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PubMedDate not supplied

[Language therapy results with adolescents of the autistic spectrum].

BACKGROUND: Results of language therapy with adolescents and children with autistic spectrum disorders. AIM: to identify changes, after a six-month period of speech-language therapy, in a group of adolescents and to compare them with a group of children. METHOD: Data referring to the communicative profile and social-cognitive performance of 12 adolescents and 12 children were analyzed. RESULTS: Just one of the 10 observed areas presented meaningful progress for the group of adolescents and 5 areas presented progress for group of children. CONCLUSION: The results reinforce the importance of language therapy for autistic children, as more progress can be obtained at this age.

Adolescent↗
PubMedDate not supplied

Intergenerational communication: fundamental but under-exploited theory for speech and language therapy with older people.

There is a body of research literature already applied in speech and language therapy practice that is concerned with communication between children and adults and the adaptations adults make to facilitate the development of language in children. There is much less and more recent literature concerned with intergenerational communication involving older people and older people in institutional care. This has not yet impacted on speech and language therapy practice, especially in the area of training others. The aims of this paper are (1) to describe some of the main theoretical concepts associated with intergenerational communication, (2) to present the results from a study of the opinions about and experiences of intergenerational communication in which children, community- based older women and professional carers of older people were included and (3) to discuss the implications for speech and language therapy practice. A hypothesis for the study was that views on and attitudes towards communication and ageing would vary among the age groups. Some of the main concepts and models associated with intergenerational communication with older people are reviewed, including the communication predicament and enhancement models and the concept of patronizing communication. A qualitative study of three different age groups of (mainly) women was undertaken using a variety of methods of data elicitation (including written questionnaire and focus group discussion). Themes arising from the data were illuminated using content analysis. Participants' responses demonstrate some current generally positive views across the life-span on what it means to be old and the value of communication with older people. The implications for speech and language therapy practice are outlined, with the main emphasis on the potential use of intergenerational communication theory in developing a new focus for training other staff groups who care for older people and for measures of effectiveness of such in-service training.

Adult↗
PubMed1998

Note on ambient noise levels in head start speech-language therapy rooms.

Only one speech-language therapy room of ten at preschool Head Start centers met the American Speech-Language-Hearing Association's (ASHA) requirements for ambient noise levels in educational settings. Preschoolers with speech-language disorders need ideal circumstances for therapy, which may be achieved through environmental changes or assistive listening devices.

Child, Preschool↗
PubMedDate not supplied

Educational provision for children with specific speech and language difficulties: perspectives of speech and language therapy service managers.

BACKGROUND: Children with specific speech and language difficulties (SSLD) pose a challenge to the education system, and to speech and language therapists who support them, as a result of their language needs and associated educational and social-behavioural difficulties. The development of inclusion raises questions regarding appropriate provision, whether the tradition of language units or full inclusion into mainstream schools. AIMS: To gather the views of speech and language therapy service managers in England and Wales regarding approaches to service delivery, terminology and decision-making for educational provision, and the use of direct and indirect (consultancy) models of intervention. METHOD AND PROCEDURES: The study reports on a national survey of speech and language therapy (SLT) services in England and Wales (129 respondents, 72.1% response rate) and interviews with 39 SLT service managers. OUTCOMES AND RESULTS: Provision varied by age group with support to children in the mainstream common from pre-school to the end of Key Stage 2 (up to 11 years), and to those in designated specialist provision, common at Key Stages 1/2 (ages 5-11 years), but less prevalent at Key Stages 3/4 (11-16 years). Decision-making regarding provision was influenced by the lack of common terminology, with SSLD and specific language impairment (SLI) the most common, and criteria, including the use of the discrepancy model for defining SSLD. Practice was influenced by the difficulties in distinguishing children with SSLD from those with autistic spectrum disorder, and difficulties translating policies into practice. CONCLUSIONS: The implications of the study are discussed with reference to SLT practice, including consultancy models, and the increasingly prevalent policy in local education authorities of inclusion of children with special educational needs.

Attitude of Health Personnel↗
PubMedDate not supplied

Demographic and epidemiological analysis of patients referred to speech and language therapy at eleven centres 1987-95.

This retrospective study analyses data collected on an information system developed specifically for the use of speech and language therapists and the management of their services. The age, gender, medical diagnoses, and speech and language therapy diagnoses associated with the referral of > 73,000 clients to 11 speech and language therapy providers between 1987 and 1995 are reviewed. In 1987, 34.8% of the patients referred to speech and language therapy did not have a formal medical diagnosis and this was commonly associated with children with speech and language delay or disorders. However, by 1995, the group not having a formal medical diagnosis had fallen to 17.2% of referrals. Whereas in 1987, 22.7% of the referrals with a medical diagnosis to speech and language therapy were associated with stroke, this has increased in 1995 to 32.0%. Dysphagia represented 0.94% of the referrals in 1987 but 20.6% of referrals in 1995. The gender balance of referrals has remained remarkably constant over the period of study: 60% of referrals were male and 40% female. Whilst nearly half of all referrals were aged under 5 years, the proportion of all referrals represented by this age group has fallen slightly over these years. This has been matched by an increase in the proportion of the caseload aged over 70.

Age Factors↗
PubMed1997

The curriculum of practice: a conceptual framework for speech-language therapy and audiology practice with a black African first language clientele.

This paper discusses the use of a conceptual framework (i.e., the curriculum of practice) to guide the transformation of professional practice toward equitable service provision, rooted in a research finding that South African Speech-Language Therapy & Audiology has a favourable service bias toward White English/Afrikaans first language speakers (Pillay, 1997b). Three perspectives of practice are discussed, i.e., the official, espoused and actual perspectives. Also, the various elements of practice are reviewed, and include clinical practice activities, resources and their utilization, professional education curricular and professional policies. It is asserted that re-constructing the profession's knowledge base in a presently (1996-) transforming South Africa, mostly requires the use of a critical (versus, for e.g., a scientific) paradigm.

Attitude of Health Personnel↗
PubMed2004

Technology assisted speech and language therapy.

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.

Greece↗
PubMed2005

Speech and language therapy for dysarthria due to non-progressive brain damage.

BACKGROUND: Dysarthria is a common sequel of non-progressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population. OBJECTIVES: To determine the efficacy of speech and language therapy interventions for adults with dysarthria following non-progressive brain damage. SEARCH STRATEGY: We searched the trials registers of the following Cochrane Groups: Stroke, Injuries, Movement Disorders and Infectious Diseases. We also searched the trials register of the Cochrane Rehabilitation and Related Therapies Field. The trials registers were last searched in September 2004. The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to September 2004), EMBASE (1980 to September 2004), CINAHL (1983 to September 2004), PsycINFO (1974 to October 2004), and Linguistics and Language Behavior Abstracts (1983 to December 2004) were searched electronically. We handsearched the International Journal of Language and Communication Disorders (1966 to 2005, Issue 1) and selected conference proceedings, and scanned the reference lists of relevant articles. We approached colleagues and speech and language therapy training institutions to identify other possible published and unpublished studies. SELECTION CRITERIA: Unconfounded randomised controlled trials (RCTs). DATA COLLECTION AND ANALYSIS: One author assessed trial quality. Two co-authors were available to examine any potential trials for possible inclusion in the review. MAIN RESULTS: No trials of the required standard were identified. AUTHORS' CONCLUSIONS: There is no evidence of the quality required by this review to support or refute the effectiveness of speech and language therapy interventions for dysarthria following non-progressive brain damage. Despite the recent commencement of a RCT of optimised speech and language therapy for communication difficulties after stroke, there continues to be an urgent need for good quality research in this area.

Adult↗
PubMed2001

Speech and language therapy for dysarthria in Parkinson's disease.

BACKGROUND: Dysarthria is a common manifestation of Parkinson's disease which increases in frequency and intensity with the progress of the disease (Streifler 1984). Up to 20% of Parkinsonian patients are referred for speech and language therapy (S & L T), its aim being to improve the intelligibility of the patient's speech. OBJECTIVES: To compare the efficacy of speech and language therapy versus placebo or no interventions in patients with Parkinson's disease. SEARCH STRATEGY: Relevant trials were identified by electronic searches of MEDLINE, EMBASE, CINAHL, ISI-SCI, AMED, MANTIS, REHABDATA, REHADAT, GEROLIT, Pascal, LILACS, MedCarib, JICST-EPlus, AIM, IMEMR, SIGLE, ISI-ISTP, DISSABS, Conference Papers Index, Aslib Index to Theses, the Cochrane Controlled Trials Register, the CentreWatch Clinical Trials listing service, the metaRegister of Controlled Trials, ClinicalTrials.gov, CRISP, PEDro, NIDRR and NRR; and examination of the reference lists of identified studies and other reviews. SELECTION CRITERIA: Only randomised controlled trials (RCT) were included. DATA COLLECTION AND ANALYSIS: Data were abstracted independently by KD and RW and differences settled by discussion. MAIN RESULTS: Three randomised controlled trials were found comparing speech and language therapy with placebo for speech disorders in Parkinson's disease. A total of 63 patients were examined. The loudness of the patients' voices were increased by between 7-18%, depending on the speaking task being performed. It is likely that this is a clinically significant improvement. After six months the degree of improvement was reduced but was still statistically significant. Overall measures of dysarthria were measured in two trials and also improved. The clinical significance of these improvements was less clear cut as intelligibility of speech was not measured in any of these studies. REVIEWER'S CONCLUSIONS: Considering the small number of patients examined, the methodological flaws in many of the studies, and the possibility of publication bias, there is insufficient evidence to support or refute the efficacy of speech and language therapy for dysarthria in Parkinson's disease. A Delphi-style survey is needed to develop a consensus as to what is 'standard' S< for dysarthria in Parkinson's disease. Then a large well designed placebo-controlled RCT is needed to demonstrate speech and language therapy's effectiveness for dysarthria in Parkinson's disease. The trial should conform to CONSORT guidelines. Outcome measures with particular relevance to patients should be chosen and the patients followed for at least 6 months to determine the duration of any improvement.

Dysarthria↗
PubMed1975

Language therapy for children: some thoughts on context and content.

A presentation of ideas on the ideal context for language therapy for children, this paper explores in detail the importance of teaching child language, centering language therapy in the present, teaching words with empirical significance to the child, attempting to provide a language context which is generative to unassisted later language learning, and finally, teaching communication, not merely to language skills. In addition a sample core lexicon is presented which was designed to relate the above contextual aspects of therapy to psycholinguistic strategies of language therapy.

Child↗
PubMedDate not supplied

Evaluating UK research in speech and language therapy.

BACKGROUND: There has been a steady growth in recent years in British higher-degree training in speech and language therapy. But what is the standing of UK research in the subject and its component areas which should underpin and inform such training? How can such research be evaluated? AIMS: The intention was to compare UK publications relevant to speech and language therapy with those of other countries, both quantitatively and qualitatively. We sought then to examine the UK papers in more detail to analyse their sources of funding, their geographical distribution and the ways in which they could appropriately be evaluated. METHODS & PROCEDURES: Papers were selectively retrieved from the Science Citation Index and the Social Sciences Citation Index for 1991-2000 by means of a filter based on journal names and paper title words. They were subsequently checked to remove many false positives. The papers were classified into one of seven subject areas and by their research level (from clinical to basic). Their importance was estimated through their potential impact on other researchers, as determined by the citation score of their journals, by the numbers of citations they actually received and by the subjective esteem in which the various journals were held by UK speech and language researchers. OUTCOMES & RESULTS: World output of speech and language therapy papers has averaged 1000 papers per year during the 1990s, and has grown by half over the period. UK output has been about 12% of the total, compared with 10% in biomedicine, and is published in high impact journals relative to the norm for the field, which is quite a low rate compared with biomedicine overall. Almost half the UK papers had no funding acknowledgements, with the private-non-profit and industrial sectors playing less of a role than in other biomedical areas. Papers in seven subject areas showed substantial differences in their performance on the four criteria selected. CONCLUSIONS: The state of British speech and language research appears to be satisfactory, with an above average output in both quantity and quality. However, it is not attracting funding from some types of sponsors and is not being published in general medical journals where it might have a wider influence on general clinical practice. It is also not clear how best such research can be evaluated, although conventional citation counts may be relevant for some subject areas.

Bibliometrics↗
PubMed2004

Speech and language therapy in hyperactivity: a United Kingdom perspective in complex cases.

In the United Kingdom, multidisciplinary teams within the National Health Service (NHS) usually manage children and adolescents with disorders of hyperactivity. These multidisciplinary teams do not routinely include speech and language therapists (SLTs), and therefore speech and language therapy services for children and adolescents with disorders of hyperactivity are limited. Consequently, research and service delivery for children and adolescents with disorders of hyperactivity in the United Kingdom is only starting to emerge. Two case studies are used to show how speech and language therapy in the United Kingdom can be involved in the treatment of hyperactivity through various types of service delivery. The cases are used to highlight the importance of detecting speech, language, and communication impairments in children with diagnoses of hyperactivity. The potential role of speech and language therapy in the assessment and management of these clients in the United Kingdom is discussed.

Adolescent↗
PubMedDate not supplied

Speech and language therapy provision for bilingual children: aspects of the current service.

The findings are presented here of a questionnaire survey which asked speech and language therapy managers in England about the caseloads of the therapists in their trust as regards bilingual children. The survey was the first part of a larger research project aiming to explore why there appears to be over-representation of bilingual children in speech and language therapy in some areas and under-representation in others (compared to the proportion of bilingual children in the population). This main research question is discussed in relation to the literature and to the survey aims. The results describe aspects of the context in which the speech and language therapy service for bilingual children is operating: the lack of information about bilingual children is high-lighted. The staffing and training implications of bilingual clients' distribution over therapists' caseloads in areas with different levels of minority ethnic population are also considered. The finding that the majority of speech and language therapists in England who work with children (59%) see at least one bilingual child speaks of the extent to which issues relating to bilingualism affects therapists.

Child↗
PubMed2001

A comparison of speech and language therapy techniques for dysarthria in Parkinson's disease.

BACKGROUND: Dysarthria is a common manifestation of Parkinson's disease that increases in frequency and intensity with the progress of the disease (Streifler 1984). Up to 20% of Parkinsonian patients are referred for speech and language therapy (S & LT), its aim being to improve the intelligibility of the patient's speech. OBJECTIVES: To compare the efficacy and effectiveness of novel S & LT techniques versus standard S & LT to treat dysarthria in patients with Parkinson's disease. To compare the efficacy and effectiveness of one S & LT technique versus a second form of S & LT to treat Parkinsonian dysarthria. SEARCH STRATEGY: Relevant trials were identified by electronic searches of MEDLINE, EMBASE, CINAHL, ISI-SCI, AMED, MANTIS, REHABDATA, REHADAT, GEROLIT, Pascal, LILACS, MedCarib, JICST-EPlus, AIM, IMEMR, SIGLE, ISI-ISTP, DISSABS, Conference Papers Index, Aslib Index to Theses, the Cochrane Controlled Trials Register, the CentreWatch Clinical Trials listing service, the metaRegister of Controlled Trials, ClinicalTrials.gov, CRISP, PEDro, NIDRR and NRR; and examination of the reference lists of identified studies and other reviews. SELECTION CRITERIA: Only randomised controlled trials (RCT) were included. DATA COLLECTION AND ANALYSIS: Data was abstracted independently by KD and RW and differences settled by discussion. MAIN RESULTS: Only two trials were identified with only 71 patients. The method of randomisation was good in only one trial and the concealment of allocation was inadequate in both trials. These methodological problems could potentially lead to bias from a number of sources. The methods used in the two studies varied so much that meta-analysis of the results was not possible. Scott 83 compared prosodic exercises with visual cues with prosodic exercises alone (See Glossary: Table 01). The authors examined prosody and intelligibility as outcome measures immediately after therapy. Ramig 95 compared the Lee Silverman Voice Therapy (LSVT) which emphasises increased vocal effort, with respiratory therapy which aimed to increase respiratory muscle activity. Ramig 95 examined a wide range of vocal characteristics, activities of daily living affected by speech, depression and the carer's impressions of the patient's speech quality. Some of these outcomes were measured up to 24 months after the end of the therapy. However, in neither study were changes in outcomes due to 'Therapy A' compared with the changes due to 'Therapy B' statistically. Therefore no comment on the comparative efficacy of these types of speech and language therapy can be made. REVIEWER'S CONCLUSIONS: Considering the methodological flaws in both of these studies, the small number of patients examined, and the possibility of publication bias, there is insufficient evidence to support or refute the efficacy of any given form of S & LT over another to treat dysarthria in Parkinson's disease. Given the lack of evidence from RCTs to support or refute the efficacy of S & LT in Parkinson's disease (see Cochrane review 'Speech and Language therapy for Dysarthria in Patients with Parkinson's Disease'), the consensus as to what is considered 'best-practice' S & LT must be proved first through a large well-designed placebo-controlled randomised trial before examining variations in S & LT methodology. The design of these trials should minimise bias and be reported fully using CONSORT guidelines (CONSORT 1996). Outcome measures with particular relevance to patients, their carers, physicians and speech and language therapists should be chosen and the patients followed for at least 6 months to determine the duration of any improvement.

Bias↗
PubMed1998

Setting speech and language therapy priorities: theory and practice.

Within speech and language therapy (SLT) systems for prioritising treatment waiting lists are emerging in response to demand exceeding resources and difficult decisions having to be made. This study evaluates the theoretical issues, the methods and criteria SLTs use to prioritise caseloads and the relationship between priority setting at the clinical, provider and purchaser levels. The results indicate that there is consensus about the priority criteria SLTs use and that the criteria can be ethically defended. Consensus is also found between SLTs and the purchasers and provider interviewed regarding the priority criteria that are valued but the relatively 'sophisticated' systems that exist at the clinical level are not reflected at these levels of the organisation. Three criteria are identified as being of relatively more importance and a framework for good practice is proposed.

Ethics, Professional↗
PubMed2002

Speech and language therapy for dysarthria due to nonprogressive brain damage: a systematic Cochrane review.

BACKGROUND: Dysarthria is a common sequel of nonprogressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population. OBJECTIVE: To determine the efficacy of speech and language therapy interventions for adults with dysarthria following nonprogressive brain damage. DESIGN: Systematic review. SEARCH STRATEGY: This review has drawn on the search strategies developed for the following Cochrane Groups as a whole: Stroke, Injuries, and Infectious Diseases. Relevant trials were identified in the Specialised Registers of Controlled Trials. We also searched the trials register of the Cochrane Rehabilitation and Related Therapies Field. The Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PsycLIT, and Linguistics and Language Behavior Abstracts were electronically searched. Hand-searching of the International Journal of Language and Communication Disorders and of reference lists from relevant articles and conference proceedings was also undertaken. Colleagues were approached to identify other possible published and unpublished studies. SELECTION CRITERIA: Unconfounded randomized controlled trials. DATA COLLECTION AND ANALYSIS: One reviewer assessed trial quality. Two co-reviewers were available to examine any potential trials for possible inclusion in the review. MAIN RESULTS: No trials of the required standard were identified. REVIEWERS' CONCLUSIONS: There is no evidence of the quality required by this review to support or refute the effectiveness of speech and language therapy interventions for dysarthria following nonprogressive brain damage. There is an urgent need for good quality research in this area.

Adult↗
PubMedDate not supplied

Speech and language therapy service delivery for bilingual children: A survey of three cities in Great Britain.

BACKGROUND: Speech and language therapy (SLT) managers are expected to ensure that there are appropriate services available for bilingual and multilingual clients in order to ensure an equitable service to all clients. However, there is a paucity of data available to inform service planning. AIMS: To identify the level to which SLT services in three UK cities meet the recommendations of The Royal College of Speech and Language Therapists (RCSLT) Good Practice Guidelines. Socio-demographic information is provided about the number of children from ethnic minorities in the population and the proportion of (bilingual) children from ethnic minorities on the speech and language therapy caseload. Based on this information, it is estimated whether there is proportionate representation of bilingual children on SLT caseloads, and whether services are in place to meet the needs of those clients. METHODS & PROCEDURES: Population statistics were gathered from Census data and data were gleaned from Local Education Authorities. The study used a combination of interview and postal questionnaires to SLTs, with particular emphasis on the issues that may affect service provision. OUTCOMES & RESULTS: As in previous studies, it was difficult to find reliable data. However, two of the three cities studied appeared to be offering a proportionate service to both monolingual and bilingual children in terms of the relative numbers of children on caseloads. Only one city was confident that their SLT service was fully meeting the RCSLT Good Practice Guidelines on bilingualism, although all three cities were aware of them and appeared to be making an effort at varying levels to address the principles of those guidelines. CONCLUSIONS: There is a need for a change in how data on linguistic diversity in society are collected and disseminated, both at a national level and within SLT services, so that informed decisions can influence the future of quality services to minority groups.

Child↗