Ciara O'Toole | University College Cork (original) (raw)

Papers by Ciara O'Toole

Multilingual Matters eBooks, Dec 31, 2013

Purpose: Parent–child interaction therapy refers to a number of interventions mediated by trained... more Purpose: Parent–child interaction therapy refers to a number of interventions mediated by trained parents to treat developmental difficulties, including speech, language, and communication. Understanding the experiences of parents who take part in parent–child interaction therapy is a key aspect of determining how this intervention can be implemented successfully. However, to date, there has been limited work on synthesizing parental views of this intervention.Method: We used qualitative evidence synthesis that involved searching the literature for qualitative studies addressing the experiences and perceptions of parent–child interaction therapy for parents of preschool children with communication difficulties. We identified 27 studies (from 32 publications) and synthesized the data using thematic synthesis. We appraised the quality of included studies using Critical Appraisal Skills Programme (CASP) and assessed our confidence in the review findings using GRADE Confidence in the Evidence from Reviews of Qualitative research (CERQual).Results: At the beginning of this intervention, parents may have competing demands and varied expectations about the intervention. Their engagement is facilitated when the intervention is tailored to their individual family, their preferences for learning, and when they have a trusting relationship with the clinician. At the end of the intervention, although most parents perceive an improvement in their child’s communication and feel empowered to facilitate this, they have concerns about their child’s future needs.Conclusions: It is important that clinicians explore parents’ readiness for this intervention by discussing their needs and preferences openly, and that they facilitate their engagement through a supportive relationship. They also need to consider how parents will transition out of the intervention and continue to support their child’s language development.Supplemental Material S1. Sample search string for Scopus Database (searched February 4, 2021 = 482 results).Supplemental Material S2. Assessment of Methodological Limitations (CASP).Supplemental Material S3. GRADE CERQual Full Evidence ProfileSupplemental Material S4. Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist.O’Toole, C., Lyons, R., & Houghton, C. (2021). A qualitative evidence synthesis of parental experiences and perceptions of parent–child interaction therapy for preschool children with communication difficulties. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2021_JSLHR-20-00732

Journal of Multilingual and Multicultural Development, Feb 10, 2022

Clinical Linguistics & Phonetics, Jul 25, 2019

People with Down syndrome (DS) can experience difficulties with speech production that can impact... more People with Down syndrome (DS) can experience difficulties with speech production that can impact on speech intelligibility. In previous research, both perceptual and acoustic analysis has shown that people with DS can have difficulties with speech production in the areas of respiration, phonation, articulation, resonance and prosody. However, these studies have investigated various aspects of speech production separately. No study has examined all components of speech production in one single study and considered how these components, if impaired, may impact on speech intelligibility in DS. This paper presents the data of three male speakers with DS and three age-and gender-matched controls as a case series. The participants' speech samples were analysed using a number of perceptual and acoustic parameters, across the major components of speech productionrespiration, phonation, articulation, resonance, and prosody. Results showed that different areas of speech production were affected in each participant, to different extents. The main perceptual difficulties included poor voice quality, monopitch, and monoloudness. Acoustic findings showed a higher mean F0, lower harmonics-to-noise ratio and longer voice onset times. These preliminary findings show that people with DS can present with mixed profiles of speech production that can affect speech intelligibility. When assessing speech production in DS, clinicians need to evaluate all components of speech production and consider how they may be impacting intelligibility.

International Journal of Bilingualism, May 15, 2019

Aims and objectives: The aim of this study was to develop and pilot a test of receptive vocabular... more Aims and objectives: The aim of this study was to develop and pilot a test of receptive vocabulary for bilingual Irish-English-speaking children, based on a model from Welsh. Design/Methodology/Approach: 310 typically developing children aged five, six and seven years took part. The children were all attending Irish-medium education in Irish-dominant Gaeltacht regions and in immersion education schools outside of these regions. Data and Analysis: Participants were identified as being from either bilingual Irish-and Englishspeaking homes or English-dominant homes. A mixed-factorial analysis of variance found a significant main effect of age and language background, but no interaction. Post hoc comparisons revealed that those from Bilingual-speaking homes had significantly higher Irish receptive vocabulary scores than those from English-dominant homes. Linear regression models showed that the receptive vocabulary scores of children in immersion schools grew by an average of 21 words per year between the ages of five and seven, compared to almost 12 words per year in Gaeltacht schools. Findings/Conclusions: The findings demonstrate the advantages of immersion education and the need for vocabulary enrichment of children in the Gaeltacht. However, the complexities of developing assessments for first language speakers of a minority language that is in conflict with a second language variety of that language and the majority English language are also highlighted.

Springer eBooks, Nov 11, 2011

Learning styles are the preferred ways individuals have for processing knowledge. Problem-based L... more Learning styles are the preferred ways individuals have for processing knowledge. Problem-based Learning (PBL) might be perceived to suit the 'active' learner because of the brainstorming and group work involved. However, PBL is also intended for those who prefer to learn by researching the literature, those who seek to explore complex questions, and those who like to problem solve and apply knowledge to practice. This study profiled the learning styles of 30 speech and language therapy students in an undergraduate PBL curriculum using the Learning Styles Questionnaire (Honey & Mumford, 2000) and measured their styles repeatedly over a three-year period. The results indicated that students entered the course with a range of learning styles, although in general were not characterized as active learners. Following three years of PBLbased education, the students became significantly more active, although as a group remained largely reflective. Learning styles had both negative and positive associations with academic outcomes in a variety of courses over the three years. The implications for PBL and education are discussed.

Journal of clinical speech & language studies, Sep 1, 2008

Profiling bilingual and minority language acquisition is becoming increasingly important for the ... more Profiling bilingual and minority language acquisition is becoming increasingly important for the work of speech and language therapists in Ireland. The Official Language Act (2003) dictates that all government and public services must be provided in Irish as well as English. Therefore SLTs must now be prepared to assess and treat clients in the Irish language. This paper describes how an assessment of early expressive vocabulary and grammatical development for children aged between 16 and 40 months was adapted to Irish from the MacArthur-Bates Communicative Development Inventories (Fenson et al., 1994). Ongoing work in piloting and measuring the validity and reliability of the parent-report instrument is also outlined. This study has implications for developing assessment tools for working with Irish-speaking and bilingual children.

Radiography, 2020

Introduction: A videofluoroscopic swallowing study (VFSS) is a fluoroscopic examination conducted... more Introduction: A videofluoroscopic swallowing study (VFSS) is a fluoroscopic examination conducted by radiographers and speech-language therapists (SLTs) to assess dysphagia. Given the potential of SLTs to feed patients during the procedure, they may be exposed to radiation. The research aimed to assess radiation protection practices utilised by SLTs to determine if radiographers have a role in providing ongoing practical education. Methods: An online questionnaire was distributed to SLTs from six countries (

Child Language Teaching and Therapy, Oct 1, 2007

This study examined the impact of a training programme which aimed to support language-, literacy... more This study examined the impact of a training programme which aimed to support language-, literacy- and social-communication-promoting strategies for professionals working with children with language delay. Sixteen teachers, special needs assistants and therapists based in services for children with mild to severe learning difficulties attended workshops and took part in six video-feedback sessions from the Hanen `Learning Language and Loving It' Programme (Weitzman, 1992). Video analysis found that participants' language and social interaction skills significantly improved on most of the targeted skills. However, the majority of skills needed further development as indicated by a rating scale. There was also a significant improvement in how participants rated their skills in working with children with speech and language difficulties and in their attitudes towards their role in remediating speech and language difficulties. There was no significant change in their opinions towards collaborative working practices. The findings suggest that with appropriate training, allied education and health professionals can produce measurable changes in behaviour and attitudes towards implementing speech- and language-promoting strategies.

Routledge eBooks, Jul 9, 2019

Multilingual Matters eBooks, Dec 31, 2015

Original citation Gatt, D., O'Toole, C. and Haman, E. (2015) 'Using parent report to assess early... more Original citation Gatt, D., O'Toole, C. and Haman, E. (2015) 'Using parent report to assess early lexical production in children exposed to more than one

Multilingual Matters eBooks, Apr 28, 2015

Using parent report to assess early lexical production in children exposed to more than one

Multilingual Matters eBooks, 2013

International Journal of Language & Communication Disorders, Dec 31, 2022

BackgroundChildren with Down syndrome have speech and language difficulties that are disproportio... more BackgroundChildren with Down syndrome have speech and language difficulties that are disproportionate to their overall intellectual ability and relative strengths in the use of gesture. Shared book reading between parents and their children provides an effective context in which language development can be facilitated. However, children with Down syndrome often take a passive role in shared book reading and the use of key word signing (KWS) as a shared book reading technique has never been investigated.AimsThis study aimed to compare children with Down syndrome's participation and use of KWS across two methods of shared book reading – one in which a book had key‐word sign prompts embedded (signed condition) and the other in which a book was read as normal (unsigned condition). Measures of child and parent communicative behaviour were taken in each condition to establish if differences emerged.Methods & ProceduresA total of 36 children with Down syndrome (aged between 18 and 61 months) and their mothers took part in the study. Parent–child dyads were videoed at home reading two books, one in a signed and one in an unsigned condition. Child measures included total number of signs produced in each condition and levels of attention and initiation as measured by the Pivotal Behaviour Rating Scale. Parent measures included total number of utterances, mean length of utterance (MLU) in morphemes and vocabulary diversity (VOCD). Parental measures were transcribed using the Codes for Human Analysis Transcripts (CHAT) software and analysed by the Computerised Language Analysis software (CLAN). Contrasts in outcomes between the signed and unsigned conditions were estimated using Poisson and linear mixed‐effects models, determined by the type of data.Outcomes & ResultsResults showed that children attempted to sign significantly more in the signed than unsigned condition, as well as showing significant increases in their levels of attention and initiation. There was also a significant increase in the total number of utterances used by parents in the signed versus unsigned condition and a decrease in MLU. VOCD was similar in both conditions.Conclusions & ImplicationsThis study shows that the simple act of embedding key word signs into commercially available books, during shared book reading between parents and young children with Down syndrome, positively affects children's participation (initiation and attention) and use of KWS. The use of KWS as a core shared book reading technique may therefore be a fruitful avenue to facilitate growth in the language abilities of young children with Down syndrome.What this paper addsWhat is already known on this subjectMost children with Down syndrome have significant speech and language difficulties, with relative strengths in the use of gesture. Shared book reading is an activity reported to positively affect language. However, children with Down syndrome are reported to take a passive role in shared book reading and are therefore more dependent on their parents to use techniques that facilitate their levels of participation, in order to maximise potential benefits. To the best of our knowledge, the communicative effects of embedding key word signing (KWS) in shared book reading have never been examined with children with Down syndrome.What this paper adds to existing knowledgeThis is the first study to investigate the communicative impact of parents embedding KWS in a shared book reading activity with their young children with Down syndrome. Our findings show that this relatively simple manipulation resulted in Increase in children's sign attempts. Increase in children's overall participation in shared book reading (indicated by levels of attention and initiation). Increase in the number of utterances produced by parents (primarily as a result of repetitions). Decrease in parental mean length of utterance. These findings suggest that embedding KWS in shared book reading is likely to facilitate increased language abilities in this cohort.What are the potential or actual clinical implications of this work?Shared book reading is part of the daily routine for many parents and their children with Down syndrome. Integrating KWS is a relatively simple adaptation to this activity which is likely to enhance children's language skills. Therapists can encourage parents to do this at home to support work carried out at school and in a clinical setting.

International Journal of Speech-Language Pathology, Feb 1, 2023

International Journal of Language & Communication Disorders

Evaluation of the In-School and Early Years Therapy Support Demonstration Project, Research Report No. 28, Oct 1, 2020

The NCSE is pleased to publish the evaluation of the first year of the In-School and Early Years ... more The NCSE is pleased to publish the evaluation of the first year of the In-School and Early Years Therapy Support Demonstration Project. This innovative project involved the development and implementation of a speech and language and occupational therapeutic support model for mainstream schools, special schools and early years' settings. It saw a unique collaboration between the Departments of Health, Education and Children along with the HSE and the NCSE to collectively deliver therapeutic supports and build capacity in 75 schools and 75 early years' settings under a new model of provision. It was delivered by a team of 31 speech and language and occupational therapists, supported by clinical leads and therapy managers. In undertaking the evaluation, the researchers engaged with project staff and therapists, surveyed school principals, centre managers, teachers and early years' practitioners on the impact on the project. They also analysed goal data relating to the activities and targets set within each setting, and the extent to which they were achieved. They undertook further in-depth work in 20 schools and early years' settings where they spoke with students, parents and educators, and observed the model being implemented. The evaluation found a number of positive impacts arising from the first year. Educators reported that they had an increased ability to differentiate instruction as a result of therapists being in the setting. They also reported that the strategies and information they acquired during their work with therapists enabled them to identify needs, created more positive interactions with students/children, and notably resulted in more positive academic engagement by students/children. Participating students spoke positively about their experiences of the project, while parents noted the potential of the project to overcome waiting lists for therapy in the community, and the in-school nature of provision negating the need for children to be taken out of school to a clinic-based setting. The evaluation noted a number of challenges as well. There were significant delays in getting therapists in post and greater time than had been anticipated to ensure therapists were familiar with the requirements of an education environment. Therapists reported ongoing challenges arising from the management structure, including confusion over reporting lines and role clarity. Challenges were faced in the management and sharing of the large volume of data gathered across settings and different levels of the model. The NCSE welcomes the Government commitment to continue to provide in-school therapy supports as part of the 2020/2021 School Inclusion Model (SIM) and to extend and expand the SIM to two other pilot areas in 2021. This evaluation identified important lessons for us to consider in this expansion so that the delivery model can be improved. Fundamentally, the evaluation demonstrates the potential that delivering in-school therapy supports has for improving outcomes for students.

Journal of Clinical Speech and Language Studies, 2000

From the middle of the last century there has been an increased focus on quality of life issues f... more From the middle of the last century there has been an increased focus on quality of life issues for people with disabilities – that they should have every opportunity to live as normally as possible and that they should be valued no less than any of their peers. Part of these experiences involves integration, which is the process where children with and without special educational needs are educated together in the mainstream school. Of prime importance for the success of integration are the attitudes of the mainstream children involved. This paper presents the results of a study of mainstream Irish primary school children’s attitudes towards children with a learning disability and educational integration. The results of this survey suggest that integration practices do not always result in positive or realistic attitudes towards people with a learning disability.

Journal of Multilingual and Multicultural Development

Diagnosing specific language impairment (SLI) in monolingual children is a complex task, with som... more Diagnosing specific language impairment (SLI) in monolingual children is a complex task, with some controversy regarding criteria. Diagnosis of SLI in bilinguals is made more complex by the lack of standardized assessments and poor understanding of clinical markers in languages other than English. There is an added complexity when one of the languages being acquired is an endangered one, where the domains of use and input are restricted, and where input is affected by convergence with the majority language. This article explores the challenge facing speech and language therapists and psychologists in diagnosing SLI in bilingual children acquiring Irish and English. Six speech and language therapists and four psychologists took part in semi-structured interviews exploring the impact of the bilingual environment, the nature of bilingual language impairment, current practices and the needs of these children. Thematic analysis was carried out and here three of the main themes emerging i...