Browsing by Subject "puheterapia"

Tavoitteet. Lähi-ihmisten roolia puheterapiassa painotetaan nykyään. Ympäristön tuen ja osallistumisen merkitys perustuvat mm. ICF-luokitukseen ja ekologisen teorian mukaiseen perhelähtöiseen toimintamalliin. Perheet nähdään aktiivisina toimijoina, joiden kanssa tehtävällä yhteistyöllä voidaan mahdollistaa heidän osallistumisensa. Aiheen ajankohtaisuudesta huolimatta siitä on varsinkin suomalaista tutkimusta toistaiseksi hyvin vähän. Tämän tutkimuksen tavoitteena oli kartoittaa perusterveydenhuollon puheterapeuttien näkemyksiä perheiden osallistumisesta puheterapiaan. Lisäksi selvitettiin kieli- ja kulttuurierojen mahdollisia vaikutuksia yhteistyöhön ja osallistumiseen, sillä lisääntyvä monikielisyys ja -kulttuurisuus voivat tuoda lisähaasteita puheterapian toteuttamiseen. Menetelmät. Tämä tutkimus toteutettiin teemahaastatteluina. Haastateltaviksi saatiin yhteensä seitsemän Espoossa ja Helsingissä työskentelevää puheterapeuttia, jotka olivat valmistuneet 6–40 vuotta sitten. Aineisto kerättiin kesän 2018 aikana, ja litteroinnin jälkeen se analysoitiin aineistolähtöisen sisällönanalyysin keinoin Atlas.ti-ohjelmaa apuna käyttäen. Tulokset ja johtopäätökset. Perheet voivat osallistua perusterveydenhuollon puheterapiaan monin eri tavoin. Vaikka puheterapeutit kokivat perheen osallistumisen tärkeänä osana puheterapiaa, perheiden kanssa tehtävässä yhteistyössä ja perheiden osallistumisessa nähtiin esiintyvän monia haasteita, jotka liittyivät esimerkiksi perheiden vaikeisiin elämäntilanteisiin tai motivaation tai huolen puuttumiseen. Erilainen kieli- ja kulttuuritausta nähtiin usein yhteistyön ja osallistumisen lisähaasteena. Perheiden motivoimiseen ja osallistamiseen oli käytössä monia keinoja. Puheterapeuttien toiminnassa perheiden kanssa ja perheiden osallistamisessa esiintyy perhelähtöisiä piirteitä. Kulttuurinen kompetenssi toteutuu puheterapeuttien työskentelyssä erilaisten perheiden kanssa, mikä näkyy erilaisten kulttuurien arvostuksena ja pyrkimyksenä ottaa erilaiset kieli- ja kulttuuritaustat monipuolisesti huomioon.

The aim of this study is to examine speech-language therapists’ evaluations after the clients’ responses in naming exercises in order to unpack the actions and structures of evaluations on interaction in the speech-language therapy of children with developmental language disorder (DLD). Especially evaluations during exercises after the client’s response are significant when supporting the client’s learning, even though feedback can be included in many stages of therapy. Previous studies of speech-language therapy interaction have mostly focused on therapy interaction generally, or on feedback in adults’ speech-language therapy, but research on evaluations in children’s speech-language therapy are still very few. At the moment the speech-language therapists’ knowledge of therapy interaction and evaluative actions is mainly empirical. Detailed analysis and knowledge of feedback would benefit speech therapists’ and speech therapy students’ ability to analyse their own evaluative actions, and ability to help parents to improve their interaction skills with their child. The method used in this study was conversation analysis developed by sociologists Harvey Sacks, Emanuel Schegloff and Gail Jefferson. The data consisted of 10 videotapes of DLDs speech-language therapy, filmed by Tuula Tykkyläinen for her doctoral thesis in late 1990s. Naming tasks with third turn feedback from 10 therapy videos were included in this study. Subjects were four speech-language therapists and five children ages 5;0 - 6;0. The naming and feedback sequences were transcribed in detail, and the feedback actions and structures were analysed. The frequencies of feedback structures were counted. With feedback actions speech-language therapists either approved the child’s naming response, or in case of incorrect responses, helped the child to produce correction or produced themselves the correct naming. There were found structural similarities in the feedback turns and ways speech-language therapists facilitate learning and the interaction between the speech-language therapist and the client. The post-expansions of feedback turns were also found to be significant in the rehabilitation of naming along feedback turns. The results mainly confirm previous findings and increase the knowledge on speech-language therapists’ evaluations. The results help observation and conceptualization of evaluative actions especially in the speech-language therapy of children with DLD.

Objective. Speech sound errors are the most common speech disorders in children that, without proper treatment, can have far-reaching effects on an individual’s quality of life. Due to limited speech therapy resources, speech sound disorders are often left without adequate treatment. In Finland, efforts have been made to reduce the geographical inequality in the availability of rehabilitation services through various time-independent teletherapy solutions. For example, the mission of Äännekoulu is to help Finnish municipalities prioritize their limited resources and enable every child to have access to speech therapy services, regardless of their place of residence. There are only few studies focusing on the use of teletherapy practicies in the treatment of speech sound disorders in Finnish-speaking children. The aim of this study was to examine whether Äännekoulu’s online therapy is an effective way to rehabilitate children's /r/-errors and to describe possible factors influencing rehabilitation results. Methods. The data used in the study consisted of demographic information and speech therapist’s notes and records on children under 10 years of age (n = 109) who participated in a three-month training period at Äännekoulu’s online therapy aiming to rehabilitate existing /r/-errors in their speech during March 2019 - April 2020. The notes and records were collected from the patient database Diarium. Participation in the study was voluntary. The collected data were categorized and analyzed using the Mann-Whitney U test and the chi-square test. Results and conclusions. More than half of the children learned to produce alveolar trill /r/ at least in isolation during a training period at Äännekoulu’s online therapy. On average children learned to produce the tongue trill on the sixth contact with the speech therapist. Most of the children learned to produce tongue trill through the dn dn dn -exercise. There was no significant difference between sexes in learning to produce the alveolar trill. The quality and the type of the speech sound error, age, sex or the children’s skill level in the beginning of the training period did not affect the rehabilitation of /r/-error. The number of contacts with the speech therapist strongly correlated with the results achieved in teletherapy. Äännekoulu’s online therapy seems to be an effective way to treat children’s /r/-errors. Learning to produce the alveolar trill correctly is significantly affected by active collaboration with the speech therapist. Further research is needed to identify the factors influencing the rehabilitation of the /r/-errors. Future research should also concentrate on the at home practice needed to treat speech sound errors in teletherapy.

The aim of the study. Multilingualism is a growing phenomenon worldwide and also in Finland. It means that speech and language pathologists (SLPs) will also encounter more multilingual people in their occupation. Multilingual customers may induce challenges to typical speech and language therapy, since international research has already shown that for example assessment methods standardized with monolinguals cannot be used as such with multilinguals. Multilingual speech therapy may also require using an interpreter which may induce even more challenges. Since the topic has only begun to majorly surface during the 2000s, presumably there are no unified clinical procedures among SLPs. Hence, the aim of this study was to gather a comprehensive overview of the clinical speech and language therapy procedures used with multilinguals in Finland today. In addition, this study aimed to gather information of the amount of multilingual customers and how they are distributed geographically throughout the country. Methods. The data was collected using an electronic questionnaire, which was sent to SLPs belonging to the speech and language pathologists' trade union. The questionnaire received 141 answers. The questionnaire comprised of four sections and basic background information of the informants. The data was analysed both quantitatively and qualitatively. The quantitative analysis was carried out by using Word Excel -spreadsheet. The qualitative analysis was carried out by gathering information from the open questions under different themes arising from the answers. Results and conclusions. Multilingual customers in speech therapy are most common in the Helsinki metropolitan area and in Southern-Finland, but their amount is increasing throughout the country. According to this study, to date, there are no unified therapy procedures in multilingual speech and language therapy. For example, the limited amount of suitable assessment materials, inaccessibility to research and cultural differences caused challenges for SLPs. With an interpreter the challenges were connected to the roles of different agents in the situation. Despite the challenges brought upon by this group of customers, the SLPs felt like they also gained a lot from working with this group of customers. This study can potentially bring SLPs closer to unified therapy procedures in multilingual speech and language therapy and evoke more studies on the subject.

Änkytys on puheen sujuvuuden häiriö, johon liittyy usein psykososiaalisia ongelmia. Puheen sujumattomuus saattaa heikentää änkyttävän henkilön elämänlaatua, vaikeuttaa ihmissuhteiden luomista ja rajoittaa yhteiskunnallista osallistumista. Hyväksyvän suhtautumisen omaa änkytystä kohtaan on todettu parantavan änkyttävän henkilön hyvinvointia. Viime vuosina änkytyksen kuntoutuksessa onkin keskitytty myös änkytyksen hyväksymistä edesauttaviin harjoituksiin. Tietoisen läsnäolon menetelmä, mindfulness, on myötätuntoista ja hyväksyvää suhtautumista painottava, meditaatioharjoituksiin pohjaava menetelmä, jota on käytetty osana erilaisia interventiomuotoja. Mindfulness-menetelmän harjoituksia on otettu myös osaksi puheen sujuvuuden häiriöiden kuntoutusta. Tämän tutkielman tavoitteena on kartoittaa änkytyksen kuntoutuksessa käytettyjä tietoisen läsnäolon harjoituksia ja harjoitusten vaikutuksia änkytyksen kuntoutumiseen. Tämä tutkielma toteutettiin integroivana kirjallisuuskatsauksena. Aineistohaku tehtiin helmikuussa 2018 neljästä kansainvälisestä kokoteksti- tai viitetietokannasta (Scopus, Pubmed, Ovid MEDLINE ja speechBITE). Hakusanoiksi valittiin sanat stutter ja tälle synonyyminen stammer ja mindfulness. Niistä muodostettiin hakulauseke ((stutter*) OR stammer*) AND mindful*. Aineistoksi hyväksyttiin ainoastaan vertaisarvioidut ja maksutta kokotekstinä luettavissa olevat artikkelit. Änkytyksen kuntoutuksessa käytetyissä tietoisen läsnäolon harjoituksissa painottuivat änkytysoireiden ja niiden aiheuttamien tunteiden tietoinen havainnointi ja hyväksyminen. Tietoisen läsnäolon harjoitukset paransivat tutkimuksiin osallistuneiden henkilöiden elämänlaatua ja itseluottamusta ja vaikuttivat myönteisesti heidän kommunikaatioasenteisiinsa. Tulosten perusteella tietoisen läsnäolon harjoituksia osana änkytyksen puheterapeuttista kuntoutusta tulisi tutkia enemmän, sillä harjoitusten vaikutukset näyttäisivät olevan kuntoutumista tukevia ja harjoitukset mahdollisia toteuttaa osana puheterapiaa.

Aims. As the amount of tracheostomized patients is increasing the clinical caseload of speech and language therapists (SLT) working with this population is expanding. International surveys show that many SLTs have poor clinical confidence while working with this population, many confront problems in their work environment what comes to team work and most SLTs believe additional training in tracheostomy management would be beneficial. There are some inconsistencies and variation in tracheostomy management among SLTs. The aim of this study was to explore the assessment and rehabilitation patterns of clinicians working with tracheostomized people as well as the role of SLTs managing this population in Finland. Clinical training preparing to work with this population was also examined. Methods. An electronic survey of University of Helsinki was sent to 1163 SLTs via the Finnish Association of Speech Therapists. The whole questionnaire was directed only to the SLTs having previous work experience with at least one patient with a tracheostomy. 61 SLTs completed the survey. Frequencies and percentages were computed to analyze the data quantitatively. Also Kruskall–Wallis -test was applied. Questions relating to clinical activities were classified according to the level of clinical consensus. The answers to the open questions were analysed qualitatively by grouping the answers according to the themes arising from the data. Results and conclusions. The respondents had little experience on assessment and rehabilitation of tracheostomized patients. Most referrals were received for dysphagia and communication assessment. SLTs found their role in tracheostomy management often poorly defined. Patients were usually assessed and rehabilitated as a team and teamwork was found important and practical. The respondents had had only a little education and practical training on tracheostomy management. Most SLTs felt they needed more training on assessment and rehabilitation of patients with a tracheostomy. The clinical confidence of SLTs working with this population varied. National guidelines in tracheostomy management for speech and language therapists would help to define the role of SLTs in this field. Additional training would help to improve clinical confidence of SLTs working with this population.

Tiedekunta – Fakultet – Faculty Lääketieteellinen tiedekunta Tekijä – Författare – Author Laura Kuusio Työn nimi – Arbetets titel – Title Valikoivan puhumattomuuden puheterapeuttinen arviointi ja kuntoutus Suomessa Oppiaine – Läroämne – Subject Logopedia Työn ohjaaja(t) – Arbetets handledare – Supervisor Suvi Stolt Tiivistelmä – Abstrakt – Abstract Tausta ja tavoitteet. Selektiivinen mutismi, eli valikoiva puhumattomuus on usein lapsuudessa alkava häiriö, jonka pääoireena on kyvyttömyys puhua tietyissä tilanteissa, vaikka toisissa puhuminen onnistuu. Häiriö asettuu lasten psykiatrian ja logopedian rajapintaan, mutta aihetta ei vielä ole Suomessa tutkittu puheterapian kontekstissa. Tämän tutkimuksen tavoitteena oli selvittää: 1. Kuinka paljon suomalaiset puheterapeutit kohtaavat valikoivasti puhumattomia henkilöitä työssään? 2. Minkälaisia menetelmiä suomalaiset puheterapeutit käyttävät valikoivasti puhumattomien henkilöiden arvioinnissa ja kuntoutuksessa? 3. Minkälaista on valikoivan puhumattomuuden puheterapeuttisen kuntoutuksen tuloksellisuus Suomessa? 4. Mikä on puheterapeuttien kokemus omasta osaamisestaan valikoivan puhumattomuuden kuntoutuksessa? Menetelmät. Tutkimus oli kyselytutkimus. Lomake laadittiin tätä tutkimusta varten Helsingin yliopiston E-lomake -ohjelmalla ja levitettiin 23.8.2016 sähköpostitse Puheterapeuttiliiton kautta kaikille liiton varsinaisille jäsenille (n=1207). Lopullinen vastausprosentti oli 12,1 %. Aineiston analyysiin käytettiin tilastollisia menetelmiä, ja se toteutettiin IBM SPSS Statistics 23 -ohjelmalla. Tulokset ja johtopäätökset. Arvioitujen valikoivasti puhumattomien asiakkaiden esiintyvyys aineistossa oli 0,94 % ja kuntoutettujen 0,80 %. Arviointimenetelmistä suosituimpia olivat vapaa havainnointi ja strukturoimaton haastattelu, harvinaisin taas strukturoitu haastattelu. Myös logopedisiä testejä oli käytetty. Kuntoutusmenetelmistä suosituimpia olivat vanhempien sekä päiväkodin tai koulun henkilökunnan ohjaaminen, vähiten suosittuja kognitiiviset menetelmät. Kuntoutuksessa oli käytetty myös puhetta tukevia ja korvaavia menetelmiä (AAC). Selkeää hoitoketjua näille asiakkaille ei vaikuttanut olevan. Tässä aineistossa puheterapeuttien antama kuntoutus vaikutti tulokselliselta, sillä valtaosa valikoivasti puhumattomista asiakkaista oli alkanut puhua kuntouttaneelle puheterapeutille, sukulaisilleen sekä päiväkodin tai koulun edustajille. Keskimäärin aineiston puheterapeutit kokivat valikoivan puhumattomuuden arvioinnissa ja kuntoutuksessa parhaimmaksi teoriatietonsa aiheesta. Tämän tutkimuksen perusteella voidaan todeta, että valikoivasti puhumattomia asiakkaita esiintyy suomalaisten puheterapeuttien vastaanotoilla, ja että he kuntouttavat näitä asiakkaita tuloksellisin keinoin. Avainsanat – Nyckelord – Keywords valikoiva puhumattomuus, selektiivinen mutismi, esiintyvyys, arviointi, kuntoutus, puheterapia Säilytyspaikka – Förvaringsställe – Where deposited Helsingin yliopiston kirjasto – Helda / E-thesis (opinnäytteet) ethesis.helsinki.fi

Objectives. Feeding disorders affect families in many ways, like causing challenges for parenthood and daily routines. Parents’ perspectives on their children’s feeding disorder and its rehabilitation has not been investigated thoroughly. It is according to clinical practice guidelines to take parents’ view into account for parents being in essential position in their children’s rehabilitation. Parents’ experience can also help speech-language pathologists to improve their practices. The objective of this study was to describe parents’ perspectives on their children’ feeding disorder and its rehabilitation in speech-language therapy. Also the impact of the therapy to the family was examined. Method. Nine parents were interviewed for the study, whose children with feeding disorder had been evaluated by speech-language pathologist in the specialized medical care. Children were under 2.5-year-old and their rehabilitation had ended less than a year earlier. Children’s etiologic background differed significantly of each other. Parents were interviewed using a semi-structured theme interview. The themes were formulated using previous research literature and clinical expertize. The interviews were recorded and transcribed, and the data were analysed using inductive content analysis. The categorisation was made from the content into themes. The themes were analysed and complemented using previous research literature. Results and conclusions. The feeding disorder manifested in children’s eating and behaviour in various ways. The feeding disorder caused mental, physical and social burden for the family. It had caused a lot of negative emotions, stress and daily challenges to the parents. Thus an early intervention could be beneficial for the family. The parents found the rehabilitation positive and beneficial. The rehabilitation took parents’ expertize and daily concerns into account, increased parents’ understanding and emotionally encountered them. The therapy methods were diverse and interdisciplinary team approach was used. The rehabilitation had changed parents’ behaviour and attitude, which was seen for example in feeding practises, parents’ emotions and competence. The effect of the rehabilitation appeared in children’ oral sensorimotoric functions and in feeding behaviour. Children were more active, self-regulated and their reaction to feeding were eased in many ways. The feeding rehabilitation can affect positively both to parents’ competence and children’s feeding disorder. In future it would be beneficial to study what kind of feeding intervention services families undergo outside specialized medical care.

Objective: Previous results support the use of video examples in voice therapy. Patient adherence and motivation for practice was improved in the video-enhanced voice therapy compared to the "written" condition. A previous study has also shown that an instructional videotape has potential to increase people's awareness about voice misuse and treatment options. However, this area is still poorly studied. The goal of this study was to review the experiences of educational video material. The focus was to map out the experiences and benefits of using the video material. The purpose of this study was also to determine if patients' voice quality and the quality of life could be improved by providing videos of vocal hygiene instructions and voice exercises exemplified by the therapist. Methods: The population consisted of 12 patients of HUS Speech and Voice Clinic who participated in an independent video-enhanced intervention. All participants were women (20-63 years) and they had a functional voice disorder diagnosed by a phoniatrician. Before the intervention participants filled up two self-assessment questionnaires: VHI and VAPP. During the intervention participants kept an exercise diary. After the intervention participants filled up three self-assessment questionnaires: VHI and VAPP once again and also a questionnaire about the experiences of educational video material. The data were analysed applying qualitative content analysis and statistical method. Results and conclusions: The participants considered the video material, especially the informative part of it, clear and useful. The training videos were also considered clear and quite easy to manage. Practice frequency was how ever quite poor. Nobody practiced every day. During one month (30 days) the participants exercised in 5 to 27 days. During one day they exercised about eight minutes. Some of the participants seemed to benefit from the independent video-enhanced voice therapy. 7/12 participants had better VHI and VAPP scores after the intervention compared to the scores before the intervention. The difference in VAPP scores of the whole group before and after the intervention was considered statistically significant (p-value =.048 < .05 ). However, there were so wide variation in the practice frequency and the VHI and VAPP scores, that no exact conclusions can be made.

Objectives. There are approximately 14,500 new cases of dementia-associated diseases each year in Finland. The most common cause of dementia is Alzheimer's disease (AD). There are many changes associated with AD that affect the person's ability to participate in interaction. Until now only very few Finnish studies have been conducted on assessing, treating and supporting language and interaction in dementia-associated diseases, and this type of treatment is not widely available in Finland. The purpose of this study is to introduce one indirect group speech therapy intervention aimed at the spouses of persons with AD, and to study its effectiveness in the interaction strategies they apply as well as their perceptions and satisfaction regarding interaction. The participants' experiences of the intervention and its usefulness are also examined. The study also touches the applicability of a recently translated method for assessing the interaction between persons with AD and their spouses. Method. Three couples participated in the study, all of whom had one partner diagnosed with AD. The studied intervention consisted of six group meetings aimed at the healthy spouses. Data was collected at three separate occasions using VNVIS-CG – a method based on analyzing video-recorded material – and a questionnaire. The participants also filled out a feedback form at the end of the intervention. Results and conclusions. The study found that the participants adopted and implemented some of the strategies that were addressed during the intervention. The changes observed in the behavior of the participants were individual. However, the intervention seems to even out the differences in the number of strategies used by the participants. All of the participants found the intervention useful, and felt that it had affected their behavior, but only one of the participants reported greater satisfaction with the couple's interaction after the intervention. The participants' perceptions of interaction varied greatly, so conclusions about possible changes in these perceptions cannot be made. Further research on the matter, with a larger group of participants and a comparison group, is definitely needed. In the future, the methods used to evaluate effectiveness, as well as the content and the execution of the intervention, should also be modified as needed.