Browsing by discipline "Logopedi"
Now showing items 41-60 of 80
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(2016)Aims. Every person with aphasia has some kind of problems with finding words. The aim of this multi-case study was to find out how people with aphasia (PWA) and their conversation partners (CP) adapt to aphasic conversation and collaboratively participate in word search. The emphasis was on the ways the CPs act on the word searches. Word finding difficulties are highlighted in aphasic interaction which can lead to problems with maintaining self-esteem and social relationships in life. Conversation is always a collaborative phenomenon which is why it is important to examine the actions of the CPs of PWA. Methods. This study was a combination of qualitative and quantitative analysis. The participants were 3 dyads: 53 years old man with fluent moderate aphasia and his conversation partners (wife and daughter) and 61 year old woman with fluent severe aphasia and her husband. The data consisted 105 minutes of video material where the aphasic people were having everyday conversation with their CPs. The videos were transcripted and all the word searches were identified. Word searches that expanded into collaborative activity were analyzed with conversation analysis and the ways of CPs participated in them were categorized. The most commonly used categories of participation in conversation were analyzed more in detail. Results and conclusions. Altogether 82 word searches were identified from the data from which 50 of them were analyzed as collaborative word searches. Nine categories of participation were identified from the turns of CPs from which completion, interrogative word offer and specified question were the most commonly used. Also actions that enhanced the asymmetry of the conversation were identified and one dyad had more of those than the other dyads. Both of the PWAs used verbal and nonverbal behavior in the word searches. This shows that it is important to offer as addition to indirect therapy, also interaction based therapy for the PWA and the CP for them to learn and practice communication skills in everyday life. In the field of language and speech therapy PWA are the biggest group of adults who need rehabilitation. Because of the great need of rehabilitation it is important for the individual and for the society that we develop intervention methods and increase the knowledge about aphasia.
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(2015)Objectives. Narrative means a way of report, understand and structure a lived experience. It is an important mean of self-expression and interaction and people use it to share information with each other. The ability to narrate appears when child becomes an active participant in fantasies, stories and actions related to himself. Children with speaking disabilities often use communication books or other equipment as an alternative or augmentative mean of communication. Their possibilities to narrate can be more limited than speaking children, due to several reasons. This study describes the characteristics of augmented narratives that are formed with communication books. This study also describes how the characteristics of narratives differ when the elicitation method is changed. Also the role of communication partner and communication aid is discussed. Methods. Study consists of two physically disabled 13 to 16-year old boys who used communication books as a alternative mean of their communication. The research material was gathered during the spring of 2014. The material consists of video recordings of examinees performing three kinds of narrative assignments. The video material was transcribed and analyzed quantitatively and qualitatively in the contexts set by the research questions. Results and conclusions. Macrostructure of the narratives produced by communication book varied. Most diverse narratives filled the characteristics of a perfect narrative whereas the most compact narratives mainly focused on describing individual events. The narratives were mainly short and use of grammatical function words was scarce. Expressions of cohesion was mainly scarce and monotonous as its best. Narratives of children communicating by AAC-means differ from ones of children developing normally and expressing themselves with speech especially on microstructures' behalf. These results support and complement previous research. Further research is important to achieve a sufficient perception of particularities of augmented narratives so that the communication aids can be developed to better support the language development and expressional needs of these children.
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(2015)The Objective. Two persons with severe chronic non-fluent aphasia had received repetitive transcranial magnetic stimulation (rTMS) and Intensive language action therapy (ILAT) interventions. The aim of this multiple-case study was to analyze if their possibly improved language skills also improved social-functional communication abilities in every day life. Another objective of the study was to analyze the adaptation to impaired speech by a person with aphasia and the significant other. Previous research has shown that aphasic people communicate better with their close relatives than their success in clinical tests may predict. Several studies have shown that persons with aphasia and the significant others can give reliable assessment of aphasic speaker's linguistic and communicative skills in every day life. Even though the mutual adaptation to impaired speech aims at improving the interaction, it can in fact cause asymmetry between aphasic speaker and his/her significant one. Data and Methods.The participants comprised two persons with aphasia and their significant others. The first participant was a 52 year old man who had had a stroke 2 years earlier and another 72 years old man, 4 years after stroke onset. Both participants had a chronic severe Broca's aphasia. The quantitative data of the study consisted of Communicative Activity Log (CAL) ratings of patients and their significant others given before and after the interventions. The qualitative data consisted of 20 videotaped conversations (about 7 hours of raw data). Focus of the analysis was on changes in communicative activity of the participants and there were identified through conversation analysis (e.g. initiating new topics or how different kinds of repair initiatives were used). Also signs of asymmetry between a person with aphasia and the significant other were identified. Results and Conclusions. The CAL evaluations revealed that 52 year old participant's performance in everyday life situations improved significantly. The participant reported a significant increase of 38% in the quality and 14% in the amount of communication in everyday life after the interventions. Consistent with this result, his significant other reported also increase of 33% in the quality and 38% in the amount of his communication. Also signs of changes in his communication into more symmetric direction were identified in conversation analysis. He aimed at producing more detailed and lengthier utterances, asking questions and initiating new topics in conversation. For the 72 year old participant the self evaluating index revealed a qualitative improvement of 27% and quantitative improvement of 38% in communicative activities. Conversely, his significant other reported hardly any improvement in his quality of communication and decrease of 9% in the amount of his communication. Changes in 72 year old participant's communication weren't that clear in conversation analysis data either. He however showed more active role in interaction initiating new topics in conversation, and producing lengthier utterances and details like names. Some noteworthy changes in both participants' repair initiatives were identified after the interventions: both participants made repair initiations to their conversation partners, they also expressed the trouble source if they could't hear or understand their conversation partner's turn. Both of the participants also made self-repairs after unsuccessful attempt to articulate the missing word. Self-repair was non-existent feature in their conversation before. These changes reveal e.g. that the linguistic competence of the participants had improved and the interaction with their significant others appeared more symmetric and harmonic compared to conversations before the interventions.
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(2017)Aims. The aim of this study was to find out how speech and language pathologists use musical methods in speech therapy in Finland. The purpose of the survey was to gather experiences and opinions about this subject. The data was collected in spring 2016. Methods. The survey was made with web-based survey-tool provided by Helsinki University. It was sent to 1209 members of Finnish association of Speech Therapists. The questionnaire was answered by 122 responders (response rate was 10%). There were 25 questions in the survey, with open, closed and combined question types. Open questions were analysed with qualitative methods: answers were categorized and sorted into themes. Closed questions were analysed by quantitative methods by calculating means and frequencies with SPSS-program. Combined questions types were analysed with both methods. Results and conclusions. The responders who had direct speech therapy as part of their job description (N=112) did use diverse musical methods as part of the therapy, but the amount of utilization varied considerably. The methods were used all around Finland, by therapists from different kind of backgrounds concerning the age and the graduate university. Musical methods were used in many patient groups. According to the answers, these methods were especially important if the patient didn't have any kind of speaking ability to use. The most common musical method mentioned was MIT (melodic intonation therapy) which was used by 32% of the responders who did direct speech therapy. The MIT was also the most popular method from which responders would like to have more education of. In the whole sample (N=122), musical methods were used widely in the part of so called indirect or consultative speech therapy, meaning that the speech and language therapists gave recommendations of using music as part of the rehabilitation process at homes, during day care and in the rehabilitation centres. Some responders utilized musical methods also as part of the speech-language assessments. In addition, based on answers the collaboration between speech therapists and music therapists is almost non-existent in Finland. Collaboration with music therapists was hoped. Many responders were interested in the practical education of this subject.
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(2018)Tiedekunta - Fakultet - Faculty Medical Sciences Laitos - Institution – Department Department of psychology and logopedics Tekijä - Författare - Author Sanni-Liisa Haikarainen Työn nimi - Arbetets titel Title Verbalizing the chances of nonverbal interaction using the intensive interaction outcomes table Oppiaine - Läroämne - Subject Logopedics Työn laji/ Ohjaaja - Arbetets art/Handledare – Level/Instructor Master’s Thesis/Kaisa Launonen Aika - Datum - Month and year 01/2018 Sivumäärä - Sidoantal - Number of pages 43 pp. + 3 appendices Tiivistelmä - Referat - Abstract Aims: The aims of this study were to investigate how the users of intensive interaction outcomes table estimate the feasibility of it. I was especially interested whether the outcomes table makes it easier to observe and verbalize the changes in a client’s way to use nonverbal interaction. I also wanted to know how the users of intensive interaction outcomes table evaluate the need of improving it. Methods: The data of this study were collected with a questionnaire. The participants were found from the intensive interaction group in Facebook and from the email list of Tikoteekki’s specialist Kaisa Martikainen. The answers were classified thematically with the help of graphic symbols. Results: According to the findings of this study it seems that the intensive interaction outcomes table supports professionals in recognising changes in their client’s ways to use nonverbal interaction. It also helps them in verbalizing the recongized changes. The participants would develop the form by shorting it. It would make it easier to be used in everyday work. Avainsanat - Nyckelord Keywords Intensive interaction, intensive interaction outcomes table, autism spectrum disorder, intellectual impairment, nonverbal interaction Säilytyspaikka - Förvaringsställe - Where deposited Helsinki University Library – Helda / E-thesis (opinnäytteet) ethesis.helsinki.fi Muita tietoja - Övriga uppgifter - Additional information
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(2015)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.
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(2015)Aims. In Finland there is only a limited amount of research on the development of the lexicon after toddler age. There is also a need for valid and comprehensive assessment tools for children. The assessment tools help for example in identifying the children who need support in their linguistic development or with reading and writing skills. This study is a part of a research project conducted in the University of Oulu (Kunnari & Välimaa, 2011). The aim of the project is to gather Finnish normative data to make the vocabulary tests valid for the use in Finnish. In the present study, the vocabulary skills of the school starters were investigated using Finnish versions of The Receptive One-Word Picture Vocabulary Test 4- and The Expressive One-Word Picture Vocabulary Test 4 (Martin & Brownell, 2011). The connections between the test results and different background variables were studied. The results were compared to earlier research data. Methods. The study subjects were Finnish speaking 1. and 2. grade pupils. In order to take part to the study it was required that the subjects were born full-term and that their overall development had been normal. 53 children from three schools in Helsinki participated in the study. There were 26 boys and 27 girls and the age varied between 7;0 and 9;0 years. The test results were inserted anonymously into a program (SPSS) for statistical analysis. Non-parametric methods were used for the data. Results and conclusions. 7;0–7;11 -year-old subjects had significantly smaller test scores in both tests than the 8;0–9;0 -year-old subjects. The standard deviation was greater in the receptive vocabulary test than in the expressive vocabulary test. There was a strong correlation between the scores of the two tests. In the younger age group the boys had greater scores in both tests than the girls. In the expressive vocabulary test the boys' results were significantly better. In the older age group the girls had greater scores in both tests, but the scores weren't significantly better than the boys'. None of the background factors (parental education level, family size, birth order, amount of ear infections) were connected to the scores in the vocabulary tests. Difficult and easy test words were mostly the same within both the girls and the boys, although there was a few interesting exceptions. The results of the study can be considered only indicative due to the small sample size. The comparations of the scores between the boys and the girls are not reliable partly because of the younger age of the girl subjects in this study.
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(2016)Aim: People with speaking disabilities have equal rights to functional interaction and communication as people without disabilities. These rights actualize only through the actions and skills of more able communicators. Guiding staff and family members is an important part of every speech and language pathologist's (SLP) job, especially if the client has severe learning disability. However, many SLPs experience guiding difficult and the results of staff communication training have been unsatisfactory. There are different models that can be used to help the process of indirect speech and language therapy. One of them is called Intensive interaction (II). Its role in enhancing interaction skills of more able communicators has only been studied a little. The purpose of this study is to find out if II is a meaningful approach to carry out indirect speech and language therapy. The aim was to find out if and how the interaction skills of a staff member change during an II process. The aim was also to figure out how she saw the significance of II. Methods: This research data were collected in the Communication and Technology Centre Tikoteekki of the Finnish Association on Intellectual and Developmental Disabilities. The data were collected during an II process that took place in 2014 and 2015 in a residential unit for people with learning disabilities. This study had two participants, one of whom was a resident with multiple learning and speaking disabilities, and the other one a staff member. The video material was composed of 14 interaction videos between the resident and the staff member, and one video of guidance discussion between the staff member and the mentoring SLP in the end of the process. The data were analysed according to the themes arising from the data, by mostly qualitative means. The changes in interaction skills were described with different tables and transcriptions. The guidance discussion was transcribed and analysed according to inductive analysis. Results and conclusions: The interaction style of the staff member became more sensitive and present. That change manifested through improvements in four elements of interaction: distance from the interaction partner, touching, quality and quantity of vocalization and tasklessness of interaction. The staff member saw II as a meaningful approach, especially for herself as an employee, but also for her interaction partner with multiple disabilities and more generally. These results suggest that II is a meaningful and effective means of mentoring significant others to become more sensitive, skillful and able interaction partners for persons with severe speaking disabilities. Additionally this study gives premises for further research on II and indirect speech and language therapy. In light of this research II is also important on societal level.
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(2015)Aim of the study. Continuous vocal loading strains the vocal cords, which can lead to voice symptoms. Especially for professional voice users like teachers, voice symptoms may cause psychosocial harm. However, the amount of psychosocial harm is not linked directly to the amount of voice symptoms, but varies according to individual's vocal needs and requirements. Teaching of some subjects is more linked to vocal risk factors and voice symptoms are more common among teachers of certain substances. Previous studies have found that teacher students have more voice symptoms than other university students, but there hasn't been any comparative research about the differences between teacher students studying different subjects. The aim of this study is to investigate the prevalence of voice symptoms of Helsinki University teacher students and examine the psychosocial harm caused to them by voice symptoms. In addition this study investigates how voice symptoms and psychosocial harm influences the assessment of ones voice. Voice symptoms and the amount of psychosocial harm of students of different subjects are being compared in order to see whether there are differences already before graduating. Methods. The data was gathered by electronical questionnaire during spring 2015. The questionnaire was sent out to all students of the department of teacher education in Helsinki University who were on any of the mailing lists of student organizations. A total of 190 students from all classes and training fields participated the study. The questionnaire consists of background information form and questionnaires about vocal symptoms (voice screening test) and the psychosocial impacts of voice disorders (VHI). The data was analyzed mainly by using quantitative methods. Results. The results show that voice symptoms are quite common among teacher students and about 40 % of them reported frequently occurring voice symptoms. This study shows a clear association between voice symptoms and psychosocial harm and the self-assessment of voice. However, one of the main discoveries of this study is that almost 90 % of the students did not have notable psychosocial impacts and almost 80 % actually considered their voice normal. Surprisingly this research shows that students can regard their voice normal despite the fact that they have voice symptoms. The amount of voice symptoms and psychosocial harm was equally high among students of all different subjects.
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(2015)Objectives. Online discussion forums are part of extensive interactive network environments known as social media. Large part of the public debate today takes place on its fields. Any search for information on the internet may easily lead to online discussion forums. Speech therapy and issues related to it are also discussed on many discussion forums. The aim of this study was to identify the main themes being discussed about speech therapy and to analyse the forum users' perceptions of speech therapy. The theoretical framework of the study relies on social constructionism and socio-cultural learning theory. Perceptions are constructed by language in social interaction, and are based on one's own and others' experiences. Sharing experiences, peer support and information online are part the cultural change taking place in society. The change affects the ways of learning and retrieving information. Connectivism is a digital age learning theory that is based on the learning online via networks. Methods. The survey was conducted by analysing 88 online discussion chains from a popular Finnish online forum. The discussions had taken place 2005-2014. The data analysis was carried out using content analysis by means of themes and phenomenographic research approach, which focused on the interpretation of the perceptions from the online discussions. The network of perceptions was contemplated by interpreting the expressed cause-and-effect relationships between the themes. Results and discussion. Based on analysis there were a total of 11 themes in discussions. Three main themes were speech therapy resources, differences of municipal and private speech therapy, and speech therapists' role and job description. All the other themes were related to the three main themes. The cause-and-effect relationships between the themes were a basis for a interpreted network of speech therapy perceptions. Online discussions can be considered to partly reflect the situation in society, as well as to follow other media. Lack of resources in speech therapy and many other social and health services has become reality in Finland in recent years. Health care services transfer to the private sector has been a topic of discussion also in traditional media. Information provided by analysing attitudes, opinions and perceptions of speech therapy could help to address the customers' needs and direct the guidance, advice and support in the best possible manner.
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(2018)Aims. Bilingual language development can have positive or negative effects on phonological development. Children with specific language impairment can have difficulties in phonological skills. This study aimed to compare the paradigmatic and phonotactic skills of sequential bilingual children with SLI to the skills of monolingual children with SLI in the Finnish language. The connection between paradigmatic and phonotactic skills was studied. The effect of bilingual language impaired children's age, sex and duration of Finnish acquisition and the effect of monolingual language impaired children's age and sex on their phonotactic skills was researched. Methods. The participants were sequentially bilingual language impaired children (N = 46) aged 3;5– 5;10 and monolingual language impaired children (N = 46) aged 3;5–5;9. The participants had been recruited to Helsinki Longitudinal SLI study in 2013–2015. The evaluation method was Finnish Test of Phonology (Fonologiatesti). The paradigmatic and phonotactic skills of the two groups were compared using statistical methods. The connection between paradigmatic and phonotactic skills was studied in both groups. A linear regression model was conducted for each group. In both models the dependent variable was phonotactic skills. In the bilingual language impaired group the explanatory variables were age, sex and duration of Finnish acquisition. In the monolingual language impaired group the explanatory variables were age and sex. Results and conclusions. Bilingual children with SLI had better paradigmatic and phonotactic skills compared to monolingual children with SLI. Paradigmatic and phonotactic skills correlated strongly in both groups. The correlations in the monolingual language impaired group were statistically more significant. Age was a statistically significant explanatory variable for phonotactic skills in both groups. The duration of language acquisition of bilingual children with SLI was not a statistically significant explanatory variable for phonotactic skills. Bilingual children with SLI may have more articulate speech than monolingual children with SLI. Bilingualism may function as a protective factor in phonological difficulties associated with SLI.
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(2017)Tavoitteet. Pikkukeskosina syntyneillä lapsilla on kohonnut riski kielenkehityksen häiriöihin verrattuna täysiaikaisina syntyneisiin lapsiin. Pikkukeskosten lukivalmiustaidoista ja varhaisen kielenkehityksen yhteydestä niihin on kuitenkin vain vähän tietoa. Tämän tutkimuksen tavoitteena oli selvittää pikkukeskosina syntyneiden lasten kahden vuoden iän sanaston koon ja koostumuksen mahdollista yhteyttä lukivalmiustaitoihin viisivuotiaana. Menetelmät. Tutkittavana oli 103 pikkukeskosena syntynyttä lasta ja 119 täysiaikaisena syntynyttä verrokkia. Keskoset ja verrokit olivat osa isompaa Pienipainoisten riskilasten käyttäytyminen ja toimintakyky –tutkimusta. Pikkukeskosten ja verrokkien ilmaistun sanaston koko ja koostumus kaksivuotiaana arvioitiin Varhaisen kommunikaation ja kielen kehityksen arviointimenetelmällä. Lukivalmiustaidot (fonologinen prosessointi ja kiirehditty nimeäminen Nepsy II –testillä, nimeäminen Bostonin nimentätestillä, kirjaintuntemus sekä sanojen ja lauseiden lukeminen) arvioitiin viiden vuoden iässä. Aineisto analysoitiin tilastollisin menetelmin. Sanaston koon, sanakategorioissa olevien sanojen määrän ja sanakategorioiden suhteellisten osuuksien yhteyttä lukivalmiustaitoihin tarkasteltiin Spearmanin korrelaatiokertoimen avulla. Sanaston koon ja koostumuksen selitysastetta hyviin lukivalmiustaitoihin tutkittiin kahden logistisen regressiomallin avulla erikseen keskos- ja verrokkiaineistossa. Ensimmäisessä mallissa selittävät muuttujat olivat sanaston koko, raskauden kesto ja äidin koulutustausta. Toisessa mallissa selittävät muuttujat olivat verbien ja sulkeisen luokan sanojen yhteismäärä, raskauden kesto ja äidin koulutustausta. Tulokset ja johtopäätökset. Pikkukeskosina ja täysiaikaisina syntyneiden lasten sanaston koko, sanaluokkakategorioiden sanamäärät ja niiden suhteelliset osuudet olivat yhteydessä moniin lukivalmiustaitoihin. Kuitenkin keskosaineistossa korrelaatiot olivat hieman suurempia ja sanaston koon sekä verbien ja sulkeisen luokan sanojen selitysaste hyviin lukivalmiustaitoihin hieman vahvempi kuin verrokkiaineistossa. Tulokset vahvistavat näkemystä pikkukeskosten varhaisen sanaston koon ja koostumuksen yhteydestä myöhempiin kielellisiin taitoihin. Tulosten perusteella keskosten varhaista kielenkehitystä tulisi seurata ja tukea lukivalmiustaitojen parantamiseksi.
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(2017)Aims. Early interaction skills are the base for later language development. Very low birth weight (VLBW) children are at a higher risk for developing language difficulties. Earlier studies have shown that both gaze behaviours and early gestures develop differently among VLBW children compared with children born full-term. The assessment of early gestures may provide help in finding at least some of the children who are at risk for later language difficulties. The aim of this study was to analyze the use of gaze behaviours and gestures in VLBW children at the age of one, comparing the results with a control group. We also compared gestures analyzed with the Finnish version of Communicative Development Inventories (FinCDI) to gestures analyzed from video data to examine the possible connection between these different types of assessment tools. Methods. The participants of this study consisted of 10 VLBW children and 10 full-term children (N=20). The same group was also a part of a bigger study, titled Development and functioning of very low birth weight children. In this study, gaze behaviours and gestures were analyzed from video data, divided into four different types of gaze behaviours and five different types of gestures. The possible connection between gaze behaviours and gestures in and between groups was analyzed by using Spearman`s correlation. In addition, Mann Whitney`s U-test was used to analyze the possible differences between these groups. Spearman`s correlation was also used to examine the possible correlation among the two different assessment tools. Results and conclusions. The types of gaze behaviours and gestures used most often by children in both groups were eye contact between mother and child, deictic gestures and gestures with objects. VLBW children had less eye contact, deictic gestures and gestures with objects compared with the full-term group. A significant difference between VLBW children and the control group was found in deictic gestures. It was also found that there was a significant correlation between the two assessment tools when comparing the two groups together (N=20). The results are similar to the findings of earlier studies and indicate that VLBW children use less eye contact and early gestures compared to the control group.
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(2015)Aims: Public health care in Finland has the main responsibility of rehabilitation, which means that public health care has to provide for persons with the severe disabilities the therapy or the rehabilitation needed. If a person fulfills the criteria of having severe disablity he is admitted Disability Allowance at its middle or highest rate. This is required for getting medical rehabilitation for persons with severe disabilities, which in Finland is financed by KELA. The speech therapy for the severely disabled organized by KELA is mainly carried out by private sector. There were approximately 500 private speech therapists under the contract of KELA during 2011-2014. Altogether 7439 persons were receiving speech therapy by KELA in 2014. The speech therapists under the contract of KELA are divided somewhat unevenly in Finland, therefore the availability of speech therapy is not equal in the whole land. Particularly areas with less inhabitants seem to suffer from inequality. The UN Convention on the Rights of Persons with Disabilities in 3.5.2008 was aimed at guaranteeing equal human rights to disabled people and to promote and support their human value. Methods: This Master's thesis looks at the availability of speech therapy in Finland both quantitatively based on open statistics by KELA and qualitatively on the nature of positive and negative decisions in the Medical District of Kanta-Häme. Results and Conclusions: The availability of speech therapy for persons with severe disabilities is not by KELAs statistics fully equal in Finland. The uneven division of speech therapists has lead to the fact that there are for example, at the insurance district of Oulu considerably more speech therapists than at the insurance district of Satakunta.The speech therapists under contract of KELA are like many other highly educated people situated close by the universities and other schooling areas, By U.N agreement the persons with disabilities should have rehabilitation near where they live and timing it optimally.The severity of language impairment was the main reason in positive decisions in the Medical District of Kanta-Häme and the insufficiency of arguments in the negative ones, which seem to refer to the fact that there, with an adequate application, speech therapy is guaranteed for the persons with most severe disabilities. One of the aims of the future social welfare and health care reform is to improve the availability of speech therapy in Finland. It remains to be seen how successfully it will answer the growing need.
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(2017)Aim. Neurogenic stuttering typically starts after brain injury. In previous research the variation of neurogenic stuttering between different tasks has been contradictory. There is a lack of domestic research on neurogenic stuttering and foreign material is similarly limited. Also, consistent practices between investigations are absent from the literature. The purpose of this study is to provide new information on neurogenic stuttering and other aspects of fluency in patients who have brain injuries.Methods. Five people with a brain injury and diagnosis of neurogenic stuttering after injury took part in this research. The control group consisted of five participants with a brain injury but without neurogenic stuttering. Speech tasks included cartoon narration and spontaneous speech. The data was analyzed by calculating speech and articulation rates, the total amount of pauses, non-fluent pauses, pause durations and pause types most commonly occurring for each task. In addition, quantitative and qualitative characteristics of stuttering were evaluated by calculating percentages and average duration of stuttering and by classifying different types of stuttering. Results and conclusions. The speech and articulation rate were slower in cartoon narration task in comparison to spontaneous speech. The durations of pauses were longer and more non-fluent pauses existed in cartoon narration task than spontaneous speech. In both tasks the most common type was the dysrytmic pause. In cartoon narration task, there was more stuttering whereas in spontaneous speech the durations of stuttering were longer in comparison to cartoon narration task. In this research speech task had influence on the variation of quantitative and qualitative characters of speech fluency on neurogenic stutterers.
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(2015)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.
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(2018)Aim: Due to the plasticity of the brain of a child under three years old early intervention can be very effective and affect the growth and development of the child extensively. As a concept early intervention is as yet unestablished within our healthcare system. The purpose of this study was to find out what kind of experiences Finnish speech-language therapists (SLTs) have about the assessment and the rehabilitation of children under three years old and the readiness of SLTs to work with these small children. The study also aimed to find out the reasons why small children are being sent to speech-language therapists. Methods: This study was done by a questionnaire and the material was gathered using an electrical survey with the E-lomake -program of the University of Helsinki between April and May 2016. The questionnaire was delivered to Finnish SLTs via the Finnish Assocation of Speech Therapists and four corporations that employ SLTs. The data was analysed with the IBM SPSS Statistics 24 -program using nonparameterized statistical tests and qualitative grouping. Results and conclusions: The questionnaire was answered by 194 SLTs out of which 111 worked regulary and 73 occasionally with children under three. The SLTs’ know-how about working with small children was mostly based on work experience. The professional capabilities were maintained and developed by additional trainings and literature. A degree in logopedics was considered to provide only minor capabilities toward working with small children. The results indicate that small children are sent to SLTs mostly because of disabilities and delayed speech development. The most popular assessment methods were tests, free observation and interviewing the child’s parents. AAC methods and playing were popular methods of rehabilitation. The practices in rehabilitating small children were varying and based on the available resources. According to the SLTs other healthcare professionals are not aware of what an SLT does and therefore their know-how is not utilized to it’s full extent.
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(2017)Abstract Study aims: For many, working is a significant part of their daily life and thus well-being at work is considered important. Well-being at work consists of finding one's job meaningful and rewarding. In previous studies, work-counselling has been shown to be an effective method in supporting people's personal growth and ability to function in their professional lives as well as improving their well-being at work. Work-counselling aims to assist people in improving as employees and addressing problematic situations and experiences related to their work by means of reflective conversation. Work-counselling has been discovered to be particularly meaningful with employees within the healthcare sector. Very little research data on the experiences of speech and language therapists (SLT) with work-counselling exists in Finland or globally. The aim of this thesis was to find out how common work-counselling is with SLTs in Finland and how its impact on e.g. well-being at work are perceived by the SLTs. Additionally, the contents and guidelines of work-counselling as well as the goals and desires of SLTs relating to work-counselling were examined. Methods: The study was carried out in survey form via a web questionnaire by the University of Helsinki. The target group of the study were the members of the Finnish Association of Speech Therapists. The web questionnaire was sent to the 1222 members of the association in December of 2016. 330 SLTs participated in the survey, resulting in a response rate of 27%. The survey data was analyzed quantitatively using the IBM SPSS Statistics 24-software, with which means, frequencies, and percentages were calculated from answers to the survey’s multiple-choice questions. The open-ended answers in the survey were analyzed qualitatively by means of content analysis, classification, and grouping of the responses. Results and conclusions: 91% of the respondents reported having received work-counselling and close to half of them had received at least six work-counselling periods. The decision to seek work-counselling was in most cases initiated by the SLT. In most cases, the expenses of the latest work-counselling period were covered by the SLT's employer, and 32% of the respondents reported having paid for their own work-counselling. 84% of the respondents that had received work-counselling perceived it as beneficial and 15% reported having experienced varying benefits. The respondents expressed wishes to receive support in matters relating to occupational safety and their professional skills, including dealing with their professional roles, reviewing practical working methods, exchanging experiences, and professional tips and ideas. Reviewing difficult case studies was also a common desire. Matters relating to occupational safety, such as well-being at work, improving the functionality of the working community, and interaction were also mentioned as desired topics in work-counselling. The results of this thesis increase the understanding of SLTs' experiences with work-counselling. Considering the results presented in this thesis it can be concluded that SLTs experienced work-counselling as an important part of their professional activity that plays a significant role in securing their well-being at work.
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(2015)Objective: Previous studies suggest that outcomes in aphasia therapy are not often routinely measured in the clinical practice. On the other hand, there has been little research on the views of speech and language therapists (SLT) on the outcome evaluation. The objective of this study was to gather information about the opinions of SLT's when it comes to the role, need and value of the outcome evaluation in the clinical practice. Methods: A conceptual framework called theory of alignment was used in this study. The data were collected by interviewing ten SLTs practicing aphasia therapy. The interviews were transcribed and the data were analyzed using qualitative content analysis. Results and conclusions: According to the results SLTs evaluate the outcomes of aphasia therapy for themselves, for the patients and their significant others and for external stakeholders. The role of the outcome evaluation is different depending on the stakeholder needing evaluation. SLTs may consider routine evaluation of the outcomes unnecessary since the different stakeholders do not always create a need for the outcome evaluation. When it comes to the outcomes of aphasia therapy, STLs found it important to get information on their patient's improvement in different contexts. SLTs also valued other persons' opinions of the outcomes as well as information on the patient's symptoms and their further need for aphasia therapy. Furthermore, SLTs considered that the extent and form of information were important when assessing outcomes. Acknowledging the views of SLTs on the outcome evaluation may help to develop the evaluation practices by resolving some problems relating to the evaluation. In case the routine evaluation of outcomes is desired nationally in aphasia therapy, the SLTs should find that there are different stakeholders needing evaluation for a certain reason. When new tests and assessment tools are developed and translated into Finnish language, it should be considered that they will provide information SLTs find worth collecting.
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(2015)Aim: The voice is an important part of group fitness instructors' work. Yet, the working conditions of group fitness instructors are vocally challenging due to acoustics, air conditioning, background noise and physical strain. Voice problems of group fitness instructors are quite briefly researched, but some studies show that these problems are common within this industry. The aim of this study is to find out what kind of voice symptoms occur among group fitness instructors, how often they occur, and also how many instructors have vocal symptoms. In addition it studies how the symptoms are felt to influence on individuals functioning and if there is a connection between the symptoms and the handicap caused by them. Methods: The material was gathered using an electrical survey and formed by answers of 276 group fitness instructors. All the subjects worked as group fitness instructors at least once a week. The survey had three parts: basic knowledge form, vocal symptom survey of seven symptoms and Voice Activity and Participation Profile. The material was analysed using statistical methods on program IBM SPSS Statistics 22. Statistical testing was made using nonparametrical tests. Frequencies, percentages and characteristics were calculated. Subjects were divided in two groups depending on whether they had two or more symptoms daily or weekly, or less than that. Results and conclusions: Almost two out of three of the respondents had at least one voice symptom weekly. About half of the subjects had two or more symptoms weekly or more often, which is considered as a severe amount. Voice getting strained, tired and hoarse were the most common voice symptoms. The effect of the voice problem on functioning were considered mild. However, the amount and rate of symptoms had a linear effect on functioning and wellbeing. Also, the subjects who had two or more symptoms daily or weekly were more restricted on their functioning. Vocal training received by group fitness instructors was thin. It could be beneficial to add aspects of vocal ergonomics on group fitness instructors' training and work.
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