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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.
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Enhancing Cultural Competence: Working in Native American and Tribal Communities
Format(s): Journal (Online)
This journal self-study focuses on rationale and techniques for enhancing clinicians’ cultural competence when working in Native American and tribal communities. The articles, originally published in a 2016 issue of Perspectives of the ASHA Special Interest Groups (SIG 14, Cultural and Linguistic Diversity), address the lasting impact of historical trauma on health and education; the importance of differentiated instruction; the perspective of a student with hearing loss who experiences traditional cultural education; and speech-language intervention programs and services in Native communities.
Practice Guidance for SLPs During the COVID-19 Pandemic
Format(s): Journal (Online)
Clinical practice for SLPs in health care settings has changed dramatically – and continues to evolve – due to the COVID-19 pandemic. This journal self-study highlights evidence-based best practices and considerations for clinicians providing care to patients with voice and upper airway disorders, tracheostomy, and head and neck cancer during the COVID-19 pandemic to maximize patient and clinician safety while ensuring efficacious care.
Treatment Planning Following Instrumental Swallow Assessment
Format(s): On Demand Webinar
This course illustrates how SLPs can develop appropriate, evidence-based, and practical treatment plans for patients with dysphagia based on the results of instrumental swallow assessments. The speaker discusses case studies involving the use of various assessments, including videofluoroscopy, endoscopy, and high-resolution manometry.
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.
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.
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.
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
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.
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.
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
SLPA Education Modules
Format(s): eWorkshop
SLPAs who want to become ASHA-certified and hold the C-SLPA credential must meet the requirements set forth in the Standards for SLPA Certification. This six-module set meets the requirement for Eligibility Pathways 2 and 3. Note: These modules are not eligible for ASHA CEUs.
Preparing Kids With Spoken Language Disorders for Reading
Format(s): Streaming Video
Children with spoken language disorders often experience difficulties with reading as well. SLPs – particularly those working in school-based settings – have a responsibility to prevent, assess, and treat reading impairments. In this video course, presenter Kelly Farquharson will discuss how SLPs can approach this important clinical need from a robust and empirically supported theoretical framework, the Simple View of Reading.
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.
Global Initiatives: Considerations for Best Practice
Format(s): SIG Perspectives
These Perspectives (SIG 17) articles discuss different aspects of international practice, including work with immigrant and refugee families. Baigorri, Crowley, and Bukari provide a service delivery model for speech-language pathologists (SLPs) and professionals working in low-and middle-income countries. Chakraborty, Schwarz, and Vaughan discuss a major consideration for ASHA to cultivate cultural sensitivity and competence in its largely female (95.30%), monolingual (93.46%) and white (92.10%) workforce. Chu et al., discuss the challenges that SLPs face when providing speech and language therapy in Malaysia and issues that need to be addressed for continued growth of this profession. Maldonado, Ashe, Bubar, and Chapman explore the experiences of monolingual, American, English-speaking SLPs and Clinical Fellows who worked with immigrant and refugee families within a preschool context. Staley et al., consider the literature on international student placements to contextualize and describe a 10-year relationship which enabled speech language pathology students in their final year of study at a Canadian university to complete a 10-week clinical placement with a non-governmental organization in Kenya.
Use of Technology to Assess  Speech Production and Voice
Format(s): SIG Perspectives
These Perspectives (SIG 19) articles provide with information relevant to speech science research and education. Lulich and Pearson present two demonstrations in this technical report to illustrate the utility of 3D/4D ultrasound technology. First, the authors report that “not only can structures be imaged which previously were impossible to identify from 2D ultrasound alone (e.g., piriform sinuses and posterior pharyngeal wall), but questions involving non-sagittal structures and asymmetrical tongue shapes, such as the pervasiveness and extensiveness of lateral contact between the tongue and the palate-teeth, can now be addressed non-invasively.” Second, they also conclude that “the fusion of ultrasound data with MRI images further enhances the utility of 3D/4D ultrasound, since it combines the strengths of ultrasound with the complementary strengths of the other modality, while mitigating the weaknesses of each.” Richardson et al., compare various acoustical measures of sustained vowels obtained using the Multidimensional Voice Program (MDVP) by Computerized Speech Lab, Praat, and TF32. Results show that the MDVP yield significantly higher values of standard deviation of fundamental frequency, jitter, and shimmer, and significantly lower values of noise-to-harmonics ratio compared to the other programs. They discuss the variation of numerical values across programs and the resulting clinical implications. Hagedorn et al. discuss the benefits of a collaboration among engineers, speech scientists, and clinicians which yield “the development of biologically inspired technology that has been proven useful for both small- and large-scale analysis,” a better understanding of speech production, and the development of assessment tools with a clinical benefit and interdisciplinary reach. They also review the use of real-time magnetic resonance imaging across clinical populations and discuss the challenges associated with collaborative work. Lee and Fischer reveal an association between acoustic vowel space and the severity of dysarthria. They review sex differences, factors that may affect formant-related measures, and clinical implications.
Issues in the School Setting
Format(s): SIG Perspectives
These Perspectives (SIG 16) addresses important issues for the speech-language pathologist (SLP) in working in the school setting, including assessing bilingual students, grammar interventions for school-aged students, the comfort level of SLPs when working with students with attention-deficit/hyperactivity disorder, and the impact of professional development on literacy knowledge and practice.
Evaluation and Management of Challenging Patient  Populations in Audiology
Format(s): SIG Perspectives
These Perspectives (SIG 6) articles focus on diagnostic tools and considerations for management of several challenging patient populations in audiology. The first article discusses utilizing magnetic resonance imaging to determine the functional and structural neural alterations associated with chronic tinnitus. Researchers are utilizing advanced imaging techniques to study variability in perceptual characteristics and reaction to tinnitus. The second article discusses the continuum of disorders known as “cortical hearing impairment,” supported by a comprehensive summary of clinical presentations. Despite its rarity, an audiologist must understand etiologies of cortical hearing impairment and know how to evaluate and characterize the accompanied hearing difficulty. The third article examines the effects of concussion of the vestibular system and presented an assessment battery for athletes postconcussion and for determining return to play.
Cultural Competence, Adult Bilingual Fluency, and LGBTQ Clients
Format(s): SIG Perspectives
These Perspectives (SIG 14) articles topics include (a) the effects of an experiential learning opportunity on undergraduates’ cultural competence; (b) a description of an LGBTQ content module that can be integrated into coursework on cultural and linguistic diversity; and (c) fluency strategies for treating bilingual adults who stutter.
Pediatric Auditory Brainstem Implants, Adult Single-Sided Deafness, and Teaching
Format(s): SIG Perspectives
These Perspectives (SIG 9) articles include topics on evidence, research, and application about pediatric auditory brainstem implants, teaching phonological awareness in young children, and development of The Assessment and Aural Rehabilitation Tool for single-sided deafness in adults.
Topics in Aural Rehabilitation
Format(s): SIG Perspectives
These Perspectives (SIG 7) articles address therapy, patient education/counseling, and novel eHealth programs to serve clients across the lifespan. The topic of multisensory integration is addressed with a review of cognitive neuroscience literature and recommendations are made for therapy protocols for infants and children with hearing loss. There is a review of the development and outcomes of a multimedia education program for adults with hearing loss. The use of eHealth in patient-centered care for adults with hearing loss is considered for current practice and its future directions. Authors discuss considerations for the use of remote microphone technology by the oldest generation of patients. Finally, patient-centered strategies for communication during audiology consultations are presented to build trust and positive therapeutic relationships.
Neurobiology of Language
Format(s): SIG Perspectives
This Perspectives (SIG 1) forum focuses on neurobiological factors associated with language learning. The first article describes a model of causation by which environmental factors influence neural and cognitive development. The second article examines learning contexts and their impact on verb learning. The third article discusses early motor deficits and their relationship to speech/language outcomes, and the final article reviews morphological processing in normal and clinical populations.
AAC Considerations for Neurogenic Communication Disorders
Format(s): SIG Perspectives
These Perspectives (SIG 2) articles review and present current issues related to augmentative and alternative communication (AAC) across different patient populations, as well as identifies and discusses team-based interprofessional practice approaches for managing individuals with complex communication needs within both pediatric and adult populations. In the first article, Shannon Taylor, Sarah Jane Wallace, and Sarah Elizabeth Wallace explore factors that influence successful use of high-technology AAC in persons with poststroke aphasia via a literature review and narrative synthesis methodology. Lori Marra and Katie Micco present a clinical focus article that assesses communication partner’s perception regarding the effectiveness of a training model to support AAC use within a parent–adolescent communication pair. Michelle Westley, Dean Sutherland, and H. Timothy Bunnell examine the experience of healthy voice donors during the ModelTalker voice banking process for New Zealand-accent synthesized voices. Sarah Diehl and Michael de Reisthal describe the complex symptoms associated with Huntington’s disease and how they influence implementation of AAC to address the communication needs of this population. Kristen Abbott-Anderson, Hsinhuei Sheen Chiou, and Brooke N. Burk address interprofessional practice via a multidisciplinary patient-centered engagement experience entitled Spring EngAGEment that serves individuals living with Alzheimer’s disease or other associated dementias. Finally, Laura Hinkes Molinaro, and Wendy Stellpflug discuss a team approach for education and support of patients and families with postoperative pediatric cerebellar mutism syndrome.
Current Issues in Dysphagia Management
Format(s): Journal (Online)
This journal self-study emphasizes clinical decision-making in swallowing and dysphagia management. The articles focus on using data to make clinical decisions, finding noninvasive ways to screen healthy adults, and patient-reported side effects and tolerability of a specific assessment technique.
Interprofessional Education and Practice SIG 2
Format(s): SIG Perspectives
These Perspectives (SIG 2) articles evaluate, highlight, and analyze various examples of interprofessional education and collaboration amongst speech-language pathologists and other professionals. Interprofessional educational models, collaborative teaming frameworks, and a case study example are also presented.
High-Resolution Pharyngeal Manometry in Dysphagia SIG 13
Format(s): SIG Perspectives
These Perspectives (SIG 13) articles discuss the use of high-resolution pharyngeal manometry in the assessment and treatment of dysphagia in pediatrics and adults. Additionally, we present an educational piece discussing considerations in clinical decision-making concerning the initiation of safe oral alimentation in patients on high-flow nasal cannula.
Patient Care and Management for Children Who Are Deaf or Hard of Hearing
Format(s): Journal (Online)
This journal self-study focuses on several aspects of patient care and management for practitioners who serve children who are deaf or hard of hearing. The articles, originally published in a 2014 issue of Perspectives on Hearing and Hearing Disorders in Childhood, discuss the unique needs of children with mild, minimal, and/or unilateral hearing loss; the effects of fatigue on children with hearing loss; and the importance of monitoring speech-language performance and progress as well as hearing aid use in this population.
Clinical and Research Implications for School-Based Services SIG 16
Format(s): SIG Perspectives
These Perspectives (SIG 16) articles address important issues for the speech-language pathologist working in the school setting. Topics include fostering preschoolers’ emergent literacy, supporting children with traumatic brain injury, collaborating with school psychologists, and providing classroom-based services in middle school.
Cultivating Student Success Through Effective Service Delivery
Format(s): Streaming Video
School-based SLPs strive to support their students’ success in school. Two critical components of fostering academic success are: (1) provision of services that address the curriculum and (2) collaboration with teachers to make that happen. This video course will present strategies to address both of these essential activities in the context of elementary, middle, and high school settings, including examples of effective collaboration and ideas for overcoming common barriers.
Research Highlights in Audiology: 2017
Format(s): Journal (Online)
This self-study features highly read and cited audiology research articles published in 2017 in ASHA’s scholarly journals. Topics reflect the diversity of the field and include: (1) a discussion of the economic impact of hearing loss in the U.S., (2) ways to improve museum accessibility for people with hearing loss, (3) how improvements in early detection of hearing loss has impacted children’s literacy outcomes, and (4) the impact of an audiologist’s language on hearing aid uptake.
Focusing on Life Participation for Individuals With Aphasia
Format(s): eWorkshop
This course includes three recorded sessions from the 2018 online conference “Improving Functional Outcomes in Aphasia.” These sessions include practical tips for creating personalized assessments and interventions to improve the everyday experiences of individuals with aphasia. The conference included a total of 15 sessions, giving a comprehensive view of the current landscape of aphasia intervention as well as related subjects, including medical management, neuroplasticity, life participation, assessment, and more. Sessions explored practical treatment strategies to meet the needs of patients across the severity spectrum and in various treatment settings, as well as the unique needs of a range of patient subgroups.
Topics in Aphasia Management
Format(s): eWorkshop
This course includes three recorded sessions from the 2018 online conference “Improving Functional Outcomes in Aphasia.” These sessions discuss best practices for medical management, addressing cognitive impairments, and supporting patient care for individuals with aphasia. The conference included a total of 15 sessions, giving a comprehensive view of the current landscape of aphasia intervention as well as related subjects, including neuroplasticity, life participation, assessment, and more. Sessions explored practical treatment strategies to meet the needs of patients across the severity spectrum and in various treatment settings, as well as the unique needs of a range of patient subgroups.
The Subtle Presentation of Autism: Core Features, Gender Differences, Motivation, and Self-Regulation
Format(s): Streaming Video
In this presentation, Donna Henderson will discuss the core features of autism as they present in children and adolescents with subtle manifestations of symptoms. She will also focus on the particular challenge of recognizing autism in girls. Then William Stixrud will discuss the motivational and self-regulatory challenges experienced by students with a mild presentation of autism and will emphasize the importance of supporting the development of autonomy.
Services for Bilingual Children With Highly Unintelligible Speech
Format(s): Streaming Video
This video program provides comprehensive information about identifying, assessing, and treating bilingual children ages 3–11 who have highly unintelligible speech. The presenter discusses case studies and current research to provide concrete solutions to common challenges such as figuring out where to begin when providing services, identifying bilingual children at-risk for other concomitant deficiencies, differentiating language difference vs. disorder, and selecting the most effective treatments.
Special Considerations for Children With Feeding and Swallowing Disorders
Format(s): Journal (Online)
Feeding and swallowing problems in children take many forms and are often intertwined with other aspects of a child’s development. This journal self-study explores some of these interactions, including the relationship between feeding and swallowing disorders and language impairment, as well as connections between hearing and feeding/ swallowing. The self-study also includes information on how mealtime duration relates to severity of feeding and swallowing problems in children with cerebral palsy, as well as how a family-centered intervention can address mealtime behaviors in children with autism spectrum disorder. Clinicians will be able to immediately apply the information in these articles to improve management of pediatric feeding and swallowing disorders.
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Effects of Lingual Strengthening on Swallowing
Format(s): Journal (Online)
Research into programmed isometric lingual exercise in order to improve swallow function has yielded promising results. This journal self-study examines evidence related to this relatively new therapeutic approach. The first article in this self-study offers a review of the recent literature on isometric lingual tasks across a variety of populations and includes clinical implications based on the findings. The second and third articles are normative studies about adults without diagnosed dysphagia. One explores how tongue strengthening affects mealtime functioning in older, long-term care residents, while the other examines relationships between performance variability, isometric strength, swallowing pressure, age, and gender.
Reading Comprehension Is Not a Single Ability
Format(s): Journal (Online)
In this journal self-study, which includes articles from a Language, Speech, and Hearing Services in Schools clinical forum, authors address the problem of declining reading comprehension in the United States. The lead article argues that reading comprehension is complex and multidimensional, varying based on reader ability, text, and task. The remaining articles focus on the implications of this view, including ideas related to assessment, intervention, and the critical role SLPs play in evaluating and addressing reading comprehension difficulties.
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Treating Childhood and Adolescent Voice Disorders
Format(s): Streaming Video
Childhood and adolescent voice disorders are observed in multiple clinical settings, with many professionals having limited background or education to properly treat them. Pediatric voice disorders can have adverse effects on children and teens in classroom and social situations. This video course provides a plethora of practical information based on research and practice in a major pediatric hospital setting. Vocal hygiene, vocal function exercises, semi-occluded vocal tract exercises, and other specific techniques are discussed.
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Cranial Nerve Examination for the SLP
Format(s): Streaming Video
A thorough cranial nerve examination is an essential part of the speech-language pathologist’s evaluation of every patient. When performed, it is useful in the diagnosis of speech and swallowing disorders, and accurate diagnosis is crucial for development of a targeted, individualized treatment plan. This video course provides an overview of the neuroanatomy and physiology of the cranial nerve examination. Participants will receive detailed instructions for testing and interpreting findings of the cranial nerve examination. The course also describes common abnormalities observed for patients with impairment of cranial nerve function.
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Interventions to Improve Young Children’s Early Literacy Skills
Format(s): Streaming Video
Young children with communication impairments, especially language disorders, face elevated risks in developing reading problems. SLPs play an important role in helping young children with language disorders develop foundational literacy skills that can enhance their literacy and reading trajectories. This video course provides evidence-based guidance on how to modify treatment to improve the foundational literacy skills of young children with language disorders.
Enhancing AAC for Adults
Format(s): Journal (Online)
This journal self-study explores preferences about topics and types of visual supports as well as information about how people who use AAC can expand their communication using social media. Clinicians working with adults who use AAC can apply this information to improve decisions about methods and types of communication supports and maximize patient success.
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Reading and Interpreting Videofluoroscopic Studies: A Tutorial
Format(s): Streaming Video
An information-rich videofluoroscopic assessment can help clinicians determine which components of the complex oropharyngeal swallow need to be targeted for intervention. Visualizing all of the elements that contribute to a well-integrated or disordered swallow mechanism requires an ordered and disciplined review. This video course demonstrates methods to enhance clinicians' ability to perform a videofluoroscopic assessment and discern the discrete elements of the oropharyngeal swallow. Participants can practice determining the integrity or disorder of the swallow mechanism by viewing and interpreting case study video.
Counseling and Support for Students With Hearing Loss
Format(s): eWorkshop
This course includes two recorded sessions from the online conference “Audiology 2016: Collaborative Strategies for Students With Hearing Loss.” These sessions focus on the transition from secondary school settings to post-secondary and vocational settings, counseling for self-advocacy, and social and emotional outcomes in children and teens with hearing loss. The conference included a total of 15 sessions, with the broad goal of providing practitioners practical, outcome-driven strategies, new information, and resources to help bridge the gap between children and teens with hearing loss, their families, and the educational and medical providers who support them. The two sessions in this course are:
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Management of Communication and Swallowing Impairments Related to Artificial Airways
Format(s): Streaming Video
Endotracheal tubes, tracheostomy tubes, and ventilator dependency can have adverse effects on communication and swallowing. SLPs who take the lead role in remediating these impairments need to have the knowledge and skills to provide appropriate, safe, and evidence-based interventions. This streaming video course is designed for the SLP who has an interest in post-extubation dysphagia and in communication and swallowing challenges associated with tracheostomy tubes and ventilator dependency. The course reviews the literature and presents a “how-to” guide for managing these medically complex patients. Medical SLPs will walk away with strategies to best manage their patients who are experiencing complications due to artificial airways.
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The Best Fit: Selecting a Targeted Aphasia Intervention
Format(s): Streaming Video
With all the developments and changes in aphasia therapy, clinicians can have difficulty keeping abreast of the latest and greatest tools and techniques to ensure they are selecting the best evidence-based treatment option to fit a particular client’s needs and language abilities. This video course uses the ASHA Practice Portal and other resources to explore case studies and apply aphasia interventions to achieve functional goals for adults of all ages. The course identifies candidacy requirements for numerous aphasia interventions, reviews the procedures for using them, and discusses how to fit them into required goal statements and outcome measures.
Adult Swallowing Safety: Impact of Changes to Feeding and Swallowing Processes
Format(s): Journal (Online)
SLPs employ many strategies when working with adults to address feeding and swallowing disorders. From evaluation through treatment, SLPs must consider the impact of alterations to foods, liquids, positioning, and more on swallowing efficiency and safety. This journal self-study investigates what impact the addition of barium to a bolus during a videofluoroscopic swallowing study has on swallowing behaviors; exactly what happens to the swallowing process when the chin-down posture is employed as a compensatory strategy; and how assisted feeding may affect swallowing. Clinicians will come away with a much better explanation of the physiological and functional changes that occur when they make bolus, head position, or feeding situation changes. The articles make specific recommendations about the appropriateness of the chin-down posture for specific types of patients, depending on the difficulties they are having during the swallow. Practical suggestions also are made for how to address some of the problems that are introduced by feeding assistance.
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Evaluating and Enhancing Children’s Phonological Skills: A Systematic Approach
Format(s): Streaming Video
This video program examines how SLPs can better manage children with highly unintelligible speech who are making very slow progress. The presentation provides a framework – the evidence-based cycles phonological pattern remediation approach – for evaluating and enhancing optimal phonological patterns.
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Autism Spectrum Disorders: Interventions for Communication and Learning
Format(s): Streaming Video
This course provides SLPs with a framework to aid them in planning appropriate, contextually valid, and evidence-based interventions for the growing population of children with autism spectrum disorders. Using two case examples, the course presents an array of strategies for selecting learning priorities and targets that truly make a functional difference in a child’s life. We also discuss connections to school standards and how to modify strategies for children of various ages. The course also includes a brief discussion of new and old diagnostic systems and their possible impact on practice.
Improve Older Adults’ Communication Through Memory Mining
Format(s): eWorkshop
There is a pressing need for creative, therapeutic approaches that appeal to a culturally and linguistically diverse population of older adults. One such approach is memory mining, a developmentally and culturally appropriate intervention strategy that can increase the communicative engagement of older adults with cognitive-communicative challenges. This presentation provides a foundation for understanding age-related demographic, cognitive, and linguistic changes and how memory mining, also known as facilitated reminiscence, can lead to better communication outcomes for this population.

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