Speech Therapy

Patients with severe aphasia are rarely treated using speech therapy. We used music therapy to continue to treat a 79-year-old patient with chronic severe aphasia. Interventions 1, 2, and 3 were to practice singing a song that the patient knew, to practice singing a song with a therapist, and to practice saying a greeting using a song with lyrics, respectively. In addition, practice of uttering names of body parts was initiated using touch and rhythm. After intervention 1, the patient could sing spontaneously and repeat lyrics. After intervention 2, she could sing with the therapist, and sing spontaneously and repeat lyrics. After intervention 3, she could memorize words with meaning, say the words in context, and use them. The patient could utter the names of two body parts after therapy with touch and rhythm. These suggest that rehabilitation therapy can still be used in patients with severe cognitive impairment.

Malgré le caractère déterminant des déficits phonologiques pour l’émergence de la dyslexie chez l’enfant, d’autres hypothèses d’explication sont possibles concernant l’origine de ce trouble durable de l’apprentissage de la lecture. La diversité des profils de dyslexie invite à s’intéresser à une variété de déficits visuo-attentionnels susceptibles de participer à des formes de dyslexies dites de surface, mais aussi phonologique ou mixte. Nous proposons d’en préciser la nature, de comprendre leurs retentissements sur la lecture et de fournir des pistes pour les dépasser. Ces déficits attentionnels seront regroupés en trois rubriques : certains perturbent le système d’analyse visuelle précoce spécialisé pour l’orthographe en amont des procédures d’adressage et d’assemblage, d’autres concernent l’orientation spatiale de l’attention, d’autres relèvent enfin de l’attention temporelle. La présentation de travaux sur les liens entre l’attention et les oscillations cérébrales permettra d’évoquer les bases neuronales de mécanismes attentionnels spatio-temporels, fondamentaux pour la dynamique de la lecture et perturbés dans les dyslexies.

To investigate the effects of an intensive, inpatient rehabilitation programme on individuals affected by Huntington's disease. A pilot study. Within-subjects design. Inpatient rehabilitation home of the Italian welfare system. Forty patients, early and middle stage of the disease, were recruited to an intensive, inpatient rehabilitation protocol. The treatment programme included respiratory exercises and speech therapy, physical and occupational therapy and cognitive rehabilitation exercises. The programme involved three-week admission periods of intensive treatment that could be repeated three times a year. A standard clinical assessment was performed at the beginning of each admission using the Zung Depression Scale, Mini-Mental State Examination (MMSE), Barthel Index, Tinetti Scale and Physical Performance Test (PPT). Tinetti and PPT were also used at the end of each admission to assess the outcomes in terms of motor and functional performance. Each three-week period of trea...

Purpose This study explores the importance of production frequency during speech therapy to determine whether more practice of speech targets leads to increased performance within a treatment session, as well as to motor learning, in the form of generalization to untrained words. Method Two children with childhood apraxia of speech were treated with an alternating treatment AB design, with production frequency differing in the 2 treatments. The higher production frequency treatment required 100+ productions in 15 min, while the moderate-frequency treatment required 30–40 productions in the same time period. One child was treated 3 times weekly for 11 weeks; the other child was treated twice weekly for 5 weeks. At the conclusion of each treatment phase, 5 min of probes were administered to determine whether generalization had occurred. Maintenance data to measure performance and learning were collected after a break from treatment. Results Both children showed improvement on all targ...

The aim of this article is to present the result of the practice of so-called «metagraphic explanations» and the observation of how school teachers «negotiate» problem-solving in French spelling with their pupils. Conceptualised by the researchers of the Group LEA (Jaffre, 1995), the «metagraphic explanations» designate «the comments which precede, accompany or follow written productions of learners in a more or less differed manner» (p. 137). The type of responses given just after metagraphic explanations of learner-writers by the teacher are analysed as «metagraphic regulations». The purpose is to complete the approach of the LEA Group concerning learners without difficulties. Nevertheless, general difficulties with French spelling occur with all learner-writers due to the complexity of this specific alphabetic writing system, we were interested in applying the same approach with slow learners acquiring literacy. In turn they were asked what they have to say about their own writte...

The introduction, in the late 70s, of the first digital spectrograph (DSP Sonograph) by Kay Elemetrics has improved the possibilities of spectroacoustic voice analysis in the clinical field. Thanks to the marketing, in 1993, of the Multi Dimensional Voice Program (MDVP) advanced system, it is now possible to analyse 33 quantitative voice parameters which, in turn, allow evaluation of fundamental frequency, amplitude and spectral energy balance and the presence of any sonority gap and diplophony. Despite its potentials, the above-mentioned system is not widely used yet, partly on account of the lack of a standard procedure. Indeed, there are still only a few case reports in the literature taking into consideration prescriptive aspects related both to procedure and analysis. This study aims to provide the results of amplitude perturbation parameter analysis in euphonic adult patients. In our opinion, these are the most significant parameters in determining the severity of a phonation ...

This study examined whether a particular type of therapy (Broad Target Speech Recasts, BTSR) was superior to a contrast treatment in facilitating speech comprehensibility in conversations of students with Down syndrome who began treatment with initially high verbal imitation. We randomly assigned 51 5- to 12-year-old students to either BTSR or a contrast treatment. Therapy occurred in hour-long 1-to-1 sessions in students' schools twice per week for 6 months. For students who entered treatment just above the sample average in verbal-imitation skill, BTSR was superior to the contrast treatment in facilitating the growth of speech comprehensibility in conversational samples. The number of speech recasts mediated or explained the BTSR treatment effect on speech comprehensibility. Speech comprehensibility is malleable in school-age students with Down syndrome. BTSR facilitates comprehensibility in students with just above the sample average level of verbal imitation prior to treatme...

Background  The level of language development reached in pre-school age is considered the most reliable predictor of reading acquisition. In normally developing children, learning to read is strongly related to early language skills, and in particular to phonological processing abilities. In dyslexic children, reading abilities seem to show a correlation with phonological awareness.Methods  A group of 65 children (aged 5–6 years) were recruited and submitted to an in-depth neuropsychological assessment [i.e. metaphonological skills, intelligence, verbal short-term memory (VSTM) and other aspects of receptive and expressive language]. We were able to identify 14 children with significant metaphonological difficulties (MD): 11 children with exclusively MD, and the other three children with specific language impairment. This study compares the neuropsychological profile obtained from children with MD with that of a peer group without any language impairment (N).Results  The performances of the MD were within the normal ability range in almost all the administered tests but significantly lower compared with those of their peers without language impairment (N) in some items of the intelligence scale (Wechsler Preschool and Primary Scale of Intelligence) and in the tests of VSTM and of receptive/expressive language. Nevertheless, there were not statistically significant differences between MD and N in output phonology.Conclusions  In pre-school age, in a group of non-clinical children, with a range of abilities, those with MD appear to be at the lower end of the normal range in many other verbal skills. These children could be considered at-risk for possible subsequent difficulties learning to read and thus need to be identified and to warrant prompt treatment.

The ending of therapy is a crucial time for speech-language pathologists and can impact on their sense of achievement and satisfaction. Drawing on literature from psychotherapy, social work and rehabilitation as well as from the area of aphasia therapy, this paper explores how speech-language pathologists juggle the tensions of coping with real versus ideal endings, of managing the building of close therapeutic relationships which then have to be broken, and of balancing a respect for client autonomy while retaining control over caseloads and fair allocation of resources. I suggest that the way in which therapy finishes reflects a merger of how clinicians manage these tensions. Clinicians may benefit from a greater recognition of what they do and feel at discharge, not only to further reflective practice, but also to encourage more sensitive involvement with both clients and students.

The child born with cleft lip and palate requires multidisciplinary care since the very first hours of its life. These actions should also include speech therapy stimulation. Initially, the work of a speech therapist over dealing with this birth defect differs from the standard therapeutic procedures as a speech therapist comes into contact with a very young patient who has difficulties with food intake and often suffers from swallowing and breathing disorders. This study contains a proposal for speech therapy care over a child with cleft lip and palate. The method is used in the clinics of the Mother and Child Institute in Warsaw.

The role of the speech-language pathologist (SLP) has developed considerably over the last 10 years given the medical and technological advances in life-sustaining procedures. Over time, children born with congenital, surgical, or "medically fragile" conditions have become mainstreamed into regular school-based settings, thus extending the traditional role of the SLP and multidisciplinary team. Understanding the impact of these voice disorders on the child’s educational performance has been a struggle for many clinicians because the eligibility decisions for students in school-based settings must be made within the framework of federal legislation and regulations governing the provision of services for students with disabilities. This article discusses how to identify children with voice disorders under the Individuals With Disabilities Education Act (IDEA) definition, the role of the SLP in assigning priority in various voice management scenarios, and how models of therap...

Despite the importance of Speech-Language Pathologists (SLPs) collaborating with parents in the treatment of children with Autism Spectrum Disorder (ASD), few studies have examined the nature of this working relationship and how best to facilitate collaboration. To explore what SLPs think parents of children with ASD expect of them when it comes to the delivery of evidence-based interventions. The participants were 22 SLPs from Australia who specialised in ASD and who each participated in a semi-structured interview. Recordings were transcribed and analysed according to the procedures outlined by Braun and Clarke. The SLPs expressed strong support for evidence-based practice (EBP) and indicated that they thought parents expected their children would be provided with evidence-based interventions. However, SLPs identified factors that influenced the way and the extent to which they were able to share information as part of a collaborative decision-making process, including the parents...

Purpose To describe a new measure of functional intelligibility, the Intelligibility in Context Scale (ICS), and evaluate its validity, reliability, and sensitivity using 3 clinical measures of severity of speech sound disorder: (a) percentage of phonemes correct (PPC), (b) percentage of consonants correct (PCC), and (c) percentage of vowels correct (PVC). Method Speech skills of 120 preschool children (109 with parent-/teacher-identified concern about how they talked and made speech sounds and 11 with no identified concern) were assessed with the Diagnostic Evaluation of Articulation and Phonology (Dodd, Hua, Crosbie, Holm, & Ozanne, 2002). Parents completed the 7-item ICS, which rates the degree to which children’s speech is understood by different communication partners (parents, immediate family, extended family, friends, acquaintances, teachers, and strangers) on a 5-point scale. Results Parents' ratings showed that most children were always (5) or usually (4) understood by...

Purpose This systematic review aimed to determine the effects of augmentative and alternative communication (AAC) intervention on speech production in children with autism or pervasive developmental disorder-not otherwise specified. Method A systematic review methodology was utilized to limit bias in searching, selecting, coding, and synthesizing relevant treatment studies. This involved a multifaceted search for studies written between 1975 and May 2007 using various bibliographic databases, dissertation databases, hand searches of selected journals and published compilations of AAC theses and dissertations, and ancestry searches. To be included, studies had to meet stringent criteria. A coding manual and form facilitated data extraction in terms of participant characteristics, treatment characteristics, design and measurement, and outcomes. Results Nine single-subject experimental design (27 participants) and 2 group studies (98 participants) were included. Results indicated that ...

Purpose Speech-language pathologists know much more about children's development of fictional narratives than they do about children's development of personal narratives and the role these personal narratives play in academic success, social–emotional development, and self-regulation. The purpose of this tutorial is to provide clinicians with strategies for assessing and developing children's and adolescents' personal narratives. Method This tutorial reviews the literature on (a) the development of autobiographical event narratives and life stories, (b) factors that contribute to development of these genres, (c) the importance of these genres for the development of sense of self-identity and self-regulation, (d) deficits in personal narrative genres, and (e) strategies for eliciting and assessing event narratives and life stories. Implications To promote development of personal event narratives and life stories, speech-language pathologists can help clients retrieve ...

The prevalence of Autism is on the rise worldwide with studies presenting the worldwide prevalence rates as 1 in 68 children. This is rising alarmingly every year and the combined presentation of Autism with ADHD in the same child is also increasing. In this scenario it is shocking to note that many medical professionals in general and paediatricians in particular are unaware of the availability of an Autism Cure that is already being accessed by parents with children with autism from all over the world and these children are thriving completely free from their limiting symptoms. This article seeks to enlighten medical professionals about this Autism Cure and emphasizes the urgent necessity for them to update themselves about the same so that more children with Autism and ADHD (and their parents) need not suffer unnecessarily due to this " autism cure awareness gap " that is currently prevailing among medical professionals and paediatricians worldwide. Read More ... #Autism #AutismCure #AutismTreatment

The features of apraxia of speech (AOS) are presented with regard to both traditional and contemporary descriptions of the disorder. Models of speech processing, including the neurological bases for apraxia of speech, are discussed. Recent findings concerning subcortical contributions to apraxia of speech and the role of the insula are presented. The key features to differentially diagnose AOS from related speech syndromes are identified. Treatment implications derived from motor accounts of AOS are presented along with a summary of current approaches designed to treat the various subcomponents of the disorder. Finally, guidelines are provided for treating the AOS patient with coexisting aphasia.