International Journal of Speech-Language Pathology最新文献

Purpose: To examine the effectiveness of communication-oriented group therapy for non-progressive dysarthria regarding functional speech and communicative participation.

Method: Prospective two-arm randomised controlled trial, targeting communication-oriented dysarthria group therapy (DGT). A non-specific social group program served as the control condition/group (CG). Participants' speech was assessed immediately before and after completing the respective three week program, using a standardised diagnostic test (objective outcome measure). Participants rated the extent of their communication participation immediately before and after group therapy, as well as three months after program completion (subjective outcome measure).

Result: Fifty-six persons aged 40-88 years with mild to severe dysarthria (median duration 29 days) from an inpatient facility participated. Prior to the intervention, self-rated communication participation correlated with severity of dysarthria. Immediately after the intervention, DGT participants achieved significantly higher scores than the CG on both outcome measures. After three months, the difference between groups in the subjective outcome measure was no longer significant.

Conclusion: Participation in DGT resulted in improved speech and better communication participation. Results suggest that three weeks may be too short to ensure maintenance of treatment gains. Also, reduced opportunity for social interaction due to COVID-19 restrictions may have influenced the results.

Purpose: Health promotion and prevention interventions to support children's early language and literacy development are essential, however little is known about how social media can be used in this context. This study evaluated an intervention which aimed to build capacity of parents in supporting children's language and literacy skills, implemented using Facebook.

Method: A cross-sector partnership of Australian speech-language pathologists developed a suite of universal messages for parents to support their child's language development. Messages were delivered across 12 weeks via Facebook. A convergent mixed methods study design was used to evaluate survey responses from parents of children aged 0-5 years, before (n = 136) and after the intervention (n = 61). Social media analytics were collected.

Result: Participants identified social media was a helpful way to receive information about supporting their child's language and literacy development, reporting an increase in knowledge following the intervention. Participants reported they trusted information provided in Facebook posts as it was from professionals and evidence-based sources. The usability (i.e. look and layout) was generally rated highly.

Conclusion: Social media is a valuable tool for speech-language pathologists to deliver universal messages. Future social media initiatives should be co-designed with families and social media professionals to ensure delivery of trusted, consistent, and user-friendly information.

Purpose: Patient reported outcome measures (PROMs) are increasingly used to inform value-based healthcare. Within speech-language pathology (SLP), there is no synthesis of validated PROMs to guide professional practice. This scoping review systematically identifies and evaluates condition-specific PROMs across adult SLP practice.

Method: A literature search was performed to identify studies published until 18th February 2022 from MEDLINE, Embase, CINAHL, PsycInfo, Scopus, Cochrane Collaboration, and Web of Science. Abstracts and full texts were screened in Covidence. Relevant studies that validated PROMs in English were extracted and assessed using the "Checklist to operationalise measurement characteristics of PROMs" by two independent reviewers.

Result: Ninety-seven articles provided validation data for 71 PROMS across seven SLP practice areas. These included voice (n = 18), swallowing (n = 14), language (n = 11), fluency (n = 8), speech (n = 4), laryngectomy (n = 3), and cognitive-communication (n = 2). No PROMs were identified for augmentative and alternative communication (AAC) (n = 0). Quality ratings were variable on the Francis et al. checklist.

Conclusion: A range of validated PROMs were identified to guide SLP practice in measuring patient perceptions across a range of practice areas in adults. Opportunities for further development in SLP practice areas with limited PROMs, such as speech, cognitive-communication, and AAC are also highlighted.

Purpose: Treatment for oral cancer has debilitating effects on speech and swallowing, however, little is known about current speech-language pathology practice.

Method: An online survey of speech-language pathologists (SLPs) was disseminated via emails to speech pathology departments, social media platforms, and professional online forums. Survey questions captured demographics, service delivery, type and timing of speech and swallowing interventions, and influences and barriers to practice.

Result: Forty-three SLPs working in Australia (n = 41) and New Zealand (n = 2) completed the survey. SLPs recommended speech and swallowing compensatory strategies significantly more frequently than active intervention. Swallowing outcomes measures were either instrumental (n = 31, 94%) or performance ratings (n = 25, 76%), whereas speech was measured informally with judgements of intelligibility (n = 30, 91%). SLPs used a range of supports for their decision making, particularly expert opinion (n = 81, 38.2%). They reported time and staffing limitations (n = 55, 55%) and a lack of relevant evidence (n = 35, 35%) as the largest barriers to evidence-based service delivery.

Conclusion: There is variability amongst SLPs in Australia and New Zealand regarding rehabilitation of speech and swallowing for people with oral cancer. This study highlights the need for evidence-based guidelines outlining best practice for screening processes, active rehabilitation protocols, and valid outcome measures with this population.

Purpose: The purpose of this study was to explore the views of teachers in early year levels about the role and scope for speech-language pathologists (SLPs) to work on literacy support in schools.Method: Sixty-one teachers from mainstream government schools across Victoria, Australia, completed an anonymous, online survey.Result: Although many respondents reported knowing that SLPs support the literacy learning of some students in their school, they had limited awareness of the scope of speech-language pathology practice in literacy instruction and intervention.Conclusion: Limited awareness of SLPs' expertise and scope of practice may be leading to missed opportunities for collaborative practices. In order to capitalise on SLPs' skill set for the benefit of students, the speech-language pathology profession should better promote and raise awareness of the various ways in which SLPs can collaborate within interprofessional literacy teams in schools.

Purpose: The purpose of the study was to determine the effect of clear speech instruction on acoustic measures of dysprosody between reading passages of differing linguistic content for speakers with and without Parkinson Disease (PD).

Method: Ten speakers with PD and 10 controls served as participants and read five simple and three standard reading stimuli twice. First, speakers read habitually and then following clear speech instruction. Acoustic measures of fundamental frequency variation (semitone standard deviation, STSD), articulation rate, and between-complex pause durations were calculated.

Result: Results indicated speakers with PD exhibited less fundamental frequency variation than controls across reading stimuli and instructions. All speakers exhibited lower STSD and longer between-complex pause durations for the standard compared to simple reading stimuli. For clear speech, all speakers reduced articulation rate and increased between-complex pause durations in both simple and standard reading stimuli. However, speakers with PD exhibited a significantly less robust reduction in articulation rate for clear speech than control speakers for all reading stimuli.

Conclusion: Linguistic content of reading stimuli contributes to differences in fundamental frequency variation and pause duration for all speakers. All speakers reduced articulation rate for clear speech compared to habitual instruction, but speakers with PD did so to a lesser extent than controls. Linguistic content of reading stimuli to examine dysprosody in PD should be considered for clinical application.

Purpose: Storytelling is an integral part of human life, providing opportunities for social closeness, relationship development, and identity exploration. Having aphasia can disrupt the ability to convey stories across a variety of settings. Structured songwriting frameworks may provide people with aphasia an opportunity to successfully engage in this medium for storytelling.

Method: Three individuals with aphasia participated in a structured songwriting intervention modified to support individuals with aphasia. Each participant-songwriter co-constructed three songs about their life in collaboration with an interdisciplinary team. Data about the songwriting process were collected via individual semi-structured qualitative interview and analysed using interpretative phenomenological analysis to identify superordinate themes and subthemes.

Result: The overarching superordinate theme related to the process itself as a catalyst that occurred as a result of participating in a songwriting intervention modified for individuals with aphasia. Three subthemes were identified: (a) relationship-centred experience, (b) engagement in meaningful activities, and (c) identity exploration.

Conclusion: Songwriting may provide meaningful opportunities for people with aphasia to experience the power of sharing stories about themselves. Key components of this experience aligned with the core elements of the positive psychology PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments) framework. Findings support incorporating storytelling through songwriting into the rehabilitation journey for individuals with aphasia.

Purpose: Age-related changes to the swallowing mechanism, or presbyphagia, may put older adults at a higher risk for developing diseases and dysphagia. Maintaining swallowing functions could help prevent frailty and facilitate healthy ageing. This review summarises and appraises the effects of oropharyngeal exercises on the swallowing functions of healthy older adults without dysphagia. It is hypothesised that these exercises will strengthen and improve the structures and functions of the normal ageing swallow.

Method: This review was reported according to the PRISMA 2020 guidelines. Five electronic databases (Medline, Embase, Cochrane Library, Web of Science, CINAHL) and Google Scholar were searched in June 2021. A rerun was done in January 2023. Study selection, data extraction, and quality assessment were done by two independent raters.

Result: A total of 23 studies were reviewed. Meta-analysis was not conducted due to the heterogenous training protocols and outcomes. Majority (n = 21) had fair quality due to incomplete reporting. Exercises targeting oral structures were implemented the most (n = 15), followed by variations of the head lift (n = 4), and effortful swallow exercise (n = 1). Others implemented combined or multiapproach exercise studies (n = 3). Apart from surface electromyography findings, statistically significant improvements in oral and pharyngeal phase swallowing outcomes such as increased lingual isometric and swallowing pressures, bite force, muscle thickness, hyolaryngeal excursion, and upper oesophageal sphincter opening diameter were reported in 95% of the studies (n = 22).

Conclusion: Collective evidence suggests that strength training for swallowing-related structures leads to increases in structural strength, endurance, and muscle mass. The effects of exercises on overall swallowing efficiency and safety remain unclear. Results should be interpreted with caution due to methodological limitations. Further research should examine the long-term effects of these exercises in preventing frailty and reducing the burden of dysphagia in older adults.

Purpose: Speech-language pathologists (SLPs) have varying levels of training and experience working with children who stutter (CWS). They often work in contexts and populations that require clinical management to take them beyond the borders of translating clinical trial protocols and evidence-based practice (EBP). This study sought to investigate the clinical experiences of Australian SLPs working with CWS, including their Lidcombe Program confidence and practices. Method: A cross-sectional online survey was completed by 215 Australian SLPs during 2017-2020. They were recruited prior to attending one of 14 workshops hosted by Speech Pathology Australia (SPA). Result: Participants worked in a range of contexts and were from all states and territories. The majority assessed and/or treated up to five CWS annually. Six predictor variables were considered for self-reported clinical confidence. The quantitative analysis identified that an SLP's previous training, reading the SPA stuttering management clinical guideline, and the annual number of CWS treated were found to significantly impact self-reported clinical confidence. Themes included: (1) client, family, service, and context factors that influence clinical decision-making; (2) SLP areas of clinical strength and aspects of paediatric stuttering management requiring further development; and (3) factors that impact Lidcombe Program success and modifications. Conclusion: This study has found that Australian SLPs working with CWS identify a range of important factors that impact their practice.

Purpose: The aim of this pilot study was to explore the efficacy of an intensive 3 week water resistance phonation (WRP) therapy program for people with presbyphonia.Method: Participants included 13 people with presbyphonia who received intensive WRP therapy. All participants completed eight sessions of therapy over 3 weeks. Auditory perceptual ratings, and acoustic and aerodynamic assessments were performed before and after treatment. Participants also completed the voice-related quality of life questionnaire before and after the treatment.Result: After 3 weeks of intensive voice therapy, significant improvements were demonstrated in acoustic, aerodynamic, and auditory perceptual parameters, as well as patient perceptions of voice-related quality of life. Acoustically, it was found there were significant decreases in shimmer (p = 0.019), noise-to-harmonic ratio (p = 0.016), and smoothed cepstral peak prominence (p = 0.001). Perceptually, the clients with presbyphonia showed significant reductions in the ratings of the overall grade, roughness, asthenia, and strain. Moreover, there was a significant increase in the total score of the Mandarin version of the Voice-Related Quality of Life measure post-therapy.Conclusion: The investigation provides preliminary evidence that people with presbyphonia can improve their vocal function and voice-related quality of life through intensive WRP therapy within a short period of time.