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2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 32-36, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825387

RESUMO

Speech disorders are widely spread in patients with Parkinson's disease, and these symptoms are only getting worse as the disease progresses. Nevertheless, only a few percent of the population have an access to an adequate and qualified care. This review describes the pathophysiology of parkinsonian speech disorders, methods of diagnostics and monitoring and treatment modalities, which include pharmacotherapy, speech therapy and surgical approaches. The authors believe that treatment of parkinsonism-related speech disorder is an integral part of a multidisciplinary patient care.


Assuntos
Doença de Parkinson , Distúrbios da Fala , Disartria , Humanos , Doença de Parkinson/complicações , Distúrbios da Fala/etiologia , Distúrbios da Fala/terapia , Fonoterapia
3.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(4): 155-161, oct.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191298

RESUMO

Introducción: Los locutores son profesionales de la voz que se caracterizan por presentar una alta exigencia vocal. El objetivo de esta investigación fue medir los cambios acústicos que podrían ser atribuidos a una rutina de calentamiento vocal sobre la calidad de la voz en locutores comerciales de radio y televisión en Chile. Material y método: Se seleccionaron 13 locutores comerciales, a quienes se le aplicó un programa de calentamiento vocal. Se midieron los parámetros de frecuencia fundamental, perturbación (jitter y shimmer), ruido, tiempo máximo de fonación y agilidad articulatoria. Todos los parámetros se midieron antes y después de la rutina de ejercicios. Por otra parte, 6 expertos fonoaudiólogos analizaron, mediante una escala visual análoga, los cambios en los espectrogramas de banda estrecha de las emisiones antes y después de la rutina de calentamiento vocal. Resultados: Se encontraron cambios significativos en la frecuencia fundamental y el tiempo máximo de fonación. En el análisis de los espectrogramas que realizaron los expertos, en 11 casos se observó mejoría entre el antes y el después de la rutina. Sumado a lo anterior, en 6 de estos casos los cambios fueron significativos. Conclusiones: El calentamiento vocal puede ser una eficaz herramienta para el cuidado de la voz en locutores comerciales


Introduction: The announcers are professionals of the voice that are characterized by presenting high vocal demand. The objective of this research was to measure the acoustic changes that could be attributed to a routine of vocal warm-up on the quality of the voice in commercial radio and television announcers in Chile. Material and method: Thirteen commercial announcers were selected and a vocal warm-up routine was applied. The parameters of fundamental frequency, jitter, shimmer, noise, maximum time of phonation and articulatory agility were measured. All parameters were measured before and after the exercise routine. On the other hand, 6 experts voice therapist analyzed through a visual analog scale changes in the narrow band spectrograms of the emissions before and after the vocal warm-up routine. Results: Significant changes were found in the fundamental frequency and maximum phonation time. In the analysis of the spectrograms performed by the experts, in 11 cases there was improvement between the before and after the routine. In addition to the above, in 6 of these cases the changes were significant. Conclusions: The vocal warm-up can be an effective tool for the care of the voice in commercial announcers


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Distúrbios da Fala/diagnóstico , Distúrbios da Voz/diagnóstico , Disfunção da Prega Vocal/diagnóstico , Temperatura Alta/efeitos adversos , Distúrbios da Fala/terapia , Distúrbios da Voz/terapia , Treinamento da Voz , Disfunção da Prega Vocal/complicações
4.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(4): 182-191, oct.-dic. 2019.
Artigo em Espanhol | IBECS | ID: ibc-191301

RESUMO

En los últimos años, en los que la logopedia ha evolucionado desde paradigmas más tradicionales a enfoques socioconstructivistas, se hace especialmente necesaria una revisión de la intervención logopédica con niños bilingües. El principal reto para la intervención logopédica en población bilingüe consiste en ofrecer una respuesta situada y significativa, tanto para el niño como para su familia en los diferentes entornos en los que se produce la interacción. Una primera cuestión que se plantea es cómo realizar la evaluación logopédica de una población bilingüe para determinar las competencias generales en las dos lenguas que utiliza. La literatura muestra que las pruebas estandarizadas diseñadas para niños monolingües no son totalmente válidas para poblaciones bilingües. Se recomienda, por tanto, una evaluación holística de las competencias de cada lengua realizada en un entorno natural de uso comunicativo. Otra cuestión importante es la elección adecuada de la lengua en la que se interviene. La tendencia actual en la intervención es recomendar un enfoque bilingüe, a pesar de que algunos profesionales siguen proponiendo y realizando abordajes monolingües, bien por no dominar la otra lengua, bien por no conocer en profundidad la evidencia actualizada. Este trabajo pretende, precisamente, facilitar al logopeda un acercamiento a los últimos estudios sobre intervención naturalista con entornos bilingües y la intervención centrada en la persona y su familia. Los resultados sugieren que la intervención centrada en la familia es un enfoque que permite empoderar a las familias para apoyar de manera significativa el desarrollo comunicativo de sus hijos


Speech and Language Therapy (SLT) has evolved from a traditional to a socio-constructivist approach over the last years. Consequently, it is now necessary to review the intervention with bilingual children. The main challenge for the SLT working with bilingual population is to offer a situated and meaningful response for both the children and their families in the different environments where interaction takes place. The first question to be solved is how to develop an evaluation of a bilingual population in order to determine the general competences in both languages. Literature shows that standardised tests designed for monolingual children are not valid for bilingual population. Therefore, it is recommended to use a holistic evaluation of each languagés competence carried out in a natural environment of communicative use. Another important issue is the choice of the language in which intervention is going to be developed. The current trend in SLT intervention is to recommend a bilingual approach; however, some professionals are still using monolingual approaches. There are several reasons for this approach: professionals may not have sufficient abilities in the other language or may not have read the latest publications in the field. This work tries, precisely, to facilitate the access to the latest works about naturalistic intervention in bilingual settings and to offer a framework in personal and family-centred intervention. Results suggest that family-centred intervention is an approach that allows to empowering families to significantly support their children's communicative development


Assuntos
Humanos , Treinamento da Voz , Distúrbios da Voz/terapia , Distúrbios da Fala/terapia , Audiologia/métodos , Multilinguismo , Terapias Complementares/métodos , Desenvolvimento Infantil
5.
Codas ; 31(5): e20180121, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31691745

RESUMO

Apraxia of speech is defined as the inability to sequence the movements required for accurate articulatory production, traditionally involving a deficit in speech motor programming. Language clinicians often confront about speech inconsistency clinical cases, which raise questions concerning the differential diagnosis between apraxia and language disorders. Such problem often results in the difficulty to establish an adequate treatment decision. In this work, we discuss a clinical report in which both diagnosis and treatment raise questions about the apraxic speech condition in childhood. We start from the recognition that, in apraxia, it seems imperative to consider that the body to be considered is the one that surpasses its organic functions and structure. Clinical consequences are drawn from the premise that the human body is one whose ear can listen, and mouth can speak, i.e., the organic structure is a material realm open to the incidence of language and its "music", which creates the speaking body.


Assuntos
Apraxias/diagnóstico , Apraxias/terapia , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Transtornos do Desenvolvimento da Linguagem/terapia , Terapia da Linguagem/métodos , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/terapia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Medida da Produção da Fala
6.
Rev. chil. fonoaudiol. (En línea) ; 18: 1-10, nov. 2019. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1095040

RESUMO

El presente trabajo evalúa la efectividad de una intervención utilizando Praxias bucofonatorias con dispositivos bucales en conjunto con realidad virtual inmersiva (RVI), mediante programas diseñados para estimular estados de relajación e interacción en diferentes ambientes virtuales. Para ello, se aplicó la terapia integrada de vibro estimulación bucal palatina, ejercitación lingual y la exposición a imágenes y sonidos empleando RVI en un grupo de 6 niños con el diagnóstico de dislalia. Se comparó los resultados de esta intervención con el de una intervención utilizando únicamente la vibro estimulación bucal palatina en un grupo de 20 niños con diagnóstico de dislalia. Finalmente, se aplicó la terapia integrada de vibro estimulación bucal palatina, ejercitación lingual y RVI en un grupo de niños con autismo. Los resultados observados mostraron que la terapia con dispositivos bucales combinadas con RVI tendía a producir mayores avances que la terapia sin RVI. Además, se observó diferentes grados de avances individuales y grupales en el dominio fonético dependiendo las habilidades de hablainicial, los niños con mejores habilidades presentaban mayores avances. El grupo de niños con autismo presentó menores avances respecto de los otros dos grupos. A pesar de las limitantes del presente estudio (diferente cantidad de sujetos por grupo y distintas edades) puede considerarse esta propuesta como prometedora para futuros estudios.


This study assesses the effectiveness of a therapy using Bucco-phonatory training practices with buccal devices and immersive virtual reality (RVI) through programs designed to stimulate states of relaxation and interaction in different virtual environments. In order to do so, an integrated therapy based on Intra buccal stimulation by means of vibrations in the palatal area, daily lingual exercises with a lingual exerciser device, and exposure to images and sounds using RVI was applied to a group of 6 children diagnosed with dyslalia. The results of this intervention were compared with those obtained in an intervention based only on intra buccal stimulation by means of vibrations in the palatal area (conducted on a a group of 20 children diagnosed with dyslalia). Finally, the integrated therapy of intra buccal stimulation by means of vibrations in the palatal area, lingual exercises, and RVI was applied to a group of children with autism. The results showed that therapy with oral devices combined with RVI tended to produce greater advances than therapy without RVI. In addition, individual differences in group advances in the phonetic domain were observed depending on the initial speech skills, children with better abilities presented greater advances. The group of children with autism progressed less than the other two groups. Even considering the limitations of this study, such as the heterogeneity in terms of group size and age, results can be considered as promising for future studies.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Fonação/fisiologia , Distúrbios da Fala/terapia , Língua/fisiologia , Terapia por Exercício/instrumentação , Realidade Virtual , Transtorno Autístico/terapia , Projetos Piloto
7.
Int J Lang Commun Disord ; 54(6): 954-970, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31531914

RESUMO

BACKGROUND: Several studies have suggested that practitioners hold speech and language therapy (SLT) practice as tacit and consequently it is difficult for the therapist to describe. The current study uses a range of knowledge elicitation (KE) approaches, a technique not used before in SLT, as a way of accessing this tacit knowledge. There is currently no agreed framework that establishes key factors underpinning practice for preschool children with speech and language disorders. This paper attempts to address that gap. AIMS: To develop a framework of SLTs' practice when working with preschool children with developmental speech and language disorders (DS&LD). METHODS & PROCEDURES: A mixed-methods approach was adopted for this study. Data were collected iteratively, from 245 SLTs with experience of working with preschool children with DS&LD across sites in England, by means of focus groups and national events. There were three stages of data collection: local sites, specific-interest groups and two national events. KE techniques were used to gather data, with initial data being collected in local site focus groups. Findings from groups were taken to subsequent larger groups where a combination of concept mapping, teach-back and sorting exercises generated a more detailed description of practice, using discussion of consensus and disagreement to stimulate further exploration and definition and provide validatory evidence. OUTCOMES & RESULTS: This paper provides a high-level framework of therapy for preschool children with DS&LD that makes practice explicit in this area. The framework proposes that therapists' aims for this group of children fall into three categories: addressing children's areas of impairment and skills; achieving functionally meaningful skills and carryover; and supporting adults to provide a supportive communication environment. The exact configuration is shaped by the child's context and needs. CONCLUSIONS & IMPLICATIONS: The framework highlights themes that are well researched in the literature (e.g., speech) and others that have been little studied (e.g., adult understanding), indicating a disconnect between research evidence and practice. The research also highlights the complex nature of interventions for preschool children with DS&LD and the importance therapists attribute to tailoring therapy to individual needs. The framework provides a scaffold upon which SLTs can focus their clinical practice and encourages the profession to understand and explore better the gaps between research evidence and clinical practice for preschool children with DS&LD.


Assuntos
Transtornos do Desenvolvimento da Linguagem/terapia , Terapia da Linguagem/métodos , Distúrbios da Fala/terapia , Fonoterapia/métodos , Atitude do Pessoal de Saúde , Linguagem Infantil , Pré-Escolar , Comunicação , Inglaterra , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/normas , Grupos Focais , Humanos , Prática Profissional/normas , Prática Profissional/estatística & dados numéricos , Patologia da Fala e Linguagem/organização & administração , Patologia da Fala e Linguagem/normas
8.
HNO ; 67(7): 547-560, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31187151

RESUMO

Persistent speech fluency disorders, mostly stuttering and less frequently cluttering, occur in approximately 1% of children and adolescents. They considerably impair the social participation and quality of life of those affected. The German interdisciplinary evidence-based S3 guidelines provide information about the pathogenesis, diagnostics and treatment of speech fluency disorders and contain a systematic review on the efficacy of stuttering treatment. For preschool children the Lidcombe therapy shows the best evidence of efficacy. Strong evidence also exists for an indirect approach. For adolescents and recently for children aged 6­12 years old there is a high level of evidence for speech restructuring methods, such as fluency shaping. There is weak evidence for stuttering modification procedures and for combined speech restructuring and stuttering modification approaches. Negative evidence exists for the eclectic, unspecified stuttering therapies, breathing regulation, and hypnosis, which are frequently applied in Germany. An early start of treatment is decisive.


Assuntos
Distúrbios da Fala , Fala , Gagueira , Adolescente , Idoso , Criança , Pré-Escolar , Alemanha , Humanos , Qualidade de Vida , Distúrbios da Fala/terapia , Fonoterapia , Revisões Sistemáticas como Assunto
11.
J Speech Lang Hear Res ; 62(3): 507-524, 2019 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-30950737

RESUMO

Purpose A key goal of researchers, clinicians, and educators within the fields of speech, language, and hearing sciences is to support the learning and memory of others. To do so, they consider factors relevant to the individual, the material to be learned, and the training strategy that can maximize learning and retention. Statistical methods typically used within these fields are inadequate for identifying the complex relationships between these factors and are ill equipped to account for variability across individuals when identifying these relationships. Specifically, traditional statistical methods are often inadequate for answering questions about special populations because samples drawn from these populations are usually small, highly variable, and skewed in distribution. Mixed-effects modeling provides advantages over traditional statistical techniques to answer complex questions while taking into account these common characteristics of special populations. Method and Results Through 2 examples, I illustrate advantages of mixed-effects modeling in answering questions about learning and memory and in supporting better translation of research to practice. I also demonstrate key similarities and differences between analysis of variance, regression analyses, and mixed-effects modeling. Finally, I explain 3 additional advantages of using mixed-effects modeling to understand the processes of learning and memory: the means to account for missing data, assess the contribution of variations in delay intervals, and model nonlinear relationships between factors. Conclusions Through mixed-effects modeling, researchers can disseminate accurate information about learning and memory to clinicians and educators. In turn, through enhanced statistical literacy, clinicians and educators can apply research findings to practice with confidence. Overall, mixed-effects modeling is a powerful tool to improve the outcomes of the individuals that researchers and practitioners serve within the fields of speech, language, and hearing sciences.


Assuntos
Aprendizagem , Memória , Modelos Estatísticos , Pesquisa Comportamental/métodos , Educação Especial/métodos , Transtornos da Audição/psicologia , Transtornos da Audição/terapia , Humanos , Transtornos da Linguagem/psicologia , Transtornos da Linguagem/terapia , Distúrbios da Fala/psicologia , Distúrbios da Fala/terapia , Estatística como Assunto
12.
Braz J Otorhinolaryngol ; 85(4): 510-519, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30902588

RESUMO

INTRODUCTION: The patient's evolution in the audiology and speech-language clinic acts as a motivator of the therapeutic process, contributing to patient adherence to the treatment and allowing the therapist to review and/or maintain their clinical therapeutic conducts. Electrophysiological measures, such as the P300 evoked potential, help in the evaluation, understanding and monitoring of human communication disorders, thus facilitating the prognosis definition in each case. OBJECTIVE: To determine whether the audiology and speech-language therapy influences the variation of P300 latency and amplitude in patients with speech disorders undergoing speech therapy. METHODS: This is a systematic review with meta-analysis, in which the following databases were searched: Pubmed, ScienceDirect, SCOPUS, Web of Science, SciELO and LILACS, in addition to the gray literature bases: OpenGrey.eu and DissOnline. The inclusion criteria were randomized or non-randomized clinical trials, without language or date restriction, which evaluated children with language disorders undergoing speech therapy, monitored by P300, compared to children without intervention. RESULTS: The mean difference between the latencies in the group submitted to therapy and the control group was -20.12ms with a 95% confidence interval of -43.98 to 3.74ms (p=0.08, I2=25% and p value=0.26). The mean difference between the amplitudes of the group submitted to therapy and the control group was 0.73uV with a 95% confidence interval of -1.77 to 3.23uV (p=0.57, I2=0% and p value=0.47). CONCLUSION: The present meta-analysis demonstrates that speech therapy does not influence the latency and amplitude results of the P300 evoked potential in children undergoing speech therapy intervention.


Assuntos
Potencial Evocado P300 , Terapia da Linguagem/métodos , Distúrbios da Fala/terapia , Fonoterapia/métodos , Eletrofisiologia , Humanos
13.
Int J Pediatr Otorhinolaryngol ; 120: 112-117, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30776568

RESUMO

INTRODUCTION: In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). The current study evaluated the hypothesized association between this speech-related HRQoL measure and perceptually and instrumentally assessed speech variables, to provide evidence for the construct validity of the Dutch version of the VELO questionnaire. MATERIALS AND METHODS: Thirty participants, twenty-five patients with cleft palate and five controls, were enrolled. Perceptual speech assessment was conducted following the recently developed Belgian Dutch outcome tool for perceptual speech assessment in patients with cleft palate. In addition, nasalance values and the Nasality Severity Index (NSI) 2.0 were determined. The relationship between these speech outcomes and the scores on the VELO parent report was determined using Spearman rank-order correlation coefficients. RESULTS: Moderate to strong correlations were found between the total score on the VELO parent report and five speech variables: the VPC-SUM score (rs = -0.476), speech understandability (rs = -0.657), passive CSC's (rs = -0.654), speech acceptability (rs = -0.591) and the need for C(L)P-related speech therapy (rs = -0.711). Furthermore, these variables were associated with at least one subscale of the VELO questionnaire. DISCUSSION AND CONCLUSION: Correlations between speech outcomes and the Dutch version of the VELO questionnaire provide evidence for the construct validity of this version of the instrument. Furthermore, insights in these associations may lead the way to efficient therapy approaches, targeting speech features with the greatest impact on the patient's health-related quality of life.


Assuntos
Fissura Palatina/fisiopatologia , Qualidade de Vida , Distúrbios da Fala/diagnóstico , Fala/fisiologia , Bélgica , Criança , Pré-Escolar , Fissura Palatina/complicações , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Distúrbios da Fala/complicações , Distúrbios da Fala/terapia , Fonoterapia/métodos , Inquéritos e Questionários/estatística & dados numéricos , Insuficiência Velofaríngea/diagnóstico
14.
Semin Speech Lang ; 40(2): 81-93, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30795019

RESUMO

When assessing toddler speech sound productions, speech-language pathologists (SLPs) must be mindful of several important but not insurmountable limitations inherent to working with this young population for whom speech sound production may be of concern. These limitations include: (1) inconsistencies in recommended connected speech sampling size and phonetic transcription accuracy, (2) the prevalence of typical intraword variability for toddlers, (3) limited information regarding the reliability of informal measures of analysis, and (4) irregularities in available normative data for referencing speech sound development and mastery. This article includes a discussion of these factors, an overview of key assessment tools for single-word and connected-speech sampling, advice for current evidence-based practice procedures, and a thorough but not exhaustive listing of opportunities to improve clinical practice in this area. Despite limitations, SLPs working with toddlers have some tools and resources available to facilitate diagnostic procedures that allow for authentic decision-making regarding access to therapeutic services.


Assuntos
Fonética , Distúrbios da Fala/diagnóstico , Medida da Produção da Fala , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Distúrbios da Fala/terapia , Inteligibilidade da Fala , Fonoterapia/métodos
15.
Semin Speech Lang ; 40(1): 27-35, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30616292

RESUMO

Research surrounding rest recommendations for the concussed population is discussed. Rest is compared with activity avoidance, which is common in several chronic disease and traumatic injury types. The case is made for rest recommendations tailored to each head-injured individual. Research is presented which suggests that activity in the initial stages of concussion recovery may be beneficial in reducing postconcussion symptom duration and severity. Furthermore, a gradual increase in activity may potentially aid in returning to normal daily activity sooner than those who avoid both physical and cognitive activity during the acute stage of a traumatic brain injury. Finally, the current state of rest recommendations is reviewed and anticipated future directions are discussed.


Assuntos
Traumatismos em Atletas/terapia , Concussão Encefálica/terapia , Exercício Físico , Descanso , Traumatismos em Atletas/complicações , Concussão Encefálica/complicações , Fidelidade a Diretrizes , Humanos , Transtornos da Linguagem/terapia , Síndrome Pós-Concussão/etiologia , Síndrome Pós-Concussão/terapia , Volta ao Esporte , Distúrbios da Fala/terapia
16.
Int J Lang Commun Disord ; 54(2): 234-248, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30039902

RESUMO

BACKGROUND: Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. AIMS: To evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. METHODS & PROCEDURES: A total of 27 children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or 'treatment as usual' over a 12-week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and reassessed immediately post- and 3 and 6 months post-intervention to measure percentage consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time points. Per cent intelligibility was also calculated using the Children's Speech Intelligibility Measure (CSIM). OUTCOMES & RESULTS: Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3 and 6 months post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared with the other groups. Statistical testing showed significant differences between groups in DEAP scores across time points, although the majority did not survive post-hoc evaluation. Intelligibility across time points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time points, no statistically significant group differences emerged. CONCLUSIONS & IMPLICATIONS: EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapy.


Assuntos
Transtornos da Articulação/terapia , Biorretroalimentação Psicológica/métodos , Síndrome de Down/complicações , Distúrbios da Fala/terapia , Fonoterapia/métodos , Adolescente , Transtornos da Articulação/complicações , Criança , Feminino , Humanos , Masculino , Método Simples-Cego , Distúrbios da Fala/complicações , Resultado do Tratamento
17.
Int J Lang Commun Disord ; 54(3): 401-416, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30478972

RESUMO

BACKGROUND: Individuals with intellectual disability (ID) often demonstrate speech impairments and reduced intelligibility. However, traditional treatment methods, which involve using repetitive verbal and non-verbal exercises, may not be fully suitable for this population. As adults with ID tend to lose interest and motivation facing the demands of a typical speech therapy session, other intervention methods are needed. The current study tested a novel intervention technique, Beatalk, based on practising vocally produced sounds and rhythms, imitating the sounds produced by rhythm machines in an a cappella musical context (i.e., human beatboxing). Human beatboxing may be a particularly effective tool since it involves intense production of speech sounds (phonemes) that can be misarticulated in the presence of speech disorders; it is relatively easy to learn and practice, and is also considered 'fun'. AIMS: As many of the features of beatboxing make it a promising method for speech therapy, this pioneering study aimed to examine its effectiveness in comparison with a traditional speech therapy. METHODS & PROCEDURES: Twelve adults with moderate ID and low speech intelligibility (age 24-48 years) participated in a speech therapy group for 6 weeks. Six participants were assigned to the Beatalk (study) group and six to a traditional (control) therapy group. Pre- to post-treatment changes in speech intelligibility and voice measures were assessed. OUTCOMES & RESULTS: The preliminary data demonstrate that both types of therapy groups resulted in improved performance in articulation accuracy and voice measures, yet the Beatalk technique yielded larger gains. CONCLUSIONS & IMPLICATIONS: The results present initial evidence for the beneficial effect of the Beatalk technique as an intervention tool for adults with ID. It is an easy-to-use technique in the context of speech therapy, and may enhance verbal communication skills in this population.


Assuntos
Deficiência Intelectual/psicologia , Musicoterapia/métodos , Distúrbios da Fala/etiologia , Distúrbios da Fala/terapia , Fonoterapia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fonação/fisiologia , Testes de Articulação da Fala/métodos , Distúrbios da Fala/fisiopatologia , Inteligibilidade da Fala , Adulto Jovem
18.
Int J Lang Commun Disord ; 54(3): 309-320, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30592118

RESUMO

BACKGROUND: Functional neurological disorder (FND) is common across healthcare settings. The Diagnostic and Statistical Manual of Mental Disorders states that speech and swallowing symptoms can be present in FND. Despite this, there is a dearth of guidelines for speech and language therapists (SLTs) for this client group. AIMS: To address the following question in order to identify gaps for further research: What is known about speech, language and swallowing symptoms in patients with FND? METHODS & PROCEDURES: A scoping review was conducted. Six healthcare databases were searched for relevant literature: CINAHL PLUS, MEDLINE, ProQuest Nursing and Allied Health Professionals, Science Citation Index, Scopus, and PsychINFO. The following symptoms were excluded from the review: dysphonia, globus pharyngeus, dysfluency, foreign accent syndrome and oesophageal dysphagia. MAIN CONTRIBUTION: A total of 63 papers were included in the final review; they ranged in date from 1953 to 2018. Case studies were the most frequent research method (n = 23, 37%). 'Psychogenic' was the term used most frequently (n = 24, 38%), followed by 'functional' (n = 21, 33%). Speech symptoms were reported most frequently (n = 41, 65%), followed by language impairments (n = 35, 56%) and dysphagia (n = 13, 21%). Only 11 publications comment on the involvement of SLTs. Eight papers report direct speech and language therapy input; however, none studied the effectiveness of speech and language therapy. CONCLUSIONS & IMPLICATIONS: Speech, language and swallowing symptoms do occur in patients with FND, yet it is a highly under-researched area. Further research is required to create a set of positive diagnostic criteria, gather accurate data on numbers of patients with FND and speech, language or swallowing symptoms, and to evaluate the effectiveness of direct speech and language therapy involvement.


Assuntos
Transtornos de Deglutição/etiologia , Transtornos da Linguagem/etiologia , Doenças do Sistema Nervoso/complicações , Distúrbios da Fala/etiologia , Humanos , Transtornos da Linguagem/terapia , Terapia da Linguagem/métodos , Distúrbios da Fala/terapia , Fonoterapia/métodos
19.
Am J Speech Lang Pathol ; 27(4): 1572-1597, 2018 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-30208483

RESUMO

Purpose: The aim of this study was to describe the clinical assessment recommendations for acquired velopharyngeal dysfunction (AVPD) and, through a literature review and online survey, summarize current practice patterns for evaluation and treatment pathway determination for this target population. Method: An online survey to query current assessment procedures and treatment pathway recommendations for AVPD was developed. Following survey results, a literature review was completed to determine evidence-based recommendations for assessment procedures and intervention recommendations based on assessment findings. Literature search terms included the following: acquired velopharyngeal dysfunction, hypernasality, non-cleft velopharyngeal dysfunction, velopharyngeal dysfunction, velopharyngeal dysfunction AND iatrogenic, velopharyngeal dysfunction AND neurogenic, velopharyngeal dysfunction AND assessment OR evaluation, velopharyngeal dysfunction AND treatment OR intervention, velopharyngeal dysfunction AND practice patterns OR clinical guidelines, velopharyngeal insufficiency. Inclusion criteria were limited to practice patterns/recommendations for assessment and/or treatment recommendations for AVPD, English language articles published between 2000 and 2017, and peer-reviewed journals. Studies regarding solely congenital or cleft palate velopharyngeal dysfunction and intervention outcome studies were excluded. Forty articles met inclusionary criteria. Results: The online survey results indicated lack of consensus for AVPD assessment and treatment recommendation protocols, with 93% of respondents indicating the need for a clinical guide for developing treatment recommendations. The majority of recommendations were filtered into an algorithm for clinical decision making. Conclusions: Clinical uncertainty among speech-language pathologists surveyed and the paucity of published clinical guidelines for assessing individuals with AVPD indicate the need for additional clinical research for this disorder, one that is heterogeneous and distinct from those with congenital velopharyngeal dysfunction. The proposed evidence-based clinical worksheet may assist in determining management for patients with AVPD and may serve as a starting place for validation of a clinical guideline.


Assuntos
Distúrbios da Fala/diagnóstico , Distúrbios da Fala/terapia , Patologia da Fala e Linguagem/métodos , Patologia da Fala e Linguagem/normas , Fala , Insuficiência Velofaríngea/diagnóstico , Insuficiência Velofaríngea/terapia , Adulto , Tomada de Decisão Clínica , Consenso , Técnicas de Apoio para a Decisão , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , Distúrbios da Fala/epidemiologia , Distúrbios da Fala/fisiopatologia , Insuficiência Velofaríngea/epidemiologia , Insuficiência Velofaríngea/fisiopatologia
20.
Neurodegener Dis Manag ; 8(5): 337-348, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30223711

RESUMO

The prevalence of speech disorders among individuals with Parkinson's disease (PD) has been reported to be as high as 89%. Speech impairment in PD results from a combination of motor and nonmotor deficits. The production of speech depends upon the coordination of various motor activities: respiration, phonation, articulation, resonance and prosody. A speech disorder is defined as impairment in any of its inter-related components. Despite the high prevalence of speech disorders in PD, only 3-4% receive speech treatment. Treatment modalities include pharmacological intervention, speech therapy, surgery, deep brain stimulation and vocal fold augmentation. Although management of Parkinsonian dysarthria is clinically challenging, speech treatment in PD should be part of a multidisciplinary approach to patient care in this disease.


Assuntos
Doença de Parkinson/fisiopatologia , Doença de Parkinson/terapia , Distúrbios da Fala/fisiopatologia , Distúrbios da Fala/terapia , Gerenciamento Clínico , Humanos , Procedimentos Neurocirúrgicos , Doença de Parkinson/complicações , Distúrbios da Fala/etiologia
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