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“我想我听到的是那样?我不确定”:言语和语言治疗师对语音转录的看法及其实践。

'I think that's what I heard? I'm not sure': Speech and language therapists' views of, and practices in, phonetic transcription.

机构信息

Leeds Beckett University, Leeds, UK.

City, University of London, London, UK.

出版信息

Int J Lang Commun Disord. 2022 Sep;57(5):1071-1084. doi: 10.1111/1460-6984.12740. Epub 2022 Jun 17.

Abstract

BACKGROUND

Phonetic transcription is recognized in regulatory standards as an essential skill for Speech and Language Therapists (SLTs) in the assessment, diagnosis and management of clients with speech difficulties. Previous research has identified that approaches to phonetic transcription vary, and that SLTs often lack confidence in transcribing. However, SLTs' views and working practices have not been investigated in detail, particularly in terms of whole service approaches and following the recent increase in telehealth.

AIMS

To investigate SLTs' views about phonetic transcription, their working practices at both individual and service levels, and the factors that influence these.

METHODS & PROCEDURES: A total of 19 SLTs from the UK were recruited to online focus groups via social media and local networks. Participants discussed their views of, and practices in, phonetic transcription. Themes were identified using reflexive thematic analysis.

OUTCOMES & RESULTS: Three broad themes were generated division and unity; one small part of a big job; and fit for purpose. SLTs were uniformly proud of their ability to phonetically transcribe and viewed this as a unique skill, but clear differences existed between different groups of SLTs in their views and practices. Investing in phonetic transcription was not always a priority for SLTs or services, and although many felt under-confident in their skills they considered these to be adequate for the populations they usually encounter. SLTs make an early judgement about possible therapy targets, which influences the level of detail used in their phonetic transcription. Practical barriers are often not addressed at service level, and assessment via telehealth poses some specific challenges.

CONCLUSIONS & IMPLICATIONS: SLTs and services would benefit from increased investment in phonetic transcription in terms of time, opportunities for continuing professional development (CPD) and initiatives such as electronic patient records (EPRs) which support the use of phonetic symbols. Identifying target sounds at an early stage raises questions about the implications of disregarding other features of speech, and the selection of appropriate intervention approaches. Further research is needed to analyse actual rather than reported practices, and to consider the relationship between phonetic transcription and intervention approaches. Future studies could also identify precise CPD requirements and evaluate the effectiveness of CPD.

WHAT THIS PAPER ADDS

What is already known on the subject Previous research has demonstrated that SLTs often lack confidence in phonetic transcription and that practices are varied, with relatively little use of narrow transcription. SLTs are interested in opportunities to maintain and develop transcription skills but do not often undertake CPD for transcription. What this paper adds to existing knowledge By using focus groups as a forum for discussions, this study provides a rich and detailed insight into SLTs' views about clinical transcription and their working practices, with previously unreported details about the reasons for these practices in a clinical context and at a service-wide level. What are the potential or actual clinical implications of this work? Transcription is often de-prioritized in non-specialist contexts, with practical barriers and a lack of clear and consistent protocols at a whole-service level. There is an opportunity for service managers to address the systemic difficulties in using transcription effectively by raising the profile and value of transcription amongst clinicians, and promoting CPD opportunities, using the findings of this study as a rationale for funding this. Together, these recommendations have the potential to improve client outcomes through more accurate assessment and diagnosis, and hence more appropriate intervention.

摘要

背景

在监管标准中,语音转录被认为是言语治疗师(SLTs)在评估、诊断和管理言语障碍客户时的一项基本技能。先前的研究已经确定,语音转录的方法存在差异,并且 SLTs 通常对转录缺乏信心。然而,SLTs 的观点和工作实践尚未得到详细调查,特别是在整个服务方法方面,以及最近远程医疗的增加方面。

目的

调查 SLTs 对语音转录的看法、他们在个人和服务层面的工作实践,以及影响这些的因素。

方法与程序

通过社交媒体和本地网络从英国招募了 19 名 SLTs 参加在线焦点小组。参与者讨论了他们对语音转录的看法和实践。使用反思性主题分析确定了主题。

结果

产生了三个广泛的主题:分裂与统一;一小部分大工作;和目的明确。SLTs 对自己的语音转录能力感到自豪,并将其视为一项独特的技能,但不同群体的 SLTs 在观点和实践上存在明显差异。投资于语音转录并不总是 SLTs 或服务的优先事项,尽管许多人对自己的技能缺乏信心,但他们认为这些技能足以满足他们通常遇到的人群。SLTs 对可能的治疗目标做出早期判断,这会影响他们在语音转录中使用的详细程度。在服务层面上,实践障碍通常未得到解决,远程医疗评估也带来了一些具体挑战。

结论和影响

SLTs 和服务将从增加时间、继续教育发展(CPD)机会以及支持语音符号使用的电子病历(EPRs)等举措方面受益于语音转录方面的投资。在早期阶段确定目标声音引发了关于忽视言语其他特征以及选择适当干预方法的问题。需要进一步研究来分析实际而不是报告的实践,并考虑语音转录与干预方法之间的关系。未来的研究还可以确定精确的 CPD 要求并评估 CPD 的有效性。

本文的贡献

  • 主题:这篇论文对该主题已经有了哪些了解?以前的研究表明,SLTs 通常对语音转录缺乏信心,而且实践方法多种多样,很少使用窄转录。SLTs 有兴趣保持和发展转录技能,但并不经常为转录进行 CPD。本文增加了哪些新的知识?本文通过使用焦点小组作为讨论的论坛,提供了有关 SLTs 对临床转录的看法以及他们的工作实践的丰富而详细的见解,包括在临床背景和服务层面上,对这些实践背后原因的详细描述。

  • 潜在或实际的临床影响:在非专业背景下,转录通常被置于次要地位,整个服务层面存在实践障碍和缺乏明确一致的协议。服务经理有机会通过在临床医生中提高转录的知名度和价值,并通过使用这项研究的结果为资金提供理由来促进 CPD 机会,从而解决有效使用转录的系统困难。这些建议一起有可能通过更准确的评估和诊断,从而提供更合适的干预,从而改善客户的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8e8/9796287/3b80d1c1f911/JLCD-57-1071-g001.jpg

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