Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.066
Filtrar
1.
S Afr J Commun Disord ; 67(1): e1-e6, 2020 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-32787417

RESUMO

In the era of coronavirus disease 2019 (COVID-19), many healthcare professionals are being faced with the question of what is considered to be an essential service. This opinion paper has attempted to answer this complex question by understanding the potential relationship between dysphagia and COVID-19 and how speech-language therapists (SLTs) in South Africa should tackle this. It also aims to answer the question through the lens of a risk-benefit discussion based around practices and decision-making. Important gaps in the field relating to how SLT practices need to move forward during this challenging time have also been highlighted. Reflective questions that can assist SLTs when seeing dysphagia cases have been provided.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transtornos de Deglutição/terapia , Pessoal de Saúde/psicologia , Terapia da Linguagem/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Fonoterapia/psicologia , Patologia da Fala e Linguagem , Atitude do Pessoal de Saúde , Betacoronavirus , Humanos , Medição de Risco , África do Sul
2.
Codas ; 32(3): e20200144, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32578694

RESUMO

We present an experience report on the implementation of real-time telehealth in speech-language and hearing therapy for patients who were previously seen on an outpatient basis in a primary health care service. The Speech-Language Therapy (SLT) team was monitoring twenty-five users when the first cases of COVID-19 were notified in southern Brazil. Of these, it was judged that twelve patients required at least a monitoring call every two weeks. Teleconsultations were available in this first stage, on an emergency basis, during the implementation of the project in this format. The idea was to guarantee, due to the suspension of the SLT sessions, the maintenance of the care service for patients who could suffer worsening of their cases or even comorbidities. The appointments were carried out by video calls by SLT students, therapists of the extension project, and supervised by a speech-language therapist, synchronously. All conversations and orientations during the teleconsultation were conducted as calmly as possible and, in the case of infant patients, permeated by some playful activities. Telehealth has shown to be an efficient resource for the care of patients with SLT demands, enabling remote care with the same quality as face-to-face care. Besides, it has relevant potential, once there is a significant number of patients, who need SLT assessment and live in regions where there is a shortage of qualified professionals.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Desenvolvimento de Programas , Fonoterapia/organização & administração , Telemedicina/organização & administração , Adulto , Idoso , Brasil , Criança , Humanos , Terapia da Linguagem/organização & administração , Terapia da Linguagem/psicologia , Fonoterapia/psicologia , Telemedicina/instrumentação , Telerreabilitação/instrumentação , Telerreabilitação/organização & administração
3.
BMJ ; 368: m520, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-32213484

RESUMO

The studyPalmer R, Dimairo M, Cooper C, et al. Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS): a multicentre, single-blinded, randomised controlled trial. Lancet Neurol 2019;18:821-33.This project was funded by the NIHR Health Technology Assessment Programme (project number 12/21/01) and the Tavistock Trust for Aphasia.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000864/after-a-stroke-computerised-speech-and-language-therapy-can-help-people-find-words.


Assuntos
Afasia , Acidente Vascular Cerebral , Atenção , Humanos , Terapia da Linguagem , Fala
4.
Clin Rehabil ; 34(3): 369-381, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31903800

RESUMO

OBJECTIVE: Pilot a definitive randomized controlled trial of speech-language telerehabilitation in poststroke aphasia in addition to usual care with regard to recruitment, drop-outs, and language effects. DESIGN: Pilot single-blinded randomized controlled trial. SETTING: Telerehabilitation delivered from tertiary rehabilitation center to participants at their home or admitted to secondary rehabilitation centers. SUBJECTS: People with naming impairment due to aphasia following stroke. INTERVENTION: Sixty-two participants randomly allocated to 5 hours of speech and language telerehabilitation by videoconference per week over four consecutive weeks together with usual care or usual care alone. The telerehabilitation targeted functional, expressive language. MAIN MEASURES: Norwegian Basic Aphasia Assessment: naming (primary outcome), repetition, and auditory comprehension subtests; Verb and Sentence Test sentence production subtest and the Communicative Effectiveness Index at baseline, four weeks, and four months postrandomization. Data were analyzed by intention to treat. RESULTS: No significant between-group differences were seen in naming or auditory comprehension in the Norwegian Basic Aphasia Assessment at four weeks and four months post randomization. The telerehabilitation group (n = 29) achieved a Norwegian Basic Aphasia Assessment repetition score of 8.9 points higher (P = 0.026) and a Verb and Sentence Test score 3 points higher (P = 0.002) than the control group (n = 27) four months postrandomization. Communicative Effectiveness Index was not significantly different between groups, but increased significantly within both groups. No adverse events were reported. CONCLUSION: Augmented telerehabilitation via videoconference may be a viable rehabilitation model for aphasia affecting language outcomes poststroke. A definitive trial with 230 participants is needed to confirm results.


Assuntos
Afasia/reabilitação , Terapia da Linguagem/métodos , Fonoterapia/métodos , Acidente Vascular Cerebral/complicações , Telerreabilitação/métodos , Idoso , Afasia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reabilitação do Acidente Vascular Cerebral
5.
J Autism Dev Disord ; 50(1): 278-291, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31621021

RESUMO

Comprehensive interventions for children with autism spectrum disorder (ASD) often incorporate augmentative and alternative communication (AAC); however, variability in outcomes exists even among children who access similar intervention. This study investigated predictors of expressive language change for 48 children with ASD aged 31 to 67 months receiving AAC-infused intervention. The relationships between participants' initial responses to AAC and expressive language change were examined. Commonly reported predictors (IQ, chronological age, ASD symptomatology) did not significantly predict expressive language change. AAC factors (visual attention, object play, word learning) entered at Step 2 of a hierarchical multiple regression, explained an additional 42% of the variance. The findings provide preliminary data on child characteristics associated with expressive language changes within AAC-infused comprehensive interventions.


Assuntos
Transtorno do Espectro Autista/terapia , Linguagem Infantil , Transtornos da Linguagem/terapia , Terapia da Linguagem/métodos , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Transtornos da Linguagem/psicologia , Masculino , Análise Multivariada , Resultado do Tratamento , Aprendizagem Verbal
7.
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
8.
Rev. chil. fonoaudiol. (En línea) ; 18: 1-7, nov. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1095118

RESUMO

En el modelo de la Práctica Basada en la Evidencia el fonoaudiólogo debe conocer los criterios diagnósticos y el nivel de evidencia de los procedimientos de intervención para ofrecer un tratamiento adecuado. En la literatura se describe un bajo grado de formación académica y un escaso uso de la Práctica Basada en la Evidencia como fuente de acceso a diagnósticos y tratamientos. Este estudio investigó las dificultades de los fonoaudiólogos para acceder a los criterios para el diagnóstico fonoaudiológico. Se realizó una encuesta masiva online a 384 fonoaudiólogos, usando un método cuantitativo, descriptivo y transeccional. Los resultados indican que, independiente de los años de ejercicio laboral, un 79,7% de los encuestados utiliza fuentes secundarias para el acceso a criterios para el diagnóstico fonoaudiológico, un 46% no conoce fuentes de información fiables para acceder a diagnósticos y un 73,4% afirma haber tenido dificultades para acceder a criterios diagnósticos. Los sujetos encuestados no utilizan fuentes primarias que les permitan acceder a criterios que apoyen los diagnósticos fonoaudiológicos. Por lo anterior, se considera relevante educar sobre Práctica Basada en la Evidencia en el contexto universitario.


In the Evidence-Based Practice model, the speech and language therapist must know the diagnostic criteria and be aware of the evidence supporting the intervention procedures, to provide an effective treatment. However, the literature describes both low levels of academic training and scarce use of evidence-based practices as a base of speech and language diagnosis and treatments. This study probes into the difficulties speech and language therapists face to access the diagnostic criteria and their bibliographic references. A massive online survey was conducted with 384 speech therapists, using a quantitative, descriptive and transectional method. Results show that 79.7% of respondents use secondary sources to access criteria on which subsequently base their speech and language diagnoses, 46% do not know reliable sources of information to access criteria for diagnoses and 73.4% maintain that they had difficulties in accessing diagnostic criteria. These difficulties do not recede with years of practice. Based on these results it is possible to conclude that surveyed therapists presented difficulty to find information on which to establish their diagnostic criteria and they do not use primary sources for access information. All of this supports training students on Evidence Based Practice when in their University programs.


Assuntos
Humanos , Fonoterapia , Prática Clínica Baseada em Evidências , Transtornos da Linguagem/diagnóstico , Terapia da Linguagem , Chile , Inquéritos e Questionários , Acesso à Informação
9.
Rev. chil. fonoaudiol. (En línea) ; 18: 1-10, nov. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1095119

RESUMO

El fonoaudiólogo en Chile es el profesional encargado de la evaluación, diagnóstico, rehabilitación, promoción y prevención de los trastornos del lenguaje, el habla, la deglución, la audición, la voz y la comunicación. Actualmente, 29 casas de estudio superior dictan la carrera de Fonoaudiología y otorgan el título profesional de Fonoaudiólogo en Chile. Dada la evolución de la profesión, es necesario que se reflexione respecto de su quehacer formador. Los objetivos del presente trabajo son: a) Describir las características de los fonoaudiólogos que se dedican a la academia en diferentes universidades chilenas y b) exponer los aspectos de autorreflexión de la formación de pregrado y formación continua en Fonoaudiología. Para ello, se realizó un estudio observacional descriptivo mediante la aplicación de una encuesta estructurada a 33 académicos representantes de 12 universidades chilenas. Los resultados mostraron que el 60,6% de los académicos asistentes ostenta el grado de Magíster. Un 59,4% de los docentes tienen una dedicación laboral completa, centrando su carga en la gestión o la docencia. Sólo un 12,1% de los informantes reporta el desarrollo de actividades vinculadas con la investigación. El 87,9% de los consultados refiere que la formación de pregrado en Chile es de calidad y un 57,6% considera que la oferta nacional de posgrado no es pertinente para el desarrollo de la profesión.Según estos antecedentes, se discuten aspectos relacionados con: afiliación, actividades académicas, distribución de carga laboral, formación en el pregrado y formación continua en Fonoaudiología.


In Chile, Speech and Language therapists (SLT) are the professionals in charge of topics as diverse as evaluation, diagnosis, rehabilitation and health promotion of language disorders, speech, swallowing, hearing, voice, and communication. Currently, 29 higher education institutions include majors in SLT in Chile. Given the evolution of the profession, some reflections and considerations on the practices of SLT training are in order.The objective of this study was to describe some aspects related with the characteristics of speech therapists in academic activity in Chile and present a discussion about practices of SLT training. A descriptive observational study was conducted by applying a structured survey to 33 academic representatives of 12 Chilean universities. The results showed that 60.6% of the attending academics hold the Master's degree. A 59.4% of the teachers consulted have a complete work dedication, focusing their load on management or teaching. Only 12.1% of the informants report the development of activities related to research. An 87.9%, of respondents say that undergraduate training in Chile is of quality and 57.6% consider that the national postgraduate offer is not useful for the development of the profession. According to this background, aspects related to: affiliation, academic activities, workload distribution, undergraduate training and continuing training in speech therapy are discussed.


Assuntos
Humanos , Fonoterapia , Educação Superior , Docentes , Terapia da Linguagem , Chile , Inquéritos e Questionários , Carga de Trabalho , Educação Continuada
10.
Int J Lang Commun Disord ; 54(6): 971-981, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31479197

RESUMO

BACKGROUND: Descriptions of community-based speech-language therapy (SLT) dysphagia practices and services are underrepresented in the research literature, despite the prevalence of dysphagia in the community. Owing to a globally ageing population and government drives to support people to remain living at home rather than in hospital or aged care, there is a growing need for SLT services to be responsive to the needs of clients living at home in the community, referred to in this study as 'community-based clients'. Exploration of current SLT services and dysphagia care practices for this population may identify ways services can be designed and enhanced to better meet the needs of clients and carers. AIMS: To explore the nature (i.e., characteristics) of dysphagia services and SLT clinical practices for adults with dysphagia living at home in the community. METHODS & PROCEDURES: Using a qualitative descriptive approach positioned within an explanatory sequential mixed methods design, this study explored SLT services and practices for adults with dysphagia living in the community to explain further and elaborate on findings from an earlier quantitative study. A total of 15 SLTs working with community-based clients with dysphagia were recruited using purposive representative sampling. Content analysis was used to explore the data. OUTCOMES & RESULTS: The overarching theme of community commands a different approach and was illustrated by three subthemes that highlighted how and why a different approach to dysphagia care in the community setting was necessary: (1) skills and mindset require adaptation in the community context; (2) values and approaches are different in the community context; and (3) organizational influences impact service delivery in the community context. From the data, it is apparent that the work undertaken in the community setting differs from dysphagia care in other settings and requires adapted SLT skills, values and approaches that encompass holistic care, client autonomy and carer engagement. SLT practices are also informed by organizational influences such as policies and resourcing, which in some services were enablers, while for others these presented challenges. CONCLUSIONS & IMPLICATIONS: Community-based SLT services must continue to foster flexible, responsive practices by SLTs to ensure the needs of clients and carers are met now and in future.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Transtornos de Deglutição/terapia , Patologia da Fala e Linguagem/organização & administração , Adulto , Atitude do Pessoal de Saúde , Austrália , Competência Clínica , Feminino , Pesquisa sobre Serviços de Saúde/métodos , Serviços de Assistência Domiciliar/organização & administração , Humanos , Terapia da Linguagem/métodos , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Características de Residência , Fonoterapia/métodos
11.
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
12.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(3): 129-140, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185831

RESUMO

Antecedentes y objetivo: una escuela inclusiva brinda apoyos a niños con necesidades educativas especiales en el contexto de la educación regular. Una necesidad educativa especial que se observa frecuentemente en la población escolar corresponde al trastorno específico del lenguaje (TEL), el cual conlleva alteraciones en las habilidades lingüísticas y metalingüísticas que podrían impactar en el desempeño académico de los estudiantes que lo padecen. La información con que se cuenta sobre los procedimientos y estrategias que permiten andamiar el desarrollo lingüístico de los niños con TEL que asisten a escuelas inclusivas chilenas es escasa. El objetivo de esta investigación es analizar el efecto de la aplicación de un programa de estimulación del lenguaje oral realizado en el aula común de kínder por medio de un modelo colaborativo-inclusivo de intervención. Materiales y métodos: participaron 28 sujetos con TEL distribuidos en 4 aulas de kínder en un estudio de pre-post test de un solo grupo. El programa fue ejecutado de manera colaborativa entre fonoaudiólogos y docentes e incluyó 30 sesiones, en las que se trabajó léxico pasivo, conciencia fonológica, comprensión y producción de narraciones. Se evaluaron las habilidades estimuladas antes y después de aplicar el programa por medio de instrumentos con normas para la población chilena. Resultados:una vez finalizado el programa se observó un incremento significativo del desempeño de los estudiantes en léxico pasivo, conciencia fonológica, comprensión y producción de narraciones. Conclusiones:la aplicación de un programa de estimulación del lenguaje oral en el contexto del aula común resulta beneficioso para incrementar el desempeño lingüístico y metalingüístico de estudiantes con TEL


Background and objective: an inclusive school offer support to children with special educational needs in a context of regular education. A special education need can be frequently found in the school population is the Specific Language Impairment (SLI), this implies alterations at level to linguistic and metalinguistic skills that could impact the academic performance of the students who suffer from it. The available information about the procedures and strategies that allow to scaffold the linguistic development of children with SLI that registered on inclusive Chilean schools is scarce. The objective of the present investigation is to analyze the effect of an oral language stimulation program, applied in the Preschool common classroom throughout an inclusive-collaborative intervention model. Materials and methods: a pre-post test study of a single group of 28 SLI subjects has been carried out, this sample was distributed in 4 preschool classrooms. The program was executed collaboratively between speech therapists and educators and included 30 sessions, in which lexicon, phonological awareness, comprehension and narrative production were worked on. The stimulated skills were evaluated before and after applying the program through instruments with norms for the Chilean population. Results: once the program was completed, there was a significant increase in students' performance in the comprehension and expression of narratives, passive lexicon and phonological awareness. Conclusions: the collaborative work in the context of the common classroom is beneficial to increase the linguistic and metalinguistic performance of students with SLI


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Desenvolvimento da Linguagem , Terapia da Linguagem , Transtornos do Desenvolvimento da Linguagem/terapia , Inclusão Escolar/tendências , Políticas Públicas Antidiscriminatórias , Transtornos da Linguagem/classificação , Avaliação de Resultado de Intervenções Terapêuticas
13.
Int J Pediatr Otorhinolaryngol ; 126: 109635, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31421357

RESUMO

OBJECTIVE: To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received. METHOD: A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received. RESULTS: The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients. CONCLUSION: A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA.


Assuntos
Implante Coclear , Determinação de Necessidades de Cuidados de Saúde , Pais , Criança , Pré-Escolar , Implante Coclear/economia , Educação de Pessoas com Deficiência Auditiva , Feminino , Humanos , Lactente , Terapia da Linguagem , Masculino , África do Sul , Fonoterapia , Inquéritos e Questionários
14.
Int J Pediatr Otorhinolaryngol ; 126: 109631, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31445481

RESUMO

OBJECTIVE: Although various studies have depicted the importance of language intervention programs in facilitating language acquisition in cochlear implanted children, to this date rarely has a specific language intervention approach been recommended as better than the other and no best practice has been introduced in terms of language acquisition outcomes. Thus, the therapists remain uncertain as to which approach to follow and how to apply evidence to practice. Hence, the main goal of this study was to take a step in this regard by comparing the communication development of pediatric cochlear implant users who enrolled in two different language intervention approaches: the routine auditory-verbal approach, and the routine auditory-verbal approach plus a new intervention protocol specifically designed to enhance receptive vocabulary development in cochlear implanted children. METHOD AND MATERIALS: This prospective experimental study compared the receptive and expressive communication developmental scores of 26 cochlear implanted 20-24 months old children who received both a routine auditory-verbal intervention and a new cognitive based intervention protocol specifically designed to enhance receptive vocabulary development, with that of a group of 25 participants whose intervention program was only auditory-verbal. The children were recruited from Fars cochlear implant center situated in the city of Shiraz in Iran, and were assigned randomly to the two groups. The communication development of both groups was evaluated by the Bayley scales of Infant and Toddler Development- Third Edition, and statistical analysis was performed using the Statistical Package for Social Sciences-version 21(SPSS-21). RESULTS: The two groups were not significantly different in terms of age, sex and parents' educational level. Both the receptive and expressive communication outcomes of the children who received auditory-verbal as well as the new specifically-designed cognitive-based intervention protocol focusing on receptive vocabulary enhancement, were significantly higher than the control group (p < 0.001). CONCLUSION: The new specifically-designed cognitive-based language intervention protocol focusing on receptive vocabulary enhancement was significantly more effective in promoting and enhancing the communication development of cochlear implanted children than the routine auditory-verbal intervention.


Assuntos
Implantes Cocleares , Surdez/reabilitação , Terapia da Linguagem , Fonoterapia , Vocabulário , Pré-Escolar , Correção de Deficiência Auditiva/métodos , Surdez/cirurgia , Feminino , Humanos , Lactente , Desenvolvimento da Linguagem , Masculino , Estudos Prospectivos
15.
Int J Lang Commun Disord ; 54(6): 914-926, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31364253

RESUMO

BACKGROUND: Primary progressive aphasia (PPA) describes a heterogeneous group of language-led dementias. People with this type of dementia are increasingly being referred to speech and language therapy (SLT) services. Yet, there is a paucity of research evidence focusing on PPA interventions and little is known about SLT practice in terms of assessment and provision of intervention. AIMS: To survey the practices of SLTs in the areas of assessment and intervention for people with PPA. METHODS & PROCEDURES: A 37-item, pilot-tested survey was distributed electronically through the Royal College of Speech and Language Therapists (RCSLT), Clinical Excellence Networks (CENs) and social media networks. Survey items included questions on care pathways, assessment and intervention approaches, and future planning. Analysis was conducted using descriptive statistics and thematic analysis. OUTCOMES & RESULTS: A total of 105 SLTs completed the survey. Respondents reported more frequently using formal assessment tools designed for stroke-related aphasia than for dementia. Informal interviews were reportedly always used during assessment by almost 80% of respondents. Respondents were significantly more likely to use communication partner training than impairment-focused interventions. Goal attainment was the most commonly used outcome measure. Respondents provided 88 goal examples, which fell into six themes: communication aid; conversation; functional communication; impairment focused; specific strategy; and communication partner. Additionally, respondents reported addressing areas such as future deterioration in communication and cognition, decision-making and mental capacity, and driving. Ten (9.4%) respondents reported the existence of a care pathway for people with PPA within their service. CONCLUSIONS & IMPLICATIONS: This survey highlights the range of current PPA assessment and intervention practices in use by the respondents. Communication partner training is commonly used by the surveyed SLTs, despite the lack of research evidence examining its effectiveness for PPA. There is a need to develop evidence-based care pathways for people with PPA in order to advocate for further commissioning of clinical services.


Assuntos
Afasia Primária Progressiva/terapia , Terapia da Linguagem/métodos , Prática Profissional/estatística & dados numéricos , Fonoterapia/métodos , Afasia Primária Progressiva/diagnóstico , Comunicação , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Avaliação de Resultados em Cuidados de Saúde/métodos , Encaminhamento e Consulta/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Patologia da Fala e Linguagem/organização & administração , Patologia da Fala e Linguagem/estatística & dados numéricos , Reino Unido
16.
J Fluency Disord ; 61: 105713, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31451301

RESUMO

PURPOSE: Individuals who covertly stutter have a unique experience of stuttering that involves concealing the core behaviors of stuttering (e.g., repetitions, prolongations, and blocks). From the listener's perspective, covert stuttering results in minimum typical, overt stuttering behaviors. However, from the speaker's perspective, covert stuttering often increases the cognitive and emotional impact of stuttering. This study explores the speech-language therapy experiences of individuals who covertly stutter in order to improve treatment recommendations and best practice. METHODS: This investigation is a qualitative analysis of individuals' speech-language therapy experiences as persons who covertly stutter. Real-time video interviews were conducted with the use of open-ended phenomenological interview questions. Interviews were transcribed and thematic analysis of interview transcripts was conducted to investigate the speech-language therapy experiences of the participants. RESULTS: The participants indicated that stuttering therapy was most impactful when it included explicit goals and activities, personalized selection of therapy techniques or strategies beyond fluency techniques, encouraged self-education, and educated those in the person's environment. CONCLUSION: The evidence suggests individualized therapy based on each client's unique manifestation of covert stuttering is beneficial; while, fluency-focused stuttering therapy is often incongruent with the needs of persons who covertly stutter. Therapeutic implications and recommendations for speech-language pathologists are discussed.


Assuntos
Terapia da Linguagem/métodos , Fonoterapia/métodos , Gagueira/psicologia , Gagueira/terapia , Adulto , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Adulto Jovem
17.
Int J Lang Commun Disord ; 54(5): 841-854, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31273875

RESUMO

BACKGROUND: Research regarding speech and language therapy (SLT) for patients in prolonged disorders of consciousness (PDOC) is very limited. The Royal College of Physicians' (RCP) PDOC guideline provides recommendations regarding best practice, but does not give detail about many aspects of assessment and management. As a result, SLTs have little information regarding best practice for this complex patient group. AIMS: To ascertain the degree of consensus amongst expert SLTs regarding SLT best practice for patients in PDOC in order to inform the future development of SLT guidelines. METHODS & PROCEDURES: A two-round modified Delphi technique was used. Participants were recruited from major trauma centres and neurorehabilitation units in England and national SLT clinical excellence networks. To participate, SLTs had to be working on neurosciences, neurosurgery or neurorehabilitation wards that treat adult PDOC patients, or have ≥ 3 years' experience of working with PDOC. The Round 1 questionnaire was developed from the RCP's PDOC guideline and from existing research literature. It included ratings of statements regarding SLT best practice using Likert or temporal scales, with optional written justifications/comments and opportunities for participants to suggest additional statements. The percentage agreement amongst participants was calculated for each Round 1 statement. Written justifications for views were analysed using content analysis. The Round 2 questionnaire contained both quantitative and qualitative feedback from Round 1, allowing participants to reappraise their views. The final degree of consensus was then calculated after completion of both rounds. OUTCOMES & RESULTS: A total of 40 SLTs completed Round 1, with 36 completing Round 2 (90% response rate). Consensus was achieved for 87% (67/77) of statements regarding best practice on a variety of topics including communication, tracheostomy, dysphagia and oral hypersensitivity. The statements represented assessment, management and service delivery components of SLT practice. CONCLUSIONS & IMPLICATIONS: A total of 67 best practice statements were created. The statements provide a useful starting point for the creation of SLT guidelines to support best practice, and also have the potential to be used to advocate for the provision of SLT services for patients in PDOC. Future studies should focus on whether the expert opinion generated here can be borne out in experimental research.


Assuntos
Terapia da Linguagem/normas , Estado Vegetativo Persistente/terapia , Fonoterapia/normas , Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos de Deglutição/diagnóstico , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Técnica Delfos , Humanos , Terapia da Linguagem/métodos , Guias de Prática Clínica como Assunto , Fonoterapia/métodos , Inquéritos e Questionários
18.
Clin Rehabil ; 33(11): 1767-1774, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31342780

RESUMO

OBJECTIVE: To investigate the effect of gradual attention training on language function with aphasia. DESIGN: Randomized controlled trial. PARTICIPANTS: A total of 40 patients (mean age: 53.47 years) with post-stroke aphasia came from the stroke rehabilitation unit of rehabilitation department in the First Hospital of Jilin University, of which 13 (32.5%) had intracerebral hemorrhage, 28 inpatients and 12 outpatients, 11 women and 29 men, 34 within three-month stroke and 6 within three months to one year. INTERVENTIONS: All participants were divided into control and experimental groups. Both groups received language treatment 20 minutes a day, six days/week, for five weeks, and the experimental group received gradual attention training 20 minutes a day, six days/week, for five weeks. MAIN MEASURES: Language function was assessed pre- and post-treatment by components of the Western Aphasia Battery (WAB) which included spontaneous speech, auditory comprehension, repetition, and naming and then calculated the aphasia quotient (AQ). RESULTS: The mean (SD) AQ of the experimental group and control group, respectively, was 25.71 (12.63) and 26.2 (12.31) at baseline. After treatment, the AQ mean (SD) was 43.08 (15.14) in the experimental group, which showed a significant improvement compared to 33.48 (14.04) in the control group (P = 0.02).All items of WAB were higher in experimental group than those in control group, especially in auditory comprehension and naming (P = 0.02, 0.01). CONCLUSION: Gradual attention training seemed to improve language function in post-stroke aphasia, specifically function of listening comprehension and naming.


Assuntos
Afasia/reabilitação , Atenção , Terapia da Linguagem , Reabilitação do Acidente Vascular Cerebral/métodos , Afasia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Acidente Vascular Cerebral/complicações
19.
Cochrane Database Syst Rev ; 7: CD013067, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31335963

RESUMO

BACKGROUND: Cough both protects and clears the airway. Cough has three phases: breathing in (inspiration), closure of the glottis, and a forced expiratory effort. Chronic cough has a negative, far-reaching impact on quality of life. Few effective medical treatments for individuals with unexplained (idiopathic/refractory) chronic cough (UCC) are known. For this group, current guidelines advocate the use of gabapentin. Speech and language therapy (SLT) has been considered as a non-pharmacological option for managing UCC without the risks and side effects associated with pharmacological agents, and this review considers the evidence from randomised controlled trials (RCTs) evaluating the effectiveness of SLT in this context. OBJECTIVES: To evaluate the effectiveness of speech and language therapy for treatment of people with unexplained (idiopathic/refractory) chronic cough. SEARCH METHODS: We searched the Cochrane Airways Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, trials registries, and reference lists of included studies. Our most recent search was 8 February 2019. SELECTION CRITERIA: We included RCTs in which participants had a diagnosis of UCC having undergone a full diagnostic workup to exclude an underlying cause, as per published guidelines or local protocols, and where the intervention included speech and language therapy techniques for UCC. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the titles and abstracts of 94 records. Two clinical trials, represented in 10 study reports, met our predefined inclusion criteria. Two review authors independently assessed risk of bias for each study and extracted outcome data. We analysed dichotomous data as odds ratios (ORs), and continuous data as mean differences (MDs) or geometric mean differences. We used standard methods recommended by Cochrane. Our primary outcomes were health-related quality of life (HRQoL) and serious adverse events (SAEs). MAIN RESULTS: We found two studies involving 162 adults that met our inclusion criteria. Neither of the two studies included children. The duration of treatment and length of sessions varied between studies from four sessions delivered weekly, to four sessions over two months. Similarly, length of sessions varied slightly from one 60-minute session and three 45-minute sessions to four 30-minute sessions. The control interventions were healthy lifestyle advice in both studies.One study contributed HRQoL data, using the Leicester Cough Questionnaire (LCQ), and we judged the quality of the evidence to be low using the GRADE approach. Data were reported as between-group difference from baseline to four weeks (MD 1.53, 95% confidence interval (CI) 0.21 to 2.85; participants = 71), revealing a statistically significant benefit for people receiving a physiotherapy and speech and language therapy intervention (PSALTI) versus control. However, the difference between PSALTI and control was not observed between week four and three months. The same study provided information on SAEs, and there were no SAEs in either the PSALTI or control arms. Using the GRADE approach we judged the quality of evidence for this outcome to be low.Data were also available for our prespecified secondary outcomes. In each case data were provided by only one study, therefore there were no opportunities for aggregation; we judged the quality of this evidence to be low for each outcome. A significant difference favouring therapy was demonstrated for: objective cough counts (ratio for mean coughs per hour on treatment was 59% (95% CI 37% to 95%) relative to control; participants = 71); symptom score (MD 9.80, 95% CI 4.50 to 15.10; participants = 87); and clinical improvement as defined by trialists (OR 48.13, 95% CI 13.53 to 171.25; participants = 87). There was no significant difference between therapy and control regarding subjective measures of cough (MD on visual analogue scale of cough severity: -9.72, 95% CI -20.80 to 1.36; participants = 71) and cough reflex sensitivity (capsaicin concentration to induce five coughs: 1.11 (95% CI 0.80 to 1.54; participants = 49) times higher on treatment than on control). One study reported data on adverse events, and there were no adverse events reported in either the therapy or control arms of the study. AUTHORS' CONCLUSIONS: The paucity of data in this review highlights the need for more controlled trial data examining the efficacy of SLT interventions in the management of UCC. Although a large number of studies were found in the initial search as per protocol, we could include only two studies in the review. In addition, this review highlights that endpoints vary between published studies.The improvements in HRQoL (LCQ) and reduction in 24-hour cough frequency seen with the PSALTI intervention were statistically significant but short-lived, with the between-group difference lasting up to four weeks only. Further studies are required to replicate these findings and to investigate the effects of SLT interventions over time. It is clear that SLT interventions vary between studies. Further research is needed to understand which aspects of SLT interventions are most effective in reducing cough (both objective cough frequency and subjective measures of cough) and improving HRQoL. We consider these endpoints to be clinically important. It is also important for future studies to report information on adverse events.Because of the paucity of data, we can draw no robust conclusions regarding the efficacy of SLT interventions for improving outcomes in unexplained chronic cough. Our review identifies the need for further high-quality research, with comparable endpoints to inform robust conclusions.


Assuntos
Tosse/terapia , Terapia da Linguagem , Fonoterapia , Doença Crônica , Humanos , Modalidades de Fisioterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Int J Pediatr Otorhinolaryngol ; 125: 23-31, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31238158

RESUMO

BACKGROUND: Despite early identification and intervention, many children who are deaf/hard of hearing (D/HH) demonstrate significant gaps in language development which can directly impact social interactions. AIMS: The objective of this pilot study was to determine whether integrating augmentative and alternative communication (AAC) core word language strategies into a speech-language therapy program for young children who are D/HH improves spoken language outcomes. METHODS: Eleven young children, median age 5 years 7 months (range 3y;11 m to 10y;8 m) with bilateral hearing loss were enrolled in a single-case experimental design and completed a 24-week intervention that incorporated high-tech AAC strategies into a traditional speech-language therapy model (technology-assisted language intervention or TALI). The goal of the TALI was to improve spoken language development in children who were D/HH. Language samples were collected throughout the study and pragmatic language was assessed pre and post intervention. RESULTS: At the end of 24 weeks, children demonstrated a significant increase in their mean length of utterance, number of words spoken, and mean turn length according to language samples. Children also made gains in their pragmatic skills pre to post intervention. CONCLUSIONS: Results of this study suggest that using AAC core word language strategies delivered via iPad technology may support continued and rapid spoken language skill growth among young school-age children who are D/HH. By leveraging AAC technology, we are pioneering a structured and dynamic approach to language learning, building an effective foundation for concepts and grammar for children who are D/HH.


Assuntos
Comunicação , Surdez/reabilitação , Pessoas com Deficiência Auditiva/reabilitação , Terapia Assistida por Computador , Criança , Pré-Escolar , Computadores de Mão , Feminino , Humanos , Desenvolvimento da Linguagem , Terapia da Linguagem , Masculino , Projetos Piloto , Software , Fonoterapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA