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Language and Literacy in Individuals with Intellectual Disability
Format(s): SIG Perspectives
This SIG 1 Perspectives activity focuses on assessing and treating students with intellectual disability (ID) in the areas of language and literacy. The first article discusses the primary components of a parent-implemented language intervention for children with fragile X syndrome. The second article discusses emergent and conventional literacy skills and the strengths and challenges in reading and spelling for adolescents with ID. The third article describes the key components and modifications that can be utilized in narrative interventions when working with individuals that are diagnosed with intellectual and developmental disabilities. The final article provides the parents’ perspectives of the home and school literacy experiences of children with ID in preschool.
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Audiologic Variability Among Patients Undergoing Cisplatin Treatment
Format(s): SIG Perspectives
The article in this SIG 6 activity focuses on the audiologic variations seen among patients undergoing the same type of ototoxic drug treatment (cisplatin). Results show a large amount of audiologic outcome variability among the two patients examined, despite similar demographic factors, drug treatments, and types of cancer. Factors relating to ototoxic susceptibility are discussed, and the importance of otoxicity monitoring programs for early detection of audiologic change is highlighted.
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Addressing Current Demands in Geriatric Care: COVID-19 and the Workforce
Format(s): SIG Perspectives
Four articles are contained within that address current demands in geriatric care, including impacts of the COVID-19 pandemic and the shifting demographics reflecting an aging population. First, Thomas et al. analyze eight interviews with caregivers of those with amyotrophic lateral sclerosis (ALS). Authors conclude positive and negative themes that were specific to the pandemic and make suggestions that could result in improved perception of medical support and lower feelings of burden for ALS caregivers. Next, Stead et al. investigate practice patterns, experiences, and changes in referrals to medically based SLPs as a result of the COVID-19 pandemic. Authors analyze results of a survey of 208 SLPs and determine themes related to COVID-19 precautions, patient flow, patient characteristics, and mental health (staff, families, and patients). This incredibly detailed article uses three research questions to guide review and discussion, including what changes SLPs had seen in their caseloads since the onset of COVID-19; inquiry into experiences with COVID precautions; and inquiry into the impact that COVID has had on patients, caregivers, and practice overall. Then, Heape examines the effect of social isolation and loneliness as a result of the pandemic, specifically in the especially vulnerable geriatric population. The author reviews existing research on social isolation and loneliness in the aging population, discusses current demographic data on the gaining population, considers principles of bioethics, and examines social determinants of health. She reveals a link between social isolation, loneliness, and negative outcomes, and suggests strategies to mitigate the negative effects of social isolation. Finally, Watson et al. address the need for practice-ready geriatric health professionals as a result of unprecedented population growth of persons aged 65 years and older. The authors review 20 SLP student perceptions after visiting a senior mentor’s home in interprofessional practice teams of 3-4 over three semesters and completing assignments aimed at growing skills in geriatric collaborative care. Authors determine that moderate positive effects were observed in perceptions of interprofessional knowledge, attitudes, and skills. The results include discussion of predominantly positive attitudes toward older persons, an appreciation for the elderly, increased knowledge and skills in geriatric care, and an interest in working with older persons in the future.
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Broad Perspectives in Speech-Language Pathology
Format(s): SIG Perspectives
This SIG 19 activity bundles four articles providing perspectives on a broad variety of topics in speech-language pathology. First, Holt provides an overview of current and historical discussions of gender and race, challenging the reader to accept that one’s perspective is indebted to a specific belief system. Readers are to evaluate how gender and race are used to categorize people and examine whether a member of a marginalized or minoritized group affects that person’s access to or use of intervention services. Next, Cox and Koenig define speech privacy and provide a brief history and applications in the health care setting. A general perspective is outlined, including threats to speech privacy, and speakers who use an electrolarynx are used as an example to highlight specific issues clinicians may encounter. Ramanarayanan et al. discuss the use of speech as a biomarker in therapy and research. In summary, robustness of analytics—specificity, diversity, and physiological interpretability—must be further developed. Finally, Weerathunge, Tomassi, and Stepp review a number of populations with voice disorders that have been studied using altered auditory feedback. Many have hyperactive auditory feedback responses and the differing underling reasons are reviewed. Therapy considerations are also described.
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Pathways to Specializing in Voice and Upper Airway Disorders: Multiple Perspectives
Format(s): SIG Perspectives
It is well known within our field that identifying voice and upper airway specialized training opportunities and subsequent positions is challenging, competitive, and sometimes elusive. In this SIG 3 activity, various pathways to specializing in voice and upper airway disorders are explored from the viewpoint of different authors at various stages of their careers. The hope is to make the process of specialization more transparent and share components that have contributed to success, while also highlighting the diversity of training and experience that is so important in our field.
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Special Populations in Dysphagia Management: COVID-19, Feeding Disorders, Drug Use, and Burn Care
Format(s): SIG Perspectives
These four SIG 13 articles provide information for dysphagia practice. They address a unique array of special populations and challenges in patient care involving swallowing and feeding difficulties.
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Self-Reported Confidence and Knowledge in Working With CLD Populations and Considerations for Assessment in Individuals Who Speak Languages Other Than English
Format(s): SIG Perspectives
The theme for this SIG 14 activity is self-reported confidence and knowledge between multilingual and monolingual speech-language pathologists in working with culturally and linguistically diverse (CLD) individuals and assessment considerations when working with individuals who speak a language other than English. Topics include (a) examining differences between self-reported confidence and knowledge in multilingual and monolingual speech language pathologists; (b) nonword repetition in assessment; and (c) sound sequencing characteristics in words of children who speak German.
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Approaches to Auditory Rehabilitation for Adult Cochlear Implant Recipients
Format(s): SIG Perspectives
These SIG 7 Perspectives articles focus on auditory rehabilitation (AR) for adults with cochlear implants. While the benefits of AR in the population are recognized in the literature, service-delivery models are variable, and there is no gold standard approach to developing and implementing a comprehensive AR program. Glade and colleagues provide an overview of clinical models currently being used for the provision of AR for adults with cochlear implants from nine clinics across the country. The article highlights the importance of interprofessional practice in AR and outlines the roles of professionals included on care teams. There is a discussion about barriers to successful implementation of AR programs, including distance to services, and recommendations for potential solutions, such as teletherapy. In the second article, Mosley describes the process of creating and implementing a comprehensive teleaudiology AR program for older adults who use cochlear implants at the University of South Alabama Speech & Hearing Center.
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Creative Solutions to Global Issues in Audiology and Speech-Language Pathology
Format(s): SIG Perspectives
In an ever-changing global landscape, it is pertinent that audiologists and speech-language pathologists “account for the complexity and diversity of healthcare contexts” (as stated in the second article by Pillay and Pillay). Pressing concerns related to advancing technology (artificial intelligence and machine learning), culturally responsive practice, and rapid climate change are all trending societal conversations. This SIG 17 self-study explores creative solutions to pressing global issues that impact the field of audiology and speech-language pathology. Topics presented include key ethical concerns regarding hearing aids with machine learning, a novel culturally responsive framework for contextualized clinical reasoning, and the impact of climate change on communication and swallowing disorders.
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Supervision: Addressing Emotional Resilience, Reflection, & Cultural Competence
Format(s): SIG Perspectives
This SIG 11 Perspectives activity addresses aspects of clinical supervision and administration beyond the “Big Nine” clinical competencies. In the first article, the author discusses the significance of emotional resilience and provides practical strategies to encourage resiliency in supervisees. The second article explains the significance of cultural competence and the value of open conversations within supervisory relationships. Finally, the third article highlights key skills used in intentional and reflective supervision.
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Telepractice & Audiology Services: International, Parental, & Practitioner Views
Format(s): SIG Perspectives
The first article in this SIG 18 activity investigates the applications speech-language pathologists (SLPs) and audiologists used most frequently during the beginning of the COVID-19 pandemic. It also discusses the main obstacles to providing speech, language, and hearing services through telepractice. Through the international distribution of an electronic survey, a total of 1,466 surveys from SLPs and audiologists from 40 countries were used for the analysis. The second article discusses the Auditory Verbal UK's training program for prospective listening and spoken language specialist certified auditory verbal therapists delivered globally via telepractice. The article explores, from a global perspective, audiology and early intervention services and perspectives regarding telepractice. The third article explores parents' and therapists' views of the benefits and challenges of telepractice for early intervention for children who are deaf or hard of hearing during the COVID-19 pandemic. Through survey and analysis, the article probes the views of parents, Listening and Spoken Language Specialist Certified Auditory Verbal Therapists in using telepractice to deliver auditory verbal sessions.
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A Trio of Articles: Students' Perspectives After Cued Speech Course, Barriers to Equity in Pediatric Hearing Health Care, and Assessing American Sign Language Across Clinical Settings
Format(s): SIG Perspectives
This trio of SIG 9 articles provides the reader with three diversely focused topics related to pediatric hearing and hearing disorders. These range from a review of barriers to equity in pediatric hearing health care, to students’ perspectives on preservice education about cued speech, and then how practitioners measure receptive and expressive American Sign Language (ASL). The review, “Barriers to Equity in Pediatric Hearing Health Care: A Review of the Evidence,” explores data to suggest that hearing health care disparities constitute a major factor in loss to follow-up or documentation for children going through the Early Hearing Detection and Intervention process. Underlying disparities are multifactorial and result in delayed care and suboptimal developmental outcomes for children who are deaf or hard of hearing. “ASL Assessment in Practice: Assessing American Sign Language Across Clinical Settings” discusses exploratory research to investigate what assessment tools professionals use in measuring receptive and expressive ASL. Conclusions indicate that there is variable access and knowledge for appropriate assessment measures in ASL. “The Effect of a Graduate Course in Cued Speech on Students' Perspectives: A Pilot Study” is a pilot study investigating the beliefs and attitudes in Deaf Education related to a course on cued speech. The investigation revealed that a single course in the approach could influence student perspectives on cued speech and other Deaf Education instructional approaches.
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Cleft Lip and Palate Care and the Opioid Crisis
Format(s): SIG Perspectives
This SIG 5 activity analyzes the relationship between the opioid crisis and cleft lip and palate care across the life span. Two main themes of prevention and treatment after exposure are explained. The articles outline alternatives to opioid use after cleft-related surgeries, impacts on infants and children who were exposed in utero, and velopharyngeal insufficiency treatment after substance abuse.
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Current Issues in Augmentative and Alternative Communication
Format(s): SIG Perspectives
These SIG 12 Perspectives articles provide information on current issues associated with visual processing of augmentative and alternative communication (AAC) displays for people with traumatic brain injury, assessment of the expressive language abilities of Spanish-speaking children who rely on AAC, and culturally sensitive approaches to aided language modeling. Readers will be more adept at designing effective AAC displays for adults with traumatic brain injury and at providing AAC services to children from multilingual and multicultural backgrounds.
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Holistic Admissions in CSD Programs
Format(s): SIG Perspectives
In this SIG 10 activity, authors explore holistic admissions in CSD programs. Carmichael, Mandulak, and Watkins provide a tutorial for incorporating interviews during the admissions process. Scheer-Cohen, Heisler, and Moineau outline an approach to holistic admissions that includes a video response to a question, an informal group interview, a live lecture with an assessment, a simulation, content quiz, a writing prompt, and an individual live interview. Reisfeld and Kaplan provide a systemic review of admission measures that may be used to predict graduate students’ clinical skills. Finally, Newkirk-Turner and Hudson explore the dangers of unconscious bias in letters of recommendation for graduate admissions.
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Paradigm Shifts in Culturally Relevant Family-Centered Intervention/Instruction
Format(s): SIG Perspectives
The theme for this SIG 14 activity is clinical considerations through paradigm shifts in providing culturally relevant family-centered intervention and instruction. Topics include (a) providing culturally relevant family centered care; (b) second language literacy instruction for multilingual adolescents; and (c) impacts of study abroad experiences on students’ intercultural competence.
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Community-Based Group Therapy for African American Elders and Public Health Frameworks in Education
Format(s): SIG Perspectives
In “Coupling Hearing Health With Community-Based Group Therapy for Cognitive Health in Low-Income African American Elders,” Postman et al. describe a community-based group intervention to address disparities experienced by African American elders in the early stages of cognitive–communicative decline. The intervention included partnerships with community health centers, culturally informed activities, and ongoing input from staff and participants. The authors describe the advantages of this community-engaged approach, as well as the benefits of joining hearing and cognition for minimizing access barriers. In “Public Health Frameworks in Audiology Education: Rationale and Model for Implementation,” Warren and Levy review how public health education can advance the field of audiology, particularly through coursework and dual degree programs. The authors also describe two frameworks for public health training in an audiology academic setting and identify the competencies that overlap in audiology and public health, helping to illustrate the relevance of public health education in addressing objectives in hearing health care.
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Clinical Impact of Research
Format(s): SIG Perspectives
These SIG Special Topics articles provide guidance to current and future researchers in communication sciences and disorders about how to maximize the clinical impact of their research. Utianski et al. describe clinical practice research and the current barriers to it, while highlighting initiatives researchers can take advantage of. Douglas et al. define knowledge brokering and outline the roles of organizations and individuals who take on that job. Then, Davidson and colleagues offer researchers concrete steps for using social media to enhance impact. Finally, Nicholson and Smith review both traditional science impact metrics and alternative metrics and offer concrete recommendations for documenting clinical impact for use in one’s CV or career advancement materials.
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Predictors of Caseload Size and Articulation Intervention
Format(s): SIG Perspectives
This SIG 16 Perspectives activity includes research that focuses on caseload issues and articulation intervention. In the first article, Shanks and Hall-Mills examine the relationship between school factors and speech-language therapy enrollment in public schools. They determined that certain factors such as socioeconomic status and English as a second or other language enrollment correlate to high caseloads. The next two articles focus on articulation intervention in special populations. Flipsen and Sacks replicate the findings of a previous study regarding the efficacy of using the SATPAC (Systematic Articulation Training Program Accessing Computers) approach with children receiving intervention through response to intervention. Reported findings indicate that SATPAC can be used effectively within the response to intervention process to remediate single sound errors in children. Finally, Findley and Gasparyan investigate the effectiveness of biofeedback technologies as a form of intervention for speech sound production. Specifically, they explore the use of speech to text in children with articulation disorders.
Dysphagia in Practice: Thickening Practices, Family-Centered Care, & Early Intervention
Format(s): SIG Perspectives
This collection of SIG 13 articles addresses popular topics in dysphagia care throughout the life span regarding thickening practices, family-centered care, and early intervention. Jane Mertz Garcia, Edgar Chambers IV, and Anna Boyer utilized a survey to re-examine practice patterns for thickened liquids and provided a comparison of past practices with current to provide insight into contemporary themes that have previously not been considered. Doreen Benson and George Barnes explore the utility of a mathematical prediction model (Bayes theorem) in dysphagia management. Samantha E. Shune, Deanna Linville, and Ashwini Namasivayam-MacDonald address maximizing treatment effectiveness by using an approach with family resiliency and adaptation. Drawing from the principles of family systems theory and the biopsychosocial-spiritual framework, they use a case study as a tutorial to explore the application of family-centered care models to dysphagia management. Stephanie C. Cohen and Karen Dilfer focus on the definition of pediatric feeding disorder (PFD) and the multifaceted needs of families and children in early intervention, support for use of responsive feeding in treatment of PFD, alignment of responsive feeding strategies with early intervention principles, and barriers limiting access to consistent, high-quality early intervention services for children with PFD.
Foundations of Stroboscopic Interpretation and Clinical Cases
Format(s): SIG Perspectives
In this series of SIG 3 articles, a foundation for laryngeal endoscopic imaging and interpreting videostroboscopic parameters is provided. These concepts are then put into practice in the context of three case studies focused on muscle tension dysphonia, bilateral vocal fold lesions, and vocal fold immobility. In the cases, auditory perceptual analysis, acoustic and aerodynamic measures, and candidacy for voice therapy are assessed in addition to videostroboscopic parameters. Video and audio examples are included to provide an interactive experience for the reader.
Autism and Telepractice
Format(s): SIG Perspectives
This SIG 1 Perspectives activity focuses on how to work with students with autism spectrum disorders (ASD) and their caregivers via telepractice. The first article provides five practical tips for supporting families of children with ASD while implementing effective interventions via various telepractice modalities. The second article reviews the feasibility of implementing telehealth programs related to behavioral interventions for families and their children with ASD. The third article explores the usability of a web-based application of the JASPER social communication intervention. The fourth article discusses the results of a survey completed by speech-language pathologists who utilized telepractice to teach children with autism to access and use augmentative and alternative communication devices. The final article shares current available research related to the barriers of and solutions to conducting telehealth assessment and interventions for families and their students with ASD.
Considerations for Dysphagia Intervention in the Hospital: Adult and Pediatric
Format(s): SIG Perspectives
This SIG 13 collection of astute articles provides information regarding managing and treating dysphagia in the hospital for both adult and pediatric patients. Nalia GurgelJuarez and colleagues explore the frequency of oral care based on staff adherence to oral care policies. Rebecca Smith et al. investigate the quality-of-life impacts of dysphagia and its interventions on mealtimes using the Swallowing Quality of Life Questionnaire and the Eating Assessment Tool. Jessica L. Rice and Maureen A. LeftonGreif review high-flow nasal cannula mechanisms of action, its use in specific populations and settings, and what is known about initiation of feeding during this therapy. Finally, Donna Edwards and colleagues explore the impact of COVID-19 on modifications in clinical practice related to pediatric feeding disorders and dysphagia via telehealth.
Assessment and Treatment Considerations
Format(s): SIG Perspectives
The first two articles in this SIG 19 activity provide information to better our assessment and treatment of individuals in the area of voice, while the latter two articles focus on treatment of individuals in the area of speech production. The authors for all four articles present a review of the literature as well as challenges and future directions. First, Van Hook and Duffy conducted a pilot study to trial the Gender Spectrum Voice Inventory. This article provides a review, discussion of validity, and speech-language pathologists’ perceptions of the inventory in an effort to address a gap in available clinical tools for transgender and nonbinary people. Next, Hammer reviews the relationship between air flow with sound pressure level during syllable production while holding fundamental frequency and subglottic air pressure constant. The results have clinical implications that stress the importance of an increase in air flow and focus on vocal fold contact. Then, Gritsyk et al. describe their study to determine which measures of somatosensory acuity best predicted change in production accuracy during vowel learning tasks while controlling auditory acuity. Results indicate only bite block adaptation with auditory masking was significantly associated with performance. Finally, Zajac et al. discuss their preliminary study that indicated cleft type contributes to production errors, specifically backing, in children with repaired cleft palate. Additionally, a history of otitis media affects the spectral contrast of alveolar consonants in children without clefts.
Counseling in Acquired Brain Injury
Format(s): SIG Perspectives
These SIG 2 Perspectives articles focus on counseling skills for working with persons with aphasia, “counseling+” activities for patients with mild cognitive impairment and dementia, and resilience in neurorehabilitation. Topics include counseling skills; counseling roles of SLPs; care partner training; and resilience in persons with acquired brain injury, aphasia, dementia, and Alzheimer’s disease.
Ethical Challenges in Various School-Based Scenarios
Format(s): SIG Perspectives
This SIG 1 activity focuses on ethical challenges that audiologists and SLPs may face in various school-based scenarios. A 5-step ethical decision-making approach is presented. An ethical decision-making model is used to help prepare clinicians for the ethical continuation of telepractice in schools. Some thoughts and tools for connecting ethical practices with the provision of culturally sensitive/responsive services are provided.
Adult Dysphagia Management: Diet, Sleep Apnea, Intensive Care Unit, and Dementia
Format(s): SIG Perspectives
This quartet of SIG 13 articles provides information regarding managing and treating dysphagia in the adult population. Caileen Harvey, Rachel Flemming, Julia Davis, and Victoria Reynolds investigate International Dysphagia Diet Standardisation Initiative implementation issues by surveying health care professionals in health care facilities in rural Upstate New York. Ankita M. Bhutada, William A. Broughton, Brenda L. Beverly, Dahye Choi, Sandip Barui, and Kendrea L. (Focht) Garand aim to identify the prevalence of dysphagia and reflux reported symptoms in patients with obstructive sleep apnea syndrome and determine associations between symptoms and demographic and clinical variables. Stevie Marvin summarizes published research on screening, evaluating, and treating post-extubation dysphagia in the intensive care unit. Rebekah Guastella, Stefania Oppedisano, Luis F. Riquelme, and Ashwini M. Namasivayam-MacDonald study bolus location at swallow onset, stage transition, pharyngeal transition duration, pharyngeal response duration, and pharyngeal phase duration between cued and uncued swallowing conditions in patients with dementia.
Clinical Practice Considerations: COVID-19, Word Retrieval, and Tinnitus
Format(s): SIG Perspectives
Three clinical practice considerations are reviewed within, including communication with patients/families in the face of the COVID-19 pandemic, identification of word finding errors in normally aging individuals, and how to address severe tinnitus. The first article points out that communication demands have changed during the pandemic, with increased need for communication about the virus and necessary precautions; however, mask use and social distancing have had a negative impact on everyone’s communication, especially those with communication disorders. COVID-19 specific precautions have included restriction of visitors in hospitals and nursing homes, quarantining, mask wearing, social distancing. Those with communication disorders experience specific circumstances that put them at a disadvantage as a result of these measures, to the extent that some disability rights groups argued that these policies may be violating acts and policies that are in place specifically to protect these individuals. This article goes on to explore, within the context of the COVID-19 pandemic, the importance of clear patient–provider communication, the impact of culture on communication, and using clear terminology. The second article sought to develop clinical practice by examining variations in performance on different verbal tasks completed by typically aging adults without neurological impairment who self-identified as either having or not having word-retrieval difficulties that frequently affected their lifestyle. The authors studied fifty-seven healthy adults between the ages of 54 and 71, by separating them into one group without selfidentified word retrieval difficulties and one group with self-identified word retrieval difficulties. Formal and informal assessment measures were used to objectively identify word-finding difficulties. The final article addresses the problem of tinnitus, which is broken down into two forms: bothersome and nonbothersome. Treatment is typically initiated when it becomes bothersome to the person experiencing it. The author reviews risk factors for developing tinnitus. In this specific instance, tinnitus was reported following a procedure that was intended to reduce vertigo. The patient opted to manage her tinnitus with pharmaceuticals, sound therapy, and education in the form of Tinnitus Retraining Therapy. The author describes the evaluation and treatment of each component in great detail. The result was a significant improvement in symptoms and the patient’s quality of life and functional abilities.
Executive Functions and Language: Self-Talk, Syntax, Semantics, and Strategies for Planning and Self-Regulation
Format(s): SIG Perspectives
This SIG 1 Perspectives activity focuses on the relationship between language and executive function (EF) in children with specific language impairment (SLI) and/or developmental language disorder (DLD). A clinical model of language therapy for adolescents with DLD and concomitant EF deficits was proposed. Finally, a theoretical framework for understanding and promoting metacognition and EF as part of assessment and treatment plans for speech-language pathologists was discussed.
Social Considerations: Exercise and Engagement, Communicative Participation
Format(s): SIG Perspectives
This Perspectives activity contains three articles, all with emphasis on social considerations in the elderly, with emphases on risk factors for dementia and treatment of Parkinson’s Disease. The first article seeks to describe the validity and reliability of the Fun and Social Engagement Evaluation (FUSE). The authors explain that this is an important topic because lack of physical activity and low social engagement are risk factors for dementia and could impact the rate of decline associated with dementia. Furthermore, physical inactivity has been identified by the World Health Organization as a leading risk factor for global mortality. Nursing home residents were evaluated using the FUSE during “Bingocize” sessions; the program combines a bingo-like game and physical activity and is scaled for differing cognitive and physical levels of ability. Results indicate that the FUSE is a valid and reliable method to measure engagement, and this is important because this measure can be recommended to nursing homes to measure engagement, as well as used in future research. The second article attempts to determine which of a variety of factors were associated with communicative participation and measured this based on the social network size of an individual. The author feels that this is important because social isolation is linked to cognitive decline and depression, both of which are risk factors for developing dementia. This study builds on previous research related to social participation and communication as predictors of successful health outcomes. Two research questions are addressed: What numbers of communication partners exist in the self-reported social network of older adults? And what factors are included in a model for predicting the social network size of older adults? They studied 337 seniors in Central Arkansas by collecting interviews and conducting standardized assessments. Results indicate that cognition and education are factors that are related to communicative participation. The results of this study, along with additional literature on this topic, suggest that there is benefit in recognizing a decrease in communicative participation and the role that cognitive decline may play in restricting communicative participation. The final article describes the program developed at Long Island University Brooklyn, which is multidisciplinary in nature, in contrast to previous treatment models which have traditionally focused on a monodisciplinary approach. In the past decade, there has been a shift from monodisciplinary models and research to a multidisciplinary approach, which is more effective in holistically treating the multifaceted effects of Parkinson’s Disease (PD), resulting in better outcomes and social participation for individuals with PD. The article describes use of the Fitness for PD exercise program twice per week for ten weeks, targeting strength, balance, agility, stretching, and aerobic exercises. Students at the university are engaged in taking vitals, facilitating resistance training, and enhancing safety; students and participants find benefit in working together. One hour Speech Clinic for PD sessions are conducted after each fitness class, including voice evaluations and therapy focusing on maximizing voice production and improving breathing patterns. The first half of sessions are conducted in game format, which encourages interpersonal interactions and collaboration and facilitates carryover into conversational contexts. Sessions incorporate Motor Learning Principles, LSVT LOUD, and respiratory exercises. The second half of sessions are conducted in whole-group format and speech practice in small groups.
Techniques for Designing Courses, Examining Preferences, and Conducting Experiential Learning
Format(s): SIG Perspectives
Pedagogical practices in communication sciences and disorders have grown thanks in part to innovative techniques from other fields. The articles in this activity each present models that can be successfully incorporated into our discipline. Slavych describes models of backward course design—course development that starts by focusing on learning outcomes before considering content or teaching methods. Squires and Squires introduce best–worst scaling, a method for examining group preferences, and reported on how it can inform admissions practices. Speights Atkins et al. describe models of mentoring undergraduate research experiences and their applications in two communication sciences and disorders research labs. Finally, Perryman et al. examine the effects of a mixed-reality simulation in which actors playing parents interacted through computer avatars with undergraduate students carrying out clinical procedures.
Educational Needs Assessments Within Communication Sciences and Disorders
Format(s): SIG Perspectives
The articles included here examine the current state of education of three topics within our discipline. DeJarnette and Wegner report on the classroom and clinical training that graduate students in speech-language pathology receive in augmentative and alternative communication. Domholdt and Billings identify associations and disconnects within graduate programs’ interests and practices in teaching population health concepts—that is, clinical care regarding communities and large systems. Finally, Tucker et al. examine practicing audiologists’ and speech-language pathologists’ interests in obtaining a research-based PhD in communication sciences and disorders and barriers to starting and completing a doctoral program.
Contextualized Language Interventions for Secondary Students
Format(s): SIG Perspectives
This SIG 1 Perspectives activity focuses on therapeutic interventions related to contextualized language for school-age and adolescent students. Articles discuss intervention to increase motivation while targeting language-based literacy skills; development of collaborative academic conversations in older students with language delays and impairments; semantic reasoning as a vocabulary teaching tool; how a written, graphic, and oral learning strategy can improve comprehension, retention, and expression; and how morphological awareness intervention can be linked to learning academic vocabulary within disciplinary literacy strategies.
Dysphagia Revelations: What We Know We Don’t Know and What Is Normal for Swallowing
Format(s): SIG Perspectives
This trio of SIG 13 articles provides information regarding unique factions of dysphagia intervention. Sophia Werden Abrams, Harmonie S. J. Chan, Jasmeet Sikand, Heather Wilkie, and Kim Smith raise awareness for the importance of neurodegenerative disorder research involving dysphagia caused by oculopharyngeal muscular dystrophy. Michela Jean Mir and Karen Wheeler Hegland aim to shed light on the subjective use of cough assessment and the importance and interest in formal clinical cough assessment training. Kendrea L. (Focht) Garand, Mary Catherine Reilly, Dahye Choi, Rajarshi Dey, Julie Estis, and Grayson Hill evaluate community dwelling adults using Modified Barium Swallow Impairment Profile components for bolus hold type to assist in defining typical swallowing behaviors.
Examining Challenges for Faculty and Students in Communication Sciences and Disorders Programs
Format(s): SIG Perspectives
The theme for this SIG 14 activity is examining challenges for faculty and students in communication sciences and disorders (CSD). Topics include (a) challenges faced by academic mothers in CSD programs; (b) challenges faced by faculty of color in CSD departments; and (c) examining microaggression endorsement in CSD students.
Increasing Equity and Inclusion for Minoritized Students and Faculty in Communication Sciences and Disorders
Format(s): SIG Perspectives
Ethnic and racial disparities within the fields of audiology and speech-language pathology have been well documented. Demographic data from the most recent ASHA survey revealed that 6.1% of ASHA members identify as Hispanic or Latino and 8.5% as “racial minorities.” These numbers are significantly below those of the overall U.S. population—16.3% and 27.6%, respectively, according to the U.S. Census Bureau. The articles in this collection present models for increasing equity and inclusion across our disciple. Girolamo and Ghali introduce a student-led grassroots initiative that supports minority students at all levels. Mohapatra and Mohan propose a model for increasing student diversity and inclusion based on successful programs from other health-related disciplines. Finally, Mishra et al. examined three challenges that faculty of color face: cultural competency, imposter syndrome, and racial microaggressions.
A Tale of Two Articles: Adolescent Misophonia and Using Apps in Service Delivery for Children With Hearing Loss
Format(s): SIG Perspectives
This activity has two articles with different foci. The misophonia case study is a contribution to the evidence base for use of sound therapy and coping strategies in treating and managing misophonia. It also shares available tools for diagnosing misophonia. The study about using learning applications in intervention for children with hearing loss shares results of a speech-language pathologists' focus group. The focus group centered on using speech and language application features, benefits, and concerns in school-based service delivery
Clinical Considerations for Working With Multicultural Populations in Schools and in the Community
Format(s): SIG Perspectives
The theme for this Perspectives activity is clinical considerations for working with multicultural populations in schools and the community. Topics include (a) assessment practices for multilingual children in schools, (b) school-based speech language pathologists working with interpreter-translators, and (c) factors associated with clear speech and accentedness in American English.
Interesting Discoveries in Adult Dysphagia Intervention: Screening, Evaluation, and Telehealth
Format(s): SIG Perspectives
This assemblage of articles provides information on interesting topics encountered in adult dysphagia practice. Aarthi Madhavan, Nicole Shuman, Claire Snyder, and Nicole Etter provide insight on the comparative consistency of the Eating Assessment Tool and Sydney Swallow Questionnaire scores for self-reported swallowing difficulties in a group of community-dwelling older adults completing both questionnaires. Georgina Papadopoulos-Nydam, Jana Maureen Rieger, and Gabriela Constantinescu evaluate the usability of a mobile health (mHealth) system designed for dysphagia exercise in persons with a history of stroke. Renata Mancopes, Fernanda Borowsky da Rosa, Lidia Lis Tomasi, Adriane S. Pasqualoto, and Catriona M. Steele demonstrate concern for people with chronic obstructive pulmonary disease (COPD) and share information regarding dysphagia in people with COPD, synthesizing knowledge both from the literature and from studies performed in the context of a multidisciplinary clinical pulmonary rehabilitation program abroad. Additionally, Talia H. Schwartz brings to light the importance and utility of the clinical swallow evaluation while caring for patients with COVID-19.
COVID-19: A Global Perspective
Format(s): SIG Perspectives
These SIG 17 Perspectives articles focus on the impact of the COVID-19 global pandemic on service provision and student training in four global contexts: Cyprus, South Africa, the United Kingdom, and the United States. Topics include the rise of telesupervision, telepractice in speech-language pathology (SLP), and distance learning in Cyprus during COVID-19; the effectiveness of SLP and related service treatment of patients with COVID-19 in an inpatient rehabilitation setting in the United States; the impact and transformation of an SLP university program in South Africa due to COVD19; and the perspectives of parents/caregivers on SLP service provision during COVID19 for children born with cleft palates in the United Kingdom.
Contemporary Issues: Augmentative & Alternative Communication Service Provision
Format(s): SIG Perspectives
These SIG 12 Perspectives articles provide information on current issues associated with display design and image complexity for individuals with cortical visual impairment and an in-depth overview of telepractice for people who rely on augmentative and alternative communication. Readers will be more adept at assessing and assisting children with cortical visual impairment and will have a better understanding of telepractice methods that can be used to improve virtual service delivery.
Epidemiology and Boothless Audiology Service Delivery
Format(s): SIG Perspectives
These SIG 8 Perspectives articles focus on topics that are important in promoting public health audiology. In “Fundamentals of Epidemiology for the Audiologist,” Torre and Reavis provide an overview of basic epidemiologic concepts including study design, prevalence, incidence, risk ratios, and odds ratios. The authors emphasize that an understanding of epidemiology is crucial for audiologists for a variety of reasons, including to help them assess the quality of publications, evaluate and discuss the efficacy of screening methods, and evaluate and communicate risk factors for ear and hearing problems. In “Hearing Health Care Delivery Outside the Booth,” Gates, Hecht, Grantham, Fallon, and Martukovich review the literature on boothless audiometry and introduce current tools used to deliver hearing health care outside of the traditional clinic setting. From their review, the authors conclude that boothless audiometry technology provides an opportunity for audiologists to expand services to nontraditional settings such as waiting grooms and nursing homes, increasing access to care, early identification, and intervention, and therefore improving health outcomes.
Patient-Centered Communication in Audiology
Format(s): SIG Perspectives
How can audiologists enhance patient-centered communication, even during the COVID-19 pandemic? This self-study is from the journal, Perspectives of the ASHA Special Interest Groups, SIG 7: Auditory Rehabilitation and Its Instrumentation. It features two articles focused on patient-centered strategies for effective communication, from initial consultations to prioritizing follow-up care, during COVID-19. It also includes the article that won the 2021 ASHA Journals Editor’s Award for Perspectives (for SIGs 6, 7, 8, and 9) by Davidson and Marrone. The first article is, “How to Provide Accessible Hearing Health Information to Promote Patient-Centered Care.” Kelly-Campbell and Manchaiah review the literature within audiology on patient-provider communication. They focus on research studies of communication during initial audiology consultation sessions. Through a summary of themes in the literature, they categorize important research findings that provide insight into communication between patients and their audiologists. Finally, they identify five key strategies for effective patient-centered communication. Each strategy is then reviewed in detail, with clinical examples and specific recommendations that can be immediately implemented in practice. The second article is, “A Clinically Valuable Interaction in the Midst of COVID-19 and Beyond: A Viewpoint on the Importance of Patient-Centered Outcomes in Rehabilitative Audiology.” Davidson and Marrone discuss patient-centered communication following hearing aid device fittings. They identify challenges facing patients and audiologists related to follow-up hearing aid services as a result of the COVID-19 pandemic. Based on a literature review and their own recent research, they developed a decision-tree algorithm to help audiologists prioritize clinical activities following hearing aid fittings, including remote formats for care. The algorithm was based on use of a patient-centered outcome measure, the Measure of Audiologic Rehabilitation Self-Efficacy. Patient-centered outcomes measurement is suggested as an engagement strategy for continued communication with patients during the COVID-19 pandemic and beyond.
Promoting Mental Health for School-Based Speech-Language Pathologists & Students
Format(s): SIG Perspectives
Upon entering into a new school year, this SIG 16 Perspectives activity highlights some of the realities faced by school-based speech-language pathologists (SLPs) and their students. Across all articles, readers will learn of the challenges that are all too often experienced by SLPs and our students, as well as recommendations for how to increase satisfaction with school-based positions, reduce burnout, and increase the mental health, representation, and motivation of our students. In the first article, the authors (Amir, Jones, Frankel, & Fritzch) report survey results that found that although school-based SLPs are satisfied with their relationships with students, they continue to experience challenges, especially related to caseload/workload and others’ misunderstanding of the roles and responsibilities of the SLP. This article is followed by a tutorial from Marante and Farquharson, in which they provide tips to address some of these challenges and reduce feelings of burnout and overwhelm, providing helpful checklists in the appendices. In the remaining three articles, authors outline ways for school-based SLPs to further support our students. The first of these articles, by Hoff and Unger, describes how to collaborate with mental health providers to address some of the unique social-emotional needs of students who stutter. Harris and Owen Van Horne, in the subsequent article, address how to include more diverse materials within therapy sessions so that the lived experiences of all students are more accurately portrayed and represented. Lastly, Abendroth and Whited discuss ways to support older students who are transitioning into adulthood, giving readers several ideas for how to increase students’ motivation, further develop rapport, and provide models of problem solving and resiliency.
Expanding Educational Opportunities in CSD Programs
Format(s): SIG Perspectives
In this activity, four recent SIG 10 articles are presented. First, Domsch, Stiritz, and Huff utilized a mixed-methods design to examine the cultural awareness of students in communication sciences and disorders (CSD) during and after a study-abroad experience. Next, Franca, Boyer, and Pegoraro-Krook explored activities designed to promote cultural and clinical competence in a collaboration between CSD programs in the United States and Brazil. Then, Veyvoda and Van Cleave reviewed the literature on service-learning and community-engaged learning, described how these approaches could be used in distance-learning modalities, and explored how doing so could be accomplished during and after the COVID-19 pandemic. Finally, Towson et al. studied the effectiveness of coaching paired with the use of a mixed-reality simulator as CSD students practiced interprofessional communication skills in role-play scenarios.
Impact of Allergies on Sleep in Stuttering; Using Solution-Focused Principles
Format(s): SIG Perspectives
These articles show the breadth of topics relevant to the understanding and treatment of fluency and fluency disorders. The articles include topics on the impact of allergies on the sleep of children who stutter and using solution-focused principles to elicit perspectives on therapeutic change in older children who stutter and their parents.
Clinical Considerations for Children and Adults From CLD Backgrounds
Format(s): SIG Perspectives
The theme for this Perspectives activity is clinical considerations in assessment of children and adults from culturally and linguistically diverse (CLD) backgrounds and providing culturally supporting treatment settings. Topics include (a) acoustic parameters of retroflex sounds, (b) the two-question method for assessing gender identity, (c) assessment recommendations for new language learners, and (d) creating culturally supportive settings to foster literacy development.
Advances in Hearing Diagnostics, Treatment, & Prevention
Format(s): SIG Perspectives
These three articles describe current issues and advances related to hearing diagnostics, treatment, and prevention. The first article is a detailed description of the impact that COVID-19 face masks and social distancing regulations have had on speech recognition and how face masks affect the acoustic signal and increase cognitive effort in listeners with hearing loss. Suggestions for mitigating these deleterious impacts on communication are provided. The second article is a research study examining the correlation between self-perceived hearing difficulty, determined using a questionnaire (Adult Auditory Performance Scale), and speech-in-noise performance (Listening in Spatialized Noise–Sentences Test) in listeners with normal pure-tone thresholds. Results highlight the relationship between self-perceived hearing abilities and binaural speech-in-noise performance supporting the inclusion of speech-in-noise testing even in those with normal pure-tone thresholds. The third article is a review of current genetic, stem cell, and pharmacotherapy research for treatment and prevention of hearing loss. Animal models are discussed, as well as steps to translate this research into clinical practice.
Emotion/Attention Issues & Stuttering: Podcasts, Stereotypes, Covert Stuttering
Format(s): SIG Perspectives
This activity is a grouping of studies related to the understanding stuttering throughout the life span. The activity is based on articles related to attentional focus on motor control in people who stutter (PWS) and the relationship to social stress, acoustic measures of emotion in children who stutter, a study of covert stuttering throughout the lifespan, vocational stereotyping of PWS by human resource preprofessionals, and audio-based podcasts to assist in self-help for PWS. Together, these articles investigate important measures in understanding stuttering and how researchers and clinicians can better understand the condition of stuttering.
Effective Relationships in Supervisory and Work Settings
Format(s): SIG Perspectives
This SIG 11 Perspectives activity presents two unique articles related to enhancing relationships in supervisory and work settings. The first article highlights specific skills sets required for clinical providers and describes primary performance indicators (PPIs) that are critical to building effective working relationships. In the second article, the authors detail the findings of a study on similarities and differences in work ethic among three generations of speech-language pathologists.
Clinical Practices for Aphasia
Format(s): SIG Perspectives
These SIG 2 articles focus on clinical assessment and practices for individuals with aphasia. Topics covered included challenges associated with diagnosing primary progressive aphasia (PPA) and the impact of adaptive yoga programs for persons with aphasia. First, Aimee Dietz, E. Susan Duncan, Lauren Bislick, Sarah Stegman, Jenna Collins, Chitrali Mamlekar, Rachel Gleason, and Michael J. McCarthy provide an overview of the potential impact adapted yoga programs can have for people with stroke-induced aphasia. Second, Adithya Chandregowda raises awareness about the challenges associated with encountering primary progressive aphasia (PPA) patients in the acute hospital setting.
Diagnostic Measures for Velopharyngeal Function
Format(s): SIG Perspectives
This Perspectives activity highlights two articles with objective measures for both evaluation and treatment of velopharyngeal dysfunction. The first article discusses the palatal closure efficiency (PaCE) index. This is an aerodynamic tool used to estimate the velopharyngeal opening during certain speech contexts. This is done by measuring a percentage of change between nasal and oral cognates of an individual. The second article describes the nasometer in depth, highlighting its use as an evaluation and treatment tool for decreasing hypernasality. It goes into further detail on the differences between hypernasality and measured nasalance, highlighting both strengths and limitations of the nasalance score.
A Myriad of Dysphagia Interventions: NICU, Cultural Humility, Instrumentation, Nursing, Tracheostomy Tubes, and Technology
Format(s): SIG Perspectives
This collection of articles presents clinicians with evidence on a variety of topics in dysphagia that can be utilized in practice immediately. Alaina Martens and Emily Zimmerman offer insight regarding changes to feeding patterns in infants diagnosed with bronchopulmonary dysplasia after prolonged oxygen therapy in the newborn intensive care unit. Paula Leslie and colleagues provide a framework of health and illness and how food and drink are much more. They stress the importance of clinician appreciation as a cultural guest in our patients’ lives. Bonnie Martin-Harris and colleagues stress the importance of instrumentation with a thorough review of available practice guidelines and appropriateness criteria issued to date, revealing a deficit of up-to-date, comprehensive, evidence-based information on the diagnosis and evaluation of oropharyngeal dysphagia. Specifically, a lack of quality guidance on the ordering, performance, and reporting of the modified barium swallow study has hindered efforts to improve standardization and ensure quality continuity of care. Naomi Gurevich and colleagues stress the need to clarify guidelines and increase interprofessional education between both professions to improve patient care. George Barnes and Nancy Toms highlight speech-language pathologists’ need for a solid foundation of knowledge when it comes to patients with highly complex disease processes and care plans. Deirdre Muldoon and colleagues conduct a review of published literature regarding management of feeding difficulties at the oral phase of feeding in children with autism spectrum disorder and/or developmental disability. Finally, Paul M. Evitts and colleagues reveal a potential way to track aspiration in healthy adults using an app.
Quality of Life in Communication Among the Elderly
Format(s): SIG Perspectives
Three articles have been grouped, all centering around quality of life: at end of life, following a stroke, and among individuals with voice disorders. In “Facilitating End-of-Life Interaction Between Patients With Severe Communication Impairment and Their Families,” the authors acknowledge the work that has been done previously and recently in outlining the role of the speech-language pathologist in dysphagia and communication at end of life. One case study is presented, which describes an end-of-life scenario following a stroke. Post–case study review, the authors include reflections, counseling points for clinicians related to the case study, and counseling points in the form of a handout that could be used as a resource for clinicians. Given that existing research on the impacts of stroke is primarily conducted within a 5-year period following the stroke, the authors of “Quality of Life Following Stroke: A Qualitative Study Across 30 Years” seek to understand the long-term effects. They draw data from 28 years of journals that were kept by the participant and conduct semistructured family interviews. The authors draw four themes from the data—family support, faith, personality, and journaling—as having influence over the participant’s long-term experience poststroke. Within the discussion, the authors examine the World Health Organization’s Quality of Life Factors and the participant’s experience through the lens of the resilience theory. Among aging individuals, voice disorders (including presbyphonia) are commonly reported—however, treated less proportionately. “Perceived Voice Disorders in Older Adults and Impact on Social Interactions” uses a cross-sectional investigation approach by examining the findings of three assessments on 332 community dwelling individuals aged 60 and older. The authors conclude that voice disorders increase with age and, conversely, social interactions requiring communication decrease among individuals with voice disorders. As a result, health-care professionals are encouraged to educate older individuals on how and why to seek management of a voice disorder by a speech-language pathologist or qualified medical professional.
Progressive Topics for Consideration: Ageism, Systems of Oppression in Geriatrics, and Health Disparities
Format(s): SIG Perspectives
Three progressive cultural topics are examined as they relate to speech-language pathology and audiology. Because negative feelings toward the elderly can result in adverse effects in healthcare settings, in “Ageism Among Graduate Students in Communication Sciences and Disorders: A Longitudinal Analysis,” Heape et al. tested 80 graduate students in speech-language pathology to determine the presence and level of ageism using the Fraboni Scale of Ageism. They conclude that positive impacts could be gained by development of graduate curriculum that encompasses all age groups, including the elderly. In “Systems of Oppression in Geriatric Clinical Service Delivery,” Kendall builds on previous work related to forms of oppression by defining institutional, symbolic, and individual systems of oppression. Additionally, she provides clinical examples specific to working in communication sciences disorders settings and suggestions as to how clinicians can disrupt oppression in the workplace. In “The Complexity of Health Disparities: More Than Just Black–White Differences,” Ellis and Jacobs bring health disparities back to light given the recent findings from 2020 indicating that Hispanic and African Americans are more than twice as likely to die from COVID-19 than White Americans. They provide definitions, review vulnerable populations and the interaction between social determinants and health disparities, and provide suggestions on how to achieve equity.
Education, Considerations, and Techniques in Gender Affirming Voice Care
Format(s): SIG Perspectives
In this series of articles, the need for clear guidelines in graduate education on the topic of transgender voice and communication is explored through an e-survey. Considerations for culturally competent voice care is presented in the context of two case studies. Case studies are also used to highlight the importance of an interdisciplinary gender affirming approach for successful voice care with adolescence. In the final article, a voice technique is adapted for voice masculinization.
Communication Choice and Agency: Thinking Beyond  Spoken Language for Individuals on the Autism  Spectrum
Format(s): SIG Perspectives
This Perspectives activity focuses on communication choice and agency for individuals on the autism spectrum. These individuals are the key informants in decisions around the conceptualization, implementation, and evaluation of educational programming for autistic learners. Speaking autistic adults encourage families, professionals, and society to promote and accept all communication as equal.
Language and Literacy Intervention Topics for Children  With Hearing Loss and Deafness
Format(s): SIG Perspectives
This activity includes two articles related to language and literacy intervention for children with hearing loss and deafness. In the first article, Stephanie Mary Raymond and Tring D. Spencer investigate the effect of narrative language intervention on the narrative retelling skills and vocabulary use of children with hearing loss. In the second article, Krystal L. Werfel and Sarah Lawrence describe specific considerations for print-referencing interventions for children with hearing loss along with a case study. The respective authors conclude that print referencing, with specific considerations for children with hearing loss, may be an effective emergent literacy intervention to increase conceptual print knowledge for children preschool-age with hearing loss; and narrative intervention is promising for facilitating language skills improvement for children with hearing loss. Both studies require replication for their findings.
Childhood Maltreatment Consequences on Social Pragmatic and Literacy Skills
Format(s): SIG Perspectives
This activity focuses on the childhood maltreatment consequences on social pragmatic communication. Based on a complex family and social conception of neglect, a logical model illustrating public health services for children experiencing neglect is proposed. The role of speech-language pathology in prevention, policy, and practice is outlined. The importance of assessing the narrative language of children exposed to complex trauma is also emphasized.
Novelty in School-Based Evaluation, Treatment, and Roles
Format(s): SIG Perspectives
This SIG 16 Perspectives activity highlights novel approaches to eligibility decision-making, intervention, and the roles and responsibilities of school-based speech-language pathologists (SLPs). In the first article, the authors present a novel approach to evaluation and eligibility. Farquharson, Coleman, Moore, and Montgomery showcase how SLPs can utilize and apply a design thinking framework when making eligibility recommendations for children with oral and written language disorders. The authors give two sample eligibility predicaments and give examples of five design thinking questions (discovery, interpretation, ideation, experimentation, evolution) for each scenario. In the second article, we learn about a novel approach to intervention. Here, Page and Johnson provide a summary of electropalatographic therapy for the remediation of speech sound disorders. They also systematically reviewed the literature to summarize the extent to which this intervention technique is supported for use with children with Down syndrome. Lastly, the last group of authors discuss novel roles and responsibilities that school-based SLPs may assume. In this article, Seal and Power-deFur discuss the similarities and differences between a fact witness and an expert witness, while also providing school-based professionals with ideas of how to prepare for these roles if called to testify in a special education dispute or civil litigation case.
Clinical, Research, Linguistic, and Technical Considerations in Telepractice
Format(s): SIG Perspectives
This activity presents a variety of topics related to telepractice service provision. The first article offers a case study on the effects of a hybrid telepractice/onsite treatment program for a child who stutters. The following article discusses common technical issues encountered during telepractice and a process for managing them with English- and Spanish-speaking clients. The final article details the findings of a study on integrating technology through telepractice to support clients with dementia.
Speech Science Views and News
Format(s): SIG Perspectives
This activity presents a diverse perspective, including four different speech science articles focused on a variety of topics. Kimball and Sayce discuss the pros and cons of research using behavior and functional assessment and treatment in the areas of speech science and voice, specifically their limitation in outlining etiology or explaining treatment resistance. They also provide an overview of genetic research approaches as a possible path forward to develop additional evidence-based treatment approaches. Neel reviews the production and perception of extralinguistic information regarding sex/gender, sexual orientation, age, non-native accent, regional and social dialect, and race and ethnicity. The article explores the literature in the above areas reviewing acoustical features and common misperceptions, concluding with instructional activities to enhance student awareness of indexical characteristics. McAllister et al. studied the effects of biofeedback for residual rhotic errors in a preliminary case series. Participants were five native English speakers who had not yet generalized rhotic production. Treatment consisted of either electropalatographic or visual-acoustic biofeedback using the Challenge Point Program software. Although participant responses to treatment were variable, the median effect size tended to exceed the minimum value considered clinically significant. Gritsyk et al. examined three measures to determine which best predicted change in production accuracy during a vowel learning task. Using 20 female college students, researchers administered three tasks: an oral stereognosis task, a bite block task using auditory making, and a new phonetic awareness task. The bite block task with auditory masking, measuring proprioceptive awareness, was the only task significantly related to performance in speech learning.
Evaluating Dysphagia Across the Life Span
Format(s): SIG Perspectives
The assemblage of articles presents clinicians with information on a variety of topics in dysphagia that can be utilized in practice. Laura L. Madhoun, Laura C. Merrell, Amanda Smith, Emily Snow, and Kristen M. Cherosky stress the importance of individualized and comprehensive feeding management for craniofacial anomalies through interdisciplinary collaboration. Lena G. Caesar and Meretu Kitila study clinicians’ perceptions and confidence with dysphagia service delivery. Aliaa Sabry, Amanda S. Mahoney, Shitong Mao, Yassin Khalifa, Ervin Sejdic, and James L. Coyle point out an objective way to assess laryngeal vestibule closure and opening at beside. Marie Jardine, Anna Miles, Jacqui Allen, and Rebecca Leonard give an interesting take of assessment of the aging swallow. Kelsey L. Thompson and Wanqing Zhang provide description and examples of mixed method research to comprehensively and holistically report of pediatric feeding disorders.
Assessment and Treatment of Social Language Deficits in School-Aged Students
Format(s): SIG Perspectives
This Perspectives activity focuses on the assessment and treatment of school-age students with social language deficits. Articles focus on conversational profiles for students with autism and intervention strategies appropriate for students within each profile; the benefit of using analog tasks with toddlers through adolescents to evaluate social communication abilities and guide intervention; best practices in assessing students with social communication deficits; and how effective commercially available standardized tests are for evaluating the social and pragmatic language deficits of students with social pragmatic communication disorder within and separate from autism.
Dysphagia & Auditory Matters in Geriatric Speech-Language Pathology
Format(s): SIG Perspectives
These articles explore thickened liquids for oropharyngeal dysphagia, importance of patient selection, & balancing physical welfare/quality of life (QOL); QOL in patients/caregivers in recovery for swallowing disorders; audiologist knowledge of cognitive impairment/screening in outcomes/communication; and hearing screening for individuals who are diagnosed with dementia.
Clinical Considerations for Clients From CLD Backgrounds
Format(s): SIG Perspectives
This Perspectives issue focuses on clinical considerations for working with children and adults from culturally and linguistically diverse (CLD) backgrounds. Topics presented include (a) effects of clear speech on perceptions of accentedness in American English, (b) ethnographic interviewing in clinical practice, (c) language errors in bilinguals under background noise and quiet conditions, and (d) assessment of speech sound disorders in school-aged children from CLD backgrounds.
Structural Anomalies Related to Cleft and Craniofacial Conditions
Format(s): SIG Perspectives
These Perspectives (SIG 5) articles focus on the functional problems caused by the structural anomalies of the craniofacial complex and pathways for intervention. Articles describes the impact of submucous cleft palate, dental/skeletal anomalies, and distraction osteogenesis on speech and resonance outcomes for individuals with craniofacial anomalies. Multidisciplinary roles and best practice recommendations are also provided.
The Impact of Hearing Loss on Language and Literacy
Format(s): SIG Perspectives
This Perspectives forum focuses on the reading outcomes of students with hearing loss and cochlear implants. The first article examines the role of vocabulary on print knowledge for students with hearing loss. The second article provides recommendations for treating the listening and spoken language skills of students with hearing loss based on the results of a 2-year study. The third article compares how reading ability and working memory are impacted in students with cochlear implants and hearing aids after they participated in a computer-based program. The final article explores the relationship between language and reading ability in students with hearing impairment.
Value-Based Health Care Relating to Management of Dysphagia
Format(s): SIG Perspectives
This collection of articles presents information currently relevant to caring for patients. Firstly, Cara Donohue and James L. Coyle, and Christina Kang and David Lott, share service delivery focusing on the diagnoses of amyotrophic lateral sclerosis and muscle tension dysphagia, respectively. Samantha Shune and Ashwini Namasivayam provide systematic strategies to better support patients’ informal caregivers. Rinki Varindani Desai and Ashwini Namasivayam-MacDonald describe the practice patterns of speech-language pathologists managing dysphagia in persons with dementia. Lastly, Nancy Swigert and Ashley Wright describe effectiveness and efficiency as the key components of a value-based health-care system.
Interprofessional Practice in an International World: 2020
Format(s): SIG Perspectives
These articles explore how the international world of speech-language pathology and audiology is expanding, and, with it, are opportunities to practice, share, and provide education around the world. The articles discuss sharing resources between speech-language pathologists and audiologists, regardless of practice setting.
Vestibular and Balance Rehabilitation
Format(s): SIG Perspectives
For people experiencing dizziness, what are possible options for vestibular and balance rehabilitation? This self-study from Perspectives of the ASHA Special Interest Groups (SIG 7) addresses treatment choices in vestibular and balance rehabilitation, the state of the evidence on their efficacy, and future directions for interdisciplinary research and practice. Written by clinicians and scholars with expertise in audiology and physical therapy, the four articles present an interdisciplinary and life span approach to vestibular and balance rehabilitation for children and adults. The first article by Christy is on the use of vestibular and balance rehabilitation therapy for dizziness in children. Next, the review by Herdman focuses on the evolution of vestibular function tests and rehabilitation for major vestibular disorders as well as areas in which research and clinical practice may grow in the future. In Holmberg, the relatively new but common diagnosis of persistent postural-perceptual dizziness (PPPD) is presented in terms of its pathophysiology, differential diagnosis, and treatment protocols. Finally, Clendaniel provides a review on the use of vestibular rehabilitation in the treatment of benign paroxysmal positional vertigo. Included are detailed photos and illustrations of current techniques and exercises. As described in the introduction to the forum by Guest Editor Neil Shepard, PhD, “It is hoped that these four articles will provide a needed look at vestibular and balance rehabilitation therapy (VBRT) so the audiologist can serve as a productive member of the treatment team and have a good understanding as to everything that
Current Issues in Augmentative & Alternative Communication Service Provision
Format(s): SIG Perspectives
These Perspectives (SIG 12) articles provide information on an assortment of current issues in augmentative and alternative communication (AAC) service provision. Specific topics include discussions regarding preparation and training of speech-language pathologists and other stakeholders in the AAC field as well as information regarding culturally competent assessment and intervention. In addition, literacy acquisition using video visual scene displays is introduced and information regarding image color in AAC displays is provided.
Unique Current Issues in Dysphagia Management
Format(s): SIG Perspectives
This collection of articles presents clinicians with information on some of the most timesensitive topics in dysphagia care of utmost relevance, particularly in the current COVID- 19 pandemic. Firstly, Liza Blumenfeld, Lisa Evangelista, Maggie Kuhn, Kristen Linnemeyer, Nogah Nativ-Zeltzer, and Heather Starmer provide best practice recommendations on the management of patients with head and neck cancers from the speech-language pathology perspective amid COVID-19. Authors Hema Desia and Jennifer Raminick then provide recommendations for safer feeding of infants on high flow oxygen therapy due to acute respiratory failure. Lastly, authors Grainne Brady and Justin Roe, Kellyn Hall and Leslie Johnson, and Annette Askren and Marnie Kershner discuss different aspects of clinician–patient collaborated dysphagia care delivery models and their impact on successful outcomes.
Assessment and Treatment of Childhood Apraxia of Speech
Format(s): SIG Perspectives
First, Julie Case and Maria Grigos provide a review of speech motor control literature in childhood apraxia of speech (CAS) and give clinical implications to the assessment and treatment of CAS. Second, Kristen Allison reviews approaches to measuring speech intelligibility in children with motor speech disorders. Third, Tricia McCabe, Donna Thomas, and Elizabeth Murray describe Rapid Syllable Transition Treatment (ReST) as a treatment for CAS. Fourth, Nancy Tarshis, Michelle Winner, and Pamela Crooke explore how communication challenges in CAS impact social competency and how speech motor challenges impact social development. Finally, Nina Benway and Jonathan Preston evaluate if features of CAS in the literature could be replicated in a sample of school-age children. Readers will describe how speech motor skills have been found to change with practice in CAS, list the linguistic factors that can influence intelligibility, describe the quality of the research that supports ReST, explain ways to consider social cognition in therapy for CAS, and rank the speech features that distinguish the narrow phonetic transcriptions of children with CAS and speech sound disorders.
Classroom Participation and Reading in Deaf or Hard-of- Hearing Children
Format(s): SIG Perspectives
This exercise highlights three articles. First, a qualitative research study with multiple high school student participants with deafness/hearing loss examining factors that promoted versus challenged their access to classroom communication and participation is included. The next article is a preliminary study exploring that children with reading impairments are more likely to fail hearing screenings that children with typical reading skills. Finally, the third article looks at shared book reading and its association with language growth aspects for children who are deaf and hard of hearing over a 4-week training program related to caregiver knowledge of emergent literacy features
Factors of Graduate and Undergraduate Student Success
Format(s): SIG Perspectives
These Perspectives (SIG 10) articles explore several issues related to student success. Sylvan, Brock, Perkins, and Garret examine prerequisites required by graduate programs in speech-language pathology across the United States. Roitsch, Murphy, and Raymer investigate the relationship between executive functions and academic outcomes in speech-language pathology graduate students. Richardson, Roberts, and Victor explore ways to predict the clinical success of graduate students studying speechlanguage pathology. Look, Shoemaker, Hoepner, and Blake discover benefits of engaging undergraduate students in research.
Bilingual Fluency/Disfluency in Children and Why Adults Attend Self-Help Groups
Format(s): SIG Perspectives
In these Perspectives (SIG 4) articles, two of the articles relate to patterns of disfluency in young bilingual children—one of these two articles adds the patterns of stuttering in young bilingual children that stutter. The third article uses a thematic analysis to help understand why adults who stutter attended self-help groups.
Speech Perception and Production
Format(s): SIG Perspectives
This Perspectives (SIG 19) includes four different speech science articles that focus on speech production, speech perception, or both. Akbari and Aoyama examine epenthetic vowels produced by Persian L2 speakers of English corroborating previous research findings regarding acoustical characteristics of anaptyctic epenthetic vowels—prothetic epenthetic vowels differ from the phonemic vowels they precede. Hitchcock et al. examine speech perception of typical adults, typical children, and children with speech sound disorders, finding that children with speech sound disorders differ as compared to both typical groups. Rong conducted a preliminary examination of the articulatory control of speech and speech-like tasks. The results revealed shared and task-specific articulatory features in speech and speech-like tasks, specifically sharing that alternating motion rate tasks may be more useful for assessing temporal aspects of articulation whereas sequential motion rate tasks may be more useful for assessing spatial aspects of articulation and coordination. Lastly, Boyd-Pratt and Donai review evidence that the high frequency region contains perceptual cues regarding segmental, speaker identity, and speaker sex as well as improved speech recognition in the presence of noise.
Clinical Approaches and Practices for the Life Participation Approach to Aphasia
Format(s): SIG Perspectives
First, Katie Strong and Barbara Shadden provide an overview of the relationship between narrative, identity, and social co-construction for persons with aphasia and narrative treatment approaches for identity renegotiation. Second, Jamie Azios and Jack Damico relate the Lifetime Participation Approach to Aphasia (LPAA) and issues in longterm care (LTC) along with practice recommendations for implementing LPAA in LTC. Third, Jerry Hoepner and Tom Sather examine the potential approaches for teaching and mentoring students in LPAA. Fourth, Rochelle Cohen-Schneider, Melodie Chan, Denise McCall, Allison Tedesco, and Ann Abramson explore balancing relationshipcentered care and professionalism. Finally, Sarah Wallace, Elena Donoso Brown, Anna Saylor, Erica Lapp, and Joanna Eskander describe aphasia-friendly modifications for occupational therapy assessments and home programs.
School Age Identification and Treatment of Traumatic Brain Injury
Format(s): SIG Perspectives
These Perspectives (SIG 2) articles focus on approaches for early identification, service delivery, and treatment of traumatic brain injury (TBI). In the first article, Juliet Haarbauer-Drupa and Michael Brink describe the existing literature on preschool children with traumatic brain injury (TBI) and illustrate a model of care for a community. Next, Lori Cook, Nellie Caulkins, and Sandra Chapman explore the potential for cognitive training delivered via telepractice to enhance cognitive performance after mild TBI in adolescence. Lastly, Mary Kennedy offers an update on the evidence the provides possible explanations for speech-language pathologists’ experiences while implementing a coaching approach with college students with TBI.
Clinical Applications of Vestibular Scientific Advancements in Specialized Populations
Format(s): SIG Perspectives
These Perspectives (SIG 6) articles describe current research, diagnostic, and management techniques for three different vestibular populations, including individuals with Usher Syndrome, Meniere’s Disease, and aging populations. The first article examines age-related changes in vestibular function and discusses findings in animal studies examining specific structural and functional changes occurring within the system. The second article is a review designed to advance understanding of the clinical presentation of individuals with Usher Syndrome and discuss the importance of a multi-disciplinary team in diagnosis and management. Additionally, the latest research in gene-therapy treatments for Usher Syndrome are discussed. The final article is a large scale retrospective study of patients with an active Meniere’s Disease diagnosis. The study examines correlations between disease duration and diagnostic assessment findings.
Ethical Considerations for Voice and Upper Airway Clinicians
Format(s): SIG Perspectives
These Perspectives (SIG 3) articles address ethical considerations for voice and upper airway clinicians, including billing questions and reimbursement issues as well as factors that guide ethical decision-making to determine what comprises medically necessary voice therapy that involves or targets singing voice.
Telepractice Establishment, Ethics, and Evidence
Format(s): SIG Perspectives
These Perspectives (SIG 18) articles present information on various aspects of telepractice, including ethics and telepractice, a guide for establishing remote services in private practice, and a systematic review of telepractice for adult speech-language pathology services.
Clinical and Research Topics in  Audiology and Public Health
Format(s): SIG Perspectives
These Perspectives (SIG 8) articles cover a wide range of audiology and public health research and clinical topics. There are three original research reports and one clinical review. In the first research report, Roman et al. examine the impact of reduced audibility and speaker voice on the mini-mental state examination score in a group of young adults without cognitive impairment. Next, Beamer et al. conduct a preliminary study to investigate the role of a hearing loss prevention education strategies in an active duty military population. Reavis et al. estimate the association between tinnitus and self-reported depression symptoms and between tinnitus and perceived anxiety in a nationally representative sample of U.S. adults. The final article by Henry and Manning is a review article on sound therapy approaches and clinical options for tinnitus management.
Considerations for Academic and Clinical  Training in Craniofacial Anomalies
Format(s): SIG Perspectives
These Perspectives (SIG 5) articles focus on the status of academic and clinical training related to cleft and craniofacial conditions, a module training series for addressing the gaps in current educational roadmaps, and resources and best practice recommendations are provided.
Perception, Technology, and Clinical Applications
Format(s): SIG Perspectives
These Perspectives (SIG 19) articles focus on perceptual considerations and the use of a system to investigate lingual coordination as a clinical tool. In the first article Rakerd et al. review the resonant effects of performers, resonance associated with nasality, and resonant voice for both normal and disordered populations. In the second article Grover et al. use the bubble noise method, which places noise randomly in time and frequency with “holes” or “bubbles” that give glimpses into the target signal, to determine what is perceptually important in the speech signal for native/first language listeners versus nonnative/second language listeners. In the final article, Dugan et al. review TonguePART, an image processing system used to track the tongue surface, as a reliable, fast method to track articulatory movement of the tongue for syllables
Dementia, Student Supervision,  and the Patient Driven Groupings Model
Format(s): SIG Perspectives
These Perspectives (SIG 15) articles discuss issues related to dementia care, student supervision, and the home health patient driven groupings model. Warren describes the rational for the development of a new payment system, how it will be changing, and what speech-language pathologists can do to be prepared and successfully navigate the transition. Davies explores the relating concepts of participation and communication in dementia care research and to propose future avenues of research within the field of communication disorders. Bice and Smith discuss current issues found in external clinical placements, their possible causes, and offers practical solutions for assisting students to benefit from their experiences.
Voice and Laryngeal Manifestations of Autoimmune Diseases
Format(s): SIG Perspectives
This Perspectives (SIG 3) article provides a thorough review of the literature regarding autoimmune disease and effects on voice and laryngeal function. To maximize patient outcomes, guidelines for differential diagnosis and referral patterns are highlighted.
Autism in Early Childhood
Format(s): SIG Perspectives
This Perspectives (SIG 1) forum focuses on the treatment of young children with a diagnosis of autism spectrum disorder. The first article examines the effects of parent-mediated intervention on the spoken language of young children. The second article focuses on an embedded teacher-implemented social communication intervention for preschoolers. The third article examined peer mediated augmentative and alternative communication for young minimally verbal children. The final article reported on social communication predictors of successful inclusion experiences for students with autism in an early childhood lab school.
Heritage Language Transmission and Community Engagement
Format(s): SIG Perspectives
These Perspectives (SIG 14) articles focus on learning about variables and challenges that impact heritage language transmission and incorporating student engagement into the local community as part of cultural diversity training in a communication disorders curriculum. Topics include (a) examining variables that contribute to heritage language transmission in Texas, and (b) increasing student awareness of cultural linguistic diversity within the local communities in and around the Los Angeles, CA area.
Student Stress, Emotional Intelligence, Applying to Graduate School, and Doctoral Training
Format(s): SIG Perspectives
In these Perspectives (SIG 10) Roos and Schreck examine the stress experienced by undergraduate students in communication sciences and disorders (CSD), including stress levels, reasons for stress, stress management, and knowledge/use of campus resources to address stress. Shah and Galantino address building the emotional intelligence of undergraduate students studying CSD through exercises completed in class. Sylvan, Perkins, and Tuglio study the experiences and perceptions of CSD students applying to master’s degree programs, including deciding factors for top choices of graduate programs, emotional involvement in the application process, biases/rumors heard, student challenges, advice to future applicants, and what students would change about the application process. Finally, Crais and Savage present an examination of CSD graduates’ perceptions of their PhD program, including challenges they faced, facilitators for success, their preparation for research/teaching/job readiness, and ways PhD education might be improved.
Graduate Education and Ethics in School-Based Practice
Format(s): SIG Perspectives
These Perspectives (SIG 16) articles focus on ethical issues and describe considerations for the development of clinical skills in school-based settings. Readers will reflect upon and learn to resolve common ethical dilemmas, review a model of graduate mentoring from the lens of implementation science, and learn about commonly reported factors that both supervisors and graduate students believe critical within successful school-based internship experiences.
Collaboration in Language, Literacy, and Dysphagia
Format(s): SIG Perspectives
These Perspectives (SIG 16) articles address strategies for working alongside, as well as teaching others, to improve preschool to middle school students’ performance in language, literacy, social skills, and feeding/swallowing abilities, as well as learn how others perceive speech-language pathologists’ efforts in some of these areas.
Palliative Care Perspective on Dysphagia Management
Format(s): SIG Perspectives
These Perspectives (SIG 13) presents clinicians with information across many aspects of feeding and swallowing. Firstly Kendrea Garand, Taylor Thomas, and Rajarshi Dey discuss the physiology of laterality in the clearance of boluses from the pharynx. Next, Jennifer Wilson, Amanda Simmons, and Jillian McCarthy then take us through an interesting description of speech-language pathologists’ experiences and education in pediatric dysphagia and encourage the incorporation of intensive education in this high-risk topic, via various avenues. In the final three articles, Pamela Smith, Jinxu Bridget Xia, and Claire Radford et al., present an in-depth and elaborate perspective on managing patients with dysphagia through a palliative care lens, across the lifespan.
Developmental Language Disorder/Specific Language Impairment Terminology in Practice
Format(s): SIG Perspectives
This Perspectives (SIG 1) forum focuses on developmental language disorder (DLD), including the history of terminology changes in the field, the relationship of specific language impairment and DLD, diagnostic criteria in the field of speech language pathology, and an examination of DLD through a school-based lens.
Dysphagia and Continuum of Care
Format(s): SIG Perspectives
These Perspectives (SIG 13) include a variety of topics in dysphagia across the age continuum and across the many settings that speech-language pathologists (SLPs) address dysphagia. Parker Huston, Robert Dempster, and Lauren Garbacz provide readers with an overview of common evidence-based psychological techniques used in the treatment of adolescents with feeding disorders, including motivational interviewing and cognitive behavioral techniques. The goal of this paper is to provide a high-level overview of these concepts so that providers outside of psychology may utilize some of these techniques in therapy, when referral to a behavioral specialist or psychologist is not feasible. Next, authors Lauren Madhoun and Robert Dempster discuss the psychosocial aspects of feeding in the neonatal intensive care unit NICU and immediately following NICU discharge. Joanne Patterson extends the discussion to the adult population by describing a biopsychosocial intervention that combines cognitive behavioral with dysphagia therapy, termed Cognitive-Behavioral Enhanced Swallowing Therapy (CB-EST) and its application in managing head and neck cancer patients with dysphagia. Finally, authors Kortney Eng, Maria Jose Flores, Elisabeth Gerrity, Nupur Sinha, Katherine Imbeau, Laddie Erbele, and Cary Yeh share details from their study investigating the effect of high-flow nasal cannula (HFNC) on swallow physiology in healthy adults. We hope these articles will be of significant value to practicing clinicians and to students learning about dysphagia.
Assessment and Treatment Approaches for Dysphagia Management Across the Lifespan
Format(s): SIG Perspectives
These Perspectives (SIG 13) articles present clinicians with useful information to help assess and treat feeding and swallowing disorders in a variety of patient populations across the lifespan. Daniel Croake and Vrushali Angadi provide an overview of evidence regarding prophylactic and reactive gastrostomy tubes in individuals with head and neck cancer, to better facilitate joint decision-making of percutaneous gastrostomy (PEG) tube timing with the patient and care team. Hema Desai and Audrey Lim extend the discussion to pediatric dysphagia by summarizing the application of neurobehavioral interventions as part of feeding treatment for infants with congenital heart defects.
Outlining the Use of Strategic Questioning and Applying the Code of Ethics
Format(s): SIG Perspectives
These Perspectives (SIG 11) articles outline the use of strategic questioning methods to stimulate students' critical thinking and other higher order thinking skills. In addition, the Code of Ethics is discussed as it relates to supervisory experiences across various settings.
History and Collaborative Efforts in  the International Cluttering Association
Format(s): SIG Perspectives
These Perspectives (SIG 17) articles present a collaborative initiative of the Committee of International Representatives of the International Cluttering Association. Reichel et al., discuss the initiative that began with the Inaugural Joint World Congress in Japan in 2018. Van Zaalen and Reichel present and discuss the auditory-visual feedback training methodology. Gosselin and Ward affirm that cluttering is a fluency disorder that is mainly characterized by an abnormally rapid or irregular rate of speech. Their pilot study expanded the evidence base by using a Stroop Task to investigate attention performance in people with cluttering. Hilda Sønsterud discuss the term working alliance as an important concept in cluttering and stuttering therapy and describe the degree to which the therapy dyad is engaged in collaborative, purposive work.

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