Background: Effective literacy skills are crucial in supporting communication for children with severe speech and physical impairments (SSPI). Reading and spelling difficulties are reported to be over-represented in this group, even where language and cognitive skills are age appropriate.
Aims: To compare the performance of children with SSPI on a range of language, reading and spelling tasks with that of their typically developing peers matched for receptive vocabulary and mental age.
Methods & Procedures: A wide range of tasks was developed as part of a larger study exploring phonological awareness, reading and spelling skills. All tasks were accessible to children with severe physical impairments. Two groups of primary school-aged children were recruited, children with SSPI of average intelligence, and naturally speaking peers, matched for receptive vocabulary. Children were assessed individually on language, non-verbal cognition, phonological awareness, reading and spelling tasks.
Outcomes & Results: Sixteen children with SSPI were recruited. Their performance was compared with that of 15 naturally speaking peers, matched for receptive vocabulary scores. The children with SSPI achieved significantly lower scores on reading and spelling measures relative to their naturally speaking peers. However, at least one participant with SSPI scored at ceiling on each task, indicating that SSPI do not preclude the development of reading and spelling, at least in the early stages of literacy development.
Conclusions & Implications: This study indicates that some children with severe speech impairments can develop phonological awareness, reading and spelling skills. However, the data suggest that phonological awareness may not be as good a predictor of reading and spelling abilities in this group of children as in typically developing children. Further research is needed to track development of reading and spelling, as well as the instructional support needed to scaffold more effective skills in these areas.
Flexible Laryngoscopy: A Comparison of Fiber Optic and Distal Chip Technologies—Part 2: Laryngopharyngeal Reflux
Part 1 of this paper compared fiber optic (FO) and distal chip (DC) flexible technologies in the diagnosis of vocal fold masses and mucosal wave abnormalities. Part 2 of this study was designed to evaluate the usefulness of FO and DC flexible imaging in the diagnosis of laryngopharyngeal reflux (LPR) disease. Thirty-four consecutive patients were examined with either FO or DC flexible stroboscopy followed immediately by rigid stroboscopy. Rigid stroboscopy was considered the “gold-standard” for this study. All stroboscopy segments were evaluated by two laryngologists, an otolaryngologist, a laryngology fellow, and an otolaryngology resident for physical findings of LPR using the Reflux Finding Score (RFS) and Posterior Erythema Grade (PE grade). Both flexible systems underrepresented the physical findings of LPR compared to the rigid examination, but the FO system was frequently more accurate than the DC system. For PE grade, agreement with the rigid endoscope was 95% for the FO system and 73% for the DC system. Total RFSs for both flexible systems were significantly different than RFSs from the corresponding rigid examinations (P = 0.001). Raters who used the RFS more often were more consistent. More severe PE grade scores correlated well with increasing RFSs. The number of patients diagnosed with LPR (RFS > 7) showed that despite differences in the category scores, the FO and DC were almost identical in how much LPR was diagnosed compared with their matched rigid examination. Because both flexible platforms significantly underrepresented reflux signs, we recommend that a rigid laryngeal telescope be used when examining the larynx for signs of LPR. If this is not available, these data suggest that a high-quality FO endoscope may be more accurate than a DC endoscope for most otolaryngologists.
from the Journal of Voice