ACQ Vol 12 No 2 2010

All parents filled out a validated questionnaire containing 74 statements followed by a 5-point Likert scale. Questions covered issues such as communication, general functioning, self-reliance, well-being and happiness, social relationships and education. Two themes related to the family and included effects of implantation and supporting the child. In addition Categories of Auditory Performance (CAP) were scored by the child’s speech therapist. The CAP is “an index describing the highest typical level of functional hearing in everyday life”. Results indicated that, in general, parents were happy with their family’s quality of life following implantation. Parents reported, in line with their expectations, improvement in social relations, communication, and general functioning with the help of hearing, as well as improved self-reliance of their child. Importantly, parents’ perceptions were consistent with the CAP scores awarded by their child’s speech therapists. For example, there were high correlations between the parents’ views of their child’s communication ability and the child’s overall CAP score. Significant correlations were also found between some background factors and questionnaire subscale scores. For example, children with additional problems scored lower in education, and children with higher speech recognition scores achieved higher scores on the communication and education subscales. In summary, the authors expressed their satisfaction with the ability of the questionnaire in examining a wide range of quality of life factors in families of children who received cochlear implants. For more information about the questionnaire the reader is referred to: http://www. earfoundation.org.uk/research/questionnaires.html. Twenty-year follow-up of children with and without speech-language impairments Johnson, C., Beitchman, J., & Brownlie, E. (2010). Twenty- year follow-up of children with and without speech-language impairments: Family, educational, occupational and quality of life outcomes. American Journal of Speech-Language Pathology , 19 , 51–65. Nicole Watts Pappas Speech pathologists do not often have the opportunity to work with individual children until they reach adulthood. Thus, our knowledge of the long-term outcomes for children with speech-language delays cannot usually be based on clinical experience. This study provides important information about outcomes for children with speech-language delays in a range of areas and would be of use to clinicians to share both with families and policy-makers. The study followed 244 people with (n = 112) and without (n = 134) speech-language impairment. Assessments were conducted at 5, 12, 19, and finally 25 years of age. At each assessment, data were collected in communicative, cognitive, academic, behavioural, and psycho- social domains. This article reported specifically on the 25th year follow-up assessments. Prediction analyses were used to determine what factors may have predicted family, educational, occupational and quality of life outcomes at age 25. The results of the study indicated that the young people with language impairment or speech-language impairment presented with poorer outcomes in communication, cognitive/ academic, educational attainment, and occupational status than the participants without language impairment. Speech impairment (which included participants with a history of speech, fluency or voice disorders) without concomitant language impairment was not associated with any significantly poorer outcomes. The prediction analyses revealed that language impairment was a significant predictor for only one of the outcomes investigated – occupational socioeconomic status (SES). Educational attainment and early parenthood (children before the age of 25 years) were better predicted by early family SES, teacher-rated child behaviour problems, performance intellectual quotient (IQ) and later reading scores. Interestingly, quality of life outcomes were found to be unrelated to a history of language impairment. The

participants with speech-language impairment were found to have similar quality of life scores to the control group. Quality of life was found to be more strongly associated with good relationships with family and friends than with IQ, language abilities, educational attainment, or occupational SES. Shared decision-making interventions for people with mental health conditions Duncan, E., Best, C., & Hagen, S. (2010). Shared decision making interventions for people with mental health conditions. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. no.: CD007297. DOI: 10.1002/14651858.CD007297.pub2. Andrea Murray With one in four people being diagnosed with a mental health condition during their life course, international health care policy has increasingly adopted a partnership model of mental health care. It is now recognised that consumers should be central in contributing to intervention plans, with health improvement being viewed more often in terms of recovery rather than just symptom relief. According to Jacobson (2001), in a recovery model of care, the professional relinquishes full control and gives more control to the consumer. This shift in emphasis necessitates significant collaboration between health care providers, consumers, and their families. Shared decision-making (SDM) is a partnership approach whereby both health care providers and consumers reach a “shared decision” regarding treatment which incorporates both consumer preferences and practitioner responsibility, and which must be agreed to by both parties (Charles, 1997). This comprehensive Cochrane review gives a clear definition and description of SDM and outlines the difference between a “shared decision-making model”, and “informed decision- making” and “professional as agent” models. The review’s objective was to explore and examine the effectiveness of SDM on a range of outcomes in mental health interventions. These included patient satisfaction, clinical outcomes, and health service outcomes. Randomised controlled trials, quasi- randomised controlled trials, controlled before-and-after studies, and interrupted time series studies were included in the review with information accessed via all reputable databases, online trial registers, and bibliographies of relevant papers. Three papers describing two studies, one conducted by Hamann (2006) and one by Loh (2007) ultimately met the selection criteria of the review and formed the basis for analysis. Although neither study demonstrated that SDM had a significant impact on clinical outcomes, Loh’s study showed a statistically significant increase in levels of consumer satisfaction. Twenty-three other studies are referred to in the review but these were excluded from analysis as the effects of SDM intervention could not be isolated due to the complex and multi-facetted nature of patient care. The review concluded that SDM was not harmful to consumers but that there was insufficient evidence to indicate that SDM was effective in the long term. The need for further research was highlighted. Of clinical interest to practitioners working in health or in mental health is the description of the criteria for shared decision-making and the features of SDM as outlined by Charles (1997). The review also refers to a decision aid used in research studies by Hamann (2006) and Loh (2007). This is a tool utilised by consumers and health care providers and is designed to support the decision-making process. Information on past treatment, consumer preferences, and treatment options is recorded and then referred to during planning meetings. With current service delivery moving increasingly toward consumer-inclusive practice, the review provides professionals with food for thought regarding their own models of practice. Note: Please visit http://www.thecochranelibrary.com for a full copy of the report including the references.

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ACQ Volume 12, Number 2 2010

ACQ uiring knowledge in speech, language and hearing