Browsing by master's degree program "Logopedian maisteriohjelma"

Tausta ja tavoitteet. Sujuvalla afasialla tarkoitetaan kielenoppimisiän jälkeen syntynyttä kielellistä häiriötä, jossa henkilö tuottaa tyypillisesti hyvin artikuloitua, mutta sisällöllisesti merkityksetöntä puhetta. Suomenkielistä tutkimusta sujuvassa afasiassa esiintyvistä itsekorjauksista eli omaan puheeseen kohdistuvista korjauksista on vain vähän. Tutkimuksen perusteella sujuvan afasian saaneet henkilöt tuottavat samanlaisia itsekorjauksen aloituksia kuin terveet henkilöt, lisäksi sujuvan afasian saaneiden henkilöiden on havaittu tuottavan enemmän itsekorjauksen aloituksia verrattuna varsinaisiin itsekorjauksiin. Tässä tutkielmassa tarkoituksena on tutkia, millaisia itsekorjauksia ja itsekorjauksen aloituksia sujuvan afasian saaneet henkilöt ja terveet keskustelukumppanit tuottavat arkikeskustelussa. Tutkielmassa selvitetään, kuinka pitkiä korjausjaksoja sujuvan afasian saaneet henkilöt ja terveet keskustelukumppanit tuottavat ja kuinka itsekorjaukset ja niiden aloitukset jakautuvat ryhmien kesken. Lisäksi selvitetään, millaisia itsekorjauksen aloituksia ryhmissä käytetään. Menetelmät. Tutkimuksen aineisto koostuu kolmen sujuvan afasian saaneen henkilön ja heidän keskustelukumppaniensa käymistä arkikeskusteluista. Aineisto on saatu puhujien välistä yhteisymmärrystä epätyypillisessä vuorovaikutuksessa tutkivasta COMPAIR-hankkeesta. Tutkimusmenetelmänä käytettiin keskustelunanalyysiä. Tulokset ja pohdinta. Sujuvan afasian saaneiden henkilöiden tuottamien korjausjaksojen keskimääräinen pituus oli lyhyempi kuin terveillä keskustelukumppaneilla, mikä on päinvastainen tulos kuin aiemmassa tutkimuksessa. Itsekorjauksen aloitusten ja varsinaisten itsekorjausten jakaumien osalta havaittiin, että sujuvan afasian saaneet osallistujat tuottivat enemmän itsekorjauksen aloituksia kuin varsinaisia itsekorjauksia, mikä tukee aiheesta aiemmin tehdyn tutkimuksen tuloksia. Terveet keskustelukumppanit tuottivat puolestaan itsekorjauksen aloituksia ja itsekorjauksia yhtä paljon. Itsekorjauksen aloitustavoista tyypillisin oli molemmissa ryhmissä ilmauksen katkaiseminen, myös tämä tulos tukee aiemmissa tutkimuksissa saatuja tuloksia. Tässä tutkielmassa saatujen tulosten perusteella voidaan päätellä, että afasian saaneet henkilöt usein aloittavat itsekorjauksen, mutta terveet henkilöt suorittavat korjauksen loppuun tai korjaus jäi kesken. Tuloksia voidaan hyödyntää kliinisessä työssä jakamalla tietoa siitä, kuinka sujuva afasia vaikuttaa oman puheen korjaamiseen ja sitä kautta keskusteluun osallistumiseen. Aim of the study. Fluent aphasia is an acquired language disorder. A person with fluent aphasia usually produces fluent sentences that are nevertheless meaningless. There are only few Finnish studies regarding self-repair and self-initiated repair in fluent aphasia. The studies show that people with fluent aphasia produce self-repair initiations that are similar to those produced by non-aphasic people. Additionally, it has been observed that people with fluent aphasia produce more initiations of self-repair than actual self-repairs. The aim of this thesis is to study what kind of self-repair initiations people with fluent aphasia and non-aphasic people produce in mundane conversation. The study focuses on length of the repair sequences produced by group of aphasic people and non-aphasic people. Also, distribution of used self-repair initiations are studied. Methods. Participants of the study are three people with fluent aphasia and their non-aphasic close relatives. The data that consist of mundane conversation is received from COMPAIR-project that examines mutual understanding in untypical interaction. The research method used in this study is conversation analysis. Results and discussion. People with fluent aphasia produced repair sequences that were on average shorter than repair sequences produced by non-aphasic people. This discovery is not in line with previous research findings. People with fluent aphasia produced more initiations if self-repair than actual self-repairs, that supports previous research findings. Then again it was detected that non-aphasic people produced initiations of self-repair and actual repairs almost equal in number. The most common type of self-repair initiation was cut-off in both groups, the result is consistent with previous findings. The conclusion that emerges from this thesis is that people with aphasia initiate self-repair but their non-aphasic interlocutors often complete their self-repair or self-repair remains unfinished. The findings can be utilized in clinical settings by sharing information about ways that fluent aphasia can affect self-repair initiation and self-repair and hence participation in a conversation.

Aims. There is an increasing number of multilingual children in the workloads of Finnish speech language pathologists. Yet there is little research on the typical and untypical language development of multilingual children. PAULA small group intervention has been developed to support the language development of multilingual children in a daycare setting. The aim of this study is to investigate whether the small group language intervention affects the Finnish language development of multilingual children and how background factors, such as the exposure to the Finnish language, affect the development of the study and control groups. Method. Subjects included 60 typically developing multilingual children, 34 in the study group and 26 in the control group. Subjects were 4 years old at the beginning of the study and the assessment was repeated 3 times within a year. Finnish language was measured with a vocabulary score calculated from Fonologiatesti (Kunnari, Savinainen-Makkonen & Saaristo-Helin 2012) and with a form filled out by the daycare staff. The data was analyzed with IBM SPSS Statistics 26. The difference between the study and control groups was analyzed with repeated measures ANOVA, Friedman test, and Mann–Whitney U test. The effect of background factors on the vocabulary scores was analyzed with linear regression, and the effect of background factors on the assessment by the daycare staff was analyzed with Spearman’s correlation coefficient and Kruskal–Wallis test. In addition, the background factors affecting the vocabulary score at the start of the study were analyzed with linear regression. Results and conclusion. The vocabulary scores of the intervention group improved more during the intervention compared to the control group, but the effect wasn’t observed in the follow-up measurement. PAULA small group intervention can support the lexical development of multilingual children, but more research is needed to confirm the findings. Being in the study group was positively associated with the change in vocabulary scores while the months spent in a Finnish language daycare were negatively associated. The months spent in daycare and the exposure to Finnish were positively associated with the vocabulary score at the beginning of the study. The children who at the beginning of the study had spent longer in daycare and had more exposure to Finnish are likely to have bigger vocabularies at the start and therefore improve less during the intervention. The children who had the least exposure to Finnish improved the most during the intervention. There was no statistically significant difference between the groups in the daycare assessments. In the study group exposure to Finnish was positively associated with the change in the daycare assessments. In the control group, no background factors had a significant connection to the daycare assessments.

Aphasia is a linguistic-cognitive disorder that impedes the understanding and production of speech and is often accompanied by disorders in non-linguistic cognitive functioning, such as working memory (WM). WM has a key role in supporting on-going linguistic processing. Earlier research shows that the impairments caused by aphasia can be alleviated with speech therapy but it is still unclear which amount of therapy is most effective, at which stage of the illness and with which intensity. Some research suggests that greater amount of therapy within a shorter time span yields greater outcome. However, research findings on the matter are difficult to synthesize as the definition of ‘intensity’ varies across studies. Language Enrichment Therapy (LET) is a systemic and developmental therapy programme for aphasia rehabilitation. LET aims to restore linguistic-cognitive functioning. LET also enables rehabilitation of working memory with “brain-jogging”. As there is hardly any prior research on the LET system, the aim of this thesis is to investigate its effectiveness as an intensive aphasia therapy programme and the role of working memory in rehabilitation and, further, to identify possible background factors predicting rehabilitation outcome. The data for this thesis was collected for a research project between 1987 and 2010. The data consists of 24 persons with aphasia (PWA) who suffered a first-time stroke and whose time post-onset at baseline was 2 to 8 months. Linguistic functioning was assessed six times within the research frame with Tsvetkova’s Speech Dynamics Test, Western Aphasia Battery and the Token test. The data was analysed statistically using Friedman’s test to analyse the change in understanding and producing speech, linear regression to analyse possible factors predicting outcome and linear correlation to analyse the connection between working memory and rehabilitation outcome. The findings show that intensive rehabilitation with the LET system improves the understanding and production of speech with PWA. LET is the most effective in ameliorating speech understanding for those PWA with greater impairment and lesser time post-onset. No factors predicting the outcome of speech production were found which might be due to the developmental nature of the LET system in which rehabilitation of understanding always precedes that of production. WM had no predictive value for rehabilitation outcome. These findings must be interpreted with caution but can still be used for clinical decision making.

Background and aims. Aphasia is a language disorder caused by brain damage that affects the production and understanding of a person's speech and can manifest itself in different areas of linguistic skills. Difficulty finding words is the most common symptom of aphasia. Non-fluent aphasia is a syndrome specifically affecting the production of speech, in which speech is slow and contains a lot of pauses and word searching. Repair sequences refer to the problems that arise in conversations and their solution. In an aphasia conversation, repair sequences typically last a long time, for several turns, and they may not always be resolved at all. Repair sequences and self-corrections produced by a person with aphasia (PWA) can tell about the severity of aphasia and rehabilitation abilities. The aim of this study was to investigate the number and quality of the repair sequences of a PWA in the before and after a speech therapy intervention, as well as the possible change that occurs in the repair sequences during the intervention. The intervention consisted of 27 treatment sessions of contextual priming -therapy. Methods. The study was a case study, the subject of which was one person with non-fluent aphasia. The research material consisted of the video material of the beginning and end conversations of the speech therapy intervention, which was a total of 55 minutes and 26 seconds. The material was analyzed with conversation analysis and annotated with the ELAN program using a template created for the COMPAIR project. In the annotation, attention was paid to the repair sequences and correction phenomena in the PWA’s speech. Results and conclusions. No major change was observed in the number of repair sequences. In the end conversation, the repair sequences were on average longer, and there were more of repair sequence compaired to the beginning conversation. There were more turn-internal pauses within the speech of the PWA in the end conversation than in the beginning. In the end conversation, the subject produced 34 % more self-initiations compared to the beginning conversation. The other-initiations produced by the speech therapist remained similar both quantitatively and qualitatively. A qualitative change was observed in the subject's and the speech therapist's way of handling problems in the themes that were discussed in both the beginning and end conversations. In the end conversation, the repair sequences were left more often unsolved, and the speech therapist offered more other-corrections. Between the beginning and end conversations of the speech therapy intervention, a change could be observed both in the quantity and quality of correction phenomena.In addition, information was obtained on what kind of repair sequences appear in the speech of an non-fluent PWA in an institutional interaction situation.

Kuulovamma on riski lapsen sanaston kehitykselle. Sanaston kehitystä voidaan arvioida sanojen määrän lisäksi nimeämisen taidoilla. Musiikin harjoittelun on todettu parantavan lasten kielellistä kehitystä, myös sanaston kasvua. Ohjatun musiikki-intervention yhteyttä kuulovammaisten lasten sanaston kasvuun ja nimeämiseen ei ole aiemmin tutkittu. Tämän pro gradu -tutkielman tarkoituksena on selvittää lasten sanastoa mittaavien vanhemmille suunnatun kyselyn ja nimeämistehtävän välistä yhteyttä, miten näillä mitattuna kuulovammaisten lasten sanasto kehittyy ohjatun ja tavoitteellisen musiikki-intervention aikana, ja miten tutkittavien taustatekijät ovat yhteydessä kehitykseen. Lisäksi tarkastellaan, eroaako sanaston ja nimeämisen kehitys enemmän tai vähemmän lapsilleen laulavien vanhempien lapsilla. Tutkielma on osa MULAPAPU-hanketta, jossa tutkitaan CIsumusa-puhemuskarin vaikutuksia 0–7-vuotiaiden kuulovammaisten lasten kielenkehitykseen. Tutkittavat (n=14) olivat 2–6-vuotiaita, suomenkielisiä, bilateraalisesti kuulovammaisia lapsia, joilla ei ollut kuulovamman lisäksi muita vammoja, ja jotka olivat osallistuneet CIsumusa-puhemuskariin vuosina 2019–2020. Tutkittavilla oli käytössään kuulokojeet, sisäkorvaistutteet tai molemmat. Sanaston kehitystä arvioitiin vanhemmille suunnatun LEINIKKI-menetelmän sanastopisteillä ja sanastoon liittyvää nimeämistä arvioitiin Bo Ege -sanaston käytön testillä. Arviointi toteutettiin ennen musiikki-interventiota (T1) ja sen jälkeen (T2). Aineisto analysoitiin tilastollisin menetelmin. LEINIKKI-menetelmän sanastopisteet ja Bo Ege -testi olivat tilastollisesti merkitsevästi yhteydessä toisiinsa, joten ne todennäköisesti mittaavat samaa asiaa eli lasten sanastoa. Tutkittavien sanasto kasvoi musiikki-intervention aikana. Vaikeampi kuulovamma oli yhteydessä parempaan nimeämiseen ennen musiikki-interventiota ja sen jälkeen. Sisäkorvaistutetta käyttävien lasten nimeäminen oli musiikki-intervention jälkeen parempaa kuin kuulokojetta käyttävien lasten. Äidin korkeampi koulutus oli yhteydessä lasten suoriutumiseen Bo Ege -nimeämistehtävässä ennen musiikki-interventiota ja kehitykseen sen aikana. Lasten, joiden vanhemmat lauloivat paljon lapsilleen, sanaston koon ja nimeämisen pisteiden keskiarvot nousivat enemmän kuin lasten, joiden vanhemmat lauloivat heille vähän. Musiikki-interventio vaikuttaa tulosten perusteella olevan toimiva kuntoutusmuoto kuulovammaisten lasten sanaston kehitykseen.

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.

Background and objectives. Hearing impairment can manifest as weak skills in several areas of speech and language. In previous studies, musical activities have been found to have a positive effect on the language skills of children with normal hearing (NH). The purpose of this thesis was to find out whether there is a difference between hearing-impaired (HI) and NH- children in picture naming skills or rapid serial naming, whether there is a connection between performance in different naming tests, and whether the amount of singing in the group was associated with naming performance. The thesis is part of the MULAPAPU study, which examines the effects of music intervention and singing on the speech perception and speech and language development of HI-children aged 0–7. Methods. The participants (N=37) were 1;11–6;10 aged children, of whom the HI-children (n=17) formed the research group and the NH-children (n=20) the control group. HI-children used bilateral cochlear implant (n=9), bilateral hearing aid (n=7) or combination of cochlear implant and hearing aid (n=1). Based on the amount of singing in the group, the children were divided into a group of children that sang more than once a week (n=19) and a group that sang less than once a week (n=14). Both groups included HI-children and NH-children. Naming skills were assessed with the Bo Ege test and the Rapid Automatized Naming test (colors and objects subtests). The amount of singing in the group was measured using a questionnaire that was sent to the children’s parents. The data was analyzed using statistical methods. Results and conclusions. No statistically significant difference was found between the performance of HI-children and NH-children in the Bo Ege test. In the Rapid Automatized Naming test, the NH-children performed significantly faster in the objects subtest. Regarding the errors made, no differences were found between the groups. No correlation was found between the performance in the Bo Ege test and the Rapid Automatized Naming test, which suggest that naming of individual pictures and serial naming should be evaluated separately in clinical work. Singing in the group was not related to the performance in the Bo Ege test. In the Rapid Automatized Naming test, children who sing more than once a week performed both subtests faster on average and made fewer errors in the colors subtest, while children who sing less made fewer errors on average in the objects subtest. The differences were not statistically significant. However, the results suggest, together with previous studies, that singing in a group could be beneficial for the development of children's rapid naming skills.

Objectives. This Master’s Thesis is part of the MULAPAPU (Miten MUsiikki-interventio ja LAulu PArantavat kuulovammaisten lasten Puhekieltä) research project and focuses on the first year pilot data. The aim of this Masters Thesis is to find out whether a music intervention of 6 or 10 weeks has an effect on how hearing-impaired children aged 2 to 6 years perform in a nonword repetition test, in repeating the number of syllables and word stresses correct as well as on their performance in the vocabulary use test. In addition, the aim is to examine whether music intervention has similar effects both on the performance in the nonword repetition test and in the vocabulary test and whether there is a correlation between them. Methods. The sample consisted of the results of 9 children using cochlear implant and/or hearing aid in the nonword repetition test and the Bo Ege vocabulary test. Four of the children participated in the music intervention in the autumn 2019 and five in the spring 2020. The effects of the intervention were analyzed by calculating percentages and averages which were presented in figures. The performance of both groups before and after the intervention was analyzed with one-sample t-test. Possible differences between the spring and autumn group on the effectiveness of the intervention were examined with the Mann-Whitney U-test. The Spearman correlation coefficient was used to examine whether music intervention has similar effects both on the performance in the nonword repetition test and in the vocabulary use test and whether there is a correlation between them. Results and conclusions. The research results show that the use of vocabulary was improved by the music intervention but no evidence was found that music intervention would improve repeating syllables or word stresses correct. No statistically significant difference was found in the performance of the autumn and spring group. When examining whether the music intervention has similar effects both on the performance in the nonword repetition test and in the vocabulary use test and whether there is a correlation between them, no significant correlation was identified. Due to the small number of the research subjects, further research is needed to draw reliable conclusions.

Hearing impairment is a risk factor for speech and language development. Previous studies with hearing-impaired children have shown that their vocabulary development is slower than normal, and they have challenges in the use of inflectional forms. The purpose of this master's thesis is to find out if there is a difference in the proficiency of expressive vocabulary or inflections and sentences in Finnish-speaking, bilaterally hearing-impaired children compared to children with normal hearing. In addition, the effect of singing on the observed language skills is examined. The thesis is part of the MULAPAPU research project, which investigates the effects of music on the language development of hearing-impaired children aged 0-7. The study included both hearing-impaired subjects (n=23) and controls with normal hearing (n=25). The subjects were between 1 and 6 years old. Hearing-impaired subjects were bilaterally using a cochlear implant, a hearing aid, or a combination of these. The exclusion criteria for both the group of hearing impaired and controls were any severe diagnosed comorbid disorders. Expressive vocabulary proficiency was assessed with the Leinikki questionnaire completed by parents, and proficiency in the use of inflectional forms and sentences was assessed with the MCDI questionnaire. Singing was surveyed with the MULAPAPU background survey. Differences in expressive vocabulary proficiency were statistically analyzed using the Mann-Whitney U-test, and the connections between parental singing, child’s singing and singing in a group, and expressive vocabulary proficiency were analyzed using correlation analysis. Very few control subjects had answered the MCDI questionnaire's section of inflectional forms and sentences, so the skills of hearing-impaired children were analyzed on an individual level by comparing their scores to the standard values of the questionnaire. No statistically significant difference in expressive vocabulary proficiency was observed between hearing-impaired and normally hearing children. However, the hearing-impaired group had a two-peaked distribution and some subjects had poor expressive vocabulary proficiency. Hearing-impaired children's proficiency in inflections and sentences fell short of the age norms, although proportionate to hearing age, some of the subjects had a good proficiency in inflections and sentences. Only the child singing was statistically significantly correlated to expressive vocabulary proficiency. The amount of singing by parents was also statistically significantly related to the amount of singing by the child. Guiding the close environment and encouraging children to sing can be a good part of rehabilitating the language skills of hearing-impaired children.

Objectives. Hearing impaired (HI) children have been found to perform more poorly in tasks measuring semantic verbal fluency compared to normal hearing peers. Music activities are known to have a positive connection to the word finding skills in HI-children. However, there has not been yet studies to find out whether organized music activities have an effect on semantic verbal fluency skills in young HI children. The purpose of this study was to determine how the number of accepted words in semantic verbal fluency task develops during a music intervention in HI-children and whether background variables (age, mother’s education and hearing device) affect development. There was also a desire to find out the effect of singing at home on the development of verbal fluency task. In addition, it was examined whether the word retrieval strategies change during the music intervention and whether they are influenced by background variables. Methods. The participants (n = 15) were HI-children aged 2–6 years. Participants were divided into non-singers and singers based how much their parents sang at home. Verbal fluency (VF) and verbal fluency strategies were measured with two semantic VF tasks (animals and clothes). Tests were performed before (T1) and after (T2) the children participated in CIsumusa music intervention, organized by LapCi ry. The results were analyzed by statistical methods. Results and conclusions. The participants developed in verbal fluency task during the music intervention in both animal and clothing categories. Higher age was strongly associated with better development in both categories. Mother’s education was related to development in the animal task. Children of non-singers developed during the music intervention, but children of singers did not. However, children of singers performed better at T1 compared to children of non-singers. In a group of all participants the number of clusters increased during the music intervention in both animal and clothing tasks and the cluster size increased in the clothing task. Higher age was associated with an increase in the number of clusters, but not in cluster size. Based on the results, the music intervention was able to improve VF of children who performed poorly before the intervention. The results suggest that if there is no singing or musical activity at home, out-of-home music activities that include singing can improve VF. Singing at home and music interventions can be recommended to children with HI.