Engaging, collaborating and empowering through research and innovation

This issue of International Journal of Speech-Language Pathology features highlights from the joint Speech Pathology Australia and New Zealand Speech-language Therapists’ Association Conference, held in Brisbane, 2019. This historic event saw, for only the second time, the confluence of our neighbouring Associations and members. Guided by the conference theme of Engaging, Collaborating, Empowering, the conference affirmed a shared vision for the future of speech pathology research and best practice. In this special issue, we showcase scientific enquiry which encapsulates this theme, and demonstrate to readers how engaging, collaborating with, and empowering our clients, families/caregivers, and professional colleagues can translate to improvements in the efficacy, integration, and synergy of contemporary speech-language pathology (SLP) practice.

The invited papers from four keynote speakers, including the Elizabeth Usher (Australia) and Grace Gane (New Zealand) Memorial Lectures, combine with a further six articles presented at the conference. Professor David Copland, from The University of Queensland, delivered an inspiring Elizabeth Usher Memorial Lecture, Empowering the audience to challenge historical assumptions and clinical-anatomical deficit models of traditional aphasia therapy, and embrace a paradigm shift towards a “neurobiological” approach (Copland, 2020). This included re-examining treatment dose, targets, timing, and scheduling, and incorporating new insights into predictors of neuroplastic potential and language recovery. Copland provides a cogent synthesis of the latest research, highlighting advances in the application of neuroplasticity principles to guide aphasia therapy, novel mechanisms for assessing treatment response, and the role of linguistic and non-linguistic predictors in aphasia treatment success. He also provides insight into the current challenges for researchers and clinicians in the translation of these exciting advancements into clinical practice, and a resounding call to our profession to adapt treatment methods/models, as new evidence emerges, to achieve maximal, long-term recovery for our clients.

Delivering the Grace Gane Memorial Lecture, Professor Suzanne Purdy (Te Rarawa, Ngai Takoto), from the University of Auckland, encapsulated all three elements of the Engaging, Collaborating, Empowering theme. Purdy explored SLP research activity within the context of Te whare tapa wh$\overline{a}$—a Māori view of health and wellness which comprises four holistic dimensions (spiritual health, mental health, physical health, and family health) and promotes the engagement and collaboration between clinicians, families, researchers, communities, organisations, and other professions, in order to live well with communication challenges. The value of applying these four dimensions is evidenced through two bodies of research (Purdy 2020). First, for people with neurological conditions, Purdy demonstrates successes for individuals and their families when all four dimensions of the te whare tapa wh$\overline{a}$ model have been applied in community-based activities. In contrast, for people with hearing loss and auditory processing disorders, the traditional focus has been on impairment and, with few exceptions, the four dimensions of the model typically have not been integrated. Through this paper, Purdy empowers clinicians and researchers, and ultimately offers a wero (challenge) for us to reflect on how we can change our practice through adopting aspects of Indigenous healthcare models such as te whare tapa wh$\overline{a},$ to forge integrated models of care with shared therapeutic power, and in turn, create positive, meaningful outcomes for clients and their families.

Professor Susan Rvachew, from McGill University, Quebec, delivered a thought-provoking keynote address around the Engaging theme, exploring the role of electronic books (e-books) to promote engagement in shared storybook reading, and the differences in successful learning in the e-book context between boys and girls. This paper (Rvachew, Thompson Forrester, & Dey, 2020) sets out two studies with a specific focus on the gender differences underpinning literacy achievement. The first study sets the scene, exploring the association between oral language skills and resultant spelling abilities in a cohort of second grade French-speaking Canadian children. The gender theme is then explored in the second study, comparing the way in which boys and girls interact with adult readers during shared e-book experiences, and discussing the important role that behaviour regulation may play in underpinning literacy development and future learning. The final keynote speaker, Professor Marian Brady, from Glasgow Caledonian University, Scotland, embodies the Collaborating theme (The RELEASE Collaboration, 2020). Brady and colleagues present a rigorous, systematic analysis of participant and intervention descriptors extracted from a large international synthesis of aphasia research datasets (RELEASE research initiative). In this work, Brady compels clinicians and researchers to unify the way in which we describe and report on our clients/participants and interventions, and work towards greater consistency in terminology, collaborative effort, and transparency to maximise both the clinical implementation and impact of our research.

An additional six articles continue the conference themes. McGill, Crowe, and McLeod (2020) ignite a call to action to consider ways to improve waiting for SLP services. Engaging consumer voices through a qualitative analysis of submissions to an Australian Government Senate Inquiry, the authors explore experiences and perspectives regarding “the long waiting lists” for SLP services. A number of themes regarding the duration, negatives consequences, and actions of consumers in response to protracted waiting lists highlight that current SLP services were not meeting the needs of the majority of clients, and thus require new ways to manage demand and ensure timely and equitable access for all. Jones, Southwood, Cook, and Nicholson (2020) continue the Engaging theme. The authors employ a mixed-methods approach to capture SLP clinicians’ perspectives on factors contributing to paediatric feeding tube dependency in New Zealand. Jones and colleagues report a complex interplay between client-related (child and family) as well as professional/institutional factors (including lack of care coordination and clinical confidence) contributing to decision-making around weaning from feeding tubes. These findings are likely to inform future international studies, and reinforce the role of speech pathologists as advocates for our clients within a multidisciplinary context. Claessen, Tucker, Dawes, and Leitão, (2020) represent the Collaborating theme, presenting a novel measure for assessing oral narrative comprehension in the early school-aged child, using analysis of free-recall of a criterion-referenced narrative re-telling assessment (The Squirrel Story). Psychometric analyses demonstrated high reliability and convergent validity with other commonly used assessment measures (i.e. the Bus Story), as well as high sensitivity to developmental progression, based on a cohort of typically developing Western Australian children. Collectively, these findings provide promising pilot data for a simple and reliable measure of oral narrative comprehension, which is likely to provide further opportunity to pursue collaborative practices between speech-language pathologists and early childhood educators.

The remaining three papers align strongly with the Engaging and Empowering themes, by investigating novel methods to engage clients and their families using innovative service-delivery models. Hersh, Balchin, Grantis, and Godfrey (2020), in a co-designed pilot study, explore a novel therapeutic approach of combining group-based dysarthria therapy with poetry for people with Multiple Sclerosis. Qualitative analysis of participant feedback demonstrated positive perceptions of the use of poetry as a medium for therapy as a way to promote breath support, volume, and intelligibility through a creative and uplifting therapeutic experience. Rose, Whitworth, Smart, Oliver, and Cartwright (2020) investigate the efficacy of a group reminiscence therapy program on communicative behaviour in individuals with mild cognitive impairment or dementia. The case series demonstrated improvements in the macrostructure and richness of nostalgic recounts for two of four participants, with some evidence of generalisation to everyday discourse. Whilst these findings are preliminary and variability was observed among the participants, the outcomes give promise for further exploration of this innovative therapy to improve communication in people with mild cognitive impairment or dementia through highly meaningful, salient activities. Finally, McLeod et al. (2020), building on McGill et al.’s recommendations (2020) to optimise SLP waiting lists, report on a randomised parallel group trial comparing direct SLP intervention (therapy) to two active waiting list conditions (i.e. face-to-face education [advice], or a purpose-built website [device]) to stimulate speech/language skills while waiting for therapy. The results validated a clear need for direct SLP services; both speech outcomes and caregiver satisfaction significantly favoured the intervention arm over the active waiting conditions. However, the findings also revealed a clinical benefit for the provision of evidence-based information while children were waiting to access therapy, which may also prepare and empower families to engage in direct therapy when available, as evidenced by measured gains across a number of endpoints. These six papers, together, provide new insights into exciting, clinically focussed practice innovation, designed to empower our clients and their families and achieve meaningful outcomes and improved satisfaction with our services.

Collectively, the ten papers in our special issue truly embody the conference theme of Engaging, Collaborating and Empowering through SLP research and innovation. They also exemplify the longstanding relationship between Speech Pathology Australia and the New Zealand Speech-language Therapists’ Association and offer insights into our combined ability to shape the future of the profession on the international stage. The dawning of this new decade, and the challenges it already is presenting, has re-affirmed the importance of connection, professional unity, and collaboration to overcome new challenges ahead. But as we stand, as always, at the summit of change, it will be exciting to witness how speech-language pathologists will continue to harness innovation to strive towards our 2030 vision of equitable access for all, uncompromising care, and empowerment of our clients to live their best lives.

Laurelie R. Wishart*
Centre for Functioning & Health Research, Metro South Health, Brisbane, Australia
School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
[email protected]
http://orcid.org/0000-0002-9474-9121

Clare McCann
School of Psychology (Speech Science), The University of Auckland, New Zealand
http://orcid.org/0000-0003-1221-608X

ISSN 1754-9507 print/ISSN 1754-9515 online 2020 The Speech Pathology Association of Australia Limited
Published by Taylor & Francis
DOI: 10.1080/17549507.2020.1759690