American Journal of Speech-Language Pathology最新文献

{"title":"Speech-Language Pathologists' Use of Patient-Reported Outcome Measures for Adult Patients With Cognitive-Communication Disorders: A Survey Study.","authors":"Faith Stagge, Matthew L Cohen, Allyson Lindsay Johnson, Alyssa M Lanzi","doi":"10.1044/2024_AJSLP-24-00285","DOIUrl":"10.1044/2024_AJSLP-24-00285","url":null,"abstract":"<p><strong>Purpose: </strong>Speech-language pathologists (SLPs) primarily assess patients with cognitive-communication disorders using performance-based measures. Patient-reported outcome measures (PROMs) may also prove useful in clinical practice with these populations, as they can capture applied communication constructs with subjective or unobservable elements (e.g., cognitive fatigue). We conducted a survey to gain insight into SLPs' clinical use of PROMs with these populations.</p><p><strong>Method: </strong>Ninety-five SLPs responded to 26 survey items that explored SLPs' (a) current use of PROMs in clinical care for adults with cognitive-communication disorders, (b) needs and barriers related to PROM use in clinical practice, and (c) gaps and needs with respect to the measurement of patient health-related quality of life. A convergent mixed-methods design was used to analyze qualitative and quantitative survey responses. Free-response questions were coded using a conventional content analysis.</p><p><strong>Results: </strong>Forty percent of respondents reported using PROMs with their patients with cognitive-communication disorders, most often for goal setting, followed by assessing treatment effects. SLPs also reported barriers to PROM use with patients with cognitive-communication disorders, such as patient insight deficits and limited time. The identified barriers of <i>poor implementation</i> and <i>dissemination</i> have implications for future research directions.</p><p><strong>Conclusions: </strong>The survey findings suggest that many SLPs do not currently use PROMs with patients who have cognitive-communication disorders, but those who do find them useful for goal setting. Survey findings also indicate several barriers that limit broader adoption of PROMs for this clinical population, which should be addressed through future implementation research and clinical initiatives such as creating PROM education for SLPs.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":"34 2","pages":"798-817"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Swallowing Dysfunction With Flexible Endoscopic Evaluation of Swallowing in the Neonatal Unit.","authors":"Aaron Heston, Anjali Patel, Kevin Ahn, Delaney Wresch, Lauren Ridgway, Bethany Shipman, Katrina Graf, Mohammed Elkhwad, Hemananda Muniraman","doi":"10.1044/2024_AJSLP-24-00173","DOIUrl":"10.1044/2024_AJSLP-24-00173","url":null,"abstract":"<p><strong>Background: </strong>Preterm and low-birth-weight infants often experience discoordination of the suck-swallow-breathe pattern, leading to dysrhythmic feeding, inefficient feeding skills, and swallowing dysfunction, increasing the risk of aspiration and respiratory morbidity. While videofluoroscopic swallowing study is commonly utilized to assess swallow function in neonates, flexible endoscopic evaluation of swallowing (FEES) has been an emerging modality and has been utilized routinely at our institution since 2018.</p><p><strong>Method: </strong>A single-center, retrospective study including 90 infants admitted to the neonatal unit between 2018-2023 who underwent FEES procedure. Our objective was to evaluate the utility of FEES for evaluating functional and anatomical abnormalities, secretions, penetration/aspiration, and residue in infants in the Neonatal Intensive Care Unit. Our secondary objective was to observe whether clinical feeding decisions were changed based on FEES and describe progress in oral feeding.</p><p><strong>Results: </strong>A majority of infants (85.5%) were reported to have abnormal FEES findings, with aspiration below the vocal cords noted in 37.7% and laryngeal penetration reported in 34.5% of the infants. Anatomical abnormalities were reported in 39% of infants including predominantly laryngomalacia (27.7%). Ten infants were noted to have unanticipated anatomical abnormalities, of which four went on to require surgical interventions. Changes in nipple or bottle were the most frequent recommendations (68.8%) with thickening of feeds recommended in 35% of infants. The percentage of oral feedings increased from median of 45% to 75% with a decrease in infants with apneic, bradycardic, and desaturation events in the 7 days after FEES guided interventions were introduced.</p><p><strong>Conclusions: </strong>Majority of the infants with clinical concerns of swallow dysfunction were noted to have abnormalities on FEES, with one third of infants reported to have aspiration and anatomical abnormalities. Changes in feeding practices were recommended to majority of the infants based on FEES evaluation. Four of the five infants with anatomical abnormalities referred urgently for specialist evaluation required interventions.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"845-852"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957563","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":"Skills Associated With Atypical Phonological Errors in English: A Scoping Review.","authors":"Elizabeth Roepke","doi":"10.1044/2024_AJSLP-24-00179","DOIUrl":"10.1044/2024_AJSLP-24-00179","url":null,"abstract":"<p><strong>Purpose: </strong>Few clinicians report incorporating error type in their assessment of speech sound disorders, despite research reporting differences between children who produce typical and atypical phonological errors. The purpose of this scoping review was to map what is currently known about the related skills of English-speaking children who produce typical versus atypical phonological errors in order to summarize currently available evidence for clinical decision making concerning atypical phonological errors.</p><p><strong>Method: </strong>A systematic search of databases was completed, including PubMed, Scopus, and APA PsycInfo. Studies that were published between 1985 and 2023, were peer-reviewed, and reported on a related skill for typical and atypical phonological errors were included. The scoping review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.</p><p><strong>Results: </strong>Twenty-seven studies were included in the review. These studies were organized into six themes: persistence of speech errors, emergent literacy difficulties, executive function difficulties, language skills, speech perception and auditory processing, and motor skills. Atypical but not typical phonological errors were related to persistence of speech errors. Emergent literacy difficulties, particularly phonological awareness difficulties, and executive function difficulties were frequently reported to be associated with atypical but not typical phonological errors. Motor skills were similar for children who produced typical and atypical errors. More research is needed for speech perception, auditory processing, and language skills.</p><p><strong>Conclusions: </strong>Children who produce atypical phonological errors have different strengths and weaknesses in related skills than children who produce typical phonological errors. Children who produce atypical phonological errors may benefit from phonological awareness and/or early literacy assessments and intervention.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"959-981"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460366","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":"Is Communication Training for Significant Others a Reasonable Rehabilitation Goal in Aphasia Therapy?","authors":"Katarina L Haley, Lucy E Hardy","doi":"10.1044/2024_AJSLP-24-00472","DOIUrl":"10.1044/2024_AJSLP-24-00472","url":null,"abstract":"<p><strong>Purpose: </strong>This study was motivated by goal samples from practicing speech-language pathologists (SLPs) that were submitted to a website our group maintains about treatment planning for aphasia. Upon analyzing the goals, we found that less than 3% involved any form of communication partner training (CPT). Considering this finding, we sought to understand how and to what extent aphasia clinicians in the United States use CPT with significant others.</p><p><strong>Method: </strong>We constructed a survey that included a mixture of multiple-choice and open response questions around goal setting and CPT for significant others. The survey was posted to the same website where we had originally collected the goal samples. Responses were summarized with descriptive statistics and thematic analysis.</p><p><strong>Results: </strong>One hundred fifty-six SLPs and 138 graduate students completed the survey. Almost all SLPs (97%) reported engaging in CPT with family members, and approximately half indicated they also wrote goals about this service at least occasionally. However, most explained that CPT was typically handled without goal setting. Graduate students reported limited experience with CPT. Thematic analysis of the open responses yielded five themes and 24 codes that collectively display a multidimensional implementation problem.</p><p><strong>Discussion: </strong>SLPs recognize the importance of CPT and employ a range of training techniques with significant others. Nevertheless, they face barriers that lead to ambivalence about writing goals for this service. On the rationale that explicit goals ensure accountability and transparency, we address some of the barriers by providing practical resources as steps toward solution-focused collaboration.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"782-797"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366319","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":"Postextubation Dysphagia Among Patients With COVID-19: Results of Instrumental Swallow Studies and Clinical Swallow Evaluations.","authors":"Renee Bricker, Chad Aldridge, Elizabeth Turner","doi":"10.1044/2024_AJSLP-23-00442","DOIUrl":"10.1044/2024_AJSLP-23-00442","url":null,"abstract":"<p><strong>Purpose: </strong>Research has shown that prolonged endotracheal intubation can increase risk of aspiration following extubation. This study examined the relationship between swallowing and intubation among patients with COVID-19. We investigated the association between the duration of intubation and time until an oral diet was safely initiated and the correlation between the length of intubation and reduced sensation with aspiration as seen on flexible endoscopic evaluation of swallowing (FEES)/videofluoroscopic swallowing study (VFSS).</p><p><strong>Method: </strong>This study is a retrospective analysis of all intubated patients admitted with the primary diagnosis of COVID-19 between April 2020 and March 2021 who received an inpatient speech-language pathology consultation. We utilized univariate linear regressions to investigate the dose-response relationship between duration of intubation and time until cleared for oral diet post-extubation. Dysphagia outcomes were analyzed, including results from 39 instrumental evaluations (VFSS and FEES).</p><p><strong>Results: </strong>During this 1-year period, 94 extubated patients were examined by a speech-language pathologist (SLP). We observed a near-exponential increase in the days until cleared for oral diet from 3% versus 69% when intubated for 10-16 days versus 17-34 days, respectively. Second, 39 patients received a VFSS/FEES evaluation. Of those who aspirated on an instrumental swallow study, there was a 78% rate of silent aspiration.</p><p><strong>Conclusions: </strong>Prolonged intubation has a near exponential dose-response on the time until a patient becomes cleared for an oral diet after extubation. Prolonged intubation also increases the rate of aspiration observed on VFSS/FEES evaluations. Thus, SLP evaluation of oropharyngeal swallow physiology is important to minimize complications and improve patient outcomes.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28165631.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"547-558"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985194","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":"We All Need at Least One Friend Who Understands What We Do Not Say: A Scoping Review of Friendship and Augmentative and Alternative Communication.","authors":"Erinn H Finke, Michelle C S Therrien, Jamie Azios, Jenessa McElfresh","doi":"10.1044/2024_AJSLP-24-00251","DOIUrl":"10.1044/2024_AJSLP-24-00251","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this scoping review was to understand what is known about the friendships of individuals who use augmentative and alternative communication (AAC) devices. Because communication is important to friendship, severe communication impairment may impact the establishment or maintenance of friendships in unique and important ways.</p><p><strong>Method: </strong>Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews and Covidence software using an established set of operationally defined inclusion criteria supported the identification of the 46 papers included in this review. Included papers presented original data on the friendships of individuals with disabilities (acquired and developmental) who could benefit from AAC across the lifespan. Data were extracted to identify features of the body of literature and to identify themes that could inform future research and clinical practice.</p><p><strong>Results: </strong>Themes identified from the included studies related to how friendship is defined, supports for friendship formation and maintenance, help and care in friendships, positive outcomes, barriers, the impact of AAC, and recommendations for moving clinical practice and research forward.</p><p><strong>Conclusions: </strong>Friendships are chosen relationships that stem from congruences in perspectives between two individuals. People who use AAC, like the broader population, are likely to seek out and maintain friendships with people who are similar to them: people who share personality traits, past experiences (including experiencing disability), interests, and activities. Creative solutions are needed to increase the independence of disabled children and adults to meet and engage with new people with a variety of lived experiences.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28119857.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"931-958"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957583","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":"Voice Meets Swallowing: A Scoping Review of Therapeutic Connections.","authors":"Adrián Castillo-Allendes, Jeff Searl, José Vergara, Natalie Ballentine, Soud Ebdah, Anaïs Rameau, Eric J Hunter","doi":"10.1044/2024_AJSLP-24-00194","DOIUrl":"10.1044/2024_AJSLP-24-00194","url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review aimed to explore the use of volitional voice tasks in assessing swallowing-related outcomes and to evaluate their therapeutic impact on swallowing disorders, including their effects on swallowing biomechanics.</p><p><strong>Method: </strong>This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A literature search was performed across multiple databases (PubMed, Web of Science, and Scopus), and additional records were identified through manual searches. After screening and eligibility assessment, 36 studies were included for data extraction and analysis. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies was employed to evaluate the quality of the included studies.</p><p><strong>Results: </strong>The review identified various volitional voice tasks, such as maximum phonation time and pitch glides, as potential assessment tools for predicting swallowing-related outcomes. Additionally, voice tasks targeting pitch modulation, increased vocal loudness, and squeezed voice quality showed promising therapeutic benefits for swallowing disorders across different populations, especially individuals with neurological conditions and head and neck cancer.</p><p><strong>Conclusions: </strong>While methodological limitations were found in current literature, volitional voice tasks demonstrate potential as complementary tools for assessing and treating swallowing disorders, leveraging their interconnected neurological and biomechanical mechanisms underlying functions. Further research with more robust methodologies is needed to establish the efficacy of these integrated interventions, facilitate their translation into clinical practice, and test new possibilities.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"877-907"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Successful Surgical Treatment of Velopharyngeal Insufficiency Aid in the Remediation of Compensatory Misarticulation Errors?","authors":"Jessica L Chee-Williams, Kate Bunton, Elizabeth Alvarez-Montoya, Kelly Nett Cordero, Jamie L Perry, Jenny Philp, Davinder J Singh, Thomas J Sitzman","doi":"10.1044/2024_AJSLP-24-00349","DOIUrl":"10.1044/2024_AJSLP-24-00349","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate whether successful surgical management of velopharyngeal insufficiency (VPI) aids in the remediation of compensatory misarticulation errors (CMAs) among children with VPI and CMAs.</p><p><strong>Method: </strong>Fourteen participants with VPI and use of CMAs from a larger study were included in this retrospective cohort study. The mean age at the time of preoperative evaluation was 8.9 years (<i>SD</i> = 1.1). Perceptual ratings of hypernasality, phonetic transcription, and anatomic measurements from magnetic resonance imaging were performed by raters blinded to the participants' medical and surgical history. The mean percentage of CMAs produced on the American English Sentence Sample was calculated. The Wilcoxon signed-ranks test was used to compare the change in CMA use pre- and postoperatively. During the study period, 71% (<i>n</i> = 10) of participants received speech therapy.</p><p><strong>Results: </strong>Nine participants had resolved hypernasality after surgery, and five had persistent hypernasality. Among those with resolved hypernasality, the mean percentage of CMAs significantly decreased from 14.6% preoperatively to 1.1% postoperatively (<i>p</i> = .028). For participants with persistent hypernasality, the mean percentage of CMAs decreased from 27.6% to 22%; this change was not significant (<i>p</i> = .586).</p><p><strong>Conclusions: </strong>Correction of VPI may aid in the remediation of CMAs as participants have more normal anatomy to achieve velopharyngeal closure. These findings suggest correction of VPI may reduce the amount of speech therapy needed to treat CMAs.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"868-876"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Analysis of Therapist Documentation of Assessments of Orally Feeding Infants Who Require Noninvasive Respiratory Support.","authors":"Carolyn Barnes, Kit N Simpson, Janina Wilmskoetter, Heather McGhee, Keeley Nichols, Heather S Bonilha","doi":"10.1044/2024_AJSLP-24-00294","DOIUrl":"10.1044/2024_AJSLP-24-00294","url":null,"abstract":"<p><strong>Purpose: </strong>This is a qualitative analysis of speech-language pathology and occupational therapy documentation of bedside assessments of infants orally feeding on noninvasive respiratory support (NRS).</p><p><strong>Method: </strong>Data were extracted from speech-language pathology and occupational therapy electronic health record documentation of bedside feeding/swallowing assessment and treatment of infants on NRS. These data included the rate of documentation of objective metrics, as well as themes in feeding safety, quality, and therapeutic interventions.</p><p><strong>Results: </strong>Notes from 37 speech-language pathologist and occupational therapist bedside visits were included. Data on the amount of NRS during oral feeding were inconsistently documented, but reported flow rate ranged from 0.2 to 5.0 l per minute. Approximately 57% of notes indicated some type of overt feeding problem. Objective data were inconsistently documented, but common metrics included signs of possible aspiration (cough in 16.2% and congestion in 13.5% of notes), liquid viscosity (43.2% of notes), feeding modality (94.6% of notes), volume offered (56.8% of notes) and consumed (81.1% of notes), and feeding time (56.8% of notes). Documentation themes include assessment of both safety and quality, implied stability and success rather than explicit documentation of such, infrequent instrumental assessment referral, differences between assessment versus follow-up treatment notes, differences in structured/templated notes versus unstructured narratives, and missing data.</p><p><strong>Conclusions: </strong>Missing data limited our ability to draw conclusions regarding safety and quality of oral feeding during NRS use. We make recommendations for documentation, including prioritizing objective data, clarifying clinical interpretations, patient responses to interventions trialed, and use of structured narratives and flowcharting.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"446-457"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525065","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":"Response to Letter Regarding Cordray et al. (2023) and Brief Commentary on the Ankyloglossia Debate.","authors":"Holly Cordray, Casiel T Gethers, Geethanjeli N Mahendran, John Nemeth, Nikhila Raol","doi":"10.1044/2024_AJSLP-24-00413","DOIUrl":"10.1044/2024_AJSLP-24-00413","url":null,"abstract":"<p><strong>Purpose: </strong>Ankyloglossia (tongue tie) is common, and its clinical relevance is hotly debated among multidisciplinary health care providers including pediatricians, lactation consultants, otolaryngologists, and speech-language pathologists. The literature focuses on breastfeeding symptoms; less evidence exists to clarify the spectrum of possible symptoms after infancy. We conducted a scoping review of potentially related symptoms in pediatric patients who presented for clinical evaluation of untreated ankyloglossia, with the aim of mapping symptoms that providers may want to evaluate and identifying targets for further research. Kummer (2025) has alleged \"erroneous statements without evidence\" about \"the effect of ankyloglossia on speech,\" \"inaccurate citations,\" and \"errors of omission\" in our scoping review (pp. 982, 983). This letter provides a rebuttal of her statements.</p><p><strong>Results: </strong>Based on results from 20 primary studies, our review drew a provisional conclusion that ankyloglossia may be associated with speech difficulty in a subset of patients; we did not assert any causal relationship. Kummer took issue with a citation in one sentence of our review; we note that some of her concerns were inaccurate, though we appreciate her clinical expertise on speech sound production. The omissions she perceived were in fact present in our original review article.</p><p><strong>Conclusions: </strong>Kummer's letter does not warrant an erratum to our scoping review. However, her letter prompts us to urge the multidisciplinary community of providers involved in studying and caring for patients with ankyloglossia to engage in a collaborative and open-minded discussion. We must reduce professional antagonism around this controversy and work together on patient-centered research to support children whose experiences may not fit the typical clinical picture.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"985-988"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366322","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}