ORCID Profile
0000-0002-4522-058X
Current Organisations
The University of Canberra
,
USDA Forest Products Laboratory
,
Children's Hospital at Westmead
,
University of Sydney
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Publisher: Informa UK Limited
Date: 30-04-2018
DOI: 10.1080/17549507.2018.1465123
Abstract: Research interest in telehealth and autism spectrum disorder (ASD) has grown. There is a need to review the literature to allow speech-language pathologists (SLPs) and other service providers to consider applicability to their settings. The aim of this review was to examine the nature and outcomes of studies examining telehealth assessment and/or intervention in ASD. A systematic search of the literature was undertaken, with 14 studies meeting inclusion criteria. The authors extracted information from each included article, including participant characteristics, technology used, measures and reported outcomes. Quality review of articles was undertaken. The 284 participants with ASD across the 14 included studies ranged in age from 19 months to adulthood. The quality of the studies varied. A range of services were provided via telehealth, including diagnostic assessments, early intervention and language therapy. Results suggested that services delivered via telehealth were equivalent to services delivered face to face, and superior to comparison groups without telehealth sessions. The findings suggest there may be a range of benefits in using telehealth with in iduals with ASD, their families, and teachers. Further research, however, is required particularly regarding the use of telehealth directly with children with ASD for assessment and intervention.
Publisher: Wiley
Date: 18-07-2023
Abstract: Echolalia, the repetition of others’ speech, is a common observation in autistic people. Research has established that echolalia is functional and meaningful for many however, some clinicians and researchers continue to characterise it as pathological and in need of reduction. The aim of this systematic review was to understand the range and impact of interventions for echolalia in autistic children. A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A total of 15 studies met predetermined inclusion criteria. Screening, data extraction and quality rating using the Scientific Merit Rating Scale (SMRS) were performed in duplicate. Ten interventions across 15 papers were found. Results indicated that interventions generally decreased levels of echolalia. However, there were considerable inconsistencies in the definitions and conceptualisations of echolalia, administration, generalisation techniques and the measures used. The quality of the studies was very low. Interventions for echolalia vary widely in terms of administration and measurement. There is limited consensus on the definition of echolalia among the reviewed studies, and no evidence that echolalia is recognised as functional or meaningful to the autistic children. Further, the lack of methodological rigour makes it difficult to draw clinical conclusions about the interventions. Echolalia is the immediate or delayed repetition of others’ speech and is a common observation in autistic children and in some older autistic people. While research and practice has established that echolalia is a functional and meaningful form of communication, particularly for those first developing spoken communication, some clinicians and researchers continue to characterise it as problematic and suggest that echolalia should be reduced or eliminated. We systematically searched the literature about echolalia interventions to try to find out about the types of interventions that aim to reduce or eliminate echolalia. We found 15 studies on this topic. The way they defined echolalia was varied, and there was a range of interventions researched. None of the research papers recognised echolalia as functional or meaningful and the quality of the research was very low. Clinicians, families and researchers should think carefully and critically about suggesting any programs or supports that aim to reduce echolalia as no recommendations can be drawn from the research we studied. Echolalia should be considered functional, and efforts made to understand the meaning and purpose of echolalic speech.
Publisher: Springer Science and Business Media LLC
Date: 17-06-2019
Publisher: Wiley
Date: 29-08-2021
Abstract: Despite emerging evidence of validity and reliability, speech and language therapists’ (SLT) uptake of telehealth has been limited and barriers remain to the effective and confident use of this service model. The COVID‐19 pandemic has caused significant disruption to essential health services, including speech and language therapy assessment and intervention, meaning that telehealth must now be considered as part of the suite of service delivery options for all clinicians. To explore the perceived barriers and facilitators of telehealth among community paediatric SLTs before and after their use of a telehealth platform with an embedded standardised assessment tool. Mixed‐methods questionnaires were developed for this study and completed by SLTs before and after the 3‐month trial of the telehealth platform. A total of 38 SLTs completed the pre‐trial questionnaire and training in the use of telehealth platform (Coviu), including instruction in using a standardised, norm referenced language test as an integrated tool within the Coviu platform. A total of 27 SLTs went on to use the telehealth platform, and 25 of these completed the post‐trial questionnaire on which subsequent qualitative and quantitative analysis was completed. Prior to using the platform, perceived barriers included technology issues, limited clinician experience and concerns around parent acceptance of the service. Potential facilitators included access to appropriate platforms, tools and resources as well as increased clinician confidence with telehealth. Following the trial, barriers to telehealth use continued to include technology barriers, particularly internet stability, and client issues, including suitability for telehealth services. Facilitators for future telehealth use included access to appropriate platforms for telehealth, stable and appropriate internet connectivity, and more extensive telehealth resources for both assessment and intervention for this mode of service delivery. This study provides insights into the perceptions of the barriers and facilitating factors for telehealth use among community‐based SLTs. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery beyond the pandemic. Research about telehealth has shown that it is a reliable and valid way of delivering speech pathology services, yet many clinicians have been wary of its use and uptake of telehealth prior to COVID‐19 had been limited. We wanted to know what SLTs thought about using telehealth before and after participating in a 3‐month trial of a telehealth platform with an embedded formal language assessment. This study indicates that technology issues including internet stability are a barrier to effective telehealth services, but that appropriate telehealth platforms, resources and experience are facilitators of uptake and successful use of telehealth. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery for children during and beyond the pandemic, including those isolated by geographical or transport barriers.
Publisher: SAGE Publications
Date: 09-07-2016
Abstract: Telehealth can be an effective way to provide speech pathology intervention to children with speech and language impairments. However, the provision of reliable and feasible standardised language assessments via telehealth to establish children’s needs for intervention and to monitor progress has not yet been well established. Further, there is limited information about children’s reactions to telehealth. This study aimed to examine the reliability and feasibility of conducting standardised language assessment with school-aged children with known or suspected language impairment via a telehealth application using consumer grade computer equipment within a public school setting. Twenty-three children (aged 8–12 years) participated. Each child was assessed using a standardised language assessment comprising six subtests. Two subtests were administered by a speech pathologist face-to-face (local clinician) and four subtests were administered via telehealth. All subtests were completed within a single visit to the clinic service, with a break between the face to face and telehealth sessions. The face-to-face clinician completed behaviour observation checklists in the telehealth and face to face conditions and provided feedback on the audio and video quality of the application from the child’s point of view. Parent feedback about their child’s experience was elicited via survey. There was strong inter-rater reliability in the telehealth and face-to-face conditions (correlation coefficients ranged from r = 0.96–1.0 across the subtests) and good agreement on all measures. Similar levels of attention, distractibility and anxiety were observed in the two conditions. Clinicians rated only one session of 23 as having poor audio quality and no sessions were rated as having poor visual quality. Parent and child reactions to the use of telehealth were largely positive and supportive of using telehealth to assess rural children. The findings support the use of telehealth in the language assessment of school-aged children using a web application and commercially available computer equipment. This reliable and innovative service delivery model has the potential to be used by speech pathologists to provide assessments to children in remote communities.
Publisher: Wiley
Date: 22-11-2018
Abstract: Access to timely and appropriate speech-language pathology (SLP) services is a significant challenge for many families. Telehealth has been used successfully to treat a range of communication disorders in children and adults. Research examining the use of telehealth for children with autism has focused largely on diagnosis, parent-implemented interventions, and behavioural interventions involving interactions between clinicians and parents. There is, however, very limited research into the use of telehealth directly to assess or intervene with children with autism. This paper reports the outcomes of a study of telehealth language assessments with primary school-aged children with autism. To evaluate the reliability and feasibility of telehealth language assessments for school-aged children with autism. The language skills of 13 children with autism aged 9-12 who attended mainstream schools or support classes were assessed using the Clinical Evaluation of Language Fundamentals-4th Edition. An SLP delivered and scored four subtests of the assessment via telehealth from a remote location. A second SLP at the same location as the child co-scored the online subtests to provide a measure of reliability and delivered the remaining subtests. The local SLP completed checklists in both conditions to provide observations regarding behaviour. Parent feedback was elicited via survey. There was strong interrater reliability between the telehealth and face-to-face conditions (correlation coefficients ranged from r = 0.919 to 0.990 across the subtests and Core Language Score) and good agreement between clinicians on all measures. Analysis using the Wilcoxon Signed Rank test indicated no significant differences in children's behaviour between the telehealth and face-to-face conditions, although variation between in iduals was observed. Parents provided generally positive feedback about the use of telehealth for the assessments. The findings of this study provide preliminary support the use of telehealth assessments of school-aged children with autism. Comparison of telehealth and face-to-face assessment scores showed high agreement and correlation, and while the children showed in idual differences in their behaviour during the telehealth sessions, there was no clear difference between the conditions at the group level. The findings suggest that telehealth may present a reliable and feasible approach to the assessment of language for children with autism in some circumstances as a primary or adjunct service model, while acknowledging that in idual differences among these children may be important to consider when planning both assessment and intervention via telehealth.
Publisher: Springer Science and Business Media LLC
Date: 10-12-2020
DOI: 10.1007/S10803-019-04332-2
Abstract: Use of empirically unsupported practices is a challenge in the field of autism spectrum disorder (ASD). We explored whether attitudes and perceived evidence were linked to intended practice use in early intervention staff. Seventy-one participants completed ratings of the evidence base, current and future use of six ASD intervention practices, and reported attitudes to research and evidence-based practice. Participants reported greater use and rated the evidence base higher for the empirically supported practices. However, variability in accuracy of evidence base ratings was observed across in iduals. Higher perceived evidence was linked to greater future use intentions for empirically supported and unsupported practices. The need for accurate information across practice types is highlighted. Self-report methodology limitations and future research directions are discussed.
Publisher: JMIR Publications Inc.
Date: 19-01-2021
DOI: 10.2196/18214
Abstract: There is a growing need for cost-efficient and patient-centered approaches to support families in hospital- and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery. This pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education, and ethnic background. Families were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first on-site clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire. Completion rates of the questionnaire before the first appointment were significantly higher for EDC (164/184, 89.1%) in comparison to paper-based methods (24/62, 39% P .001). Within the EDC group, a vast majority of respondents indicated a preference for completing the questionnaire online (151/173, 87.3%), compared to paper completion (22/173, 12.7% P .001). Of the caregiver demographic characteristics, only the respondent’s level of education was associated with modality preference, such that those with a higher level of education reported a greater preference for EDC (P=.04). These results show that EDC is feasible in hospital-based clinics and has the potential to offer substantial benefits in terms of centralized data collation, time and cost savings, efficiency of service, and resource allocation. The results of this study therefore support the continued use of electronic methods to improve family-centered care in clinical practices.
Publisher: JMIR Publications Inc.
Date: 12-02-2020
Abstract: here is a growing need for cost-efficient and patient-centered approaches to support families in hospital- and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery. his pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education, and ethnic background. amilies were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first on-site clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire. ompletion rates of the questionnaire before the first appointment were significantly higher for EDC (164/184, 89.1%) in comparison to paper-based methods (24/62, 39% i P /i & .001). Within the EDC group, a vast majority of respondents indicated a preference for completing the questionnaire online (151/173, 87.3%), compared to paper completion (22/173, 12.7% i P /i & .001). Of the caregiver demographic characteristics, only the respondent’s level of education was associated with modality preference, such that those with a higher level of education reported a greater preference for EDC ( i P /i =.04). hese results show that EDC is feasible in hospital-based clinics and has the potential to offer substantial benefits in terms of centralized data collation, time and cost savings, efficiency of service, and resource allocation. The results of this study therefore support the continued use of electronic methods to improve family-centered care in clinical practices.
Publisher: Springer Science and Business Media LLC
Date: 17-06-2021
Publisher: Informa UK Limited
Date: 17-05-2021
Publisher: Springer Science and Business Media LLC
Date: 27-02-2015
Publisher: Oxford University Press (OUP)
Date: 09-2014
Abstract: Phenylcoumaran benzylic ether reductase (PCBER) is one of the most abundant proteins in poplar (Populus spp) xylem, but its biological role has remained obscure. In this work, metabolite profiling of transgenic poplar trees downregulated in PCBER revealed both the in vivo substrate and product of PCBER. Based on mass spectrometry and NMR data, the substrate was identified as a hexosylated 8–5-coupling product between sinapyl alcohol and guaiacylglycerol, and the product was identified as its benzyl-reduced form. This activity was confirmed in vitro using a purified recombinant PCBER expressed in Escherichia coli. Assays performed on 20 synthetic substrate analogs revealed the enzyme specificity. In addition, the xylem of PCBER-downregulated trees accumulated over 2000-fold higher levels of cysteine adducts of monolignol dimers. These compounds could be generated in vitro by simple oxidative coupling assays involving monolignols and cysteine. Altogether, our data suggest that the function of PCBER is to reduce phenylpropanoid dimers in planta to form antioxidants that protect the plant against oxidative damage. In addition to describing the catalytic activity of one of the most abundant enzymes in wood, we provide experimental evidence for the antioxidant role of a phenylpropanoid coupling product in planta.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2012
Publisher: SAGE Publications
Date: 06-06-2018
Abstract: Access to cognitive assessments for children living remotely is limited. Telehealth represents a potential cost- and time-effective solution. A pilot study was conducted to determine the feasibility of telehealth to assess cognitive function in children with learning difficulties. Thirty-three children (median age = 9 years 11 months), recruited from the New South Wales (NSW) Centre for Effective Reading, underwent assessment of intellectual ability. Comparisons were made between the intellectual ability index scores obtained by a psychologist sitting face-to-face with the children and another psychologist via telehealth using a web-based platform, Coviu. The telehealth administration method yielded comparable results to the face-to-face method. Correlation analyses showed high associations between the testing methodologies on the intellectual ability indices (correlation coefficient range = 0.981–0.997). Findings indicate that telehealth may be an alternative to face-to-face cognitive assessment. Future work in a broader range of cognitive tests and wider range of clinical populations is warranted.
Publisher: SAGE Publications
Date: 13-03-2017
Abstract: More boys than girls are diagnosed with autism spectrum disorder however, there are conflicting findings about whether they differ in their presentation. This study involved a survey of parents of school-aged children on the autism spectrum (171 parents of girls and 163 parents of boys) that was distributed via social media. The surveys provided insights regarding the characteristics of boys and girls (as perceived by parents) as well as some demographic information. There were very few differences reported regarding communication and social strengths and difficulties of boys and girls with autism. No differences were reported in the number of boys and girls on the autism spectrum with special interests or repetitive behaviours however, significant differences were found in the types of special interests with boys and girls showing generally interests along traditional gender lines. Qualitative analysis of open comments indicated that some parents of girls on the autism spectrum described their daughter as trying to hide or mask her difficulties more but no parents of boys on the spectrum described this phenomenon.
Publisher: Mary Ann Liebert Inc
Date: 04-2019
Abstract: Background/Introduction: Literacy difficulties have significant long-term impacts on in iduals, and therefore early identification and intervention are critical. Access to experienced professionals who conduct standardized literacy assessments with children is limited in rural and remote areas. The emerging literature supports the feasibility of using telepractice to overcome barriers to accessing specialist literacy assessment. The current study sought to determine the feasibility and reliability of telepractice assessments, using consumer-grade technology, in children with reading difficulties. Thirty-seven children, aged 8 to 12 years, with reading difficulties, attended a multidisciplinary reading clinic. Children completed literacy assessments delivered via a web-based application by a remotely located research assistant. A teacher was stationed with the child and coscored the assessments. Scores and qualitative observations of the two assessors were compared. Spearman's correlation analyses revealed strong agreement between telepractice- and face-to-face-rated scores (r = 0.79-0.99). Bland-Altman plots indicated excellent agreement between derived scores. Parents reported a high degree of comfort with the telepractice assessments. Clinicians reported the audio and video quality was sound in most cases. Web-based technology can enable remote delivery of literacy assessments. The technology has the potential to increase the availability of assessments to meet the needs of children who live remotely, in a timely manner and at their family's convenience.
No related grants have been discovered for Rebecca Sutherland.