The ongoing evolution of speech-language pathology: Broadening the lens of clinical practice

This special issue reflects the conference proceedings from the Speech Pathology Australia National Conference held in Canberra (May 2015). It presents some highlights from what was a dynamic, motivating and exciting conference. The central themes: Challenge, Broaden and Revolutionise, feature clearly in the scope and diversity of the articles and the expansive range of methodologies and approaches used to document, appraise or investigate content. Figure 1 presents a word-salad of the keywords for articles in this special issue and it provides support for the breadth of issues covered. Notably, topics are widely distributed, leaving little room for overlap. The words and phrases explore young children to adults; speech-language pathologists to parents; language and literacy; student clinical learning to professional clinical practice; reflective practice; and the list goes on. Eight articles appear in this special issue; three of these are from the keynote speakers and the remaining five are selected papers drawn from the conference.

Figure 1. Word-salad of the keywords for articles in this special issue.

This conference was privileged to host three highly regarded keynote speakers who shared their wealth of experience and reflections on the profession of speech-language pathology in a contemporary context. All three delivered rich material for consideration; each providing a unique perspective on the principal themes of the conference. In the Elizabeth Usher Memorial Lecture, Professor Pamela Snow integrated a vast body of literature to present a compelling argument for speech-language pathologists (SLPs) to conceive their clinical practice as spanning naturally across a continuum of oral and written language (Snow, 2016). Although at a theoretical level this is not revolutionary for our profession and for many of our multidisciplinary colleagues, Professor Snow provided excellent foundations for SLPs to move more seamlessly between working in the oral language and the literacy domains. Nelson (2016) reports on her research into the use of a new assessment tool that integrates oral and written measures of language and literacy into the Test of Integrated Language & Literacy Skills (TILLS™). Professor Nelson provides a comprehensive history and rationale for the genesis of the TILLS and describes the extensive process of developing its norms. Her paper concludes with two case-studies that demonstrate the TILLS in action and the clinical interpretations that can arise. Rosenbek (2016) challenges readers to reflect on bridging gaps between clinical practice and research evidence; primarily in the context of reconsidering the role of the randomised clinical trial as the “gold standard” level of evidence. Using examples primarily drawn from his own area of research and clinical expertise in neurological rehabilitation, Professor Rosenbek calls on SLPs to challenge many well-held principles. As examples, he urges SLPs to demand and expect a bilateral approach to translational research; whereby research informs practice and practice informs research, and that SLPs commit to a biopsychosocial model of practice.

The five selected articles describe qualitative, quantitative and mixed research methodologies. In their qualitative study using in-depth interviews, Trembath, Hawtree, Arciuli, and Caithness (2016) explore what SLPs assume that parents of children with Autism Spectrum Disorder expect in relation to the provision of evidence-based interventions. Their study was designed to contribute to knowledge about collaborative decision-making processes between parents and SLPs. The 22 Australian SLPs believed that parents expected them to provide evidence-based intervention. However, Trembath et al. also found that participating SLPs identified various barriers that may restrict the amount of information-sharing with parents regarding the nature of the interventions that may occur. They conclude their paper with suggestions about overcoming some of these barriers. Howells, Barton, and Westerveld (2016) present a mixed-methods approach to gauge and track the growth of SLP students’ development of cultural awareness in the context of a clinical placement. A large group of students were surveyed about their own cultural awareness as a starting point. Howells et al. then sought written reflections from seven final year SLP students prior to and following a clinical placement in culturally and/or linguistically diverse settings. Two focus groups were also held with these seven participants. The researchers conclude that students’ awareness of their own cultural background combined with the experiences of clinical placements contributed positively to preparing students to develop cultural competency.

The remaining three articles all adopted quantitative methodologies. Both Masso, McLeod, Baker, and McCormack (2016) and Westerveld and Vidler (2016) present research that contributes to knowledge about building SLPs’ repertoire for assessing children’s communication. In contrast, Beales, Cartwright, Whitworth, and Panegyres (2016) document outcomes following an intervention for older adults who have received a diagnosis of Primary Progressive Aphasia.

Masso et al. (2016) introduce the Framework of Polysyllabic Maturity as a means of describing children’s performance when producing polysyllabic words. Their study was based on the premise that, for children with speech sound disorders, standard speech sampling is not sufficient to comprehensively test production of polysyllabic words. They also compared polysyllabic word production with a standardised test among 93 children with speech sound disorders and found, among other things, that vowel accuracy was significantly different between the two test formats. This study provides further empirical support and confirmation for the important role of polysyllabic word sampling when completing a comprehensive assessment of children’s speech.

Westerveld and Vidler (2016) complement Masso et al. (2016) by examining spoken language samples of Australian children across a variety of discourse genres. Based on the well-established perspective that oral language sampling is a powerful and representative means of analysing children’s oral language competence, Westerveld and Vidler’s study was designed to contribute to the current gap in normative data on children’s spoken language across genres. Westerveld and Vidler used a variety of extended oral language tasks including conversation, personal narrative accounts, expository accounts and story retelling and included a sample of 127 typically-developing Australian school-aged children. Their findings provide information that can support SLPs’ diagnostic practices, particularly in the context of oral language requirements for classroom. A further arm of this study involved a comparison of children from New Zealand and this analysis revealed some important differences in performance.

Turning attention to adults, Beales et al. (2016) detail an intervention study for four people with various sub-types of Primary Progressive Aphasia designed to stimulate learning or re-learning words. Using a multiple baseline case-series design, Beales et al. evaluated the capacity of a self-cueing lexical retrieval intervention to consolidate word retrieval for targeted and non-targeted words. They found that their participants showed significant improvements retrieving targeted words when they were tested immediately post- and 4 weeks post-intervention. For non-targeted word items, results were more variable across participants and the authors consider these findings in the context of Primary Progressive Aphasia sub-type. This study demonstrates the important fact that people with this diagnosis can make gains in word retrieval following intervention, but that the nature of generalisation is likely to vary according to the specific underlying deficit.

I hope you enjoy reading the contents of this special issue of IJSLP as much as I have enjoyed my role as guest editor. It is rewarding to see how much these keynote articles and selected papers have contributed to the growth of speech-language pathology practice and highlight the central themes of broadening our lens, challenging some well-held viewpoints and revolutionising the way we practise.

Declaration of interest

The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.