This study examines how emotional demands and surface acting contribute to burnout and mental wellbeing among professionals in healthcare, care, and service roles. A cross-sectional online survey was conducted with 1,506 participants involved in frequent patient, care-receiver, or customer interactions. Using Partial Least Squares Structural Equation Modelling (PLS-SEM), we tested a serial mediation model. Surface acting mediated the relationship between emotional demands and burnout, defined as exhaustion and disengagement. In turn, these burnout dimensions mediated a negative association with mental wellbeing. These effects were consistent across professional groups, indicating the widespread impact of emotional demands and surface acting across occupations. We found no significant linear or curvilinear age moderation effects in the relationships between emotional demands and surface acting, nor between surface acting and burnout. Only workers aged 60+ showed a slightly stronger reliance on surface acting in response to perceived (but not contact-related) emotional demands compared to those aged 50–59. The absence of broader age effects suggests that emotional demands and surface acting contribute to burnout and mental wellbeing similarly across ages. These findings underscore the importance of recognising emotional demands as key occupational hazards affecting workers across professions and throughout the working lifespan.

Aim

This study re-evaluated the classification accuracy of language screening. This is because the new Swedish child health programme moved this screening from 3 to 2.5 years of age. Another aim was to investigate the stability of diagnoses between these two time points.

Methods

Children were recruited consecutively during 2016–2017 from three Child Health Services in Gävle, Sweden. Forty-eight monolingual children (31 boys) and 93 bilingual children (38 boys) underwent language screening and a clinical examination by a speech and language pathologist at 2.5 years of age. They were re-examined after 6 months (at 36–38 months) for clinical diagnosis.

Results

Of the 48 monolingual children, 45 retained their status at both 2.5 and 3 years of age, while three no longer met the criteria for development language disorder. Among the 93 bilingual children, 87 retained their 2.5-year status at age 3, two no longer met the criteria, and four new cases were diagnosed. These differences were not statistically significant. All changes in screening parameters between 2.5 and 3 years were within the 95% Confidence Interval, indicating stable classification.

Conclusion

Screening accuracy and language status were robust between 2.5 and 3 years, providing no support for a wait-and-see approach.

Introduction: Speech and language disorders are common developmental concerns. Identifying language issues in bilingual children presents a significant challenge. In this study, we examined how bilingualism, gender and age predicted the timing and types of diagnoses in a large clinical sample of children referred to speech and language therapy (SLT) services in a Swedish healthcare setting.

Methods: A retrospective analysis of medical record data was undertaken involving 1025 children under the age of 7 referred to public speech and language clinics. Data on age, gender, bilingualism and speech and language diagnoses were analysed.

Results: Bilingual children and boys were diagnosed at a younger age compared with monolingual children and girls. Speech and language diagnoses were associated with bilingualism and age. Bilingual children were more likely to have mixed receptive-expressive language disorders and developmental disorders of speech and language unspecified, and less likely to have specific speech articulation disorder and expressive language disorder, compared with monolingual Swedish-speaking children.

Conclusions: The timing and type of speech and language diagnoses were associated with sex, bilingualism and age. These observations may stem from the resources, tools and guidance available to professionals assessing bilingual children. Professionals should be cautious of these potential biases and take suitable measures to address them. Further studies in other geographical settings are warranted.

This study investigated how moral distress contributed to burnout and mental well-being among 1318 healthcare and care professionals in Sweden using cross-sectional survey data and partial least squares structural equation modeling. Moral distress significantly increased both exhaustion and disengagement, which in turn negatively impacted mental well-being. Mediation analyses confirmed that burnout processes mediated the relationship between moral distress and mental well-being. Job control buffered the moral distress-exhaustion link, while collegial support had no effect. Linear moderation by age was non-significant, but curvilinear analysis suggested that moral distress affects burnout differently across ages. Age-group comparisons revealed that professionals under 30 and over 60 were most vulnerable to moral distress-related burnout. These findings highlight the need for preventive, age-sensitive strategies and workplace interventions that reduce moral distress and strengthen protective resources. The Swedish version of the Moral Distress Scale was validated across healthcare and care groups.

Introduction: The purpose of the present study was to investigate whether information from the Swedish version of the Communicative Development Inventories III (SCDI-III) is informative to the Speech and Language Pathologist (SLP) when examining children with suspected speech and language disorders at a SLP unit.

Method: Parents to 50 children (25 girls, 25 boys, age 30–80 months) that had been referred to the local SLP unit completed the SCDI-III. Nine children came from multilingual families and 41 children came from monolingual, Swedish speaking homes. The children were diagnosed as having developmental speech disorders (12) or developmental language disorders (33). Five children were not diagnosed with any disorder.

Results: The results showed that the referred children performed significantly lower on scales for word production, grammar, and metalinguistic awareness, compared to a subset from the norms with a similar age and gender composition. Most children fell below the 10th percentile on word production and grammatical constructions. The intercorrelation between the three scales were in general substantial. Comparisons of children’s performance on the vocabulary and grammar scales of SCDI-III, and the medical records revealed 18 cases of discordance that would have motivated further examination. The parents rated sometimes their child’s vocabulary and grammar skills as higher and sometime as lower to the medical records.

Discussion: Limitations due to attrition and sample size were discussed. It was concluded that the SCDI-III can provide valuable information to the examination at the SLP clinic in addition to parent interviews, observations of children, and various tests, and that the potential for adapted versions would be particularly high for examinations of multilingual children.

Background

The Language Development Survey (LDS) and the MacArthur–Bates Communicative Development Inventories (MB-CDI) are two parental report forms that have been productive in providing data on early child language during the past 30 years. The instruments have been used both in studies relating to typical developing children and in screening for language difficulties.

Aim

To review the evidence for the LDS and the MB-CDI utility as screening instruments.

Methods

A literature search in PubMed and PsychInfo identified 16 articles based on LDS or MB-CDI that reported statistics pertinent to early screening for language difficulties.

Main Contribution

It was found that most reviewed studies were explorative in nature and tried out different versions of the screening test, including different cut-off values, multiple reference tests, small sample sizes and rarely reported confidence intervals. Spectrum, verification and review biases were common. Moreover, no study could convincingly show that the actual diagnostic accuracy was sufficient for clinical use.

Conclusions

There is insufficient evidence that the LDS or any version of the MB-CDI is a valid tool for screening for language difficulties. Of course, this is not to say that sufficient evidence will not be achieved in future studies, or that the instruments do not work well for purposes other than screening.

Background

Autonomy is recognized as important for individual well-being and constitutes one dimension in the KIDSCREEN-instrument measuring health related quality of life (HRQoL) in children and adolescents. However, the autonomy questions in KIDSCREEN are restricted to opportunities to influence leisure time activities, which is a form of autonomy as volition. Yet, there are other aspects of autonomy that might be related to adolescent’s HRQoL. The aims of the present study were first to investigate the psychometric properties of a scale measuring autonomy in adolescence from a control perspective (AAC) including its relation to the autonomy dimension in KIDSCREEN, and second; to investigate AACs ability to predict each of the 10 dimensions constituting KIDSCREEN.

Methods

Students (n = 154) aged 15–16 years who were recruited from schools located in both low (two schools) and high (two schools) socioeconomic status (SES) areas in Sweden participated in a cross-sectional study. The adolescents answered a questionnaire including a new 6-item scale measuring perceived autonomy and HRQoL assessed by the KIDSCREEN-52 instrument. A factor analyses was computed to investigate the relation between the items in the AAC scale and the autonomy items in the KIDSCREEN instrument. Hierarchical regression analyses were computed to investigate if the AAC scale predicted HRQoL in any of the 10 dimensions in KIDSCREEN after controlling for gender, SES and the original autonomy scale included in KIDSCREEN.

Results

The factor analysis showed that all the items from the autonomy scale loaded in one factor and that all the items from the AAC scale loaded in another dimension. The hierarchical regression models showed that the AAC scale uniquely predicted HRQoL in all dimensions of the KIDSCREEN instrument after controlling for gender, SES and the original autonomy scale included in KIDSCREEN-52. A high level of perceived autonomy was associated with a high level of HRQoL for both scales.

Conclusion

A new scale for measuring autonomy from a control perspective has been presented and shown to differ from autonomy as volition. Both forms of autonomy are positively related to HRQoL in adolescence 15–16 years old.

Reply by the current authors to the comments made by Daisy I. Perry & Gurdas V. Singh (see record 2020-99156-061) on the original article (see record 2020-99156-046). We read the commentary by Perry and Singhs with great interest and would like to take the opportunity to respond to their concerns, namely exclusion criteria; quality of parental information; control for SES; limited languages; varying expertise of professionals; and low sample size. The purpose of the screening was to identify new cases. Premature (<37 weeks) children and those with known disabilities were excluded as they are already in receipt of CHC services. Although we agree with Perry and Singhs that SES is associated with the prevalence of DLD, we cannot see that SES would affect the choice between the four screening models tested, negating the need for a control group. The issue of different professionals, with unclear or inadequate training, being involved is discussed. To this, we want to clarify that the screening method was already established and has been used for around two decades in the CHCs, albeit conducted solely in Swedish with 36-month-old children, rather than in multiple languages with 30-month-olds. Finally, we are in agreement with Perry and Singhs that the sample size was relatively small and the inclusion of more children would strengthen reliability. 

AIM: Bilingual children are at risk of being overlooked for early identification of language difficulties. We investigated the accuracy of four screening models for children aged 2.5. The first model screened the child using their mother tongue, the second screened in Swedish, and the third screened in both languages used by the child. The fourth model consisted of direct screening in Swedish and using parental information about the child's language development in their mother tongue.

METHODS: Overall, 111 bilingual children (51% girls), 29-33 months, were recruited from three child health centres in Gävle, Sweden, from November 2015 to June 2017. All children were consecutively assessed by a speech and language pathologist, blinded to the screening outcomes.

RESULTS: Developmental language disorder was confirmed in 32 children (29%). Only the third model, based on direct assessment using the two languages used by the child, attained adequate accuracy; 88% sensitivity, 82% specificity, 67% positive and 94% negative predictive values.

CONCLUSION: Bilingual children should be screened directly in both their languages in order to achieve adequate accuracy. Such screening procedure is particularly important for children from families with low socio-economic status living in complex linguistic environments.

The own-anchor effect concerns the assimilation of judgments of other people's external characteristics such as age, weight, and height toward the estimator's own characteristics. The phenomenon is related to theories of social projection and classical anchoring. It has previously been described as an estimation bias in studies of eyewitness accuracy and has been measured by the correlation between the estimates and the participants' own corresponding characteristics. We suggest that the term own-anchor effect should be reserved for cases when the estimate and the estimator's own value both are bigger than the target person's value, or when both are smaller than the target person's value. Two subtypes of own-anchoring and their association to different target persons of different ages and sizes are also described. A new index of own-anchoring based on the deviation between the estimate and the target persons' values is introduced, and differences between the two measures are discussed, as well as the implications for moderation by gender.