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

Catherine Cantor-Cutiva, Lady ; Ensar, Büşra ; Castillo-Allendes, Adrián ; Whitling, Susanna LU ; Searl, Jeff and Hunter, Eric J. (2025) In Journal of Speech, Language, and Hearing Research 68(10). p.4758-4780
Abstract

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 data-bases: 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... (More)

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 data-bases: 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.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Speech, Language, and Hearing Research
volume
68
issue
10
pages
23 pages
publisher
American Speech-Language-Hearing Association
external identifiers
  • pmid:40966103
  • scopus:105018682557
ISSN
1092-4388
DOI
10.1044/2025_JSLHR-25-00070
language
English
LU publication?
yes
id
a9e2079c-4ee6-4bdd-bdbd-dbb8a41b7619
date added to LUP
2025-12-16 14:33:35
date last changed
2026-01-13 17:43:49
@article{a9e2079c-4ee6-4bdd-bdbd-dbb8a41b7619,
  abstract     = {{<p>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 data-bases: 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.</p>}},
  author       = {{Catherine Cantor-Cutiva, Lady and Ensar, Büşra and Castillo-Allendes, Adrián and Whitling, Susanna and Searl, Jeff and Hunter, Eric J.}},
  issn         = {{1092-4388}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{4758--4780}},
  publisher    = {{American Speech-Language-Hearing Association}},
  series       = {{Journal of Speech, Language, and Hearing Research}},
  title        = {{How Is Effort Defined in Communication Sciences and Disorders? A Systematic Review of Literature}},
  url          = {{http://dx.doi.org/10.1044/2025_JSLHR-25-00070}},
  doi          = {{10.1044/2025_JSLHR-25-00070}},
  volume       = {{68}},
  year         = {{2025}},
}