipated that the measure will be developed
further as formalized studies are conducted on the reliability,
validity, and sensitivity of detecting change associated with
the measure. Some of these studies are already in progress and
the results are encouraging (Skwarchuk, Robertson, & Devlin,
2004; C. Johnson, personal communication, 2004).
Furthermore, although the project has been locally endorsed,
future work is needed to determine the broad applicability
of the pediatric measure to other populations (e.g., adults),
other regions in Canada and other parts of the world.
National endorsement, followed by national statistics on
prevalence rates and treatment effects, will contribute to the
ultimate success of this project. Future studies could describe
the prevalence and severity rates of the functional
communication measures on a longitudinal basis as a
function of many demographic variables. Knowledge about
the composition of a very large caseload from across the
province will aid in providing appropriate treatment options
and ensure the overall viability of the profession.
Acknowledgements
The authors gratefully acknowledge the speech-language
pathologists from the Interlake, South Central, and South
East Regions who donated their time and efforts to the
development of this project. Further thanks are extended to
all other S-LPs in Manitoba who have included their caseloads
in the database and who have provided their commentaries
in terms of further developing the measure.
Thanks also to Manitoba Education, Citizenship and
Youth consultants and support staff for their assistance with
the project, and to two anonymous reviewers who provided
commentary on an earlier version of the manuscript.
Author Note
addressed to Sheri-Lynn Skwarchuk, Faculty of Education
and Extended Learning, University of Winnipeg, 515 Portage
Avenue, Winnipeg, Manitoba, R3B 2E9, or through electronic
mail at [email protected]. Mark Robertson,
Manager, School Support Unit, may be reached at Manitoba
Education, Citizenship and Youth, W310 1970 Ness Avenue,
Winnipeg, Manitoba, R3J OY9, or through electronic mail
at [email protected].
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Accepted: July 28, 2005
25
Predicting Reading from Oral Language
Predicting Reading Abilities from Oral Language Skills:
A Critical Review of the Literature
Prévoir les aptitudes à la lecture à partir des capacités
langagières : un compte rendu documentaire
Elizabeth Ekins
Phyllis Schneider
Abstract
The early identification of children who may be at risk for reading difficulty is important so that
intervention can be provided early and subsequent reading problems can be avoided. Traditionally,
children with reading problems are identified after reading instruction has begun. However,
knowledge of oral language skills that predict reading abilities is necessary to identify children who
may be at risk for later reading problems.
This document discusses research literature documenting oral language measures that may predict
lower level (decoding) and higher level (comprehension) reading abilities as well as reader-group
membership. The predictive ability of expressive language, receptive language, Rapid Automatized
Naming (RAN), and phonological awareness are discussed.
The research results indicate that some oral language measures predict reading achievement.
Although standardized measures of expressive language account for some variance in lower level
reading, phonological awareness and RAN account for more. Standardized measures of expressive
and receptive language predict reading comprehension in Grade 2. RAN tasks predict lower level
reading and reader-group membership. Various combinations of syllable and phoneme deletion,
syllable and phoneme blending, and rhyme detection predict lower level reading achievement,
reading comprehension, or reader-group membership. The research information reviewed here can
help guide future investigations in the area of predicting reading abilities.
Abrégé
Il est important de repérer très tôt les enfants qui risquent d’avoir de la difficulté à lire, afin de pouvoir
intervenir rapidement et prévenir l’apparition de troubles ultérieurs. Habituellement, nous arrivons
à identifier les enfants éprouvant de la difficulté à lire après le début de l’enseignement de la lecture.
Toutefois, il est nécessaire de connaître au préalable les capacités langagières qui permettent de
prédire les aptitudes à la lecture.
Elizabeth Ekins, M.S.L.P.,
S-LP(C)
Royal Inland Hospital
Kamloops, BC Canada
Department of Speech
Pathology and Audiology
Edmonton, AB Canada
Le présent article traite des recherches sur les mesures de la capacité langagière qui peuvent prédire
les aptitudes à la lecture de niveau inférieur (décodage) et de niveau supérieur (compréhension) de
même que l’adhésion à un groupe de lecture. Il examine la valeur prédictive de l’expression orale du
langage, du langage dans son versant réceptif, de la dénomination rapide automatisée (DRA) et de
la reconnaissance des sons.
Les résultats de la recherche indiquent que certaines mesures du langage verbal permettent de prédire
le niveau de lecture. Bien que les mesures normalisées de l’expression orale du langage expliquent
certaines variations des capacités de lecture au niveau inférieur, la reconnaissance des sons et la DRA
en expliquent davantage. Les mesures normalisées de l’expression orale du langage et du langage dans
son versant réceptif permettent de prédire la compréhension en deuxième année. Les exercices de la
DRA permettent de prédire les capacités de lecture au niveau inférieur et l’adhésion éventuelle à un
groupe de lecture. Il est possible de prédire la capacité de lecture au niveau inférieur, la compréhension
de ce que l’enfant lira ou l’adhésion éventuelle à un groupe de lecture selon que l’enfant combine la
suppression de syllabes et de phonèmes, la confusion de syllabes et de phonèmes et la détection des
rimes. Les résultats de la recherche dont on donne ici le compte rendu peuvent aider à orienter des
études futures dans le domaine de la prédiction des aptitudes à la lecture.
Ke y Words: reading, oral language, receptive language, expressive language, phonological
awareness
26
Predicting Reading From Oral Language
S
peech-language pathologists (S-LPs) have been
viewed as experts on speech and language, yet
have not had extensive involvement in children’s
development of reading skills. However, given the growing
view that reading is a language-based skill combined with
S-LPs’ expertise in the area of language, S-LPs are becoming
more actively involved in the assessment of and the
intervention for reading disabilities. Further, S-LPs
potentially have an important role in the process because
oral language problems develop before children receive
formal reading instruction. Since S-LPs often see these
children first in the preschool years, they can play an important
role in the early identification of reading problems.
Traditionally, reading disabilities have been identified
after reading instruction has begun (Catts, 1997). That is,
children with reading problems are identified when they
receive reading instruction in school and experience significant
difficulties in learning to read. However, the number of
children with early language disorders who eventually
experience reading problems is estimated to be around 50%
(Catts & Kamhi, 1999). Oral language does not need to be
exceedingly weak to be related to poor reading; children may
be found to be at risk even though present oral language
status does not qualify them for S-LP services (Catts, Fey,
Zhang, & Tomblin, 2001). Some negative consequences of
reading problems include decreased motivation (Taylor,
Harris, Pearson, & Garcia, 1995), lowered expectations of
one’s abilities, and falling further behind peers in reading and
consequently in academic achievement (Spear-Swerling &
Sternberg, 1994). These negative consequences provide
support for the early identification of children at risk for
reading difficulties to prevent subsequent reading problems.
Once these children are identified, treatment could begin
before reading instruction. Such intervention may decrease
any negative effects of reading failure on a child’s self-esteem,
encourage academic achievement, and foster a positive
outlook on reading and the value of reading abilities. An SLP’s expertise on language should lead to his/her involvement
in program design to help decrease a child’s risk for future
reading problems. Oral language is a broad construct and for
intervention to proceed, S-LPs need to know which of its
many variables are the strongest predictors of reading ability.
This paper summarizes and discusses the results of 13
research articles that examined oral language measures that
may predict both lower level and higher level
(comprehension) reading abilities. Studies included in the
review were longitudinal studies conducted between 1990
and 2001 that used correlational or regression designs and
included at least one measure of oral language as a predictor.
After a short review of current views on oral language and
reading, the research findings are summarized followed by a
discussion of clinical implications.
Statistical Methods of Identifying Predictors
One method of identifying which measures predict later
reading achievement is to look for correlations between oral
language measures and reading tasks. Correlational research
is used to analyze relationships between and among two or
more variables. The strength and the direction (positive or
negative) of the relationship are examined. The results of
correlational research indicate an association or relationship.
Causation cannot be attributed between the variables.
Correlational research can be applied to both longitudinal
and cross-sectional study designs. Longitudinal studies are
more appropriate for predicting reading abilities because
the same children are followed over a period of time and the
relations among variables are examined across time.
Studies using correlational techniques have established
that a relationship exists between oral language abilities and
reading achievement. However, correlational techniques do
not automatically correct for multiple comparisons; they
cannot reveal which of a set of variables is the best predictor
of a criterion variable. Investigators can apply the statistical
method of multiple regression to a longitudinal study to
examine the contribution of different variables in predicting
reading achievement. Multiple regression enables the
identification of more than one predictor variable of a
criterion variable and the relative predictive value of each
predictor (Norman & Streiner, 1998; Rosenberg & Daly,
1993; Schiavetti & Metz, 2002). Hierarchical (or fixed-order)
regression is a type of regression analysis. The predictor
variables are entered into the equation in an order
determined by the researcher (Tabachnick & Fidell, 1996).
Stepwise multiple regression is another type of regression
analysis. In this case, the order of the entry of variables is
determined by correlations among the variables, with the
independent variable most highly correlated with the
dependent variable entered first.
Measurement of Oral Language and Reading
Ability
A variety of standardized and nonstandardized measures
of oral language have been used to predict reading ability.
These measures can be categorized into phonological
awareness, Rapid Automatized Naming (RAN), expressive
language, and receptive language. A description of the
measures used in all the studies reviewed can be found in
Appendix A.
Two approaches to reading have been discussed in the
literature — lower level and higher level (Catts and Kamhi,
1999). Lower level reading abilities include sound-symbol
correspondence and word recognition. When one reads
written words, the word’s meaning can be accessed by two
methods. The first is an indirect method of phonological
representation in which the reader uses knowledge of
phoneme-letter correspondence to recode the letters into
their corresponding phonemes. The second method is a
direct method by way of visual representation. A match is
made between the visual configuration and a visual
representation that is part of the mental lexicon for the
particular word. The first method could be thought of as
sounding a word out or decoding and the second method a
whole-word approach.
To assess lower level reading abilities, children say real
words and nonwords, also referred to as pseudowords. Tasks
involving real words are referred to as reading accuracy, real
27
word tasks, or word identification (Bishop & Adams, 1990;
Felton & Brown, 1990). Tasks involving nonwords are
referred to as nonword or word attack tasks (Bishop &
Adams, 1990; Felton & Brown, 1990; Muter & Snowling,
1998).
Higher level reading abilities, or reading comprehension,
enable one to understand sentences and paragraphs (Catts
& Kamhi, 1999). Lower level reading skills may be the focus
of attention when a child is learning to read, whereas
comprehension skills may be a concern for older children
who have mastered lower-level skills but now must read to
learn. To assess higher level reading, children are typically
instructed to answer questions based on a reading passage.
A variety of standardized and nonstandardized tests assess
lower level and higher level reading abilities. A list of the tests
used in the studies reviewed can be found in Appendix A.
Studies have tried to predict lower level and/or higher
level reading skills from oral language measures (Badian,
2001; Bishop & Adams, 1990; Catts, 1993; Catts et al., 1999
& 2001; Felton & Brown, 1990; Hurford, Schauf, Bunce,
Blaich, & Moore, 1994; Manis, Seidenberg, & Doi, 1999;
McCormick, Stoner, & Duncan, 1994; Menyuk, Chesnick,
Liebergott, Korngold, D’Agostino, & Belanger, 1991; Muter
& Snowling, 1998; O’Connor & Jenkins, 1999; Snow, Tabors,
Nicholson, & Kurland, 1995). Some studies have included
lower level reading skills or higher level reading skills (Felton
& Brown, 1990; Manis, Seidenberg, & Doi, 1999; Muter &
Snowling; 1998), have included both lower level and higher
level reading skills (Badian, 2001; Bishop & Adams, 1990;
Catts, 1993; Catts et al., 1999; Menyuk et al., 1991), or have
combined these two skills under one label called reading
(McCormick et al., 1994; Snow, Tabors, Nicolson, & Kurland,
1995). It should be noted that when two skills are combined
into one measure, it is impossible to determine which oral
language skills predict lower level reading and which oral
language skills predict higher level reading.
Methods
Criteria were outlined to determine the inclusion of
studies in the literature review. Studies since 1990 were chosen
because they seem to have a richer view on predicting reading
skills and include phonological skills, narratives and standard
tests in the studies. Studies prior to 1990 are generally limited
to phonological skills and reading. Further, studies that used
longitudinal designs were included in this review. These
studies are more effective and appropriate for determining
what oral language abilities predict later reading difficulties.
Once the criteria were determined, an exhaustive search was
completed using the online data bases ERIC, PsycInfo, and
PUBMED as well as through secondary references.
Summary of Studies Reviewed
A brief summary of the participants as well as the oral
language and reading measures used in each of the studies can
be found in Appendix B. Although some studies included
measures other than oral language and reading, only oral
language and reading variables are of interest in this review.
This section comments on general strengths and weaknesses
of the studies.
28
It is important to comment on the number of
participants in each study compared to the number of
predictor variables entered in the regression analysis. When
discussing regression analysis, Norman and Streiner (1998)
suggest that the number of participants be 5 or 10 times the
number of variables entered in the regression analysis. When
the authors discuss logistic regression analysis and analysis of
covariance, they suggest that the number of participants be
10 times the number of predictor variables. The authors
recommend that caution be used when overinterpreting
regression models based on relatively small samples.
However, they do not define a small sample size. Other
authors recommend that the sample size be 30 (Pedhazur,
1983) or 50 (Glass & Hopkins, 1996) subjects for every
predictor variable, providing support for more than 5
subjects for every predictor variable. It seems that larger
numbers of subjects for every predictor variable is more
desirable. We will use the smallest recommendation of 5
subjects per variable as the minimum when evaluating studies.
Some studies had an adequate number of participants
based on Norman and Streiner’s (1998) suggestion of 10
participants for each predictor variable entered in the
regression analysis (Badian, 2001; Bishop and Adams, 1990;
Catts, 1993; Catts et al., 1999; Felton & Brown, 1990; Manis
et al., 1999; ). Muter and Snowling (1998) were close to the
suggestion of 10 subjects for every predictor variable. Menyuk
et al. (1991) met the minimum of 5 participants for every
predictor variable and McCormick et al. (1994) fell short of
the minimum recommendation.
Tabachnick and Fidell (1996) suggest that when
predicting group membership and using a discriminant
analysis or stepwise logistic regression, the smallest group
size needs to exceed the number of predictor variables. All
studies that predicted group membership (Catts et al., 2001;
Hurford et al., 1994; Muter & Snowling, 1998; O’Connor &
Jenkins, 1999; ) included an adequate number of participants.
In one study, (Menyuk et al., 1991) the authors did not
differentiate between kindergarten, Grade 1, and Grade 2
reading skills. Rather, these three levels were considered
together. When all three grades are grouped together, it is
possible to lose the accuracy in predicting because the
predictability of skills may change with different ages. As well,
it is possible that kindergarten children may not yet have
learned decoding skills.
Two studies (McCormick et al., 1994; Snow et al., 1995)
combined lower level and higher level reading measures. It
is difficult to interpret the findings of McCormick et al.
(1994) because the reading measure, Iowa Tests of Basic
Skills (Hieronymus, Hoover, & Lindquist, 1986), included
both lower level and higher level skills. As well, Snow et al.
(1995) combined the subtests of the Wide Range
Achievement Test (WRAT) (Jastak & Jastak, 1976). When
the two skills are combined, one cannot determine which
oral language skills predict lower level reading and which
oral language skills predict higher level reading.
Catts (1993) and Catts et al. (1999) entered scores from
different tests into the regression analysis, thereby losing
some information on the predictive value of individual tests.
In one study (Catts, 1993), the oral language measures were
entered into the regression analysis as receptive language,
expressive language, RAN, and phonological awareness. In
another study (Catts et al., 1999), the language measures
were entered into the regression analysis as oral language,
RAN, and phonological awareness.
Most of the studies used some measure of intellectual
ability to control for this factor. Some studies used a general
measure of IQ (e.g., Catts, 1999; Felton & Brown, 1990;
Muter & Snowling, 1999), while others used a measure of
verbal IQ (Badian, 2001) or nonverbal IQ (Catts, 1993; Catts
et al., 2001). Authors do not discuss why they chose one of
these types over the other. However, there are important
implications of each of these choices. If we are interested in
the predictive ability of language measures on reading scores,
then using either full-scale or verbal IQ is likely to remove
some of the effect of the language measures, since the IQ tests
will be testing at least some of the same aspects of language,
and thus there is likely to be a smaller relationship between
the language and reading measures. Studies that control for
nonverbal IQ would have avoided this confound by
controlling for non-verbal cognitive abilities only. Bishop
and Adams’s (1990) study was the only one to look at
regression results with the effects of verbal IQ as well as both
verbal and nonverbal IQ, but they do not discuss the
implications of these different analyses.
In some studies, the authors do not indicate whether or
not the potentially confounding variable of nonverbal ability
was controlled for (Badian, 2001; Manis et al., 1999;
McCormick, 1994). These factors are important to control
for as differences may arise from them. For example, without
controlling for the non-verbal abilities of children, one does
not know if these abilities contribute to the prediction of
reading skills. Authors chose to control for non-verbal
abilities in a variety of ways.
Catts (1993) is the only researcher who controlled for
grade differences as a result of some students repeating a
grade or being placed in an alternative classroom. A
‘matriculation’ variable was entered first into the regression
analysis. It is possible that previous classroom exposure may
influence reading ability.
Many of the studies performed correlations on the
variables before entering oral language measures into a
regression analysis. Menyuk et al. (1991) did not perform
correlations before entering predictor variables into
regression analyses. Further, all studies, with the exception
of Felton and Brown (1990), entered all the predictor
variables into a regression analysis. Felton and Brown entered
only the variables that showed the highest correlations to
reading outcome and that were representative of the three
areas of phonological processing in the study. According to
Stevens (2002), entering only those variables that are the
most correlated to the dependent variables tends to make the
results sample specific and therefore unreplicable.
Reader-Group Membership
Some studies were interested in predicting reader-group
membership rather than or in addition to predicting actual
reading scores. This approach determines whether and to
what degree the measures used in a particular study
discriminated between previously identified groups of
children and thus adds another dimension to the investigation
of prediction. An individual measure may predict a reading
measure in isolation, but it might not predict who would
actually be identified as having a reading problem, which is
likely to be based on problems in several skill areas.
There have been a variety of methods used to classify
reader-group membership. Menyuk et al. (1991) used a cutoff score of 79 on the WRAT to define poor readers. The
authors state that this score indicates borderline or deficient
reading abilities at the beginning stages.
In Hurford et al. (1994), the three reading groups
(nondisabled, reading disabled, and “garden variety” poor
readers) were created according to the reading tasks and the
Peabody Picture Vocabulary Test – Revised (PPVT-R)
performance at the end of grade 2. The authors state that
PPVT-R scores were used as a measure of intellectual ability.
The nondisabled group consisted of children whose standard
scores were above 1 standard deviation below the mean on
composite reading score. The children classified as reading
disabled had standard scores equal to or below 1 standard
deviation below the mean in composite reading, with PPVTR standard scores above 1 standard deviation below the
mean. The garden-variety group had standard scores equal
to or below 1 standard deviation below the mean in composite
reading, but also had PPVT-R standard scores equal to or
below 1 standard deviation below the mean.
Muter et al. (1998) defined good readers as those having
reading accuracy scores above the 75th percentile on the Neale
Analysis of Reading Ability Test (Neale, 1966). Poor readers
had reading accuracy scores below the 25th percentile on the
same test.
Badian (2001) defined poor readers as those children
who scored below the 25th percentile on word recognition.
Although not stated, this definition leaves good readers
to be defined as those who scored above the 25th percentile
on the word recognition task.
O’Connor and Jenkins (1999) used the Word
Identification and Word Attack subtests of the Woodcock
Reading Mastery Tests- Revised (WRMT-R) (Woodcock,
1987) to classify the children into one of two groups
(average readers and reading disabled). The authors do
not describe in detail the criteria for classifying the
children.
Catts et al. (2001) defined reading difficulties as scores
greater than 1 standard deviation below the mean on the
composite measure of reading comprehension. This
definition is consistent with Hurford et al. (1994). The authors
felt that this definition is a compromise when compared to
more liberal definitions and more conservative definitions of
reading disabilities used in the literature.
29
Thus, studies used different definitions of poor or
disabled readers. Some were based on lower-level reading
skills, others on higher-level skills, and others on composite
reading scores. Cut-off scores ranged from at or below one
standard deviation to the 25th percentile, which is well within
the normal range of scores.
Results
This section summarizes those measures found to predict
lower level reading, higher level comprehension skills, and
reader-group membership. The predictive ability of
phonological awareness, RAN, expressive language, and
receptive language is discussed.
Phonological Awareness
Phonological awareness is the ability to attend to, reflect
on or manipulate the speech sounds in a word. Five
phonological awareness activities were explored in seven of
the articles reviewed. The results indicate that some
phonological measures predict reading achievement while
other measures need further research before making firm
conclusions.
Syllable and phoneme deletion and blending are
phonological awareness tasks that predict lower level
(Catts, 1993; Catts et al., 1999; Manis et al., 1999; Muter
& Snowling, 1998) and higher level (Catts, 1993; Manis et
al., 1999) reading ability. In some studies, syllable and
phoneme deletion combined were found to predict both
lower level and higher level reading (Catts et al., 1999;
Manis et al, 1998). Muter and Snowling (1998) found that
phoneme deletion alone predicts lower level reading. If
phoneme deletion alone can predict lower level reading,
then fewer tests would need to be administered. One
cannot determine how much syllable deletion contributes
to the prediction of lower level reading or comprehension
as this task was not considered independently from
phoneme deletion in the studies reviewed.
Catts (1993) found syllable and phoneme deletion,
combined with syllable and phoneme blending, to predict
both word identification and word attack in Grade 1 and
Grade 2, accounting for 4% to 37% of the variance.
Further, this measure accounted for 25% of the variance
when predicting comprehension in Grade 2. Although
phonological awareness tasks predicted comprehension
in Grade 2, receptive and expressive language measures
accounted for more variance when entered first in the
regression analysis (Catts, 1993).
None of the studies reviewed for this paper looked at
syllable and phoneme blending independently of deletion
tasks. Therefore, it is difficult to determine which task,
deletion or blending, contributes more to predicting or if
both tasks contribute equally. The research to date
indicates that 1) syllable and phoneme deletion together
predict lower level reading and comprehension, 2)
phoneme deletion predicts lower level reading, 3) syllable
and phoneme deletion and syllable and phoneme blending
combined predict lower level reading.
30
A number of phonological measures require further
research before one can conclude that these tasks predict
reading. Syllable and phoneme segmenting were found to
predict lower level and higher level reading in one study
(Menyuk et al. 1991). The results of this study need to be
interpreted with caution. First, the scores from
kindergarten, Grade 1, and Grade 2 participants were
grouped together. The relationships may not be the same
at all these ages since reading level changes dramatically
during this period. Second, the authors did not indicate
whether they had controlled for potentially confounding
variables such as nonverbal ability and children repeating
grades. Finally, the inclusion of more than 130 participants
would have strengthened the study given that 17 variables
were in the regression analysis.
Further, although syllable segmenting was found to
predict lower level reading in Badian (2001), this task only
accounted for a small amount of variance (never more than
7%) (Badian, 2001). Another measure, rhyme detection,
was not found to predict lower level reading in one study
(Muter & Snowling, 1998). However, the results from the
study conducted by Badian (2001) indicated that rhyme
detection predicted word reading in Grade 1, although it
accounted for a small amount of variance (never more than
6%). Further, rhyme detection inconsistently predicted a
small amount of variance in reading comprehension in this
study.
McCormick et al. (1994) found the identification of
consonants at the beginning of words presented orally to
significantly predict a combined reading score of lower level
reading and reading comprehension. Consonant
identification accounted for 34% of the variance. It is unclear
which level of reading this measure predicts as lower level and
higher level reading were combined as a composite score.
Further, the amount of variance consonant identification
accounts for is unclear because the amount of variance
changed from 34% to 6% depending upon the order entered
into the regression. The unclear results make it difficult to
determine the predictive power of consonant identification,
and thus additional research is needed.
Syllable and phoneme segmenting, syllable and phoneme
deletion, and rhyme detection were used in two studies to
predict reader group membership (good versus poor reader),
either on its own or with a combination of other tasks. Rhyme
detection did not contribute to the prediction of group
membership in the study conducted by Muter and Snowling
(1998), but it did identify 71% of the poor readers and 85%
of the good readers in the study conducted by Badian (2001).
Differences between these two studies may be explained by
the small number of participants, 34, used by Muter and
Snowling. Badian’s study had a larger number of participants
and thus had greater power to yield significant results.
Another reason for differences may be explained by the
definition of reader-group membership. Muter and Snowling
had used composite reading scores to define poor readers,
while Badian used word recognition only; it is possible that
rhyme detection would be more closely related to word
recognition, a lower-level reading skill, than to a composite
reading score.
Phoneme and syllable deletion seem to be predictors of
reader-group membership when measured at an early age.
Catts et al. (2001) determined phoneme and syllable deletion
to be among the best five predictors of reader-group
membership when measured in kindergarten. Muter and
Snowling (1998) found phoneme deletion combined with
nonword repetition measures to predict group membership
when measured at age 5 or 6. Finally, O’Connor and Jenkins
(1999) found that syllable deletion when combined with two
other measures predicted group membership only when it
was measured in early kindergarten.
Of the two segmenting tasks, syllable and phoneme,
phoneme segmenting predicts reader-group membership in
kindergarten and in Grade 1 (O’Connor and Jenkins, 1999).
Badian (2001) found syllable segmenting to classify most
good readers, but only a small percentage of poor readers.
Ideally, one would want the measurements used to classify
correctly most of the members of both groups. Based on these
results, syllable segmenting may not be a strong variable in
predicting reader-group membership.
Rapid Automatized Naming
In rapid automatized naming (RAN) tasks, children are
shown an array of items to name as quickly as possible
proceeding left to right, row by row. Before beginning the
task, the children demonstrate their ability to name each
item in isolation.
Five different RAN measures, numbers, letters, objects,
colours, and animals, have been used in several of the studies
reviewed as either a composite score or as a single score to
predict lower level reading. The results of the studies reviewed
indicate strong support for the prediction of lower level
reading from RAN measures (Catts, 1993; Catts et al., 1999;
Felton & Brown, 1990; Manis et al., 1999; Menyuk et al.,
1991).
For example, Felton & Brown calculated simple
correlations between RAN measures and word identification
and word attack skills for children in first grade. Correlations
ranged from .19 to .30 and were stronger for word
identification than for word attack. All correlations were
significant except for the correlation between colours and
word attack and letters and word attack.
Catts et al. (1993) calculated correlations between RAN
measures and word identification and word attack in first
and second grade, all of which are significant. Correlations
ranged from .35 to .56. Catts and his colleagues (1999) only
included the rapid naming of animals. The correlation
between this measure and the combination of second grade
reading comprehension and word recognition was 0.424.
The above results indicate that a variety of RAN measures can
be used to predict lower level reading.
One study remains the exception. Menyuk and her
colleagues (1991) found RAN letters, rather than tasks with
colours, numbers, or objects, to be the only significant RAN
task to predict word identification and a composite reading
score consisting of word identification, word attack, and
comprehension. The methodology of this study differs from
the other studies. RAN tasks were administered prior to
kindergarten and subjects from all 3 grades were included in
the correlations without considering grade as a factor, which
may affect generalizability of the results.
Catts and his colleagues (1999) offered an argument for
the use of one RAN measure in research. The investigators
included only RAN animals in their study because previous
work (Catts, 1993) had shown that many kindergarten
children, particularly those with language impairment, could
not consistently name letters or numbers. However,
correlations obtained by Felton and Brown (1990) for
numbers and letters summarized above do not appear to
support this argument. Although it is evident that lower level
reading can be predicted from RAN measures, more research
is needed in this area to determine which RAN measure, if
any, is best at predicting lower level reading. Such research
could support these initial findings that, in fact, it does not
matter which RAN measure is used.
Although RAN tasks were found to predict reading
comprehension in the four studies, the results indicate that
RAN measures may not be the strongest predictor of reading
comprehension. In Catts’ 1993 study, when a composite
score of RAN was entered first in the multiple regression
analysis, it accounted for 16% of the variance. However,
phonological awareness, receptive language, and expressive
language, when entered first, accounted for much more
variance in reading comprehension (25%, 35%, and 33%
respectively). When phonological awareness was entered
first, RAN accounted for 7% of the variance, when receptive
language was entered first, RAN accounted for 4% of the
variance, and when expressive language was entered first,
RAN was not significant. In another study, Manis et al.
(1999) found that RAN letters accounted for 4% of the
variance and RAN digits 3% of the variance once prior
reading level was accounted for in the hierarchical regression
analyses. Finally, in the study conducted by Catts and his
colleagues (1999), once RAN was entered into the hierarchical
regression, it only accounted for an additional 7% of the
variance in one instance and 2% of the variance in another.
Menyuk and her colleagues (1991) found RAN letters to
consistently account for the largest amount of the variance,
accounting for 22.52 % for the WRAT, 1.35% for the Gray
Oral Reading Test (GORT) (Weiderholt & Bryant, 1986)
and 19.45% using the Test of Reading Comprehension
(TORC) (Brown, Hammill, & Weiderholt, 1978). It is
difficult to determine the predictive nature of RAN in this
study because of the methodology concerns discussed
earlier and the fact that reading comprehension and
lower level reading abilities were measured together in
two of the tests.
RAN has been used to differentiate between reading
groups (Catts et al., 2001; Menyuk et al., 1991; O’Connor
& Jenkins, 1999). Again, the studies differed on which RAN
score was used. One study used animals (Catts et al., 2001),
31
one used letters (O’Connor & Jenkins, 1999), and another
used four separate scores — animals, objects, numbers, and
colours (Menyuk et al., 1991). O’Connor and Jenkins found
RAN letters to be one of the best three predictors of group
membership. It consistently predicted group membership
when administered in kindergarten and Grade 1. O’Connors
& Jenkins started with a large number of predictors before
narrowing to the best three.
Catts and his colleagues (2001) started with a large
number of predictors. However, the logistic regression
analysis identified five significant variables that predicted the
probability of reading difficulties in Grade 2. RAN (animals)
was the fifth best predictor. The scores of the five predictors
are entered into an equation devised by the authors to
determine the probability of reading problems in Grade 2.
With a cut off score of 0.30, the specificity level (accuracy at
identifying normal readers as such) was high at 91.1%, the
sensitivity level (accuracy at identifying problem readers as
such) was moderate at 73.5% and the percentage of false
negatives was 4.9%.
In the study conducted by Menyuk and her colleagues
(1991), the seven battery measures of which RAN colours,
numbers, letters and objects were a part, identified only
21.7% of the poor readers as poor readers. The combination
of 17 intake and battery measures identified only 45.7% of
the poor readers as poor readers. Given the methodological
concerns previously discussed regarding the study conducted
by Menyuk and her colleagues, it can be argued that more
weight should be given to the results of the other two studies.
It appears reasonable to include RAN letters and animals as
predictors of reader group membership.
Expressive Language
Expressive language has not been studied extensively as
a predictor of reading ability, with only 5 out of the 13 studies
reviewed including measures of this (Bishop & Adams, 1990;
Catts, 1993; Catts et al., 1999; Menyuk et al., 1991; Snow et
al., 1993). The expressive language measures found to predict
lower level reading skills in these studies were mean length of
utterance (MLU), a cloze task, formal definitions,
superordinates, narrative production, and standardized
measures of expressive language. The measures that predicted
reading comprehension included formal definition, narrative
ability, and standardized measures.
MLU, measure of syntactic skill, was found to predict
reading accuracy and nonword reading at age 8 when
measures were taken at 4 ½ and 5 ½ years of age (Bishop &
Adams, 1990). MLU accounted for 43% to 48% of the
variance. Granted that because this study is the only one to
include MLU, the strength of MLU in predicting lower level
reading in this study warrants further investigation. If the
findings of Bishop and Adams are replicated, it would
warrant the use of this measure in practice. MLU is a
measure of linguistic productivity that predicts syntactic
development in young, typically-developing children.
Thus it represents an aspect of language distinct from
phonological awareness measures. One advantage of
using MLU in practice is its ease of use. Further, this study
measured MLU in preschool. The validation of MLU as a
32
predictor would enable clinicians to use this measure with
confidence to determine if preschoolers were to encounter
later reading problems. The earlier a child is recognized to
have future reading difficulties, the earlier intervention can
begin.
A cloze task, designed to measure syntactic skills, was
found to predict word identification and comprehension
composite scores using the GORT, accounting for 31% of the
variance. It was also found to predict lower level reading
behaviors measured with the WRAT-R, accounting for 34%
of the variance (Menyuk et al., 1991). The authors did not
specify if other subtests of the WRAT-R were used. It is
difficult to determine exactly which aspect of reading
their cloze task predicts when the WRAT-R and the GORT
are used.
The results of this study need to be interpreted with
caution. First, the scores from kindergarten, Grade 1, and
Grade 2 participants were grouped together. It is possible
that kindergarten children may not yet have learned decoding
skills. Second, this study is the only one that used a cloze task.
Other concerns discussed previously were sample size and no
indication of controlling for potentially confounding
variables. However, if the usefulness of the cloze task as a
predictor is replicated in subsequent studies, clinical practice
would benefit with the inclusion of a cloze task in assessment
materials.
Snow, Tabors, Nicholson, and Kurland (1995)
investigated how print knowledge, metalinguistic awareness,
and oral language skills relate to each other and how these
skills relate to later literacy achievement, lower level reading
ability, comprehension, and spelling abilities. The authors
found that narrative production was strongly related to the
WRAT-R score, but not to the GORT score; in both of these
composite scores, lower and higher reading skills are
combined.
Two semantic language tasks, one requiring the child to
provide a formal definition of an item and another requiring
the child to supply a superordinate, were found to be
correlated to the WRAT-R and the GORT (Snow et al.,
1995). These results need to be interpreted carefully as the
WRAT-R and the GORT measure a range of reading skills.
Bishop and Adams (1990) used the Bus Story (Renfrew,
1995) among other variables to predict reading
comprehension using the Neale Analysis of Reading Ability.
Using multiple regression analysis, narrative production at
age 4 ½ was found to predict reading comprehension at age
8, accounting for 57% of the variance. This finding suggests
that narrative production may be useful for predicting
higher level reading abilities, if confirmed with additional
research. The authors describe the Bus Story measure to be
a measure of the ability to express semantic relationships.
However, the explanation for its predictiveness may lie in the
fact that it is a narrative measure, and as such taps the ability
to use a number of language skills (syntax, semantics, and
pragmatics) to convey a story to a listener. Narratives have
been described as a bridge between oral and written language,
and knowledge of story schemas is believed to be important
for reading comprehension (Westby, 2005).
Catts (1993) found expressive language skills measured
by the Expressive One-Word Picture Vocabulary Test
(Gardner, 1979), the Structured Photographic Expressive
Language Test-II (SPELT-II) (Werner & Kresheck, 1983),
and the sentence imitation and grammatical closure subtests
of the Test of Language Development (TOLD-2) (Newcomer
& Hammill, 1988) to predict word attack and word
identification abilities in Grade 1 (24% and 14% respectively)
and in Grade 2 (17% and 15% respectively) when entered
first in the multiple regression. However, phonological
awareness skills and RAN tasks accounted for more variance
for both grades when entered into the regression analysis
before the expressive language measures. Catts et al. (1999)
combined expressive and receptive language skills to predict
word recognition abilities (word identification and word
attack) in Grade 2. These results are consistent with Catts’
1993 study, but phonological awareness and expressive and
receptive language accounted for a large and similar amount
of variance when entered first in the 1999 study. Perhaps
when expressive language is combined with receptive language
skills to include a larger language skill base, they contributed
as much to prediction of word recognition as phonological
awareness. Although expressive language measures were
found to predict lower level reading, other measures such as
phonological awareness and RAN have been investigated
much more often.
The results predicting reading comprehension from
expressive language abilities are inconsistent among the
three studies that included this measure. It is important to
remember that expressive language is a broad construct and
was measured differently across studies. In one study (Menyuk
et al., 1991), scores from expressive language tests did not
predict reading comprehension when scores from
kindergarten, Grade 1, and Grade 2 were combined.
However, the cloze task did predict reading comprehension
in this study. In two other studies, expressive language (Catts,
1993) and expressive language combined with other oral
language measures (Catts et al., 1999) predicted Grade 2
reading comprehension (33% and 56% respectively). In the
latter two studies, the language measures contributed as
much or more to Grade 2 reading comprehension than the
phonological awareness and RAN tasks. The study conducted
by Menyuk and her colleagues may have different results
because the comprehension scores were reported on one
group of students from a variety of grades, most of whom
probably had not developed enough reading comprehension
for the relationship to have developed yet. At present, with
the available research, expressive language measures collected
in kindergarten appear to predict reading comprehension in
Grade 2.
Two studies included expressive language measures when
predicting reader group membership (Catts et al., 2001;
Menyuk et al., 1991). Menyuk and her colleagues included
expressive language scores along with receptive language
measures, an articulation measure, a verbal fluency measure,
and an auditory discrimination measure. These measures
correctly classified only 6.5% of the poor readers. When
Menyuk and her colleagues combined all the predictor
variables, they classified 46% of the poor readers. In the study
conducted by Catts and his colleagues, expressive and
receptive language skills were combined. This composite
score was not a significant variable in predicting readergroup membership. The low classification rates in one study
and the finding that expressive language scores are not
significant predictors in another study suggest that expressive
language scores are not an ideal predictor of reader-group
membership, at least in the lower grades.
Additional research is needed in the area of expressive
language. Although a variety of expressive language skills
have been studied, many have not been studied extensively.
It would be beneficial to continue to use a range of expressive
language subskills and analyze them separately and together.
Further research is warranted in predicting reader-group
membership since some expressive language skills have been
shown to predict individual scores but not group
membership.
Receptive Language
Like expressive language abilities, receptive language
abilities have not been studied extensively in predicting
reading achievement. Six of the studies reviewed included
this independent variable (Bishop & Adams, 1990; Catts,
1993; Catts et al., 1999; McCormick, 1994; Menyuk et al.,
1991; Snow et al., 1995).
The results of the studies suggest that receptive
language abilities are not the strongest predictors of lower
level reading skills. Receptive vocabulary skills, measured
using the Peabody Picture Vocabulary Test-Revised (PPVTR) (Dunn & Dunn, 1981) or the British Picture Vocabulary
Scale (BPVS) (Dunn, Dunn, Whetton, & Pintilie, 1982),
either did not predict lower level skills (Bishop & Adams,
1990; Catts, 1993; McCormick et al., 1994; Menyuk, 1991) or
accounted for little variance (10%) (Catts, 1993). PPVT-R
was entered into the regression analysis with the Token Test
for Children and the Test of Language Development – 2
(TOLD-2). There is one exception to this finding. Snow et al.
(1995) found the PPVT-R to have a strong correlation with
word identification (.44) and a strong correlation to scores
on the Gray Oral Reading Test – Revised (GORT-R) (.48), a
test that measures both lower level and comprehension
abilities. It is difficult to compare this result to others
because it is a bivariate correlation; studies in which the
PPVT-R was used in multiple regressions may not have found
it to be a predictor because the variance was better accounted
for by other variables in the regression.
The Token Test for Children, a measure of receptive
language, was found to predict lower level reading (Catts,
1993; Menyuk et al., 1991). This test accounted for 25% of
the variance in the study conducted by Menyuk and her
colleagues. However, there were concerns regarding the
methodology used by Menyuk and her colleagues as
discussed earlier. Further, Catts entered the Token Test for
Children into the multiple regression with the scores from
the PPVT-R and TOLD-2; the results indicated that receptive
language accounted for only a small amount of variance
(10%) or was insignificant in some cases. Given these factors,
33
the Token Test for Children cannot be considered a reliable
predictor of lower level reading achievement.
The TOLD-2 was used in two studies with inconsistent
results. First, Catts (1993) entered the Grammatical
Understanding subtest of the TOLD-2 into a multiple
regression with the Token Test for Children and the PPVTR, and they accounted for no or little variance (10% to 17%).
However, lower level reading was predicted when the TOLD2 was entered with the other receptive language scores as well
as the expressive language scores (Catts et al., 1999). It is
difficult to determine which area of language, receptive or
expressive, is accounting for the prediction. It is possible that
expressive language accounts for more of the prediction
capabilities when receptive and expressive language scores
are combined. Bishop and Adams (1990) found the Test for
Reception of Grammar (TROG) (Bishop, 1989), a British
test of receptive syntax, to predict reading accuracy,
accounting for 52% of the variance at age 4 ½ and 51% at age
5 ½. Given the mixed results involving the TOLD-2 and the
TROG, further investigation of receptive syntax would be
beneficial. The above results indicate that syntactic measures
of receptive language may be stronger predictors of lower
level reading skills than semantic measures alone or as
syntactic and semantic measures combined.
Receptive language scores have been found to predict
reading comprehension. Bishop and Adams (1990)
determined that the TROG and the BPVS predicted reading
comprehension at age 5 ½. The TROG accounted for 63% of
the variance and the BPVS accounted for 57% of the variance.
Catts (1993) determined that the PPVT-R, the Token Test for
Children, and the TOLD-2, when entered together, predicted
reading comprehension. These three tests accounted for 6%
to 35% of the variance. Menyuk and her colleagues (1991)
also determined that the Token Test for Children predicted
comprehension, accounting for 10% of the variance. The
Screening Test of Auditory Comprehension of Language
(TACL) (Carrow, 1973) and the PPVT-R did not account for
any variance, although the methodology concerns in Menyuk
et al. make the results less reliable. Snow and her colleagues
(1995) found PPVT-R scores to be strongly related to lower
level and comprehension abilities measured by the GORT-R.
However, in McCormick et al. (1994), PPVT-R failed to
predict reading comprehension. There were two concerns
with this study. First, the reading measure, the Iowa Test of
Basic Skills, combines decoding and comprehension abilities
as one score. When the two skills are combined, one cannot
determine which oral language skills predict lower level
reading and which oral language skills predict higher level
reading. Second, the study may have lacked sufficient power
given the number of variables entered into the regression
analysis relative to the number of subjects. Given the results
from Bishop and Adams (1990) and Catts (1993), receptive
language tests that measure semantic and syntactic skills do
appear to predict reading comprehension.
Three studies included receptive language as possible
predictors of reader-group membership. Two of these
studies, Menyuk et al. (1990) and Catts et al., (2001), were
discussed earlier. One study (Menyuk et al., 1990) found that
34
receptive language, when combined with the other measures
used in the study, had low group prediction abilities. The
other study (Catts et al., 2001) did not find receptive language
scores, when combined with expressive language scores, to be
a significant predictor of group membership. The third study
(Hurford et al., 1994) included PPVT-R scores with other
scores (phonological discrimination task and phonemic
segmentation task) and had high group membership
classification with only 2% being misclassified. However, the
authors defined the reading disabled group as having weak
reading abilities and typical receptive vocabulary abilities.
This definition assumes that reading disabled children have
normal language abilities. In contrast, many authors hold
that most reading disabled children have accompanying
language problems (Catts, 1997).
As with expressive language scores, receptive language
scores may not be ideal for predicting group membership.
Given the limited scope of research in this area, more research
is needed. In particular, it is important to consider expressive
and receptive language skills separately in order to determine
whether they each are predictive of reading skills or only
predict when both are considered.
Conclusions
The research results from these studies indicate that
some oral language measures predict lower level and higher
level reading achievement as well as reader-group
membership. Although standardized measures of expressive
language account for some variance in lower level reading,
other measures, phonological awareness and RAN, account
for more. Standardized measures of expressive and receptive
language are better than phonological awareness skills and
RAN tasks when predicting reading comprehension in
Grade 2. They seem to be more suited for predicting reading
comprehension than for predicting lower level reading skills.
RAN tasks predict lower level reading and reader-group
membership. RAN also contributes to the prediction of
reading comprehension, although it does not account for as
much variance as other measures. Results of the studies
indicate that syllable and phoneme deletion together,
phoneme deletion alone, and syllable and phoneme deletion
and blending all predict lower level reading achievement.
Syllable and phoneme deletion together predict reading
comprehension. Finally, rhyme detection and syllable and
phoneme deletion predict reader-group membership.
From the research results, one can start to create a
battery of tests that predict reading. Measures that predict
lower and higher level reading should be included in the
battery as lower level reading skills are the foundation to
reading and higher level reading enables one to understand
sentences and paragraphs. Ideally the smallest number of
tests should be used to maximize efficiency. Syllable and
phoneme deletion and RAN could be included in a battery to
predict lower level reading abilities. To predict higher level
reading skills, the TOLD-2: P and a narration task, such as the
Bus Story, could be included in the battery.
Some measures require further research before making
firm conclusions. More research is needed regarding MLU,
cloze tasks, formal definition, and superordinates in relation
to lower level reading. In addition, receptive language results
are inconclusive for lower level reading because of
inconsistencies among studies. Additional research is needed
to determine the predictive nature of syllable and phoneme
segmenting, rhyme detection, and consonant identification
for reading comprehension. As well, more research is needed
to determine whether or not syllable segmenting can be used
to predict reader-group membership.
When designing future research studies, there are some
suggestions to keep in mind. First, the use of regression
analysis enables the identification of the relative predictive
value of a predictor variable. Second, it may be helpful to
enter oral language measures independently into a
regression analysis rather than grouping them into broad
categories such as receptive language or expressive language.
This would allow one to determine the specific measures that
enable one to predict. Third, it is important to distinguish
between lower level reading and higher level reading measures
as a criterion variable. Fourth, it is important to include an
adequate number of participants in the study. We recommend
that the number of participants be at least 5 or 10 times the
number of variables entered in the regression analysis. It is
also important to control for nonverbal abilities when
entering variables into the regression analysis to help ensure
that the variance accounted for can be attributed to oral
language skills and not nonverbal abilities.
The conclusions made regarding the variables that predict
reading achievement are based on those measures and tasks
used in the studies reviewed here. Other measures such as
memory, cognition, parent/child interactions, and mother’s
education level may also be useful in predicting reading
achievement.
Clinical Application
Research to date has provided insight on predicting
reading problems from oral language skills and will help
guide future research. S-LPs, who have an expertise in the
area of language, will assess preschoolers’ language skills and
thus can have an important role in helping to identify children
who would be at risk for later reading problems in school.
The research results suggest possible measures that can
help determine whether or not a young child would be at risk
for future reading problems. Phonological measures, such as
syllable and phoneme deletion and syllable and phoneme
blending, as well as RAN measures predict lower level reading
skills. Further, standard measures of expressive and receptive
language predict reading comprehension abilities. It is
important to remember that a child’s score that is within
normal limits on language tests does not guarantee that the
child will not have future reading difficulties.
Once these measures are collected, the information needs
to be utilized to benefit the child. There are a few available
options. First, the child could receive early intervention
regarding language skills from an S-LP to help eliminate or
reduce future reading difficulties. This may be challenging
given the large caseloads of S-LPs. However, it need not
involve additional therapy — the S-LP can choose to work
on language goals that will benefit both oral and written
language. As well, suggestions can be made to classroom
teachers about activities from which all students can benefit.
Specific phonological awareness activities can be
incorporated into speech and language therapy. Rhyme
awareness is a beginning form of phonological awareness
because it involves an ability to analyze words at the level of
the onset and rime. When treating phonological processes
minimal pairs and nonsense words can be used. Children’s
books written using rhymes can be utilized in therapy. The
concept of segmentation can be incorporated into therapy
by the careful selection of words. For example, compound
words and their parts can be used to indirectly demonstrate
syllable deletion (e.g. ‘cowboy’, ‘cow’, and ‘boy’). The work
that S-LPs do to improve oral language skills contributes to
children’s reading comprehension abilities.
A second way to utilize the information to benefit the
child is to inform the child’s parents or caregivers about how
early oral language difficulties can impact later reading skills.
With this information, parents or caregivers, with the support
of an S-LP, may be able to implement a home program to
benefit the child. As well, parents or caregivers can help to
transfer the information to the school when the child enters
kindergarten.
Third, it is important to increase the awareness of S-LPs
and other professionals, such as teachers, regarding the
relationship of oral language skills and reading abilities. This
will enable professionals who did not work with the child in
preschool to apply the knowledge of oral language measures
to the acquisition of reading in school. In addition, shared
knowledge about this topic among those involved with the
child will increase the child’s support system. The current
research, combined with future investigations regarding the
predictive nature of oral language skills, will assist in the early
identification of children who are at risk for reading difficulties.
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Acknowledgements
We would like to extend our thanks to Bonnie Dobbs,
professor and colleague, for assisting with statistical
analysis, as well as the Editor at the time, Phil Doyle, and
reviewers of JSLPA for guidance during the editorial
process.
Author note
addressed to Elizabeth Ekins, Rehabilitation Services,
Royal Inland Hospital, 311 Columbia Street, Kamloops,
BC V2C 2T1, [email protected]
Received: November 20, 2003
Accepted: April 25, 2005
APPENDIX A
Oral Language and Reading Measures
The standardized and nonstandardized tests are described as they are in the articles, with a description of either the task or
the skills that the task measures. In some cases, such as with a rhyme task, authors used variations to a similar task.
Phonological Aw areness-Standardiz ed Tests
Lindamood Auditory Conceptualization Test
(Lindamood & Lindamood, 1979)
The child manipulates different coloured blocks to indicate
conceptualization of the speech sound patterns presented by the
examiner
Phonological Aw areness-Nonstandardiz ed Tests
Initial Consonant Not Same (Felton & Brown, 1990)
Four words are spoken by the examiner and the child chooses the
word that does not begin with the same sound as the first word in the
list
Final Consonant Different (Felton & Brown, 1990)
Four words are spoken by examiner and child chooses the word that
has a different ending sound from the other words
Rhyme (Felton & Brown, 1990)
The child names as many words as he can that rhyme with a given
word
Rhyme production (O'Connor & Jenkins, 1990)
The child is required to provide a rhyme to a given word
Rhyme detection (Muter & Snowling, 1998; Badian,
2001)
Given the pictures of three words, the child had to indicate which of
the three words, supplied by the examiner, rhymed with the target
word. All words were depicted by a drawing, the examiner supplying
the names of all four words in each item
Syllable Counting Test (Felton & Brown, 1990)
The examiner pronounces 1,2 or 3 syllable words and the child uses
a wooden dowel to tap out the number of syllables heard
Word String Memory Test (Felton & Brown, 1990)
The child repeats a string of four words after the examiner. Four
strings are composed of rhyming words and four strings are not.
Researchers consider this phonetic recoding in working memory
Deletion task -- syllable (Catts, 1993; Catts et al.,
1999 & 2001; Manis et al., 1999; O'Connor &
Jenkins, 1999)
Requires the child to delete a syllable from a compound word or a
two-syllable word and say the remaining sound sequence
Deletion task -- initial phoneme (Muter & Snowling,
1998)
Requires the child to delete the initial phoneme from a word and say
the remaining sound sequence
Deletion task -- phoneme (Catts, 1993; Catts et al.,
1999 & 2001; Manis et al., 1999)
Requires the child to delete a phoneme from a word and say the
remaining sound sequence
Blending task -- syllable (Catts, 1993; O'Connor &
Jenkins, 1999)
Requires the child to blend together and pronounce syllables
Blending task -- phoneme (Catts, 1993; O'Connor &
Jenkins, 1999)
Requires the child to blend together and pronounce
phonemes
Segmenting -- syllable (Menyuk et al., 1991; Badian,
2001)
Requires the child to say the word broken into syllables. Another
version requires the child to tap the number of syllables in a given
word
Segmenting -- phonemes (Menyuk et al., 1991;
O'Connor & Jenkins, 1999)
Requires the child to segment monosyllabic words
Consonant identification task (McCormick et al.,
1994)
The child names the letter for the beginning sound of a
spoken word
Phonological discrimination task (Hurford et al., 1994) Requires the child to compare a standard pair of syllables to a
comparison pair separated by 1,000 ms. Each syllable within a pair
is separated by intersyllable intervals of 10, 80 or 160 ms (e.g.
/gi/10ms/gi/1,000ms/di/10ms/gi/)
37
APPENDIX A
Oral Language and Reading Measures (continued)
Phonemic segmentation task (O'Connor & Jenkins,
1999)
The child repeats a CVC word or pseudoword after the examiner and
then pronounces the word again without the designated consonant
(initial or final)
Non-word repetition test (Muter & Snowling, 1998)
The child repeats 40 nonwords of between one and four syllables in
length
Sound repetition (O'Connor & Jenkins, 1999)
The child repeats isolated phonemes separated with a 0.5 second
pause
Rapid letter naming (O'Connor & Jenkins, 1999)
The child is presented with a card of 60 randomly ordered letters in
large uppercase type and is asked to name as many letters as he
can in 1 minute
First-sound isolation (O'Connor & Jenkins, 1999)
Requires the child to say the first sound of an orally given word (i.e.
"Tell me the first sound of _____.")
Rapid Automatiz ed Reading (RAN)
RAN requires the child to name representations of familiar items, such as common objects, colours, letters, numbers, or
animals, presented in a series as rapidly as possible. This is a timed test and a lower score is more desirable. The items
are displayed in an array and are named from left to right, row by row. The child demonstrates the ability to name each item
in isolation before beginning.
Expressive language- Standardiz ed Tests
Bus Story Test- Information Score
Standardized story retell test- the child retells a story while looking at
a picture book; the amount of information recalled is totalled
Expressive One-Word Picture Vocabulary Test
Measures expressive vocabulary of single words
Structured Photographic Expressive Language Test- II Declarative, interrogative, negative and embedded sentences are
tested
(SPELT-II)
Test of Language Development-2:Primary (TOLD-2:P) Sentence Imitation, Grammatical Completion, and Oral Vocabulary
(Newcomer & Hammill, 1988)
subtests
38
Boston Naming Test (Kaplan, Goodglass, &
Weintraub, 1982)
Confrontation naming task; the child names line drawings
Illinois Test of Psycholinguistic Ability (ITPA) (Kirk,
McCarthy, & Kirk, 1968) grammatical closure subtest
Screens the expression of syntactic class relations and
morphological markers
Development Sentence Scoring Procedures (DSS)
(Lee, 1974)
Measures syntactic structures in spontaneous speech
Reporters Test (DeRenzi & Ferrari, 1978)
Measures expression of semantic relations in utterances
Goldman-Fristoe Test of Articulation
(Goldman & Fristoe, 1986)
Assesses the child's phonological skills
Templin-Darley Articulation Screening Test
(Templin & Darley, 1969)
Assesses the child's phonological skills
McCarthy Scales of Children's Abilities --verbal
fluency subtest (McCarthy, 1970)
The child is asked to name as many articles in a given category as
possible within 20 seconds
APPENDIX A
Expressive Language- Nonstandardiz ed Tests
Mean Length of Utterance (MLU) (Bishop & Adams,
1990)
The number of morphemes are calculated in relation to the number of
utterances spoken by the child to measure syntactic development
Expressive phonology (Bishop & Adams, 1990)
Measured by the percentage of consonants correct in a picture
naming task
Cloze (Menyuk et al, 1991)
The child is required to provide a word that has been left out of a
sentence
Story recall (Menyuk et al., 1991)
The child listens to a story over headphones and retells the story to a
puppet
Sementactic judgement (Menyuk et al., 1991)
The child is required to determine if a sentence is grammatically
correct. If it is not, the child needs to correct the sentence
Word recall (Menyuk et al., 1991)
The child learns the names of pictures and then is required to tell the
items back to the examiner without the use of the pictures
Narrative production (Snow et al., 1995)
The child tells a story based on three slides
Picture description (Snow et al., 1995)
Requires the child to describe a picture as completely as possible
Definitions (Snow et al., 1995)
The child defines 14 familiar nouns (e.g. bird, alphabet)
Narrative story task (Catts et al., 1999 & 2001)
Assesses child's abilities to comprehend, organize, and retell the
major details of a story read aloud by the examiner
Receptive Language- Standardiz edTests
British Picture Vocabulary Scale (Dunn, Dunn,
Whetton, & Pintilie, 1982)
A British version of the Peabody Picture Vocabulary Test - Revised
Child selects from an array of pictures that match the word spoken
by examiner
Test for Reception of Grammar (TROG) (Bishop,
1989)
The child selects from an array of pictures that match the phrase or
sentences spoken by examiner
British Abilities Scales (BAS) (Elliot, Murray, &
Pearson, 1978)
Verbal comprehension subtest- a general measure of the ability to
carry out instructions
Naming vocabulary subtest - confrontation naming task
Peabody Picture Vocabulary Test-Revised (PPVT-R)
(Dunn & Dunn, 1981)
The child selects from four pictures the one that best represents a
word read by the examiner
Token Test for Children (DiSimoni, 1978)
Measures semantic comprehension in sentences
Test of Language Development-2:Primary (TOLD-2)
(Newcomer & Hammill, 1988)
Grammatical understanding, picture vocabulary subtests auditory
discrimination subtest
Metropolitan Readiness Test-Level II, Form P (Nurss
& McGauvran, 1976)
Orally administered readiness test requiring the child to mark
responses in a test booklet. Three components were 1) Auditorydiscrimination of initial sounds and sound-symbol association, 2)
visual discrimination among visual symbols and separation of visual
patterns from context, 3) language- cognitive concepts, grammatical
structures of standard English, and listening skills
Screening Test of Auditory Comprehension of
Language (TACL) (Carrow, 1973)
Screens comprehension of syntactic classes and relations and
morphological classes and relations
Clinical Evaluation of Language FundamentalsRevised (CELF-R) (Semel, Wiig, & Secord, 1987)
Listening to Paragraphs subtest
Receptive Language- Nonstandardiz ed Tests
Story comprehension task (Snow et al., 1995)
Comprehension questions are asked while a story is read aloud
Comprehension of complex sentences (Menyuk et al.,
1991)
The child is asked a question about what happened in a complex
sentence.
39
APPENDIX A
Low er Level Reading- Standardiz ed Tests
Neale Analysis of Reading Ability, form C
As the child reads stories a loud, errors in reading words are scored
Woodcock Reading Mastery Test - form A (WRMT-R)
Word Identification subtest- untimed reading of a list of sight words
Word Attack subtest- untimed reading of a list of pseudo-words
Gray Oral Reading Test - Revised (GORT-R)
(Wiederhold, & Bryant, 1986)
Measures ability to read passages with speed and accuracy,
assesses oral reading comprehension, and provides a total measure
of reading performance
Iowa Tests of Basic Skills, Early Primary Battery,
Level 6 (Hieronymus, Hoover, & Lindquist, 1986)
Measures the child's ability to read words in isolation and to use
context and picture cues for word identification. The children were
also asked sentence and story comprehension questions.
Wide Range Achievement Test- Revised (WRAT-R)
(Jastak & Jastak, 1976)
Sight word recognition subtest
Graded Nonword Reading Test (Muter & Snowling,
1998)
The child is required to read 20 nonwords, 10 one-syllable words
and 10 two-syllable words
Stanford Achievement Test, 8th Edition (SAT)
(Psychological Corporation, 1992)
Word reading subtest- The child reads several words and decides
which word tells about a picture
Word study skills subtest- Measures phonological awareness and
knowledge of grapheme-phoneme relationships
Low er Level Reading - Nonstandardiz ed Test
Reading of non-words (Bishop & Adams, 1990)
The child reads a list of non-words (e.g. bab, wob, zok)
Exception-word reading task (Manis et al., 1999)
The child reads a list of 70 exception words until six errors in a row
are made
Higher Level Reading Tests- Standardiz ed
Neale Analysis of Reading Ability, form C (Neale,
1966)
Comprehension questions are asked after the child has read a short
p a ssa g e
Gray Oral Reading Test- Revised (GORT-R)
(Wiederhold, & Bryant, 1986)
Comprehension subtest- the child reads a passage and answers
multiple choice questions
Iowa Tests of Basic Skills, Early Primary Battery,
Level 6 (Hieronymus, Hoover, & Lindquist, 1986)
Measures the child's ability to read words in isolation and to use
context and picture cues for word identification. The children were
also asked sentence and story comprehension questions
Woodcock Reading Mastery Test- form A (WRMT-R)
Passage comprehension subtest
Diagnostic Achievement Battery- 2 (DAB)
(Newcomer, 1990)
Reading Comprehension subtest- open-ended questions are asked
Silveroli Classroom Reading Inventory- Graded Oral
Paragraphs (Silveroli, 1984)
The child reads paragraphs aloud with reading mistakes noted. The
child is then asked to answer five questions without looking back at
the paragraph
Stanford Achievement Test, 8th Edition (SAT)
(Psychological Corporation, 1992)
Reading vocabulary subtest- The child reads a list of words and
decides which one of them means the same as an underlined word
Reading comprehension subtest- the grade 1 edition measures
understanding of simple written sentences and short passages; the
grade 3 and grade 7 edition measures the ability to read passages
and to answer multiple-choice questions about them
40
APPENDIX A
Higher level Reading Tests - Standardiz ed (continued)
Test of Reading Comprehension (TORC) (Brown,
Hammill, & Weiderholt, 1978)
Silent reading of passages (no further information available)
Some studies included tests that were not oral language measures. These tests are described below.
Standardiz ed Tests
Developmental Test of Visual-Motor Integration
(Beery, 1982)
The child copies geometric forms of increasing complexity
Early Childhood Diagnostic Instrument: The
Comprehensive Assessment Program (Mason &
Stewart, 1989)
The 5 subtests used include environmental print in and out of context,
story and print concepts, upper and lower case letter naming,
beginning and ending word sound awareness and writing
Verbal Memory (Weschler Preschool and Primary
Scale of Intelligence Sentences; Weschler, 1967)
The child repeated sentences gradually increasing in length
Nonstandardiz ed Tests
Alphabet Recitation Test (Felton & Brown, 1990)
The child says the alphabet
Finger Localization Test (Felton & Brown, 1990)
With the child's hands under a cover, the examiner touches fingers
one at a time in a random order and the child identifies which finger
was touched by indicating it on a drawing
Uppercase and lowercase letter identification
(McCormick et al., 1994)
First 26 uppercase and then the 26 lower case letters were
presented in mixed order and the child was asked to give orally the
name for each letter
Letter name knowledge (Muter & Snowling, 1998)
Child is required to give the name of each letter in the alphabet
presented in random order and written in lower case
Short-vowel identification test (McCormick et al.,
1994)
12 objects were pictured with three words printed under each and the
child circled the correct word
Spelling test (Snow et al., 1995)
The child is required to spell eight words
Preschool Reading Achievement (PRA)
Parents were asked whether their child could read not at all, a few
words, many words, or books
Orthographic processing (Badian, 2001)
The child points to the one of four stimuli (numbers, letters, and
words) that exactly matches the item at the left of the row
41
APPENDIX B. Descriptions of the studies review ed.
Bishop and Adams (1990)
D e si g n
Longitudinal; multiple regression and step-wise multiple regression
analyses
Participants
83 children whose language development had been impaired at 4
years of age; oral language measures were assessed at ages 4 ½
and 5 ½ and reading abilities assessed at 8 ½
Oral Language measures
Expressive phonology, MLU, Bus Story Test, BPVS, TROG, and BAS
verbal comprehension and expressive vocabulary subtests
Lower level reading measures
Reading of non-words and the Neale Analysis of Reading Abilityform C
Higher level reading measures
Analysis of Reading Ability- form C
Felton and Brown (1990)
D e si g n
Longitudinal; multiple regression analyses
Participants
81 children at risk for reading disabilities, 12 repeating kindergarten;
oral language skills were assessed in kindergarten and lower level
reading was assessed in Grade 1
Measures entered into the regression analyses: RAN of numbers and
letters (combined score), Initial Consonant Not Same, Rhyme,
Lindamood Auditory Conceptualization Test, Syllable Counting Test,
Metropolitan Readiness Test auditory component, and Otis-Lennon
Mental Ability Test
Measures not entered into the regression analyses: Final Consonant
Different, RAN of colours and objects, Metropolitan Readiness Test
visual component and language component, Boston Naming Test,
Word String Memory Test, Alphabet Recitation Test, and Finger
Localization Test
WRMT- form A (word identification and word attack subtests)
N/A
Menyuk, Chesnick, Liebergott, Korngold, D'Agostino, and Belanger (1991)
42
D e si g n
Longitudinal; step-wise regression analyses
Participants
130 children between the ages of 4 ½ and 6 ½ were followed for 3
years; the participants were divided into three groups: 1. Children
with specific language impairment (SLI) as determined by
standardized tests, 2. at-risk children who had previously been seen
for speech and language evaluation, but did not meet the criteria for
SLI, and 3. Children who had been born premature weighing less
than 1500 grams at birth.
Token Test for Children, TACL, PPVT-R, DSS, Reporters Test, ITPA
grammatical closure subtest, Expressive One Word Vocabulary Test,
McCarthy Scales of Children's Ability Verbal Fluency subtest,
Templin-Darley Articulation Screening Test, TOLD-P auditory
discrimination subtest, syllable awareness (syllable segmentation
task), phoneme awareness (phoneme segmentation task), word
recall, RAN of colours, numbers, letters, and objects, semantactic
judgement, cloze, story recall, comprehension of complex sentences.
sight word recognition subtest of the WRAT and oral reading subtest
of the GORT
silent reading passages from the TORC
APPENDIX B. Descriptions of the studies review ed (continued)
Catts 1993
D e si g n
Longitudinal; hierarchical fixed-order regression analyses
Participants
86 children- 56 speech language impaired and 30 with normal
speech-language abilities; oral language measures were first tested
in kindergarten and reading abilities were tested in Grade 1 and
Grade 2
Oral language measures
PPVT-R, Token Test for Children, TOLD-2: P (grammatical
understanding, sentence imitation and grammatical closure subtests),
Expressive One-Word Picture Vocabulary Test, SPELT- II, RAN of
colours, objects, and animals, syllable deletion, phoneme deletion,
syllable blending, phoneme blending, and Goldman-Fristoe Test of
Articulation (not entered into regression analysis)
WRMT- form A (word identification and word attack subtests),
GORT-R
GORT-R
McCormick, Stoner, and Duncan (1994)
D e si g n
Longitudinal; multiple regression analyses
Participants
38 children of middle socioeconomic whose oral language skills
were assessed in kindergarten and whose reading skills were
assessed in Grade 1
PPVT-R, consonant identification task
Iowa Tests of Basic Skills, Early Primary Battery, Level 6
Iowa Tests of Basic Skills, Early Primary Battery, Level 6
Other measures
The following predictor variables were used, but are not discussed in
this manuscript as they extend beyond oral language skillsDevelopmental Test of Visual-Motor Integration, uppercase and
lowercase letter identification, short-vowel identification test
Hurford, Schauf, Bunce, Blaich, and Moore (1994)
D e si g n
Longitudinal; discriminant analysis
Participants
171 students followed from beginning of Grade 1 to the end of
Grade 2. All language measures were administered four times over
the two years to determine if they could predict reader-group
membership.
phonological discrimination task, phonemic segmentation of initial
and final consonants of real words and pseudowords, PPVT-R
WRMT-R (word identification and word attack subtests)
N/A
Snow, Tabors, Nicholson, and Kurland (1995)
D e si g n
Longitudinal; bivariate correlations
Participants
84 children from low socioeconomic families tested in kindergarten
and again in Grade 1.
PPVT- R, narrative production, picture description, definitions, story
comprehension task, superordinates (a subtest of CAP), CELF-R
(listening to paragraphs subtest)
WRAT-R reading subtest, GORT-R
GORT-R
43
Other measures
Subtests from the Early Childhood Diagnostic Instrument: The
Comprehensive Assessment Program (scores were tallied and used
as an emergent literacy score), spelling test
Muter and Snowling (1998)
D e si g n
Longitudinal; fixed-order multiple regression analyses; discriminant
analyses
Participants
34 children assessed at ages 4, 5, and 6 to determine if lower level
reading skills could be predicted at age 9
Rhyme detection, deletion task- initial phoneme, and nonword
repetition task
Neale Analysis of Reading Ability- Revised and Graded Nonword
Reading Test
N/A
Other measures
Letter name knowledge was also a predictor variable
O'Connor and Jenkins (1999)
D e si g n
Longitudinal; discriminant analyses
Participants
445 children followed from kindergarten to the end of Grade 1; three
cohorts- the first cohort was used to calibrate a model for predicting
reading acquisition problems. The second cohort was used to test
the reliability of the model and refine scoring criteria. Tests were
repeated on the third cohort.
PPVT-R, sound repetition, rapid letter naming, syllable blending,
syllable deletion, syllable segmenting, blending phonemes,
segmenting phonemes, first sound isolation, rhyme production
WRMT-R (vocabulary and comprehension subtests)
Manis, Seidenberg, and Doi (1999)
D e si g n
Longitudinal; hierarchical regression analyses
Participants
67 grade 1 children representing the full range of reading abilities
followed for one year until the end of Grade 2
RAN of letters and numbers, deletion- syllables, deletion- phonemes
(the two deletion tasks were combined into one score when entered
into the regression analysis)
WRMT-R (word identification and word attack subtests) and
Exception-word reading task
Silveroli Classroom Reading Inventory- Graded Oral Paragraphs
Catts, Fey, Zhang, and Tomblin (1999) and (2001)
44
D e si g n
Longitudinal; hierarchical regression analyses (1999);
stepwise logistic regression analyses (2001)
Participants
604 children were followed from kindergarten and reading was
assessed in Grade 2; 328 children had language impairments or
nonverbal impairments or both and 276 subjects were typically
developing children
deletion task (syllable and phoneme), RAN of animals, TOLD-2:P
(sentence imitation, grammatical completion, picture vocabulary, oral
vocabulary and grammatical understanding subtests), Narrative story
task
WRMT-R passage comprehension subtest, GORT-R comprehension
component, Diagnostic Achievement Battery reading comprehension
subtest
The authors used data from their 1999 study to predict the likelihood
a child in kindergarten will have reading difficulties in Grade 2.
Badian (2001)
D e si g n
Longitudinal; stepwise and hierarchical regression analyses
Participants
Oral language measures were assessed in kindergarten and reading
abilities were assessed in Grades 1, 3, and 7. Ninety-six children
participated in Grades kindergarten, 1 and 3. Seventy-nine
participants remained by Grade 7.
rhyme detection and syllable segmentation
Grade 1: SAT (word reading and word study skill subtests)
Grade 1: SAT (word reading and word study skill subtests)
Grade 3: SAT (vocabulary and comprehension subtests)
Grade 7: SAT (vocabulary and comprehension subtests)
Other measures
The following predictive measures were also included in the paper,
but are not the focus for this manuscript: parent questionnaire of the
amount of words the child could read, verbal IQ, verbal memory, and
orthographic processing; the authors also predicted spelling
(Grade 7 only)
45
Book Review / Évaluation de ressource écrit
Clinical Education in Speech-Language Pathology
Lindy McAllister & Michelle Lincoln (2004)
Publisher:
Whurr Publishers, London and
Philadelphia
Available from: The Guilford Press
Cost: $51.99
Reviewer: Jeanne Classen, M.A., Head of Clinical
Program
Affiliation: School of Communication Sciences and
Disorders, McGill University, Montreal, QC
This is an excellent resource for anyone involved in the
clinical education (supervision) of speech-language
pathology and audiology¹ students: novice or experienced
clinical educators (CEs) (supervisors); students at any
level in their clinical education; and university
coordinators of clinical education. Both authors are
faculty in Australian universities and have doctoral degrees
in speech-language pathology and extensive expertise in
clinical education. What makes the book both unique and
highly appealing is its focus on the voices of CEs and
students involved in the clinical education experience.
The first-hand accounts of CEs are drawn from
McAllister’s doctoral thesis study; the students are heard
through the master’s thesis work of one of her students
and from the clinical education experiences of both
authors. In the preface, the authors explain the central
theme of their book, namely “the personal and professional
growth that can be achieved by students and clinical
educators learning together”. The authors argue for “a
humanistic approach to clinical education which is
encapsulated in the learning relationships of CEs and
students”. The text throughout addresses all involved at
various levels of clinical practicum, from one end of the
spectrum to the other: from the “novice” student, to the
“intermediate”, to the “entry level” student; and from the
“beginner” CE, to the “advanced beginner” CE, to the
“competent” CE, to the “professional artist”. Some of the
authors’ objectives are: to provoke mutual reflection on
professional practice and personal development in
students and CEs; to provide practical principles and
strategies for everyday clinical education situations; and
to outline professional development from novice student
to professional artistry in the CE.
The book consists of eight chapters, each comprising
practical learning exercises, checklists, case studies and
vignettes, drawn from interviews with CEs and students.
Throughout, CEs and students alike are invited,
individually or together, to engage in personal reflection,
self-assessment, discussion, and problem solving
strategies. Chapter 1 explains how growth and
46
development for CEs and students can occur as parallel
processes. The underlying assumption is that CEs are not
only considered teachers but also life-long learners, and
both parties support each other’s learning. The chapter
sets out to ask a very basic question: What are the goals for
professional development in the clinical education process
for both the student and the CE (e.g., continuous
development of clinical knowledge and skills)? Next,
various models of clinical education are outlined that
offer opportunity for professional development for both
students and their CEs. The chapter concludes with a
description of the stages of professional development in
CEs and students. Chapter 2 outlines how the two parties
can prepare for the clinical education process. From the
CE’s perspective, advantages and disadvantages of taking
a student are considered (including motivational aspects
for accommodating a student, suitability of the site,
appropriate clientele). Students are given advice on how
to plan and prepare for a placement (e.g., considering
their motivations for accepting a placement; reviewing
the goals from the previous placement; studying the
orientation package before the next placement). Chapter
3 considers factors that contribute to the development of
learning relationships in clinical education. Apart from
the usefulness of the self-evaluation and learning exercises,
these exercises furnish experienced CEs with a fresh outlook
on the learning relationship. The authors further describe
some of the problems that may arise in the student-CE
relationship and offer suggestions regarding how these
can be dealt with. Chapter 4 provides in-depth discussion
of the stages of development of personal skills across the
spectrum, from the point of view of the novice CE, to the
(very) advanced CE. In parallel are described the stages
of development of personal skills in the novice student
clinician and the intermediate and the competent entry
level student. The chapter also deals with issues such as
using assertive communication, avoiding or managing
emotional labour, and preventing or dealing with burnout in clinical education. Chapter 5 discusses the
development of cognitive skills. It describes four areas of
cognitive skill, namely: 1) different types of knowledge
(theoretical, practical, personal, tacit); 2) different
approaches to reasoning; 3) clinical reasoning; and 4)
ethical reasoning. Of these, clinical reasoning may be of
particular interest to the reader, even if not involved in
clinical education. Our professions are introduced to the
relatively little known concept of clinical reasoning – in
contrast to many other rehab and medical professions
where this is a well established concept. The authors
advance that clinical reasoning is not much used in speechlanguage pathology due, in part, to the focus on problem
solving (i.e. outcome) rather than on the process of
thinking about problems. The vignettes and learning
exercises in this chapter illustrate with specific examples
how different types of reasoning can be engaged in and
how these skills can be applied in specific situations.
Chapter 6 describes the learning processes that can be
applied in clinical education. Reflection is considered an
important learning process for students and CEs alike, as
well as for clinicians not engaged in student training.
Students are encouraged and given suggestions on how to
reflect on activities, such as producing treatment plans,
report/note writing, journaling and supervision
conferencing. Clinicians are invited to reflect on areas
such as ethical dilemmas, case presentations and team
meetings. Chapter 7 discusses how learning can be assessed
in clinical settings and how learning can be facilitated
through assessment. Different types of assessment
terminology are described (e.g., formative versus
summative assessment). The importance of selfassessment for students and CEs and the need for each
party to assess the other are stressed. The final chapter
outlines a plan for ongoing skill development in clinical
education. It outlines the professional development for
all levels of CEs and students. Suggestions are given in
regard to the different responsibilities that can be
undertaken by CEs with different levels of expertise. For
example, more experienced CEs may mentor new
colleagues or try innovative clinical education models.
The authors further stress the need for raising the status
and recognition of CEs by their employers, universities
and professional associations. This is followed by a
number of strategies for dealing with this issue (e.g.,
provision of funding and resources, recognition of
excellence, putting in place creative placements that benefit
students and organizations). This chapter also discusses
the role and responsibilities of universities in preparing
students for clinical placements and providing training
and support for CEs.
The text devoted to the development of professional
and personal skills would be arguably somewhat lengthy
or redundant in places were it not for its original focus,
namely the first-hand accounts of CEs and students. This
allows the reader, whether a student or a CE, an
opportunity to become acquainted not only with his or
her own learning processes and some of the challenges
involved and strategies to deal with these, but also those
of the other party. With the book’s emphases on personal/
professional skill building on the one hand and
development of clinical reasoning skills on the other, one
clinical education model that could have comfortably
nestled inside this text is missing, in my opinion. I refer to
the “two-to-one supervision” model or “reciprocal peer
coaching” model where two students simultaneously
undertake a clinical practicum with one CE. The recent
clinical reasoning literature (which has emerged largely
from Australia) has reported on the enhanced learning
outcomes that may result when two students during a
two-to-one practicum have ongoing opportunity to
engage together in clinical reasoning, with or without the
presence of their CE. Employing such a clinical education
model may give a new impetus to the more experienced CE
or professional artist. The chapter on assessment (i.e.,
feedback in its many forms) is very informative, and
provides all levels of CEs with information for adopting
in their feedback and evaluation sessions with students.
Strategies are offered on how CEs can teach students to
self-assess, or what to do if the CE’s assessment of the
student does not match the student’s self-assessment.
Students are given tools for self-assessment, such as videotaping and journaling.
This book is highly recommended for speechlanguage pathologists and audiologists with or without
any background or experience in clinical education.
University coordinators of clinical education will find
this textbook a rich resource when preparing students for
clinical practicum and for developing workshops for CEs.
One of the major strengths and attractions of this
easy-to-read book that abounds in practical ideas is that
it includes throughout the perspective of both the CE and
the student. Aside from making it a very useful resource
for both these groups, it thus allows each party to see the
other’s perspective throughout the learning process, which
in turn is likely to lead to greater mutual appreciation and
understanding. In this way, the work has lived up to its
premise to espouse the humanistic approach, which should
particularly appeal to our communication-based
professions.
________________________________________________________________________
¹ Although this book is not specifically addressed to
audiologists, it is recommended for other health care
professionals, and indeed, most, if not all of the content,
may equally apply to audiologists. The most likely reason
why audiologists are not explicitly mentioned is that in
Australia the two professions are not associated.
47
Phonological Awareness: From research to practice
Gail T. Gillon (2004)
Publisher: The Guilford Press: New York, NY
Cost: $35.00 US
Reviewer: Susan Rvachew, Ph.D., S-LP(C), Assistant
Professor
Affiliation: School of Communication Sciences and
Disorders, McGill University, Montreal, QC
This book was written for professionals and students
who are responsible for helping children who are at risk
or experiencing difficulties with the acquisition of reading
and spelling skills. It is intended to help the reader
understand phonological awareness and its role in the
development of reading and spelling. Furthermore, it is
intended to make explicit the path from research to
practice by providing a framework for the accurate
identification and successful resolution of phonological
awareness deficits.
The book is comprised of ten chapters. The first defines
the construct of phonological awareness and describes
the tasks that are used to measure it at the syllable, onsetrime, and phoneme levels. The next three chapters are
focused on reading and spelling development, with the
second reviewing models of literacy acquisition, the third
discussing the role of phonological awareness in reading
development, and the fourth describing the phonological
awareness skills of children with dyslexia. The fifth chapter
discusses the phonological awareness skills of children
with specific language impairment, articulation disorders,
phonological delay of unknown origin and dyspraxia of
speech. Chapters six through nine are focused on clinical
practice, describing assessment tools, instructional
frameworks, and some of the activities that can be used to
remediate deficits in phonological awareness for children
of different ages. The final chapter, with sections written
by Sally Clendon, Linda Cupples, Mark Flynn, Teresa
Iacono, Traci Schmidtkie, David Yoder, and Audrey
Young, briefly reviews the literature relating to the
phonological awareness skills of children with physical,
sensory, or intellectual impairments.
This book is a very good resource for any
professional who is working with children who are at risk
for phonological awareness deficits. The review of the
research evidence is comprehensive but readable. The
right balance between breadth and depth of coverage is
maintained throughout the book. Individual studies are
described with just enough detail to allow the reader to
fully understand the findings and conclusions (although
the author’s evaluation of the quality of the studies is
somewhat shallow as described below). The implications
of the research literature for clinical and educational
48
practice are made explicit at the end of each chapter.
Informative case examples appear throughout the book.
The two chapters on intervention do not provide a stepby-step ‘how-to’ guide to the remediation of phonological
awareness deficits. Rather, these chapters emphasise
guiding principles that should underlay the development
of a comprehensive intervention program that is
customized to meet the needs and interests of each
individual client. Some specific intervention activities are
described but the clinician is advised to continually
monitor the client’s progress and adapt the activities
accordingly.
This book would also be appropriate as a text book for
a senior undergraduate or graduate level course on
phonological awareness. As with any text book, however,
the instructor would need to be thoroughly familiar with
the background literature in order to compensate for
some of the weaknesses of the literature review. The
primary weakness of the book is that the links drawn
between research and practice are more intuitive than
systematic. The author fails to explicitly apply the
principles of evidence-based practice when helping the
reader use the research evidence to guide clinical practice.
(More information about the process of evidence-based
clinical decision making can be found on the ASHA
website1). A particularly important aspect of evidencebased decision making is the necessity of evaluating rather
than simply summarizing the available research. This
failure to evaluate the research evidence is apparent in
some of the unresolved issues that reoccur throughout the
book. For example, the literature relating to the
relationship between rime awareness and reading
acquisition is, on the surface, highly confusing, leaving
the clinician uncertain about whether to teach rime
awareness to a child with delayed phonological awareness
skills. In order to make sense of the conflicting conclusions
of researchers who have investigated this relationship, it
is necessary to consider the psychometric properties of the
tests used and the quality of the research designs employed.
For example, correlational studies in which an unreliable
measure of rime awareness yields a restricted range of test
outcomes by the participants should be discounted.
Unfortunately, this level of analysis is curiously lacking in
much of the book and some studies with glaring weaknesses
are cited repeatedly (the final chapter is an exception as it
contains some nice examples of appropriate evaluation of
the quality of evidence). Another unresolved issue concerns
the number of different skills that should be taught within
the context of a phonological awareness intervention.
Some programs recommend a dizzying array of target
skills while others focus on one or two core skills, such as
segmenting words into phonemes. Specific guidelines for
evaluating the quality of evidence have been proposed
and could have been applied in an effort to both model
this decision-making process and to answer the question
about the optimum number of target skills. Unfortunately
the author appears to credit her own study (in which a
non-experimental, self-selected control group was
employed) more highly than the meta-analyses that have
examined the efficacy of phonological awareness
interventions. Non-experimental studies can make very
valuable contributions, especially when establishing the
feasibility of a treatment approach early in the history of
a research program. However, randomised control trials
and meta-analyses constitute the strongest evidence that
can be brought to bear on questions of relative efficacy of
competing treatment practices. This criticism
notwithstanding, the book is still valuable as a textbook
and would provide an opportunity for the instructor to
demonstrate the use of evidence-based decision making to
resolve some of the conflicting findings that emerge from
the literature that is summarized by Gillon.
In summary this book would be a valuable resource
for practicing clinicians and educators as well as a useful
textbook for students who expect to help children who
may have difficulties with phonological awareness. It
provides a valuable introduction for readers who are new
to this topic as well as a useful quick reference for those
who are more familiar with this large literature.
1
ASHA members can access the Technical Report
entitled ‘Evidence-Based Practice in Communication
Disorders: An Introduction’ at www.asha.org.
49
Materials Review / Évaluation de ressource écrit
Resource Reviews / Évaluation des ressources
Pre-Reading Inventory of Phonological
Awareness
B. Dodd, S. Crosbie, B. McIntosh, T. Teitzel, and
A. Ozanne (2003)
Publisher: The Psychological Corporation, 19500
Bulverde Road, San Antonio, TX 78259
www.PsychCorp.com
Cost: $153.00 (US)
Reviewed by: Lu-Anne McFarlane, Associate
Professor
Affiliation: Department of Speech Pathology and
Audiology, University of Alberta, Edmonton, AB
The Pre-Reading Inventory of Phonological
Awareness is designed to assess six areas of phonological
awareness development in children age 4 years, 0 months
through 6 years, 11 months. In the younger age range
(pre-kindergarten and early kindergarten), it is intended
as a baseline of phonological awareness skills. For the
older age group, it can be used to identify those with
phonological awareness deficits. The six areas tested are:
Rhyme Awareness, Syllable Segmentation, Alliteration
Awareness, Sound Isolation, Sound Segmentation, and
Letter-Sound Knowledge.
All sub-tests include clear administration instructions
within the stimulus book. All of them also include
demonstration items that allow feedback on response
accuracy. Some also include trial items. For the sub-tests
with pictures, the illustrations are simple, colored and age
appropriate. The testing protocol allows the examiner to
discontinue testing after a prescribed number of errors on
three of the sub-tests; the rest need to be administered in
their entirety.
The sub-tests for Rhyme Awareness and Alliteration
Awareness are done in an “odd one out” format. This
format presents the child with four words and asks them
to identify which “doesn’t belong”. The four items are
pictured, which reduces the load on short-term memory.
However, the odd one out format is a more complex
response than identifying a word that does rhyme or
alliterate. This can pose challenges in measuring rhyme or
alliteration skills in the younger age range, where the
complexity of the response type may prevent
demonstration of emerging skills.
The Syllable Segmentation and Sound Segmentation
tasks are scored on the basis of the child’s ability to orally
segment the word into syllables or sounds. For Syllable
Segmentation, the instructions ask the child to “clap out”
the syllables as he or she says the word with clear syllable
boundaries, or to point to drums on the page while
segmenting the word orally. The demonstration word
50
(elephant) is pictured, but none of the 4 trial words or test
words is pictured. None of the test words used for Syllable
Segmentation is likely to be in the vocabulary of the target
age for the test (abyss, periodical, magnitude,
elaboration). This fact, combined with the lack of pictures,
would definitely place a load on short-term memory for
4 to 6 year olds, confounding any results. In the Sound
Segmentation task, the child is asked to orally segment the
word into sounds, using counters as a support. No picture
support is provided but the target words are appropriate
for the target age (spoon, shoe, lady, cake).
The Sound Isolation task asks the child to identify the
first sound in a pictured word. All of the words are
appropriate vocabulary items for the target age range.
The Letter-Sound task provides the child with a
grapheme (or graphemes) in print and asks the child to
identify what sound the letters make. Digraphs, vowels
and clusters are included.
Raw scores from each subtest are converted to
percentile ranges. These ranges are in 5-percentile
increments. Additionally, there are often large jumps in
percentile ranks for only a small raw score difference. For
example, in the conversion chart for 5 year olds taking the
Alliteration Awareness subtest, a raw score of 1 places the
child in the 0 – 4th percentile, a score of 2 results in a
percentile of 10 – 14, and a raw score of 3 places the child
in the 30 – 34th percentile. The percentiles are then
grouped into three categories: Emerging/Below Basic (0
– 29th percentile), Basic (30th to 69th percentile), and
Proficient (70th to 99th percentile). This grouping blurs
important distinctions in performance. The Emerging
category is used for the 4 and 5 year olds, rather than
labeling them as Below Basic. The authors recommend
that those scoring in the Below Basic or in the low end of
Basic receive intervention focused on phonological
awareness skills. The manual includes several case studies
as examples in interpretation.
The standardization sample for this test included 450
children stratified by variables such as ethnicity,
geographic region and parent education. Interestingly,
11% of the standardization sample had some area of
educational or developmental concern, including speech
and language disorder/delay, learning disability, and
developmental delay. A wide range of reliability and
validity analyses were undertaken, indicating general
support for the test.
The Pre-Reading Inventory of Phonological
Awareness test can provide the speech-language
pathologist or classroom teacher with information on
development of phonological awareness. The strengths of
this test are the clear instructions in the stimulus book and
ease of scoring. The subtests most suitable for the 4 and
5 year olds (Rhyme Awareness, Alliteration Awareness
and Syllable Segmentation) have complex response types,
so are unlikely to be sensitive to early stages of development.
The Canadian Association of Speech-Language Pathologists and Audiologists
Position Paper on the Use of Telepractice for CASLPA
Speech-Language Pathologists and Audiologists
POSITION:
The Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) endorses the use of telepractice
in both speech-language pathology and audiology as a means of improving access to services provided by fully qualified
professionals. CASLPA members who provide services via telepractice are expected to adhere to the CASLPA Code
of Ethics (2005) and privacy legislation and abide by guidelines established by the regulatory body of the province in
which they reside. Members may provide services via telepractice if they determine that it is in the best interests of their
clients. Members shall base telepractice on best evidence and encourage ongoing research in this field.
DEFINITIONS:
“Client” refers to the individual receiving professional services and in the case of an individual who is not
capable, the legal guardian or legal representative. With the consent of the individual or of the legal
guardian/representative, “client” may also include family members and caregivers.
“Informed consent” means a client gives consent to receive a proposed service following a process of decision-making
leading to an informed choice. Valid consent may be either verbal or written unless otherwise required by institutional
or provincial/territorial regulation. The client is provided with sufficient information, including the benefits and risks,
and the possible alternatives to the proposed service, and the client understands this information. The client can
withdraw informed consent at any time.
“Member” used throughout the document refers to a speech-language pathologist or audiologist who is a full member
of the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA).
“Provider site” refers to the site where the member providing service is physically located.
“Recipient site” refers to the site where the client is located.
“Telepractice” refers to the use of technology to deliver audiology and speech–language pathology services at a distance.
Telepractice may involve “live” or “store-and-forward” service. Live or real time service may include but is not limited
to telephone, or videoconferencing. Store and forward involves the recording, storing, and subsequent transmission
of audio and/or visual images for later examination (e.g., e-mail, fax, audiotape or videotape recordings).
RATIONALE:
a) Advances in technology have allowed professionals in various fields including speech-language pathologists and
audiologists to utilize telepractice. It is therefore important that members have guidelines for minimum
standards for telepractice.
b) The challenges of travel distance and cost, weather, mobility and disruption of family and work schedules, can
impede access to services. Telepractice may help overcome such challenges by:
• increasing the frequency of contact and efficiency of service;
• increasing accessibility of services for clients;
• providing members with access to continuing professional development opportunities.
c)
Telepractice can aid collaborative work by:
• providing members with access to consultation with those with more specialized expertise;
• providing members with access to team services where other team members are separated by distance.
d) Telepractice may help maximize the use of available supports in the client’s area by:
• affording members opportunities for educating caregivers and service providers in the client’s community;
• accessing the services of interpreters to provide services to clients in their native language.
51
RECOMMENDATIONS/GUIDELINES FOR CASLPA SPEECH-LANGUAGE PATHOLOGISTS AND
AUDIOLOGISTS:
1.
Members shall be aware of and accountable to the appropriate jurisdiction(s) and any/all scope of practice
requirements, particularly with respect to provider and recipient sites. Applicable jurisdiction(s) shall be
consulted for details.
2.
The scope and nature of activities conducted via telepractice shall be comparable to that provided during an inperson session. The quality of audio and video signals must be appropriate for the activity being conducted.
Alterations to standard in-person clinical protocols should be documented (e.g. explain and document how oral
motor or otoscopic examinations were conducted and adapted, identify any limitations in interpretation).
3.
Members shall ensure that:
• they are competent in the use of the equipment and/or that the appropriate technological assistance is
•
•
•
available to them;
all equipment is operational and calibrated (if applicable);
they comply with applicable safety laws, regulations and codes;
relevant infection control policies and procedures are followed.
4.
Members shall be aware that the success of services provided through telepractice may be influenced by
cultural beliefs. Comfort levels of participants may vary depending on previous experience.
5.
The member providing the service via telepractice shall protect the privacy and confidentiality of the client
with the knowledge that some forms of transmission are more secure than others and that unauthorized
persons may access exchanges and/or information. Members shall inform clients that safeguards have
been established to protect privacy and confidentiality but that no technological communication system is
entirely secure. Members shall identify all attendees in both provider and recipient sites.
6.
Members shall ensure that informed consent is obtained prior to the telepractice session. Informed consent
shall encompass such information as the advantages and limitations of the mode of service, alternative
service options, use and storage of transmitted signals, plan of action in the event of technology failure and
who is responsible for on-going care.
7.
The responsibility for fee reimbursement shall be established prior to the telepractice service if applicable.
8.
The member in the recipient site shall be responsible for the main care of the client unless alternative
arrangements have been made.
9.
Provincial/territorial professional bodies should expand on these telepractice guidelines to ensure that
practice standards are in accordance with provincial/territorial regulations.
10. This position statement shall be reviewed within two (2) years or sooner as necessary. Consideration should
be given to evolving technologies, resources and requirements for increasing competencies.
Background
Background:
The CASLPA Ad Hoc Committee on telepractice was formed in the fall of 2003 in response to needs expressed by CASLPA
members. The mandate of this committee was to develop a position statement that identified issues concerning the role
of speech-language pathology and audiology members in the use of telepractice, and to establish professional practice
guidelines for providing services via telepractice. The committee was comprised of speech-language pathologists and
audiologists with experience, interest, and expertise in issues related to service delivery in the area of telepractice.
This position paper was developed following review of literature, relevant position statements and guidelines, dialogue
and consultation.
Suggested Reading:
National Initiative for Telehealth (NIFTE): National Initiative for Telehealth (NIFTE) Framework of Guidelines.
September 2003, Ottawa; NIFTE www.nifte.ca
52
References:
American Speech-Language-Hearing Association: Telepractices and ASHA: Report of the Telepractices Team, December 2001: www.asha.org.
American Speech-Language-Hearing Association (2005) Speech-language pathologists providing clinical services via telepractice: Position Statement. ASHA Supplement 25, in
press.
American Speech-Language-Hearing Association.(2005) Audiologists providing clinical services via telepractice: Position statement. ASHA Supplement 25, in press.
American Speech-Language-Hearing Association.(2005) Audiologists providing clinical services via telepractice: Technical report. ASHA Supplement 25, in press.
American Speech-Language-Hearing Association.(2005) Speech-language pathologists providing clinical services via telepractice: Technical Report. ASHA Supplement 25, in
press.
Canadian Association of Occupational Therapists: CAOT Position Statement Tele-Health and Teleoccupational Therapy (2000)
http://www.caot.ca/default.asp?ChangeID=190&pageID=187.
Canadian Association of Speech-Language Pathologists and Audiologists (2005). Code of Ethics. : http://www.caslpa.ca/english/resources/ethics.asp.
Canadian Physicians and Surgeons of Manitoba Telehealth Guidelines and Statements, www.cpsm.mb.ca/guidelines and statements/166.html.
College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO), Position Paper: Use of Telepractice Approaches in Providing Services To Patients/
Clients.Toronto,ApprovedJune2004 http://www.caslpo.com/english_site/mptelepractice.doc.
College of Occupational Therapists of Ontario, Telepractice: Information for Occupational Therapists Providing Telehealth Services, 2001.
http://www.coto.org/media/documents/Telepractice_brochure.pdf.
National Initiative for Telehealth (NIFTE): National Initiative for Telehealth (NIFTE) Framework of Guidelines. September 2003 ,Ottawa; NIFTE www.nifte.ca.
Steinecke, Richard: Regulating Telepractice, May 2002-no 51 Grey Areas, Steinecke Maciura Leblanc, Publications and Newsletter, www.sml-law.com.
Committee members:
Candace Myers, MSc, S-LP(C), Chair
Patricia Carey, M.Ed., S-LP(C), Registered SK
Alvilda Douglas, M.Sc., Aud(C)
Sean Kinden, M.A., Aud(C)
Deborah Kully, M.S., R.SLP, S-LP(C), CCC-SLP, BRS-FD
Ariane Laplante-Levesque, MPA, MSc, Aud(C)
Wendy MacDonald, M.Sc.(A), S-LP(C)
Mary Pole, S-LP(C)
Carrie Stacey, M.Sc., S-LP(C)
Karen Svitich, MSLP, R.SLP, S-LP(C)
Acknowledgements:
The Committee wishes to thank Morley Hewison, Provincial Network Operations Manager of Telehealth
Saskatchewan for his input, and Sharon Fotheringham of CASLPA for her guidance and support throughout this project.
A position paper represents the direction CASLPA has taken on a particular topic or provides guidelines for
particular areas of practice. These positions are time-bound, representing the thinking at a particular point in time.
53
L’Association Canadienne des Orthophonistes et Audiologistes
Énoncé de position sur l’utilisation de la télépratique par les
orthophonistes et les audiologistes membres de l’ACOA
Position:
L’Association canadienne des orthophonistes et audiologistes (ACOA) appuie le recours à la télépratique tant dans le
domaine de l’orthophonie que de l’audiologie en vue d’améliorer l’accès à des services prodigués par des professionnels
compétents. Les membres de l’ACOA qui offrent des services par le biais de la télépratique doivent respecter le Code
de déontologie de l’ACOA (2005), la législation relative à la protection de la vie privée ainsi que les lignes directrices
établies par l’organisme de réglementation de la province où ils se trouvent. Les membres peuvent fournir des services
par le biais de la télépratique s’ils jugent que cela est dans l’intérêt supérieur de leur client. Ils doivent fonder leur exercice
de la télépratique sur des données probantes et encourager la poursuite de la recherche dans ce domaine.
Définitions
Définitions:
L’expression « client » renvoie à une personne qui bénéficie de services professionnels et, dans le cas d’une personne
inapte, à son tuteur légal ou à son représentant légal. Avec le consentement de la personne ou de son tuteur/représentant
légal, l’expression « client » peut aussi inclure les membres de la famille et les fournisseurs de soins.
L’expression « consentement éclairé » renvoie au consentement que donne un client qui accepte en toute connaissance
de cause de recevoir un service proposé. Un consentement valide peut être verbal ou écrit, à moins que la réglementation
institutionnelle, provinciale ou territoriale ne stipule autrement. Le client doit être bien informé, y compris des
avantages et des risques ainsi que des solutions de rechange au service proposé. Il doit comprendre ces renseignements.
Il peut retirer son consentement éclairé à n’importe quel moment.
L’expression « membre » renvoie aux orthophonistes et aux audiologistes membres en règle de l’Association canadienne
des orthophonistes et audiologistes (ACOA).
L’expression « emplacement du fournisseur » renvoie à l’endroit où se situe le membre qui offre le service.
L’expression « emplacement du bénéficiaire » renvoie à l’endroit où se situe le client.
L’expression « télépratique » renvoie à l’utilisation de la technologie pour offrir des services d’orthophonie et
d’audiologie à distance. La télépratique peut comprendre un service « en direct » ou « en différé ». Le mode « en direct » ou
en temps réel fait appel notamment au téléphone ou à la vidéoconférence. Le mode « en différé » nécessite l’enregistrement,
la sauvegarde et la transmission d’images audio ou visuelles qui seront examinées ultérieurement
(p. ex. : courriel, télécopie, bande sonore ou enregistrements magnétoscopiques).
Fondement :
a) Les percées technologiques permettent à des professionnels de différentes disciplines, y compris l’orthophonie et
l’audiologie, de recourir à la télépratique. Pour cette raison, il est important que les membres disposent de lignes
directrices qui établissent des normes minimales pour la télépratique.
b) Les difficultés et les coûts qu’entraînent de longs déplacements, le climat, la mobilité et les dérangements pour
la famille et le travail sont autant de facteurs qui nuisent à l’accès à des services. Le recours à la télépratique permet
de surmonter une partie de ces obstacles, car elle :
• accroît la fréquence du suivi et l’efficacité du service
• améliore l’accessibilité des services pour les clients
• offre aux membres l’accès à des occasions des activités de perfectionnement.
c)
La télépratique peut favoriser la collaboration, car elle :
• offre aux membres la possibilité de consulter une personne qui possède des compétences spécialisées
• offre aux membres la possibilité de travailler en équipe, même si l’un des membres de l’équipe se situe à distance.
d) La télépratique aide à maximiser l’utilisation des services de soutien dans la région du client, car elle :
• donne aux membres l’occasion de former des fournisseurs de soins et des fournisseurs de service dans la
collectivité du client
• accède aux services d’interprètes afin d’offrir des services à des clients dans leur langue maternelle.
54
Recommandations/Lignes directrices pour les orthophonistes et audiologistes membres de l’ACOA :
1.
Les membres doivent connaître et respecter les compétences appropriées ainsi que toutes les exigences visant la
pratique, notamment en ce qui a trait à l’emplacement du fournisseur et du bénéficiaire. Il faut consulter toutes
les compétences pour connaître leurs exigences.
2.
Le champ et la nature des activités menées par le biais de la télépratique doivent être comparables à ceux durant
les séances en personne. La qualité des signaux audio et vidéo doit convenir pour les activités menées. Toute
déviation au protocole habituel pour les rencontres privées en clinique doit être consignée par écrit (p. ex. :
expliquer et documenter comment s’est déroulé l’examen moteur et otoscopique et comment il a été adapté,
préciser les limites imposées à l’interprétation des résultats).
3.
Les membres doivent s’assurer que :
• ils ont les compétences nécessaires pour utiliser l’équipement ou qu’ils disposent de l’aide technique nécessaire
• tout le matériel fonctionne et qu’il est calibré (s’il y a lieu)
• ils se conforment aux lois, règlements et codes visant la sécurité
• ils respectent les politiques et méthodes pertinentes pour la prévention des infections.
4.
Les membres doivent savoir que la réussite des services offerts par le biais de la télépratique peut être tributaire des
croyances culturelles. Le sentiment d’aise des participants variera selon leur expérience.
5.
Les membres offrant un service par le biais de la télépratique doivent protéger la vie privée et les renseignements
personnels du client. Il faut savoir que certaines formes de transmission sont plus sécurisées que d’autres et que des
personnes non autorisées pourraient avoir accès aux échanges et à des renseignements. Les membres doivent aviser
le client que des mesures de protection sont en place pour préserver la confidentialité des renseignements
personnels, mais qu’aucune technologie n’est infaillible. Les membres doivent présenter toutes les personnes
présentes tant à l’emplacement du fournisseur qu’à celui du bénéficiaire.
Les membres doivent veiller à obtenir un consentement éclairé avant les séances de télépratique. Pour ce faire, ils
doivent expliquer les avantages et les limites d’un mode de prestation de services, les services de rechange,
l’utilisation et le stockage des signaux transmis, le plan d’action en cas de défaillance technique et la personne qui
sera responsable des soins de suivi.
6.
7.
Il faut établir avant le début des services de télépratique qui assumera le remboursement des frais afférents.
8.
Il incombe aux membres à l’emplacement du bénéficiaire d’assurer l’essentiel des soins du client à moins que
d’autres dispositions n’aient été prises.
Les organismes provinciaux et territoriaux devraient se fonder sur ces lignes directrices visant la télépratique pour
s’assurer que les normes de pratique respectent la réglementation provinciale ou territoriale.
9.
10. Le présent énoncé de position doit être révisé d’ici deux (2) ans ou plus tôt selon les besoins. Il faudra
tenir compte des nouvelles technologies, des ressources disponibles et de l’évolution des besoins afin d’améliorer
les compétences.
Mise en contexte:
Le comité spécial de l’ACOA sur la télépratique a vu le jour à l’automne 2003 en réaction à des besoins exprimés par
les membres de l’ACOA. Ce comité avait pour mandat d’élaborer un énoncé de position pour cerner les questions
entourant le recours à la télépratique par les orthophonistes et audiologistes membres et pour établir des lignes
directrices visant la prestation de services par le biais de la télépratique. Ce comité se composait d’orthophonistes et
d’audiologistes ayant l’expérience de la télépratique, des intérêts en la matière et l’expertise de la prestation de services
par ce moyen.
Pour élaborer cet énoncé de position, les membres du comité ont passé en revue la documentation sur le sujet ainsi que
les énoncés de position pertinents; ils ont dialogué et ont tenu des consultations.
Lecture proposée:
National Initiative for Telehealth (NIFTE). National Initiative for Telehealth (NIFTE) Framework of Guidelines.
Septembre 2003, Ottawa, www.nifte.ca.
55
Références:
American Speech-Language-Hearing Association (décembre 2001). Telepractices and ASHA: Report of the Telepractices Team, www.asha.org.
American Speech-Language-Hearing Association (2005). Speech-language pathologists providing clinical services via telepractice: Position Statement. ASHA Supplement 25,
sous presse.
American Speech-Language-Hearing Association(2005). Audiologists providing clinical services via telepractice: Position statement. ASHA Supplement 25, sous presse.
American Speech-Language-Hearing Association.(2005). Audiologists providing clinical services via telepractice: Technical report. ASHA Supplement 25, sous presse.
American Speech-Language-Hearing Association.(2005) Speech-language pathologists providing clinical services via telepractice: Technical Report. ASHA Supplement 25, sous
presse.
Association canadienne des ergothérapeutes (2000). Prise de position révisée sur les services de télé-ergothérapie de qualité, www.caot.ca/default.asp?ChangeID=190&pageID=187.
Association canadienne des orthophonistes et audiologistes (2005). Code de déontologie, www.caslpa.ca/francais/resources/ethics.asp.
Canadian Physicians and Surgeons of Manitoba Telehealth Guidelines and Statements, www.cpsm.mb.ca/guidelines and statements/166.html
National Initiative for Telehealth (septembre 2003). National Initiative for Telehealth Framework of Guidelines. Ottawa, NIFTE, www.nifte.ca.
Ordre des audiologistes et des orthophonistes de l’Ontario (juin 2004). Énoncé de principe : Utilisation d’approches de télépratique pour la prestation de services aux patients
ou clients, Toronto, www.caslpo.com/french_site/m_memposit.asp.
Ordre des ergothérapeutes de l’Ontario (2001). Télémédecine : renseignements à l’intention des ergothérapeutes qui offrent des services de télémédecine. www.coto.org/media/
documents/Telepractice_brochure_fr.pdf.
Steinecke, Richard (mai 2002). Regulating Telepractice no 51 Grey Areas, Steinecke Maciura Leblanc, Publications and Newsletter, www.sml-law.com.
Membres du comité :
Candace Myers, MSc, O(C), présidente
Patricia Carey, M.Ed., O(C), Registered SK
Alvilda Douglas, M.Sc., Aud(C)
Sean Kinden, M.A., Aud(C)
Deborah Kully, M.S., R.SLP, O(C), CCC-SLP, BRS-FD
Ariane Laplante-Levesque, MPA, MSc, Aud(C)
Wendy MacDonald, M.Sc.(A), O(C)
Mary Pole, O(C)
Carrie Stacey, M.Sc., O(C)
Karen Svitich, MSLP, R.SLP, O(C)
Remerciements:
Le comité souhaite remercier Morley Hewison, directeur de l’exploitation provinciale des réseaux pour ses suggestions
et Sharon Fotheringham de l’ACOA pour ses conseils et son soutien tout au long de cette initiative.
Un énoncé de position représente l’orientation adoptée par l’ACOA concernant un sujet particulier ou fournit des lignes
directrices visant un aspect quelconque de la pratique. Ces énoncés ont une durée limitée et représente le raisonnement
d’un moment précis.
56
CASLPA 2006 Abstracts
CASLPA 2006
Abstr a c ts
Winnip
anit
o ba
innipee g , M
Manit
anito
M a y 3-6, 2006
Preconference Workshops
Tracheostomy and Ventilator Dependency Management of Breathing, Speaking and Swallowing in
Adults
Donna Tippett, Departments of Otolaryngology – Head and Neck Surgery, and Physical Medicine and Rehabilitation,
Johns Hopkins University, Baltimore, MA
Management of speaking and swallowing disorders in adults with tracheostomy/ventilator dependency is challenging.
This workshop will be presented at a basic-intermediate level to prepare speech-language pathologists to evaluate
and treat speaking and swallowing disorders in this population. Workshop content will also be relevant to
occupational therapists, physical therapists, nurses, and respiratory therapists.
The SCERTS Model: A Comprehensive, Multidisciplinary Educational Approach for Children with
Autism Spectrum Disorders
Emily Rubin, Director, Communication Crossroads, Carmel, CA
This workshop will outline the SCERTS model, a comprehensive, multidisciplinary educational approach designed
to enhance the communication and socio-emotional abilities of children with Autism Spectrum Disorders (ASD)
while providing family support and support to professionals. The acronym “SCERTS” refers to the three primary
dimensions of the model. Developmental objectives in Social Communication (SC) and Emotional Regulation (ER)
are addressed by implementing Transactional Supports (TS) (e.g., interpersonal style adjustments, environmental
arrangements, visual supports, etc.) throughout a child’s daily activities and across social partners in order to
facilitate competence within these identified goal areas in functional and meaningful contexts (e.g., home, school,
and community). The presentation will begin with a review of current treatment efficacy literature and the
recommended guidelines for educational programming put forth by the National Academy of Sciences in the United
States. This discussion will then be followed with practical guidelines for implementation, as illustrated through
video case reviews.
Speech-Language Pathology and Audiology Workshop
Coaching: Unleashing Individual and Service Potential
Jim McLaren, Winnipeg, MB
Forward thinking practitioners understand that relationships are the real and future “currency” of the work world
and that coaching skills can help develop those relationships. Coaching works on the belief that it is the client who
ultimately has the answers for any situation, and coaching can assist in uncovering those answers. Alison Hendron,
director of training for the Certified Executive Coaching program at Royal Roads University, describes coaching this
way: “You take bike riding: a consultant explains the different bikes and recommends the best one for you; a therapist
helps you overcome your fear of falling, while the executive coach runs along beside you to make sure you’re steady
before you ride away on your own.” This plenary session is designed to share insights on the power of a coaching
approach and the potential it offers for those in clinical practice settings.
I Used to Have a Handle on Life, but It Broke
Shari Robertson, Phoenix Enterprises, Inc., Indiana, PA
This session provides proven strategies for managing time and stress specific to professionals within the field of
communicative disorders. This is a fast-paced seminar with lots of audience participation and lots of laughter.
57
Third Party/Insurance Coverage – Demystifying the World of Insurance and Third Party Payers
Katherine Cheney, Stewart McIntosh, Veterans Affairs Canada; Tania Stote, Blue Cross Medavie; Jocelyne
Lavergene-Robenhymer, First Nations and Inuit Health Branch, Non-Insured Health Benefits (NIHB); Michael
O’Brien, Canada Revenue Agency: Disability Tax Credit
This session will provide you with the opportunity to hear from Veterans Affairs Canada, the Workman’s
Compensation Board, Non-Insured Health Benefits, Blue Cross, and other third party payers and insurance
companies on their policies and funding procedures. You will be provided with the opportunity to ask specific
questions of each of the individuals presenting.
Think Critically!: What to Look for in the Research You Read
Lisa Lix, University of Manitoba, Winnipeg, MB
Evidence-based decision-making is a popular catch phrase. How can you effectively use research evidence to make
decisions in your job? This presentation will focus on the three key things you should “get” from a critical research
review: (1) get the message: What are the main findings of this research? (2) get the methods: Are the conclusions
justified based on the data and analyses?, and (3) get the big picture: Are the results of one study relevant to the
clients I see each day?
Universal Design Teaching Strategies
Karen Priestley, Winnipeg, MB
Universal design is an exciting new framework facilitating new ways to meet the needs of our diverse student
population. It is a movement towards actualizing inclusion in its truest sense as it looks at students in terms of needs
and does not adhere to disability categorization. Universal design emphasizes the goal of student access to the
general curriculum for all of our children. It involves a paradigm shift from adapting instruction, curriculum and
assessment to meet diverse or exceptional student needs as they arise (inclusion), to using great foresight to expect
and plan for all needs as the norm (universal design). It is not a radically new way of teaching but extends many
of our current methodologies and is built on what people in the field of education already know from research and
practice about good teaching and creating accessible environments. Universal design is all-encompassing and
involves all members of the learning community.
The theoretical underpinnings of the universal design concept emerged from the field of architecture and have been
applied to education since around 1990. Universal design is particularly associated with the field of special education
as philosophically applying the universal design concept to education means that the general curriculum is readily
accessible to all students regardless of varied learning needs. Implementation of universal design involves
restructuring, creativity and collaboration.
A Coach Approach
Jim McLaren, Winnipeg, MB
This workshop will provide a dynamic, experience-based approach to learning. The day is designed for maximum
flexibility to address the “pain points” and meet the needs and interests of individual participants. It includes an
emphasis on group discussion and draws from the collective wisdom and experiences of participants. Activities
include such learning techniques as case studies, practice exercises, role plays, demonstrations, self awareness and
“team” assignments.
At the end of the workshop participants will have:
·
Shared experiences and highlighted current behaviors that challenge them in their practice
·
Explored the coach approach and determined what key aspects might help them with the delivery of services
·
Practiced coaching skills required to address challenges that impede successful service delivery
·
Increased confidence, self accountability and enthusiasm for a coach approach
Multidisciplinary Assessment and Management of Auditory Processing Disorders
James W. Hall III, University of Florida, Gainesville, FL; Diane P. Wertz, University of Florida, Gainesville, FL
There is unprecedented interest in auditory processing disorders (APD) among audiologists, speech pathologists,
and parents of children who are academic underachievers. Differential diagnosis of APD is challenging for many
audiologists. Assessment procedures and protocols extend far beyond the audiogram, and treatment strategies are
highly varied and must be closely coordinated with other professionals. Furthermore, APD must be differentiated
from among a variety of co-existing disorders, such as dyslexia, language impairment, and ADHD. This exciting new
workshop will provide the clinical audiologist or speech pathologist with a practical and logical multidisciplinary
approach for assessment and management of this substantial and under-served population that’s based on a
foundation of basic and applied science, and used daily by the University of Florida Department of Communicative
Disorders and Multidisciplinary Diagnostic and Treatment Program. The session will provide the clinician with
practical take-home messages.
58
Audiology Workshops
Selection and Verification of Modern Hearing Aids
Gustav Mueller, Vanderbilt University, Nashville, TN
Dr. Mueller will discuss the following:
A.
Features that are desired and/or required in modern hearing aids
B.
Formulating fitting goals
C.
Verifying fitting goals
D.
Verifying hearing aid features
E.
Troubleshooting patient problems
Beyond the Basics: Exploring the Auditory System
Barbara Reynolds, Green Valley, ON
Temporal Processing and Spatial Acoustics: The auditory system is at least one order of magnitude faster in
processing information than the visual system. Temporal auditory processing problems do affect how we hear and
understand speech as well as other aspects including interhemispheric transfer and spatial processing. This
presentation will include information on temporal processing and its impact on auditory perception developmentally,
through the aging process and as a result of auditory deprivation. The auditory system does have a “what” and
“where” pathway. This presentation will give information on the varying aspects of human auditory spatial
perception, which goes beyond simple right/left sound localization. Included will be an overview of the neurophysiology
and the consequences of the loss of spatial acoustics, but in perceptual terms and in its relationship to hearing aid
amplification and counseling needs.
Feedforward/Feedback Systems: Cortical Processing Systems Involved in Plasticity and Implications to
Deprivation/Rehabilitation - Often when we think of the auditory system, we tend to limit ourselves to the
ascending pathways. Different areas of the brain that are not often considered can impact the auditory system as
far down as the cochlear nucleus and the cochlea. This presentation will include the concepts of feedforward
(ascending) and feedback (descending) systems that can influence cortical plasticity, learning and rehabilitation/
deprivation. Understanding the complete auditory system can help us to communicate with patients and other
medical professionals about the importance of the auditory system beyond the cochlea.
Taking a History: Why Things Matter in a Patient’s History - Taking a patient’s history may seem
straightforward, but being thorough involves much more than asking the standard questions of noise and listening
difficulties. This presentation will include other questions regarding past history and health issues that can impact
perception and can affect the adjustments or settings of hearing aids. Also included in this presentation will be
counseling considerations in getting patients to understand the importance of early amplification and the realistic
rehabilitation time course and outlook based on their individual history.
Alzheimer’s Update: This presentation will continue the information supplied previously on the effects of
Alzheimer’s disease on the auditory system and related systems. Included will be the effects on the neurophysiology
and the perceptual changes one can expect in a patient with Alzheimer’s disease. Amplification and counseling
issues will also be addressed.
ASSR and Tinnitus
James W. Hall III, University of Florida, Gainesville, FL
The Role of the Auditory Steady State Response (ASSR) in Audiology Today
This session will begin with a historical perspective on the ASSR followed by a review of principles and procedures
for ASSR measurement. The role of the ASSR in the pediatric test battery will be defined with an emphasis on the
use of ASSR in estimating auditory thresholds in infants and young children. Clinical advantages and disadvantages
of ASSR in pediatric diagnostic assessment will be illustrated with original case reports. The session will also include
discussion of other diagnostic clinical applications of the ASSR technique in pediatric and adult populations.
Audiologic Assessment and Management of Tinnitus
Tinnitus or hyperacusis affects millions of persons in the United States, Canada, and other developed countries.
Within recent years, we have witnessed unprecedented research and clinical interest in tinnitus and hyperacusis.
This instructional course will emphasize principles, protocols, and current practices important in the audiologic
assessment and management of tinnitus, and will provide the practicing audiologist or otolaryngologist with a
clinically feasible approach to caring effectively for this challenging and underserved patient population. The
presentation will include a review of the basic mechanisms of tinnitus/hyperacusis, a detailed test battery for
diagnostic tinnitus assessment, and a review of effective tinnitus treatment options.
59
Speech-Language Pathology Workshops
Tracheostomy and Ventilator Dependency Management of Breathing, Speaking and Swallowing in
Adults
Donna Tippett, Departments of Otolaryngology – Head and Neck Surgery, and Physical Medicine and Rehabilitation,
Johns Hopkins University, Baltimore, MA
This course will be presented at an intermediate-advanced level, primarily for speech-language pathologists. Topic
areas include clinical controversies, evidence-based practice, quality of life, and ethical considerations. There will
also be an interactive portion to present and discuss challenging cases.
Addressing Social Communication in Children and Adolescents with High Functioning Autism and
Asperger’s Syndrome
Emily Rubin, Director, Communication Crossroads, Carmel, CA
The session will begin with a review of the core social and communicative challenges faced by children and
adolescents with High Functioning Autism and Asperger’s Syndrome as well as our current understanding of the
learning style differences that differentiate these disorders. Next, we will explore the essential components of a
comprehensive educational program in order to establish guidelines for prioritizing educational and therapeutic
objectives. Guidelines for determining appropriate learning supports and educational accommodations will also be
provided. An emphasis will be placed on learning supports designed to address social communication and emotional
regulation (e.g., video replay, friendship maps, and feelings books).
Esophageal Phase Deglutition and Its Disorders: What Speech Pathologists Need to Know
Caryn Easterling, University of Wisconsin-Milwaukee, Pewaskee, WI
This half-day session by Caryn S. Easterling, Ph.D. will include the anatomy and physiology of the esophageal phase
of deglutition in adults. A review of research in the area of esophageal physiology and pathophysiology will be
presented with clinical interpretation and implications. Clinical instrumentation used for diagnosis and management
of esophageal phase disorders will be discussed. The rationale, development, clinical application, and multidisciplinary
team implementation of the Shaker Exercise, an exercise for deglutitive upper esophageal sphincter opening, will
be discussed.
Read with Me
This workshop will provide background regarding the relationship between language and literacy (both deal with
form, content, and use) and will demonstrate six interactive strategies that can be used to boost language and literacy
across age groups, disability areas, and even taught to parents. Extensions on how to use interactive reading with
older children and to boost formal reading skills can also be included Book lists, parent handouts, hands-on practice,
etc., will be provided.
Cleft Lip/Palate and Velopharyngeal Dysfunction: Effects on Speech and Resonance
Ann Kummer, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
This seminar will cover basic oral-pharyngeal anatomy, types of clefts, velopharyngeal dysfunction and resonance
disorders. High tech, low tech and no-tech evaluation techniques will be described. Treatment options will be
discussed, including surgery, prosthetic devices, and speech therapy. Specific therapy techniques will be
demonstrated.
Head and Neck Cancer/Oncology: An Update for S-LPs
Candace Myers, CancerCare Manitoba, Winnipeg, MB
This presentation will provide an overview of current management of patients with head and neck cancer, including
treatment options, assessment and management of dysphagia and symptom issues, psychosocial care, and
transition to end-of-life care. A review of functional outcomes from the current literature and at CancerCare
Manitoba will be presented. References, resources, and direction for continuing education will be provided.
Making Connections in the Classroom
This workshop is geared toward intervention with school-aged students. It targets 3 major goals – increasing
cognitive skills, increasing pragmatic skills and building linguistic and metalinguistic skills with an emphasis on
written language skills (Narrative and Expository). The workshop will provide numerous examples and lesson plans.
60
Complementary and Alternative Treatment of Aphasia
Kristine Lundgren, Harold Goodglass Aphasia Research Center, Boston, MA
The field of Complementary and Alternative Medicine (CAM) is a fast-growing component of many medical and
rehabilitation programs and has been integrated into internal medicine, oncology, psychology, physical therapy and
occupational therapy. This workshop will provide background information about the field, will describe preliminary
research to support the use of some nontraditional approaches (relaxation, animal-assisted therapy, MindfulnessBased Stress Reduction, acupuncture, Transcranial Magnetic Stimulation), and will discuss ways in which some
of these therapies can be incorporated into traditional speech and language practices. Case studies with
communicatively impaired adults and adolescents will be presented. This course will be presented at an intermediate
level.
Training Preschool Teachers to Promote Language and Literacy Development
Janice Greenberg, The Hanen Centre, Toronto, ON
Learn about a research-validated approach for training early childhood teachers to promote children’s social,
language and literacy development in naturalistic settings. Through a unique combination of group training sessions
and individualized videotaping and feedback sessions, teachers learn how to use play and daily activities to create
inclusive interactive language-learning environments.
The S-LP’s Role in the Treatment of Selective Mutism and Other Psychogenic Disorders
Suzanne Hungerford, Plattsburgh State University of New York, Plattsburgh, NY
Although psychogenic communication disorders are not common, speech-language pathologists (S-LPs) do
encounter individuals with these disorders, and when they do, they often feel ill-prepared to meet their needs. The
goal of this session will be to familiarize S-LPs with some of the disorders and to offer an introduction to treatment.
Audiology Contributed Papers
Can You Provide What Consumers Want/Need?
Michel David, Janice McNamara, Canadian Hard of Hearing Association, Ottawa, ON
This workshop will outline the findings of the of 2005 Hearing Awareness Survey of Hearing Loss. It will suggest some
cause and effect analysis to understand some of the issues expressed by consumers. The responses are instructive
as they help identify where problems lie and what issues need to be addressed.
Speech-Language Pathology Contributed Papers
Multiple System Atrophy: Multiple Responsibilities for Speech-Language Pathologists
Richard J. Welland, Brock University, St. Catharines, ON
Multiple system atrophy is a term that encompasses a group of adult-onset neurodegenerative conditions, such
as Shy-Drager Syndrome. Patients with multiple system atrophy typically develop a triad of signs and symptoms:
dysarthria; dysphagia; and dementia. The combination of these three disorders represents a particular challenge
for the speech-language pathologist.
Dysphagia Care Teams for Stroke Survivors in the LTC Setting
Rosemary Martino, Becky French, Shelley Sharp, Lisa Durkin, UHN, Toronto Western Hospital, Toronto, ON
Dysphagia care teams will be established for stroke survivors in three long-term care (LTC) facilities within the
Toronto West Regional Stroke Network. Barriers to implementation, and staff knowledge and satisfaction will be
assessed. Establishing dysphagia care teams will aid appropriate identification of stroke survivors requiring
consultation by an S-LP.
Outcome Measurement in Aphasia: A Framework for “Counting What Counts”
Aura Kagan, Jennifer Hicks, Elyse Shumway, The Aphasia Institute, Toronto, ON; Nina Simmons-Mackie,
Southeastern Louisiana University and The Aphasia Institute, Abita Springs, LA; Maria Huijbregts, Baycrest Centre
for Geriatric Care, Toronto, ON; Sara McEwen, The Aphasia Institute, Hawkestone, ON
This presentation will identify gaps in outcome measurement related to real-life participation and living with
aphasia. The authors will present a user-friendly and accessible framework for clinical aphasiologists that captures
key concepts in current thinking within and beyond our field and apply this specifically to measuring real-life
outcomes of aphasia interventions.
61
Aphasia in Residential Care
Jennifer Sweeney, Private Practice, Vancouver, BC
In recent years speech-language pathology practice has evolved to incorporate the principles of client-centred and
family-centred care. We have knowledge and tools that encourage increased independence and quality of life. This
session will focus on the challenges of system-wide support for people with aphasia when admitted to residential
care.
Communication Needs of Nonspeaking Adults in Acute Care: Survey Results
Colleen A. Braun-Janzen, Leslie Mennell, Health Sciences Centre, Winnipeg, MB
This study investigated practice patterns, and opinions of best practice standards regarding management of
nonspeaking adult patients in acute care. Survey results suggest that S-LP staffing levels in many acute care facilities
are insufficient to adequately respond to communication needs and nurses are frequently facilitating hands-on
communication intervention.
Attitudes and Perceptions of Adults with Severe Acquired Communication Disorders
Colleen A. Braun-Janzen, Deer Lodge Centre, Winnipeg, MB
Fourteen adults with acquired communication disorders who use AAC were interviewed. Respondents reflected on
benefits and frustrations of using AAC, transition from being a verbal communicator to using AAC, and suggestions
for verbal communicators in interfacing with people who use AAC.
Assessment of Higher Level Cognitive-Communication Deficits
Sheila MacDonald, Sheila MacDonald & Associates, Guelph, ON
Assessment of subtle cognitive-communication deficits following acquired brain injuries can pose a significant
clinical challenge for speech-language pathologists. The Functional Assessment of Verbal Reasoning and
Executive Strategies (FAVRES) is a standardized test that was designed to meet this challenge. This presentation
will discuss issues of assessment of cognitive-communication deficits and present the results of a normative study
of the FAVRES.
Outcome Measures for Children with ASD Following Parent Training
Tara Davies, Luigi Girolametto, University of Toronto, Toronto, ON; Fern Sussman, Elaine Weitzman, The Hanen
Centre, Toronto, ON
This presentation will summarize outcomes following participation in More Than Words, a parent program for
children with autism spectrum disorder. Following the program, all 12 children demonstrated increases in the length
of joint attention episodes. The parents’ outcomes, examined using the Joy and Fun Scale (JAFA; McConachie &
Currill, 2002) revealed improvements in the total score of JAFA from pretest to posttest.
An Introduction to Relationship Development Intervention™ for Individuals with Autism Spectrum
Disorders
Stephannie R. Motuz, Rehabilitation Centre for Children, Winnipeg, MB
This presentation will define Relationship Development Intervention ™ reviewing the service delivery model and the
consultant certification process. A brief overview of the core deficits targeted for remediation and the intervention
techniques will precede two case studies. A description of the local ongoing efficacy study of RDI techniques will
also be offered to the attendee.
Exploring the Ethical Dimension of Paediatric Speech-Language Pathology
Eleanor Stewart, University of Alberta, Edmonton, AB
This study developed a substantive account of ethical practice for speech-language pathologists working with
paediatric populations. Using grounded theory methodology, the research explored the perspectives of clinicians
active in clinical practice. The resulting model identified the central moral aim and defined ethical actions and the
characteristics of the ethical clinician.
Meeting the Clinical Education Challenge!
Susan J. Wagner, University of Toronto, Toronto, ON; Lu-Anne McFarlane, University of Alberta, Edmonton, AB;
Speakers TBD from Dalhousie University, Halifax, NS, McGill University, Montreal, QC, University of British
Columbia, Vancouver, BC, University of Laval, Laval, QC, University of Montreal, Montreal, QC, University of Ottawa,
Ottawa, ON and University of Western Ontario, London, ON
Research and experience indicate that clinicians receive minimal formal preparation in providing best practice
clinical education to students. The objectives of this panel session of academic coordinators of clinical education
will be to examine the clinical education process and share successful strategies among participants to meet the
clinical education challenge.
62
Something Tells Me We’re Not in the Therapy Room Anymore
John Serkiz, New Brunswick Department of Health and Wellness, Fredericton, NB;
Michele Lonergan, Miramichi Regional Health Authority, Miramichi, NB
New Brunswick has implemented Parle-moi/Talk With Me Services, which support communication development
in all preschool children. This unique service is expected to have a positive impact on school readiness skills across
the province through promotion, prevention, and community capacity building.
Using the ENNI for Narrative Assessment or Norm Development
Phyllis Schneider, Denyse Hayward, University of Alberta, Edmonton, AB; Rita V. Dube, Toronto District School Board,
Toronto, ON
In this seminar, we will present an instrument for collecting information about storytelling skills from children aged
4-9, the Edmonton Narrative Norms Instrument (ENNI). We will describe how the ENNI is used to assess children’s
storytelling; hands-on practice will be provided. We will also discuss how to develop local norms.
Poster Sessions
SPEECH-LANGUAGE PATHOLOGY
Communication Skills in Creutzfeldt-Jacob Disease: A Case Vignette
Gopee Krishnan, Raj Shekar, Manipal Academy of Higher Education, Manipal, Karnataka, India
Creutzfeldt-Jacob Disease (CJD) is an extremely rare, rapidly progressing, fatal condition with a unique clinical
phenotype. Communication skills and various other cognitive and motor skills are often compromised. This case
report will attempt to highlight the clinical characteristics, pathophysiology, findings of neurological and cognitivelinguistic evaluations, and management strategies in CJD.
FLUENCY
Subjective Severity Ratings of the Effect of SpeechEasy® on Stuttering
Marie S. Mossman, Cape Breton Family Place Resource Centre, Sydney, NS; Tiffany M. Steeves, Berry Mills, NB; Joy
Armson, Michael Kiefte, Dalhousie University, Halifax, NS
Participants rated the stuttering severity of oral reading samples made before and after persons-who-stutter wore
a SpeechEasy® device. Stuttering severity decreased by 3.31 points on a 9-point scale for the device compared to
the no-device condition. Except in two cases, a linear relationship between severity ratings and stuttering
frequencies was found.
DYSPHAGIA
The Need for Dysphagia Care Matrices in Acute Care Settings
Genefer Behamdouni, St. Jospeh’s Health Centre, Toronto, ON
In the past, case prioritization has been based on a variety of clinical, emotional, and time pressure factors. This
presentation will discuss a standardized approach to case load management, which supports clinical decision
making and reduces patient risk, and the development of an Adult Care Matrix.
Feeding and Swallowing Management: Manitoba Guidelines and Winnipeg Policy
Shelley Irvine Day, Angela Forrest Kenning, Kelly Tye Vallis, Monique Piatt, Deer Lodge Centre, Winnipeg, MB
In 2001, Manitoba Health distributed the Manual for Feeding and Swallowing Management in Long-Term Care (LTC)
Facilities to all personal care homes in Manitoba. The Winnipeg Regional Health Authority (WRHA) coined these
guidelines into policy in 2004. This poster will outline the breadth of the statements contained in both documents,
the implications on speech-language pathology and the implementation process in the WRHA.
Effortful Versus Non-Effortful Swallowing: Investigating Laryngeal Movement Patterns
Veronique L. Philbin, Rebecca C. Smith, Syed Salman Qadri, Ruth E. Martin, University of Western Ontario, London,
ON
We sought to determine whether effortful and non-effortful swallowing could be differentiated through the use of
a laryngeal movement transducer in healthy subjects. Results indicated that effortful and non-effortful swallowing
produce significantly different patterns of laryngeal movement. Thus, techniques for recording and displaying
laryngeal movement may prove to be effective biofeedback approaches for dysphagic patients.
Enhancing Dysphagia Rehabilitation: Is There a Role for the ICF?
Julie A. Theurer, University of Western Ontario, London, ON
This presentation will review traditional approaches to dysphagia rehabilitation, and examine issues arising in the
recent dysphagia literature that highlight the need for innovative new clinical and research practices. The role of
the International Classification of Functioning, Disability and Health (ICF) in enhancing dysphagia rehabilitation
will be explored.
63
CHILD LANGUAGE
Efficacy of Phonological Awareness Intervention for Children with Down Syndrome
Patricia L. Cleave, Elizabeth Kay-Raining Bird, Katie MacIsaac, Melissa Armstrong, Dalhousie University, Halifax,
NS; Derrick C. Bourassa, Acadia University, Wolfville, NS
This poster will describe the results of a training program designed to facilitate phonological awareness skills in
children with Down syndrome. Eight children were involved in the 22-week program. The response to the
intervention was variable such that 4 of 8 children showed gains. Variables predicting success will be discussed.
“Let’s Read and Talk”: A Community Preschool Language and Literacy Program
Janet P. Simpson, Winnipeg Regional Health Authority, Winnipeg, MB
This presentation will describe a community-based health promotion program designed to enhance caregiver skills
to facilitate language and literacy development in preschool children. Using storybook reading, “best practice”
strategies were presented, facilitated and coached. Evaluation of pre- and post-program videotapes has shown
substantive and statistically significant positive changes.
Computer-Assisted Treatment: Effects and Utilization in Speech-Language Pathology
Karla N. Washington, Genese A. Warr-Leeper, University of Western Ontario, London, ON
The pre-to-post outcomes of two computer-assisted treatment (C-AT) programs for preschoolers were examined.
One program targeted phonology and the other language. The effects of the phonology program included increased
accuracy and intelligibility and the effects of the language program were increased accuracy and variety of sentence
structures, length, and complexity.
Recast Density and Acquisition of Irregular Past Tense Verbs
Kerry E. Proctor-Williams, East Tennessee State University, Johnson City, TN; Marc E. Fey, University of Kansas
Medical Center, Kansas City, KS
At conversational recast rates 13 children with typical language produced irregular past verbs more accurately than
13 children with SLI. At intervention recast rates verb accuracy did not improve in the SLI group and the TL group’s
performance declined. The children’s metalinguistic productions suggest the groups used recast information
differently.
ADULT SERVICES
Analyse de la syntaxe chez les aphasiques de Broca et de Wernicke
Fouzia Badaoui, CRSTDLA, Alger
This paper presents the results of a research on two aphasics to examine their use of syntax based on the neokhalilien
linguistic model.
Effect of Language Therapy in Non-Fluent Primary Progressive Aphasia (NFPPA)
Annie Delyfer, Fanny Singer, CRIR, Jewish Rehabilitation Hospital, Laval, QC; Eva Kehayia, McGill University and
CRIR, Montreal, QC; Nancy Azevedo, McGill University, Montreal, QC
This poster presentation will address the usefulness of traditional language therapy with NFPPA patients. A review
of the literature as well as the test results of one NFPPA patient taken at three points in time indicate that language
therapy can improve some language functions for a certain period of time.
Crossed Aphasia and Singing Ability
Patrick Coppens, Plattsburgh State University of New York, Plattsburgh, NY; Sylvie Hébert, Université de Montréal,
Montreal, QC; Lise Gagnon, Université de Sherbrooke, Sherbrooke, QC
Crossed aphasia is caused by a lesion in the right hemisphere in a right-hander. Does this unusual language
lateralization pattern influence the neurological organization of right hemisphere skills, such as singing? Illustrated
by a clinical case, this poster presentation will attempt to answer this question and to extrapolate to aphasia
rehabilitation issues.
Development of an Interdisciplinary Low Tolerance Long Duration (LTLD) Stroke Rehabilitation
Program
Lauren Murphy, Fabian Krupski, St. Joseph’s Health Centre, Toronto, ON
Rehabilitation needs of stroke survivors are not homogenous. This presentation will examine the development of
an interdisciplinary low-tolerance, long duration (LTLD) stroke rehab program in a long-term care facility, designed
specifically for individuals who because of their age or severity of their stroke, are in need of more specialized services.
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Role of Phonology in Word Identification: A Comparison of College Readers
Randeep K. Sidhu, University of North Dakota, Winnipeg, MB; Charlene Chamberlain, University of North Dakota,
Grand Forks, ND
Undergraduate students (11 good, 11 average, and 9 poor readers) completed a reading test, a lexical decision and
a naming task with pseudohomophone stimuli to examine the role of phonology in word recognition as a function
of reading skills. Results showed no interaction. Clinical implications will be discussed.
CLINICAL PRACTICE
Competency-Based Intervention: What Would It Look Like?
Carolyn Cronk, Julie Fortier-Blanc, Louise Duchesne, Université de Montréal, Montreal, QC
This presentation will explore the implications of approaching speech and language intervention as a process of
establishing a series of competencies or functional capabilities constructed from a combination of accumulated
knowledge or awareness, basic abilities, and practiced skills. It will be illustrated by several clinical examples.
S-LP Practice Forges Ahead with Personal Digital Assistants
Alexa Okrainec, Brandon University, Brandon, MB
The Personal Digital Assistant (PDA), a powerful handheld computer, is an innovation that can advance the delivery
of speech-language pathology services. This presentation will feature the usefulness of the PDA in clinical practice,
going beyond the popularized date and address book functions.
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Congrès de l’ACOA 2006 - Abrégés
C o ngrès de l’ACOA 2006
Winnip
anit
o ba
innipee g , M
Manit
anito
du 3 au 6 mai 2006
Ateliers pré-congrès
Trachéotomie et gestion de la respiration par ventilation assistée, verbalisation et déglutition chez
les adultes
Donna Tippett, Départements d’oto-rhino-laryngologie – chirurgie de la tête et du cou, de médecine physique et
de réadaptation, Johns Hopkins University, Baltimore (Maryland)
La gestion des troubles de verbalisation et de déglutition chez les adultes ayant subi une trachéotomie et respirant
par ventilation assistée pose tout un défi. Cet atelier présentera de l’information de niveau de base et intermédiaire
pour préparer les orthophonistes à évaluer et à traiter des adultes ayant des troubles de verbalisation et de déglutition.
Le contenu de l’atelier intéressera aussi les ergothérapeutes, les physiothérapeutes, les infirmières et les
inhalothérapeutes.
Le modèle SCERTS : une approche pédagogique complète et multidisciplinaire pour les enfants aux
prises avec les troubles du spectre autistique
Emily Rubin, Director, Communication Crossroads, Carmel (Californie)
Cet atelier définira le modèle SCERTS, une approche pédagogique complète et multidisciplinaire conçue pour
augmenter les capacités socio-émotionnelles et de communication des enfants aux prises avec les troubles du
spectre autistique et pour offrir un soutien aux familles et aux professionnels. L’acronyme SCERTS fait référence
à trois grandes dimensions du modèle. Les objectifs de développement en communication sociale (social
communication – SC) et la régulation des émotions (emotional regulation – ER) sont atteints grâce à des soutiens
au traitement interactif (transactional supports – TS) (p. ex. : adaptation du style interpersonnel, accommodement
de l’environnement, soutiens visuels, etc.) à chaque instant du quotidien de l’enfant et chez les partenaires sociaux
afin de faciliter la compétence dans les domaines ciblés des contextes fonctionnels et significatifs (p. ex. : à domicile,
à l’école et dans la collectivité). L’atelier débutera par un survol de la documentation actuelle sur l’efficacité des
traitements et sur les lignes directrices de traitement pour la programmation pédagogique mises de l’avant par la
National Academy of Science aux États-Unis. Cette présentation sera suivie par des lignes directrices pratiques pour
mettre en œuvre ce modèle, ce qui sera illustré par des études de cas sur vidéo.
Ateliers en orthophonie et audiologie
Donner libre cours au potentiel des particuliers et des services
Jim McLaren, Winnipeg (Man.)
Les intervenants avant-gardistes comprennent que les relations constituent la véritable « monnaie » actuelle et future
du monde du travail et que les techniques d’encadrement peuvent servir à nouer des relations. L’encadrement fonctionne
sur le principe que le client est celui qui possède la clé des réponses à toutes les situations. L’encadrement sert à l’aider
à trouver ces solutions. Alison Hendron, directrice de la formation pour la programme Certified Executive Coaching à la
Royal Roads University, décrit l’encadrement en ces termes : « Prenons l’exemple de quelqu’un qui veut apprendre à
faire de la bicyclette : un consultant lui explique les différentes bicyclettes et lui recommande la meilleure pour sa
situation; un thérapeute l’aide à surmonter sa peur de tomber; et la personne chargée de l’encadrement court à côté
d’elle pour s’assurer qu’elle ne tombera pas avant de pouvoir pédaler seule ». Cette séance plénière vise à partager l’état
des connaissances sur la puissance de l’encadrement et sur toutes les possibilités qu’il offre pour l’exercice clinique.
Ateliers en audiologie
J’avais une emprise sur ma vie, mais je ne l’ai plus
Shari Robertson, Phoenix Enterprises, Indiana (Pennsylvanie)
Cette séance offrira des stratégies éprouvées pour gérer le temps et le stress. Elle s’adresse aux professionnels dans
le domaine des troubles de la communication. Cette séance se déroulera à un rythme accéléré et fera souvent appel
à la participation de l’auditoire. Il y aura beaucoup de rires.
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Couverture par l’assurance/une tierce partie – Démystifier le monde des assurances et des tiers
payants
Katherine Cheney, Stewart McIntosh, Anciens combattants Canada; Tania Stote, Croix bleue Medavie; Jocelyne
Lavergne-Robenhymer, Direction générale de la santé des Premières nations et des Inuits, Services de santé non
assurés (SSNA); Michael O’Brien, Agence du revenu du Canada : Crédit d’impôt pour personnes handicapées
Cette séance vous offrira l’occasion de découvrir les politiques et les mécanismes de financement du ministère
canadien des Anciens combattants, de la Commission des accidents du travail, des Services de santé non assurés,
de la Croix bleue et d’autres tiers payants et compagnies d’assurance. Vous aurez l’occasion de poser des questions
particulières à chacun des conférenciers.
Soyons critique!: que faut-il chercher dans les rapports de recherche que nous lisons
Lisa Lix, Université du Manitoba, Winnipeg (Man.)
L’expression « prise de décisions fondée sur des résultats scientifiques » est presque devenue un cliché. Mais dans
les faits, comment est-il possible d’utiliser effectivement des résultats scientifiques pour prendre des décisions au
travail? Cette séance mettra l’accent sur trois principaux éléments qui doivent ressortir d’un examen critique d’une
étude : (1) le message : quelle sont les principales conclusions? (2) la méthode : les conclusions sont-elles justifiées
par rapport aux données et à l’analyse? (3) le portrait d’ensemble : les résultats sont-ils pertinents pour les clients
qui viennent me consulter?
Conception universelle : une éducation sensée pour tous les élèves
Karen Priestley, Winnipeg (Man.)
La conception universelle est un nouveau cadre intéressant pour instaurer de nouvelles façons de répondre aux
besoins de notre population étudiante variée. Il s’agit d’un mouvement vers l’actualisation de l’inclusion dans le
sens le plus pur de l’expression puisque ce cadre voit les élèves du point de vue de leurs besoins et n’adhère pas
à la catégorisation des incapacités. La conception universelle met l’accent sur l’accès de tous les élèves au
programme. Elle sous-entend que l’on cesse d’adapter les instructions, les programmes et les évaluations afin de
tenir compte des besoins variés ou exceptionnels des élèves à mesure qu’ils se manifestent (inclusion) pour plutôt
faire preuve de clairvoyance en prévoyant et en planifiant des moyens de répondre à tous les besoins de manière
unilatérale (conception universelle). Cette méthode d’enseignement n’est pas radicalement nouvelle, mais elle
élargit plutôt nombre de nos façons de faire actuelles et mise sur ce que les personnes qui œuvrent dans le domaine
de l’enseignement savent déjà à partir de la recherche et de la pratique au sujet des bonnes méthodes d’enseignement
et de la création de milieux accessibles. La conception universelle est englobante et fait appel à tous les membres
de la communauté d’apprentissage.
Les bases théoriques de la conception universelle sont issus du domaine de l’architecture et sont utilisées en
éducation depuis environ 1990. La conception universelle est particulièrement associée avec le champ de
l’éducation spéciale. Ce domaine se sert de la conception universelle pour faire en sorte que le programme général
est accessible à tous les élèves peu importe les besoins en matière d’apprentissage. La mise en œuvre de la conception
universelle fait appel à la restructuration, à la créativité et à la collaboration.
Une méthode d’entraînement
Jim McLaren, Winnipeg (Man.)
Cette séance présentera une approche dynamique et fondée sur l’expérience pour l’apprentissage. La journée est
conçue pour offrir la souplesse maximale afin de traiter les « points de douleur » et de répondre aux besoins ainsi
qu’aux intérêts de chaque participant. Elle met l’accent sur la discussion de groupe et mise sur la sagesse et
l’expérience collective des participants. Les activités portent sur des techniques d’apprentissage, telles que les
études de cas, les exercices pratiques, les jeux de rôles, les démonstrations, la prise de conscience de soi et les travaux
en équipe.
À la fin de la séance, les participants auront :
·
partagé leur expérience et fait ressortir les comportements qui leur posent des défis dans leur pratique
·
mis à l’essai la méthode d’entraînement et déterminé les aspects clés qui peuvent les aider à assurer la
prestation de leurs services
·
mis à l’essai des techniques d’entraînement nécessaires pour relever les défis qui nuisent à la prestation des
services
·
rehaussé la confiance en leurs moyens, leur responsabilisation à leur égard et leur niveau d’enthousiasme
vis-à-vis de la méthode d’entraînement
Évaluation multidisciplinaire et gestion des troubles de traitement des informations auditives
James W. Hall III, University of Florida, Gainesville (Floride); Diane P. Wertz, University of Florida, Gainesville, (Floride)
Les troubles de traitement des informations auditives suscitent un intérêt sans précédent chez les audiologistes,
les orthophonistes et les parents d’enfants qui ne réussissent pas bien à l’école. Le diagnostic différentiel de ces
troubles pose cependant des défis pour les audiologistes. Les méthodes et les protocoles d’évaluation vont largement
au-delà de l’audiogramme et les stratégies de traitement sont très variées et doivent être étroitement coordonnées
67
avec d’autres professionnels. De plus, il faut distinguer ces troubles d’une série d’autres troubles concomitants,
tels que la dyslexie, les troubles du langage et l’hyperactivité avec déficit de l’attention. Ce nouvel atelier intéressant
fournira à l’audiologiste et à l’orthophoniste en milieu clinique une approche multidisciplinaire pratique et logique
pour évaluer et gérer cette population substantielle et mal desservie. Fondée sur des sciences fondamentales et
appliquées, cette approche est utilisée quotidiennement au département des troubles de la communication,
programme de diagnostic et de traitement multidisciplinaire, de l’University of Florida. Cette séance offrira au
clinicien des messages pratiques qui lui serviront de retour chez lui.
Ateliers en audiologie
Sélection et vérification des appareils auditifs modernes
Gustav Mueller, Vanderbilt University, Nashville (Tennessee)
Le Dr Mueller abordera les points suivants :
A.
Caractéristiques souhaitables ou nécessaires dans un appareil moderne
B.
Établissement des objectifs d’appareillage
C.
Vérification des objectifs d’appareillage
D.
Vérification des caractéristiques de l’appareil auditif
E.
Diagnostic des difficultés éprouvées par le patient
Au-delà de l’essentiel : explorer le système auditif
Barbara Reynolds, Green Valley (Ont.)
Traitement temporel et acoustique spatiale : Le système auditif traite l’information au moins une fois plus
rapidement que le système visuel. Les troubles de traitement auditif temporel ont une incidence sur ce que nous
entendons et ce que nous comprenons ainsi que sur d’autres aspects, y compris le transfert interhémisphérique
et le traitement spatial. Cette séance présentera de l’information sur le traitement temporel et son incidence sur
le développement de la perception auditive, par le biais du vieillissement et à la suite d’une carence auditive. Le
système auditif possède une voie du « quoi » et du « où ». Cette séance présentera divers aspects de la perception
spatiale auditive chez les humains, qui depasse simplement la localisation à gauche ou à droite d’un son. Elle fera
un survol de la neurophysiologie et des conséquences de la perte de l’acoustique spatiale, mais du point de vue
de la perception et de sa relation avec les appareils auditifs et les besoins de counselling.
Systèmes de stimulation ascendante et descendante : systèmes de traitement du cortex qui influent sur
la plasticité et incidences sur la carence/réadaptation auditive – Lorsque nous pensons au système auditif,
nous nous limitons souvent aux voies ascendantes. Divers domaines du cerveau qui ne sont pas souvent pris en
considération peuvent pourtant avoir une incidence sur le système auditif, aussi loin que le noyau cochléaire et
la cochlée. Cette séance porte sur les concepts de systèmes de stimulation ascendante (feedforward) et de
stimulation descendante (feedback) qui peuvent influencer la plasticité corticale, l’apprentissage et la réadaptation/
carence auditive. Le fait de comprendre le fonctionnement complet du système auditif peut nous aider à faire
comprendre aux patients et aux autres professionnels de la santé l’importance du système auditif au-delà de la
cochlée.
Antécédents médicaux : pourquoi est-ce important – Il peut sembler tout simple de noter les antécédents
médicaux d’un patient, mais il ne faut pas se limiter à poser les questions habituelles sur les bruits entendus ou
les difficultés d’écoute. Cette séance abordera d’autres questions concernant les antécédents et la santé qui
peuvent avoir une incidence sur la perception et influer sur l’ajustement ou le réglage des appareils auditifs. De
plus, elle traitera aussi du counselling pour faire comprendre aux patients l’importance de l’amplification précoce,
l’échéancier réaliste de la réadaptation ainsi que les résultats individuels à escompter.
Mise à jour sur l’Alzheimer : Cette séance se veut la suite d’une autre précédente sur les effets de l’Alzheimer
sur le système auditif et les systèmes connexes. Elle traitera des effets sur la neurophysiologie et les changements
perceptuels auxquels on peut s’attendre chez un patient souffrant de la maladie d’Alzheimer. Les questions liées
à l’amplification et au counselling seront aussi abordées.
ASSR et acouphène
James W. Hall III, University of Florida, Gainesville (Floride)
Rôle des réponses auditives à l’état stable en audiologie de nos jours
Cette séance débute par un survol historique des réponses auditives à l’état stable (RAÉS) suivi par un examen
des principes et des procédures de mesure de ces réponses. Le rôle des RAÉS dans la batterie de tests en pédiatrie
sera défini en mettant l’accent sur l’utilisation de ces réponses pour évaluer le seuil d’audition des enfants en bas
âge. Les avantages et les inconvénients en milieu clinique des RAÉS pour l’évaluation des enfants seront illustrés
grâce à des exposés de cas originaux. La séance comprendra aussi une discussion sur d’autres applications cliniques
des RAÉS chez les enfants et les adultes.
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Évaluation audiologique et gestion de l’acouphène
L’acouphène ou l’hyperacousie affecte des millions de personnes aux États-Unis, au Canada et dans d’autres pays
développés. Au cours des dernières années, un nombre de recherches sans précédent ont été menées dans ce
domaine, qui a aussi suscité beaucoup d’intérêt en milieu clinique. Ce cours d’instruction mettra l’accent sur les
principes, les protocoles et les pratiques actuels qui importent pour l’évaluation audiologique et la gestion de
l’acouphène. Il fournira aussi aux audiologistes et aux oto-rhino-laryngologistes en exercice une méthode réaliste
en milieu clinique pour traiter efficacement cette population complexe et mal desservie. La présentation
comprendra un survol des mécanismes de base de l’acouphène ou hyperacousie, une batterie de test détaillée pour
établir un diagnostic et un examen des options de traitement.
Ateliers en orthophonie
Trachéotomie et gestion de la respiration par ventilation assistée, verbalisation et déglutition chez
les adultes
Donna Tippett, Départements d’oto-rhino-laryngologie – chirurgie de la tête et du cou, de médecine physique et
de réadaptation, Johns Hopkins University, Baltimore (Maryland)
Ce cours présentera de l’information de niveau intermédiaire et avancé et s’adresse tout particulièrement aux
orthophonistes. Il abordera les polémiques du monde clinique, l’exercice fondé sur les résultats cliniques et
scientifiques, la qualité de vie et les dilemmes d’ordre éthique. Il comprend aussi une partie interactive où les
participants pourront présenter des cas difficiles et en discuter.
La communication sociale chez les enfants et les adolescents aux prises avec l’autisme de haut
niveau et le syndrome d’Asperger
Emily Rubin, Director, Communication Crossroads, Carmel (Californie)
Cette séance débutera par un survol des principaux défis sociaux et troubles de communication des enfants et des
adolescents aux prises avec l’autisme de haut niveau et le syndrome d’Asperger. Elle passera aussi en revue l’état
actuel de nos connaissances sur les divers styles d’apprentissage qui distinguent ces troubles. Ensuite, elle explorera
les composantes essentielles d’un programme d’éducation complet en vue d’établir des lignes directrices pour
classer par ordre de priorité les objectifs d’éducation et de thérapie. Les lignes directrices pour déterminer les aides
appropriées à l’apprentissage et les aménagements éducatifs nécessaires seront également abordées. La séance
mettra l’accent sur les aides à l’apprentissage conçus pour améliorer la communication sociale et la régulation des
émotions (p. ex. : reprise vidéo, cartes des amitiés et livrets des sentiments).
Phase œsophagienne de la déglutition et ses troubles : ce que doit savoir tout orthophoniste
Caryn Easterling, University of Wisconsin-Milwaukee, Pewaskee (Wisconsin)
Cette séance d’une demi-journée animée par Caryn S. Easterling, Ph. D., portera sur l’anatomie et la physiologie
de la phase œsophagienne de la déglutition chez les adultes. Elle présentera un survol de la recherche dans le
domaine de la physiologie et de la pathophysiologie de l’œsophage, les interprétations cliniques et les incidences.
Les instruments cliniques qui servent à poser un diagnostic et à gérer les troubles de la phase œsophagienne de
la déglutition y seront également abordés. La séance présentera le raisonnement derrière l’exercice de Shaker, son
élaboration, son application clinique et son utilisation par une équipe multidisciplinaire. Cet exercice vise à renforcer
l’ouverture du sphincter supérieur de l’œsophage lors de la déglutition.
Lis avec moi
Cette séance mettra en contexte la relation entre la langue et l’apprentissage de la lecture et de l’écriture (les deux
font appel à la forme, au contenu et à l’utilisation) et démontrera six stratégies interactives pour favoriser ces deux
aspects chez tous les groupes d’âge et pour toutes les formes de déficiences. Ces stratégies peuvent même être
enseignées aux parents. Il est aussi possible d’élargir les stratégies pour inclure des façons d’utiliser la lecture
interactive avec des enfants plus âgés et de rehausser les aptitudes à la lecture. Des listes de livres, de la
documentation pour les parents, des exercices pratiques et autres ressources seront fournis.
Fente labiale/palatine et dysfonctionnement vélopharyngé : effets sur la parole et la résonance
Ann Kummer, Cincinnati Children’s Hospital Medical Center, Cincinnati (Ohio)
Cette séance présentera l’anatomie oro-pharyngée de base, les types de fente, le dysfonctionnement vélopharyngé
et les troubles de résonance. Elle décrira les techniques d’évaluation de haute technologie et de base. Les options
de traitement y seront abordées, y compris la chirurgie, les prothèses et l’orthophonie, et des techniques de thérapie
précises y seront démontrées.
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Cancer/oncologie de la tête et du cou : des nouvelles pour les orthophonistes
Candace Myers, CancerCare Manitoba, Winnipeg (Man.)
Cette séance effectuera un survol de la gestion actuelle des patients atteints d’un cancer de la tête et du cou, y
compris les options de traitement, l’évaluation et la gestion de la dysphagie et des symptômes, les soins
psychosociaux et la transition vers les soins en fin de vie. Elle présentera aussi un examen des résultats fonctionnels
contenus dans la documentation actuelle et obtenus par CancerCare Manitoba. Enfin, elle fournira des références,
des ressources et une orientation pour la formation professionnelle continue.
Établir des liens en salle de classe
Cet atelier porte sur l’intervention auprès des enfants d’âge scolaire. Il vise trois objectifs principaux : accroître les
capacités cognitives, accroître les capacités pragmatiques et renforcer les capacités linguistiques et métalinguistiques,
notamment des capacités langagières (narration et exposition). Cet atelier fournira de nombreux exemples et des
plans de leçon.
Traitement de l’aphasie par thérapie complémentaire et parallèle
Kristine Lundgren, Harold Goodglass Aphasia Research Center, Boston (Massachusetts)
Le champ de la médecine complémentaire et parallèle occupe une place en plein essor dans bien des programmes
de médecine et de réadaptation. Il a été intégré dans la médecine interne, l’oncologie, la psychologie, la
physiothérapie et l’ergothérapie. Cette séance mettra ce champ en contexte, décrira les recherches préliminaires
qui sont favorables à l’utilisation d’approches non traditionnelles (relaxation, zoothérapie, pleine conscience du
moment présent, acupuncture, stimulation magnétique crânienne), et expliquera des façons d’intégrer certaines
de ces thérapies dans l’orthophonie traditionnelle. Des études de cas auprès d’adultes souffrant de troubles de la
communication seront aussi présentées. La séance sera de niveau intermédiaire.
Former les éducatrices de la petite enfance à favoriser l’acquisition du langage et l’apprentissage
de la lecture et de l’écriture
Janice Greenberg, The Hanen Centre, Toronto (Ont.)
Cette séance présentera une démarche fondée sur la recherche pour former les éducatrices de la petite enfance
à favoriser le développement social et linguistique ainsi que l’apprentissage de la lecture et de l’écriture dans des
milieux naturels. Grâce à une combinaison de formation en groupe et à des séances individuelles de filmage et de
rétroaction, les éducatrices apprennent comment utiliser le jeu et les activités quotidiennes pour créer des milieux
inclusifs propices à l’apprentissage du langage.
Rôle de l’orthophoniste dans le traitement du mutisme sélectif et d’autres troubles psychogènes
Suzanne Hungerford, Plattsburgh State University of New York, Plattsburgh (New York)
Bien que les troubles de communication psychogènes ne soient pas courants, les orthophonistes reçoivent en
consultation des personnes qui en sont atteintes. Dans ces cas, ils se sentent souvent mal préparés pour répondre
aux besoins de cette clientèle. Cette séance vise à mieux faire connaître certains de ces troubles aux orthophonistes
et à aborder le traitement.
Les présentations proposées en audiologie
Pouvez-vous offrir ce que les consommateurs cherchent/veulent?
Michel David, Janice McNamara, Association des malentendants canadiens, Ottawa (Ont.)
Cette communication abordera les conclusions de l’enquête 2005 sur la sensibilité à la perte auditive. Elle présentera
une analyse des causes et effets pour comprendre certaines des préoccupations formulées par les consommateurs.
Les réponses à cette enquête sont révélatrices puisqu’elles mettent en lumière les problèmes et les enjeux dont il
faut tenir compte.
Les présentations proposées en orthophonie
Syndrome de Shy-Drager: des responsabilités multiples pour les orthophonistes
Richard J. Welland, Brock University, St. Catharines (Ont.)
L’atrophie multisystématisée est une expression qui comprend un groupe de troubles neurodégénératifs chez
l’adulte, notamment le syndrome de Shy-Drager. Les patients atteints de ce type d’atrophie présentent généralement
trois signes et symptômes : dysarthrie, dysphagie et démence. La combinaison de ces trois troubles pose des défis
particuliers pour les orthophonistes.
Équipes de soins de longue durée en dysphagie pour les survivants d’un accident vasculaire
cérébral
Rosemary Martino, Becky French, Shelley Sharp, Lisa Durkin, UHN, Toronto Western Hospital, Toronto (Ont.)
Trois établissements de soins de longue durée du Toronto West Regional Stroke Network (réseau régional de
traitement des accidents vasculaires cérébraux de l’Ouest de Toronto) mettront sur pied des équipes de soins pour
les survivants d’un accident vasculaire cérébral atteints de la dysphagie. La communication présentera les obstacles
à franchir pour former ces équipes, les connaissances qui doit posséder le personnel et leur niveau de satisfaction.
Ces équipes aideront à repérer les survivants qui doivent être suivis par un orthophoniste.
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Mesures d’impact de l’aphasie : cadre pour « mesurer ce qui compte »
Aura Kagan, Jennifer Hicks, Elyse Shumway, The Aphasia Institute, Toronto, ON; Nina Simmons-Mackie,
Southeastern Louisiana University and The Aphasia Institute, Abita Springs, LA; Maria Huijbregts, Baycrest Centre
for Geriatric Care, Toronto, ON; Sara McEwen, The Aphasia Institute, Hawkestone, ON
Cette communication relèvera les écarts de la mesure des résultats entre la vraie participation à la vie et la vie avec
l’aphasie. Les auteures présenteront un cadre convivial et accessible pour les aphasiologistes en milieu clinique qui
saisit les grands concepts du savoir actuel au sein de notre secteur et au-delà et elles s’en serviront particulièrement
pour mesurer les résultats de vie réelle des aphasiques ayant subi une intervention.
L’aphasie et les soins en établissement
Jennifer Sweeney, cabinet privé, Vancouver (C.-B.)
Au cours des dernières années, l’exercice de l’orthophonie a changé pour inclure les principes de soins axés sur les
clients et sur la famille. Nous disposons de connaissances et d’outils pour favoriser l’autonomie et la qualité de vie.
Cette communication mettra l’accent sur les défis d’offrir un soutien dans tout le système aux aphasiques qui sont
admis en établissement.
Les besoins en matière de communication des adultes qui ne parlent pas et qui reçoivent des soins
actifs: résultats d’une enquête
Colleen A. Braun-Janzen, Leslie Mennell, Centre des sciences de la santé, Winnipeg (Man.)
Cette communication présente une étude sur les modèles de pratique, les opinions concernant les normes des
meilleures pratiques pour la prise en charge en soins actifs de patients qui ne parlent pas. Les résultats de l’enquête
laissent entendre que le nombre d’orthophonistes dans les établissements de soins actifs est insuffisant pour
répondre de manière adéquate aux besoins en matière de communication, ce qui fait que les infirmières doivent
souvent faciliter la communication directe.
Attitudes et perceptions des adultes aux prises avec des troubles acquis graves de la communication
Colleen A. Braun-Janzen, Deer Lodge Centre, Winnipeg (Man.)
Cette communication présente une enquête menée auprès de quatorze adultes aux prises avec un trouble acquis de
la communication et qui doivent recourir à la communication suppléante et alternative. Les répondants ont réfléchi
aux avantages et aux frustrations d’utiliser cette forme de communication, à la transition d’une personne qui parle
et à une personne qui doit compter sur la communication suppléante et alternative, et à des suggestions pour aider
les personnes qui parlent à communiquer avec les personnes qui utilisent la communication suppléante et alternative.
Évaluation des carences de la communication cognitive de haut niveau
Sheila MacDonald, Sheila MacDonald & Associates, Guelph (Ont.)
L’évaluation d’un déficit léger de la communication après une lésion cérébrale acquise peut poser tout un défi pour
l’orthophoniste en milieu clinique. L’évaluation fonctionnelle de la logique verbale et des stratégies d’exécution est
un test uniforme conçu pour aider l’orthophoniste dans cette situation. Cette communication discutera des enjeux
liés à l’évaluation des troubles cognitifs de la communication et présentera les résultats d’une étude normative de
cette évaluation.
Mesures des résultats obtenus par les enfants atteints du spectre autistique après que leurs parents
aient suivi une formation
Tara Davies, Luigi Girolametto, University of Toronto, Toronto (Ont.); Fern Sussman, Elaine Weitzman, The Hanen
Centre, Toronto (Ont.)
Cette communication résumera les résultats obtenus par les participants au programme More Than Words, qui
s’adresse aux parents d’un enfant atteint du spectre autistique. À la suite du programme, les douze enfants ont
réussi à accroître leur durée d’attention conjointe. Les résultats obtenus par les parents, tels qu’ils ont été mesurés
par l’échelle Joy and Fun (JAFA; McConachie et Currill, 2002) montrent une amélioration du score final entre le test
mené avant la formation et celui après.
Initiation au traitement Relationship Development Intervention™ pour les personnes aux prises
avec le spectre autistique
Stephannie R. Motuz, Rehabilitation Centre for Children, Winnipeg (Man.)
Cette communication définira les techniques de Relationship Development Intervention™ en passant en revue les
modes de prestation de services et la démarche d’agrément pour les experts-conseils. Elle effectuera un bref survol
des grandes lacunes qui seront corrigées et des techniques d’intervention avant de présenter deux études de cas. Elle
décrira aussi l’étude locale en cours sur l’efficacité de ces techniques.
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Explorer la dimension éthique de l’orthophonie pédiatrique
Eleanor Stewart, University of Alberta, Edmonton (Alb.)
Cette communication présentera un compte rendu détaillé des pratiques en matière de déontologie adoptées par les
orthophonistes qui travaillent auprès d’enfants. À partir d’une méthode fondée sur la théorie à base empirique, cette
recherche s’est penchée sur le point de vue des cliniciens exerçant en milieu clinique. Le modèle qui en résulte a fait
ressortir l’objectif moral central et a défini les actions en matière d’éthique et les caractéristiques d’un clinicien
respectueux de la déontologie.
Relever le défi de la formation clinique!
Susan J. Wagner, University of Toronto, Toronto (Ont.); Lu-Anne McFarlane, University of Alberta, Edmonton (Alb.)
Conférenciers à annoncer: Dalhousie University, Halifax (N.-É.), Université McGill, Montréal (Qué.), University of
British Columbia, Vancouver (C.-B.), Université Laval, Québec (Qué.), Université de Montréal, Montréal (Qué.),
Université d’Ottawa, Ottawa (Ont.) et University of Western Ontario, London (Ont.)
La recherche et l’expérience montrent que les cliniciens reçoivent seulement une préparation minimale pour offrir
une formation clinique fondée sur les meilleures pratiques aux étudiants. Ce panel d’experts composé de
coordonnateurs de stages en milieu clinique a pour objectif d’examiner la formation clinique. Les participants
pourront partager leurs stratégies fructueuses pour relever le défi de la formation clinique.
Mon petit doigt me dit que nous ne sommes plus en séance de thérapie
John Serkiz, ministère de la Santé et du Bien-être du Nouveau-Brunswick, Fredericton (N.-B.); Michele Lonergan,
Régie régionale de la santé de Miramichi, Miramichi (N.-B.)
Le Nouveau-Brunswick a mis en œuvre l’initiative Parle-moi/Talk With Me, qui favorise l’apprentissage de la
communication chez tous les enfants d’âge préscolaire. Grâce à la promotion, à la prévention et à la mise en valeur
du potentiel, ce service unique devrait avoir une incidence positive pour préparer les enfants à l’école dans toute la
province.
Recours à l’ENNI pour l’évaluation narrative ou l’élaboration de normes
Phyllis Schneider, Denyse Hayward, University of Alberta, Edmonton (Alb.); Rita V. Dube, Toronto District School
Board, Toronto (Ont.)
Dans cette communication, nous présenterons un instrument pour recueillir de l’information sur les capacités à
conter des histoires des enfants de 4 à 9 ans. Cet instrument porte le nom d’Edmonton Narrative Norms Instrument
(ENNI). Nous décrirons comment l’ENNI sert à évaluer les capacités à conter des histoires des enfants. Les participants
auront la possibilité d’en faire l’expérience pratique. Nous discuterons aussi de la façon d’élaborer des normes
locales.
COMMUNICATIONS AFFICHÉES
ORTHOPHONIE
Les aptitudes de communication et la maladie de Creutzfelt-Jakob : une vignette d’étude de cas
Gopee Krishnan, Raj Shekar, Académie d’études supérieures de Manipal, Manipal, Karnataka, Inde
La maladie de Creutzfelt-Jakob est un trouble mortel extrêmement rare à progression rapide. Elle a un phénotype
clinique unique. Les aptitudes à la communication et différentes autres habiletés cognitives et motrices sont souvent
atteintes. Ce rapport de cas tentera de présenter les caractéristiques cliniques, la pathophysiologie, les résultats
d’évaluations neurologiques et cognitivo-linguistiques, et les stratégies de gestion de la maladie.
FLUIDI
TÉ
FLUIDIT
Indice de gravité subjective de l’effet de SpeechEasy® sur le bégaiement
Marie S. Mossman, Cape Breton Family Place Resource Centre, Sydney (N.-É.); Tiffany M. Steeves, Berry Mills (N.B.); Joy Armson, Michael Kiefte, Dalhousie University, Halifax (N.-É.)
Des participants ont évalué la gravité du bégaiement à partir d’échantillons de lecture orale prélevés avant que des
personnes bègues portent l’appareil SpeechEasy® et après. La gravité du bégaiement décroît de 3,31 points sur une
échelle de 9 points pour les personnes qui portent l’appareil par comparaison à celles qui ne le portent pas. Exception
faite de deux cas, nous avons trouvé une relation linéaire entre l’évaluation de la gravité et la fréquence du
bégaiement.
DYSPHAGIE
Nécessité d’une matrice de soins pour la dysphagie en milieu de soins actifs
Genefer Behamdouni, St. Joseph’s Health Centre, Toronto (Ont.)
Dans le passé, la priorité de chaque cas était fondée sur divers facteurs cliniques, émotifs et liés à des contraintes de
temps. Cette communication présentera une approche uniforme pour la gestion des cas qui sert à prendre des
décisions en clinique et à réduire les risques pour les patients. Elle traitera aussi d’une matrice de soins aux adultes.
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Gestion de l’alimentation et de la déglutition: lignes directrices du Manitoba et politique de
Winnipeg
Shelley Irvine Day, Angela Forrest Kenning, Kelly Tye Vallis, Monique Piatt, Deer Lodge Centre, Winnipeg (Man.)
En 2001, le ministère de la Santé du Manitoba a distribué le Manuel de Gestion des problèmes alimentaires et des
troubles de déglutition dans les établissements de soins de longue durée à tout le personnel des établissements de
soins de longue durée de la province. En 2004, l’Office régional de la santé de Winnipeg a transformé ces lignes
directrices en une politique. Cette présentation par affiche soulignera la portée des énoncés contenus dans les deux
documents, les incidences pour l’orthophonie et le processus de mise en œuvre à l’Office.
Déglutition laborieuse par opposition à non-laborieuse : enquête sur les modèles de mouvement
du larynx
Veronique L. Philbin, Rebecca C. Smith, Syed Salman Qadri, Ruth E. Martin, University of Western Ontario, London
(Ont.)
Nous avons cherché à déterminer s’il était possible de distinguer la déglutition qui demande un effort de celle
sans effort chez des sujets en santé grâce à un transducteur de mouvement laryngien. Les résultats montrent
que chaque forme de déglutition produit des types très différents de mouvement laryngien. Ainsi, les techniques
d’enregistrement et d’affichage du mouvement laryngien pourraient s’avérer être des approches de rétroaction
biologique très utiles pour les patients atteints de trouble de la déglutition.
Améliorer la réadaptation des personnes dysphagiques : l’ICF a-t-elle un rôle à jouer?
Julie A. Theurer, University of Western Ontario, London (Ont.)
Cette communication passera en revue les méthodes habituelles de traitement des troubles de déglutition et
examinera les questions soulevées dans des articles récents qui mettent en lumière la nécessité d’adopter de
nouvelles pratiques novatrices en clinique et en recherche. Elle explorera aussi le rôle de la Classification
internationale sur le fonctionnement, l’invalidité et la santé en vue d’améliorer le traitement de la dysphagie.
LANGAGE DE L’ENFANT
Efficacité de la sensibilisation phonologique chez les enfants atteints du syndrome de Down
Patricia L. Cleave, Elizabeth Kay-Raining Bird, Katie MacIsaac, Melissa Armstrong, Dalhousie University, Halifax (N.É.); Derrick C. Bourassa, Acadia University, Wolfville (N.-É.)
Cette présentation par affiche décrira les résultats d’un programme de formation conçu pour faciliter la sensibilisation
phonologique chez les enfants atteints du syndrome de Down. Huit enfants ont participé à un programme de vingtdeux semaines. Leur réaction à l’intervention a varié; quatre des huit enfants ont montré une amélioration. Les
variables permettant de prévoir le succès de l’intervention seront présentées.
« Let’s Read and Talk » : un programme communautaire préscolaire pour apprendre à parler, à lire
et à écrire
Janet P. Simpson, Office régional de la santé de Winnipeg, Winnipeg (Man.)
Cette communication décrira un programme communautaire de promotion de la santé conçu pour améliorer les
compétences des intervenants afin qu’ils puissent faciliter l’apprentissage du langage ainsi que l’éveil à la lecture et
à l’écriture chez les enfants d’âge préscolaire. À partir d’une histoire dans un livre, on a présenté les meilleures
pratiques et on a encadré leur mise en œuvre. Une évaluation et des enregistrements effectués avant et après le
programme ont montré des améliorations importantes et significatives.
Traitement assisté par ordinateur : effets et utilisation de l’orthophonie
Karla N. Washington, Genese A. Warr-Leeper, University of Western Ontario, London (Ont.)
Les résultats avant et après deux programmes de traitement assisté par ordinateur chez des enfants d’âge préscolaire
ont été examinés. Un programme visait la phonologie et l’autre, la langue. Le programme sur la phonologie a eu pour
effet d’accroître l’exactitude et l’intelligibilité. L’autre programme a réussi à améliorer l’exactitude ainsi que la
variété, la longueur et la complexité des structures de phrases.
Densité de la reformulation et acquisition des temps de verbe irréguliers du passé
Kerry E. Proctor-Williams, East Tennessee State University, Johnson City (Tennessee); Marc E. Fey, University of
Kansas Medical Center, Kansas City (Kansas) Center, Kansas City, KS
À un débit de reformulation en conversation, treize enfants ayant un langage type ont utilisé des verbes irréguliers
au passé avec davantage d’exactitude que des enfants atteints d’un trouble d’orthophonie. À un débit de reformulation
en cours de traitement, l’exactitude des verbes ne s’est pas améliorée chez les enfants atteints d’un trouble et elle
a diminué chez les autres enfants. Les productions métalinguistiques des enfants semblent indiquer que les groupes
ont utilisé l’information de reformulation de manière différente.
73
SERVICES POUR ADULTES
Analy
se de la ssynt
ynt
ax
e chez les aphasiques de Br
oca et de W
ernick
e
Analyse
yntax
axe
Broca
Wernick
ernicke
Fouzia Badaoui, CRSTDLA, Alger
Nous présentons dans cet article les résultats d’une recherche portant sur l’analyse de la syntaxe chez deux
aphasiques pour déduire son fonctionnement en appliquant le modèle linguistique néo-khalilien.
Incidence de l’orthophonie dans les cas d’aphasie primaire progressive avec communication non
fluide
Annie Delyfer, Fanny Singer, CRIR, Hôpital juif de réadaptation, Laval (Qué.); Eva Kehayia, Université McGill et CRIR,
Montréal (Qué.); Nancy Azevedo, Université McGill, Montréal (Qué.)
Cette présentation par affiche traitera de l’utilité de l’orthophonie conventionnelle auprès de patients atteints
d’aphasie primaire progressive avec communication non fluide. Une analyse documentaire de même que les
résultats de tests effectués chez l’un de ces patients à trois moments différents indiquent que l’orthophonie peut
améliorer certaines fonctions du langage pendant un certain temps.
Aphasie croisée et capacité de communication gestuelle
Patrick Coppens, Plattsburgh State University of New York, Plattsburgh (New York); Sylvie Hébert, Université de
Montréal, Montréal (Qué.); Lise Gagnon, Université de Sherbrooke, Sherbrooke (Qué.)
L’aphasie croisée résulte d’une lésion de l’hémisphère droit chez un droitier. Ce type de latéralisation inhabituelle de
la langue influence-t-il l’organisation neurologique des compétences dans l’hémisphère droit, comme la capacité de
chanter? À partir d’un cas clinique, cette présentation par affiche s’attardera à cette question et fera des extrapolations
pour la réadaptation des personnes aphasiques.
Élaboration d’un programme interdisciplinaire de réadaptation fondé sur la faible tolérance aux
longues durées pour les personnes ayant subi un accident vasculaire cérébral
Lauren Murphy, Fabian Krupski, St. Joseph’s Health Centre, Toronto (Ont.)
Les besoins en réadaptation des survivants d’un accident vasculaire cérébral ne sont pas homogènes. Cette
communication se penchera sur l’élaboration d’un programme interdisciplinaire de réadaptation fondé sur la faible
tolérance aux longues durées dans un établissement de soins prolongés. Ce programme est conçu spécialement
pour les personnes qui, en raison de leur âge ou de la gravité de leur accident vasculaire cérébral, ont besoin de
services plus spécialisés.
Rôle de la phonologie dans la reconnaissance des mots : une comparaison de lecteurs de niveau
collégial
Randeep K. Sidhu, University of North Dakota, Winnipeg (Man.); Charlene Chamberlain, University of North Dakota,
Grand Forks (North Dakota)
Des étudiants de premier cycle (11 qui sont bons en lecture, 11 qui sont moyens et 9 qui sont faibles) ont passé un test
de lecture et ont effectué une tâche de décision lexicale et de dénomination à partir de stimulus quasi-homophones.
Cet exercice visait à examiner le rôle de la phonologie pour la reconnaissance de mots nécessaire à la lecture. Les
résultats montrent qu’il n’y a pas d’interaction. Cette communication abordera les conséquences en milieu clinique.
EXERCICE CLINIQUE
Intervention axée sur les compétences : à quoi cela ressemblerait-il?
Carolyn Cronk, Julie Fortier-Blanc, Université de Montréal, Montréal (Qué.)
Cette communication explorera l’incidence des services d’orthophonie comme moyen d’établir une série de
compétences ou de capacités fonctionnelles construites à partir d’une combinaison de connaissances accumulées
ou de sensibilité, d’aptitudes de base et d’habiletés apprises. Plusieurs cas tirés du milieu clinique serviront d’exemples.
L’orthophonie va de l’avant avec les assistants numériques
Alexa Okrainec, Brandon University, Brandon (Man.)
L’assistant numérique, qui est un puissant ordinateur de poche, est une nouveauté qui peut faire progresser la
prestation de services d’orthophonie. Cette communication mettra en valeur l’utilisation de cet outil en pratique
clinique, qui dépasse les fonctions bien connues de carnet d’adresse et d’agenda.
74
Information for Contributors
The Journal of Speech-Language Pathology and Audiology
(JSLPA) welcomes submissions of scholarly manuscripts related
to human communication and its disorders broadly defined.
This includes submissions relating to normal and disordered
processes of speech, language, and hearing. Manuscripts that
have not been published previously are invited in English and
French. Manuscripts may be tutorial, theoretical, integrative,
practical, pedagogic, or empirical. All manuscripts will be evaluated
on the basis of the timeliness, importance, and applicability of the
submission to the interests of speech–language pathology and
audiology as professions, and to communication sciences and
disorders as a discipline. Consequently, all manuscripts are
assessed in relation to the potential impact of the work on
improving our understanding of human communication and its
disorders. All categories of manuscripts submitted will undergo
peer-review to determine the suitability of the submission for
publication in JSLPA. The Journal recently has established multiple
categories of manuscript submission that will permit the broadest
opportunity for disseminaion of information related to human
communication and its disorders. New categories for manuscript
submission include:
Tutorials. Review articles, treatises, or position papers that
address a specific topic within either a theoretical or clinical
framework.
Articles. Traditional manuscripts addressing applied or
basic experimental research on issues related to speech, language,
and/or hearing with human participants or animals.
Clinical Reports. Reports of new clinical procedures,
protocols, or methods with specific focus on direct application
to identification, assessment and/or treatment concerns in speech,
language, and/or hearing.
Brief Reports. Similar to research notes, brief
communications concerning preliminary findings, either clinical
or experimental (applied or basic), that may lead to additional
and more comprehensive study in the future. These reports are
typically based on small “n” or pilot studies and must address
disordered participant populations.
Research Notes. Brief communications that focus on
experimental work conducted in laboratory settings. These reports
will typically address methodological concerns and/or
modifications of existing tools or instruments with either normal
or disordered populations.
Field Reports. Reports that outline the provision of services
that are conducted in unique, atypical, or nonstandard settings;
manuscripts in this category may include screening, assessment,
and/or treatment reports.
Letters to the Editor. A forum for presentation of scholarly/
clinical differences of opinion concerning work previously
published in the Journal. Letters to the Editor may influence our
thinking about design considerations, methodological confounds,
data analysis and/or data interpretation, etc. As with other
categories of submissions, this communication forum is
contingent upon peer-review. However, in contrast to other
categories of submission, rebuttal from the author(s) will be
solicited upon acceptance of a letter to the editor.
Submission of Manuscripts
Contributors should send five (5) copies of manuscripts
including all tables, figures or illustrations, and references to:
Editor, JSLPA
Dept. of Speech Pathology and Audiology
2-70 Corbett Hall
Edmonton, AB T6G 2G4
Along with copies of the manuscript, a cover letter indicating
that the manuscript is being submitted for publication
consideration should be included. The cover letter must explicitly
state that the manuscript is original work, that has not been
published previously, and that it is not currently under review
elsewhere. Manuscripts are received and peer-reviewed contingent
upon this understanding. The author(s) must also provide
appropriate confirmation that work conducted with humans or
animals has received ethical review and approval. Failure to
provide information on ethical approval will delay the review
process. Finally, the cover letter should also indicate the category
of submission (i.e., tutorial, clinical report, etc.). If the editorial
staff determines that the manuscript should be considered
within another category, the contact author will be notified.
All submissions should conform to the publication
guidelines of the Publication Manual of the American
Psychological Association (APA), 5th Edition. Manuscripts
should be word processed, IBM format preferred. Should the
manuscript be accepted for publication, submission of a diskette
version of the submission will facilitate the publication process.
A confirmation of receipt for all manuscripts will be provided
to the contact author prior to distribution for peer-review.
JSLPA seeks to conduct the review process and respond to
authors regarding the outcome of the review within 90 days of
receipt. If a manuscript is judged as suitable for publication in
JSLPA, authors will have 30 days to make necessary revisions
prior to a secondary review.
The author is responsible for all statements made in his or
her manuscript, including changes made by the editorial and/
or production staff. Upon final acceptance of a manuscript and
immediately prior to publication, the contact author will be
permitted to review galley proofs and verify its content to the
publication office within 72 hours of receipt of galley proofs.
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Organization of the Manuscript
76
All copies should be typed, double-spaced, with a standard
typeface (12 point, noncompressed font) on high quality 8 ½ X 11
paper. All margins should be at least one (1) inch. An original and
four (copies) of the manuscript should be submitted directly to the
Editor. Author identification for the review process is optional; if
blind-review is desired, three (3) of the copies should be prepared
accordingly (cover page and acknowledgments blinded).
Responsibility for removing all potential identifying information
rests solely with the author(s). All manuscripts should be prepared
according to APA guidelines. This manual is available from most
university bookstores or is accessible via commercial bookstores.
Generally, the following sections should be submitted in the order
specified.
Title Page: This page should include the full title of the
manuscript, the full names of the author(s) with academic degrees,
each author’s affiliation, and a complete mailing address for the
contact author. An electronic mail address also is recommended.
Abstract
Abstract: On a separate sheet of paper, a brief yet informative
abstract that does not exceed one page is required. The abstract
should include the purpose of the work along with pertinent
information relative to the specific manuscript category for which
it was submitted.
Key Words: Following the abstract and on the same page, the
author(s) should supply a list of key words for indexing purposes.
Tables: Eachtableincludedinthemanuscriptmustbetypewritten
and double-spaced on a separate sheet of paper. Tables should be
numbered consecutively beginning with Table 1. Each table must
have a descriptive caption. Tables should serve to expand the
information provided in the text of the manuscript, not to duplicate
information.
Illustrations: All illustrations included as part of the manuscript
will need to be included with each copy of the manuscript. While a
single copy of original artwork (black and white photographs, x-ray
films, etc.) is required, all manuscripts must have clear copies of all
illustrations for the review process. For photographs, 5 x 7 glossy
prints are preferred. High quality laser printed materials are also
acceptable. For other types of computerized illustrations, it is
recommended that JSLPA production staff be consulted prior to
preparation and submission of the manuscript and associated
figures/illustrations.
Legends for Illustrations: Legends for all figures and illustrations
should be typewritten (double-spaced) on a separate sheet of paper
with numbers corresponding to the order in which figures/
illustrations appear in the manuscript.
Page Numbering and Running Head: Thetextofthemanuscript
should be prepared with each page numbered, including tables,
figures/illustrations, references, and if appropriate, appendices. A
short (30 characters or less) descriptive running title should appear
at the top right hand margin of each page of the manuscript.
Acknowledgments: Acknowledgments should be typewritten
(double-spaced) on a separate sheet of paper. Appropriate
acknowledgment for any type of sponsorship, donations, grants,
technical assistance, and to professional colleagues who contributed
to the work, but are not listed as authors, should be noted.
References: Referencesaretobelistedconsecutivelyinalphabetical
order, then chronologically for each author. Authors should consult
the APA publication manual (4th Edition) for methods of citing
varied sources of information. Journal names and appropriate
volume number should be spelled out and italicized. All literature,
tests and assessment tools, and standards (ANSI and ISO) must be
listed in the references. All references should be double-spaced.
Potential Conflicts of Interest
and Dual Commitment
Participants in Research
Humans and Animals
As part of the submission process, the author(s) must
explicitly identify if any potential conflict of interest, or dual
commitment, exists relative to the manuscript and its author(s).
Such disclosure is requested so as to inform JSLPA that the author
or authors have the potential to benefit from publication of the
manuscript. Such benefits may be either direct or indirect and
may involve financial and/or other nonfinancial benefit(s) to the
author(s). Disclosure of potential conflicts of interest or dual
commitment may be provided to editorial consultants if it is
believed that such a conflict of interest or dual commitment may
have had the potential to influence the information provided in
the submission or compromise the design, conduct, data collection
or analysis, and/or interpretation of the data obtained and
reported in the manuscript submitted for review. If the manuscript
is accepted for publication, editorial acknowledgement of such
potential conflict of interest or dual commitment may occur
when publication occurs.
Each manuscript submitted to JSLPA for peer-review that
is based on work conducted with humans or animals must
acknowledge appropriate ethical approval. In instances where
humans or animals have been used for research, a statement
indicating that the research was approved by an institutional
review board or other appropriate ethical evaluation body or
agency must clearly appear along with the name and affiliation
of the research ethics and the ethical approval number. The
review process will not begin until this information is formally
provided to the Editor.
Similar to research involving human participants, JSLPA
requires that work conducted with animals state that such work
has met with ethical evaluation and approval. This includes
identification of the name and affiliation of the research ethics
evaluation body or agency and the ethical approval number. A
statement that all research animals were used and cared for in an
established and ethically approved manner is also required. The
review process will not begin until this information is formally
provided to the Editor.
Renseignements à l’intention des collaborateurs
La Revue d’orthophonie et d’audiologie (ROA) est heureuse
de se voir soumettre des manuscrits de recherche portant sur la
communication humaine et sur les troubles qui s’y rapportent,
dans leur sens large. Cela comprend les manuscrits portant sur
les processus normaux et désordonnés de la parole, du langage
et de l’audition. Nous recherchons des manuscrits qui n’ont
jamais été publiés, en français ou en anglais. Les manuscrits
peuvent être tutoriels, théoriques, synthétiques, pratiques,
pédagogiques ou empiriques. Tous les manuscrits seront évalués
en fonction de leur signification, de leur opportunité et de leur
applicabilité aux intérêts de l’orthophonie et de l’audiologie
comme professions, et aux sciences et aux troubles de la communication en tant que disciplines. Par conséquent, tous les
manuscrits sont évalués en fonction de leur incidence possible
sur l’amélioration de notre compréhension de la communication humaine et des troubles qui s’y rapportent. Peu importe la
catégorie, tous les manuscrits présentés seront soumis à une
révision par des collègues afin de déterminer s’ils peuvent être
publiés dans la ROA. La Revue a récemment établi plusieurs
catégories de manuscrits afin de permettre la meilleure diffusion
possible de l’information portant sur la communication humaine
et les troubles s’y rapportant. Les nouvelles catégories de
manuscrits comprennent :
Tutoriels : Rapports de synthèse, traités ou exposés de
position portant sur un sujet particulier dans un cadre théorique
ou clinique.
Articles : Manuscrits conventionnels traitant de recherche
appliquée ou expérimentale de base sur les questions se
rapportant à la parole, au langage ou à l’audition et faisant
intervenir des participants humains ou animaux.
Comptes rendus cliniques : Comptes rendus de nouvelles
procédures ou méthodes ou de nouveaux protocoles cliniques
portant particulièrement sur une application directe par rapport
aux questions d’identification, d’évaluation et de traitement
relativement à la parole, au langage et à l’audition.
Comptes rendus sommaires : Semblables aux notes de
recherche, brèves communications portant sur des conclusions
préliminaires, soit cliniques soit expérimentales (appliquées ou
fondamentales), pouvant mener à une étude plus poussée dans
l’avenir. Ces comptes rendus se fondent typiquement sur des
études à petit « n » ou pilotes et doivent traiter de populations
désordonnées.
Notes de recherche : Brèves communications traitant
spécifiquement de travaux expérimentaux menés en laboratoire.
Ces comptes rendus portent typiquement sur des questions de
méthodologie ou des modifications apportées à des outils
existants utilisés auprès de populations normales ou
désordonnées.
Comptes rendus d’expérience : Comptes rendus décrivant
sommairement la prestation de services offerts en situations
uniques, atypiques ou particulières; les manuscrits de cette
catégorie peuvent comprendre des comptes rendus de dépistage,
d’évaluation ou de traitement.
Courrier des lecteurs : Forum de présentation de divergences de vues scientifiques ou cliniques concernant des ouvrages
déjà publiés dans la Revue. Le Courrier des lecteurs peut avoir un
effet sur notre façon de penser par rapport aux facteurs de
conception, aux confusions méthodologiques, à l’analyse ou
l’interprétation des données, etc. Comme c’est le cas pour d’autres
catégories de présentation, ce forum de communication est
soumis à une révision par des collègues. Cependant, contrairement
aux autres catégories, on recherchera la réaction des auteurs sur
acceptation d’une lettre.
Présentation de manuscrits
On demande aux collaborateurs de faire parvenir cinq (5)
exemplaires de leurs manuscrits, y compris tous les tableaux, figures
ou illustrations et références, à :
Phyllis Schneider, Ph.D.
Rédactrice en chef, Revue d’orthophonie et d’audiologie
Dept. of Speech Pathology and Audiology
2-70 Corbett Hall
Edmonton (Alberta) T6G 2G4
On doit joindre aux exemplaires du manuscrit une lettre d’envoi
qui indiquera que le manuscrit est présenté en vue de sa publication.
La lettre d’envoi doit préciser que le manuscrit est une œuvre
originale, qu’il n’a pas déjà été publié et qu’il ne fait pas actuellement
l’objet d’un autre examen en vue d’être publié. Les manuscrits sont
reçus et examinés sur acceptation de ces conditions. L’auteur (les
auteurs) doit (doivent) aussi fournir une attestation en bonne et due
forme que toute recherche impliquant des êtres humains ou des
animaux a fait l’objet de l’agrément d’un comité de révision
déontologique. L’absence d’un tel agrément retardera le processus
de révision. Enfin, la lettre d’envoi doit également préciser la catégorie
de la présentation (i.e. tutoriel, rapport clinique, etc.). Si l’équipe
d’examen juge que le manuscrit devrait passer sous une autre
catégorie, l’auteur-contact en sera avisé.
Toutes les présentations doivent se conformer aux lignes de
conduite présentées dans le Publication Manual of the American
Psychological Association (APA), 5th Edition. Les manuscrits doivent
être dactylographiés sur traitement de texte en format IBM, de
préférence. L’envoi d’une disquette, si le manuscrit est accepté, facilite
la publication. Un accusé de réception de chaque manuscrit sera
envoyé à l’auteur-contact avant la distribution des exemplaires en
vue de la révision. La ROA cherche à effectuer cette révision et à
informer les auteurs des résultats de cette révision dans les 90 jours
de la réception. Lorsqu’on juge que le manuscrit convient à la ROA,
on donnera 30 jours aux auteurs pour effectuer les changements
nécessaires avant l’examen secondaire.
L’auteur est responsable de toutes les affirmations formulées
dans son manuscrit, y compris toutes les modifications effectuées
par les rédacteurs et réviseurs. Sur acceptation définitive du manuscrit
et immédiatement avant sa publication, on donnera l’occasion à
l’auteur-contact de revoir les épreuves et il devra signifier la vérification
du contenu dans les 72 heures suivant réception de ces épreuves.
77
Organisation du manuscrit
Tous les textes doivent être dactylographiés à double interligne,
en caractère standard (police de caractères 12 points, non comprimée)
et sur papier 8 ½” X 11" de qualité. Toutes les marges doivent être
d’au moins un (1) pouce. L’original et quatre (4) copies du manuscrit
doiventêtreprésentésdirectementaurédacteurenchef.L’identification
de l’auteur est facultative pour le processus d’examen : si l’auteur
souhaite ne pas être identifié à ce stade, il devra préparer trois (3)
copies d’un manuscrit dont la page couverture et les remerciements
seront voilés. Seuls les auteurs sont responsables de retirer toute
information identificatrice éventuelle. Tous les manuscrits doivent
être rédigés en conformité aux lignes de conduite de l’APA. Ce manuel
est disponible dans la plupart des librairies universitaires et peut être
commandé chez les libraires commerciaux. En général, les sections
qui suivent doivent être présentées dans l’ordre chronologique
précisé.
Page titre : Cette page doit contenir le titre complet du manuscrit,
les noms complets des auteurs, y compris les diplômes et affiliations,
et l’adresse complète de l’auteur-contact. Une adresse de courriel est
également recommandée.
Abrégé : Sur une page distincte, produire un abrégé bref mais
informateur ne dépassant pas une page. L’abrégé doit indiquer
l’objet du travail ainsi que toute information pertinente portant sur
la catégorie du manuscrit.
Mots clés : Immédiatement suivant l’abrégé et sur la même
page, les auteurs doivent présenter une liste de mots clés aux fins de
constitution d’un index.
Tableaux : Tous les tableaux compris dans un même manuscrit
doivent être dactylographiés à double interligne sur une page distincte.
Les tableaux doivent être numérotés consécutivement, en
commençant par le Tableau 1. Chaque tableau doit être accompagné
d’une légende et doit servir à compléter les renseignements fournis
dans le texte du manuscrit plutôt qu’à reprendre l’information
contenue dans le texte ou dans les tableaux.
Illustrations : Toutes les illustrations faisant partie du manuscrit
doiventêtreinclusesavecchaqueexemplairedumanuscrit.Quoiqu’un
Conflits d’intérêts possibles
et engagement double
Dans le processus de présentation, les auteurs doivent déclarer
clairementl’existencedetoutconflitd’intérêtspossiblesouengagement
double relativement au manuscrit et de ses auteurs. Cette déclaration
est nécessaire afin d’informer la ROA que l’auteur ou les auteurs
peuvent tirer avantage de la publication du manuscrit. Ces avantages
pour les auteurs, directs ou indirects, peuvent être de nature financière
ou non financière. La déclaration de conflit d’intérêts possibles ou
d’engagement double peut être transmise à des conseillers en matière
de publication lorsqu’on estime qu’un tel conflit d’intérêts ou
engagement double aurait pu influencer l’information fournie dans
la présentation ou compromettre la conception, la conduite, la
collecte ou l’analyse des données, ou l’interprétation des données
recueillies et présentées dans le manuscrit soumis à l’examen. Si le
manuscrit est accepté en vue de sa publication, la rédaction se réserve
le droit de reconnaître l’existence possible d’un tel conflit d’intérêts
ou engagement double.
78
seul exemplaire du matériel d’illustration original (photographies,
radiographies, etc.) soit requis, chaque manuscrit doit contenir des
copies claires de toutes les illustrations pour le processus de révision.
Dans le cas de photographies, on préfère les photos sur papier glacé
5" X 7". Les impressions au laser de haute qualité sont acceptables.
Pour les autres types d’illustrations informatisées, il est recommandé
de consulter le personnel de production de la ROA avant la préparation
et la présentation du manuscrit et des figures et illustrations s’y
rattachant.
Légendes des illustrations : Les légendes accompagnant chaque
figure et illustration doivent être dactylographiées à double interligne
sur une feuille distincte et identifiées à l’aide d’un numéro qui
correspond à la séquence de parution des figures et illustrations dans
le manuscrit.
Numérotation des pages et titre courant : Chaque page du
manuscrit doit être numérotée, y compris les tableaux, figures,
illustrations, références et, le cas échéant, les annexes. Un bref (30
caractères ou moins) titre courant descriptif doit apparaître dans la
marge supérieure droite de chaque page du manuscrit.
Remerciements : Les remerciements doivent être
dactylographiés à double interligne sur une feuille distincte. L’auteur
doit reconnaître toute forme de parrainage, don, bourse ou d’aide
technique, ainsi que tout collègue professionnel qui ont contribué à
l’ouvrage mais qui n’est pas cité à titre d’auteur.
Références : Les références sont énumérées les unes après les
autres, en ordre alphabétique, suivi de l’ordre chronologique sous
le nom de chaque auteur. Les auteurs doivent consulter le manuel
de l’APA (5e Édition) pour obtenir la façon exacte de rédiger une
citation. Les noms de revues scientifiques et autres doivent être
rédigés au long et imprimés en italiques. Tous les ouvrages, outils
d’essais et d’évaluation ainsi que les normes (ANSI et ISO) doivent
figurer dans la liste de références. Les références doivent être
dactylographiées à double interligne.
Participants à la recherche –
êtres humains et animaux
Chaque manuscrit présenté à la ROA en vue d’un examen par
des pairs et qui se fonde sur une recherche effectuée avec la participation
d’être humains ou d’animaux doit faire état d’un agrément
déontologique approprié. Dans les cas où des êtres humains ou des
animaux ont servi à des fins de recherche, on doit joindre une
attestation indiquant que la recherche a été approuvée par un comité
d’examen reconnu ou par tout autre organisme d’évaluation
déontologique, comportant le nom et l’affiliation de l’éthique de
recherche ainsi que le numéro de l’approbation. Le processus
d’examen ne sera pas amorcé avant que cette information ne soit
formellement fournie au rédacteur en chef.
Tout comme pour la recherche effectuée avec la participation
d’êtres humains, la ROA exige que toute recherche effectuée avec des
animaux soit accompagnée d’une attestation à l’effet que cette
recherche a été évaluée et approuvée par les autorités déontologiques
compétentes. Cela comporte le nom et l’affiliation de l’organisme
d’évaluation de l’éthique en recherche ainsi que le numéro de
l’approbation correspondante. On exige également une attestation
à l’effet que tous les animaux de recherche ont été utilisés et soignés
d’une manière reconnue et éthique. Le processus d’examen ne sera
pas amorcé avant que cette information ne soit formellement fournie
au rédacteur en chef.
APPEL POUR COMMUNICATIONS
Congrès de l’ACOA 2007
Moncton, Nouveau-Brunswick
du 25 - 28 avril, 2007
Date limite de réception des propositions:
le 1er septembre 2006
Vous pouvez soumettre votre proposition de communication en ligne au:
www.caslpa.ca/francais/events/conference.asp
Le congrès annuel 2007 de l’Association canadienne des orthophonistes et audiologistes (ACOA) se tiendra à Moncton
(Nouveau-Brunswick). L’ACOA vous invite donc à soumettre vos propositions de communication pour son
programme du congrès annuel 2007.
Les cliniciens de tous genres de pratique sont encouragés à partager leurs réflexions, leurs expériences, leurs méthodes
et leurs recherches. L’ACOA souhaite recevoir des propositions de communications, de communications affichées,
d’expositions scientifiques, de mini-séminaires de formation et de vidéocassettes. Les présentations multidisciplinaires
seront également prises en considération. Les sessions se tiendront pendant le jour, du 25 au 28 avril, 2007.
TYPES DE SESSION
Présentation de communication
communication: Une présentation de communication devrait être basée sur une recherche courante,
une expérience clinique ou sur une étude de cas, être récente et ne pas avoir été publiée (durée de 45 minutes).
Mini-séminaires
Mini-séminaires: Ces séances sont conçues de manière à susciter des discussions interactives au sujet de la pratique
clinique et des problèmes professionnels (durée de 90 minutes).
Séances d’affichage: La présentation des affiches doit suffire, à elle seule, à fournir de l’information. Chaque présentoir
doit contenir le titre et le nom du ou des auteurs, l’énoncé de principe, la méthodologie, les résultats et conclusions. Les
affiches doivent être présentées sous format en largeur et selon des dimensions ne dépassant pas 2.4m par 1.2m. Lors
de périodes établies à l’avance, les auteurs devront être présents pour répondre aux questions et participer aux échanges
(discussions).
Expositions scientifiques: Ces activités seront incorporées aux sessions d’affichage. Lors de périodes établies à
l’avance, les exposants devront être présents pour décrire et discuter de leur exposition. Une table mesurant
approximativement 1.8 m par .75 m et un tableau d’affichage de 2.4 m x 1.2 m seront mis à la disposition des exposants.
Les exposants doivent fournir tout autre équipement nécessaire.
Présentations de vidéocassette: Les vidéocassettes peuvent présenter des sujets cliniques, des études de cas, des agences,
programmes, procédures de thérapie ou autres. Les vidéocassettes doivent être de type VHS (1/2 pouce).

Évaluation et mise en oeuvre de nouvelles technologies/méthodes
Mesure de performance ou de rendement (outcome) et efficacité
Ce qui fonctionne en pratique/ conseils à suivre en milieu clinique
Les services aux clientèles difficiles
Formation de médiateurs/facilitateurs
Éthique en milieu clinique
Le formulaire pour soumettre les propositions de
Effets du multiculturalisme
communications, les conditions et les instructions peuvent être
Modèles de prestation de services
téléchar
gés à partir du site W
eb de l’
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téléchargés
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www.caslpa.ca/
Situations de transition (p. ex.: préscolairefr
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demande en ligne ou en communiquant avec [email protected] pour
La planification et la réalisation de recherche en
obtenir un formulaire et informations par envoi postal ou
milieu clinique.
électr
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électronique
télécopieur..
Autre
79
CALL FOR PAPERS
CASLPA Conference 2006
Moncton, New Brunswick
April 25 - 28, 2007
Deadline for receipt of all program submissions:
September 1, 2006
Online abstract submissions at:
www.caslpa.ca/english/events/conference.asp
The Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) 2007 conference will be held
in Moncton, New Brunswick. CASLPA invites program submissions to the annual conference.
Clinicians from all practice settings are encouraged to share their insight, experience, methods and research. CASLPA
invites submissions of papers, poster sessions, scientific exhibits, mini-seminars and videotapes. Multidisciplinary
presentations will be considered. Sessions will be scheduled daily from April 25 - 28, 2007.
SESSION TYPES
Paper Presentations: A paper presentation should be based on current research that has not been published, clinical
experience, or case studies (45 minutes in duration).
Mini-seminars: These sessions are designed to provide opportunity for interactive discussion of clinical practice and
professional issues (90 minutes in duration).
Poster Sessions: Poster presentations should stand alone in conveying information. Each display should contain title
and author(s), statement of purpose, methodology, results and conclusions. Posters must be in landscape format, no
larger than 2.4 m x 1.2 m. Authors are required to be present at designated times to respond to questions and discussion.
Scientific Exhibits: These sessions will be incorporated with the Poster Presentations. Exhibitors are required to be
present at designated times to describe and discuss the exhibit. A table of approximately 1.8 m x .75 m and a poster board
of approximately 2.4 m x1.2 m will be available. Exhibitors are responsible for providing all equipment that will be
required.
Videotape Presentations: Videotapes may be presented on clinical topics, case studies, agencies, therapy procedures
or other topics. Videotapes must be on 1/2-inch VHS video cassette.

80
Evaluating and implementing new technologies/methods
Measuring outcome and efficacy
Best practice/clinical guidelines
Hard-to-serve populations
Mediator/facilitator training
The complete Call ffor
or P
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or
Paper
aperss including Conditions ffor
Ethics in clinical practice
Acceptance, Instructions and Request for Presentation form, can
Multicultural considerations
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[email protected] to have a hard copy emailed, faxed or mailed to
Designing and implementing clinical research
you.
Other
AUDIOLOGIST 1
PERMANENT or LOCUM
Stephenville, Newfoundland and Labrador
Western Regional Integrated Health Authority has a career opportunity for an Audiologist on the
beautiful, scenic west coast of Newfoundland and Labrador, Canada. We offer our employees a
unique wellness program, flexible working arrangements, excellent benefits package and a strong
leadership team. To find out why we are one of the most desirable regions of Canada in which to live
and work, log on to http://www.hcsw.nf.ca/arealinks.htm.
This position offers an excellent opportunity to apply and develop skills while providing a variety of
audiological services to persons of all ages with concerns of hearing and auditory function. The
incumbent would work as a member of an interdisciplinary team. Included in the responsibilities of
the position are diagnostic assessment and rehabilitative services, dispensing for the Provincial Hearing
Aid Plan, public and professional education, consulting, regional clinics, and participation in
collaborative community/professional partnerships which serve our clients and communities. The
incumbent is also responsible for the supervision of an Audiology Technician. This position reports
to the Regional Clinical Leader of Audiology located in Corner Brook.
QUALIFICATIONS: A Master’s Degree in Audiology from a recognized university and eligibility
for CASLPA certification.
Monthly regional travel is required. A valid driver’s license and use of a private vehicle are also
required.
SALARY SCALE: $53,644.50 to $63,219.00 per Annum
A $10,000 bursary is available to a new graduate in return for a service commitment of two years.
Reimbursement of relocation expenses will be considered. We offer an attractive benefit package
which includes four weeks annual vacation, nine statutory holidays, pension plan, health insurance,
dental and long-term disability plans.
Please Send Resume, Proof of Qualifications and the Names of Two References to:
Donna Foss
Recruitment & Orientation Coordinator
Western Regional Integrated Health Authority
P. O. Box 156, Corner Brook, NL A2H 6C7
Fax: (709) 637-5155
E-Mail: [email protected]; Website: www.hcsw.nf.ca
PLEASE QUOTE ORDER NO. WH-06-93 WHEN APPLYING.
Just another reason we’re continuing to raise the bar.
To save a life, to get closer to a cure, to teach, to learn, to give someone a second chance
and to make an impact…
T
his is why you chose a health care career. But to make the greatest impact, you need the best tools, the best resources and the
strength of a dedicated team on your side. With a reputation for innovation and excellence, Capital Health has been recognized as a
leading health system for ﬁve consecutive years by the Canadian Institute for Health Information. Afﬁliated with the University of Alberta,
Capital Health is Canada’s largest academic health care region. Our staff enjoys a vibrant and diverse setting, a strong local economy,
high calibre training and, most importantly, the opportunity to raise the bar.
Enjoy the challenges and rewards offered by a leader in health care.
Visit our website at www.capitalhealth.ca
Talk to us today!
Relocation assistance is available
Capital Health Regional Recruitment
Toll-free: 1-877-488-4860 • Local: 735-0124
E-mail: [email protected]
People who care. Work that matters.
We welcome all inquiries and thank you for your interest.
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