Dr Fiona Lewis

Lecturer in Speech Pathology

School of Health and Rehabilitation Sciences
Faculty of Health and Behavioural Sciences
f.lewis@uq.edu.au
+61 7 336 56087

Overview

Interest in developmental and acquired communication disorders in children and the development of screening tools to identify early which children are most vulnerable to language difficulties

Dr Lewis has a research interest in both developmental and acquired disorders of communication. Her PhD, undertaken at the University of Queenland, examined how best to conceptualise autism spectrum disorder through an examination of language skills associated with the presentation. Earlier, her Honours research investigated language associated with Parkinson's disease. Dr Lewis returned to the University of Queensland in 2008 as a full-time researcher. Her current research interests encompass behavioural and neurophysiological investigations of language skill development following cancer treatments, acquired brain injury, and inherited/metabolic disorders such as galactosaemia.

Dr Lewis was co-leader of the School of Health and Rehabilitation Sciences' "Healthy Start to Life" Research Theme from 2012-2015 and is a member of the Paediatric Communication Research Group, a cross-disciplinary group of like-minded researchers from within the School of Health and Rehabilitation Sciences. She is a member of the SHRS Professional Educator Research Theme group.

She lectures predominantly in the paediatric field to undergraduate and master's entry students in Speech Pathology and has given guest lectures on research methodology in health sciences. She is a Clinical Educator supervising students on clinical placement at the UQ Heatlh Clinics (Speech Pathology).

Research Interests

  • The emergence and development of language in infants and children with galactosaemia
    Language development is recognised as one of the most critical precursors to school readiness. The emergence and development of oral language undergoes exponential growth during the infant, toddler, and preschool years. Oral language skills are vital supports for the subsequent development of literate language in the school-aged child. Intentional pre-verbal communication skills such as eye gaze, gestures, object use, and vocalisations are known to underpin oral language development. It is possible that these early pre-verbal/pre-linguistic skills may provide the basis for early markers of language vulnerability in infants and young children with the metabolic disorder galactosaemia. Children’s developmental trajectories are shaped by inherent vulnerabilities, but reduced outcomes for children with impairments are not inevitable or unable to be changed. Parents want and expect care directed at maximising their child’s development. Therefore, the focus of modern health care for children should be directed towards screening and intervention programmes for existing problems or for identifying risk factors in order to optimise each child’s developmental potential. Dr Lewis's research aims to address this aspect of child health care, as the findings will retrospectively describe the emergence of pre-linguistic skills and investigate the subsequent language development in pre school aged children with GAL and identify factors that lead to reduced language outcomes in the disorder. Her aim is to develop clinical assessments that assist with early detection of potential language impairment associated with a sizable subgroup of children with a diagnosis of galactosaemia.
  • Working memory in children with galactosaemia
    The concept of impaired working memory in the metabolic disorder galactosaemia has been alluded to in previous galactosaemia outcome reports, but has not specifically been examined as to the incidence and impact on children’s development. A research collaboration involving Dr Lewis, Associate Professor David Coman (Department of Metabolic Medicine, Royal Children's Hospital, Brisbane), Dr Diana Ting (Department of Metabolic Medicine, Royal Children's Hospital, Brisbane) and Penelope Blackwell (Paediatric Rehabilitation Department, Royal Children's Hospital, Brisbane) will investigate working memory in children with the disorder.
  • The conceptualisation of high functioning autism, Asperger syndrome, and autism spectrum disorder.
    The conceptualisation of Asperger Syndrome (AS) and high functioning autism (HFA) being variations on a theme has provided three theoretical approaches to research. Dr Lewis applied the three approaches when comprehensively assessing the language skills of children and adults diagnosed with AS, HFA, and/or autism spectrum disorder (ASD) in order to encourage discussion on how best to conceptualise AS, HFA, and ASD. In 2012 it was announced that the separate diagnostic categories from DSM-IV will be replaced in DSM-V (2013) with a single diagnostic category of autism spectrum disorders. Distinctions will be made according to severity levels of behaviours including language/social communication deficits. Dr Lewis’s 2007-08, 2010 recommendations pre-empted the changes recommended by DSM-V’s working parties which were incorporated into the new classification.
  • An examination of the long-term impact of paediatric closed head injury on language functioning: A multiple techniques approach.
    The long term impact of head injury sustained during childhood will be investigated using behavioural language, neurophysiological (event related potentials), and diffusion tensor imaging.
  • Behavioural and neurophysiological investigation of linguistic deficits associated with treatments for childhood cancer
    Dr Lewis has undertaken longitudinal research applying both behavioural language and neurophysiological (event related potentials) assessments to examine the language outcomes and neural correlates of change following treatments for tumours of the central nervous system and leukaemia in children.
  • Healthy Start to Life Research Theme (NHMRC Research Priority)
    Dr Lewis was the co-leader of the Healthy Start to Life Research Theme within the School of Health and Rehabilitation Sciences from 2012-2015. This multi-disciplinary group meets throughout the year with guest speakers presenting different facets of paediatric research. Research Theme activity available at http://www.shrs.uq.edu.au/healthy-start-to-life

Research Impacts

Translation into Policy/Practice

Research: In the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition [DSM-IV] (1994) Autistic Disorder [AD] (which includes high functioning autism [HFA]) and Asperger Syndrome [AS] were listed as categorically distinct presentations, with the pertinent diagnostic distinction between the two disorders being developmental language history. Through a series of comprehensive language assessments, Dr Lewis's PhD research investigated how best to conceptualise AD, HFA, and AS.

Dr Lewis's overall research conclusion was that conceptualising AD, HFA, and AS as presentations on a spectrum of autistic disorders (ASD) provides the most reliable and clinically applicable descriptions of the language and communication strengths and weaknesses of individuals presenting with the diagnoses. Viewing ASD as a dimensional disorder on an autism spectrum enables clinicians to identify specific strengths and weaknesses in children on the spectrum which can be incorporated into individualised intervention planning. Dr Lewis's PhD was conferred in 2008.

Organisations Affected: Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Year of Change: 2013

Changes: It was announced in December 2009 that the classification of AD, HFA, and AS was undergoing active discussion within the DSM-V Neurodevelopmental Disorders Work Group. In February 2010, the DSM-V draft proposed that the diagnostic criteria will include a single diagnostic category of “autism spectrum disorders” that will incorporate the current diagnoses of AD, HFA, and AS. The DSM-V draft criteria were for review and refinement over the following two years. In August 2010, Dr Lewis was a Platform Presenter at the 28th World Congress of the International Association of Logopedics and Phoniatrics, Athens, Greece (1000 delegates from 50 countries), where she offered support, based on her PhD findings, of the DSM-V proposal of the single diagnostic category of “autism spectrum disorders”. Her concluding remarks from the platform addressed the heterogeneity identified in the group of participants in her PhD research, whereby she expressed the need for DSM-V to accommodate the heterogeneous behaviours and levels of severity observed in the spectrum of disorders.

Outcomes: In 2012 it was announced that the separate diagnostic categories from DSM-IV will be replaced in DSM-V (due for publication in May 2013) with a single diagnostic category of autism spectrum disorders. Distinctions will be made according to severity levels of behaviours including language/social communication deficits.

Dr Lewis’s 2007-08 recommendations were incorporated into the new DSM classification.

Qualifications

  • Doctor of Philosophy, The University of Queensland
  • Bachelor of Speech Pathology with Hons Class 1, The University of Queensland
  • Bachelor of Speech Therapy, The University of Queensland
  • Bachelor of Arts, The University of Queensland

Publications

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Publications

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