-
American Family Physician Nov 2021
Topics: Diagnostic Self Evaluation; Humans; Laryngoscopy; Speech Therapy; Vocal Cord Dysfunction
PubMed: 34783515
DOI: No ID Found -
The South African Journal of... Sep 2021The need for communication-related services in sub-Saharan Africa to support individuals experiencing communication disability is a longstanding and well-documented...
BACKGROUND
The need for communication-related services in sub-Saharan Africa to support individuals experiencing communication disability is a longstanding and well-documented situation. We posit the inequities highlighted by coronavirus disease 2019 (COVID-19) make this a relevant time for speech language therapists and the professional bodies that govern us to broadly consider our roles and practices in education, health and disability in local, national and global contexts.
OBJECTIVE
To illustrate what services developed with local knowledge can look like in Kenya in order to promote dialogue around alternative speech language therapy models, particularly in contexts where there are insufficient services, few trained speech language therapists and limited structures to support the emerging profession.
METHOD
This article examines three clinical case studies from Western Kenya, using a conceptual framework for responsive global engagement.
RESULTS
Service needs in Western Kenya well exceed a direct one-on-one model of care that is common in the minority world. The service delivery models described here emphasise training, skills sharing and engaging the myriad of communication partners available to individuals with communication disabilities.
CONCLUSION
We offer up these case studies of collaborative practice as contextual realities that may be present in any speech language therapy programming in under-resourced communities. We dispel the idea that success in this work has been linear, progressed on planned time frames or come to fruition with targeted goal attainment. The fact that our relationships have endured in these communities since 2007 is our primary success.
Topics: COVID-19; Humans; Kenya; Language; Language Therapy; SARS-CoV-2; Speech; Speech Therapy
PubMed: 34636594
DOI: 10.4102/sajcd.v68i1.838 -
Acta Otorhinolaryngologica Italica :... Oct 2010
Topics: Humans; Laryngectomy; Speech Therapy
PubMed: 21804688
DOI: No ID Found -
The Journal of Craniofacial SurgeryAlthough a number of international cleft organizations and cleft professionals in low- and middle-income countries (LMICs) have built and supported comprehensive cleft...
BACKGROUND
Although a number of international cleft organizations and cleft professionals in low- and middle-income countries (LMICs) have built and supported comprehensive cleft care and speech therapy models to address the shortage of speech services in LMICs, the specific speech needs of individuals with cleft lip and palate (CLP) in such countries remain unknown. The objective of this study was to evaluate the barriers to accessing speech services for patients with CLP as well as the resources and models of speech services that are currently available for individuals with CLP in LMICs, with the goal of better understanding the needs of this population.
METHODS
Qualitative and quantitative methods consisted of Smile Train partner surveys that were distributed June 25th to July 31st, 2018 worldwide. Surveys were distributed through Smile Train's online medical database, Smile Train Express, which every Smile Train partner uses to report their Smile Train sponsored treatment outcomes. A total of 658 Smile Train partners responded to the surveys. Respondents included surgeons, speech therapists, orthodontists, administrators and nurses who represented non-governmental organizations, hospitals (private or public), hospital groups, and private clinics.
RESULTS
Results indicated that lack of resources, including access to local speech providers and language materials, as well as financial constraints such as patient travel and speech treatment costs, are the most commonly reported barriers to accessing speech services across all geographic regions surveyed.
CONCLUSIONS
Improving access to CLP speech services in LMICs may require strategies that address lack of speech providers, language materials, and financial constraints.
Topics: Cleft Lip; Cleft Palate; Humans; Speech; Speech Therapy
PubMed: 34320574
DOI: 10.1097/SCS.0000000000007988 -
The Cochrane Database of Systematic... Jul 2016Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, strength and co-ordination of any or all of the... (Review)
Review
BACKGROUND
Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, strength and co-ordination of any or all of the muscles used for speech. Resulting speech difficulties can range from mild, with slightly slurred articulation and breathy voice, to profound, with an inability to produce any recognisable words. Children with dysarthria are often prescribed communication aids to supplement their natural forms of communication. However, there is variation in practice regarding the provision of therapy focusing on voice and speech production. Descriptive studies have suggested that therapy may improve speech, but its effectiveness has not been evaluated.
OBJECTIVES
To assess whether any speech and language therapy intervention aimed at improving the speech of children with dysarthria is more effective in increasing children's speech intelligibility or communicative participation than no intervention at all , and to compare the efficacy of individual types of speech language therapy in improving the speech intelligibility or communicative participation of children with dysarthria.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015 , Issue 7 ), MEDLINE, EMBASE, CINAHL , LLBA, ERIC, PsychInfo, Web of Science, Scopus, UK National Research Register and Dissertation Abstracts up to July 2015, handsearched relevant journals published between 1980 and July 2015, and searched proceedings of relevant conferences between 1996 to 2015. We placed no restrictions on the language or setting of the studies. A previous version of this review considered studies published up to April 2009. In this update we searched for studies published from April 2009 to July 2015.
SELECTION CRITERIA
We considered randomised controlled trials and studies using quasi-experimental designs in which children were allocated to groups using non-random methods.
DATA COLLECTION AND ANALYSIS
One author (LP) conducted searches of all databases, journals and conference reports. All searches included a reliability check in which a second review author independently checked a random sample comprising 15% of all identified reports. We planned that two review authors would independently assess the quality and extract data from eligible studies.
MAIN RESULTS
No randomised controlled trials or group studies were identified.
AUTHORS' CONCLUSIONS
This review found no evidence from randomised trials of the effectiveness of speech and language therapy interventions to improve the speech of children with early acquired dysarthria. Rigorous, fully powered randomised controlled trials are needed to investigate if the positive changes in children's speech observed in phase I and phase II studies are generalisable to the population of children with early acquired dysarthria served by speech and language therapy services. Research should examine change in children's speech production and intelligibility. It must also investigate children's participation in social and educational activities, and their quality of life, as well as the cost and acceptability of interventions.
Topics: Age Factors; Child; Child, Preschool; Dysarthria; Humans; Speech Intelligibility; Speech Therapy
PubMed: 27428115
DOI: 10.1002/14651858.CD006937.pub3 -
Ciencia & Saude Coletiva Mar 2020To estimate the prevalence of access and use of speech-language therapy services and identify the variables associated with access. Cross-sectional population-based...
To estimate the prevalence of access and use of speech-language therapy services and identify the variables associated with access. Cross-sectional population-based study. The sample consisted of adult individuals living in Porto Alegre, southern Brazil. The data were collected using an instrument constructed with domains of national research questionnaires, with a module on speech-language therapy. The outcome was the access to a speech-language therapist. Poisson regression with robust variance was used to calculate Prevalence Ratios with 95% confidence intervals. A total of 214 people participated in the study, of which 67.3% (n = 144) were female. The mean age was 54.28 (SD±18.83) years. Fifty-six (26.2%) people mentioned the need for speech-language therapy consultation. All 56 subjects were able to perform speech-language therapy, of which 69.4% (n = 39) in private practice and 19.6% (n=11) used healthcare insurance plans at partnering providers. In the final model, the highest prevalence of access was associated with female (PR=1.09,95%CI1.01-1.18) and had some deficiency (PR = 1.09,95%CI1.03-1.17). Access to a speech-language therapist is more frequent in private services. It is observed that women and the disabled individuals have a higher prevalence of access to speech-language therapist.
Topics: Adult; Aged; Brazil; Cross-Sectional Studies; Facilities and Services Utilization; Female; Health Services Accessibility; Humans; Language Therapy; Male; Middle Aged; Speech Therapy
PubMed: 32159652
DOI: 10.1590/1413-81232020253.17212018 -
CoDAS 2021To analyze the factors associated with the professional insertion of Speech Therapy graduates. (Observational Study)
Observational Study
PURPOSE
To analyze the factors associated with the professional insertion of Speech Therapy graduates.
METHODS
Observational analytical cross-sectional study, with a non-probabilistic sample, composed of 245 graduates from a Speech Therapy course in Brazil. The research applied a questionnaire containing objective and open questions, segmented into six axes. Bivariate and multivariate analysis of the data were performed.
RESULTS
There was an association between working as a speech therapist with the variables, gender (p=0.031), age (p≤0.001), initiative (p=0.001), leadership ability (p=0.001), decision making ability (p=0.001), teamwork ability (p=0.001), managerial skills (p=0.034), interest in new knowledge (p≤0.001), pride in the profession (p=0.001), network of contacts (p=0.001) and participation in outreach projects (p≤0.001). There was a higher chance of entering the job market as a speech therapist for those graduates who acquired network contacts during an undergraduate course (3.3 times more); were interested in knowledge (3.2 times more); develop leadership skills (2.6 times more); younger than 29 years old (0.3 times more) and carried out outreach projects during graduation (0.2 times more).
CONCLUSION
Graduates in Speech Therapy who develop a network of contacts, have an interest in knowledge, develop leadership skills and participate in outreach projects during graduation have enlarged possibilities of entering the job market as speech therapists.
Topics: Adult; Brazil; Cross-Sectional Studies; Humans; Perception; Professional Competence; Speech Therapy
PubMed: 34231712
DOI: 10.1590/2317-1782/20202020130 -
International Journal of Language &... Sep 2020There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's...
BACKGROUND
There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's health and well-being. However, there remains a paucity of evidence for assessment and intervention practices for dysphagia and mealtime difficulties. Furthermore, there is a limited understanding of how speech and language therapists (SLTs) support people with these dementia-related issues and what are the barriers and facilitators to practice. Further research is therefore needed to guide policy as well as service guideline and delivery development.
AIMS
To establish the current practices of SLTs managing dementia-related dysphagia and mealtime difficulties in the UK and Republic of Ireland (ROI), and to establish their opinions and experiences of what challenges or supports to practice they have encountered.
METHODS & PROCEDURES
An anonymous, cross-sectional web-based survey was developed and distributed to SLTs working in the UK and ROI. Respondents completed a questionnaire that consisted of open and closed questions across nine topic areas. Closed responses were evaluated using descriptive statistics; open-ended questions were analysed using conventional content analysis.
OUTCOMES & RESULTS
A total of 310 people accessed the survey, and 125 respondents completed it fully. While respondents agreed on their role in dysphagia management, they varied in their views on the extent of their role in managing mealtime difficulties. Additionally, their self-rated knowledge of mealtime difficulties in dementia was lower than their dysphagia knowledge. The respondents predominantly based their management decisions on their clinical experience of working with people with dementia. They primarily used compensatory strategies and frequently cited the need for family and care staff training. Respondents also highlighted barriers to effective management and training provision such as inefficient referral systems, a lack of carer knowledge and lack of SLT resources.
CONCLUSIONS & IMPLICATIONS
The results provide valuable insight into the issues facing SLTs practising in this area. The SLTs surveyed considered dysphagia a core part of their role when supporting people with dementia; however, respondents' views on mealtime difficulties varied. This highlights the need to establish consensus guidelines on the SLT's role in order to avoid variations in service delivery that could negatively impact the health and well-being of people with dementia. Moreover, further research to develop efficient and effective training for care staff supporting mealtime difficulties and dysphagia is essential. What this paper adds What is already known on the subject Research indicates that people with dementia develop dysphagia and mealtime difficulties as dementia progresses. SLTs often manage these, but there is no research on the effective assessment and management procedures, or guidance on best practice. What this paper adds to existing knowledge This paper provides an understanding of the variation in practice across the UK and ROI. Respondents described barriers to delivering an effective service and frequently linked these to the SLTs' resources as well as service constraints. What are the potential or actual clinical implications of this work? These findings support the need for future research to develop guidelines for SLT practice in this area. They also support the need to examine resource allocation and workforce management to enable SLTs to manage dementia-related dysphagia and mealtime difficulties effectively.
Topics: Adult; Allied Health Personnel; Attitude of Health Personnel; Cross-Sectional Studies; Deglutition Disorders; Dementia; Female; Humans; Ireland; Language Therapy; Male; Meals; Middle Aged; Speech Therapy; Surveys and Questionnaires; United Kingdom; Work
PubMed: 32706516
DOI: 10.1111/1460-6984.12563 -
American Family Physician Nov 2021Vocal cord dysfunction (i.e., vocal cords closing when they should be opening, particularly during inspiration) should be suspected in patients presenting with... (Review)
Review
Vocal cord dysfunction (i.e., vocal cords closing when they should be opening, particularly during inspiration) should be suspected in patients presenting with inspiratory stridor or wheezing; sudden, severe dyspnea (without hypoxia, tachypnea, or increased work of breathing); throat or chest tightness; and anxiety, particularly in females. Common triggers include exercise, asthma, gastroesophageal reflux disease, postnasal drip, upper or lower respiratory tract infection, and irritants. Nasolaryngoscopy and pulmonary function testing, with provocative exercise and methacholine, can help diagnose vocal cord dysfunction and are helpful to evaluate for other etiologies. Conditions that can trigger vocal cord dysfunction should be optimally treated, particularly asthma, gastroesophageal reflux disease, and postnasal drip, while avoiding potential irritants. Therapeutic breathing maneuvers and vocal cord relaxation techniques are first-line therapy for dyspnea that occurs with vocal cord dysfunction. A subset of vocal cord dysfunction leads to dysphonia, as opposed to dyspnea, secondary to abnormal laryngeal muscle spasms (vocal cord closure is less severe). OnabotulinumtoxinA injections may be helpful for spasmodic dysphonia and for treating dyspnea in certain cases, although evidence is limited.
Topics: Airway Management; Humans; Laryngoscopy; Respiratory Function Tests; Respiratory Therapy; Speech Therapy; Vocal Cord Dysfunction; Vocal Cords
PubMed: 34783512
DOI: No ID Found -
Current Neurology and Neuroscience... Feb 2021This review summarizes the evidence on rehabilitation for people with Parkinson's disease, including when to refer, what rehabilitation professionals should address, and... (Review)
Review
PURPOSE OF REVIEW
This review summarizes the evidence on rehabilitation for people with Parkinson's disease, including when to refer, what rehabilitation professionals should address, and how to deliver rehabilitation care.
RECENT FINDINGS
Clinical practice guidelines support physical therapy, occupational therapy, and speech-language pathology for Parkinson's disease. However, integrating guidelines into practice may be difficult. Implementation studies take into account patient and clinician perspectives. Synthesizing guidelines with implementation research can improve local delivery. There is moderate to strong evidence supporting physical therapy, occupational therapy, and speech-language pathology soon after diagnosis and in response to functional deficits. We propose a framework of three pathways for rehabilitation care: (1) consultative proactive rehabilitation soon after diagnosis for assessment, treatment of early deficits, and promotion meaningful activities; (2) restorative rehabilitation to promote functional improvements; and (3) skilled maintenance rehabilitation for long-term monitoring of exercise, meaningful activities, safety, contractures, skin integrity, positioning, swallowing, and communication.
Topics: Communication; Exercise; Humans; Parkinson Disease; Speech Therapy
PubMed: 33615420
DOI: 10.1007/s11910-021-01096-0