Browsing by Subject "puheterapia"

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.

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.

Aims: Repair is one the three structures that organizes conversation. Repair organization is used for solving problems in speaking, hearing and understanding in conversation. Self-repair is initiated by the person who has produced the trouble source turn. Language deficits affect person's possibilities to communicate with speech. Different kinds of language deficits affect in different ways to person's possibilities to participate in conversation and to be understood. Self-repair is a way to maintain intersubjectivity in conversation. If one of the participants in conversation can't self-repair his speech because of the language deficit, the intersubjectivity between the participants might be endangered. The aim of this study is to describe self-repairs made by a 4-year-old boy and how his language deficits affect on his self-repairs. Methods: The main approach to this study was conversation analytic. Conversation analysis is a qualitative method. It is used for finding recurrent structures in conversation. The study examined self-repairs made by a 4-year-old boy who has deficits in speech understanding, naming and inflection. The material for the study was from speech therapy sessions. Speech therapy was held 20 times and a partner in the conversations was a logopedics student. The study observes three types of situations in speech therapy. The conversation topics were limited in different ways. Results & Conclusions: The participant made lots of fluent self-repairs despite his language deficits. He also made self-repairs when they were started by the other. The deficits of speech understanding and naming caused self-repairs. The deficits of naming caused multiple self-repairs one after the other. To the inflection the participant made just few self-repairs. The participant had not acquired the language skills of inflection at the time.

Background and aim. Bilingualism is a worldwide and old phenomenon. It is also a current topic in speech therapy. Bilingualism can be defined in many ways, for example by the age when a person has been exposed to his/her languages. Bilingual children are common clients in Finnish speech therapy field due to increased immigration. When evaluating the linguistic skills of a bilingual child the speech therapist might need to co-operate with an interpreter. In this research the aim was to identify how the SLT's feel the co-operance with the interpreters in evaluation situations. There is only few former studies about this subject, especially in Finland. Some studies have been made to examine the co-operation of the interpreter and another healthcare provider. In this study we also asked if there are some typical challenges in the co-operation and could something be done to develop this liaison. Methods. In this study 12 SLT's were interviewed. They worked in the capital area of Finland. I contacted the leading SLT's to recruit the examinees. The SLT's had been working 2-34 years and they all had evaluated bilingual children in co-operation with an interpreter. The semistructured interview material was gathered and transcribed in the autumn 2014. After transcribing the material was separated into four main themes for reporting the results. Results and discussion. Co-operation between SLT and interpreter shows out to be working mainly fine. Typical challenge mentioned is for example achieving a natural interaction. There are still some lacks in the language skills of the interpreters and the SLT's hope to develop the co-operation with a better guidance (also in the training program of logopedics) and diverse co-operation opportunities. The SLT's seem to appreciate interpreters' social skills, language proficiency, natural interaction with children and flexibility in diverse therapy situations.

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.

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.