Browsing by master's degree program "Logopedian maisteriohjelma"

Objective. Speech sound errors are the most common speech disorders in children that, without proper treatment, can have far-reaching effects on an individual’s quality of life. Due to limited speech therapy resources, speech sound disorders are often left without adequate treatment. In Finland, efforts have been made to reduce the geographical inequality in the availability of rehabilitation services through various time-independent teletherapy solutions. For example, the mission of Äännekoulu is to help Finnish municipalities prioritize their limited resources and enable every child to have access to speech therapy services, regardless of their place of residence. There are only few studies focusing on the use of teletherapy practicies in the treatment of speech sound disorders in Finnish-speaking children. The aim of this study was to examine whether Äännekoulu’s online therapy is an effective way to rehabilitate children's /r/-errors and to describe possible factors influencing rehabilitation results. Methods. The data used in the study consisted of demographic information and speech therapist’s notes and records on children under 10 years of age (n = 109) who participated in a three-month training period at Äännekoulu’s online therapy aiming to rehabilitate existing /r/-errors in their speech during March 2019 - April 2020. The notes and records were collected from the patient database Diarium. Participation in the study was voluntary. The collected data were categorized and analyzed using the Mann-Whitney U test and the chi-square test. Results and conclusions. More than half of the children learned to produce alveolar trill /r/ at least in isolation during a training period at Äännekoulu’s online therapy. On average children learned to produce the tongue trill on the sixth contact with the speech therapist. Most of the children learned to produce tongue trill through the dn dn dn -exercise. There was no significant difference between sexes in learning to produce the alveolar trill. The quality and the type of the speech sound error, age, sex or the children’s skill level in the beginning of the training period did not affect the rehabilitation of /r/-error. The number of contacts with the speech therapist strongly correlated with the results achieved in teletherapy. Äännekoulu’s online therapy seems to be an effective way to treat children’s /r/-errors. Learning to produce the alveolar trill correctly is significantly affected by active collaboration with the speech therapist. Further research is needed to identify the factors influencing the rehabilitation of the /r/-errors. Future research should also concentrate on the at home practice needed to treat speech sound errors in teletherapy.

Varhaisen sanaston koostumus kehittyy sanaston määrällisen kehityksen myötä. Sanaston koostumuksen on havaittu kehittyvän omaksuttavasta kielestä riippumatta pääpiirteittäin samantyyppisesti. Aiemmissa tutkimuksissa on löydetty yhteyksiä varhaisen sanaston kehityksen ja muiden kielellisten taitojen kehityksen välillä. Sanaston koostumuksen kehityksen yhteyttä muihin kielellisiin taitoihin on kuitenkin tutkittu vain vähän. Tämän tutkimuksen tarkoituksena oli tarkastella ilmaistun sanaston koostumuksen kehitystä toisen ikävuoden lopulla sekä sen yhteyksiä ymmärretyn ja ilmaistun kielen kokonaistasoon kaksivuotiaana. Tämän tutkimuksen otos (n = 50) koostui Sanaseula-tutkimushankkeen tutkittavista. Tutkittavat olivat terveitä suomenkielisten perheiden lapsia. Ilmaistun sanaston koostumusta mitattiin 18 ja 24 kuukauden iässä Varhaisen kommunikaation ja kielen kehityksen arviointimenetelmällä. Menetelmästä käytettiin Lapsen kommunikaation kehitys: Sanat, taivutukset ja lauseet -versiota. Ilmaistun sanaston koostumusta tarkasteltiin sanakategorioiden raakapisteiden, word opportunity -pisteiden sekä kokosanamäärästä laskettujen prosentuaalisten osuuksien avulla. Ymmärretyn ja ilmaistun kielen kokonaistasoa mitattiin 24 kuukauden iässä Reynellin kielellisen kehityksen testillä sekä Bayley III -testin kielellisen kehityksen asteikolla. Ilmaistun sanaston koostumuksen sekä ymmärretyn ja ilmaistun kielen kokonaistason välisiä yhteyksiä tutkittiin Spearmanin korrelaatiokertoimien ja lineaaristen regressiomallien avulla. Ilmaistut sanastot koostuivat 18 kuukauden iässä enimmäkseen sosiaalis-pragmaattisista sanoista sekä substantiiveista. Toisen ikävuoden lopulla tutkittavat omaksuivat ilmaistuihin sanastoihinsa erityisesti substantiiveja sekä verbejä. Sosiaalis-pragmaattisten sanojen prosentuaalinen osuus pieneni, kun taas muiden sanakategorioiden prosentuaaliset osuudet kasvoivat toisen ikävuoden lopulla. Ilmaistun sanaston koostumuksen yhteydet ilmaistun kielen kokonaistasoon olivat pääosin vahvempia kuin vastaavat yhteydet ymmärretyn kielen kokonaistasoon. 24 kuukauden iässä mitattu ilmaistun sanaston koostumus korreloi pääosin 18 kuukauden iässä mitattua vahvemmin kahden vuoden iässä mitatun ymmärretyn ja ilmaistun kielen kokonaistason kanssa. Ilmaistun sanaston sanakategorioiden raakapisteet 18 ja 24 kuukauden iässä selittivät yhdessä sukupuolen kanssa ymmärretyn sekä ilmaistun kielen kokonaistasoa kahden vuoden iässä tilastollisesti merkitsevästi. Ilmaistun sanaston koostumus selitti selvästi paremmin ilmaistun kielen kokonaistasoa kuin ymmärretyn kielen kokonaistasoa. Tutkimuksen tulokset tukevat näkemystä, että tyttöjen varhaiset kielelliset taidot ovat keskimäärin poikia paremmat, ja että varhaisessa kielenkehityksessä ilmenee huomattavaa yksilöllistä vaihtelua. Tulokset osoittavat, että varhaisen sanaston koon arvioimisen lisäksi on aiheellista tarkastella myös sanaston koostumusta, sillä näin saadaan tarkempaa tietoa lapsen varhaisista kielellisistä taidoista.

Tavoitteet. Tässä maisterintutkielmassa tarkastellaan, millaisia sanoihin liittyviä ongelmia 5-vuotiaiden lasten ja heidän aikuisten vuorovaikutuskumppaniensa välisissä keskustelutilanteissa ilmenee ja miten niitä käsitellään. Tutkimuksen kohteena ovat sekä lapsen että aikuisen tekemät itsekorjaukset ja toisen vuoroon kohdistuvat korjausaloitteet yksittäisiin sanoihin liittyen. Erilaisten korjauskäytänteiden avulla pyritään säilyttämään keskustelijoiden välistä yhteistä ymmärrystä. Itsekorjauksilla tarkoitetaan puhujan omaan puheeseen kohdistuvia korjauksia, kun taas toisen puheeseen kohdistuvilla korjausaloitteilla nostetaan esille jotain toisen puhujan puheessa ongelmalliseksi tulkittua. Ilmiötä tarkastellaan kahdessa erilaisessa vuorovaikutustilanteessa, joista toinen on puheterapeuttinen arviotilanne ja toinen äidin ja lapsen välinen leikkitilanne. Lisäksi verrataan, onko sanoihin liittyvien ongelmien esiintymisessä tai käsittelyssä eroa eri vuorovaikutustilanteiden välillä. Menetelmät. Tässä tutkielmassa aineistona oli videoituja vuorovaikutustilanteita neljältä eri lapselta, jokaiselta sekä leikkivuorovaikutustilanteesta että puheterapeuttisesta arviosta. Aineisto on kerätty osana Lapsen kehittyvä kieli ja vuorovaikutus -tutkimushanketta (nyk. COMPAIR). Aineiston analyysi perustuu keskustelunanalyysiin, jonka perusteella aineistosta poimittiin sanoihin liittyvät korjausjaksot. Tulokset ja johtopäätökset. Yksittäisiin sanoihin liittyviä ongelmakohtia nostettiin käsiteltäviksi monista eri syistä. Ongelmia koettiin ja nostettiin käsiteltäviksi enemmän leikkitilanteissa kuin puheterapiatilanteissa. Näitä kohtia käsiteltiin keskustelutilanteissa aikuisen tai lapsen aloittamilla itsekorjauksilla, lapsen tai aikuisen tekemillä toisen vuoron korjausaloitteilla sekä aikuisen tekemillä suorilla korjauksilla. Sanoihin liittyvien korjauskäytänteiden määrässä oli suurta vaihtelua eri lasten vuorovaikutustilanteissa, mikä voi johtua esimerkiksi lapsikohtaisesta vaihtelusta kielellisissä taidoissa tai eri vuorovaikutuskumppaneiden välisistä erilaisista kommunikointityyleistä. Lasten tekemät itsekorjaukset olivat enimmäkseen sanahakuja, joiden lisäksi ilmeni sanan äännerakenteen tuoton haasteisiin liittyviä itsekorjauksia sekä sanan korvaamista toisella sanalla. Aikuiset puolestaan tekivät itsekorjauksia tyypillisimmin korvaamalla sanomansa tai aloittamansa sanan toisella lapselle mahdollisesti helpommin ymmärrettävällä sanalla. Lapset nostivat muutaman kerran aikuisen käyttämän sanan merkityksen ongelmalliseksi keskustelussa. Sen sijaan aikuiset tekivät sanoihin liittyviä toisen puheeseen kohdistuvia korjausaloitteita useimmin liittyen lapsen käyttämän sanan oikeellisuuteen. Vuorovaikutustilanteen yleinen luonne saattoi vaikuttaa sanoihin liittyvien ongelmien ilmaantumiseen sekä niiden käsittelyyn. Tutkimuksen tuloksista saadaan alustavaa tietoa viisivuotiaiden lasten ja heidän aikuisten vuorovaikutuskumppaneidensa tavoista käsitellä erilaisia esiin nousevia sanoihin liittyviä ongelmakohtia erilaisissa vuorovaikutustilanteissa. Sanoihin liittyvien ongelmakohtien selvittely osaavamman vuorovaikutuskumppanin kanssa auttaa lasta uuden sanaston oppimisessa, ja siksi aiheesta on tärkeää saada tutkimustuloksia tyypillisesti kehittyneiden lasten osalta. Ilmiötä on kuitenkin tärkeää tutkia lisää isommilla aineistoilla, jotta tuloksia voidaan yleistää ja myöhemmin hyödyntää puheterapeuttisessa arvioinnissa ja kuntoutuksessa.

Aims. Speech processing has traditionally been studied with simple paradigms that do not take the variety of natural speech perception situations into consideration. Speech processing in everyday situations becomes more difficult if, for example, the auditory quality of speech is poor, there are other distracting voices in the listening environment or if the semantic context of the conversation is not clear. Nevertheless, humans possess an exceptional capability to selectively attend to a specific speech stream even in suboptimal listening conditions. In a recent functional magnetic resonance imaging (fMRI) study, participants followed audiovisual dialogues amongst distracting speech. The dialogues were presented in various experimental conditions including two different levels of semantic predictability. The results gave support to the novel notion that high-level semantic information has an impact already at lower levels of auditory processing. The aim of the present study was to examine whether support for this notion would be demonstrated using a method that has a better temporal resolution than fMRI. I examined the effects and interaction of semantic context and selective attention in the processing of naturalistic speech using the same stimuli as the recent fMRI study but collected neurophysiological data with electroencephalography (EEG) as it has a temporal resolution of milliseconds. Methods. Thirty adults selectively attended to audiovisual two-person dialogues with distracting speech in the background during EEG recordings. Half of the dialogues had a coherent narrative and the other half consisted of mixed lines from unrelated dialogues. The participants answered questions on dialogue content. In addition, the participants carried out a visual control task during which they were instructed to ignore all speech. I analyzed behavioral performance and event-related potentials (ERPs) timed to the beginning of dialogue lines in the two tasks. Results and conclusions. Based on the behavioral results, a coherent semantic context enhanced speech intelligibility. The ERP results suggested that semantic contextual coherence modulated the processes of auditory selective attention at around 180 ms after dialogue line onset. This attentional effect was significant only when the dialogues were attended to, and the semantic context was coherent. Furthermore, the beginnings of lines in incoherent dialogues elicited a P300 effect which could be linked to memory-related operations of contextual updating. Alternative interpretations are discussed. In conclusion, the present study provides both behavioral and neural evidence that semantic contextual information enhances the processes of auditory selective attention in compromised listening conditions. A coherent semantic context seems to facilitate the processing of contextually relevant information through semantic priming already at early stages of auditory attentional processing.

Objectives. The aim of this thesis was to obtain information about the development of pointing gesture use among typically developing Finnish speaking children, at the age of 1–3 years. Pointing gesture use was analysed every six months at 1;0, 1;6, 2;0, 2;6 and 3;0 years. The relation between children’s pointing gesture use and vocabulary development at the age 3 and 5 was explored. Relation between the use of pointing gestures and language development has been found in many international studies, but with regard to Finnish, there is only little research on pointing or use of gestural communication in play situations between children and parents. Methods. The data consisted of video recordings of five children and the results of language tests evaluating children’s vocabulary development. The video material was annotated with computer software ELAN. ELAN was used to mark the pointing gestures used by the children and the types of these pointing gestures (declarative/ imperative pointing). Childrens vocabulary development was assessed with Bo Ege test at the age of 3, and with the Boston Naming Test and Type/Token Ratios at the age of 5. Tables, graphs and calculation of percentages and means were used as statistical description of the phenomena. Non-parametric statistical tests were also used: The Friedman test to determine the distribution of pointing gestures used by children in different age points 1;0, 1;6, 2;0, 2;6 and 3;0, and Spearman’s Rank correlation coefficient to explore the re-lation of pointing gestures and vocabulary development. Results and conclusions. All children used pointing gestures, althought there were notable individual differences in the amount of pointings. The greatest increase in the quantity of pointings used was found between the age range 1;0–1;6 years. Children used most pointing gestures at the age of 1;6. All children used considerably more declarative than imperative pointings. The proportion of declarative pointings of the pointing gestures used, increased between the ages 1;0–1;6 and then remained constant until the age of 3;0. No significant correlations were found between pointing gesture use and vocabulary development. However, from this thesis, it appears that children with typical vocabulary development tend to use pointing gestures to a large extent, and of the pointings they use, the proportion of declarative pointing gestures is considerably higher than the imperative ones.

Background. Aphasia is a deficit of language and cognition caused by brain damage. Rehabilitation is based on reactivating and reorganizing the nervous system – or learning things anew. Learning is based on many factors, that would require more thorough examination to best allocate and plan rehabilitation. The impact of reaction speed on the ability to learn novel words has not yet been studied in aphasic patients, although inter- and intraindividual variability in their reaction times clearly exists. Some aphasic patients have also been associated with a behavioral pattern called speed-accuracy trade-off, a pattern where a person balances between acting fast or accurately. This has led to overly cautious or overly hasty responding in some aphasic patients, which potentially could influence the learning ability. Objectives. The purpose of this study is to examine reaction times and response accuracy and their possible relationship in a novel word learning task in aphasic patients and healthy controls. Special interest is placed on the occurrence of speed-accuracy trade-offs, or overly cautious or fast responding related to response accuracy outcome. Additionally, it is being examined if intrapersonal variability in reaction times predicts novel word learning ability. Methods. The participants of this study consist of 10 aphasic patients in subacute stage and 21 healthy age-matched controls. This study was executed as a part of “Opi sanoja” research project, in which novel word learning ability was studied through a computer-based word learning task. The purpose of the task was to learn six pseudo-words associated with a picture. The pictures were shown in pairs, of which the examinee was told to choose the right one according to seen and heard pseudo-word and earlier received feedback. Reaction speed was measured by reaction times recorded by the word learning task. Reaction times were compared with response accuracy in and between the study groups. Results and conclusions. Aligned with previous studies, aphasic patients learned novel words worse than the controls, although great interindividual variability was noted. The reaction times of aphasic patients were significantly slower, but again interindividual variability was large in the group. Reaction speed correlated with novel word learning in the control group, but not significantly in the aphasic group. Intraindividual reaction time variability was notable in both groups, being twice as large in the aphasic group. Broader intraindividual variability correlated with weaker novel word learning ability in the control group. The speed-accuracy trade-off pattern occurred in two aphasic patients: one with overly cautious and one with overly hasty response behavior. According to this study, examining reaction times and possibly speed-accuracy trade-offs with, for example, a specific learning test would help to recognize the patients with maladaptive timing patterns. This would benefit the patient, as optimizing the speed-accuracy trade-offs has been studied to improve item naming, the effect even being transferred to connected speech. The relationship of speed-accuracy trade-offs with novel word learning requires further studying, taking into consideration factors behind reaction times and word learning ability.

Aims. Long-term rehabilitation of post-traumatic brain injury can be stressful for rehabilitators and is often costly for society. There is a great need for new rehabilitation practices, that are both multimodal and motivating. Dance rehabilitation can be a considerable form of rehabilitation for those with severe brain injury because it can potentially rehabilitate several dimensions simultaneously. There are a variety of changes in the communication skills of people with severe brain injuries that affect an individual’s inner circle and everyday functioning. Identifying these changes is paramount in planning and targeting rehabilitation. Because post-traumatic brain injury is typically associated with incomplete symptom awareness, the assessment of the rehabilitative close others plays an important role. The purpose of this study was to investigate the effect of dance rehabilitation on the communication of adults with severe brain injury. Although dance has been researched and utilized in neurological rehabilitation to some extent, no research has been conducted on the effect of dance rehabilitation on the communication skills of a person with traumatic brain injury. Methods. The study included 10 adults aged 19 to 45 years with severe brain injuries. Rehabilitators participated in a dance rehabilitation intervention for 2 hours per week for 3 months. In addition, 10 well-known people close to the rehabilitator participated in the study. Subjects (N = 20) assessed the rehabilitator’s communication skills using the La Trobe Communication Questionnaire at the beginning and end of the dance rehabilitation intervention. Responses from rehabilitators and their close others were examined in five different content areas of communication. Analyzes of the research data were performed by statement groups by calculating the mean variables at the beginning and end of the intervention using statistical methods. In addition, the evaluations of the rehabilitator and the close other were compared. Results and conclusions. In this study, there was no statistically significant change in the estimates of rehabilitators and their close others at the beginning and end of the intervention. There was also no statistically significant difference in the assessments of the rehabilitators and their close others. Communication skills of people with brain injuries have not been previously studied in the context of a dance rehabilitation intervention. Further research is needed on both the rehabilitation of communication skills for severe brain injury and the effectiveness of dance rehabilitation.

Aims. There are many individual, hereditary and environmental factors affecting children’s language development. However, there are relatively few studies studying background factors related to preschool-aged Finnish children’s language development. The aim of this study is to study the possible effect of background factors to language development of preschool-aged children. Background factors included to this study are gender, familial risk of dyslexia and education of parents. Methods. The data is part of the LEINIKKI study data. The participants (n = 50) were healthy, Finnish-speaking children aged 3;2–4;0. Participants were evaluated with LEINIKKI method, Reynell Developmental Language Scales and LUKIVA method’s subtest for familial dyslexia. Group differences were analyzed for each of the background factors by descriptive statics and Mann-Whitney test. Finally, all the variables were analyzed together with a linear regression model. Results and conclusions. Gender was statistically significantly correlating with language skills. Preschool-aged boys had weaker overall language skills and receptive language skills. In this study, risk for familiar dyslexia or parents’ education wasn’t affecting the language skills of the child. The explanatory power of the linear regression model was weak suggesting that there are also many other additional variables affecting the language development of the children in this age. The results of this study suggest that boys’ language development should be paid attention to. In this study, familial risk for dyslexia didn’t affect to chldren’s language skills. It seems that in Finland, education of parents isn’t as strongly correlated to preschool-aged healthy children’s language development as reported in international research. In addition to the background factors studied in this study, there seems to be also many other background factors that affect children’s language development in preschool age. Further studies on these background factors are needed to gain deeper understanding of children’s language development in preschool age.

Objectives The present study is a Finnish survey of literacy skills and literacy teaching of children and young pupils studying by the activity areas. Teaching by the activity areas is part of special support. Severely disabled pupils and pupils with severe chronic illnesses usually attend area-of-activity teaching as they are unable to follow the subject-specific curriculum. Literacy is an essential skill in everyday life which is why learning of literacy is also justified for students studying by the activity areas. Reading is a complex process that requires mastery of various skills. Previous studies show that the development of literacy in people with disabilities broadly resembles the development of literacy in typically developed peers. However, poor cognitive skills of people with disabilities usually make the process of learning to read more difficult and time consuming. Hence development of literacy skills in people with disabilities requires time, multiple repetitions as well as regular and systematic practice of reading. The aim of the study was to survey whether literacy is taught to pupils studying by the activity areas, what level of literacy skills are usually achieved by these pupils and what teaching methods and materials are used to teach literacy for pupils studying by the activity areas. Methods The study was conducted as part of the INTO project (inclusion and area-specific curriculum) carried out by the universities of Helsinki and Jyväskylä. INTO project studies teaching by the activity areas in Finland. The present study was an interview study. Research material collected and analyzed in the study consisted of interviews of 85 teachers teaching pupils studying by the activity areas. Alltogether 406 pupils were taught by the teachers interviewed in the study. One interview question focused on teaching pupils studying by the activity areas to read. From the conducted interviews, I collected and analyzed all the mentions of and references to reading. Results and Conclusions About half of the pupils studying by the activity areas got reading lessons. Wether pupil had reading lessons depended largely on the pupil's general abilities. For most pupils literacy skills remained on the pre-reading level. A small proportion of pupils had learned to read on word- or sentence-level. Ability to learn to read on sentence-level may suggest that it might be possible, at least in part, to organize the teaching of these pupils according to the subject-specific curriculum. The teachers interviewed in the study mentioned various different methods and materials that they use to teach pupils to read and emphasized experimental approach to teach reading. Analytical and synthetic methods were both commonly used when teaching pupils to read. Further research in litteracy skills and litteracy teaching of children and young pupils studying by activity areas is needed.

Tavoitteet. Tutkimuksen tavoite on selvittää, millaisia toisen puheeseen kohdistuvia korjausaloitteita 4-vuotiaat suomenkieliset lapset tyypillisesti tekevät. Huomion kohteena ovat vuorovaikutuksen ongelmat, joita korjausaloitteilla pyritään ratkomaan sekä lasten käyttämät korjausaloitetyypit. Menetelmät. Tutkittavana on 10 normaalisti kehittyvää suomenkielistä 3;11–4;1 lasta. Jokaista lasta on kuvattu leikkimässä noin tunnin verran oman vanhempansa kanssa. Korjausaloitteita analysoidaan keskustelunanalyysin keinoin videonauhalta. Analyysin pohjana on suomenkielisessä tutkimuksessa vakiintunut tapa jaotella korjausaloitetyyppejä. Tulokset ja pohdinta. Aineistossa esiintyy korjausaloite-esiintymiä melko vähän. Lasten käyttämät korjausaloitetyypit ovat vahvasti sidoksissa ratkottaviin vuorovaikutuksen ongelmiin. Lapset käyttävät korjausaloitetyypeistä useimmin ymmärrysehdokkaita, joiden avulla ratkotaan kolmea neljästä eri ongelmatyypistä. Ratkottavat ongelmatyypit ovat kuulemisen tai epätarkan kuulemisen ongelmat, viittaussuhteisiin liittyvät ongelmat sekä muut ongelmat. Korjausaloitteiden huomattavan pieni määrä poikkeaa aiemmista tutkimuksista. Osin samoja lapsia on tutkittu 3;6 vuoden iässä, jolloin lapset tekivät enemmän korjausaloitteita.