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PubMed2001

The UK education of overseas students in speech and language therapy.

Informal evidence suggests that many overseas speech and language therapists (SLTs) either do not return to their home country on qualification or do not work as SLTs in the public sector. Many factors may contribute to this situation. However, concern that it may result in part from a poor match between UK SLT education and the demands of the role in other countries, led the Royal College of Speech and Language Therapists (RCSLT) to fund a study of overseas SLT students' experiences of UK qualifying courses. The study involved questionnaires and interviews with current students and those qualifying since May 1994. The focus of this paper is the respondents' experiences of studying and working in the UK, their views of the advantages and disadvantages of working in their home countries and the UK and supportive strategies that UK universities and other agencies might adopt. Implications of the findings are discussed.

Consumer Behavior↗
PubMedDate not supplied

[Evaluation of language therapy in aphasia after stroke].

In 27 patients with aphasia and hemiparesis following strokes speech was tested before and after completion of sanatorium treatment. After three weeks of speech re-education aphasia improved in various degrees in 19 patients. The best results of logopedic treatment were obtained in patients with medium-grade or slight aphasia subjected to rehabilitation treatment during the first three months after stroke. Effective motor rehabilitation conducted parallelly with re-education exercises in early period after stroke has a favourable effect on advance in therapy and later resocialization of patients.

Adult↗
PubMed2004

Bronchial auscultation: an effective adjunct to speech and language therapy bedside assessment when detecting dysphagia and aspiration?

Detection of aspiration by bedside examination has frequently been found to be clinically inadequate when compared with videofluoroscopy (VF) as the gold standard. In Doncaster, UK, a new multidisciplinary approach to bedside assessment was devised using physiotherapists (PT) performing bronchial auscultation (BA) in combination with the speech and language therapists' (SLT) clinical examination of dysphagia. In this study 105 patients referred for VF examination of dysphagia were first tested by the BA team. Comparison was made between the results of the VF team and the results of the BA team in classifying the patients as "aspirating" or at "risk of aspirating." A high degree of agreement was found for risk of aspiration (sensitivity 87%), although specificity was low (37%). BA was highly specific (88%) when confirming the absence of aspiration, but sensitivity to the presence of aspiration was 45%. From the 105 patients tested, the BA team would have failed to modify the diet in only one subject who was aspirating and would have unnecessarily modified the diet of 17 subjects. In conclusion, in the sample population of individuals with complex dysphagia, the BA team approach reliably detected patients identified by VF as at risk of aspiration. In the group of patients identified by VF as aspirating, the BA team proved unreliable in detecting the presence of aspiration, although it did reliably identify patients who were not aspirating. BA is a potentially useful clinical tool which requires further research.

Adolescent↗
PubMed1999

Issues to consider in the evaluation of speech and language therapy for preschool children.

This paper reviews some of the methodological issues involved in the design of a randomized controlled trial currently underway in Bristol. The trial compares the progress of preschool children randomly allocated to a 'watching-waiting' control group with the experimental group who have immediate access to therapy. This paper reviews a number of relevant studies, which have either followed up preschool children with early language delays or have investigated the effects of therapy with this age group. The basic design of the trial is outlined along with a discussion of the sample, the measurements used and the therapy given.

Child, Preschool↗
PubMed1995

Improving fundamental frequency modulation in head trauma patients: a preliminary comparison of speech-language therapy conducted with and without IBM's Speech Viewer.

This study involves a preliminary comparison of traditional speech therapy for head trauma patients with therapy assisted by computer. Two subjects were treated in a 'crossover' design to compare the effects of each treatment. While both subjects improved, there was no obvious difference in treatment effectiveness. However, the computer support provided the measures of treatment efficacy which made this comparison possible.

Adult↗
PubMed1976

Mime in language therapy and clinician training.

A speech pathologist developed a program with language goals which included spontaneous communication, focus, attention span, auditory memory, receptive and expressive vocabulary, and concepts such as body image, spatial relationships, and same and different polarities. The services of a professional mime were used to translate these goals into mimetic activities and to perform the activities in group sessions with the children. In addition, the mime taught the speech clinicians some simple mimetic activities. The subjects were five children with mental retardation, language delay, lack of spontaneity, short attention span and very poor visual and auditory memory. The results suggested increase in spontaneity and attention span in all the children and a facility to remember the illusions depicted for them by the mime. The experience with the mime training for clinicians was also positive.

Adolescent↗
PubMed1994

Following the dolphins: an ethnographic study of speech and language therapy with people with learning difficulties.

The purpose of this study was to examine speech and language therapists' practices, and their perceptions of the knowledge and skills that they use in everyday clinical practice. The paper compares the knowledge and skills identified in a much larger consultative study of speech and language therapists' competence with the knowledge and skills identified by four speech and language therapists reflecting on a representative or 'typical' day in their working lives. This comparison between the outcome of a large survey and a more detailed ethnographic investigation of speech and language therapists' competence confirmed earlier reports that speech therapy appears to have a broad knowledge and skills base. Ethnographic analysis also revealed that this broad knowledge and skills base was, in the main, highly relevant to everyday clinical practices.

Clinical Competence↗
PubMed1998

Referral criteria for speech and language therapy assessment of dysphagia caused by idiopathic Parkinson's disease.

OBJECTIVE: To examine the prevalence of dysphagia in idiopathic Parkinson's disease (IPD) in the outpatient setting and to determine what assessment criteria to use to select patients with dysphagia for referral to speech and language therapists. MATERIAL AND METHODS: Sixty-four patients with IPD and 80 age-matched controls were interviewed in clinic about their swallowing history and an objective swallowing test administered. All patients were assessed over the next few weeks by an experienced speech and language therapist and dysphagia rated according to a modified Rehabilitation Institute of Chicago Dysphagia Rating Scale and a novel global rating scale. The ability of various clinic criteria to predict patients with severe dysphagia were examined. RESULTS: Dysphagia for food was found in 30% of patients, significantly more than in controls. Swallowing speed and bolus volume were significantly lower in patients compared with controls and were correlated with declining Hoehn and Yahr score. Swallowing speed fell significantly on withdrawal of medication. The therapist's global rating score and Chicago score declined with Hoehn and Yahr score and duration of disease. However, only 10% of patients required dietary advice and none needed gastrostomy or tracheostomy. Discriminant analysis showed that various combinations of clinic selection criteria were no better than the presence of dysphagia for food at predicting which patients had significant dysphagia requiring advice from a therapist. CONCLUSIONS: Patients with idiopathic Parkinson's disease should be questioned about dysphagia for food on a regular basis and, if present, should be referred to a speech and language therapist for further assessment and treatment. The outcome of this protocol should be tested prospectively.

Aged↗
PubMed2004

The effect of videoconference-based telerehabilitation on story retelling performance by brain-injured subjects and its implications for remote speech-language therapy.

This paper presents results from a study conducted at the Rehabilitation Engineering Research Center (RERC) on Telerehabilitation at the National Rehabilitation Hospital. The study was designed to measure performance by brain-injured subjects, with medical diagnoses of stroke or traumatic brain injury, on a standardized Speech-Language Pathology evaluation conducted in both face-to-face and videoconference-based telerehabilitation settings. The Story Retelling Procedure (SRP), which measures connected language production and comprehension of spoken narratives, was administered to each subject in both settings. The primary objectives of this study were to: (1) compare communication as measured by the SRP between experimental settings, and (2) determine if subject variables (such as age, education, technology experience or gender) had an effect on performance differences between settings. The rationale was that any difference in this aspect of performance must be identified and characterized before this mode of intervention can be used clinically. Across all subjects (n = 40), no significant difference (p > 0.05) was found between SRP performance measured in the two settings. Additionally, variables including age, education, technology experience, and gender did not significantly affect the difference between performance in the two settings. Overall, subjects reported a high level of acceptance of videoconferencing with 34 subjects responding "yes," 4 responding "no," and 2 responding "maybe" when asked if they would use videoconferencing again to talk to a clinician. Results of this study confirm the potential for SLP treatment using videoconferencing and indicate a need for continued research in the field.

Adolescent↗
PubMed1992

The effects of speech and language therapy for a case of dysarthria associated with Parkinson's disease.

We report the results of a single-subject multiple baseline across behaviours experiment of a 74-year-old woman presenting with Parkinson's disease. Her speech was typical of a hypokinetic dysarthria. The main features of her dysarthric speech were: a restriction in the modulation of fundamental frequency, an inappropriate pitch level and a rate disturbance. Three measures of prosody were operationally defined as follows: (1) linguistic modulation of fundamental frequency, (2) mean fundamental frequency and (3) rate. Treatment focused on ameliorating these aspects employing a multiple baseline design. Measures during and post-therapy documented improvement for each of these three aspects of prosody. Independent judges were also more capable of understanding her speech and her speech prosody after therapy. Upon follow-up measures 10 weeks later, most of the improvement was maintained.

Aged↗