Content area

Abstract

Stimulability testing is a widespread and valued evaluation technique for voice-specialized speech-language pathologists. However, there is currently no research exploring how speech-language pathologists describe, think about, and perform stimulability testing. In this mixed-methods study, semistructured interviews were conducted with eight speech-language pathologists (four early-career, four late-career) to explore how each described stimulability testing and how it informed their clinical reasoning process. Each speech-language pathologist also performed stimulability testing trials on three adults without voice complaints, each followed by a second debrief interview. Semi-structured interviews were analyzed qualitatively using interpretative phenomenological analysis (IPA), and stimulability testing trials were specified using the Rehabilitation Treatment Specification System for Voice (RTSS-V). The alignment between each speech-language pathologist’s description of their stimulability testing process and their performance during each stimulability testing trial was also examined. Five Themes emerged from qualitative coding, as well as 147 descriptions of clinical practice, which together captured how and why the sampled clinicians performed stimulability testing, as well as the varied methods they used to measure stimulability level. Nine definitions of stimulability testing and 22 methods of measuring stimulability level were provided across clinicians, none of which were provided by consensus. Early-and late-career clinicians utilized similar amounts of unique voicing facilitators during stimulability testing trials, but early-career clinicians spent significantly more practice time at the nonspeech level and utilized a significantly higher amount of knowledge of performance feedback. The overall alignment between reported actions and processes for stimulability testing in initial interviews and observed actions and processes during stimulability testing trials was approximately 75%. Five methods of measuring stimulability level were provided following stimulability testing trials that had not been provided in the initial interviews, resulting in 27 total methods of measuring stimulability level suggested throughout the study. The results reveal valuable insight into the patterns of speech-language pathologists in how they define, describe, and utilize stimulability testing, and particularly the extreme variability in how stimulability level is determined. Lack of consistency between speech-language pathologists in measuring stimulability level limits the validity, reliability, and ultimately the utility of stimulability testing in both research and clinical practice.

Details

1010268
Title
How Voice-Specialized Speech-Language Pathologists Across the Experience Spectrum Describe and Perform Stimulability Testing: A Mixed-Methods Study
Number of pages
467
Publication year
2025
Degree date
2025
School code
0240
Source
DAI-A 87/3(E), Dissertation Abstracts International
ISBN
9798293840182
Committee member
Barkmeier-Kraemer, Julie M.; Roy, Nelson; Shembel, Adrianna; Ziegenfuss, Donna H.
University/institution
The University of Utah
Department
Communication Sciences and Disorders
University location
United States -- Utah
Degree
Ph.D.
Source type
Dissertation or Thesis
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
32120285
ProQuest document ID
3250852906
Document URL
https://www.proquest.com/dissertations-theses/how-voice-specialized-speech-language/docview/3250852906/se-2?accountid=208611
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Database
ProQuest One Academic