BACKGROUND: Children who are deaf or hard-of-hearing (DHH) are at risk for speech and language delay. Language outcomes are worse in DHH children from lower socioeconomic backgrounds, due in part to disparities in access to specialised speech-language therapy. Teletherapy may help improve access to this specialised care and close this language gap. Inclusion of diverse DHH children in prospective randomised clinical trials has been challenging but is necessary to address disparities and pursue hearing health equity. Stakeholder input regarding decisions on study design elements, including comparator groups, masking, assessments and compensation, is necessary to design inclusive studies. We have designed an inclusive, equitable comparativeness effectiveness trial to address disparities in paediatric hearing health. The specific aims of the study are to determine the effect of access to and utilisation of speech-language teletherapy in addressing language disparities in low-income children who are DHH.
METHODS: After stakeholder input and pilot data collection, we designed a randomised clinical trial and concurrent longitudinal cohort trial to be conducted at four tertiary children\'s hospitals in the USA. Participants will include 210 DHH children aged 0-27 months. 140 of these children will be from lower income households, who will be randomised 1:1 to receive usual care versus usual care plus access to supplemental speech-language teletherapy. 70 children from higher income households will be simultaneously recruited as a comparison cohort. Primary outcome measure will be the Preschool Language Scales Auditory Comprehension subscale standard score, with additional speech, language, hearing and quality of life validated measures as secondary outcomes.
BACKGROUND: This study was approved by the Institutional Review Boards of the participating sites: the University of California, San Francisco (19-28356), Rady Children\'s Hospital (804651) and Seattle Children\'s Hospital (STUDY00003750). Parents of enrolled children will provide written informed consent for their child\'s participation. Professional and parent stakeholder groups that have been involved throughout the study design will facilitate dissemination and implementation of study findings via publication and through national and regional organisations.
BACKGROUND: NCT04928209.

People with Parkinson\'s disease (PD) experience a range of progressive motor and non-motor symptoms, that negatively affect their daily functioning, social participation and quality of life. Allied health therapies have emerged as an effective treatment approach-complementary to pharmacological and neurosurgical treatments-which reduces the impact of PD in daily life. In this article, we propose criteria for what constitutes specialized allied health care for PD, and we review allied health research in PD in terms of meeting these criteria and its outcomes for monodisciplinary approaches as well as multi- or interdisciplinary allied health interventions. We focus on the three most studied allied health disciplines in PD: physical therapy, occupational therapy and speech-language therapy. Overall, the available evidence underscores the importance and potential benefits of specialized allied health care for people with PD. Our proposed criteria and recommendations for future research might help in further delineating specialized allied health care.

UNASSIGNED: This study examines the accuracy of Interaction Detection in Early Childhood Settings (IDEAS), a program that automatically transcribes audio files and estimates linguistic units relevant to speech-language therapy, including part-of-speech units that represent features of language complexity, such as adjectives and coordinating conjunctions.
UNASSIGNED: Forty-five video-recorded speech-language therapy sessions involving 27 speech-language pathologists (SLPs) and 56 children were used. The F measure determines the accuracy of IDEAS diarization (i.e., speech segmentation and speaker classification). Two additional evaluation metrics, namely, median absolute relative error and correlation, indicate the accuracy of IDEAS for the estimation of linguistic units as compared with two conditions, namely, Oracle (manual diarization) and Voice Type Classifier (existing diarizer with acceptable accuracy).
UNASSIGNED: The high F measure for SLP talk data suggests high accuracy of IDEAS diarization for SLP talk but less so for child talk. These differences are reflected in the accuracy of IDEAS linguistic unit estimates. IDEAS median absolute relative error and correlation values for nine of the 10 SLP linguistic unit estimates meet the accuracy criteria, but none of the child linguistic unit estimates meet these criteria. The type of linguistic units also affects IDEAS accuracy.
UNASSIGNED: IDEAS was tailored to educational settings to automatically convert audio recordings into text and to provide linguistic unit estimates in speech-language therapy sessions and classroom settings. Although not perfect, IDEAS is reliable in automatically capturing and returning linguistic units, especially in SLP talk, that are relevant in research and practice. The tool offers a way to automatically measure SLP talk in clinical settings, which will support research seeking to understand how SLP talk influences children\'s language growth.

UNASSIGNED: Treatment response is the degree to which an individual benefits from a treatment. This systematic review sought to identify and synthesize research evidence regarding individual characteristics that predict language treatment response among children with developmental language disorder (DLD).
UNASSIGNED: To be eligible for inclusion, articles needed to report results of an oral language treatment program in a group of children aged 4-10 years with identified DLD and also include a quantitative analysis of the relation between one or more pretreatment child characteristics and the outcome of language treatment. Seven databases (Cumulated Index to Nursing and Allied Health Literature, Dissertations and Theses Global, Education Resources Information Center, Linguistics and Language Behavior Abstracts, PsycINFO, Medline, and Web of Science) were searched for articles in June and July 2021, with search updates conducted in May 2023. Studies were categorized by the type of treatment provided, and results were synthesized qualitatively.
UNASSIGNED: The review included 31 studies, 1,551 participants with DLD, and over 300 statistical tests of a predictor\'s effect on language treatment response. Most studies (n = 21) included only monolingual speakers of English, with five studies including bilinguals and five including monolingual speakers of non-English languages. Language treatments targeted word learning in controlled or clinical conditions, grammatical learning in controlled or clinical conditions, or multiple language targets in clinical conditions. Predictors of treatment response are summarized across four categories: cognitive, demographic, pretreatment language levels, and other.
UNASSIGNED: There were relatively few significant tests of the predictors of language treatment response. A central limitation of the evidence is that most included studies were designed to consider language treatment efficacy, not predictors of treatment response. Increasing research attention to the question of predictors of language treatment response in children with DLD is needed to enhance treatment and optimize outcomes for individual children.
UNASSIGNED: https://doi.org/10.23641/asha.26170006.

To assess the clinical effectiveness of two speech and language therapy approaches versus no speech and language therapy for dysarthria in people with Parkinson\'s disease.
Pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial.
The speech and language therapy interventions were delivered in outpatient or home settings between 26 September 2016 and 16 March 2020.
388 people with Parkinson\'s disease and dysarthria.
Participants were randomly assigned to one of three groups (1:1:1): 130 to Lee Silverman voice treatment (LSVT LOUD), 129 to NHS speech and language therapy, and 129 to no speech and language therapy. LSVT LOUD consisted of four, face-to-face or remote, 50 min sessions each week delivered over four weeks. Home based practice activities were set for up to 5-10 mins daily on treatment days and 15 mins twice daily on non-treatment days. Dosage for the NHS speech and language therapy was determined by the local therapist in response to the participants\' needs (estimated from prior research that NHS speech and language therapy participants would receive an average of one session per week over six to eight weeks). Local practices for NHS speech and language therapy were accepted, except for those within the LSVT LOUD protocol. Analyses were based on the intention to treat principle.
The primary outcome was total score at three months of self-reported voice handicap index.
People who received LSVT LOUD reported lower voice handicap index scores at three months after randomisation than those who did not receive speech and language therapy (-8.0 points (99% confidence interval -13.3 to -2.6); P<0.001). No evidence suggests a difference in voice handicap index scores between NHS speech and language therapy and no speech and language therapy (1.7 points (-3.8 to 7.1); P=0.43). Patients in the LSVT LOUD group also reported lower voice handicap index scores than did those randomised to NHS speech and language therapy (-9.6 points (-14.9 to -4.4); P<0.001). 93 adverse events (predominately vocal strain) were reported in the LSVT LOUD group, 46 in the NHS speech and language therapy group, and none in the no speech and language therapy group. No serious adverse events were recorded.
LSVT LOUD was more effective at reducing the participant reported impact of voice problems than was no speech and language therapy and NHS speech and language therapy. NHS speech and language therapy showed no evidence of benefit compared with no speech and language therapy.
ISRCTN registry ISRCTN12421382.

The S3 Guideline on the Treatment of Language Development Disorders: Summary of Recommendations Abstract: The German S3 Guidelines on the Treatment of Developmental Speech and Language Disorders (AWMF: No. 049-015) were published on the AWMF homepage at the end of 2022. The German Society for Phoniatrics and Paedaudiologie coordinated the work and developed the guideline text together with linguists and speech and language therapists. Many scientific medical societies consented to the respective recommendations. For the first time in the German-speaking area, the guideline group reviewed international research results on the treatment of various speech and language disorders and formulated evidence- or consensus-based recommendations for clinical care. The present article summarizes these recommendations and evaluates the guidelines from the perspective of child and adolescent psychiatry and psychotherapy.
Zusammenfassung: Die S3-Leitlinie zur Therapie von Sprachentwicklungsstörungen (AWMF: Nr. 049-015), die Ende 2022 auf der Homepage der AWMF veröffentlich wurde, ist unter Federführung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie in Kooperation mit zahlreichen Sprachwissenschaftler_innen und Sprachtherapeut_innen entwickelt und von zahlreichen wissenschaftlichen medizinischen Fachgesellschaften konsentiert worden. Die Leitliniengruppe hat erstmalig für den deutschen Sprachraum versucht, die internationale Studienlage zur Therapie unterschiedlicher Sprach- und Sprechstörungen aufzuarbeiten und darauf basierend Evidenz- oder auch Konsensus-basierte Empfehlungen für die klinische Versorgung zu formulieren. In dem vorliegenden Artikel werden diese Empfehlungen zusammenfassend dargestellt, und es wird eine Wertung der Leitlinie aus Kinder- und Jugendpsychiatrischer Sicht vorgenommen.

UNASSIGNED: We investigated the efficacy of Story Champs for improving oral language in third-grade Spanish-English bilingual children with developmental language disorder (DLD).
UNASSIGNED: We implemented a concurrent multiple-baseline across-participants single-case design with four bilingual Spanish-English third-grade students with DLD. Treatment was carried out over 12 sessions with approximately two sessions per week. Maintenance sessions were conducted 1, 2, and 4 weeks postintervention. Participants were explicitly taught story grammar elements, causal and temporal connections, and modifiers within story retells and personal narratives. Dependent variables were story grammar, grammatical complexity, modifiers and listening comprehension within story retells, and story grammar and grammatical complexity within personal narratives. Outcome measures were assessed at the end of every baseline, intervention, and maintenance session using the Narrative Language Measures-Listening (NLM-L).
UNASSIGNED: Visual analyses for outcome measures suggested slight increases in scores on the NLM-L during intervention accompanied by marked variability. Within-case analyses of story retell performance suggested an intervention effect on story grammar for two participants and on grammatical complexity and modifier use for one participant. For personal narratives, within-case analyses of personal narrative performance suggested an intervention effect on story grammar for one participant.
UNASSIGNED: Overall, Story Champs demonstrated efficacy for improving story grammar use in story retells for three out of four participants. It did not show efficacy for improving grammatical complexity, modifier use, or listening comprehension within story retells, nor did it show efficacy for improving story grammar and grammatical complexity within personal narratives.
UNASSIGNED: https://doi.org/10.23641/asha.26053033.

UNASSIGNED: We investigated the effectiveness of a highly individualized morphosyntactic intervention using the SHAPE CODING™ system delivered at different dosages.
UNASSIGNED: Eight children with developmental language disorder aged 8;0-10;10 (years;months) received 10 hr of explicit individualized intervention for morphosyntax delivered in 30-min individual sessions once per week for 20 weeks. Following at least four baseline probe tests, two grammatical targets per session received explicit instruction until they reached criterion (90%), when the next target was introduced. To control for session length and teaching episode density, either both targets received 20 teaching episodes per session or one target received 10 teaching episodes and the other 30. Maintenance testing of completed targets was also carried out.
UNASSIGNED: Scores on probe tests post-intervention were significantly higher than during the baseline phase (d = 1.6) with no change during the baseline or maintenance phases. However, progress during the intervention phase was highly significant. One participant showed significantly faster progress with intervention, while one (with the lowest attention score) made little progress. When considering progress relative to cumulative intervention sessions, progress was faster with 30 teaching episodes per session and slower with 10. However, when cumulative teaching episodes were used as the predictor, all three within-session dosages showed very similar rates of progress, with the odds of a correct response increasing by 3.9% for each teaching episode. The targets that were achieved required an average of 40-60 teaching episodes.
UNASSIGNED: With the exception of one participant, the individualized intervention was highly effective and efficient. Thus, the individualized target identification process and intervention method merit further research in a larger group of children. The cumulative number of teaching episodes per target provided across sessions appeared to be key. Thus, clinicians should aim for high teaching episode rates, particularly if the number of sessions is constrained. Otherwise, intervention scheduling can be flexible.
UNASSIGNED: https://doi.org/10.23641/asha.25996168.

BACKGROUND: Stroke survivors with aphasia want to improve their everyday talking (discourse). In current UK practice, 90% of speech and language therapists believe discourse assessment and treatment is part of their role but are hampered by barriers in resources, time and expertise. There is a clinical need for well-articulated discourse assessment and treatments. LUNA is a multi-level treatment targeting words, sentences and discourse macrostructure in personal stories that addresses this clinical need.
OBJECTIVE: This study aimed to assess the feasibility and acceptability of LUNA trial procedures in a randomised waitlist-controlled trial; and to evaluate preliminary efficacy.
METHODS: This paper reports a phase II, waitlist-controlled, proof-of-concept feasibility trial. Participants with chronic aphasia (n = 28) were recruited from the community and randomised to an Immediate (n = 14) or Delayed (n = 14) group. LUNA treatment was delivered twice weekly for 10 weeks via the videoconferencing technology, Zoom. Feasibility was assessed in terms of participant recruitment and retention, adherence, missing data, and treatment fidelity. Preliminary treatment efficacy was assessed in terms of between group differences in outcome measures relating to discourse, language, and psychosocial state.
RESULTS: The remote LUNA trial was feasible: 85% of those eligible consented to the trial; trial retention was 86%; 87% of treatment sessions were delivered as scheduled, and 79% of participants completed 80%+ of the treatment programme; data was missing only for participants who withdrew; treatment fidelity was high at 92% adherence; and only one clinical outcome measure demonstrated ceiling effects. ANCOVA analysis of the clinical outcome measures revealed group differences with medium and large effect sizes, indicating, improvements in the production of words, sentences, discourse macrostructure, overall language functioning (WAB-R), and psychosocial state (VAMS) following LUNA treatment. For most outcomes measured, similar treatment benefits were suggested in a secondary, non-parametric analysis.
CONCLUSIONS: Large-scale evaluation of the clinical efficacy and cost-effectiveness of LUNA is warranted and supported by these findings.
BACKGROUND: Clinical trials registration: NCT05847023 (clinical trials.gov).

UNASSIGNED: Non-invasive brain stimulation has been widely used as an adjunctive treatment for aphasia following stroke.
UNASSIGNED: The aim of this study was to investigate the effect of non-invasive brain stimulation as an adjunctive treatment on naming function in aphasia following stroke.
UNASSIGNED: This review included randomized controlled trials (RCTs) involving 5 databases (Web of Science, Embase, Cochrane Library, OVID and PubMed) that investigated the effects of electrical stimulation on stroke patients. The search included literature published up to November 2023.
UNASSIGNED: We identified 18 studies, and the standardized mean differences (SMDs) showed that the effect sizes of TMS and tDCS were small to medium. Moreover, the treatment effects persisted over time, indicating long-term efficacy.
UNASSIGNED: This study suggested that NIBS combined with speech and language therapy can effectively promote the recovery of naming function in patients with post-stroke aphasia (PSA) and that the effects are long lasting.