Clinical Speech-language Pathologists Research Articles

Evaluating Geographic Access to Interdisciplinary Laryngology and Speech-Language Pathology Clinic Models in the Southeast Region of the United States

Evaluating Geographic Access to Interdisciplinary Laryngology and Speech-Language Pathology Clinic Models in the Southeast Region of the United States

Aphasia Assessment: Translation of a Research Test Battery To A Practical Clinical Tool

<h3>Research Objectives</h3> To translate a research-based test of aphasia to a clinical version that maintains the theoretical and psychometric aspects of the research version and addresses the practical constraints of a busy health care setting. <h3>Design</h3> Based on the principles of implementation science we used a survey to elicit clinician input throughout the creation of a clinical version of the Temple Assessment of Language and Short-term Memory in Aphasia (TALSA). The survey was active for 15 months and was one component of a larger researcher-clinician partnership that included focus groups, case discussions, and training sessions. <h3>Setting</h3> Five clinical settings including one rehabilitation hospital, two acute care hospitals and two university clinics. <h3>Participants</h3> Clinical speech language pathologists. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Survey responses including Likert scale question data and short answers to the prompt, "Tell us about your experience with the TALSA." <h3>Results</h3> Survey results – 122 responses Likert scale questions: High level of satisfaction with test instructions (M = 6.56 on a 7-point Likert scale) and test administration (M = 6.54). Lower satisfaction reported for the usefulness of the TALSA in understanding individual patients' aphasia (M = 5.85) and the perceived value of the TALSA in setting therapy goals (M = 5.67). Open ended prompt – percentage of responses by topic: 34% quality of audio stimuli; 21% value of the TALSA; 13% quality of visual stimuli; 12% instructions; 5% interpretation. <h3>Conclusions</h3> Clinicians report that administration of the TALSA is quick and easy. High quality of audio stimuli and visual stimuli are important to clinicians. Higher audio and visual standards will be used in the creation of the second iteration of the Clinical TALSA. Guidance on interpretation of results needs further development. In partnership with clinicians, a treatment guide was created. This issue will be further addressed in a future implementation study. <h3>Author(s) Disclosures</h3> No conflicts of interest.

Effects of Intensive Voice Treatment on Perceived Swallowing Abilities in Parkinson's Disease: Clinical Case Series

<h3>Research Objectives</h3> The purpose of this study was to determine the change in perception of swallowing abilities in patients with Parkinson's disease (PD) after completion of an intensive voice therapy program as evidenced by self-rated perception scales and interview data. <h3>Design</h3> A prospective mixed methods case study design. <h3>Setting</h3> Hospital based outpatient speech language pathology clinic. <h3>Participants</h3> Four PD patients with varying medical histories, therapeutic needs, and clinical presentations. <h3>Interventions</h3> The Lee Silverman Voice Treatment (LSVT LOUD) program which uses high effort exercises for improved voice production. The program requires completion per protocol, daily homework and carryover assignments. <h3>Main Outcome Measures</h3> The voice handicap index (VHI), the perceptual rating scale, and the dysphagia handicap index (DHI), interview forms that are part of the voice program, and additional interview questions related to this project. <h3>Results</h3> Changes from pre- and post- LSVT LOUD sessions for voice, dysphagia, and communication abilities as measured by all self-rated scales and interview data. The physical (sensations of choking), emotional (fear of choking), and functional (avoidance of eating) perceptions as measured by the DHI were improved. Each patient, regardless of medical history or treatment program format, reported improved emotional perceptions of their swallowing problems. This was consistent even for those patients without changes to their diet consistency status. <h3>Conclusions</h3> The incorporation of a dysphagia perception self-rating scale may contribute to improved outcomes even for those PD patients not seeking out dysphagia treatment specifically. Other benefits may include clarifying the treatment plan by ensuring to address all issues, education for the patient in regard to their dysphagia concerns, and education for the family by expanding the objective measures to include subjective perceptions which may help explain the scope of the disability. <h3>Author(s) Disclosures</h3> Nothing to disclose.

Singing for the Rehabilitation of Acquired Neurogenic Communication Disorders: Continuing the Evidence Dialogue with a Survey of Current Practices in Speech-Language Pathology

Therapeutic applications of singing (e.g., melodic intonation therapy) for acquired neurogenic communication disorders (ANCD) such as post-stroke aphasia, dysarthria, or neurodegenerative diseases have emerged from innovations by clinical speech-language pathologists (SLPs). However, these specialists have never been systematically consulted about the use of singing in their practices. We report a survey of 395 SLPs in France using an online questionnaire (September 2018–January 2019). Most (98%) knew that singing could be a therapeutic tool. A wide variety of uses emerged in our data. Some practices (e.g., song games) have not yet been investigated in research settings. Melodic therapy, which is supported by scientific evidence, is familiar to clinicians (90%), but they lack training and rarely follow a full protocol. Over half of respondents (62%) recognize group singing for various benefits, but do not often use it, mainly due to the lack of adapted or welcoming choirs in their area. These results provide key information for continued dialogue between researchers, clinicians, and the community. Considering the aging population and the associated increase in the prevalence of ANCD, access to group singing in particular could be facilitated for these patients from a social prescription perspective with further research evidence.

Syllabic Diadochokinesis in Adults With and Without Traumatic Brain Injury: Severity, Stability, and Speech Considerations.

Purpose Syllabic diadochokinesis (DDK) is a standard assessment task for motor speech disorders. This study aimed to compare rate and regularity of DDK according to the presence or absence of traumatic brain injury (TBI) and severity of TBI, examine the stability of DDK over time, and explore associations between DDK and extemporaneous speech. Method Military service members and veterans were categorized into three groups: no history of TBI (control), uncomplicated mild TBI (mTBI), and moderate through severe (including penetrating) TBI (msTBI). Participants produced rapid alternating-motion and sequential-motion syllable repetitions during one or two sessions. A semi-automated protocol determined syllabic rate and regularity. Perceptual ratings of selected participants' connected speech samples were compared to DDK results. Results Two hundred sixty-three service members and veterans provided data from one session and 69 from two sessions separated by 1.9 years (SD = 1.0). DDKs were significantly slower overall for mTBI and msTBI groups compared to controls. Regularity of productions did not differ significantly across groups. A significant Group × Task interaction revealed that the msTBI group produced sequential-motion syllable repetitions but not alternating-motion repetitions with greater regularity, whereas the opposite occurred for control and mTBI groups. DDK results did not differ significantly between sessions. Perceptual speech analysis for 30 participants, including 20 with atypical or questionable DDK performance, revealed two participants with mildly abnormal speech. Conclusions Overall, DDK productions are slower than normal in adults with moderate, severe, and penetrating TBI and are stable over time. Regularity of productions did not differentiate groups, although this result differed according to task. There were surprisingly few people identified with disordered speech, making comparisons to DDK data tenuous, and indicating that dysarthria is a rare complication in a population of adults with mostly uncomplicated mTBI who are not selected from referrals to a speech-language pathology clinic.

Speech language disorders unfolded in Islamabad's periphery: A tertiary health care facility experience

Speech language disorders are common and result in communication problems. Impaired hearing, speech, language, fluency, cognition, and neuro-motor mechanisms of speech may be involved in causation. Prevalence varies from place to place, setups and socio demographic factors. Islamabad’s periphery harboring low- and middle-income population was focused in this observational cross-sectional study to retrospectively determine the prevalence of speech-language disorders and their association with socio-demographic variables. This study included all cases with speech language disorders (SLD’s), from departmental patient record of Speech Language Pathology clinic, Al-Nafees Medical College & Hospital, Isra University from 1st January 2014 to 31st December 2018. Population included male and female genders with no limitation of age. Descriptive analysis was performed using SPSS version 21. Population included n=3148 cases, with M:F ratio of 2.28:1 and mean age of 11.8±13.38 years. Most prevalent pathology was SLD secondary to hearing impairment (19.82%), followed by SLD secondary to intellectual disability (17.4%), stuttering (16.84%) and delayed speech and language (15.2%). This study concludes that speech language disorders due to hearing impairment and intellectual disability are most prevalent and have association with lower and middle socioeconomic class, male gender, consanguinity, being first child, increase in number of children and a weak referral system.

Sense of Coherence and Coping Strategies in Patients With Dysphonia

To analyze sense of coherence (SOC) of dysphonic individuals considering the type and degree of dysphonia, coping strategies, and sociodemographic variables. This cross-sectional study was performed with 50 dysphonic individuals under follow-up at a Brazilian Speech-Language Pathology Clinic. They answered a questionnaire with sociodemographic information, the PEED-10 (Brazilian Voice Disability Coping Questionnaire) and the Brazilian version of Sense of Coherence scale. The SOC was categorized as high or low using Cluster analysis. After descriptive analysis, data were analyzed through both the bivariate and multivariate logistic regression model method and the Spearman's correlation test (P< 0.05). Most individuals presented a high SOC (60%). Individuals with mild dysphonia were 7.00 times more likely to present high SOC (95% CI=1.24-39.38). Individuals between 45 and 70 years old were 5.03 times more likely to present high SOC (95% CI=1.25-20.28). In addition, the higher SOC, as well as the scores of manageability domain, the lower the use of strategies focused on emotion. Patients with mild dysphonia are more likely to have a high SOC. The same goes for individuals over the fourth decade of life. Also, the greater the SOC, the fewer emotional strategies are used to cope with dysphonia.

Adherence to Dysphagia Treatment Recommendations: A Conceptual Model.

Purpose Conceptual models of complex health problems are useful when designing targeted clinical interventions and focused research studies. Understanding and studying patient adherence often involves interplay among many factors that influence whether a patient successfully follows recommendations or completes a therapy program. Functional frameworks serve to arrange these factors visually, increasing interpretability and allowing for empirical testing of relationships among concepts. The purpose of this article is to integrate relevant factors from the literature into a comprehensive framework that describes adherence to dysphagia treatment. Method Using peer-reviewed, published guidelines regarding conceptual model construction, the authors created a list of potential factors that influence patient adherence to dysphagia-related treatment recommendations. During model construction, following extensive review of the literature and existing theories that have been applied in other areas of health care, factors were identified and grouped into conceptually similar domains (clusters). Clusters were arranged into larger categories that emerged during model optimization. Ultimately, two models were created: one that illustrates the interrelated factors of patient adherence and another that illustrates a subset of modifiable risk factors that a clinical speech-language pathologist may influence when developing a dysphagia treatment plan. Results Three general categories from 14 factors emerged based on relationships between factors and aspects of patient care: health factors, individual patient factors, and contextual factors. A second model consisting of modifiable risk factors included access, treatment type, patient perceptions, self-efficacy, health literacy, support factors, and provider bias. Conclusions This conceptual model allows clinicians and researchers to identify and explore the mechanisms driving adherence. Continual refinements of this model should be made as future studies uncover how the interconnectedness of factors affects adherence in dysphagia management. The models we have presented here are ready for clinical application and should also serve researchers as they generate hypotheses and design targeted research questions.

The Language of Teaching Voice: A Qualitative Study

ABSTRACT Voice practitioners use a variety of language to describe the act of sounding. Because practitioners cannot literally “see the voice,” they rely on imagery, imagination, anatomical descriptions, and acoustic feedback to encourage positive results for clients. There is often a debate among voice practitioners about the value of science and art when choosing both the type of voice exercise to give and ultimately the language to use with clients in order to achieve positive vocal training outcomes. This article outlines a qualitative research study assessing the effectiveness of using metaphorical or scientific language or both for improving student and client outcomes in the voice studio, the speech-language pathology clinic, and in performance. The results of the study suggest that there is a pedagogical advantage to using both metaphorical and literal language with voice clients. Because of this, there is a potential need to advocate for the increased intersection between art and science in teaching voice. Suggestions for this approach are given, and the implications for training future voice practitioners are discussed.

A 200-Year History of the Study of Childhood Language Disorders of Unknown Origin: Changes in Terminology

Purpose The current “specific language impairment” and “developmental language disorder” discussion might lead to important changes in how we refer to children with language disorders of unknown origin. The field has seen other changes in terminology. This article reviews many of these changes. Method A literature review of previous clinical labels was conducted, and possible reasons for the changes in labels were identified. Results References to children with significant yet unexplained deficits in language ability have been part of the scientific literature since, at least, the early 1800s. Terms have changed from those with a neurological emphasis to those that do not imply a cause for the language disorder. Diagnostic criteria have become more explicit but have become, at certain points, too narrow to represent the wider range of children with language disorders of unknown origin. Conclusions The field was not well served by the many changes in terminology that have transpired in the past. A new label at this point must be accompanied by strong efforts to recruit its adoption by clinical speech-language pathologists and the general public.

Conhecimento de mães sobre formas de aleitamento e hábitos deletérios

Introdução: O aleitamento materno exclusivo é fundamental até os seis meses, pois além de promover a saúde integral para o bebê, auxilia no desenvolvimento craniofacial e nas funções estomatognáticas. Objetivo: Investigar o conhecimento das mães sobre aleitamento materno, hábitos orais deletérios e outros métodos para ofertar a dieta ao bebê. Método: Trata-se de um estudo descritivo de caráter quantitativo. Foi aplicado um questionário semiestruturado com perguntas abertas e fechadas, em 80 mães de uma Clínica Escola de Fonoaudiologia, no período de junho a setembro de 2017. Resultados: 66,3% das mães possui idade entre 18 a 30 anos, 98,8% realizou pré-natal, 63,8% realizou aleitamento materno exclusivo até os seis meses de idade, a maioria (88,8%) demonstrou conhecimento acerca da amamentação exclusiva e 72,5% receberam informações sobre o aleitamento no hospital, 43,8% receberam informações sobre o uso da chupeta e 27,5% quanto ao uso da mamadeira. Observou-se que a mamadeira é a segunda forma mais conhecida para ofertar leite ao bebê, totalizando 52,7%. Em relação ao profissional que mais orientou sobre a amamentação, hábitos orais deletérios e utensílios de alimentação foi o enfermeiro (57,5%) e apenas 16,30% receberam orientações de fonoaudiólogos. Conclusão: Pode-se concluir que há grande adesão do aleitamento materno exclusivo, porém há ainda uma parcela que não realiza desta forma. As mães possuem conhecimento em relação à chupeta, mamadeira, aleitamento materno e outras formas de aleitar, porém, as informações sobre o Sistema Estomatognático estão escassas. Verificou-se que não houve muita atuação do fonoaudiólogo com essa população. Vale ressaltar que há maior número de enfermeiros, em comparação com o número de fonoaudiólogos.

Clinician perspectives on the assessment of short-term memory in aphasia

ABSTRACT Background: Verbal short-term memory (STM) and the related ability, working memory (WM), are widely understood to be integral components of language production and comprehension. However, assessment of these abilities in people with aphasia is hampered by a lack of valid, standardized measures that are clinically appropriate. Focusing primarily on verbal STM, we held a series of five focus groups with speech-language pathologists (SLPs) to understand better their current clinical practices and their beliefs and attitudes regarding assessment of verbal STM in aphasia. Aims: The purpose of this study was to explore the attitudes, beliefs and preferences of clinical SLPs to determine: (1) current practices related to verbal STM assessment; (2) the extent to which practices reflect current theories of aphasia and the role of verbal STM in language processing; and (3) practical considerations regarding aphasia assessment in clinical practice. Methods & Procedures: Five focus groups were conducted using a semi-structured interview protocol with a total of 44 SLPs. Grounded theory methodology was used to collect, code and analyse the data. Codes were reviewed to identify emerging themes. Themes were compared to explore meta-themes, connections and potential theoretical frameworks. Outcomes & Results: Five main themes were identified: (1) The theoretical understanding that clinical SLPs have regarding the role of verbal STM in aphasia is not always consistent with clinical practice; (2) Clinical SLPs highly value functionally relevant assessments; (3) The intense time constraints in clinical practice affect all aspects of assessment; (4) Clinical SLPs feel that there is a lack of appropriate tests for assessment of STM in aphasia; and (5) Clinical SLPs prefer tests that are comprehensive, easy to administer and psychometrically sound. Conclusions: Clinical SLPs report a lack of standardized measures to assess STM in individuals with aphasia. Researchers are met with several challenges in the development of these tests including effective communication with clinicians regarding the benefit of verbal STM assessments, especially as it relates to functional skills, and the creation of a test that is comprehensive yet simple, quick and easy to administer.

Gestures in the speech-language pathology clinic: a study in the light of the materialist discourse analysis

ABSTRACT Objective: this study aimed to investigate gestures in the speech-language pathology clinic and the dominant ideology in the light of the Materialist Discourse Analysis. Methods: twelve speech-language pathologists who work in different clinical fields were interviewed to investigate the main discursive thread supporting their discourse. These semi-open interviews were recorded and the discursive data were later transcribed. Fragments were extracted and analyzed from the above mentioned perspective. Results: the analysis shows that the conducting thread of the therapists’ discourse is the positivist ideology of Science, which fragments the subjects, body and language allocating speech and gesture in a hierarchy system where gesture is subordinated to the former. The language materiality shows an unconscious identification of the therapists with the signifier “Fono-Speech, Audio-Audio, Logia-Study” (Fonoaudiologia, or Speech-language Pathology in Portuguese), since the return of speech and their professional identity is brought up. From this perspective, there are formations that challenge the dominant ideology welcoming gesture as an important tool in the clinic, both in evaluation and treatment. Conclusion: the dominant ideological belief shows a hierarchical and historical association between speech and gesture that excludes gesture of the speech-language pathology clinic as it represents a threat to the speech status and the identity of this professional.

Avaliação de crianças com Síndrome de Down através da CIF-CJ: comparação da visão dos pais e das terapeutas

Introdução: A chegada de um filho com deficiência traz muitos desafios aos familiares podendo impactar na funcionalidade da criança. A visão que a família possui da criança nem sempre condiz tanto com suas potencialidades quanto com déficits. Por isso, interessa comparar a visão dos pais e terapeutas da criança. Objetivo: Comparar a visão dos pais e dos terapeutas em relação à funcionalidade de crianças com Síndrome de Down (SD). Métodos: Trata-se de um estudo qualitativo, de amostra por conveniência, com três crianças com SD, seus pais e terapeutas. A coleta de dados se deu por meio da aplicação da CIF-CJ com um dos responsáveis da criança e com a terapeuta estagiária responsável por cada caso, todos atendidos em clínica-escola de Fonoaudiologia. Resultados: Após análise dos três casos observou-se que a diferença nas respostas entre familiares e terapeutas esteve concentrada na percepção da linguagem das crianças, sobretudo em relação à fala. Também se observou que os terapeutas percebem a relação dos familiares com os profissionais de saúde mais frágeis do que os pais. Os resultados reforçam a importância sobre um olhar sobre a funcionalidade na clínica da infância. Conclusão: Na comparação da funcionalidade na percepção de pais e terapeutas, destacou-se a diferença na percepção da produção linguística das crianças.

Clinical Decision Making in the ICU: Dysphagia Screening, Assessment, and Treatment

Clinicians often perceive the intensive care unit as among the most intimidating environments in patient care. With the proper training, acquisition of skill, and approach to clinical care, feelings of intimidation may be overcome with the great rewards this level of care has to offer. This review-spanning the ages of birth to senescence and covering oral/nasal endotracheal intubation and tracheostomy-presents a clinically relevant, directly applicable review of screening, assessment, and treatment of dysphagia in the patients who are critically ill for clinical speech-language pathologists and identifies gaps in the clinical peer-reviewed literature for researchers.

The 2016 G. Paul Moore Lecture: Lessons in Voice Rehabilitation: Journal of Voice and Clinical Practice

This Paul Moore Lecture honors the contributions made by authors to the Journal of Voice during a period of 30 years, from 1987. Fifty articles were selected and included under the following five topics: (1) normalcy of the larynx and voice; (2) the clinical speech-language pathologist's evaluation; (3) the patient's perspective; (4) the core of vocal rehabilitation; and (5) behavioral versus organic dysphonias. The analysis reflects a vivid landscape of the specific area and significant advances in knowledge. It also shows the valuable interdependence between science and clinical practice. The topics highlight the following information: (1) The physical appearance of a healthy larynx varies across individuals with normal voices. (2) The voice is not a binary descriptor (normal versus abnormal) but a variable measure, with many cultural influences on the perceptual auditory analysis of a voice. (3) The clinical speech-language pathologist assessment is multidimensional and multiparametric, with both subjective and objective analyses. The patients' opinion about the impact of a voice problem on his or her quality of life is significant when proposing a treatment. Therefore, it is also included in the initial assessment. (4) Vocal rehabilitation is a nonlinear process that combines direct and indirect approaches. Evidence of the positive effect of voice therapy is now well established. (5) Behavioral dysphonias may be linked to self-regulation of the use of voice and this needs to be taken into consideration. Although organic dysphonias are not necessarily the result of harmful vocal behaviors, they too can benefit from vocal rehabilitation.

Effects of Voice Therapy: A Comparison Between Individual and Group Therapy

The primary aim of this clinical evaluation project is to study the effect of voice therapy given in the speech-language pathology clinic, as individual and group therapy, as well as finding out some of the reasons for not attending the recommended therapy. All patients visiting the speech-language department during the study period were asked to participate in a clinical evaluation project. The project included filling out the questionnaire Swedish Voice Handicap Index (VHI-11) twice: at their first visit at the clinic, and approximately 1 year later. Depending on the degree of voice problems, the patients were offered either individual or group therapy. The study included 187 patients at their first visit to the clinic and 109 patients at follow-up. All participants completed self-evaluation of voice function with the VHI-11 and separate questions regarding overall voice problems, hoarseness, and vocal fatigue. For the patients who responded to the follow-up survey, statistically significant improvements of self-perceived voice function were demonstrated in individual and group therapy. The improvement between the first visit and the follow-up was found to be of moderate to large effect size, with statistically significant improvements for both patients who attended individual therapy and those who attended group therapy. The most common reason for not attending the recommended voice therapy was lack of time. Individual and group therapy is effective, resulting in improved VHI-11 scores. The magnitude of improvement is similar when comparing individual and group therapy. Patients with higher scores of the VHI-11 were generally recommended individual voice therapy.

Speech-language pathology insights into genetics and neuroscience: Beyond surface behaviour

For almost a century, speech-language pathologists (SLPs) have worked at refining communication disorder phenotypes. Yet a hundred years of mastering the characterization of surface behaviours has provided only limited understanding of the neurobiological underpinnings of communication disorder. Arguably, the most momentous aetiological findings in speech-language pathology have been made relatively recently and by cross-disciplinary colleagues in the fields of molecular genetics and neuroimaging. Such findings include discovery of FOXP2, for example, the first gene found to be associated with a primary speech disorder. New gene-brain-behaviour discoveries in communication disorder are occurring on an almost weekly basis and it is challenging for clinical SLPs to engage with, interpret, and keep abreast of this literature. This paper aims to provide a brief overview of genetic and neuroimaging approaches to the study of communication disorders. Further examples of key findings in these fields are presented, with a discussion of the impacts on core SLP practice. Future research directions for further illuminating gene-brain-behaviour relationships in communication disorder are identified.

Project T.A.L.K. Delivers the Sounds of Summer to Hearing-Impaired Children

Figure: Attendees of the camp on Rock Star Day.All over Texas, live music, the crack of a baseball bat, and children laughing can be heard. Thanks to The Center for Hearing and Speech (CHS) in Houston, deaf children can hear these sounds, too, and be a part of these memories. CHS is the only full-service resource in Houston, and one of three in Texas, that teaches children with mild to profound hearing loss literacy skills and to communicate through spoken language. The center utilizes advanced technology, a highly trained staff, and a listening-based approach to developing communication skills that help these children achieve success in the hearing world. That world, however, can be challenging. Some children may be an only child with hearing loss, some may be misunderstood, and some have a hard time making friends because of their hearing loss. Project T.A.L.K., which stands for Talking and Listening for Kids, has been in place for the past five years at CHS to enhance spoken language social skills in a fun environment, giving hearing-impaired children the opportunity to meet others with similar experiences. CHS’ speech-language pathology clinic partners with speech-language pathology students from the University of Houston's School of Communication Sciences and Disorders to host an interactive program for hearing-impaired children ages 4 to 10. (See FastLinks.) This year's camp, held in July, had the most attendees and volunteers to date. Exciting new activities were scheduled, making the week even more engaging for students. Activities and events included the Houston Rodeo, a 26-foot-tall water slide, a photo booth, catered lunches, and themes like Dr. Seuss, the Olympics, and Under the Sea Day. The camp is mostly made possible by generous principal funding from the Houston Scottish Rite Masons who have greatly increased its annual success. Other key donors were Valero Energy Corporation, which generously contributed all major supplies by facilitating a drive, and the Hess Corporation, which provided decorations to tie the themes together. CHS also values the community-building partnership with the university's speech-language pathology graduate students who helped create summer camp activities that develop the children's teamwork and leadership skills. Each activity gives these hearing-impaired children the chance to practice the communication skills needed to gain independence and be successful. CHS alumni often return to volunteer and serve as mentors. “The kids love working with the alumni. There is a comfort in knowing that they are not alone, and having the alumni volunteer provides the children with a boost for their sense of self,” said Michael Douglas, CHS’ director of intervention services. Through CHS and Project T.A.L.K., children with hearing loss are able to increase their communication skills, develop their leadership and relationship skills, learn from expert staff and collegiate clinic partners, have fun, and most importantly, experience the sounds of summer. FastLinks Watch a video about the camp at http://youtu.be/iqrvdurT-CY. Learn more about CHS and Project T.A.L.K. at www.centerhearingandspeech.org/project-talk. Visit HJ’s Student Blog at http://bit.ly/HJStudentBlog. Check out HJ’s R&D Blog at http://bit.ly/RDBlog. Click and Connect! Access the links in The Hearing Journal by reading this issue on our website or in our new iPad app, both available at thehearingjournal.com. Follow us on Twitter at twitter.com/hearingjournal and like us on Facebook at www.facebook.com/HearingJournal. HJ Return to thehearingjournal.com

Treating the Signature Injury

Treating the Signature Injury