Browsing by discipline "Logopedia"

Aphasia is often a chronic impairment. Regaining the premorbid language function is rare. Anomia is the most common residual disorder once the aphasia has stabilized. Earlier studies indicate that transcranial magnetic stimulation (rTMS, repetitive Transcranial Magnetic Stimulation) together with intensive speech therapy improves the outcome of the language rehabilitation. The aim of the current study was to find out what kinds of quantitative and qualitative changes occur in the participants' ability to name noun and verb pictures that were shown during the rTMS/sham-rTMS protocol. All of the participants received two weeks of either rTMS or sham-rTMS treatment and after a one-week break another two weeks of either rTMS or sham- rTMS treatment together with intensive group speech therapy (ILAT, Intensive Language Action Therapy). This is a multiple case study with six participants that have chronic expressive aphasia. The first two groups of a larger study were selected into this study. Group 1 (n=3) received 1Hz- rTMS therapy and group 2 (n=3) received sham-rTMS. rTMS was given to the right hemisphere on the pars triangularis area. Every participant named the same amount of action and object pictures during the rTMS/sham-rTMS treatment. Namings were analysed with a rating system derived for the current study. Each participant received intensive group speech therapy in the latter two-week part of the intervention. Language testing was conducted before, during and three months after the intervention. The naming abilities in all participants seemed to improve in both noun and verb series during the rTMS/sham-rTMS treatment and language tests. Results of the follow-up testing suggest that the positive results are long lasting. The results of this study are promising, even though the amount of participants is too small to draw further conclusions. This study brings positive evidence and reason for further research on the effectiveness of aphasia therapy.

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.

Study aims: Parents' role has been emphasized in children's speech therapy in recent years. There has, however, been very little research done on parents' experiences of their children's speech therapy. By learning more about parents' perceptions of speech therapy it is possible to increase the acceptance of therapy, develop therapy practices and the training of professionals. This study concentrated on stuttering children's speech therapy because there is very little research done on the topic and the role of parents is especially important in the speech therapy of stuttering children. The aim of this study was to increase the knowledge of parents' experiences of stuttering children's speech therapy as a part of daily life. Methods: The method in this study was a semi-structured interview. Altogether eight interviews were done in which seven mothers and one mother-father pair was interviewed. All the stuttering children were boys, aged 7 to 17 years. The interviews were done during May-June 2014. Theory bound content analysis was used in the study. Results and conclusions: For the parents speech therapy and the cooperation with the speech therapist was mainly a positive experience. The biggest challenge was the lack of therapy resources. The parents had mainly been successful in combining family life and therapy although the hurry of everyday life in families with small children was evident. Supporting children's speech fluency was seen as challenging. Some of the advice received in supporting the child's speech fluency had been seen helpful for the parents while some others were questioned. The parents would have wanted more guidance from the speech therapist in supporting the child's speech fluency in everyday life. Acceptance and commitment therapy was seen as more helpful than speech therapy in helping the parents come to terms with their child's stuttering and in supporting the child's speech fluency. Parents saw the peer support as especially helpful. The child's age had a bearing on the parents' experiences of their own role, on how well family life could be combined with therapy and on which of the ways to support the child's speech fluency were seen as helpful. The lack of therapy resources and especially the regional differences in therapy resources was evident in this study. On the basis of this study it can be stated that the parents of stuttering children experience their role in speech therapy as an important one. The role of parents is also experienced as challenging due to the lack of therapy resources and the hurry of everyday life. There should be more emphasis in speech therapy on parental guidance and on considering the family's overall situation. The lack of therapy resources, however, makes increasing the parental guidance difficult. More research is needed on parents' experiences of their stuttering children's speech therapy in order to take the parents' perspective better in to consideration in speech therapy.

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.

Aims. Improved quality of life is considered to be the overarching goal of aphasia rehabilitation based on the social model. Around the world research has been done on the factors that affect the quality of life with people with aphasia. Different kinds of structured quality of life measurements have been developed that aim to enable people with aphasia to self-report quality of life. In Finland research on the subject has been scarce. The aim of this study was to explore the views of Finnish speech and language therapists (SLT) on the quality of life in aphasia rehabilitation and the prevailing clinical practices as well as to investigate how they compare internationally. Methods. For the purposes of this study a questionnaire composed by the Aphasia Committee of the International Association of Logopedics and Phoniatrics (IALP) was translated into the Finnish language. 64 questionnaires were filled out. The Finnish data was analysed by using descriptive statistics and content analysis. The data collected in this survey formed Finland's part of an international survey conducted by IALP, which allowed the comparison between the Finnish and international results. The international survey contained 581 respondents from 16 countries including Finland. The Finnish and international data were compared by cross tabulation and Chi Squared -test. Results and conclusions. According to Finnish SLTs it is important to incorporate into practice with aphasia several quality of life domains, such as communication, affect, in/dependence, social activities, personal outlook and in addition to consider life satisfaction, social support and environment. Almost all of the Finnish SLTs used interviewing as their primary method for assessing the quality of life, only four used structured quality of life measures. Internationally there were mentioned many different structured quality of life assessments. This study indicates explicitly that there is a demand for structured quality of life assessments in Finland. The results can be applied in developing education, research and clinical practice.

Aims. The purpose of this single-case study was to investigate the effects of intensive tablet-based treatment in overall language performance level and in reading and writing processes in mild aphasia. The communicative effectiveness and task performances on the tablet software were also studied. The tablet software included tasks where semantic, syntactic and phonological processing were required; written naming, sentence writing and reading comprehension. Previous studies have indicated improvements in language skills after computer-based treatment (Katz & Wertz, 1997; Wade, Mortley & Enderby, 2003). Especially reading and writing skills can be treated by the computer-based softwares (Katz, 2008). Methods & Procedures. In this single subject research the ABA design was used. The participant in this study was a 47 year old man who had a stroke 2.5 years earlier. He had a mild chronic aphasia with difficulties in writing, reading and naming. The data of this study was formed by linguistic tests and by a self-assessment method as the participant evaluated his communicative effectiveness (CETI). The methods used in the analysis of written and read narratives included assessing rate, authenticity and the types of errors. The analysis of written narratives also included assessing word classes and type-token –ratio. Based on the data by the tablet-based software the rate and the share of errors of task performances were assessed. Results & Conclusions. Based on the Western Aphasia Battery (WAB) results, the severity of the aphasia decreased but the change was not clinically significant. Naming improved but the change wasn't stable until the follow-up. The participant showed positive development in his written and reading production; he made less spelling and reading errors after the treatment. At the same time reading and writing processes became slower. The share of lexical verbs, adjectives, pronouns and numerals increased in written narratives. The communicative effectiveness improved. The task performance on the tablet software was faster during the fourth week compared to the first week. Also the amount of incorrect performances decreased or remained the same. Based on the results, an intensive self-monitored tablet-based language treatment was effective to the subject.

Aim. In conversation mutual understanding is achieved through co-operation of each participant. Mutual understanding might be more at risk in conversation where one or more participants use augmentative and alternative communication (AAC). To be able to support people who use AAC and guide their communication partners, interventionists should understand how communication problems and challenges are being resolved in a natural conversation. The aim of this study is to describe how participants orient to problems in AAC conversation. Conversation partners' other-initiations of repair and the problems these initiations indicate are being studied. Method. The database consists of two videotaped conversations where one aided speaker, a 15-year-old boy with cerebral palsy, talks with a speech-language pathology student (conv 1) and with his speech-language pathologist (conv 2). The data was originally videotaped for speech therapy follow-up. Problems and how they were managed were studied using conversation analysis (CA) and one of its basic organizations, repair organization. CA enables detailed examination of natural interaction. Results and conclusions. Almost every other-initiation of repair fell upon the problems in aided speaker's turn and were initiated by conversation partners. These problems related broadly to speech understanding, more precisely to understandability of utterances. No problems of hearing were raised. Reasons underlying the trouble sources were most often conversation partner's difficulty in understanding the meaning of aided speaker's whole turn or part of a turn, extra words or other mistakes in selecting symbols, or vague reference. From all the conversation partners' other-initiations of repair interpretative means, candidate understandings, were used most often and the initiations of repair were at the same time pointing a problem and trying to resolve it. Interpretation seemed to be explicitly on display in both conversations. It was used to show understanding of AAC turn and to initiate repair. In order to be able to understand how to support AAC users' human agency and active participation in conversation, more research needs to be done on different conversations.

Aims. Knowledge of performance in other areas of cognitive processing in children with specific language impairment is contradictory. The aim of this study was to research verbal and cognitive performance as well as intelligence of children with specific language impairment using neuropsychological evaluation data. In addition, the methods used to evaluate neuropsychological processing of the children and their school recommendations were studied. Methods. The participants (N=67) were diagnosed with F80.1 and / or F80.2 in Lastenlinna hospital in 1998-1999 and were neuropsychologically evaluated in 1996 2001. The study retrospectively examined which methods of evaluation were used to assess children with specific language impairment. The participants' test battery scores were gathered. Descriptions of spontaneity, ability to cooperate and concentrate as well as school recommendations were gathered from neuropsychologists' reports. Occurrences of and connections between variables were analyzed with descriptive statistics, graphs, t-tests, chi-square tests, one-way ANOVAs and contrasts. Results and conclusions. The methods used to neuropsychologically evaluate children with specific language impairment in Lastenlinna hospital in 1996 2001 included different versions of Wechsler intelligence scales with which verbal and non-verbal processing were analyzed. In addition, the neuropsychological evaluation was often augmented with the linguistic subtests of Nepsy and Nepsu. The participants performed worse than standard on verbal tasks, whereas in non-verbal tasks their performance was close to standard. Participants with expressive language disorder F80.1 had the verbal IQ close to normal, and only participants with receptive language disorder F80.2 had a significantly low verbal IQ. Children with specific language impairment were mostly recommended to participate in prolonged primary education, full-time special education or general education. The school recommendations were connected to verbal performance: the more severe the problems with language, the more rehabilitating education was recommended. The evaluation of children with specific language impairment should be more comprehensive so that a clearer picture of their cognitive processing and ability to function could be attained. The difference between the verbal and non-verbal performance

Objectives. Specific language impairment (SLI) is a heterogeneous disorder and its symptoms change with development. For most people it has a profound effect on functional ability, participation, and learning. The symptoms are persistent especially among those with difficulties in speech-reception. Simultaneous learning of multiple languages increases the individual variation in linguistic difficulties. Language functioning of Finnish monolingual and multilingual children at age over 10 years has not been thoroughly investigated. The objective of this study was to describe how SLI manifests itself in 11–12-years-old monolingual and multilingual children. The study focused on language ability and health-related quality of life. The acquired information may help in improving supporting practices. Methods. Four male participants at age of 11–12 years living in the Capital Region of Finland, and with SLI diagnosis (F80.2) were recruited from Helsinki University Central Hospital Audiophoniatric ward 22 for the study. Two participants were monolingual and two were multilingual learning Finnish as their second language. The gathered data consisted of language tests and questionnaires intended for parents, teachers, and the participants. Testing was videotaped and the acquired narratives were transcribed. Results were compared against age norms as well as previous literature. Furthermore, the questionnaire data were grouped based on the content, and the results were analyzed qualitatively. In addition, the test results and questionnaire data were compared to each other. Finally, the differences in language abilities were examined in relation to medical reports written before school age. Results and conclusions. All participants had deficiencies in language abilities, but language symptoms, social ability, academic achievement, and quality of life varied individually. Results were in line with previous studies. Difficulties were observed especially in grammatical and reading abilities, short-term memory and word naming. Moreover, according to parents and teachers, the participants had problems in speech reception, narration, pragmatics, and some of them also in social interactions. Finnish vocabulary among the multilingual participants was smaller than that of their monolingual counterparts. However, differences in other areas were larger at single-level than at group-level. Three of the participants still received substantial support in school. Support of the fourth participant had been discontinued due to favorable progress. Majority of the participants perceived their health-related quality of life slightly weaker than that of controls. Based on the results, it is important to support pragmatic skills at school age since previous studies have shown an association of these to social integration. A Study with a larger sample size and longitudinal setting is needed in the future.

Aim. The Verbal Fluency task is one of the naming tasks and it is generally used in clinical neuropsychology and logopedics to investigate for example word retrieval strategies and cognitive flexibility. Previous studies have shown that fluency skills increase strongly as the child grows. So far little is known about the quantitative fluency skills in children under six years of age. The aim of this study is to examine how Finnish-speaking healthy and typically developed children perform a semantic verbal fluency task. The task was divided into six different semantic categories. The aim of the study is to find out whether there is a difference between the performance of 3-year-old, 4-year-old and 5-year-old children, and whether gender has an effect on performance. In addition, the children's performance of the fluency task is compared to their performance in Boston Naming Test and Rapid Automatized Naming Test of pictures and colours to find out whether there is any congruence between the fluency task and the naming tests. Methods. The data was gathered in three different day-care centers in Helsinki from 30 children ages 3 to 5. The children were tested at the day-care centers and their performance was recorded with a dictation machine. Testing was divided into two sections of which the first included the naming tests and the second all the fluency categories. The data was analysed using mainly statistical methods. Results. The results show that age has a significant impact on fluency skills. The largest amounts of correct words were produced by the 5-year-old and the smallest amounts by the 3-year-old children. The older children also made fewer errors than the younger children. All children produced more nouns than verbs. The gender had no impact on the performance in the semantic fluency task, the Boston Naming Test or the Rapid Automatized Naming Test. The results also show some connections between fluency task and naming tests.