How Is Effort Defined in Communication Sciences and Disorders? A Systematic Review of Literature.

Purpose: This systematic literature review aims to develop a comprehensive understanding of effort as a multidimensional construct in individuals with impaired swallowing and/or spoken communication. Method: A comprehensive literature search was conducted across three databases: PubMed/MEDLINE, Emba...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 68; no. 10; pp. 4758 - 4781
Autores principales: Cantor-Cutiva, Lady Catherine, Ensar, Büşra, Castillo-Allendes, Adrián, Whitling, Susanna, Searl, Jeff, Hunter, Eric J.
Formato: Artículo
Publicado: American Speech-Language-Hearing Association Oct2025
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2025
      vid: 68
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      pub: American Speech-Language-Hearing Association
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        10.1044/2025_JSLHR-25-00070
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        atl: How Is Effort Defined in Communication Sciences and Disorders? A Systematic Review of Literature.
      aug:
        au:
          Cantor-Cutiva, Lady Catherine
          Ensar, Büşra
          Castillo-Allendes, Adrián
          Whitling, Susanna
          Searl, Jeff
          Hunter, Eric J.
        affil:
          Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City
          Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
      su:
        Communicative competence
        Exercise
        Communicative disorders
        Cognition
        Tongue physiology
        Medical information storage & retrieval systems
        Vocal cords
        Research funding
        Respiration
        CINAHL database
        Fatigue (Physiology)
        Aerodynamics
        Verbal behavior testing
        Descriptive statistics
        Systematic reviews
        MEDLINE
        Thematic analysis
        Physiological aspects of speech
        Electromyography
        Speech evaluation
        Auditory perception
        Online information services
        Speech perception
        Deglutition
        Human voice
        Deglutition disorders
        Articulation (Speech)
        Range of motion of joints
        Evaluation
      sug:
        subj:
          Communicative competence
          Exercise
          Communicative disorders
          Cognition
          Tongue physiology
          Medical information storage & retrieval systems
          Vocal cords
          Research funding
          Respiration
          CINAHL database
          Fatigue (Physiology)
          Aerodynamics
          Verbal behavior testing
          Descriptive statistics
          Systematic reviews
          MEDLINE
          Thematic analysis
          Physiological aspects of speech
          Electromyography
          Speech evaluation
          Auditory perception
          Online information services
          Speech perception
          Deglutition
          Human voice
          Deglutition disorders
          Articulation (Speech)
          Range of motion of joints
          Evaluation
      ab: Purpose: This systematic literature review aims to develop a comprehensive understanding of effort as a multidimensional construct in individuals with impaired swallowing and/or spoken communication. Method: A comprehensive literature search was conducted across three databases: PubMed/MEDLINE, Embase, and CINAHL, covering publications from 1966 to 2024. The search included terms related to communication effort, speech effort, vocal effort, swallowing effort, and articulatory effort. A total of 1,226 publications were initially identified, with 131 meeting the inclusion criteria for full-text review. Methodological quality assessment was performed to evaluate the rigor and reliability of the studies included in the review. Given the diverse types of articles and the broad inclusion criteria, assessing the quality was challenging but necessary to ensure a comprehensive synthesis of the concept of effort. This assessment helps identify strengths and weaknesses in the current research, guiding future studies toward more standardized and robust methodologies. Results: As was expected, the review identified that effort in communication sciences and disorders is a multifactorial concept involving physical, cognitive, emotional, and physiological dimensions. Definitions and assessment methods varied across different types of effort, with vocal effort being the most frequently studied. The quality of the publications varied, with 8% rated as strong evidence, 34% as moderate, and 57% as weak. Conclusions: This review identifies conceptual fragmentation and measurement inconsistency in how effort is defined and operationalized across domains in communication sciences and disorders. By thematically synthesizing the literature, the review reveals a need for more integrated theoretical models and standardized assessment frameworks to advance clinical practice and research in this area. While vocal effort was the most frequently studied type, the definitions and assessment methods varied widely. The quality of the reviewed publications was diverse, with only 8% rated as strong evidence.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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