Advances in communication and swallowing最新文献

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Waiting list management: Professionals’ perspectives and innovations 候补名单管理:专业人士的视角与创新

Advances in communication and swallowing

Pub Date : 2021-08-25 DOI: 10.3233/acs-210026

N. McGill, S. Mcleod, Suzanne C. Hopf

BACKGROUND: Waiting lists for speech and language therapy exist when services do not meet demand. Waiting lists pose practical and ethical challenges for speech and language therapists (SLTs) and workplaces to manage, with potential flow on effects for children and families. OBJECTIVE: The present study aimed to describe SLTs’ perspectives about waiting lists for children with speech, language, and communication needs (SLCN) and explore waiting list management strategies. METHODS: The present study reports on 187 SLTs’ written responses to open-ended questions in a questionnaire. SLTs were from nine countries, had an average of 12 years’ experience in the profession (range 0.2–45 years), and either currently or had previously worked with children. Data were analysed qualitatively using thematic analysis. RESULTS: SLTs’ feelings about their waiting lists centred on three themes: (1) negative (e.g., “overwhelmed”, “stressed”, “anxious”, “embarrassed”); (2) neutral (e.g., “not too bad”, “okay”); and (3) positive (e.g., “manageable”, “proud”). Four themes related to waiting list management: (1) SLT service delivery (e.g., triage, use of technology in service provision); (2) workplace processes and policies (e.g., eligibility criteria, prioritisation); (3) SLT workforce actions (e.g., recruitment and retention of skilled SLTs); and (4) inaction (e.g., waiting list management was “out of my hands”). CONCLUSIONS: Waiting lists can have negative consequences and many SLTs take action to manage waiting lists; however, waiting list management strategies are not necessarily effective which can impact children’s outcomes. There is a need to reimagine service delivery and identify effective actions for managing speech and language therapy waiting lists at a local and systemic level in order to optimise outcomes for children and families.

背景:当服务不能满足需求时，就会出现等待言语和语言治疗的名单。等候名单对言语和语言治疗师(slt)和工作场所的管理构成了实际和道德上的挑战，可能对儿童和家庭产生影响。目的:本研究旨在探讨有言语、语言和沟通需要的儿童在等候名单上的观点，并探讨等候名单管理策略。方法:本研究报告了187名学生对开放式问题的书面回答。特殊教师来自9个国家，平均有12年的专业经验(0.2-45年)，目前或以前从事儿童工作。采用专题分析对数据进行定性分析。结果:学生对候补名单的感受主要集中在三个主题上:(1)消极情绪(如“不堪重负”、“紧张”、“焦虑”、“尴尬”);(2)中性的(例如，“不太坏”，“还好”);(3)积极的(例如，“可管理的”，“骄傲的”)。与轮候名单管理有关的四个主题:(1)提供特殊服务(例如，分类、在提供服务时使用技术);(2)工作场所流程和政策(例如，资格标准、优先顺序);(3) SLT劳动力行动(例如，招聘和保留熟练的SLT);(4)不作为(例如，等候名单管理“不在我的掌控之中”)。结论:等候名单可能产生负面影响，许多slt采取措施管理等候名单;然而，等候名单管理策略不一定有效，这可能会影响儿童的结果。有必要重新构想服务提供方式，并确定有效的行动，在地方和系统层面管理言语和语言治疗等候名单，以优化儿童和家庭的结果。

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引用次数: 0

An exploration of lexical selection in adults who stutter 成人口吃的词汇选择研究

Advances in communication and swallowing

Pub Date : 2021-08-25 DOI: 10.3233/acs-210023

A. Lee, G. O'Beirne, M. Robb

BACKGROUND AND OBJECTIVE: People who stutter (PWS) are able to anticipate a moment of stuttering. We wished to explore whether this anticipation might be reflected by either unusual word choice and/or delayed word production during a single-word confrontation naming task. METHOD: Nine PWS and nine age- and sex-matched fluent controls completed the single-word confrontation-naming task. Groups were compared on numbers of word-finding and fluency errors, response latency, and naming accuracy, measured against a novel ‘usuality’ criterion. Regression modelling of response accuracy and latency was conducted. RESULTS: The groups did not differ on naming task performance, except for a greater frequency of response latency errors in the PWS group. For both groups, responses containing word-finding or fluency errors were more likely to be non-usual names, and these were associated with longer latencies than accurate responses. For PWS, latency was positively related to participant age, and accuracy inversely related to stuttering severity. CONCLUSIONS: The findings provide insights into word substitution as a generalized behaviour, its function, and associated time-cost. Group-specific relationships imply greater sensitivity in PWS to changing demands and capacities, and highlight the complexity of interactions between physical stuttering behaviour and verbal avoidance.

背景与目的:口吃者(PWS)能够预料到口吃的时刻。我们希望探索在单字对抗命名任务中，这种预期是否可以通过不寻常的单词选择和/或延迟的单词生成来反映。方法:9名PWS和9名年龄和性别匹配的流利对照完成了单字对抗命名任务。各组被试在单词查找和流畅性错误、反应延迟和命名准确性方面进行了比较，并以一种新的“寻常性”标准来衡量。对响应精度和延迟进行了回归建模。结果:各组在命名任务表现上没有差异，除了PWS组的反应延迟错误频率更高。对于这两组人来说，包含找词或流利性错误的回答更有可能是不常用的名字，而这些回答比准确的回答延迟更长。对于PWS，延迟与参与者年龄正相关，准确性与口吃严重程度负相关。结论:研究结果提供了对词替代作为一种普遍行为，其功能和相关的时间成本的见解。群体特定关系意味着PWS对不断变化的需求和能力更敏感，并突出了身体口吃行为和言语回避之间相互作用的复杂性。

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引用次数: 0

Cluttering framed: An historical overview 杂乱的框架:历史概述

Advances in communication and swallowing

Pub Date : 2021-08-21 DOI: 10.3233/acs-210029

J. Duchan, S. Felsenfeld

BACKGROUND: Cluttering has been described in the literature on speech disorders for over 300 years. Despite this, it remains a poorly understood condition whose history has not been analyzed as a whole to identify common themes and underlying frameworks. OBJECTIVE: The purpose of this review is to identify thematic questions and frameworks contained within the literature on cluttering since the earliest found reference in 1717. METHODS: Information from influential historical and contemporary documents were analyzed. Particular attention was paid to the types of questions, both implicit and explicit, that were posed in these materials. This information was ultimately organized into five thematic strands, presented here in the form of key questions. RESULTS: Five questions were derived from our historical analysis: (1) What should the problem be called? (2) What kind of problem is it? (3) What are its defining features? (4) What are its causes? and (5) How should it be treated? The first four questions are discussed in this review. The fifth question will be addressed in a forthcoming paper. CONCLUSIONS: Consensus has been achieved on what to call the disorder (cluttering) and in what domain it should be placed (fluency). Less agreement exists regarding its defining features, causes, and treatment. We propose that alternative conceptual frameworks may be useful in breaking new ground in our understanding and management of this complex condition.

背景:混乱已经在语言障碍的文献中描述了300多年。尽管如此，它仍然是一个知之甚少的条件，其历史没有作为一个整体进行分析，以确定共同的主题和潜在的框架。目的:本综述的目的是确定自1717年最早发现的参考文献以来关于杂乱的文献中包含的主题问题和框架。方法:对有影响的历史和当代文献资料进行分析。特别注意了这些材料中所提出的问题的类型，包括隐性和显性问题。这些资料最终被组织成五个主题部分，在这里以关键问题的形式提出。结果:从我们的历史分析中得出了五个问题:(1)这个问题应该被称为什么?这是什么样的问题?(3)它的特征是什么?(4)原因是什么?(5)如何治疗?本文讨论了前四个问题。第五个问题将在即将发表的一篇论文中讨论。结论:对于什么叫障碍(杂乱)和在什么领域它应该被放置(流畅)已经达成共识。关于其定义特征、病因和治疗方法的共识较少。我们建议，替代的概念框架可能有助于在我们对这一复杂情况的理解和管理中开辟新的领域。

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引用次数: 1

Characterization of dysphagia following anterior cervical spine surgery. 颈椎前路手术后吞咽困难的特征。

Advances in communication and swallowing

Pub Date : 2021-01-01 Epub Date: 2021-11-09 DOI: 10.3233/acs-210034

John P Ziegler, Kate Davidson, Rebecca L Cooper, Kendrea L Garand, Shaun A Nguyen, Erick Yuen, Bonnie Martin-Harris, Ashli K O'Rourke

Background: Post-operative dysphagia is one of the most common complications of anterior cervical spine surgery (ACSS).

Objective: Examine post-operative structural and physiologic swallowing changes in patients with dysphagia following ACSS as compared with healthy age and gender matched controls.

Methods: Videofluoroscopic swallow studies of adults with dysphagia after ACSS were retrospectively reviewed. Seventy-five patients were divided into early (≤2 months) and late (> 2 months) post-surgical groups. Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale (PAS) scores, and pharyngeal wall thickness (PWT) metrics were compared.

Results: Significant differences were identified for all parameters between the control and early post-operative group. MBSImP Pharyngeal Total (PT) scores were greater in the early group (Interquartile Range (IQR) = 9-14, median = 12) versus controls (4-7, 5, P < 0.001) and late group (0.75-7.25, 2, P < 0.001). The early group had significantly higher maximum PAS scores (IQR = 3-8, median = 7) than both the control group (1-2, 1, P < 0.001) and late post-operative group (1-1.25, 1, P < 0.001). PWT was significantly greater in the early (IQR = 11.12-17.33 mm, median = 14.32 mm) and late groups (5.31-13.01, 9.15 mm) than controls (3.81-5.41, 4.68 mm, P < 0.001).

Conclusion: Dysphagic complaints can persist more than two months following ACSS, but often do not correlate with validated physiologic swallowing dysfunction on VFSS. Future studies should focus on applications of newer technology to elucidate relevant deficits.

背景：术后吞咽困难是颈椎前路手术最常见的并发症之一：术后吞咽困难是颈椎前路手术（ACSS）最常见的并发症之一：与年龄和性别匹配的健康对照组相比，研究 ACSS 术后吞咽困难患者的吞咽结构和生理变化：方法：对 ACSS 术后吞咽困难成人的视频荧光屏吞咽研究进行回顾性审查。75名患者被分为术后早期（≤2个月）和晚期（>2个月）两组。比较了改良钡吞咽功能障碍档案（MBSImP）、穿刺-吞咽量表（PAS）评分和咽壁厚度（PWT）指标：结果：对照组和术后早期组的所有参数均存在显著差异。与对照组（4-7，5，P < 0.001）和晚期组（0.75-7.25，2，P < 0.001）相比，早期组的 MBSImP 咽部总（PT）评分更高（四分位数间距（IQR）= 9-14，中位数= 12）。早期组的最大 PAS 评分（IQR = 3-8，中位数 = 7）明显高于对照组（1-2，1，P <0.001）和术后晚期组（1-1.25，1，P <0.001）。早期组（IQR = 11.12-17.33 mm，中位数 = 14.32 mm）和晚期组（5.31-13.01，9.15 mm）的脉搏波速度明显大于对照组（3.81-5.41，4.68 mm，P <0.001）：吞咽困难的主诉可在 ACSS 后持续两个月以上，但往往与 VFSS 验证的生理性吞咽功能障碍不相关。未来的研究应侧重于应用更新的技术来阐明相关缺陷。

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引用次数: 0

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