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October 2021 Edition (06)<\/p>\n
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Stefano Rezzonico Ph.D.<\/a><\/p>\n Assistant professor, School of Speech-Language Pathology and Audiology, Universit\u00e9 de Montr\u00e9al<\/em><\/p>\n Researcher, CRIR\u2013Institut universitaire sur la r\u00e9adaptation en d\u00e9ficience physique de Montr\u00e9al <\/em>(IURDPM), Laurier Pavilion, CIUSSS du Centre-Sud-de-l’\u00cele-de-Montr\u00e9al<\/em><\/p>\n <\/p>\n CLEA Laboratory \u2014 Communication and Language in Children and Adolescents<\/a><\/strong><\/p>\n <\/p>\n <\/p>\n Yes! \u201cMegaphone\u201d is a clinical group program of 8 adolescents with communication disorders, 1 speech-language pathologist and 1 social worker. The goal of the program is to use artistic activities \u2013 film in this cohort \u2013 to help improve communication skills in the adolescents with communication disorders. For 8 weeks (2.5 hours once a week), the group met up in person, discussed what types of films they liked and wanted to make, wrote a script, filmed and edited a short movie. As for the research component, we added 2 more weeks to the program (1 at the beginning and 1 at the end, for a total of 10 weeks) in order to add some questionnaires evaluating their language use as well as social anxiety. We also placed two cameras in the room to record and observe what went on during the sessions.<\/p>\n The group program itself was not my idea. In this particular case, I actually saw it at the IURDPM Carrefour de connaissances<\/a>! It\u2019s a program that already existed in the Adolescent and Young Adult Program at the Institut Raymond-Dewar<\/em> (IRD)<\/a> and Jessica Swallert, a speech-language pathologist was presenting a poster and I told her \u201cWow! This is exactly what I\u2019m interested in as a researcher, the pragmatic side, can we collaborate?\u201d. So, we applied to CRIR\u2019s New Initiatives program<\/a> and once we received the grant we started a new cohort where I was able to add in research evaluations around language and social anxiety.<\/p>\n Megaphone was a pilot for many things and a pioneer in many ways. There is not much data or many tools in the literature for understanding how language functions in adolescents, so one of our major questions was precisely, how do we evaluate language in adolescents with communication disorders?<\/p>\n Adolescents are a bit left out when we talk about communication skills in the literature. For example, in an international conference on the development of language, you\u2019ll see roughly 60% of presentations about children under 5 years old, 40% about elementary school age, and then only 4 presentations on adolescence. A lot of research and clinical tools are validated for up until 16 years old and the ones that start at 16 years are more for individuals who have had a stroke or a traumatic brain injury. But what about from a developmental perspective? It\u2019s not the same thing. In that respect, Megaphone was very interesting because we had to develop tools on-the-go to evaluate things like communication, interaction, etc. This actually gave way for a bigger theoretical project funded by the Social Sciences and Humanities Research Council (SSHRC)<\/a> which is underway as we speak.<\/p>\n There were two major things got us excited. First, was in regards to social anxiety and the avoidance of certain communication situations. For some adolescents, at pre-test they told us they didn\u2019t avoid communication situations and then at post-test they said they did. But let me explain, I don\u2019t think it was the intervention that made them avoid situations, I think it just made them realize they were avoiding them. For example, in a pre-test questionnaire they would say \u201cyes\u201d to \u2018does this situation make you scared?\u2019 and \u201cno\u201d to \u2018do you avoid it?\u2019 but then post-test it became \u201cyes, it scares me\u201d and \u201cyes, I avoid it\u201d. I think the intervention gave them a better awareness of how they manage their anxiety and that was something we didn\u2019t expect.<\/p>\n The second thing was the power of the pauses. Over the 2.5 hours at some point, they would take a little pause, eat some chips, talk a little, etc., and it was in these pauses where they put in practice their objectives. Each person had their own mini objective for the day, for example, \u2018talk to 3 people\u2019 or \u2018ask someone what their favourite film is\u2019, and it was in the pauses where they completed those tasks. This was exciting because the clinicians hadn\u2019t originally planned the pauses in their program so moving forward it\u2019s definitely an element to maintain and spawned numerous questions to research further!<\/p>\n I\u2019m a non-clinician researcher, so it\u2019s really clear to me that my role is to look for the literature, bring evaluation instruments to the table, brainstorm for the methodology and how to validate and measure things, do the statistics, etc. But I don\u2019t have the impression that the clinical interventions belong to me, I\u2019m not the one who intervenes with the children. It\u2019s like I am a hammer builder but not a carpenter; I build the hammer and then you use the hammer to make your house as you wish. Similarly, it\u2019s not my job to tell people how to intervene, but I am here to help so that we can evaluate together with an objective eye. This is where the collaboration is extremely fruitful. Clinicians have a very developed antenna; they know a lot of things and in this case, they\u2019re probably a bit ahead of the literature. I feel lucky as a researcher to be able to study this because I feel like it\u2019s coming out of years of practice. With that being said, I\u2019m more detached emotionally so it\u2019s also a little easier to say \u201clisten, it didn\u2019t work\u201d if need be, but I think they\u2019re all good programs and projects or else I wouldn\u2019t be spending my time on it.<\/p>\n We are actually currently starting up a new project in collaboration with clinicians, also funded by New Initiatives, where we will be evaluating the \u201cJe me raconte<\/em>\u201d intervention in the Language and Auditory Processing Disorder program at the IRD. The intervention has been offered for roughly 10 years now for children between 7 and 12 years old with the goal of facilitating and encouraging their storytelling abilities. I\u2019m collaborating with Elin Thordadottir, Ph.D.<\/a> and with the help of the Clinical Research Coordinator, Patrizia Mazzocca<\/a>, we spoke to the program director a couple years ago about our respective interests and now, here we are with a research project we are all engaged in. So, to come back to your question, I regularly work with clinicians and I love it!<\/p>\n Absolutely. With \u201cJe me raconte<\/em>\u201d we are working with parent-child dyads so parents will be participants as well. But even if they are not formal participants, they can have a strong influence on our work. For example, in Megaphone an adolescent mentioned at post-test that their mother noted their speech was getting better. It seems anecdotal but it\u2019s really making us think of the importance of parents\u2019 perceptions on the confidence and progress of our participants and how best to evaluate that. Parents can also influence recruitment. Many parents tell us \u201cMy child needs this and it\u2019s not a group that can provide it\u201d but you\u2019d be surprised how much a group intervention can have individualized benefits. The Megaphone group allows them to practice with others who are their age; to be confronted by other adolescents, to help them and to be helped by them, to observe how others work through their difficulties, etc. The quality of a group intervention is not lower just because it\u2019s cheaper.<\/p>\n Megaphone launched about a million new questions and the pandemic launched hundreds more! Questions like, how does the intervention change if it were to take place online? What about a video gaming intervention for adolescents? Would virtual reality increase engagement and participation in the program? Could this program take place in a community setting? Could it transfer easily to other speech and language pathologists in another CIUSSS? Do the adolescents stay in contact after the program has ended? Currently, it\u2019s all in French but could we imagine a bilingual group? Or a group with more attention to cultural diversity? How can we have a partnership with the school system?<\/p>\n <\/p>\n We\u2019ll be continuing to do more pilot projects to further define these research avenues and then hopefully get some larger grants for larger cohorts that can have a greater effect on the literature!<\/p>\n <\/p>\n Our social system is based on the fact that we communicate. A society exists because of communication. To be a citizen, you need to be able to communicate. For example, to have an active life, to have a life partner, to work, to vote, it pretty much all happens around communication. Communication really is key! So, I think it\u2019s our responsibility as a society to create an inclusive, safe, and supportive communicational environment which allows everyone to express themselves and participate.<\/p>\n Stefano, thank you so much! It\u2019s been a great pleasure learning more about this incredible research and I can\u2019t wait to see how things advance. Best of luck in your continuation!<\/strong><\/p>\n Interview and text:\u00a0Alida Esmail<\/strong>,\u00a0Coordinator\u2014Partnerships and Knowledge Mobilization<\/em>, CRIR at:\u00a0partenariat.crir@ssss.gouv.qc.ca<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":" October 2021 Edition (06) Communication is Key: Improving Participation for Adolescents with Communication Disorders AN INTERVIEW SUMMARY WITH Stefano Rezzonico Stefano Rezzonico Ph.D. Assistant professor, School of Speech-Language Pathology and Audiology, Universit\u00e9 de Montr\u00e9al Researcher, CRIR\u2013Institut universitaire sur la r\u00e9adaptation…Let\u2019s jump right in! Tell me the story of the project \u201cMegaphone\u201d \u2026<\/h4>\n
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Where did the idea for this project come from?<\/h4>\n
What was your biggest challenge?<\/h4>\n
What surprised you the most about the results of Megaphone?<\/h4>\n
It seems like your collaboration with clinicians is a key component of this project. Do you always collaborate with clinicians?<\/h4>\n
Given that you work with minors, can I assume that parents are also a large part of your work?<\/h4>\n
Talk to me about the future\u2026where are these projects taking you next?<\/h4>\n
Wow. You certainly have your work cut out for you! Is there anything else you\u2019d like to share today?<\/h4>\n
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