More randomised controlled studies in speech and language therapy.
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A survey was designed to investigate the previously unaddressed issue of resistance to discharge from speech therapy. One hundred and eighty-seven speech-language clinicians in clinical and hospital settings were sent a questionnaire based on research from the medical profession indicating that patients may become overly dependent on their physicians. Eighty-six percent of 159 usable respondents reported their clients resisted discharge. Many speech-language pathologists suggested techniques they have used to manage such clients.
Speech and language therapists (SLTs) are faced daily with a diversity of speech and language disabilities, which are associated with a variety of conditions ranging from client groups with overall cognitive deficits to those with more specific difficulties. It is desirable that those working with such a range of problems and with such a demanding workload, plan care efficiently. Therefore, the introduction of methodologies, reference models of work and tools, which significantly improve the effectiveness of therapy, are particularly welcome. This paper describes the first web-based tool for diagnosis, treatment and e-Learning in the field of Language and Speech therapy. The system allows SLTs to find the optimum treatment for each patient, it also allows any non-specialist user--SLT, patient or helper (relative etc.)--to explore their creativity, by designing their own communication aid in an interactive manner, with the use of editors such as: configuration and vocabulary. The system has been tested and piloted by potential users in Greece and the UK.
A total of 60 right-handed patients with acute aphasia due to left hemispheral stroke were randomly assigned to two modes of therapy for six months, beginning one month after the ictus. Conventional speech therapy provided by professional speech pathologists twice weekly was compared with emotionally supportive counseling therapy, also provided by professional speech pathologists at the same intervals. Language function was tested periodically by the Porch Index of Communicative Ability. Fifty of the subjects were also tested at ten months after the ictus. There was no difference in the amount of improvement between the two groups.
This paper discusses the characteristics of action research and promotes its potential for speech and language therapists. Action research is an approach which involves the practitioner and has as its purpose the improvement of practice. Small-scale studies by practitioners can be used to examine practical applications and implications of larger-scale studies. A group of therapists, motivated by a wish to investigate their own practice, proposed the development of a group to support their work, facilitated by the author.
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Data on aphasia management were collected by questionnaires to UK speech and language therapists. Returns representing over 90% of health districts were obtained. Variation amongst districts is evident in levels of staffing for the adult neurological case load, and in speed of response to referral, frequency and types of treatment available, and in other forms of support for patients and carers. Although individual therapists or districts are able to adhere to some of the professional recommendations for a 'quality' service, few are able to provide this high level of care in all aspects of aphasia management.
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More information into the natural course of dysphasia has improved information related to prognosis. An increased understanding regarding the underlying complex basis of language and communication leads to interesting intellectual debate and confronts the previously more simplistic approaches to assessment and remediation without necessarily assisting by replacing these with coherent and practical methods of management of this disability in context.
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This investigation looked at the vocabulary learning and use, and social and communication growth of 8 severely handicapped toddlers under two different language conditions. A computer-based approach was compared to traditional intervention techniques. Treatment conditions were administered in randomized order by two graduate student clinicians. Communication growth was assessed by using a standard set of measures administered before the intervention, at midpoint between the two treatment conditions, and at the end. The results from this study indicated that the subjects made notable progress regardless of the treatment condition received.