Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Gent, Belgium.
Department Neurosciences, KU Leuven, Leuven, Belgium.
Int J Lang Commun Disord. 2023 Jul-Aug;58(4):1191-1203. doi: 10.1111/1460-6984.12852. Epub 2023 Jan 31.
BACKGROUND & AIMS: Even though evidence for the use of linguistic-phonological intervention approaches in children with a cleft (lip and) palate (CP±L) is still limited, these approaches are being used by speech-language pathologists (SLPs) to treat active or compensatory cleft speech disorders in clinical practice. It is, however, unknown to what extent linguistic-phonological intervention is acceptable to SLPs. The aim of this study is to investigate the retrospective acceptability of linguistic-phonological intervention in children with a CP±L from the perspective of SLPs using the theoretical framework of acceptability (TFA).
METHODS & PROCEDURES: A total of 18 female community SLPs, aged between 23 and 63 years, were included in the study. An independent interviewer conducted semi-structured interviews. Data were analysed using a deductive coding approach. Statements of the SLPs were related to the seven constructs of the TFA: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self-efficacy.
OUTCOMES & RESULTS: The affective attitude and perceived effectiveness of linguistic-phonological intervention differed among the SLPs: some therapists had positive attitudes towards these approaches, while others did not. Positive attitudes were related to the successful use of linguistic-phonological intervention in the past. The construct 'ethicality' revealed that negative attitudes towards these approaches were attributed to the limited available scientific evidence or negative experiences while using these approaches. In contrast, SLPs who had positive attitudes considered these interventions as 'important' and 'valuable'. Some SLPs had negative reflections on linguistic-phonological intervention as these approaches were considered demanding in terms of time needed to gain knowledge on using them in children with a CP±L (constructs 'burden' and 'opportunity costs'). Additionally, some SLPs doubted their self-efficacy to use these approaches in clinical practice.
CONCLUSIONS & IMPLICATIONS: The acceptability of linguistic-phonological intervention differed between the SLPs in this sample and was most likely related to their previous experiences with these linguistic-phonological approaches. It is important to increase not only the amount of scientific evidence for linguistic-phonological approaches but also the supply of evidence-based workshops and training courses on this topic. These initiatives should distribute scientific information that is translated into guidelines that are immediately applicable in clinical practice. This may potentially reduce the time-related burden that some SLPs currently experience to gain expertise in this matter. In future research, it is necessary to investigate if there exist differences in acceptability between the different types of linguistic-phonological therapy.
What is already known on this subject Linguistic-phonological speech intervention approaches are often used by SLPs to treat active or compensatory cleft speech disorders in clinical practice. What this paper adds to existing knowledge This study investigated whether linguistic-phonological intervention cleft speech intervention is acceptable to SLPs. Some therapists had positive attitudes towards these approaches, while others did not. Positive attitudes were related to the successful use of these approaches in the past. If SLPs indicated having negative attitudes, these negative feelings were attributed to the limited available scientific evidence or negative experiences while using these approaches. What are the potential or actual clinical implications of this work Even though linguistic-phonological speech intervention approaches are being used in clinical practice, these approaches are not always considered acceptable by SLPs. Acceptability could be enhanced by increasing the amount of scientific evidence for linguistic-phonological approaches, but also by increasing the supply of workshops and training courses on this topic. These initiatives should distribute hands-on information that is immediately applicable in clinical practice. This may potentially reduce the time-related burden that some SLPs currently experience to gain expertise in this matter.
尽管在腭裂（唇腭裂）儿童中使用语言语音干预方法的证据仍然有限，但言语语言病理学家（SLP）在临床实践中使用这些方法来治疗活跃或代偿性腭裂语音障碍。然而，目前尚不清楚语言语音干预在多大程度上被 SLP 接受。本研究旨在从 SLP 的角度，使用可接受性理论框架（TFA），调查腭裂儿童语言语音干预的回顾性可接受性。
共纳入 18 名年龄在 23 岁至 63 岁之间的社区女性 SLP。一名独立的访谈者进行了半结构化访谈。使用演绎编码方法对数据进行分析。SLP 的陈述与 TFA 的七个构建体相关：情感态度、负担、伦理性、干预一致性、机会成本、感知效果和自我效能。
SLP 对语言语音干预的情感态度和感知效果存在差异：一些治疗师对这些方法持积极态度，而另一些则没有。积极的态度与过去成功使用语言语音干预有关。“伦理性”这一构念表明，对这些方法的消极态度归因于有限的可用科学证据或使用这些方法时的负面经验。相比之下，认为这些干预措施“重要”和“有价值”的 SLP 则认为这些干预措施是可以接受的。一些 SLP 对语言语音干预有负面看法，因为这些方法需要花费大量时间来了解如何在唇腭裂儿童中使用这些方法（构建体“负担”和“机会成本”）。此外，一些 SLP 怀疑自己在临床实践中使用这些方法的自我效能。
本研究的意义在于，确定了语言语音干预在该研究样本中是否被 SLP 接受，并进一步调查了 SLP 对语言语音干预的接受度是否与他们以前使用这些语言语音方法的经验有关。未来的研究需要调查不同类型的语言语音治疗之间是否存在可接受性差异。
