Browsing by Subject "puheterapia"

Background and aims: Aphasia is commonly associated with deficits in all linguistic modalities.In mild, chronic aphasia syndromes difficulties in reading can interfere with tasks of everyday life. The rehabilitation of reading difficulties caused by a general linguistic deficit is closely related to the rehabilitation of spoken language, especially in the early stages. Partly due to the limited resources granted to speech therapy, rehabilitation seldom proceeds to reading in its own right. Research has shown that rehabilitation of reading as such can however be beneficial to more general linguistic abilities. In this study, the quality and responsiveness to treatment of a sublexical reading deficit related to mild, chronic conduction aphasia were examined. The aim was to investigate, whether a sublexical therapy method and in particular text-level reading practice were effective in enhancing the fluency of reading or more general linguistic abilities. Methods: A 37-year-old man with mild, chronic conduction aphasia and resulting phonological alexia participated in the study. The intervention consisted of 17 training sessions (total of40 hours) of speech therapy, during which independent practice of repetitive reading that lasted for 11 weeks was started. Therapy consisted of phonological and word-level repetition and naming tasks combining the auditive and written modalities. Data consisted of linguistic tasks collected before, during and after the practice period. The effects of the intervention were evaluated by examining oral reading speed and accuracy of connected text and nonwords. More general phonological and linguistic abilities were examined through auditive repetition and auditive memory tasks. Results and discussion: The reading deficit reflected a more general linguistic difficulty that seemed to originate in auditive processing. Difficulties in reading seemed to arise from weakened phonological activation of word forms. No clinically significant changes were observed after the rehabilitation period. Still, positive changes were noted that imply the rehabilitation can be efficient when carried out through a longer period. Reading speed increased in nonword reading task, but speed of reading connected text increased steadily through the whole study period. A positive change in oral reading speed was observed in first readings of practice texts that might imply a more consistent enhancement during a longer training interval. No rehabilitative effect was apparent in auditive repetition or auditive memory, even though individual tasks improved. The results of this case study imply that repetitive reading ought to be further investigated as a reading rehabilitation method for persons with mild phonological reading deficits. Considering more general phonological rehabilitation, systematic methods could enhance the effectiveness of practice.

Goals. Event schema, also known as a script, contains information about a structure of a particular event; about the sequences of events and their temporal order. With the information the scripts contain, one can anticipate and plan for future events and actions. People with traumatic brain injury (TBI) can have difficulties in the verbal planning of actions. Previous international research has shown that the scripts produced by people with TBI contain fewer actions central to the schema, than scripts produced by healthy control subjects. The aim of this study is to examine what kind of scripts Finnish speaking subjects with TBI and their healthy control subject counterparts generate in a script generation task consisting of eight scripts. This study also examines whether the script type has influence on the features of the generated scripts. Methods. Fifteen subjects with TBI and fifteen healthy control subjects participated in the study. The researcher collected the research material during the spring and summer 2015. The research material consisted of the scripts generated by the subjects and control subjects, as well as the results of the control tasks (Boston Naming Test, Rapid Automatized Naming Test, semantic and phonemic fluencies). The subjects were asked to generate event schemas for eight everyday tasks belonging to four schema categories. The categories were ‘open high frequency’ (go shopping, go for a walk), ‘open low frequency’ (apply for a job, go on a vacation), ‘closed high frequency’ (make coffee, brush teeth), and ‘closed low frequency’ (go to a doctor, go to a restaurant). Closed scripts are related to events where the actions involved in their execution are well established and tightly related to each other. Open scripts are less structured and have loose connections between the actions involved. High and low frequency scripts differ on how frequent the event is. Time given for generating each script was 60 seconds. The scripts were scored for the total number of events produced, the number of event repetitions, the informativeness of the script, and the meaningfulness and the centrality of the events. The results of the qualitative analysis were displayed in a statistical form and analyzed with the non-parametrical Mann-Whitney U -test. Results and conclusions. The results showed that the scripts produced by the subjects with TBI were less informative and contained less actions than the scripts produced by the healthy control subjects, regardless of the script type. Closed scripts were found to be more informative than open scripts, and the subjects produced more actions to the closed than to the open scripts. When the high and low frequency scripts generated by the subjects with TBI were examined, no significant difference was found between the two script types. The results of this study can be explained by the disturbances in executive functions, and disturbances in the working memory as well as the episodic memory, all of which can affect the subject’s ability to produce a coherent story and recall actions belonging to a certain event.

Objectives: 18 percent of Finnish children have some kind of articulation problems when starting their school path. Lack of speech therapists and unequal spread of these professionals has reduced possibility to receive speech therapy for mild problems. Instead resources are allocated for clients with severe speech and language disorders. In some municipalities parents and special education teachers are already responsible for the remediation of articulation problems. The aim of this study was to identify if Äännekoulu-website (www.aannekoulu.fi) can help to rehabilitate articulation problems and if the site will meet the needs of the parents struggling with their children' articulation problem. Methods: The study was qualitatively centred mixed method design that had also some quantitative elements. 21 children between the ages of 5 and 7 with /r/ articulation problem participated in this study. Children were tested three times. Children's spontaneous development of /r/ was controlled by having one month break after the first testing. After the second test families received the right to use Äännekoulu practice materials. Families were instructed to use the site for two months just as regular paying customers would do. Outcome of the intervention was observed during the third test. Families were also given a phone call after one and a half months of the last test to explore the possible changes in the /r/ articulation. In addition families were asked to keep a record of their home practices and answer in a survey concerning the Äännekoulu intervention period. Results and conclusions: Six families dropped out from the intervention. Five children found the right /r/ spontaneously. 12 families participated in the remediation period and one child found the missing /r/. Nine children had no changes in their articulation. From these nine children three continued their practice after the real intervention. During one month of practice two out of these three children found the /r/ completely and one learned to do long /r/-vibration. Families didn't practice a lot and they were unsatisfied with the amount of practice. According to the parents health issues within the family, burdensome family situations, lack of time, child's unwillingness to complete assignments, technical difficulties and laziness were the biggest barriers for practicing. Families considered Äännekoulu to be a good way to practice. Families were pleased about the nice games and the possibility to practise whenever and wherever since the exercises were available online. Unfortunately families trained impractically without knowing it and actually reinforced the incorrect articulation. Parents thought that the visual look of Äännekoulu should be revised and some of them also longed for more diverse games. Still the most crucial target for development in Äännekoulu is the instructions of the assignments. The model of the site hasn't been clear to the users even though families didn't consider the website to be confusing. It's clear that the the instructions have been insufficient since only one family realised how to progress accordingly. On the basis of this study it can be stated that speech therapist's guidance is significant when rehabilitating articulation problems. In the future it would be beneficial to explore, what kind of home instructions help families to execute their role in a best way possible, what is the role of a speech therapist in the future especially when considering telepractice or other technological services and can Äännekoulu fulfill the gap in the field of articulation remediation.

Objectives. Autism spectrum disorder (ASD) is a neurobiological developmental disorder that involves challenges in social interaction and restricted/repetitive behaviors. Since generalization and maintenance of acquired skills is essential in the rehabilitation of ASD, it is important to integrate interventions into the home environment by parental guidance. There has been some research on the rehabilitation of children with ASD in Finland, but no research has been conducted on the guidance of parents from the perspective of speech therapist. The purpose of this study is to find out the views of parental guidance from speech therapists who rehabilitate children with ASD. Interviews with speech therapists will clarify the ways in which parents of children with ASD are guided through speech therapy and the challenges and contributing factors in parental guidance. Methods.The research method was a semi-structured interview. Five speech pathologists with experience in the rehabilitation of ASD were interviewed. The interviews were recorded and transcribed. The data was analyzed by content analysis. Results and conclusion. Parental guidance of children with ASD was divided into information sharing, interaction & discussion and direct guidance. The challenges were parental strain, parent attitude and in some cases multiculturalism. Contributing factors appeared in training practices and home conditions. Challenges and benefits were influenced by the individuality of families. Speech therapists hoped for more opportunities to arrange separate parental guidance sessions so that they would be able to discuss deeper about the methods and family situation without the child’s presence. Speech therapists considered parental guidance important in the rehabilitation of children with ASD because, with the guidance of parents it helped to increase skills in everyday life and guaranteed training intensity. As parental strain was identified as a challenge in this study, it would be important to explore how they could be more effectively supported during rehabilitation. In addition, it could be explored whether separate parental guidance sessions should be increased or whether the number of parental guidance sessions has been adapted through the development of new working practices.

Tavoitteet: Kun terveyspalvelujen tarjonta ei vastaa kysyntää ja tarvetta, seuraa vaikeuksia hoitoon pääsyssä. Suomessa perusterveydenhuollon hoitoon pääsystä säädetään terveydenhuoltolaissa, jossa hoitoon pääsylle on asetettu tietyt määräajat (hoitotakuu). Perusterveydenhuollon lääkinnälliseen kuntoutukseen ja siten puheterapiaan tulisi päästä viimeistään kolmen kuukauden kuluessa hoidon tarpeen arvioinnista. Tämän pro gradu -tutkielman tarkoituksena oli selvittää hoitoon pääsyä perusterveydenhuollon puheterapiassa. Tarkemmin tarkoituksena oli selvittää puheterapeuttien väestövastuuta (yhden kokoaikaisesti työskentelevän puhetrapeutin vastuulla oleva väestömäärä), hoitotakuun mittaamista ja toteutumista, odotusaikoja sekä priorisointia. Puheterapian hoitotakuuta, odotusaikoja ja priorisointia ei ole Suomessa tiettävästi aiemmin tutkittu. Menetelmät: Pro gradu -tutkielma toteutettiin kyselytutkimuksena kunnissa työskenteleville puheterapeuteille ja muille ammattilaisille, jotka parhaiten tunsivat alueen puheterapiatilanteen. Tutkimuksen perusjoukkona oli Manner-Suomen 133 kuntaa ja yhteistoiminta-aluetta, joista pyrittiin saamaan maantieteellisesti mahdollisimman edustava otos. Otos muodostui 47 alueesta, joihin kysely lähetettiin. E-lomakkeelle tehty kyselylomake koostui 52 osiosta sisältäen sekä suljettuja että avoimia osioita. Aineiston tilastollinen kuvaus ja analyysi suoritettiin IBM SPSS Statistics -ohjelmalla. Avoimiin osioihin tulleet vastaukset luokiteltiin sisällön mukaan. Tulokset ja johtopäätökset: Vastauksia saatiin 34 alueelta, ja vastaajia oli yhteensä 40. Tulosten mukaan alueiden väestövastuiden keskiarvo oli 13 232 (md 10 712, kh 9 030, min.–maks. 6 801–49 701). Hoitotakuun osalta hoitotakuun mittaamisessa havaittiin vaihtelua niin alueiden sisällä kuin alueiden välillä. Yleisimmin terveydenhuoltolaissa mainittu hoidon tarpeen arviointi katsottiin tehdyksi, kun puheterapeutti oli käsitellyt asiakkaan lähetetietoja tai yhteydenottoa (43 %). Laissa mainitun hoidon taas katsottiin yleisimmin alkaneen, kun puheterapeutti oli tavannut asiakkaan ja aloittanut arvioinnin tekemisen (76 %). Hoitotakuun arvioitiin toteutuneen aina 20 %:ssa alueita, 44 %:ssa useimmiten, 12 %:ssa noin puolessa tapauksista ja harvoin 24 %:ssa alueita. Arvioiduissa keskimääräisissä odotusajoissa ensikäynnille oli alueittain vaihtelua alle kuukaudesta yli puoleen vuoteen. Merkittävää vaihtelua oli myös arvioiduissa keskimääräisissä odotusajoissa puheterapeutin ensikäynneistä kuntoutuksen alkamiseen, ja yli kolmen kuukauden odotusaika ensikäynneistä kuntoutukseen oli 38 %:ssa alueita. Priorisointia koskevissa tuloksissa tuli ilmi eritoten kouluikäisten jääminen alemman prioriteetin ryhmiin. Heidän kerrottiin usealla alueella saaneen puheterapiaa vain poikkeustapauksissa. Lisäksi tuloksissa tuli esille resurssien riittämättömyyden ilmeneminen lyhentyvinä kuntoutusjaksoina ja kuntoutustyöhön jäävän ajan vähenemisenä. Vastausten määrä eri tuloksissa vaihteli riippuen käytettävissä olevien vastausten määrästä kussakin tulososiossa. Kaiken kaikkiaan tämän tutkimuksen tulosten perusteella perusterveydenhuollon puheterapiaan pääsyssä on merkittävää vaihtelua ja siten alueellista eriarvoisuutta. Puheterapiaresurssit perusterveydenhuollossa näyttäytyvät tarpeeseen nähden riittämättöminä, ja hoitoon pääsy jää monella alueella toteutumatta lain edellyttämällä tavalla.

Aims: Speech and language development is delayed or proceeds atypically with children with intellectual disabilities. Speech expression is limited and a person communicates mainly by early means such as gestures and vocalizations. Interaction is heavily dependent on communication partners. Logopedic interaction studies aim to find out how interaction works when some of the participants have communication problems. Earlier study has brought much information on the communication features of people with aphasia. Communication of people with intellectual disabilities has been studied less. This study provides information on communication features of an adolescent with severe intellectual disability. Methods: The study examined the conversation between Sari and a logopedics student during speech therapy sessions. Conversation analysis (CA) was applied. CA is a qualitative method used to search regularities in naturally occurring conversations. Sari is a 14-year-old girl with Cornelia de Lange Syndrome. She has been diagnosed with severe intellectual disability with autistic features. Her communication is mainly non-verbal. The data consisted of six videotaped speech therapy sessions. The study focused on task phases of the sessions when the participants conducted a speech therapy exercise with four different tasks. For analysis, the videotaped data was transcribed in detail. Sari’s communication features and the sequential construction of conversation were described. Things that made interaction fluent or nonfluent were analysed. Results and conclusions: Repetitive structures of interaction were discovered applying CA. Therapy task sequences consisted of three-part structures, where the student first assigned a task, Sari responded and the student commented Sari’s response. Negotiation sequence was often built between the first and the second turn. Interaction was fluent when Sari’s response to the student’s turn was preferred and nonfluent when Sari’s response was not preferred. Sari communicated mostly with pointing gestures and bodily activity. Success of Sari’s communication was largely determined of how well the student was able to interpret her communication.

Tavoitteet. Keskustelunanalyysin menetelmää on käytetty paljon afasian, aikuisten hankitun kielihäiriön, tutkimuksessa, ja saatua tutkimustietoa on voitu hyödyntää afasiakuntoutuksessa. Aiemmassa kieli- ja/tai kommunikaatiohäiriöisten lasten vuorovaikutuksen keskustelunanalyyttisessä tutkimuksessa on tarkasteltu mm. kielihäiröisen lapsen tekemiä korjausaloitteita, kuulovammaisen lapsen puheen ja vuorovaikutuksen kehittymistä sisäkorvaistutteen asettamisen jälkeen ja lapsen ja puheterapeutin välistä puheterapiavuorovaikutusta, mutta tutkimusta keskustelunananalyysin soveltavasta käytöstä ei juuri ole. Kandidaatintutkielmani tarkoituksena oli kartoittaa keskustelunanalyysin menetelmän käyttöä lasten suorassa ja epäsuorassa puheterapiassa kymmenen viimeisimmän vuoden aikana ja pohtia, mitä hyötyä menetelmän käytöstä voi olla lasten puheterapiassa. Tutkielman tutkimuskysymykset kuuluivat: ”Mitä lasten puheterapiassa on nostettu keskustelunanalyyttisen tutkimuksen kohteeksi?” ja ”Minkä lapsen kielen ja/kommunikaation häiriöiden puheterapian yhteydessä keskustelunanalyysiä on käytetty?” Menetelmät. Tutkielman menetelmänä oli kuvaileva kirjallisuuskatsaus. Tutkimusaineisto kerättiin aineistohaun kautta kolmesta kansainvälisestä viitetietokannasta. Aineisto koostui yhdeksästä vertaisarvioidusta artikkelijulkaisusta, jotka olivat ilmestyneet kansainvälisissä tieteellisissä aikakauslehdissä vuosina 2007–2016. Tulokset ja johtopäätökset. Keskustelunanalyyttiset tutkimuskohteet jakautuivat kolmeen ryhmään: puheterapeutin ammatillisiin käytänteisiin, kieli- ja/tai kommunikaatiohäiriöisen lapsen vuorovaikutustaitoihin ja keskustelunanalyysin soveltavaan käyttöön. Menetelmää oli käytetty kehityksellisten kielihäiriöiden, autisminkirjon häiriön ja vaikean kuulovamman puheterapian yhteydessä. Menetelmän avulla voi tutkia empiirisesti ja systemaattisesti sekä puheterapia-asiakkaan että puheterapeutin vuorovaikutuskäyttäytymistä. Saatua tietoa voi hyödyntää puheterapeuttien koulutuksessa ja ammatillisessa kehittymisessä. Menetelmä antaa lapsen vuorovaikutuksesta tietoa, johon ei yleensä päästä käsiksi kielellisten testien kautta ja jota voidaan käyttää hyväksi dynaamisessa arvioinnissa.

Objectives. Interprofessional collaboration has become increasingly important in health and social care. Collaboration with professionals in other fields is also part of the work of many speech therapists and the method has been found to benefit the work in many ways. The number of studies on interprofessional collaboration is also increasing, although the perspective of speech therapists is rarely considered. The purpose of this study was to investigate the experiences speech and language therapists and their team members of other professions have on interprofessional collaboration. The participants were primary health care employees working in two municipalities of the Helsinki Metropolitan Area. The interviewees were also asked about their views on the benefits and challenges of cooperation. In addition, it was investigated what skills the study period provided for the interviewees’ interprofessional work, as well as what qualities close cooperation requires from the employee. Methods. The study was conducted in February and March 2020 in two separate group interviews involving a total of six speech therapists, three psychologists, three occupational therapists and one nurse. The interviews were videotaped and transcribed into text files. The data was analysed by means of inductive content analysis, and the results were reviewed in the light of previous research and literature. Results and conclusions. The work of the speech therapists interviewed involved a variety of multidisciplinary practices, and the speech therapists collaborated with professionals in many other fields. The closest co-operation was in the employees' own offices, where professionals from different fields, among other things, consulted each other and met customers together. Interprofessional collaboration was thought to benefit the work in many ways, while the disadvantages were perceived to be minor. Interviewees felt that little attention was paid to interprofessional cooperation during their studies. Many felt that it would have been useful to get to know the job descriptions of future partners in particular during their studies. Based on the results of this study, speech therapists in primary health care seem to appreciate the opportunity for interprofessional collaboration. Cooperation seems to benefit their work as well as reduce work-related stress. For example, challenges in schedules, information flow, and workplace space solutions seem to make it difficult for workers to collaborate. Studies in speech therapy appear to provide rather limited skills for multidisciplinary work on the basis of this study. As cooperation with workers in other fields is usually part of the job description of speech therapists, the inclusion of multidisciplinarity more closely as part of speech therapy studies would be justified.

Aim. Approximately 50-60 children are born with severe to profound hearing impairment in Finland every year. Speech therapy for hearing impaired (HI) children consists of many different methods depending on the child's and his/hers family's individual needs. The main emphasis in HI children's speech therapy in Finland is in the auditory-verbal method. There is only a little information to be found in the literature about the contents of speech therapy for HI children (who use cochlear implants (CI) or hearing aids (HA)). The aim of this study was to find out how much Finnish speech and language therapists (SLTs) have experience about the rehabilitation of HI children. In addition the goal was to find out what components are used in HI children's speech therapy and what role does the children's parents have in their child's linguistic rehabilitation. Method. This study was carried out as a survey. An electronic questionnaire was send via the Finnish Association of Speech Therapists to 1154 SLTs in Finland. A total of 85 responses were received so the response rate was 7.4 %. The data was analyzed using IBM SPSS Statistics 22 -program. Frequencies, percentages and descriptive statistical analysis were computed (for example average and standard deviation). The data was demonstrated graphically. Rank correlation of ordinal variables was measured using Spearman's rho (ρ), Kendall's tau-c (τ) and Goodman and Kruskal's gamma (γ) rank correlations. Results and conclusions. The results show that Finnish SLTs have only little experience about the rehabilitations of HI children. The most common components in HI children's speech therapy were supporting and guiding children's early vocalizations, auditory training and training of vocabulary. The contents of CI- and HA- children's speech therapy seems to be very similar. The most common approach used in speech and language therapy was auditory-verbal method but total communication and pictures were commonly used as well. The results show that parent's role in HI children's rehabilitations varied quite a lot. It was quite common that parents were not present during their child's speech therapy and the SLTs reported that they would ask separately if they wanted the parents to be present in some speech therapy session. However the results show that most of the SLTs and parents were equal partners in HI children's linguistic rehabilitation. More research is needed to discover factors that influence the contents of HI children's speech therapy and the parent's role in their child's linguistic rehabilitation.

Tavoitteet. Lähes kolmanneksella puheen- ja kielenkehityksen häiriöistä kärsivillä lapsilla on tarkkaavuuden ongelmia. Ongelmat voivat vaikuttaa puheterapian onnistumiseen, koska ne voivat ilmetä esimerkiksi tehtäviin keskittymisen vaikeutena, vaikeutena noudattaa annettuja ohjeita tai tehtävien tekemisen välttelynä. Erilaisten musiikkiaktiviteettien on todettu parantavan tarkkaavuutta ja kielen kehitystä. Laulun tiedetään kiinnostavan vauvaa luontaisesti puheäänen lisäksi ja äidin laulun vaikutuksesta lapsen käyttäytymiseen on tutkittu jonkun verran. Tämän tutkimuksen tarkoituksena oli kerätä viimeisen kymmenen vuoden aikana syntynyttä tutkimustietoa laulamisen vaikutuksesta lapsen tarkkaavuuteen. Lisäksi tarkoituksena oli pohtia, miten laulamisen vaikutuksia voidaan hyödyntää puheterapiassa. Menetelmät. Tutkimusmenetelmänä oli kuvaileva kirjallisuuskatsaus. Tutkimuksen aineisto kerättiin aineistohaulla kahdesta kansainvälisestä viitetietokannasta. Tutkimuksen kohteena oli neljä kansainvälisissä julkaisuissa ilmestynyttä vertaisarvioitua artikkelia, jotka olivat ilmestyneet vuosina 2013-2016. Tulokset ja johtopäätökset. Kaksi tutkimuksista vertaili puhetta ja laulua. Kumpikaan esitystapa ei ollut toista tehokkaampi ylläpitämään lapsen tarkkaavuutta. Iloinen, lapselle suunnattu esitystapa sen sijaan vaikutti lapsen tarkkaavuuden ylläpitämiseen. Aidin laulamisen vaikutusta koskevan tutkimuksen mukaan laulu vaikutti lapsen tarkkaavuuden kohdentamiseen ja ylläpiti lapsen tarkkaavuutta. Mainittuja tuloksia voidaan hyödyntää puheterapiassa terapeutin esitystapaa valittaessa ja laadittaessa kotiharjoitteita. Hyödynnettävyyttä heikentää kuitenkin se, että tutkimustieto koski vain enintään noin vuoden ikäisiä ja pääosin tyypillisesti kehittyneitä lapsia. Neljännessä tutkimuksessa vertailtiin laulun ja puheen vaikutuksia tekstin ymmärtämiseen autismin kirjon henkilöillä. Tilastollisesti merkittävää eroa eri esitystavan kuulleiden ryhmien välillä ei ollut.