Browsing by discipline "Logopedi"

Objectives. Studies have shown that word finding difficulties form a significant trouble source in speech of individuals with moderate Alzheimer's disease (AD). However systematic research has focused typically in naming tests even though managing in test situations does not reveal how word finding difficulties really affect in conversational interaction. Analysis of conversation have shown that continuing word finding difficulties complicates person's possibilities to participate in an interaction. The aim of this study is to report what kind of word searches appear in a conversational interaction of individuals with moderate AD. Using conversation analytic approach this study focuses on what kind of traits typically appear in word searches and how speakers deal with word searches. Methods. Participants of this study were four individuals with moderate AD who participated in a conversation group. Database was formed from two filmed appointments and the total duration was 70 minutes 16 seconds. Conversation group appointments were held by two speech and language therapist students and their instructor. Appointments were transcribed and word searches were identified by using verbal and nonverbal traits that indicates word search. Using conversation analytic approach word searches were analyzed and each indicating trait was classified. Results and conclusions. Nearly three thirds of all word searches found in this data were solved successfully. Approximately half of them were solved by the speaker with AD himself and a bit less than fifth of word searches were solved in co-operation with the communication partner. However solution was not always completing target word but reformulating the trouble source or elaboration made by the communication partner. Around fourth of word searches were left unsolved and persons with AD had great difficulties to handle the trouble source. This study has given knowledge about conversational interaction of individuals with moderate AD and results highlights the significance of conversation partner in maintaining a conversation.

Goals. Event schema or a script is a knowledge structure that describes appropriate sequences of events in a particular context. Script contains components which are vertically and horizontally connected to each other. A person may learn about scripts by personal experience, reading about them, hearing about them and seeing them done. Therefore, scripts contain information from episodic and semantic memory. Script research provides information about memory functions and the representation and the damage of the systems in different diseases affecting the neural systems, such as in Alzheimer's disease (AD). With increasing theoretical knowledge it is possible to develop differential diagnostic and rehabilitation methods for the patients in clinical work. The purpose of the study is to examine the script production of two different scripts in the mild and moderate stage of AD. Methods. The material of AD patients was gathered in 1994-1997 at the Department of Neurology (Memory Clinic) of the Helsinki University Central Hospital. The normal control subjects were from the pool of participants of the Helsinki Aging Brain Study which started in 1989. Ten people with mild AD (LiAT), ten with moderate AD (KoAT) and ten matched normal controls (NoI) were asked to produce as many script events as possible for two scripts: What do you do between waking up and having lunch? (The Morning script) representing episodic memory and What happens at a doctor's appointment? (The Doctor script) representing semantic memory. Sixty seconds were allotted for each script. The scripts were scored for the total number of events, the number of event repetitions, the informativeness of the contents and the plausibility and the centrality of the events. Statistical methods used were the Kruskal-Wallis one way variance analysis and the Mann-Whitney U –test post hoc –test. Results and conclusions. The results showed that the number of events for the both script types was statistically significantly lower for the people with AD compared to the control group. In addition, the ratio of informativeness was statistically significantly poorer for the people with AD. Depending on the script type, people with AD produced less plausible and central events than the control group. The results of the study are consistent in many aspects with the literature and the studies of AD suggesting that episodic memory is first impaired in AD, followed by the impairment of semantic memory.

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.

Aims: There can be many speech sound errors in the speech of a person with verbal apraxia. The speaker with verbal apraxia usually detects the speech sound errors he/she makes and tries to correct them. Those corrections do not always succeed and, therefore, those speakers may need help. There are only few studies of speech sound errors and corrections with speakers who have verbal apraxia. This study provides information about speech sound errors in the speech of a person with verbal apraxia and about the correction of the speech sound errors. Method: This study examined the sound errors of a 45-year-old Matti and the correction of those sound errors. The corrections were made by Matti or Maija, a student in logopedics. Matti was diagnosed with aphasia and verbal apraxia. The data consisted of five videotaped speech therapy sessions in which Matti and Maija conducted few different speech therapy exercises. For the analysis, videotaped data were transcribed in detail. Speech sound errors and the correction of those errors were searched from the transcription. Speech sound errors were analysed by using the sound system of the Finnish language. The corrections of the speech sound errors were analysed by using conversation analysis. Results and suggestions for future research: There were many different speech sound errors in Matti's speech, for example: substitutions, assimilations, omissions, additions and metatheses. The number of the different speech sound errors remained relatively similar in different exercises in the same therapy session. In different therapy sessions the number in different therapy exercises varied some amount. The number of the speech sound errors Matti made diminished during the therapy period. Matti and Maija made different kind of corrections focused on Matti's speech sound errors. Matti usually tried to self-correct his speech. When it did not work he asked for help by looking at Maija, by asking questions or by making a gesture. Sometimes Maija corrected Matti's speech by saying the difficult word or phrase. In future it would be interesting to do more research on the construction of Matti's corrections and the success of Matti's self-corrections.

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.

Aims: Delays in early language development are quite common and for most children transient. Recognizing a delay is nevertheless important as it might also be the first sign of more persistent language difficulties that can lead to reading difficulties at school age. The most widely researched form of a reading difficulty is dyslexia which has a strong genetic basis. Among Finnish speaking people dyslexia typically appears as problems in reading fluency. Difficulties in reading can also be due to primarily reading comprehension problems that often stem from broader oral language difficulties. The purpose of this study was to examine the childhood language skills and adolescent reading skills of Finnish speaking children with delayed early language development and familial risk for dyslexia. Furthermore, this study examined how an early language delay predicts adolescent reading difficulties in children with familial risk for dyslexia. Method: The research data were part of the data collected in Jyväskylä Longitudinal Study of Dyslexia. The participants were divided into groups based on their early language skills. Children with delayed early expressive skills but age-equivalent receptive skills (VKK1-group, n=10) and children with delay in both receptive and expressive skills (VKK2-group, n=12) were compared to age-matched children whose early language skills were age-equivalent and who either had familial risk for dyslexia (LR-group, n=83) or did not have the risk (ER-group, n=79). Group differences in language skills between the ages 1.5–5.5 years and reading skills (decoding and functional literacy) between the ages 14–15 years were studied with One-Way and Mixed-Design ANOVAs. The connection between language delay and adolescent reading difficulties was examined using cross-tabulation and the chi-squared test. Results and conclusions: VKK1-group had weaker early expressive skills than both control groups. Later language skills in VKK1-group were at single age points weaker than in ER-group. In adolescence, VKK1-group was weaker than ER-group in reading fluency. VKK2-group was weaker than controls in all expressive and receptive language skills throughout the studied age period and partly weaker than VKK1-group. VKK2-group was weaker than ER-group in reading accuracy and weaker than all other groups in functional literacy. The prevalence of dyslexia did not deviate from expectation in either of the VKK-groups or in LR-group. Thus, delayed language development does not seem to further increase the risk for adolescent dyslexia in children with familial risk for dyslexia. The prevalence of poor functional literacy deviated significantly from expectation in VKK2-group. This indicates that an early delay in both expressive and receptive language development together with familial risk for dyslexia might predict functional reading difficulties in adolescence. However, only an expressive delay with familial risk does not seem to increase the risk for poor functional literacy.

Objectives. The paradigm of speech and language therapy has changed from linear cause-effect thinking to systemic perspective that impresses the importance of environmental factors. Community-based speech and language therapy is one example of systemic action. In community-based rehabilitation the focus is on working with people close to individual with special needs. With reference to children important communities are family members and kindergarten workers. There are some applications of community-based speech and language therapy in the field of rehabilitation but more information is needed. The aim of this study is to bring more information about community-based rehabilitation by introducing one way of implementing it. This study focuses on Hyvinkää's community-based speech and language therapy (yhteisöllisen toiminnan puheterapia). Goal of this study was to find out how the Hyvinkää model works and what do workers think of it. Methods. Two community-based speech and language therapists and six kindergarten workers working with Hyvinkää's community-based model participated in semistructured interviews. Interviews were recorded and transcribed. A qualitative analyze was used where data was themed and typed in the way by which it was possible to answer research questions. Results. Community-based speech and language therapy in Hyvinkää included primarily work with kindergarten staff to promote interaction and to support children's speech and language development. Functions occurred always in groups and were not defined as rehabilitation. Collaboration with speech and language therapists often included concrete actions like how to link signs in everyday activity. Kindergarten workers described speech and language therapists as a professional of their field, and that their own task was to put into practice those techniques therapists has introduced. Interviewees were very satisfied working with Hyvinkää's model. It seems like when kindergarten workers are motivated to work in collaboration with community-based speech and language therapist it is possible to carry out community-based model and ways of supporting speech and language development can be implemented in day care groups. It also seems like Hyvinkää's community-based model has a chance to be good support in children's individual rehabilitation.