Sudhin Karuppali

Shared book reading (SBR) is an evidence-based approach that promotes language and emergent literacy development. Though widely studied globally, research from India remains limited and has largely concentrated on typically developing children. This study aimed to develop a structured SBR intervention module for Malayalam-speaking children (3–5 years) with language disorders using a three-round Delphi survey with 20 experienced speech-language pathologists. Experts provided input on training mode, frequency, book selection, emergent literacy domains, and fidelity measures. Consensus supported in-person training with 12 sessions delivered twice weekly, and the combined use of logbooks and video recordings to ensure the fidelity of implementation. Culturally relevant storybooks with rich illustrations and minimal text were preferred. Target areas included print conventions, word and letter discrimination, rhyme, and word awareness. The finalized SBR module integrates dialogic reading, print referencing, and phonological awareness strategies, offering a culturally adapted early intervention model for children with language disorders in India.

Purpose: This study examined the prevalence of swallowing-related fatigue in individuals with stroke and its association with self-perceived swallowing difficulties. It also explored differences across stroke phases, lesion sites, and severity levels, and examined the association between the Swallowing and Eating-Related Fatigue Scale (SERF) scores and self-reported dysphagia risk (Eating Assessment Tool [EAT-10], Dysphagia Handicap Index [DHI]). Method: A cross-sectional study was conducted with 170 poststroke adults (120 men, 50 women) recruited at a tertiary care hospital. Participants were categorized into early subacute, late subacute, and chronic phases. Stroke severity was measured using the National Institutes of Health Stroke Scale, and lesion site was determined from radiological reports. Swallowing fatigue was assessed using the SERF scale, general fatigue with the Fatigue Severity Scale, and self-reported swallowing difficulties with the EAT-10 and DHI. Analyses included chi-square test, Spearman correlations, Kruskal–Wallis with post hoc comparisons, and logistic regression. Results: Swallowing-related fatigue was most prevalent in the early subacute phase (92%), among individuals with brainstem lesions (84%), and in those with greater stroke severity (72.7%). SERF scores strongly correlated with EAT-10 and DHI, indicating an association with both functional swallowing impairments and psychosocial handicap. Logistic regression identified stroke phase as a significant predictor, with lower prevalence in later phases. Conclusions: Swallowing-related fatigue emerges as a notable and unique complication of stroke, especially prominent in early recovery and among individuals with brainstem involvement. Incorporating the SERF scale into routine assessment may enable early identification of patients at risk of reduced mealtime endurance and guide targeted rehabilitation.

The implementation of Augmentative and Alternative Communication (AAC) systems for individuals with nonverbal Autism Spectrum Disorder (nvASD) remains highly debated, especially in a multilingual and multicultural country like India. Existing AAC guidelines are largely Western-based and may not be fully applicable in the Indian context. This study explored the perspectives of Indian Speech-Language Pathologists (SLPs) on AAC implementation in individuals with nvASD. A cross-sectional study was conducted in two phases. Phase 1 involved developing and validating a questionnaire assessing SLP’s practices and attitudes towards AAC. In phase 2, the validated questionnaire was administered online to 93 Indian SLPs (29.23 years of mean age, 71% female) represented diverse clinical, educational, and academic settings. The survey explored key parameters, including AAC candidacy, cultural and linguistic adaptation, AAC selection and customization, interdisciplinary collaboration and caregiver involvement, outcome based evaluation practices, speech-AAC integration, and barriers to AAC implementation. Most SLPs emphasized working on communication prerequisites before introducing AAC. Vocabulary selection was prioritized over partner training. AAC was primarily used for both intervention and communication, employing goal-oriented approaches alongside other speech and language strategies. Challenges included lack of resources, inadequate training, and limited interdisciplinary collaboration. Parental involvement and caregiver feedback were identified as critical to success. SLPs in India broadly recognize AAC as a valuable tool for individuals with nvASD but report facing multiple systemic and practical challenges to its implementation. The findings underscore the need for culturally and contextually relevant AAC guidelines, targeted clinician training, and supportive policy measures to improve access and long-term communication outcomes in Indian settings.

Background Primiparous mothers face diverse challenges during pregnancy and post-childbirth. There is limited data on the effectiveness of postnatal educational programs for new mothers (Subramanian et al., 2020). This study aimed to assess the efficacy of an educational program designed to improve primiparous mothers’ attitudes toward newborn communication, general health, feeding, and swallowing. The objectives were (1) to develop an attitude questionnaire (AQ), a parent education program [Newborn Communication, Health, Feeding and Swallowing Education Program (N-CHFSEP)], and a feedback questionnaire (FQ); and (2) to estimate the efficacy of N-CHFSEP pre- and post-delivery. The research, conducted between August 2023 and February 2024, involved 98 primiparous mothers who gave birth to healthy newborns through any delivery method. Participants were proficient in English or Kannada. The study excluded mothers delivering multiples, those with significant medical or psychological issues, and health professionals. Methods The study had two phases: Phase 1 developed and validated the AQ, N-CHFSEP, and FQ. N-CHFSEP covered key topics, including milestones in communication, feeding, and general health from birth to 6 months. Phase 2 administered these tools to participants. The data was analyzed using descriptive statistics, paired t-tests, and chi-square tests. Results 93% of mothers reported increased confidence in recognizing communication, feeding, and health-related signs in their infants after completing the program. This change was statistically significant (p < 0.05). Sociodemographic factors like maternal age, education, occupation, and family type significantly influenced confidence levels. Feedback from participants highlighted the program’s effectiveness in enhancing knowledge, with suggestions for improvements. Conclusions N-CHFSEP significantly boosted mothers’ confidence in newborn care, contributing to better maternal and infant health. However, the study lacked a control group, and the effectiveness was evaluated only immediately after the program. Future research could incorporate practical demonstrations and hands-on training to further enhance the program’s impact.

Background Pragmatic language assessment in children is performed in line with standard protocols, guidelines, and best practices. The absence of these aspects in the Indian context has resulted in the quest to explore the approaches used by speech-language pathologists (SLPs) to assess pragmatic language impairments. This survey explored the current practices of SLPs towards the assessment of pragmatic language among preschool children in India. It also aimed to identify the barriers, facilitators and identify the level of knowledge, skill and overall practice of SLPs towards their practices using self-appraisal. Methods A total of 100 SLPs(94 females and 6 males) working with preschool aged children (three-to-six-year-olds) from across different Indian states participated in the survey. Participants were enquired about the aspects of pragmatic language assessed, methods used for assessment, awareness and use of Indian tools, the settings, members, and language used for the assessment. Additionally, they were asked to mention the specific tools used, informal methods used, barriers and facilitators, and self-appraise their knowledge, skill and overall practice. Results Majority of participants assessed multiple aspects of pragmatic language. All used a combination of different assessment methods, with the participants commonly using informal compared to formal approaches. Preschoolers were assessed at multiple settings, along with different communication partners. Lack of awareness on assessment tools developed in India was the major barrier, while the use of informal tasks or activities were the major facilitators influencing pragmatic language assessment to a greater extent. The knowledge and skills for the assessment of pragmatic language obtained poorer scores compared to practices. Conclusions The assessment practices of the SLPs were largely influenced by the unavailability of developed or adapted tools for Indian preschoolers, leading to the need to develop indigenous assessment tools. Certain considerations for further assessment practices have been identified and discussed.

Background Primiparous mothers face diverse challenges during pregnancy and post-childbirth. There is a lack of comprehensive educational programs for primiparous mothers on maternal functioning and newborn care. This study aimed to explore the efficacy of a developed educational program on the attitude of primiparous mothers towards newborn communication, general health, feeding and swallowing. The objectives were (1) to develop an attitude questionnaire (AQ), a parent education program, and a feedback questionnaire (FQ); and (2) to estimate the efficacy of the education program pre- and post-delivery. Methods Ninety-eight primiparous mothers without any obstetric history, proficient in English or Kannada, and delivering healthy newborns were recruited for the study. Phase 1 involved the development and validation of AQ, the parent education program [Newborn Communication, Health, Feeding and Swallowing Education Program (N-CHFSEP)], and FQ; while Phase 2 comprised of administering them on the mothers. Both quantitative (descriptive statistics, paired t-test, and chi-square test) and qualitative analysis were done on the parameters of interest. Results The results of the study demonstrated a notable increase in the number of mothers (not all) reporting heightened confidence levels following receiving the N-CHFSEP (which was observed in all the domains). This observed change (pre and post) was statistically significant as per paired t-test analysis (p <0.05) indicating a significant increase in confidence levels post-N-CHFSEP intervention, as well as recognizing warning signs related to the same. Sociodemographic factors such as age, education, occupation, and family type were reported to have a significant effect (p <0.05) on maternal confidence levels before and after N-CHFSEP administration. Feedback from participants highlighted the effectiveness of the program in enhancing knowledge and awareness, while also suggesting areas for improvement. Conclusions This study demonstrates the effectiveness of N-CHFSEP in enhancing primiparous mothers' confidence in newborn care, thereby improving maternal and infant health.