Speech-language Intervention Research Articles

Retrieval practice and spacing effects in multi-session treatment of naming impairment in aphasia

Retrieval practice and spacing are two factors shown to enhance learning in basic psychological research. The present study investigated the clinical applicability of these factors to naming treatment in aphasia. Prior studies have shown that naming treatment that provides retrieval practice (i.e., practice retrieving names for objects from semantic memory) improves later naming performance in people with aphasia (PWA) more so than repetition training. Repetition training is a common form of naming treatment that can support errorless production of names for objects, but it does not provide retrieval practice. Prior work has also demonstrated enhanced naming treatment benefit in PWA when an item's training trials are separated by multiple intervening trials (i.e., spacing) compared to only one intervening trial (i.e., massing). However, in those studies, items were only trained in one session. Also, the effects of the learning factors were probed after one day and one week. The goal of the present study was to examine the effects of retrieval practice and spacing in a more clinically-inspired schedule of delivery and to assess the effects of the learning factors at retention intervals of greater functional significance. Matched sets of errorful items for each of four PWA were presented for multiple trials of retrieval practice or repetition in a spaced or massed schedule in each of multiple training sessions. Mixed regression analyses revealed that retrieval practice outperformed repetition, and spacing outperformed massing, at an initial post-treatment test administered after one week. Furthermore, the advantage for retrieval practice over repetition persisted at a follow-up test administered after one month. The potential clinical relevance of retrieval practice and spacing for multi-session interventions in speech-language treatment is discussed.

Speech therapy activity in a patient with traqueal amyloidose: a case report

Introduction: Tracheal amyloidosis can be defined as the accumulation of fibrillar proteins, which can occur in any organ or tissue of the body. Objectives: To present a case report of the speech-language intervention in a patient with tracheal amyloidosis. Summary report: Case report of a 30-year-old male patient in an intensive care unit with altered cardiorespiratory parameters, requiring intubation. It presents a history of several procedures in the larynx since the age of 13, with a medical diagnosis of tracheal amyloidosis. It is tracheostomized, presents a large deviation in the larynx, which does not allow sufficient bronchial hygiene, besides the passage of nasoenteric probe for nutrition. Speech therapy team joins the case to enable and rehabilitate swallowing. Conclusion: Deglutition and vocal therapy were performed, using a speech valve, allowing functional swallowing of the patient.

How Old Do You Think I Am? Speech-Language Predictors of Perceived Age and Communicative Competence.

Purpose Spoken language serves as a primary means of social interaction, but speech and language skills change with age, a potential source of age-related stereotyping. The goals of this study were to examine how accurately age could be estimated from language samples, to determine which speech and language cues were most informative, and to assess the impact of perceived age on judgments of the speakers' communication skills. Method We analyzed narratives from 84 speakers aged 30-89 years to identify age-related differences and compared these differences to factors affecting perceptions of age and communicative competence. Three groups of raters estimated the speakers' ages and judged the quality of their communication: 44 listeners listened to audio-recorded narratives, 51 readers read transcripts of the narratives, and 24 voice raters listened to 10-s samples of speech extracted from one of the narratives. Results Older speakers spoke more slowly but showed minimal linguistic differences compared to younger speakers. Speakers' ages were estimated quite accurately, even from 10-s samples. Estimates were largely based on cues available in the acoustic signal-speech rate and vocal characteristics-so listeners were more accurate than readers. However, an overreliance on these cues also contributed to overestimates of speakers' ages. Communication ratings were not strongly related to perceived age but were influenced by various aspects of speech and language. In particular, speakers who produced longer narratives and spoke more quickly were judged to be better communicators. Conclusion Speakers tend to be judged on relatively superficial aspects of spoken language, in part because age-related change is most evident at these levels. Implications of these findings for age-related theories of stereotyping and speech-language intervention are discussed.

언어치료 역량강화를 위한 AAC훈련 프로그램 설문조사

배경 및 목적: 복합적인 의사소통 요구를 지닌 장애인의 성공적인 AAC 사용을 도모하기 위해서는 관련 전문가들의 기기 및 애플리케이션 활용능력이 뒷받침되어야 한다. 본 연구에서는 언어치료 역량 강화를 위한 목적으로 언어재활사를 대상으로 AAC 훈련을 실시하고, 추후에 보다 향상된 전문가 교육을 제공하고자 훈련프로그램에 대한 만족도조사를 실시하였다. 방법: 훈련에 참가한 총 24 명(sex=female, mean age=35yrs, SD=9.90, max=59, min=23)을 대상으로 설문 조사를 실시하였다. 훈련은 미국 피츠버그대학교의 대학원 석사과정과 미국의 비영리기관인 AAC institute에서 일반 언어치료사들 대상으로 활용하고 있는 로테이션 방식의 AAC 훈련방식을 도입하여 국내 실정에 맞게 수정하여 실시하였다. 훈련이 종료된 직후 모든 참가자를 대상으로 응답자의 기본정보, AAC 교육 및 임상경험 그리고 본 훈련에 대한 만족도 조사항목으로 구성된 설문을 실시하였다. 결과: 설문조사 결과 참가자의 다양한 연령과 학력, 근무지형태와 지역이 확인되었으며 대학의 정규과정을 통해 AAC 과목을 이수한 사람은 반 이상인 것으로 나타났다. 그러나 이들 중 상당수가 수업 중에 전혀 AAC기기를 실습하지 않은 것으로 나타났으며 현재까지 AAC 치료를 해오고 있는 것으로 확인되었다. 훈련에 대한 만족도 조사결과 실습시간과 관련된 문항을 제외한 대부분의 문항에서 4.08 부터 4.58 에 이르는 비교적 긍정적인 리커트 평점 척도 분포가 나타났다. 논의 및 결론: 참가자의 항목별 점수와 주관적인 의견을 토대로 추후 효과적인 교육을 개발하기 위한 방안이 논의되었다.

Opinions of Speech-Language Pathologists Regarding Speech Management for Children With Cleft Lip and Palate

The purpose of the present study was to examine practice patterns and opinions that speech-language pathologists (SLPs) have about speech-language intervention for children with cleft lip and palate. One hundred seven speech-language pathology members of the American Speech-Language-Hearing Association Special Interest Group 5: Craniofacial and Velopharyngeal Disorders Special Interest Group completed a 37-item online survey that examined common practices in early intervention as well as opinions about speech characteristics, assessment, and management strategies for children with cleft lip and palate. The overwhelming majority of respondents (96%) agreed that speech-language pathologists (SLPs) should meet with parents before palatal surgery to discuss speech-language issues. Although 90% of the SLPs identified increasing consonant inventory as an early intervention goal, lack of consensus was evident regarding the type of consonant to stimulate. Respondents agreed that while blowing activities are not useful in strengthening labial, lingual, or velopharyngeal movements, they are useful in heightening awareness of oral airflow for children with cleft palate. A large degree of variability was evident in opinions regarding prevalence and treatment of compensatory articulations as well as the effectiveness of treatment strategies designed to reduce perceived hypernasality and audible nasal emission. The findings of this study indicate a large degree of variability in opinions of SLP respondents regarding assessment and treatment of children with cleft lip and palate.

CSD Program Makes College Possible After Brain Injury

CSD Program Makes College Possible After Brain Injury

Virtual Speech-Language Therapy for Individuals with Communication Disorders: Current Evidence, Limitations, and Benefits

To review currently available research on virtual therapy for individuals with speech-language disorders. Virtual speech-language therapy refers to speech-language therapy delivered via computer-simulation technology to improve speech and language abilities for children and adults with communication disorders. In addition, this paper addressed limitations of previous studies and benefits of virtual therapy. Recent research reports suggest that virtual therapy is a viable option for treating children and adults with speech-language disorders. However, most current research studies were conducted without a rigorous experimental design. Also, the quality of technology is indeterminate and application to real clinical practice is currently lacking. More studies should be conducted with a rigorous experimental design as well as advanced technology in the future. This paper has reviewed current evidence related to the effectiveness of virtual speech-language intervention for children and adults with speech-language impairment. This paper discussed limitations of the current research and benefits of virtual therapy.

Clinical Decision Making in Speech-Language Intervention for Toddlers With Autism and Other Social Communication Delays

Purpose This study investigated current speech-language intervention practices with young children with social communication delays including autism and the educational experiences that shape these practices. Method A 25-item web-based survey was completed by 264 speech-language pathologists who worked with children under the age of 3 years. Results A majority of respondents reported targeting a variety of areas of social communication across daily activities, regularly utilizing the parent as the primary agent, and often providing in-home services; however, a minority of respondents reported only using materials available in families' homes. Previous clinical experiences and continuing education were reported to most influence clinical decision making. Results indicated the incorporation of many aspects of evidence-based naturalistic interventions into practice and the use of continuing education opportunities to expand clinical knowledge. Conclusion Although speech-language pathologists reported promising directions toward recommended best practices, further research and training are needed to optimize services provided to young children and their families.

People with aphasia’s perspectives of the therapeutic alliance during speech-language intervention: A Q methodological approach

Purpose: To identify which elements of the therapeutic alliance are important to people with aphasia (PWA) attending speech-language pathology post-stroke.Method: A Q methodology design was adopted to explore which elements of the therapeutic alliance were valued by PWA. Statements (n = 453) relevant to the research question were extrapolated from the literature and qualitative interviews. A representative sample of statements (n = 38) was identified from the expansive data set. PWA (n = 23) sorted statements hierarchically according to whether they thought the statement was important or unimportant. Completed Q sorts were analysed using a by-person factor analysis.Result: Analysis yielded a five-factor solution, representing five distinct viewpoints: (1) acknowledge me, help me to understand; (2) respect me, listen to me; (3) challenge me, direct me; (4) understand me, laugh with me; and (5) hear me, encourage me.Conclusion: The findings highlight the need for clinicians to adopt a flexible and idiosyncratic approach to therapeutic alliance construction in order to meet the relational needs of a heterogeneous population. This is the first study to use Q methodology with PWA, demonstrating that Q methodology is an effective and viable method for investigating subjectivity in this population.

Phonotherapeutic Intervention in Patients With Mucosal Leishmaniasis Sequelae

To characterize the voice before and after speech-language intervention, with Humming nasal sound in patients with sequelae Mucosal Leishmaniasis (ML) and Cutaneous Leishmaniasis (CL). Collection of phonation /a:/ from 44 patients with ML and CL for perceptual voice analysis and computed acoustic. The Wilcoxon nonparametric test and Fisher's exact test were used, with significance level of 5%. It was observed, prespeech therapy, that 27.7% of participants with ML presented asthenic vocal quality, and for the acoustics characteristics there was a statistically significant result for measures of frequency, frequency disturbance, noise, and subharmonic measurements, indicating phonatory instability, weakness, and noise emission giving the emission a feeling of vocal weakness. After therapy, the subharmonic segment measurements for the group with ML, showing reduction noise emission. Patients with CL had more grade 1 instability (36.4%), indicating tremor in vocal tract structures. After speech therapy, this group presented a reduction in the degree of roughness and reduction of the frequency disturbance measures, indicating a decrease in tension in the larynx and pharynx. Even after completing treatment for LM, patients may experience vocal changes due to the sequelae of the disease, like vocal alterations due to nasal lesions or in other locations that interfere in the correct vocal emission. As for participants with CL, no vocal changes would be expected, since these patients present thorax, leg and arm lesions that would not cause problems for the voice. Nevertheless, the two groups of participants presented vocal changes to different degrees before vocal therapy. However, it was observed that patients with ML present vocal alterations with more severe degrees. After the speech-language intervention, the participants of both groups showed vocal improvement, but the group with CL presented more vocal benefits, possibly due to the previous vocal alterations not being so severe.

Quality of life in individuals diagnosed with larynx tumor

Introduction: Malignant neoplasm of the larynx (C32), has clinical-stage depending on the tumor (T) and the region of involvement of the larynx. If the patient is assisted by the speech therapist since the pre-surgery up to the rehabilitation helps re-establishing speech communication. Evaluating the quality of life of those individuals makes it possible to understand how the chosen method of the speech rehabilitation interferes with the aspects of the life of those individuals. Objective: Analysing global and voice-related quality of life in individuals diagnosed with a laryngeal tumor. Methodology: 35 participants were invited (29 men and 6 women), all of whom were exclusively diagnosed with T3 and T4 larynx tumors. Characterization data of the sample related to the speech-language intervention were collected. In addition, the respondents answered two specific questionnaires to the quality of life: SF-36 and EORTC QLQ-C30, as well as a specific questionnaire of vocal disadvantage, was applied Voice Handicap Index. Conclusion: Results indicate that although individuals perceive little voice disadvantage, even in adverse communication conditions, the overall quality of life is greatly affected.

Gray matter predictors of treatment outcomes in semantic variant primary progressive aphasia

Gray matter predictors of treatment outcomes in semantic variant primary progressive aphasia

Analyses of Priorities in Contexts for the Script-based Speech Language Intervention by Age for 3~6 years Old Children in SLPs and Caregivers

Analyses of Priorities in Contexts for the Script-based Speech Language Intervention by Age for 3~6 years Old Children in SLPs and Caregivers

Interferência do frênulo lingual para a evolução do quadro fonológico: caso clínico

Introdução: A alteração de frênulo lingual se torna agravante em crianças com Transtorno Fonológico. Tendo em vista a complexidade da produção de fala, é necessário garantir que a intervenção fonoaudiológica contemple o equilíbrio entre forma e função. Objetivo: objetivo deste estudo foi descrever o processo terapêutico de uma criança, do sexo masculino, aos cinco anos de idade, com Transtorno Fonológico e alteração de frênulo lingual Métodos: O diagnóstico de Transtorno Fonológico foi realizado aos 5 anos de idade. A avaliação do aspecto fonológico foi realizada por meio da aplicação das provas de imitação e nomeação do Teste de Linguagem Infantil ABFW- item fonologia e cálculo de Porcentagem de Consoantes Corretas (PCC) em três momentos distintos. A intervenção terapêutica foi baseada no Modelo de Ciclos Modificado e realizada Frenectomia. Resultados: No processo de intervenção foram realizadas 12 sessões de terapia fonoaudiológica enquanto a criança aguardava o procedimento cirúrgico, notando-se evolução limitada dos fonemas /r/ e /l/. Foi realizado procedimento cirúrgico de Frenectomia e 23 sessões de terapia fonoaudiológica com o objetivo de organizar o sistema fonológico. Após intervenção terapêutica e cirúrgica foi observado melhora no grau de inteligibilidade de fala que passou de Levemente Moderado para Leve e adequação de processos fonológicos não esperados para a idade. Conclusão: A terapia fonoaudiológica com o enfoque nos processos fonológicos foi importante para amenizar a gravidade da inteligibilidade de fala, porém se faz fundamental o procedimento cirúrgico, visando melhorar as distorções articulatórias justificadas pela forma alterada.

Speech therapy intervention in a teenager with autism spectrum disorder: a case report

ABSTRACT Autism Spectrum Disorder is a neurodevelopmental disorder that affects socio-communicative and behavioral abilities. In the language aspect, there is a greater impairment at the pragmatic level and in non-verbal aspects. The objective of this study was to characterize the severity of Autism Spectrum Disorder in an adolescent, pre-and post-speech-language therapy, and describe the process of speech-language intervention using Picture Exchange Communication System allied to the principles of behavioral analysis applied to language. The Autism Treatment Evaluation Checklist with the parents was applied. Then, a therapeutic program of 14 sessions of 50 minutes was developed, one per week, and then the questionnaire was reapplied. In the course of the therapeutic process, it was possible to observe an increase in the number of figure exchanges independently, an increase in the number of vocalizations with communicative intention or functional speech, longer time of visual contact and social smile, reduction of inappropriate behaviors with a significant improvement in the Autism Treatment Evaluation Checklist score.

O jogo simbólico na intervenção fonoaudiológica de crianças com transtorno do espectro autístico

Objetivo: Verificar a proposta do jogo simbólico na intervenção fonoaudiológica com crianças diagnosticadas com Transtorno do Espectro Autístico. Método: Estudo de casos, com abordagem qualitativa. Foi realizada em duas instituições filantrópicas de uma capital de um estado do Nordeste, com fonoaudiólogos que atuam com crianças autistas. Os fonoaudiólogos, denominados como F1, F2, F3, F4 e F5, responderam a uma entrevista estruturada com treze questões. As entrevistas obtiveram, em média, duração de 30 minutos, e foram realizadas no ambiente de trabalho do profissional. As respostas dos participantes foram analisadas e descritas conforme análise de conteúdo. Resultados: Os profissionais, quatro do sexo feminino e um do sexo masculino, possuem entre dois e nove anos de atuação, apenas dois têm formação relacionada ao autismo e dois relataram atender a uma demanda de mais de vinte crianças por semana. A maioria dos profissionais atua de forma generalista, não havendo busca por formação relacionada ao autismo. Em relação à estimulação do jogo simbólico, apenas três relataram que ocorre desde o início da terapia. Relataram avanços relacionados ao comportamento das crianças, e justificaram que tais avanços também são relatados por pais e outros profissionais. Conclusão: Foi possível observar variáveis que influenciam diretamente na estimulação do jogo simbólico relacionadas à formação, tempo de atuação e carga horária exclusiva para atendimentos dos pacientes. Para alguns fonoaudiólogos que atuam na área, são necessárias abordagens que estimulem comportamentos funcionais e hábitos de vida diária, considerando o jogo simbólico como secundário para o desenvolvimento cognitivo e da linguagem.

Learner-Driven Telepractice

Learner-Driven Telepractice

Management of developmental speech-language disorders in children : Part1: Diagnosis and underlying comorbid diseases

Compared to other countries, the prevalence of speech-language disorders among children and also the intervention frequency appear to be much higher in Germany. Since otorhinolaryngologists often initiate speech-language interventions, the first part of this review systematically outlines the guideline-conform diagnostic pathway from examination to therapeutic intervention. The process of first developing asuspected diagnosis which justifies speech-language tests is explained. Beyond this, the rational selection of a set of tests from all those available-some of which the otorhinolaryngologist can perform, some of which require referral-is discussed, as is how these results can be used to assess the severity of the disorder. Aspecial focus of this paper is the differential diagnosis of underlying causes, e. g., hearing disorders and global developmental disorders. Acomplete set of tests permits aworking diagnosis and ICD-10 classification of the case.

Factors Contributing to Preschoolers' Communicative Participation Outcomes: Findings From a Population-Based Longitudinal Cohort Study in Ontario, Canada.

The aim of this study was to identify predictors of communicative participation outcomes for a large cohort of preschoolers with speech and language impairments. A secondary analysis of longitudinal program evaluation data from Ontario, Canada's Preschool Speech and Language Program was done. Data available for 46,872 children 18-67 months of age (M = 41.76 months, SD = 11.92; 68% boys, 32% girls) were previously used to predict children's communicative participation skill development in 5 levels of function. Demographic and intervention-based variables were added to the models to identify new predictors of growth. Three demographic and 3 intervention-based variables were statistically significant predictors of children's communicative participation outcomes. Clinically significant predictors included participation in an early learning environment, receipt of speech-language interventions, and the amount of time spent in intervention. These variables impacted predicted outcomes differently, depending on a child's level of communicative function. This population-based study of preschoolers with speech and language impairments identified predictors of growth in communicative participation skills-an outcome important and meaningful to families but not often explored. A broad picture emerged of factors that may influence the development of communicative participation skills and may be used to predict outcomes for preschoolers. Given the large sample size, these robust findings may be used to predict outcomes outside the Preschool Speech and Language Program as well. https://doi.org/10.23641/asha.6024422.

Speech-language intervention in schizophrenia: an integrative review

ABSTRACT Objective: to perform an integrative review to identify speech and language pathology intervention for schizophrenia. Methods: the review covered SCIELO, PUBMED, OXFORD JOURNALS and SCIENCEDIRECT databases for speech and language pathology intervention studies for schizophrenia. A narrative synthesis was adopted considering the level of clinical and methodological heterogeneity amid studies. Results: the results demonstrated an increase in publications since 2012 with 11 articles meeting the criteria. Language and discourse assessment were the speech and language pathology privileged procedures. Conclusion: the review indicates that the most eligible intervention was assessment, that studies’ methodology were heterogeneous and that the communication disorders identified were related to discursive, pragmatic and syntactic disorders, which evidences the importance of more systematized intervention procedures and research on schizophrenic patients.