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At least 19 recordsLinked to original sources
PubMed2001

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: 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 (see Review Group Details for more information). 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 Colleagues were approached to identify other possible published and unpublished studies. Date of most recent searches: May 2000. SELECTION CRITERIA: Unconfounded randomised 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. REVIEWER'S 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. There is an urgent need for good quality research in this area.

Adult↗
PubMedDate not supplied

Teaching and learning speech and language therapy skills: the effectiveness of classroom as clinic in speech and language therapy student education.

BACKGROUND: Terms such as 'clinical intuition' have often been applied to the practice of speech and language therapy. Various authors have aimed to make the process of therapy practice more explicit, and it is argued that recently developed descriptive/analytic frameworks have the potential to engender the critical mindset necessary for student speech and language therapists to become good reflective practitioners, with the potential for enhancing clinical education. AIMS: To investigate whether and how aspects of clinical skills education could be usefully addressed in an academic, as opposed to a clinical, setting. The study aimed to address the question of whether use of an interaction analysis system, in conjunction with video observation, and 'practice simulation' in a teaching-learning programme could be shown to have a positive impact on: (1) students' perceptions of their own understanding and practice of therapy, and their perceptions of themselves as self-reflective practitioners; and whether (2) this was borne out by students' ability to observe and interpret therapeutic interaction, as measured by (i) an objective written assessment; (ii) an objective video observation assessment; and (iii) assessment of their abilities in clinical practice. METHODS & PROCEDURES: Thirty-six students from City University took part in an experimental, placebo-controlled study using a deferred intervention design. Assessments designed to reflect changes resulting from the teaching-learning curriculum were carried out pre- and post-intervention with experimental and control groups. Quantitative and qualitative results were obtained. OUTCOMES & RESULTS: The intervention programme was found to have had a significant impact on students' perceptions of their understanding of therapy, but not on their perceptions of their practice of therapy. The experimental group scored significantly better on a written assessment of 'interpretation of therapy interaction', but were no better than the control group on a 'Video observation' assessment. Owing to attrition and the poor quality of videos submitted for assessment, it was not possible to measure changes in actual clinical practice. Qualitative feedback from the teaching-learning programme suggests that students generally found the approach to be beneficial. CONCLUSIONS: While there were some encouraging results, it is still uncertain whether addressing the actual practice of therapy in an academic setting gives 'added value' to the work carried out on clinical placements. However, there is no doubt that bringing this type of programme under the umbrella of an academic institution would greatly increase the consistency of teaching and the range of experiences available to students.

Adult↗
PubMed1998

Analysis of practice-role perceptions of physical therapy, occupational therapy, and speech-language therapy students.

The purpose of this study was to determine whether physical therapy (PT), occupational therapy (OT), and speech-language therapy (SLP) students shared common perceptions of the practice roles of the three disciplines. The survey instrument used in this study contained 55 questions that addressed practice-role perceptions. The questions were based on a case study. A total of 172 undergraduate students (PT 71, OT 52, SLP 49) from a southeastern university participated. Chi-square test of association was used to analyze the data. Results showed that PT, OT, and SLP students shared common perceptions of administrative and educational practice roles but differed on their perceptions of assessment and physical/mental treatment roles. Practice-role confusion was particularly acute between OT and PT and between OT and SLP students in these areas.

Attitude of Health Personnel↗
PubMedDate not supplied

Is speech and language therapy meeting the needs of language minorities? The case of deaf people with neurological impairments.

The cultural diversity of the UK poses a challenge for speech and language therapists. Work with children from language minorities has been documented, but less so with adults. This raises the question of whether adults from minority communities are gaining access to services. Deaf people who use British Sign Language (BSL) are one language minority. It is known that sign language is vulnerable to neurological damage. Of interest is whether Deaf people with such damage are referred to speech and language therapy (SLT). The aim was to find out how many deaf people were referred to SLT services in the UK over the last 5 years, and reasons for the referrals. We also explored the service offered to Deaf referrals, and whether SLT teams had access to BSL skills, either internally or via interpreters. A brief questionnaire was sent to the managers of all SLT services in the UK (n=264). There was as 60% response rate. Only 34 services received referrals of Deaf patients, with a total of 39 Deaf people seen. This is substantially below the predicted rates. Most referrals were for dysphagia, or dysphagia with communication impairments. In line with this, dysphagia management was the dominant service, although most referrals also received language assessment. Most teams did not have signing staff members and access to interpreters was variable. The results suggest that many Deaf people are not gaining access to SLT after neurological impairment. Those who are referred are unlikely to receive language therapy. The instigation of a national team specializing in BSL impairments is recommended.

Adult↗
PubMedDate not supplied

Therapy outcome measures in speech and language therapy: comparing performance between different providers.

BACKGROUND: The use of outcome measures to monitor improved quality of care has been advocated for 20 years but has only achieved prominence with the increasing resource pressures and related changed in health service provision in the past 6 years. OBJECTIVE: This paper describes the development of an approach to outcome measurement suitable for all patients receiving speech and language therapy. The measure, which is based on rating the dimensions of impairment, disability, handicap and well-being, is tested to assess whether it can usefully be used to compare the services of different providers. METHOD: Five trusts volunteered for the study. Service descriptions suggest that these services are typical for the purposes of providing speech and language therapy. Twenty-five therapists were trained to use the Therapy Outcome Measure (TOM); their reliability was assessed and they provided prospective data on clients with speech and language impairments related to dysphasia, stammering and dysphonia. RESULTS: The study provides evidence indicating the differences in the types of patients being referred to different providers of speech and language therapy. Different services have different impacts on the number and type of domains and that services discharge patients at different points in their recovery. DISCUSSION: Different outcomes by different providers may be associated with different referral policies, base populations, skills and work policies of therapists. Differences in outcomes associated with certain therapy services can initiate the task of analysing attributions and progress endeavours to provide equitable quality of care which is the philosophy underpinning the move towards benchmarking in health service delivery.

Adolescent↗
PubMed1991

Opportunities for using computers in speech and language therapy: a study of one language unit.

Whilst the use of information technology is increasing in importance as an aid to speech and language therapy, its introduction has so far been unsystematic. Systems analysis methodologies for assessing how information technology can best be employed have been developed for use in the business world. The present study used one such methodology--Checkland's soft systems--to investigate which aspects of the activities of one language unit were most likely to be improved or helped by the introduction of new technology. Such an approach was found to yield useful insights and several opportunities for increased computer use were revealed. However, it was also concluded that, to take maximum advantage of new technology, changes would need to be introduced and resources made available at a higher organisational level than that of the individual unit or department.

Child↗
PubMed2006

A pilot study of use-dependent learning in the context of Constraint Induced Language Therapy.

This investigation reports the results of a pilot study concerning the application of principles of use-dependent learning developed in the motor rehabilitation literature as Constraint Induced Therapy to language rehabilitation in a group of individuals with chronic aphasia. We compared treatment that required forced use of the language modality, Constraint Induced Language Therapy, (CILT) to treatment allowing all modes of communication. Both treatments were administrated intensively in a massed practice paradigm, using the same therapeutic stimuli and tasks. Results suggest that whereas both interventions yielded positive outcomes, CILT participants showed more consistent improvement on standard aphasia measures and clinician judgments of narrative discourse. These findings suggest that CILT intervention may be a viable approach to aphasia rehabilitation.

Adult↗
PubMedDate not supplied

Examining interaction in language therapy.

Discussions around a 'theory of therapy' have prompted attempts to delineate the components of therapy for language impairment in aphasia. Here it is suggested that the therapy components associated with how language therapy is enacted need more precise specification, especially in relation to what is entailed by interaction between therapist and person with aphasia. Presented too is a system used for the analysis of interaction in language impairment therapy for aphasia and its possible applications are discussed. Components of the system are described and a sample analysis presented. The methodological difficulties entailed in making comparisons of therapy enactment are discussed. It is suggested furthermore that unless more is known about precisely defined interactions in therapy, it will be difficult to answer basic questions not only about how language therapy is being carried out, but also, subsequently, whether the ways in which therapy tasks are enacted have a significant impact on the outcome.

Aphasia↗
PubMed1994

The knowledge and attitudes of occupational therapy, physiotherapy and speech-language therapy students, regarding the speech-language therapist's role in the hospital stroke rehabilitation team.

The purpose of the present study was to survey and compare the knowledge and attitudes of final year occupational therapy, physiotherapy and speech-language therapy students, concerning the role of the speech-language therapist as a member of the stroke rehabilitation team in the hospital setting. In order to achieve this aim, a questionnaire was administered to final year students in these three disciplines, and included questions on most areas of stroke rehabilitation with which the speech-language therapist might be involved, as well as the concepts of rehabilitation and teamwork in relation to stroke rehabilitation. Results suggested a fairly good understanding of the concepts of rehabilitation and teamwork. Students appeared to have a greater understanding of those disorders following a stroke, with which the speech-language therapist is commonly involved, such as Aphasia, Dysarthria, Verbal Apraxia and Dysphagia. However, students appeared to show less understanding of those disorders post-stroke, for which the speech-language therapist's role is less well defined, such as Agraphia, Alexia and Amnesia. In addition, a high percentage of role duplication/overlapping in several aspects of stroke rehabilitation, such as family and social support, was found. Several implications for facilitating communication, collaboration and understanding between paramedical professions, as well as for further research are also provided.

Cerebrovascular Disorders↗
PubMed2000

Speech and language therapy for aphasia following stroke.

BACKGROUND: Aphasia describes language impairment associated with a brain lesion. OBJECTIVES: The objective of this review was to assess the effects of formal speech and language therapy and non-professional types of support from untrained providers for people with aphasia after stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched: March 1999), and reference lists of relevant articles to December 1998. We also contacted academic institutions and other researchers to identify further published and unpublished trials. We searched The International Journal of Disorders of Communication by hand (known by other names in the past), from 1969 to 1998. Date of most recent searches: January 1999. SELECTION CRITERIA: Randomised controlled trials comparing: 1. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus no treatment. 2. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus any type of informal support for aphasia, given by speech and language therapists or volunteers, whether these were trained or untrained. 3. One type of speech and language therapy versus another type. Outcome measures included measures of any type of communication, other measures of functioning, numbers of drop-outs, and other non-clinical outcomes. DATA COLLECTION AND ANALYSIS: The principal reviewer collected the data, and assessed the quality of the trials with independent data checking and methodological advice. If we could not perform a statistical combination of different studies, we sought missing data. Failing that we provided a description. MAIN RESULTS: We considered sixty studies in detail, from which we identified twelve trials suitable for the review. Most of these trials were relatively old with poor or unassessable methodological quality. None of the trials was detailed enough for us to complete description and analysis. We could not determine whether formal speech and language therapy is more effective than informal support. REVIEWER'S CONCLUSIONS: The main conclusion of this review is that speech and language therapy treatment for people with aphasia after a stroke has not been shown either to be clearly effective or clearly ineffective within a RCT. Decisions about the management of patients must therefore be based on other forms of evidence. Further research is required to find out if effectiveness of speech and language therapy for aphasic patients is effective. If researchers choose to do a trial, this must be large enough to have adequate statistical power, and be clearly reported.

Aphasia↗
PubMed2003

Speech and language therapy interventions for children with primary speech and language delay or disorder.

BACKGROUND: It is thought that approximately 6% of children have speech and language difficulties of which the majority will not have any other significant developmental difficulties. Whilst most children's difficulties resolve, children whose difficulties persist into primary school may have long-term problems concerning literacy, socialisation, behaviour and school attainment. OBJECTIVES: To examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder. SEARCH STRATEGY: The following databases were searched: The Cochrane Controlled Trials Register (Cochrane Library, CENTRAL: 2002/3), CINAHL (1982 - July 2002), EMBASE (1980 - Sept Week 4 2002), ERIC (1965 - 2002), MEDLINE (1966 - Sept Week 3 2002), PsycINFO (1872 - 2002/10 Week 2), The National Research Register (2002/3). In addition to this references were taken from reviews of the literature and reference lists from articles. SELECTION CRITERIA: The review considered randomised controlled trials of speech and language therapy interventions for children or adolescents with primary speech and language delay/disorder. DATA COLLECTION AND ANALYSIS: Titles and abstracts were identified and assessed for relevance, before the full text version was obtained of all potentially relevant articles. The data were categorised depending on the nature of the control group and considered in terms of the effects of intervention on expressive and receptive phonology, syntax and vocabulary. The outcomes used in the analysis were dependent on the focus of the study with only the primary effects of therapy being considered in this review. MAIN RESULTS: The results of twenty-five studies were used in the meta-analysis. The results suggest that speech and language therapy is effective for children with phonological (SMD=0.44, 95%CI: 0.01,0.86) or vocabulary difficulties (SMD=0.89, 95%CI: 0.21,1.56), but that there is less evidence that interventions are effective for children with receptive difficulties (SMD=-0.04, 95%CI: -0.64,0.56). Mixed findings were found concerning the effectiveness of expressive syntax interventions (n=233; SMD=1.02, 95%CI: 0.04-2.01). No significant differences were shown between clinician administered intervention and intervention implemented by trained parents, and studies did not show a difference between the effects of group and individual interventions (SMD=0.01, 95%CI: -0.26,1.17). The use of normal language peers in therapy was shown to have a positive effect on therapy outcome (SMD=2.29, 95%CI: 1.11,3.48). REVIEWER'S CONCLUSIONS: The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated.

Adolescent↗
PubMed1997

Piracetam as an adjuvant to language therapy for aphasia: a randomized double-blind placebo-controlled pilot study.

OBJECTIVE: To determine whether piracetam 4.8 g/day together with intensive language therapy improved language function more than language therapy alone. DESIGN: Double-blind, placebo-controlled parallel group study. SETTING: Referral speech and language clinic of a university department of neurology. PATIENTS: Sixty-six inpatients with aphasia present between 4 weeks and 36 months. INTERVENTIONS: Intensive language therapy for 6 weeks in all patients. Thirty-two patients received piracetam 4.8 g daily and 34 patients received placebo. MAIN OUTCOME MEASURE: The Aachen Aphasia Test (AAT), a standardized procedure for evaluating the severity of aphasia, was performed at baseline and after 6 weeks' treatment. RESULTS: In 50 patients evaluated for efficacy, a trend toward improvement in the active group was observed in all subtests of the AAT. This trend was statistically significant for absolute differences in recovery of "written language" and "profile level." CONCLUSION: Piracetam appears to have a positive adjuvant effect on the recovery of aphasia in patients receiving intensive language therapy.

Adult↗
PubMedDate not supplied

Investigating parental views of involvement in pre-school speech and language therapy.

Today, speech and language therapists working with the pre-school population routinely involve parents in their children's treatment programmes. Also, there is increasing recognition of the importance of considering client and carer views in evaluating services. Thus, in both clinical and research terms, the role of parents is key. This paper reports an aspect of a study that investigated parents' views and perceptions of their pre-school children's speech and language difficulties and the speech and language therapy (SLT) they received. The methodology of the study was qualitative and data were collected from the parents of 16 pre-school children, using in-depth interviews. The parents' perceptions could be characterized as a process with three phases. On the whole, parents viewed their involvement in SLT positively but crucially, the interviews highlighted discrepancies between therapists' and parents' perceptions of the therapy process. The study demonstrates that when parents' views are considered, a fuller understanding of the effectiveness and acceptability of treatment can emerge.

Attitude to Health↗
PubMed2000

Randomised controlled trial of community based speech and language therapy in preschool children.

OBJECTIVE: To compare routine speech and language therapy in preschool children with delayed speech and language against 12 months of "watchful waiting." DESIGN: Pragmatic randomised controlled trial. SETTING: 16 community clinics in Bristol. PARTICIPANTS: 159 preschool children with appreciable speech or language difficulties who fulfilled criteria for admission to speech and language therapy. MAIN OUTCOME MEASURES: Four quantitative measures of speech and language, assessed at 6 and 12 months; a binary variable indicating improvement, by 12 months, on the trial entry criterion. RESULTS: Improvement in auditory comprehension was significant in favour of therapy (adjusted difference in means 4.1, 95% confidence interval 0.5 to 7.6; P=0.025). No significant differences were observed for expressive language (1.4, -2.1 to 4.8; P=0.44); phonology error rate (-4.4, -12.0 to 3.3; P=0.26); language development (0.1, -0.4 to 0.6; P=0.73); or improvement on entry criterion (odds ratio 1.3, 0.67 to 2.4; P=0.46). At the end of the trial, 70% of all children still had substantial speech and language deficits. CONCLUSIONS: This study provides little evidence for the effectiveness of speech and language therapy compared with watchful waiting over 12 months. Providers of speech and language therapy should reconsider the appropriateness, timing, nature, and intensity of such therapy in preschool children. Continued research into more specific provision to subgroups of children is also needed to identify better treatment methods. The lack of resolution of difficulties for most of the children suggests that further research is needed to identify effective ways of helping this population of children.

Analysis of Variance↗
PubMed2001

Teaching sociology within the speech and language therapy curriculum.

In the United Kingdom, the Royal College of Speech and Language Therapists suggests that sociology should be included within the speech and language therapy curriculum. However, in spite of this, sociology is seldom given priority. Although the role of sociology with the curricula of other professions has been discussed, the role of sociology within speech and language therapy has not. Given the contemporary climate of competence-based training, the position of subjects such as sociology is being compromised. This paper sets out three reasons in support of including sociology within speech and language therapy by drawing on the distinction between a "personal education" and a "semantic conjunction" model of the relationship between theory and professional practice. First, it is argued that sociology makes a valid contribution to an holistic approach to care--which is rapidly becoming the cornerstone of speech and language therapy practice. Second, this paper suggests that the inherent reflexivity within the discipline provides health professionals with an invaluable tool with which to engage in reflexive practice. Finally, it is argued that given the global emphasis on evidence-based practice, the study of sociology and sociological research methods equips therapists to interpret and conduct empirical research. This paper concludes by arguing that sociology should be viewed as an essential component of the speech and language therapy curriculum.

Journal Article↗
PubMedDate not supplied

Perceptions of speech and language therapy amongst UK school and college students: implications for recruitment.

BACKGROUND: Communication disorders affect both sexes and people from all ethnic groups, but members of minority ethnic groups and males in the UK are underrepresented in the speech and language therapy profession. Research in the area of recruitment is limited, but a possible explanation is poor awareness and understanding of speech and language therapy as a profession. AIMS: To investigate factors influencing attitudes to a career in speech and language therapy amongst UK school and college students focusing on the similarities and differences between males and females, and between minority ethnic and white students. METHODS & PROCEDURES: A total of 651 male and female school and college students from a range of ethnic groups and all close to selecting degree courses completed a questionnaire designed to examine the attitudes and awareness of speech and language therapy. Eleven semi-structured follow-up interviews were conducted to help understand the questionnaire findings. Quantitative and qualitative analyses examined differences in attitudes and the awareness of speech and language therapy amongst these groups. OUTCOMES & RESULTS: Overall, one-third of participants said they knew nothing about speech and language therapy, and males were significantly less familiar with it. Less than half the participants were aware that speech and language therapy is a degree course, and minority ethnic participants were significantly less likely to know this. Compared with males, females were almost five times as likely to say they would consider a career in speech and language therapy. Participants with relatives in health-related jobs were significantly more likely to consider speech and language therapy than those without such relatives. Compared with white participants, minority ethnic participants said they placed greater importance on studying for a degree, a profession and a scientific career, and were more influenced by a career's prestige and a high salary. CONCLUSIONS: In order to increase the ethnic and gender diversity of speech and language therapists, the profile of the profession needs to be raised with increased awareness of the degree level courses, the scientific, evidence-based nature of the work, and current salary scales.

Adolescent↗
PubMedDate not supplied

Recent advances in speech and language therapy.

Speech and language therapists are involved in the care of a wide range of pathogies. Recent changes have been marked by an increased involvement in feeding and swallowing work with premature babies, and oropharyngeal cancer sufferers. Changes have also occurred in assessment and management of communication problems resulting from acquired neurological pathologies such as stroke, Parkinson's disease and dementia. Some of these are discussed in the following article.

Aged↗
PubMed1995

Speech and language therapy: is it effective?

As part of a needs assessment of local speech and language therapy services, a review of the literature was carried out to examine the evidence for effectiveness of speech and language therapy. Purchasing authorities and general practice fundholders need to know whether what they are buying for their local population is effective, and whether the service is being provided in the most cost-effective way. This paper considers the published evidence and some of the limitations of the studies, and gives suggestions for purchasing speech and language therapy services based on current evidence. More evaluative work needs to be done to provide purchasers with the information necessary to decide which speech and language therapy services will result in real benefits for their population.

Adult↗