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PubMed1998

New approaches to learning on clinical placement.

Traditional models of clinical placements for students in speech and language therapy (SLT) are often based on a one-to-one model where the structure of the learning process is: theory, observation and practice. Literature relating to adult learning and professional education suggests alternative approaches to clinical training which may be relevant to SLT. Work in progress is discussed where alternative approaches to placements and student learning in a range of placement settings are being developed.

Adult↗
PubMed1998

A comparison of training approaches for support assistants using the Hanen philosophy.

The introduction of the Hanen Programme (Watson, 1993) for parents of children who will in the future attend special schools can have training implications for their school's staff. These factors have led to a speech and language therapy service working in collaboration with its local schools to offer courses for special needs support assistants. The design, planning and delivery of the courses were based on Hanen philosophy. Some courses were exclusively for support assistants and others offered the opportunities for them to work in differing degrees of partnership with children's parents. The successes and the limitations of support assistants attending parents Hanen courses were evaluated.

Education, Continuing↗
PubMed1991

Early second language acquisition: a comparison of the linguistic output of a pre-school child acquiring English as a second language with that of a monolingual peer.

Two pre-school children were recorded at regular intervals over a 9-month period while playing freely together. One child was acquiring English as a second language, whilst the other was a monolingual English speaker. The sociolinguistic domain was such that the children were likely to be motivated to communicate with each other in English. A variety of quantitative measures were taken from the transcribed data, including measures of utterance type, length, type-token ratios, use of auxiliaries and morphology. The child for whom English was a second language was found to be well able to interact on equal terms with his partner, despite being somewhat less advanced in some aspects of English language development by the end of the sampling period. Whilst he appeared to be consolidating his language skills during this time, his monolingual partner appeared to be developing rapidly. It is hoped that normative longitudinal data of this kind will be of use in the accurate assessment of children from dual language backgrounds, who may be referred for speech and language therapy.

Child Language↗
PubMedDate not supplied

[Relation between social cognitive aspects and the functional communicative profile in a group of adolescents of the autistic spectrum].

BACKGROUND: Issues concerning language development and their relation with social cognitive aspects give direction to the clinical practice when assisting the population with the diagnosis within the autistic spectrum. The deficits or differences in this development can result in different ways of analyzing and counseling this population. Adolescence becomes a question mark in this analysis since, in most cases, researches address only early childhood. The speech pathologist must assess the relationship between language abilities and communicative competence. Language abilities refer to the possibilities to understand and formulate spoken or written symbolic systems, whereas the communicative competence refers to the ability to use language as an effective tool to interact with other people in several social contexts. PURPOSE: To verify the development of the functional communicative profile and of the social cognitive aspects of adolescents, who attend a specialized institution and who have a psychiatric diagnosis within the autistic spectrum in three different situations of communication during a 12 months period and to study the relation between these variables in the same situations, during the same period of time. METHOD: Subjects of this study were five adolescents with ages between 12 and 17 years. Two recording sets, with a 12 month interval, were obtained for each subject. Each recording set was composed by three 30 minutes videotaped situations of different interactive contexts: Situation I--individual language therapy; Situation II--child in a group with coordinator; Situation III--child in a group without coordinator. RESULTS: Differences exist between the subjects in the three studied situations regarding the social cognitive performance and the functional communicative profile. CONCLUSION: There is a relationship between the development of the social cognitive aspects and the functional communicative profile in the three situations of communication for the studied period.

Adolescent↗
PubMed1987

Improvement of deficits in mnemonic rhyme for multiplication in Japanese aphasics.

Since Japanese learn the multiplication tables by means of mnemonic rhymes called kuku, i.e., via the auditory-speaking route, it is hypothesized that aphasics who have a deficit in kuku might relearn it via the visual-writing route. After having ordinary language therapy for more than 3 months, eight patients were admitted to this special kuku training. The comparisons of scores on multiplication tests showed that the visual-writing route improved most after a 1- or 2-month training period while the auditory-speaking route improved least. These results, suggesting that the visual processor can take on the new role in conducting multiplication, can be considered a realization of functional reorganization in the brain.

Adult↗
PubMed1998

Service development to meet the needs of 'people with communication disabilities' in developing countries.

PURPOSE: In spite of the catastrophic consequences of impaired communication skills on the quality of human life, development of services for people with communication disabilities have low priority in health care and rehabilitation. Nowhere is this more apparent than in developing countries. The low coverage levels of the limited services which do exist in these countries, indicate a need to develop new and innovative service structures. It is to this end, given the limited literature available, that this review looks mainly at articles of a descriptive nature based on clinical experience. The review seeks to identify ideology which could be used to under-pin alternative service delivery and structures. METHOD: Three collections of literature relevant to the topic under discussion are identified, one collection relates to impairment categories, one to disability perspectives and one to speech and language therapy provision. It is recognized that all three collections are needed to form a basis for innovative change, but this review aims to examine the latter collection only, referring the reader to items in the other collections, when relevant. RESULTS: The information reviewed is analysed for recurring themes and the results are seen to concur with many of the disability perspectives expressed in present day literature.

Communication Disorders↗
PubMed2004

Connexin 26 mutations in nonsyndromic autosomal recessive hearing loss: speech and hearing rehabilitation.

OBJECTIVE: Hearing loss is the most common form of sensory impairment, with approximately one infant/1000 born with profound congenital deafness. A pre-lingual bilateral sensorineural hearing impairment poses a substantial problem as it negatively impacts on the subject's ability to conduct a normal social life. The aim of the study was to observe, in a group of children affected by pre-lingual non-syndromic autosomal recessive hearing impairment: (1) the role of the possible mutation of connexin 26 in the pathogenesis of the hearing loss; (2) the audiological and clinical aspects of the hearing impairment; (3) therapy to be adopted for the different patients. METHODS: The study was carried out on 39 patients, 16 males and 23 females, aged between six and 17 years (mean 12 years), affected by non syndromic congenital deafness, presumably hereditary, referred to the out-patients audiology clinic for children of the Department of Otolaryngology of the Federico II University of Naples. RESULTS: Our study conducted on 39 children with pre-lingual bilateral sensorineural autosomal recessive deafness showed as follows: (I) from a molecular perspective: an incidence of 41% in the cases studied of mutations in the encoding of the connexin 26 gene; a prevalence in our case study of the 35delG mutation (69%). (II) The characteristics of the hearing impairments in the children studied were homogeneous, regardless of the presence or absence of a connexin 26 mutation: the hearing impairment was pre-lingual bilateral sensorineural, the impairment often involved mainly the high frequencies, but, especially in the severe forms an involvement of all the frequencies was not rare; the hearing impairments were symmetrical and non progressive in time. (III) The results of the application of prosthesis and thereafter rehabilitative language therapy are generally satisfactory but correlated of course to the severity of the hearing loss. CONCLUSION: In conclusion, we hope that further developments in the research on genetic hearing impairments will promptly result in advances in clinical practice.

Adolescent↗
PubMed1993

A survey of aphasia services in the United Kingdom.

A survey of the service available, in speech and language therapy departments, to adults with aphasia revealed that many districts in the United Kingdom are unable to fulfil the professional recommendations for the care of aphasic clients. Although individual 'good practice' criteria could be satisfied, only a minority of districts were able to provide a comprehensive service. Levels of staffing for the adult neurological caseload are variable and even, at best, hinder therapists in delivering the recommended standard of management to aphasic clients and their carers.

Aphasia↗
PubMed1993

Teaching word-finding strategies to severely language-impaired children.

The present study describes how four severely language-impaired pupils participated in an intervention programme aimed towards improving their word-finding skills. Short intervention sessions that concentrated upon a combination of both elaboration and retrieval techniques were conducted over a period of 4 weeks. Four control subjects received language therapy that was unrelated to word-finding activities. The subjects were matched for age, sex and word-finding difficulties. Results revealed that the two groups differed significantly on the accuracy of word retrieval. The four subjects that had received specific intervention improved in their ability to retrieve words. Two-tailed t-tests indicated that the improvement was highly significant at the probability level of p < 0.01 between the stages of testing. The contribution of the intervention sessions towards facilitating word-finding strategies of the four children is discussed.

Child↗
PubMed1998

The hidden determiner of student learning opportunity on clinical placement.

A qualitative study was undertaken to gain deeper insight into the nature of learning opportunities afforded to speech and language therapy (SLT) students on clinical placement. The study aimed to illuminate aspects of the placement learning environment that have a positive or negative influence. Indepth interviews were conducted with two groups of students (13 in total), five education-based clinical tutors and five National Health Service (NHS)-based clinical supervisors. Interviews were transcribed, indexed, charted and analysed. A previously unexplored theme emerged from the data--that of risk. This paper explores the concept of risk and looks at the ways in which risk defines the amount, timing and nature of clinical experience for students.

Humans↗
PubMedDate not supplied

A review of Clinical Terms Version 3 (Read Codes) for speech and language record keeping.

There may be bugs, there may be viruses, but computers are here to stay. Access to computers may vary greatly from 'seen one once' to daily usage. However, with an increasing dependence on electronic records, even the most remote therapist will ultimately be faced with computerization. To make this process as painless as possible some commonality in approach is logical. A common vocabulary, for instance, would ensure that dysphasia in Cape Town is the same as dysphasia in Dundee. This is great in theory but is Clinical Terms Version 3 (Read Codes) (CTV3) sufficient to encode records in clinical practice? It is to this end that the Speech and Language Therapy Department at Burton Hospital took part in a multidisciplinary project with the NHS Centre for Coding and Classification (NHS CCC). (NHS CCC became the NHS Information Authority, Coding and Classification on 1 April 1999.) Their CTV3 offers a standardized clinical terminology. An audit of patient case-notes found that 78% of the terms used by therapists were available in CTV3. Although there are many issues raised concerning electronic patient records, CTV3 presented as a potential vocabulary for recording patient information in this acute setting.

Humans↗
PubMed1998

Developing critical practice: a South African's perspective.

The manner in which speech and language therapy (SLT) considers communicating evidence of practice with a multicultural clientele is considered in context of cultural imperialism. A conceptual framework (i.e., the curriculum of practice) developed from a South African study (Pillay 1997), is highlighted for use in understanding, evaluating and communicating evidence of practice with the clientele in focus. The lens (or paradigm) used by SLT to view its curriculum of practice may reveal different stories about the same subject. Given this, the critical paradigm is proffered over that of the empirical-analytical (or 'scientific') and hermeneutic-interpretive types of paradigms. Finally, suggestions regarding the development of critical SLT are discussed.

Clinical Competence↗
PubMedDate not supplied

Communication skills workshops in learning disability nursing.

This article investigates the effects of a combination of direct speech, language therapy and staff training on the communication skills of nursing and support staff working with people who have a severe learning disability and challenging behaviour. The approach aimed to help staff choose, prioritize and implement changes in communication. The input was effective in increasing the knowledge of the staff group with regard to challenging behaviour and communication breakdown, and in changing the communicative behaviour of staff. The changes measured were those of longer interactions occurring between staff and service users, and the use of non-verbal communication to support interactions. The implementation of the communication strategies is being audited.

Clinical Competence↗
PubMed1997

A model of educational resource use by children with cochlear implants.

We have tracked patterns of use of educational and rehabilitative resources as part of an initial assessment of cost-benefit ratios of cochlear implants in children. Forty-two children with cochlear implants in the Listening Center at Johns Hopkins program of aural rehabilitation have served as our study cohort to develop the measures to be assessed. An educational resource matrix stratifies school setting (residential vs special education vs non-specialized "mainstream" setting) and levels of rehabilitative support (speech and language therapy and interpreter use) to map past and current use of these services. Initial cost-benefit projections based on observed advancement toward educational independence in the educational resource matrix indicate an extremely favorable net present value of the implant (cost savings minus cost). These cost-benefit projections will need to be supplemented with measures of the impact on quality of life and future educational and vocational options to determine the overall cost-effectiveness of cochlear implants in children.

Baltimore↗
PubMed2006

Assessing adherence to the evidence base in the management of poststroke dysphagia.

OBJECTIVE: To evaluate the reliability and responsiveness to change of an audit tool to assess adherence to evidence of effectiveness in the speech and language therapy (SLT) management of poststroke dysphagia. DESIGN: The tool was used to review SLT practice as part of a randomized study of different education strategies. Medical records were audited before and after delivery of the trial intervention. SETTING: Seventeen SLT departments in the north-west of England participated in the study. SUBJECTS: The assessment tool was used to assess the medical records of 753 patients before and 717 patients after delivery of the trial intervention across the 17 departments. A target of 10 records per department per month was sought, using systematic sampling with a random start. ANALYSIS: Inter- and intra-rater reliability were explored, together with the tool's internal consistency and responsiveness to change. RESULTS: The assessment tool had high face validity, although internal consistency was low (ra = 0.37). Composite scores on the tool were however responsive to differences between SLT departments. Both inter- and intra-rater reliability ranged from 'substantial' to 'near perfect' across all items. CONCLUSIONS: The audit tool has high face validity and measurement reliability. The use of a composite adherence score should, however, proceed with caution as internal consistency is low.

Deglutition Disorders↗
PubMed1997

Specialist speech and language therapists' use and evaluation of visual speech aids.

Sixty speech and language therapy service managers and 233 specialist speech and language therapists (SLTs) throughout the UK completed a postal questionnaire which asked for caseload data, patterns of use of visual speech aids (VSAs) and ratings of VSAs on a number of dimensions (in a follow-up to the survey carried out by Coventry, Clibbens, Cooper and Rood, 1997). Information was also elicited about frequency of use of VSAs together with comments relating to the range of applicability of each type of aid. The results revealed that no VSA scored better than average ratings and, in particular, 'Portability' and 'Affordability' scored lowest overall. In addition, no differences were found in ratings of particular VSAs between specialist types. The caseload data reported also confirmed the need to take baserate into account when purchasing and designing VSAs.

Adult↗
PubMed1979

Influence of rehabilitation on language skills in aphasic patients. A controlled study.

The influence of language rehabilitation on specific language skills (speaking, understanding, writing, and reading) was investigated in 281 aphasic patients (162 reeducated and 119 controls) who were subjected to a second examination no less than six months after the first. The relationship of the following factors to improvement was studied: (a) time between onset of aphasia and first examination; (b) type of aphasia; (c) overall severity of aphasia on first examination; (d) presence or absence of rehabilitation between first and subsequent examination. It was found that rehabilitation has a significant positive effect on improvement in all language skills. Time between onset and first examination and overall severity of aphasia were negatively related to improvement. The relationship of type of asphasia to improvement was not significant. Additional evidence of the efficacy of rehabilitation is provided by experience with patients who began language therapy several months or years after the onset of their language disorder.

Adolescent↗