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Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

OBJECTIVE: The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) after introduction of a dedicated preventive rehabilitation program for stage III-IV oropharyngeal carcinoma (OPC).METHODS: Swallowing, mouth opening and speech function were collected before and at six- and twelve-month follow-up after RT(+) for OPC as part of ongoing prospective assessments by speech-language pathologists .RESULTS: Objective and patient-perceived function deteriorated until 6 months and improved until 12 months after treatment, but did not return to baseline levels with 25%, 20% and 58% of the patients with objective dysphagia, trismus and speech problems, respectively. Feeding tube dependency and pneumonia prevalence was low.CONCLUSION: Despite successful implementation, a substantial proportion of patients still experience functional limitations after RT(+) for OPC, suggesting room for improvement of the current rehabilitation program. Pretreatment sarcopenia seems associated with worse functional outcomes and might be a relevant new target for rehabilitation strategies.

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31-12-2021

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Fusing the electromagnetic articulograph, high-speed video cameras and a 16-channel microphone array for speech analysis

Electromagnetic articulography (EMA) is one of the instrumental phonetic research methods used for recording and assessing articulatory movements. Usually, articulographic data are analysed together with standard audio recordings. This paper, however, demonstrates how coupling the articulograph with devices providing other types of information may be used in more advanced speech research. A novel measurement system is presented that consists of the AG 500 electromagnetic articulograph, a 16-channel microphone array with a dedicated audio recorder and a video module consisting of 3 high-speed cameras. It is argued that synchronization of all these devices allows for comparative analyses of results obtained with the three components. To complement the description of the system, the article presents innovative data analysis techniques developed by the authors as well as preliminary results of the system’s accuracy.

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31-05-2018

Fusing the electromagnetic articulograph, high-speed video cameras and a 16-channel microphone array for speech analysis

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Cluttering identified: differential diagnostics between cluttering, stuttering and speech impairment related to learning difficulties

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31-12-2008

Cluttering identified: differential diagnostics between cluttering, stuttering and speech impairment related to learning difficulties

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Collaboration between parents and SLTs produces optimal outcomes for children attending speech and language therapy: Gathering the evidence

Background: Collaboration between parents and speech and language therapists (SLTs) is seen as a key element in family-centred models. Collaboration can have positive impacts on parental and children’s outcomes. However, collaborative practice has not been well described and researched in speech and language therapy for children and may not be easy to achieve. It is important that we gain a deeper understanding of collaborative practice with parents, how it can be achieved and how it can impact on outcomes. This understanding could support practitioners in daily practice with regard to achieving collaborative practice with parents in different contexts. Aims: To set a research agenda on collaborative practice between parents and SLTs in order to generate evidence regarding what works, how, for whom, in what circumstances and to what extent. Methods & Procedures: A realist evaluation approach was used to make explicit what collaborative practice with parents entails. The steps suggested by the RAMESES II project were used to draft a preliminary programme theory about collaborative practice between parents and SLTs. This process generates explicit hypotheses which form a potential research agenda. Discussion & Conclusions: A preliminary programme theory of collaborative practice with parents was drafted using a realist approach. Potential contextual factors (C), mechanisms (M) and outcomes (O) were presented which could be conﬁgured into causal mechanisms to help explain what works for whom in what circumstances. CMO conﬁgurations were drafted, based on the relevant literature, which serve as exemplars to illustrate how this methodology could be used. In order to debate, test and expand our hypothesized programme theory for collaborative practice with parents, further testing against a broader literature is required alongside research to explore the functionality of the conﬁgurations across contexts. This paper highlights the importance of further research on collaborative practice with parents and the potential value of realist evaluation methodology

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31-12-2019

Collaboration between parents and SLTs produces optimal outcomes for children attending speech and language therapy: Gathering the evidence

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Language Sample Analysis in Clinical Practice: Speech-Language Pathologists’ Barriers, Facilitators, and Needs

Purpose: Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, although they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. The primary aim of this study was to identify facilitators, barriers, and needs related to performing LSA by Dutch SLPs working with children with DLD. The secondary aim was to investigate whether a training would change the actual performance of LSA. Method: A focus group with 11 SLPs working in Dutch speech-language pathology practices was conducted. Barriers, facilitators, and needs were identified using thematic analysis and categorized using the theoretical domain framework. To address the barriers, a training was developed using software program CLAN. Changes in barriers and use of LSA were evaluated with a survey sent to participants before, directly after, and 3 months posttraining. Results: The barriers reported in the focus group were SLPs’ lack of knowledge and skills, time investment, negative beliefs about their capabilities, differences in beliefs about their professional role, and no reimbursement from health insurance companies. Posttraining survey results revealed that LSA was not performed more often in daily practice. Using CLAN was not the solution according to participating SLPs. Time investment remained a huge barrier. Conclusions: A training in performing LSA did not resolve the time investment barrier experienced by SLPs. User-friendly software, developed in codesign with SLPs might provide a solution. For the short-term, shorter samples, preferably from narrative tasks, should be considered.

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31-12-2021

Language Sample Analysis in Clinical Practice: Speech-Language Pathologists’ Barriers, Facilitators, and Needs

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The indoor sound environment and human task performance

A substantial amount of studies have addressed the inﬂuence of sound on human performance. In many of these, however, the large acoustic differences between experimental conditions prevent a direct translation of the results to realistic effects of room acoustic interventions. This review identiﬁes those studies which can be, in principle, translated to (changes in) room acoustic parameters and adds to the knowledge about the inﬂuence of the indoor sound environment on people. The review procedure is based on the effect room acoustics can have on the relevant quantiﬁers of the sound environment in a room or space. 272 papers containing empirical ﬁndings on the inﬂuence of sound or noise on some measure of human performance were found. Of these, only 12 papers complied with this review's criteria. A conceptual framework is suggested based on the analysis of results, positioning the role of room acoustics in the inﬂuence of sound on task performance. Furthermore, valuable insights are pre- sented that can be used in future studies on this topic. Whi le the inﬂuence of the sound environment on performance is clearly an issue in many situations, evidence regarding the effectiveness of strategies to control the sound environment by room acoustic design is lacking and should be a focus area in future studies.

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31-12-2016

The indoor sound environment and human task performance

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Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results:Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children.

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31-12-2019

Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

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Collaboration between Speech and Language Therapists and Parents of Children with Developmental Language Disorders

In order to optimize collaboration between Speech and Language Therapists (SLTs) and parents of children with Developmental Language Disorders (DLD), our aim was to study what is needed for SLTs to transition from the parent-as-therapist aide model to the FCC model and optimal collaborate with parents. Chapter 2 discusses the significance of demystifying collaborative working by making explicit how collaboration works. Chapter 3 examines SLTs’ perspectives on engaging parents in parent-child interaction therapy, utilizing a secondary analysis of interview data. Chapter 4 presents a systematic review of specific strategies that therapists can employ to enhance their collaboration with parents of children with developmental disabilities. Chapter 5 explores the needs of parents in their collaborative interactions with SLTs during therapy for their children with DLD, based on semi-structured interviews. Chapter 6 reports the findings from a behavioral analysis of how SLTs currently engage with parents of children with DLD, using data from focus groups. Chapter 7 offers a general discussion on the findings of this thesis, synthesizing insights from previous chapters to propose recommendations for practice and future research.

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31-12-2023

Collaboration between Speech and Language Therapists and Parents of Children with Developmental Language Disorders

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Speech and language therapists' insights into severity of speech sound disorders in children for developing the speech sound disorder severity construct

Background Children with speech sound disorders (SSD) are at higher risk of communication breakdown, but the impact of having an SSD may vary from child to child. Determining the severity of SSD helps speech-language therapists (SLTs) to recognise the extent of the problem and to identify and prioritise children who require intervention. Aims This study aimed to identify severity factors for SSD in order to develop a multifactorial Speech Sound Disorder Severity Construct (SSDSC) using SLTs’ views and the International Classification of Functioning, Disability and Health (ICF). Method In an explorative five-staged qualitative study, the research question was answered: ‘How do SLTs determine the severity of SSD in children?’. A total of 91 SLTs from The Netherlands participated in data collection and analysis. The iterative process included three different qualitative research methodologies (thematic analysis [TA], constructivist grounded theory [CGT] and content analysis [CA]) to ensure validation of the results by means of method triangulation. Results SLTs considered nine themes: intelligibility, speech accuracy, persistence, the child's perception, impact, communicative participation, concomitant factors, professional point of view, and environmental factors. The themes were summarised in three main severity factors: (I) Speech accuracy, (II) The child's perception of the impact of their speech, and (III) Intelligibility in communication. Other severity factors were concomitant factors and impact. Expertise and support were identified as facilitators or barriers that may worsen or relieve the severity of SSD. Conclusions This study highlights the need for SLTs to rethink how they think about severity as a simplistic construct reflecting only speech accuracy. It is recommended that a broader holistic approach to measuring severity is adopted.

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31-12-2024

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Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

Fusing the electromagnetic articulograph, high-speed video cameras and a 16-channel microphone array for speech analysis

Cluttering identified: differential diagnostics between cluttering, stuttering and speech impairment related to learning difficulties

Collaboration between parents and SLTs produces optimal outcomes for children attending speech and language therapy: Gathering the evidence

Language Sample Analysis in Clinical Practice: Speech-Language Pathologists’ Barriers, Facilitators, and Needs

The indoor sound environment and human task performance

Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

Collaboration between Speech and Language Therapists and Parents of Children with Developmental Language Disorders

Speech and language therapists' insights into severity of speech sound disorders in children for developing the speech sound disorder severity construct

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