Journal of Communication Disorders最新文献

{"title":"Parent-therapist therapeutic alliance - a neglected factor in pediatric speech-language intervention: A longitudinal study","authors":"Michal Icht ,&nbsp;Maayan Tayar ,&nbsp;Mario Mikulincer ,&nbsp;Riki Taitelbaum-Swead ,&nbsp;Boaz M. Ben-David","doi":"10.1016/j.jcomdis.2026.106637","DOIUrl":"10.1016/j.jcomdis.2026.106637","url":null,"abstract":"<div><h3>Background</h3><div>The therapeutic alliance (TA) has been widely used to explain variations in psychotherapy, but its role in pediatric speech-language therapy remains underexplored.</div></div><div><h3>Aims</h3><div>This longitudinal study examined whether the TA between speech-language therapists (SLTs) and parents of children undergoing speech-language intervention predicted therapeutic outcomes and whether it moderated the effects of parental psychological factors.</div></div><div><h3>Methods</h3><div>Forty-one parents of children aged 3–12 years and 12 SLTs participated in a 12-week intervention. SLTs rated child disorder severity at onset, TA after two sessions, and therapeutic outcomes at completion. At the onset of therapy, parents completed measures of caregiving style, perceptions of their child, and child-related emotions. Hierarchical regression models assessed predictors of therapeutic outcomes, and moderation analyses tested interactions between TA and parental variables.</div></div><div><h3>Results</h3><div>Background variables explained 18% of the variance in therapeutic outcomes. Adding parental psychological variables increased the explained variance to 40%, and including TA significantly increased it to 50%. Stronger TA predicted better therapeutic outcomes, while greater disorder severity, compulsive caregiving, and highly positive parental perceptions of the child predicted poorer outcomes. Importantly, the moderation analysis indicated that a strong TA buffered the negative impact of compulsive caregiving on therapeutic outcomes.</div></div><div><h3>Conclusions</h3><div>Findings underscore the role of early parent-SLT alliance in promoting therapeutic success and mitigating the negative effects of intrusive parenting. Clinicians should prioritize building a strong TA with parents and address parental psychological factors as part of pediatric speech-language therapy. Future research should include parent-reported alliance and independent outcome measures, in longitudinal multi-informant designs.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"121 ","pages":"Article 106637"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linear versus nonlinear modeling of dysphonia severity: A comparison between Acoustic Voice Quality Index and machine learning","authors":"Ahmed M. Yousef ,&nbsp;Adrián Castillo-Allendes ,&nbsp;Mark L. Berardi ,&nbsp;Juliana Codino ,&nbsp;Adam D. Rubin ,&nbsp;Eric J. Hunter","doi":"10.1016/j.jcomdis.2026.106648","DOIUrl":"10.1016/j.jcomdis.2026.106648","url":null,"abstract":"<div><h3>Purpose</h3><div>This study compares the Acoustic Voice Quality Index (AVQI-3) with machine learning (ML) models to evaluate their clinical utility for estimating voice quality.</div></div><div><h3>Methods</h3><div>Audio from 187 American English speakers (49 healthy, 138 with voice disorders) was rated for overall voice quality by six voice specialists. AVQI-3 and its six acoustic parameters were extracted, and these parameters were used to train 14 ML models (linear, curvilinear, nonlinear). Correlations and classification accuracy (normal–mild vs. moderate–severe) were compared against perceptual ratings as ground truth.</div></div><div><h3>Results</h3><div>AVQI-3 correlated strongly with perceptual ratings (Spearman <span><math><msub><mi>r</mi><mi>s</mi></msub></math></span>=0.75), comparable to linear and curvilinear models, yet outperformed most nonlinear models. At a cutoff score of 2.52, AVQI-3 achieved the highest classification accuracy (0.92) with balanced sensitivity (0.90) and specificity (0.93). Among ML models, linear regression performed best (<span><math><msub><mi>r</mi><mi>s</mi></msub></math></span>=0.77, accuracy=0.92, sensitivity=1.0, specificity=0.89), whereas nonlinear models showed reduced performance (average <span><math><msub><mi>r</mi><mi>s</mi></msub></math></span>=0.74, accuracy=0.87, sensitivity=0.95, specificity=0.85).</div></div><div><h3>Conclusion</h3><div>AVQI-3 is a simple, accessible index that quantifies voice quality as effectively as complex ML models. This is supported by the best-performing ML models being linear, indicating that linear combinations of acoustic measures are effective, accurate, and clinically interpretable, whereas added nonlinear complexity offered little benefit.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"121 ","pages":"Article 106648"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linguistic correlates of Chinese children with developmental dyslexia: a systematic review","authors":"Caixia Du,&nbsp;Yonggang Zhao","doi":"10.1016/j.jcomdis.2026.106629","DOIUrl":"10.1016/j.jcomdis.2026.106629","url":null,"abstract":"<div><div>Developmental dyslexia can negatively affect children’s cognitive, emotional, and academic development. This systematic review synthesizes findings from cross-sectional studies on linguistic correlates of developmental dyslexia in Chinese children. A total of 50 studies comprising 185 effect sizes were synthesized using a random-effects model to identify key linguistic correlates. Four significant correlates were identified: morphological awareness (Hedges’s g = -1.14), phonological awareness (Hedges’s g = -1.14), orthographic awareness (Hedges’s g = -0.99), and rapid automatic naming (Hedges’s g = 0.93). Short-term memory showed a moderate association (Hedges’s g = -0.59) relative to age-matched typically developing children. Moderation analyses revealed that phonological awareness was more strongly associated with Chinese developmental dyslexia in older children, under comprehensive diagnostic criteria (character recognition + comprehension), and in self-designed tasks. While orthographic awareness showed stronger associations with developmental dyslexia in regions using traditional Chinese (Hong Kong and Taiwan). However, age, location, diagnostic criteria and task designs did not emerge as moderators of morphological awareness, rapid automatic naming and short-term memory. Implications for identification and intervention for Chinese children with developmental dyslexia were discussed.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106629"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplementary motor area: A promising neurostimulation target to improve speech production","authors":"Fatemeh Tabari,&nbsp;Karim Johari","doi":"10.1016/j.jcomdis.2026.106630","DOIUrl":"10.1016/j.jcomdis.2026.106630","url":null,"abstract":"<div><div>The supplementary motor area (SMA) works in concert with several cortical and subcortical regions to produce speech in a timely, accurate, and fluent manner. Despite the SMA’s critical role in speech motor control, it has been inadequately addressed in neurostimulation studies, and its exact mechanism remains unexplored. We investigated the SMA’s function through the lenses of various theoretical models, as well as lesion and neuroimaging studies. This review synthesizes the current evidence on the potential of SMA-targeted non-invasive neurostimulation techniques, including repetitive transcranial magnetic stimulation (rTMS), continuous theta burst stimulation (cTBS), and high-definition transcranial direct current stimulation (HD-tDCS). Current evidence supports the integrative role of the SMA in coordinating planning-related and sensory-guided aspects of speech motor control and demonstrates that both excitatory and inhibitory stimulation of the SMA modulate speech-related processes, including motor planning, temporal coordination, auditory-vocal integration, and vocal compensation, in healthy individuals and clinical populations, particularly those with Parkinson’s disease and stuttering. Collectively, the SMA holds promise for improving speech motor function and motivates future studies using diverse stimulation techniques and speech production tasks to inform therapeutic applications.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106630"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Leave the thorn, enjoy the rose” identity formation of people with aphasia in the early rehabilitation phase","authors":"Rianne Brinkman ,&nbsp;Mieke Cardol ,&nbsp;Karin Neijenhuis ,&nbsp;Margreet Luinge ,&nbsp;Carlo Leget","doi":"10.1016/j.jcomdis.2026.106627","DOIUrl":"10.1016/j.jcomdis.2026.106627","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Aphasia can profoundly affect an individual’s identity. Yet studying identity in people with aphasia presents methodological challenges, as language, our primary medium for self-expression, is disrupted. This study explored how people with aphasia experience and reshape identity during early rehabilitation, using narrative inquiry and visual ethnography. This approach aims to deepen understanding of identity formation and change, and the potential value of creative arts in supporting meaningful research participation.</div></div><div><h3>Methods</h3><div>Twenty-two people with post-stroke aphasia (aged 34–62) were recruited from Dutch rehabilitation centers six to eight weeks post-admission. Each participant took part in two sessions: one individual session and one follow-up session attended by proxies. In the individual sessions, arts-based visual participatory methods were used to elicit narratives. Data analysis integrated the listening guide, embodiment, and the production of the image and the image itself.</div></div><div><h3>Results</h3><div>Findings reveal that identity formation after aphasia is complex and ongoing, characterized by multiple, complementary, and sometimes conflicting voices. Affirming, coping, and challenging voices interact within key tensions: connection versus disconnection, agency versus disempowerment, and personal growth versus living loss. Visual participatory methods were valued by participants. The creative process provided an alternative way to express experiences when verbal communication was limited.</div></div><div><h3>Conclusions</h3><div>Combining narrative inquiry and visual ethnography, supported by skilled facilitation, offers a promising way to reveal identity changes and support people with aphasia in sharing their experiences. This study shows that using integrated approaches is not only methodologically necessary but also ethically important for enabling meaningful participation.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106627"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of communication ability in Angelman syndrome: evidence from Polish individuals","authors":"Marcin Opacki ,&nbsp;Agata Suleja ,&nbsp;Robert Śmigiel ,&nbsp;Dominik Cysewski ,&nbsp;Kacper Łukasiewicz","doi":"10.1016/j.jcomdis.2026.106624","DOIUrl":"10.1016/j.jcomdis.2026.106624","url":null,"abstract":"<div><h3>Background</h3><div>Angelman syndrome (AS) is a neurodevelopmental disorder that affects cognitive and executive functioning, as well as emotional, expressive, sensory, and physical behavior. Children with AS demonstrate a distinct lack of expressive speech, with recognizable words appearing only seldom. No data regarding the prevalence of AS in the Polish population is available to date, resulting in a diagnostic gap.</div></div><div><h3>Methods</h3><div>The current work reports on the results of applying the Observer Reported Communication Ability (ORCA) questionnaire to provide new data on the linguistic abilities of Polish individuals affected by AS. 73 individuals were included in the analysis with a median age of 111.02 months, 39 of them female.</div></div><div><h3>Results</h3><div>Based on our analyses, we conclude that individuals without deletions have a greater communication ability relative to individuals with deletions. We found no correlation between age and language ability in AS, which corroborates previous claims that language skills in AS become stunted at some point. We did not find any significant predictors of communication ability tied to socio-economic status or gender.</div></div><div><h3>Conclusion</h3><div>Our results suggest that – as far as communication abilities are concerned – an awareness of an individual’s genetic diagnosis when choosing therapy can increase the likelihood of optimized care being given.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106624"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking aural (Re)habilitation outcomes with the mandarin auditory skills checklist: Normative data and clinical insights","authors":"Yi-ping Chang ,&nbsp;Hsuan-Mei Hong ,&nbsp;Shu-Ting Chang ,&nbsp;Pei-Hua Chen","doi":"10.1016/j.jcomdis.2026.106616","DOIUrl":"10.1016/j.jcomdis.2026.106616","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to establish a clinically robust and time-efficient tool for tracking auditory development in young children undergoing early intervention. By building upon the Auditory Skills Checklist (ASC), the study introduced a validated short form (ASC-SF), developed age-based norms, and demonstrated its real-world applicability using large-scale data from Mandarin-speaking children. While adapted for a specific linguistic context, the tool’s design and methodology are broadly transferable and relevant to pediatric audiology across diverse populations.</div></div><div><h3>Methods</h3><div>The Mandarin ASC and ASC-SF were respectively administered to 520 children with normal hearing (NH) aged 0–78 months, and 357 children with hearing loss (HL) aged 8–78 months receiving auditory-verbal (AV) therapy. Psychometric evaluation included internal consistency, test-retest reliability, and criterion-related validity with the Parent’s Evaluation of Aural/Oral Performance of Children (PEACH) scale. Normative curves were derived using a logistic function fitted to parent-reported ASC scores from NH children. Large-scale cross-sectional data using the ASC-SF were analyzed to track developmental outcomes in children with HL by both chronological age and duration of intervention. Case studies were also included to demonstrate how ASC results can guide individualized goal setting and intervention adjustment.</div></div><div><h3>Results</h3><div>The Mandarin ASC demonstrated excellent internal consistency (Cronbach’s α = 0.97) and test-retest reliability (<em>r</em> = 0.97, <em>p</em> &lt; 0.00001). Criterion validity was strong with PEACH scores (<em>r</em> = 0.94, <em>p</em> &lt; 0.00001). Normative data showed age-related increases in auditory skills, with median scores reaching 93% by age four. Among children with HL, approximately 70% achieved comparable auditory skills to their NH peers by age two, 80% by age four, and 90% by age six. Based on AV intervention duration, over 80% reached age-appropriate auditory skills after two years, and over 90% after four years. Subscale analyses and case studies further demonstrated how the ASC framework supports individualized progress monitoring and clinical decision-making.</div></div><div><h3>Conclusion</h3><div>The Mandarin ASC is a valid, reliable, and clinically valuable tool for tracking auditory development in Mandarin-speaking children. The ASC-SF extends its practicality by enabling efficient routine follow-up in large clinical populations. With age-specific norms, case-based interpretation, and flexible formats, the ASC provides a robust framework for evaluating intervention outcomes, setting personalized goals, and communicating progress with families in pediatric audiology and aural (re)habilitation.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106616"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicultural perspective of stuttering in the workplace","authors":"Angela M. Medina ,&nbsp;Monica L. Johnson ,&nbsp;Kristina E. Bonfield ,&nbsp;Madison O. Irvine ,&nbsp;Maria K. Nadal","doi":"10.1016/j.jcomdis.2026.106628","DOIUrl":"10.1016/j.jcomdis.2026.106628","url":null,"abstract":"<div><h3>Purpose</h3><div>It is well-documented that people who stutter face inequities and discrimination in the workplace; however, there exists a gap in the literature regarding what the workplace is like for people who stutter with intersecting, marginalized identities. The purpose of this qualitative study was to describe the workplace experiences of culturally diverse people who stutter (CDPWS) through the lens of the intersectional ecological framework.</div></div><div><h3>Methods</h3><div>Qualitative methods were adopted for the collection and analysis of data. The seven participants in this study completed an online questionnaire and participated in a semi-structured focus group. Transcripts generated from the focus group were investigated using thematic analysis procedures.</div></div><div><h3>Results</h3><div>The data gave rise to five major themes as well as multiple subthemes: (1) Disclosure at work, (2) Career-specific challenges, (3) Motivations for choosing career, (4) Intersectionality, and (5) Roles of others in the workplace.</div></div><div><h3>Conclusion</h3><div>This study offers a novel view of the workplace experiences of CDPWS by adopting qualitative methods and using the intersectional ecological framework to enhance thematic analysis findings. While the workplace-based concerns revealed in this study are similar to those described in previous literature, a major difference was the sentiment that CDPWS bring two types of “baggage” to their jobs, their stuttering and their race/ethnicity. The findings of this study have clinical implications for the imperativeness of having open conversations with clients about the identities that intersect with their stuttering and how this impacts them in different aspects of their lives, including the workplace.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106628"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the performance of bilingual children with developmental language disorder and typical development on sentence repetition: A systematic review","authors":"Seow Li Ang ,&nbsp;Alicia Yue Hwa Lee ,&nbsp;Mary Lay Choo Lee ,&nbsp;Wei Ping Sze","doi":"10.1016/j.jcomdis.2025.106614","DOIUrl":"10.1016/j.jcomdis.2025.106614","url":null,"abstract":"<div><h3>Purpose</h3><div>Over the past decade, researchers have compared the performance of bilingual children with developmental language disorder (DLD) to those with typical development (TD), using the Sentence Repetition Task (SRT) to assess language abilities. Understanding the differences in their performance on the SRT is crucial for future assessment, intervention and research. This systematic review compares the performance of bilingual children with DLD against those with TD on their first (L1) and second (L2) language SRT results. It also investigates the impact of participant-related variables (e.g., scores on receptive vocabulary tasks) on the results.</div></div><div><h3>Method</h3><div>A systematic search of eight electronic databases (PubMed, Scopus, PsycINFO, CINAHL, LLBA, ERIC, Embase and Dissertations and Theses) yielded 3204 records. Studies assessing bilingual children with TD and DLD on the SRT were included. Risk of bias was assessed using the modified Cochrane Risk Of Bias Assessment Tool for Non-Randomized Studies of Interventions.</div></div><div><h3>Results</h3><div>After screening, 15 studies met the eligibility criteria. Eight studies reported on L1 performance and 13 studies reported on L2 performance. All eight L1 studies and 12 of the L2 studies showed that the performance of bilingual children with DLD was significantly weaker than that of TD children on the SRTs. Data suggested that working memory (represented by nonword repetition scores) and receptive vocabulary might influence participants’ performance.</div></div><div><h3>Conclusions</h3><div>This review suggests that the performance of bilingual children with DLD is significantly weaker than those with TD on both L1 and L2 SRTs. There is preliminary evidence from a small number of studies examining participant-related variables that weaker working memory and receptive vocabulary may underlie poorer SRT performance in bilingual children with DLD.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"120 ","pages":"Article 106614"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feeling excluded in financial environments: Challenges and strategies to promote financial inclusion for adults with post-stroke communication disabilities","authors":"Elaheh Keshavarz ,&nbsp;Nancy Hansen ,&nbsp;Jerry Buckland ,&nbsp;Lisa Engel","doi":"10.1016/j.jcomdis.2025.106595","DOIUrl":"10.1016/j.jcomdis.2025.106595","url":null,"abstract":"<div><h3>Introduction</h3><div>Participating in financial environments may be challenging for people with stroke due to the communication disabilities they may experience. Understanding the experiences of adults with stroke-related communication disabilities in financial environments could help to identify strategies to improve their participation and performance. This study aimed to explore the experiences and potential challenges of people with post-stroke communication disabilities in financial environments, and introduce strategies for improving financial participation.</div></div><div><h3>Method</h3><div>Four adults, three being women, from Manitoba with stroke-related speech and language disabilities participated in individual interviews for this qualitative descriptive research study. The data were analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Four themes and three subthemes were developed, highlighting that post-stroke communication disabilities often lead to financial exclusion due to external factors like institutional structures and social environments. Ableism, reflected in others' attitudes or behaviors, may have also impacted financial inclusion and participation. However, participants suggested strategies to improve financial participation and inclusion of people with stroke-related communication disabilities.</div></div><div><h3>Conclusion</h3><div>This study adds to the growing area of speech-language pathology practice and research related to critical disability theory. Clinicians need to be aware that environments, including financial environments, have a key influence on the participation of people with post-stroke communication disabilities. Future studies should examine policies and practices in financial environments for people with stroke-related communication disabilities to improve their social inclusion.</div></div>","PeriodicalId":49175,"journal":{"name":"Journal of Communication Disorders","volume":"119 ","pages":"Article 106595"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145594644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}