Journal of speech, language, and hearing research : JSLHR最新文献

{"title":"Modeling Depression as a Gradient Condition Using Acoustic Features of Mandarin Speech.","authors":"Shiyi Wang, Fenqi Wang, Delin Deng, Lin Zhou","doi":"10.1044/2026_JSLHR-26-00145","DOIUrl":"10.1044/2026_JSLHR-26-00145","url":null,"abstract":"<p><strong>Purpose: </strong>Depression is prevalent yet frequently underdiagnosed. Although speech-based detection methods show promise, most prior studies have emphasized binary classification in nontonal languages. This study examined whether acoustic features of spontaneous Mandarin speech reflect depression as a categorical condition or a continuous, dimensional construct.</p><p><strong>Method: </strong>A validated emotional Mandarin speech corpus paired with self-reported depression severity scores was analyzed. Acoustic features were extracted using the extended Geneva Minimalistic Acoustic Parameter Set. A multistage analytic framework was applied, including random forest classification to distinguish depressed from nondepressed clips, linear mixed-effects modeling to examine group and severity effects, and unsupervised clustering to examine latent structure in the acoustic feature space.</p><p><strong>Results: </strong>The random forest classifier achieved an accuracy of 72.3% and an area under the receiver operating characteristic curve of 0.826 on the held-out test set. Model performance favored sensitivity over precision in identifying depressed clips. SHapley Additive exPlanations analysis identified features across multiple acoustic domains, including spectral, pitch-related, voice quality, cepstral, and intensity measures, as important contributors to model predictions. Among the Top 10 features, no acoustic features showed statistically significant group differences. In contrast, median and mean fundamental frequencies were significantly positively associated with depression severity. Clustering analysis revealed overlapping group structures and a continuous distribution of severity scores across clusters.</p><p><strong>Conclusions: </strong>These findings provide preliminary support for a dimensional conceptualization of depression in spontaneous Mandarin speech. While classification models can distinguish depressed from nondepressed speech with moderate accuracy, acoustic features appear to vary more consistently with symptom severity than with diagnostic group. Speech-based measures may therefore have potential for continuous monitoring of depression, although this possibility requires further longitudinal verification.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4168-4182"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of Phonological Information to Lexical Access in School-Age Children With Cochlear Implants.","authors":"Bénédicte Grandon, Esther Ruigendijk","doi":"10.1044/2026_JSLHR-25-00750","DOIUrl":"10.1044/2026_JSLHR-25-00750","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores the interplay of phonological and lexical processing in children, focusing on whether German-speaking school-age children with cochlear implants (CIs) use phonological information for lexical access in the same way as their peers with typical hearing (TH). The study aimed at understanding how different phonological contrasts between a target and a phonological competitor affect lexical access when this acoustic information is less available, as is the case with CIs.</p><p><strong>Method: </strong>Using an eye-tracking visual-world paradigm, we hypothesized that lexical access would differ for the children with CIs due to their shorter hearing experience and/or the characteristics of the auditory input provided by the implants. We further hypothesized that processing the difference between a target and its phonological competitor would depend on the types and number of contrasting features available.</p><p><strong>Results: </strong>Our results show that (a) lexical access is slowed down in children with CIs when compared to their peers with TH, (b) not all phonological contrasts are used similarly in lexical access in both groups, and (c) individual factors do not explain these effects in this study.</p><p><strong>Conclusions: </strong>These results show that school-age children using CIs have a slower lexical access than their peers; that pattern is, however, not qualitatively different with regard to the phonological information. Lexical access is facilitated for all children when phonological neighbors are less closely related and when specific phonological features are present-such as voicing in consonants and the front-back dimension in vowels.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32988002.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4290-4307"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficient Language Sampling for Deaf and Hard of Hearing Children: Evaluating Reliability Across Length, Timing, and Context.","authors":"Meganne Muir, Adriana M Valtierra, Angie Walker, Julie Bustos, Jena McDaniel","doi":"10.1044/2026_JSLHR-25-00696","DOIUrl":"10.1044/2026_JSLHR-25-00696","url":null,"abstract":"<p><strong>Purpose: </strong>Given the time demands of language sample analysis, this study aimed to identify efficient, flexible sampling procedures that maintain strong reliability. We examine how language sample length in minutes, timing (i.e., beginning vs. later in the elicitation task following a warm-up period), and elicitation context (i.e., play or conversation) influence the reliability of four common language measures in young deaf and hard of hearing (DHH) children.</p><p><strong>Method: </strong>Participants included 21 DHH children (3-5 years old) who completed 10-min play and conversation samples in English. Samples were transcribed and analyzed for mean length of utterance in words, mean length of utterance in morphemes, total number of words per minute, and number of different words per minute. We evaluated the reliability of these measures by comparing shorter segments (i.e., 1, 3, 5, and 7 min) to the full sample using Cronbach's alpha, with additional comparisons based on the sample's timing and elicitation context.</p><p><strong>Results: </strong>Language samples with durations of 3, 5, and 7 min yielded strong reliability across all measures. Timing and elicitation context had minimal impact overall, particularly when sample length was sufficient.</p><p><strong>Conclusions: </strong>The findings support the use of samples as short as 3 min as a reliable and time-efficient approach to language sample analysis in DHH preschoolers. Results also challenge the assumption that a \"warm-up\" period is necessary before sampling, suggesting that reliable measurement can begin as soon as the elicitation task begins.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32978336.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4427-4435"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Lexical Stress, Lexical Type, and Voicing Context on Symptom Expression in Individuals With Adductor Laryngeal Dystonia.","authors":"Evangeline Yeh, Katherine L Marks, Taylor Feaster, Cara Sauder, Laura E Toles, Lauren F Tracy, J Pieter Noordzij, Gregory A Grillone, Ted Mau, John Paul Giliberto, Tanya K Meyer, Albert L Merati, Tanya L Eadie, Cara E Stepp, Saul A Frankford","doi":"10.1044/2026_JSLHR-25-00883","DOIUrl":"10.1044/2026_JSLHR-25-00883","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the effects of lexical stress, voicing context, and lexical type on voice symptoms in individuals with adductor laryngeal dystonia (AdLD).</p><p><strong>Method: </strong>Forty-eight individuals with AdLD produced sentences containing a balanced set of words that varied across the linguistic factors of onset voicing, lexical stress, and lexical type. AdLD symptoms (frequency shifts, creaky voice, and voicing breaks) were then identified from the speech acoustics and compared across these factors. An exploratory analysis was performed on recordings from 22 age- and sex-matched controls with the same procedure to assess whether significant effects identified in speakers with AdLD were specific to AdLD.</p><p><strong>Results: </strong>Stress and onset voicing had an overall significant effect on symptom expression-that is, stressed syllables elicited more AdLD symptoms than unstressed syllables and syllables beginning with a vowel elicited more symptoms than syllables beginning with an unvoiced consonant. Furthermore, within voiceless consonant-initial syllables, stressed syllables were more likely to elicit AdLD symptoms than unstressed syllables. With respect to lexical type, within unstressed syllables, content words were less likely to contain symptoms than function words. In controls, there were significant effects of onset voicing and an interaction between stress and lexical type but no interaction between stress and voicing context.</p><p><strong>Conclusions: </strong>These findings support the well-known effects of voicing onset on symptom elicitation in AdLD and clarify the effects of other linguistic factors such as lexical type and stress. Taken together with previous literature, this work has the potential to advance understanding of the causal mechanisms of task specificity in AdLD.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33050387.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4056-4068"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Submental Neuromuscular Activity of Swallowing Rehabilitation: An Electromyographic Evaluation of Rehabilitative Maneuvers in Healthy Adults.","authors":"Ching-Hsuan Peng, Macy R Griffis, Arica Rusco, Kevin L Berry, William G Pearson, Bruce A Craig, Georgia A Malandraki","doi":"10.1044/2026_JSLHR-25-00829","DOIUrl":"10.1044/2026_JSLHR-25-00829","url":null,"abstract":"<p><strong>Purpose: </strong>The effortful swallow (ES), the Mendelsohn maneuver (MM), and isometric tongue presses (TPs) are widely used swallowing maneuvers/exercises to improve elements of swallowing, such as muscle strength and biomechanics. However, the underlying neuromuscular mechanisms of these exercises remain unclear, potentially limiting our ability to specify treatment targets and improve treatment efficacy. This study aimed to compare submental neuromuscular activation patterns during the ES, MM, TPs, and typical swallows in healthy young and older adults.</p><p><strong>Method: </strong>As part of a larger randomized crossover validation study, 60 healthy adults (30 young and 30 older) completed typical swallows and three maneuvers using a wearable submental surface electromyographic (sEMG) system (i-Phagia). Outcome variables included (a) normalized mean sEMG amplitude and (b) time to peak sEMG amplitude. Linear mixed models were used to examine effects of task, age, and sex on both outcomes.</p><p><strong>Results: </strong>Normalized mean amplitude was significantly different across tasks. Post hoc pairwise comparisons confirmed that all three maneuvers produced higher normalized mean sEMG amplitude than typical swallows, with the ES eliciting the highest amplitude across age groups. Time to peak amplitude differed significantly across tasks, with typical swallows requiring the shortest time to reach peak amplitude, followed by the ES, MM, and TP.</p><p><strong>Conclusions: </strong>The ES required the highest neuromuscular effort with the shortest time to reach peak amplitude, suggesting its potential for targeting submental muscle power. Typical swallows required the least neuromuscular effort with the shortest time to reach peak amplitude, suggesting their potential for training submental muscle speed. The MM and TP may also improve submental muscle strength; however, given their temporal requirements (longer durations), they may be more beneficial for targeting coordination and endurance, though more research in this area is warranted. These findings underscore the importance of task-specific neuromuscular profiling to inform mechanism-based swallowing rehabilitation.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32948549.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4042-4055"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Word Learning With and Without Retrieval Practice in Children With Developmental Language Disorder.","authors":"Laurence B Leonard, Sharon L Christ, Jeffrey D Karpicke, Patricia Deevy, Justin B Kueser, Sofía Souto, Eileen Haebig","doi":"10.1044/2026_JSLHR-25-00595","DOIUrl":"10.1044/2026_JSLHR-25-00595","url":null,"abstract":"<p><strong>Purpose: </strong>Both children with developmental language disorder (DLD) and their peers with typical language development (TD) vary in their response to word learning activities, even when a consistent procedure is used. In this study, we examine child factors that might help explain this variation in outcomes and whether any interaction between these factors operates in the same way as a function of whether retrieval practice is included in the word learning procedure.</p><p><strong>Method: </strong>We examined the relations between a common set of child factors and children's responses in five previously published novel word learning studies with similar procedures. Participants were 4- and 5-year-old English-speaking children with DLD and their same-age peers with TD. Factors included scores on standardized language and nonverbal intelligence tests, nonword repetition, maternal education, age, and group status (TD, DLD). The role of each factor was examined while controlling for the other factors.</p><p><strong>Results: </strong>With all other factors controlled, age proved to be predictive of children's novel word learning. Nonword repetition was also predictive, though it interacted with age. Findings indicated that for children with DLD, increases in novel word learning for older children were less likely when nonword repetition ability was low. The disadvantage of weak nonword repetition ability was also apparent in learning conditions that lacked opportunities for retrieval. When retrieval practice was included, gains with age were less dependent on nonword repetition ability.</p><p><strong>Conclusions: </strong>For preschoolers with DLD and especially those with weak nonword repetition skills, including retrieval practice in the experimental procedure provided additional benefit. If future studies reveal that these findings apply as well to the clinical setting, the inclusion of retrieval practice during vocabulary intervention might help children avert a period of especially slow word learning.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32914790.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4268-4289"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Auditory Perception of Masculinity and Naturalness in Transmasculine Voices.","authors":"Robert Brinton Fujiki, Caitlin K Croegaert-Koch, Susan L Thibeault","doi":"10.1044/2026_JSLHR-25-00971","DOIUrl":"10.1044/2026_JSLHR-25-00971","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined speaker- and listener-related factors that influence auditory perception of masculinity, naturalness, and gender attribution in transmasculine voices on hormone replacement therapy and in cisgender speakers.</p><p><strong>Method: </strong>Voice recordings were collected from six transmasculine and 12 age-matched cisgender individuals. One hundred five listeners of varying age, sexual orientation, and gender identity rated voices for masculinity and naturalness as well as attributed a gender to each voice. Speaker- and listener-related predictors of voice ratings were examined. Speaker-related factors included speaker gender, acoustic measures of voice quality, and self-report of vocal function. Acoustic measures included fundamental frequency (<i>F</i>0), smoothed cepstral peak prominence, <i>F</i>0 range, Dysphonia Severity Index, and perturbation measures. Self-perceptual measures included speaker ratings of their own voice's masculinity/femininity and naturalness, as well as the Voice Handicap Index (VHI). Listener-related factors included age, gender, and sexual orientation.</p><p><strong>Results: </strong>Ratings of voice naturalness and masculinity were predicted by <i>F</i>0 on connected speech (<i>p</i> < .01). Masculinity was negatively associated with <i>F</i>0 (<i>r</i> = .79), and naturalness significantly increased when <i>F</i>0 was within normative range for cisgender speakers (<i>p</i> < .01). Ratings of naturalness differed across generational groups as older listeners rated transmasculine voices as significantly less natural than cisgender voices (<i>p</i> < .01). For transmasculine voices, listener age moderated the relationship between masculinity and naturalness, as these parameters were more strongly associated for older listeners (<i>r</i> = .41) and less so for younger listeners (<i>r</i> = .18-.23). Transmasculine speakers were 21% more likely to be misgendered than cisgender speakers (<i>p</i> < .01). Transmasculine voices were acoustically similar to cismale voices; however, VHI scores were significantly higher in transmasculine participants (<i>p</i> < .01).</p><p><strong>Conclusions: </strong>Although transmasculine and cis male voices were acoustically similar, both speakers and listeners rated transmasculine voices as less masculine and less natural than cis male voices. Listener age influenced the perception of voice naturalness. Future research may examine how gender-affirming voice therapy can best meet the needs of transmasculine speakers.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4084-4099"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Speaking Rate and Sentence Context on Comprehension and Recognition Memory of Degraded Speech.","authors":"Tirth R Patel, Victoria A Sevich, Xiaoke Feng, Liping Du, Terrin N Tamati","doi":"10.1044/2026_JSLHR-25-00491","DOIUrl":"10.1044/2026_JSLHR-25-00491","url":null,"abstract":"<p><strong>Purpose: </strong>Variability in speaking rate and sentence context affects the cognitive processing of speech. Individuals relying on a degraded speech signal may be particularly susceptible to these effects. In this study, we examine how artificial alterations to speaking rates and sentence context affect sentence comprehension and recognition memory for cochlear implant (CI) users and normal-hearing (NH) adults presented with spectrally degraded speech.</p><p><strong>Method: </strong>Thirty-seven adult CI users and 71 NH adults participated in the study. Participants completed a sentence verification task paired with a recognition memory task consisting of sentences with artificially manipulated speaking rates and variable sentence context. The sentences presented to NH adults were vocoder processed to simulate CI hearing. Accuracy and response times (RTs) from both the sentence verification task and the sentence recognition memory task were assessed. Logistic and ordinal regression models were constructed to assess the effects of speaking rate and sentence context on the participants' performance.</p><p><strong>Results: </strong>On the sentence verification task, slow sentences had a greater accuracy of sentence comprehension and faster RTs compared to fast sentences, particularly more so for low-context sentences. On the recognition memory task, slow sentences had a greater accuracy of sentence recognition and faster RTs compared to fast sentences. However, the effect of context was less pronounced and actually favored low-context sentences. CI users and older listeners, regardless of hearing status, showed lower overall accuracy and slower RTs.</p><p><strong>Conclusions: </strong>Speaking rate and sentence context impact sentence comprehension and recognition memory for spectrally degraded speech. Slower speech facilitates processing, especially when contextual support is limited. CI users and older listeners showed slower and more effortful processing. These findings may highlight the importance of speaking rate in effective communication strategies and support theoretical approaches linking increased cognitive effort to the perception of spectrally degraded speech.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33179354.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4526-4542"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural Processing of Phoneme Changes: Differences Between Children and Adults.","authors":"Jinghan Liang, Xiuhong Tong","doi":"10.1044/2026_JSLHR-25-00900","DOIUrl":"https://doi.org/10.1044/2026_JSLHR-25-00900","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined neural differences in processing of phoneme changes between 5- and 6-year-old Chinese-English bilingual young children and adults using a passive oddball task and event-related potentials.</p><p><strong>Method: </strong>Natural speech stimuli with digital refinement were used. Two syllables differing in vowels were manipulated: /da/ (the standard) and /di/ (the deviant).</p><p><strong>Results: </strong>The mismatch negativity (MMN) and P3a were elicited by /di/ relative to /da/ in both the young child and adult groups. However, young children showed a reduced MMN, indicated by smaller mean amplitudes and later peak latencies, compared with adults, although peak-amplitude differences were not statistically significant. Young children also exhibited a significantly enhanced P3a (both mean amplitude and peak amplitude) alongside a delayed peak latency relative to adults. Notably, young children elicited a robust late mismatch response, manifesting as a significant positivity, whereas adults showed no significant response.</p><p><strong>Conclusion: </strong>These findings indicate maturational differences in early auditory change detection and involuntary attention orienting during phoneme processing.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33416941.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed-Methods Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Study of Implementation Outcomes of the Childhood Dysphagia Management Scale (CDMS): Part 1 of a CDMS Hybrid Effectiveness-Implementation Study.","authors":"Jennifer Maybee, Emily DeBoer, Emily Meneses, John T Brinton, Juliana G Barnard, Jeremy Prager, Arwen Jackson","doi":"10.1044/2026_JSLHR-25-00823","DOIUrl":"10.1044/2026_JSLHR-25-00823","url":null,"abstract":"<p><strong>Purpose: </strong>The Childhood Dysphagia Management Scale (CDMS) is a validated outcomes measure completed by evaluating therapists following instrumental swallow assessments to determine the level of follow-up care needed for children with dysphagia. We assessed the implementation outcomes of the CDMS to evaluate its readiness to be scaled out.</p><p><strong>Method: </strong>The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) implementation science framework informed our explanatory sequential mixed-methods design. CDMS implementation outcomes were tested in a single tertiary-care children's hospital with five sites. <i>Quantitatively</i>, completion (number of CDMS completed/number of possible) was measured across all possible instrumental swallow assessments over a 30-month period (<i>N</i> = 4,829), compared across sites and settings (inpatient vs. outpatient), measured longitudinally, and evaluated using linear mixed models across sociodemographic variables. <i>Qualitatively</i>, therapists (<i>n</i> = 35) and referring providers (<i>n</i> = 17) participated in surveys, focus groups, and semistructured interviews. Qualitative data were analyzed and integrated with quantitative findings.</p><p><strong>Results: </strong>By RE-AIM domain, CDMS completion was not significantly associated with any patient sociodemographic factor outside of age, showing effective <i>reach</i> across patient-level factors. <i>Effectiveness</i> outcomes are reported on in a separate article (Part 2). Variability in CDMS completion was observed across the five sites and inpatient versus outpatient settings, suggesting that <i>adoption</i> was influenced by site of care. The CDMS was completed in 4,456 (92.3%) instrumental swallow assessments, demonstrating strong <i>implementation</i> across the hospital system. Surveys and qualitative interviews revealed that workflow integration and short CDMS scoring time supported high completion rates. Lower completion rates in some sites/settings were explained by inpatient characteristics and barriers to dissemination to local providers. Over 30 months, completion rates ranged from 77.1% to 92.8% across the hospital system, indicating strong <i>maintenance</i>.</p><p><strong>Conclusion: </strong>CDMS implementation outcomes across a five-site pediatric hospital system indicate that this validated outcomes measure for instrumental swallow assessments can be implemented, adopted, and sustained, demonstrating its readiness for widespread diffusion.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32942303.</p>","PeriodicalId":520690,"journal":{"name":"Journal of speech, language, and hearing research : JSLHR","volume":" ","pages":"4183-4199"},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}