Browsing by discipline "Logopedia"

Goals. Specific language impairment (SLI) has a negative impact on child's speech and language development and interaction. Disorder may be associated with a wide range of comorbid problems. In clinical speech therapy it is important to see the child as a whole so that the rehabilitation can be targeted properly. The aim of this study was to describe the linguistic-cognitive and comorbid symptoms of children with SLI at the age of five, as well as to provide an overview of the developmental disorders in the families. The study is part of a larger research project, which will examine paths of development and quality of life of children with SLI as young adults. Methods. The data consisted of patient documents of 100 5-year old children, who were examined in Lastenlinna mainly at 1998. Majority of the subjects were boys, and children's primary diagnosis was either F80.1 or F80.2, which was most common, or both. The diagnosis and the information about the linguistic-cognitive status and comorbid symptoms were collected from reports of medical doctors and experts of other fields, as well as mentions related to familiality. Linguistic-cognitive symptoms were divided into subclasses of speech motor functions, prosessing of language, comprehension of language and use of language. Comorbid symptoms were divided into subclasses of interaction, activity and attention, emotional and behavior problems and neurologic problems. Statistical analyses were based mainly on Pearson's Chi Square test. Results and conclusions. Problems in language processing and speech motor functions were most common of the linguistic-cognitive symptoms. Most of the children had symptoms from two or three symptom classes, and it seemed that girls had more symptoms than boys. Usually children did not have any comorbid symptoms, or had them from one or three symptom classes. Of the comorbid symptoms the most prevalent ones were problems in activity and attention and neurological symptoms, which consisted mostly of motoric and visuomotoric symptoms. The most common of the comorbid diagnoses was F82, specific developmental disorder of motor function. According to literature children with SLI may have problems in mental health, but the results of this study did not confirm that. Children with diagnosis F80.2 had more linguistic-cognitive and comorbid symptoms than children with diagnosis F80.1. The cluster analyses based on all the symptoms revealed four subgroups of the subjects. Of the subjects 85 percent had a positive family history of developmental disorders, and the most prevalent problem in the families was delayed speech development. This study outlined the symptom profile of children with SLI and laid a foundation for the future longitudinal study. The results suggested that there are differences between linguistic-cognitive symptoms of boys and girls, which is important to notice especially when assessing and diagnosing children with SLI.

Aim: An undiagnosed language learning disability, such as SLI (specific language impairment), may play a role in an adult immigrant's learning problems. There is no previous research in Finland on referrals to assessment or the assessment process of adult immigrants based on symptoms of SLI. The purpose of this study was to find out how SLI symptoms are recognized in adult immigrants, how are referrals for assessment being made and what kind of specific issues are related to these assessments. Methods: The methods in this study are a short email survey and semi-structured interviews. The survey and the interviews were carried out between March 2016 and Ferbruary 2017. The survey area covered the whole country, but all but one of the interviews were carried out in three regions of Southern Finland. The research material consists of the email responses from 27 health care professionals and one teacher as well as the interviews of two L2 teachers, two adult immigrants, two SLTs and one neurologist. The material was analyzed with theory-bound content analysis. Results and conclusions: The results show that adult immigrants are rarely referred to assessment based on symptoms of SLI. There is no uniform practice in referring adult immigrants to an SLP. Health care professionals see diagnosing an SLI in adult immigrants as problematic, since a person's learning abilities may be affected by a number of other background factors besides an SLI. L2 teachers have a crucial role in recognizing verbal learning disabilities in adult immigrants as well as in referring them to assessment. Special knowledge gained on learning disabilities helps them in recognizing verbal learning disabilities. However, recognizing the problem and referring a person to assessment may be delayed due to lack of background information, lack of information about assessment opportunities and immigrants not being open about their learning difficulties. The composition of the team involved in the assessment process may vary, and there is no harmonised assessing protocol to follow. The use of assessment methods is largely based on the clinicians' own clinical experience. A clinical interview is an important assessment method. An interpreter also plays a vital role in the assessment, but the use of an interpreter involves challenges of its own.

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

Alzheimer’s disease is the most common type of dementia in Finland. Very early on, it can impair the linguistic and cognitive abilities. Dysgraphia, the disorder in writing, is a common symptom in Alzheimer’s disease. There has been little research on dysgraphia and texts written by people suffering from dementia in Finland, and presumably no research has been done previously regarding the cohesion of written texts. The aim of this study is to examine, if the number of cohesive devices, the linguistic devices creating cohesion, changes in the diary entries written by a person with Alzheimer’s disease as the disease progresses, and if it is possible to see the outset of the possible changes. The data of this study were the diaries written by a person with Alzheimer’s disease during the years 1967–2012. The diary entries written in June 1986, 1991, 1996, 2001, 2006, 2008, 2010 and 2012 were selected for the analysis. The number of grammatical and lexical cohesive devices as well as the number of exophoric pronouns or the pronouns referring to the extralinguistic situation in the diary entries was counted. The IBM SPSS Statistics 24 program was used for the quantitative analysis of the data. A scatter diagram of the number of the cohesive devices was created, and a line of best fit was added to the diagram in order to demonstrate the temporal changes. The correlation between the number of cohesive devices and years was measured with Spearman’s rho or Spearman’s rank correlation coefficient. The study showed that the number of all grammatical cohesive devices, exophora, anaphora or the expression that depends upon an antecedent expression and reiteration seemed to have increased as time passed by. The number of all lexical cohesive devices, collocation or the semantically related words and ellipsis or the omission of words seemed to have decreased. The results were not statistically significant. The changes seemed to have begun year 2001, but the result was inaccurate, because the data varied considerably. The writing style of the person with Alzheimer’s disease resembled note taking, which influenced the occurrence of cohesive devices. Examining the spontaneously written texts by people with dementia provides more knowledge of the effects of dementia on the linguistic abilities and the possibility to develop diagnostic tools for the speech-language pathologists.

Objectives. The ability to detect and to resolve disturbances of interaction is an important conversational skill. In the field of conversation analytic research, the practices of repairing troubles of speaking, hearing and understanding are known as repair sequences. Individuals with Alzheimer's disease have growing difficulties to recognize their own linguistic deficiencies and to understand the interactional intensions of others. As the disease progresses, the repair initiations made by the demented individuals decrease, and their healthy conversation partners are given a central role in maintaining mutual understanding. Using conversation analytic approach, this qualitative research describes repair sequences caused by different kinds of conversational trouble sources in institutional group conversations between individuals with middle to late-stage Alzheimer's disease and their healthy conversation partners. Methods. The database of the study consisted of videotaped meetings of a conversation group held by speech and language pathology students in a day care center for demented people. Two individuals with middle to late-stage Alzheimer's disease and 15 healthy conversation partners took part in the study. Four group meetings from both demented individuals were chosen for the analysis. The conversation sessions were transcribed using conversation analytic conventions. Repair initiators and the attempts to repair following them were used to identify the repair sequences caused by the troubles of speaking of the individuals with Alzheimer's disease. Every repair sequence was then analysed according to the type of the trouble source and the progression of the repair. Results and conclusions. Three main trouble source categories were recognised from the conversations. The most common trouble type resulting in repair was problems of the content of the language while problems of the form and the use of language were less prominent. The lexico-semantic troubles of the content of the language, such as word finding problems, were dealt with collaborative but often ineffective repair efforts. Repair sequences dealing with troubles of the form of the language (e.g. phonological paraphasias and morpho-syntactic distortions) were quick and successful self-initiated self-repairs, whereas the responsibility of clarifying wider troubles with language use was left solely to the healthy conversation partners. The results of this study emphasise healthy conversation partners' active role in maintaining mutual understanding while conversing with individuals with Alzheimer's disease.

The Objective. According to many studies, social isolation, decreased quality of life and psychosocial problems such as depression are some of the most difficult consequences of aphasia. The aim of this study was to explore the amount and the quality of aphasic peoples' social participation. The questions of the study were how much and what kind of social events did the participants have and also how happy they were with the quality of the participation. In addition, one aim of this study was to find out what kind of thoughts did the participants have about the impact of aphasia on their social life. The further goal was to survey the importance of aphasia groups. Data and Methods. Four chronically aphasic people were included in the study. They all took part in an aphasia group in an adult education center. The participants kept a diary for two weeks, marked all of their social occasions and gave a satisfaction-score for each of them. Later the participants took part in a semi-structured interview where their views and experiences on social life were examined. In addition, the participants filled the Communication Activity Log to evaluate the amount and the quality of their daily communication Results. The participants participated in different social events every day despite of the severity of the aphasia. The quality of the communication did not seem to have effect on the amount of the communication. The satisfaction in social events was reasonably high with only a few exceptions. Overall, the participants thought that they had succeed to adapt to live with aphasia. Despite the difficulties in communication, they felt that they could participate in social life although they had some limitations. They all avoided occasions with a lot of people because they felt that it was difficult to participate in conversations. All of the participants took regularly part in activities that were targeted for aphasic people because they felt that such occasions were easy to participate in. All of the participants had lost friends after the stroke, and hoped they could participate more in social occasions. Severe solitude or social isolation wasn't, however reported. All of the participants had regular contact with the people that were important for them. The participants felt that the general knowledge about aphasia was quite low, which made it more difficult to communicate with strangers. It was easier to communicate with familiar people, but even the closest family members didn't always understand the consequences of aphasia.

Aim. Approximately 50-60 children are born with severe to profound hearing impairment in Finland every year. Speech therapy for hearing impaired (HI) children consists of many different methods depending on the child's and his/hers family's individual needs. The main emphasis in HI children's speech therapy in Finland is in the auditory-verbal method. There is only a little information to be found in the literature about the contents of speech therapy for HI children (who use cochlear implants (CI) or hearing aids (HA)). The aim of this study was to find out how much Finnish speech and language therapists (SLTs) have experience about the rehabilitation of HI children. In addition the goal was to find out what components are used in HI children's speech therapy and what role does the children's parents have in their child's linguistic rehabilitation. Method. This study was carried out as a survey. An electronic questionnaire was send via the Finnish Association of Speech Therapists to 1154 SLTs in Finland. A total of 85 responses were received so the response rate was 7.4 %. The data was analyzed using IBM SPSS Statistics 22 -program. Frequencies, percentages and descriptive statistical analysis were computed (for example average and standard deviation). The data was demonstrated graphically. Rank correlation of ordinal variables was measured using Spearman's rho (ρ), Kendall's tau-c (τ) and Goodman and Kruskal's gamma (γ) rank correlations. Results and conclusions. The results show that Finnish SLTs have only little experience about the rehabilitations of HI children. The most common components in HI children's speech therapy were supporting and guiding children's early vocalizations, auditory training and training of vocabulary. The contents of CI- and HA- children's speech therapy seems to be very similar. The most common approach used in speech and language therapy was auditory-verbal method but total communication and pictures were commonly used as well. The results show that parent's role in HI children's rehabilitations varied quite a lot. It was quite common that parents were not present during their child's speech therapy and the SLTs reported that they would ask separately if they wanted the parents to be present in some speech therapy session. However the results show that most of the SLTs and parents were equal partners in HI children's linguistic rehabilitation. More research is needed to discover factors that influence the contents of HI children's speech therapy and the parent's role in their child's linguistic rehabilitation.

Aims and Objectives. Devices for treating stuttering have become more common in the last decades. One of these is an anti-stuttering device based on Altered Auditory Feedback (AAF). The auditory feedback of speech can be altered so that the speaker hears their voice either with a delay (DAF, Delayed Auditory Feedback) from a different frequence (FAF, Frequency Altered Feedback) or utilizing both of these settings simultaneously. The Hospital Districts of Helsinki and Uusimaa (HUS) Foniatrics Unit launched an anti-stuttering device trial in 2008. The aim of this study is to provide information on that anti-stuttering device trial, the use of the device and the effects it has on speech. The aim is to discover the occasions when the device can be useful, on what occasions it cannot be used, and what kind of issues the use has caused. There is no former Finnish study on the use of anti-stuttering devices, but internationally the topic has been widely researched. Methods. The research method in this thesis was a survey sent by post. The survey was sent to patients who had participated in the anti-stuttering device trial, and it included two different forms, A and B. Form A was for patients who were still using the device and form B for those who had either returned the device or were not using it. The forms comprise of both open and closed questions. The responses to the open questions were analysed qualitatively by categorizing and sorting into themes, and then coding them to the same data along with the closed question responses. The quantitative analysis of the final data was made with an SPSS-program by calculating frequencies and relative frequencies and by cross-tabulating the dependencies between the variables. Results and conclusions. The results showed that the experiences of the trial participants varied greatly. A majority of the respondents had returned the device, yet almost half of all those who answered the survey had found the device useful. The most common finding was that the anti-stuttering device cannot be utilized in background noise. There had also been technical difficulties with the devices, concerning the settings and battery life. Those who answered form A, i.e. device-users, found it useful on singular occasions, e.g. while speaking on the phone or face to face with another person, or in all communication situations in general. Majority of the respondents had received positive feedback on their speech while using the anti-stuttering device. The most frequent feedback was that the speech of the stutterer was slower and clearer. All those who had received positive feedback would have recommended the anti-stuttering device to stutterers. Opinions on the use of the device are mixed, but based on individual positive experiences testing the device can be recommended when deciding on rehabilitation and therapy methods.

The aim of the study. A need to involve customers in decision making, planning, implementation and evaluating quality regarding their services has been identified in health care since 1990s'. According to ecological theories, communication should be rehabilitated by impacting both the communication disabled person and his/her communication partners and environments. For communication interventions, ICF classification offers a framework that emphasizes individual's functioning and participation. In speech therapy, community –based rehabilitation has become a common working method beside and even ahead direct ways of working with a customer. Community –based approach means collaborating with communication partners to enable development of communication. Parents have taken part in their children's speech therapy, but up until the beginning of the millennium their perceptions about the received services had not been explored. The effectiveness of speech therapy can be studied from different perspectives with qualitative and quantitative measures. The aim of this study was to explore parental views and experiences of the impact of the speech therapy their child has received on daily communication and interaction. Method. Data was collected by a questionnaire. Questionnaire was sent to those parents of medical and therapy clinic Contextia's speech therapy customers, whose child had received speech therapy for at least six months. 25 respondents filled in the questionnaire. Data was analyzed by using key statistic figures and cross tabulation plus qualitatively classifying the answers of open questions. Results and conclusions. The impact of the received speech therapy was considered significant relative to development of child's communication skills and parents were satisfied with the guidance received. The role of spontaneous development was viewed minor and the role of therapy major. Cross-tabulation did not reveal dependency between the perceived impact and potential explanatory variables, since the perceived impact was large and variation was minor. Practicing linguistic skills was considered the most significant content area of speech therapy. Practicing with computer or mobile applications was considered least efficient relative to daily communication. Utilizing their use in practicing has also been guided least to parents and kindergarten/school personnel. Respondents perceived kindergarten's/school's role more significant than family's role in supporting rehabilitation. The result challenges professionals and decision makers to consider how to ensure families' commitment and support to the goals and the implementation of therapy.

Background and aims. The most common and persistent symptom of aphasia is word retrieval deficit, anomia. There is evidence of selective verb retrieval problems amongst non-fluent aphasic speakers. Training verbs in sentence context increases verb naming accuracy in naming tests and enhances verb usage and the use of well-formed syntactic structures in connected speech. Especially intensive interventions in which training takes place in communicative contexts may be beneficial. The aim of this study was to investigate whether a sentence-level verb intervention affects verb naming and the structures and vocabulary of the connected speech of Finnish non-fluent aphasic speakers. Methods. Two speakers with chronic Broca's aphasia participated in this study. Markku, a 35-year-old man, and Annikki, a 72-year-old woman, had both become aphasic due to a single stroke in the left hemisphere. The intervention programme lasted 6–7 weeks and consisted of 15 training sessions of 90 minutes (a total of 22,5 hours). In six different speech production tasks the participants were trained to place obligatory and optional sentence elements around a verb. The target was to promote verb usage in narratives. The effects of the intervention were evaluated by examining verb naming accuracy and speed in a naming test, by calculating the mean length of utterances and the proportion of empty speech in connected speech, and analysing the syntax and the vocabulary of narratives. Results. Markku's aphasia quotient (WAB) increased by 20 points after the intervention as his speech became more fluent and informative. There were no changes in Annikki's aphasia quotient. The intervention had no effect on verb naming in a verb naming test. Both participants produced longer narratives after the intervention, but at the same time the proportion of empty speech increased in Annikki's speech. The mean lengths of utterances didn't change after the intervention. The proportion of utterances including a finite verb increased slightly in Markku's narratives. Simultaneously, the proportion of clauses with an incomplete verb phrase or no verb phrase decreased slightly. The intervention had no effect on syntactic structures in Annikki's case. The number of different verbs increased in both participants' picture description narratives, although the change was much smaller in Annikki's case. There was some evidence in Markku's case that the intervention had a small effect on the vocabulary of personal narratives and descriptions of event sequences. Discussion. The results of this study provide preliminary support for the usefulness of sentence-level verb interventions in aphasia rehabilitation in Finland. The results indicate that this intervention can have a positive effect on the number of different verbs and the number of finite verbs used in non-fluent narratives. However, the response to the intervention seems to be highly individual. The next step would be to examine the efficacy of the intervention method in a larger scale study. The intervention could be modified by increasing the intensity of training and increasing the amount of training without picture support. The intervention method is applicable in the clinical world. In addition, an aphasic speaker and their significant other can train at home using the intervention tasks, so that possible intervention results could be better maintained after the intervention is withdrawn.