Browsing by discipline "Logopedia"

Aphasia is often a chronic impairment. Regaining the premorbid language function is rare. Anomia is the most common residual disorder once the aphasia has stabilized. Earlier studies indicate that transcranial magnetic stimulation (rTMS, repetitive Transcranial Magnetic Stimulation) together with intensive speech therapy improves the outcome of the language rehabilitation. The aim of the current study was to find out what kinds of quantitative and qualitative changes occur in the participants' ability to name noun and verb pictures that were shown during the rTMS/sham-rTMS protocol. All of the participants received two weeks of either rTMS or sham-rTMS treatment and after a one-week break another two weeks of either rTMS or sham- rTMS treatment together with intensive group speech therapy (ILAT, Intensive Language Action Therapy). This is a multiple case study with six participants that have chronic expressive aphasia. The first two groups of a larger study were selected into this study. Group 1 (n=3) received 1Hz- rTMS therapy and group 2 (n=3) received sham-rTMS. rTMS was given to the right hemisphere on the pars triangularis area. Every participant named the same amount of action and object pictures during the rTMS/sham-rTMS treatment. Namings were analysed with a rating system derived for the current study. Each participant received intensive group speech therapy in the latter two-week part of the intervention. Language testing was conducted before, during and three months after the intervention. The naming abilities in all participants seemed to improve in both noun and verb series during the rTMS/sham-rTMS treatment and language tests. Results of the follow-up testing suggest that the positive results are long lasting. The results of this study are promising, even though the amount of participants is too small to draw further conclusions. This study brings positive evidence and reason for further research on the effectiveness of aphasia therapy.

Goals. Event schema, also known as a script, contains information about a structure of a particular event; about the sequences of events and their temporal order. With the information the scripts contain, one can anticipate and plan for future events and actions. People with traumatic brain injury (TBI) can have difficulties in the verbal planning of actions. Previous international research has shown that the scripts produced by people with TBI contain fewer actions central to the schema, than scripts produced by healthy control subjects. The aim of this study is to examine what kind of scripts Finnish speaking subjects with TBI and their healthy control subject counterparts generate in a script generation task consisting of eight scripts. This study also examines whether the script type has influence on the features of the generated scripts. Methods. Fifteen subjects with TBI and fifteen healthy control subjects participated in the study. The researcher collected the research material during the spring and summer 2015. The research material consisted of the scripts generated by the subjects and control subjects, as well as the results of the control tasks (Boston Naming Test, Rapid Automatized Naming Test, semantic and phonemic fluencies). The subjects were asked to generate event schemas for eight everyday tasks belonging to four schema categories. The categories were 'open high frequency' (go shopping, go for a walk), 'open low frequency' (apply for a job, go on a vacation), 'closed high frequency' (make coffee, brush teeth), and 'closed low frequency' (go to a doctor, go to a restaurant). Closed scripts are related to events where the actions involved in their execution are well established and tightly related to each other. Open scripts are less structured and have loose connections between the actions involved. High and low frequency scripts differ on how frequent the event is. Time given for generating each script was 60 seconds. The scripts were scored for the total number of events produced, the number of event repetitions, the informativeness of the script, and the meaningfulness and the centrality of the events. The results of the qualitative analysis were displayed in a statistical form and analyzed with the non-parametrical Mann-Whitney U -test. Results and conclusions. The results showed that the scripts produced by the subjects with TBI were less informative and contained less actions than the scripts produced by the healthy control subjects, regardless of the script type. Closed scripts were found to be more informative than open scripts, and the subjects produced more actions to the closed than to the open scripts. When the high and low frequency scripts generated by the subjects with TBI were examined, no significant difference was found between the two script types. The results of this study can be explained by the disturbances in executive functions, and disturbances in the working memory as well as the episodic memory, all of which can affect the subject's ability to produce a coherent story and recall actions belonging to a certain event.

Study aims: Parents' role has been emphasized in children's speech therapy in recent years. There has, however, been very little research done on parents' experiences of their children's speech therapy. By learning more about parents' perceptions of speech therapy it is possible to increase the acceptance of therapy, develop therapy practices and the training of professionals. This study concentrated on stuttering children's speech therapy because there is very little research done on the topic and the role of parents is especially important in the speech therapy of stuttering children. The aim of this study was to increase the knowledge of parents' experiences of stuttering children's speech therapy as a part of daily life. Methods: The method in this study was a semi-structured interview. Altogether eight interviews were done in which seven mothers and one mother-father pair was interviewed. All the stuttering children were boys, aged 7 to 17 years. The interviews were done during May-June 2014. Theory bound content analysis was used in the study. Results and conclusions: For the parents speech therapy and the cooperation with the speech therapist was mainly a positive experience. The biggest challenge was the lack of therapy resources. The parents had mainly been successful in combining family life and therapy although the hurry of everyday life in families with small children was evident. Supporting children's speech fluency was seen as challenging. Some of the advice received in supporting the child's speech fluency had been seen helpful for the parents while some others were questioned. The parents would have wanted more guidance from the speech therapist in supporting the child's speech fluency in everyday life. Acceptance and commitment therapy was seen as more helpful than speech therapy in helping the parents come to terms with their child's stuttering and in supporting the child's speech fluency. Parents saw the peer support as especially helpful. The child's age had a bearing on the parents' experiences of their own role, on how well family life could be combined with therapy and on which of the ways to support the child's speech fluency were seen as helpful. The lack of therapy resources and especially the regional differences in therapy resources was evident in this study. On the basis of this study it can be stated that the parents of stuttering children experience their role in speech therapy as an important one. The role of parents is also experienced as challenging due to the lack of therapy resources and the hurry of everyday life. There should be more emphasis in speech therapy on parental guidance and on considering the family's overall situation. The lack of therapy resources, however, makes increasing the parental guidance difficult. More research is needed on parents' experiences of their stuttering children's speech therapy in order to take the parents' perspective better in to consideration in speech therapy.

Objectives: 18 percent of Finnish children have some kind of articulation problems when starting their school path. Lack of speech therapists and unequal spread of these professionals has reduced possibility to receive speech therapy for mild problems. Instead resources are allocated for clients with severe speech and language disorders. In some municipalities parents and special education teachers are already responsible for the remediation of articulation problems. The aim of this study was to identify if Äännekoulu-website (www.aannekoulu.fi) can help to rehabilitate articulation problems and if the site will meet the needs of the parents struggling with their children' articulation problem. Methods: The study was qualitatively centred mixed method design that had also some quantitative elements. 21 children between the ages of 5 and 7 with /r/ articulation problem participated in this study. Children were tested three times. Children's spontaneous development of /r/ was controlled by having one month break after the first testing. After the second test families received the right to use Äännekoulu practice materials. Families were instructed to use the site for two months just as regular paying customers would do. Outcome of the intervention was observed during the third test. Families were also given a phone call after one and a half months of the last test to explore the possible changes in the /r/ articulation. In addition families were asked to keep a record of their home practices and answer in a survey concerning the Äännekoulu intervention period. Results and conclusions: Six families dropped out from the intervention. Five children found the right /r/ spontaneously. 12 families participated in the remediation period and one child found the missing /r/. Nine children had no changes in their articulation. From these nine children three continued their practice after the real intervention. During one month of practice two out of these three children found the /r/ completely and one learned to do long /r/-vibration. Families didn't practice a lot and they were unsatisfied with the amount of practice. According to the parents health issues within the family, burdensome family situations, lack of time, child's unwillingness to complete assignments, technical difficulties and laziness were the biggest barriers for practicing. Families considered Äännekoulu to be a good way to practice. Families were pleased about the nice games and the possibility to practise whenever and wherever since the exercises were available online. Unfortunately families trained impractically without knowing it and actually reinforced the incorrect articulation. Parents thought that the visual look of Äännekoulu should be revised and some of them also longed for more diverse games. Still the most crucial target for development in Äännekoulu is the instructions of the assignments. The model of the site hasn't been clear to the users even though families didn't consider the website to be confusing. It's clear that the the instructions have been insufficient since only one family realised how to progress accordingly. On the basis of this study it can be stated that speech therapist's guidance is significant when rehabilitating articulation problems. In the future it would be beneficial to explore, what kind of home instructions help families to execute their role in a best way possible, what is the role of a speech therapist in the future especially when considering telepractice or other technological services and can Äännekoulu fulfill the gap in the field of articulation remediation.

Aims: Embodied practices among people with aphasia remain relatively little known until now. The aim of this study was to describe free conversation interaction between a seriously aphasic speaker and his wife. This study aims to explore what kinds of nonverbal elements appear during the conversation of the aphasic person, and how the nonverbal elements arise in different conversational turns. The main focus of this study is on the substitutive and the complementary gestures of the speech. Earlier studies on aphasia interaction suggest that gestures are an important resource to construct meanings in turns of an aphasic speaker. Data and methods: This is a qualitative study where conversational analysis is used as a research method. Data consists of two videotaped recordings of the couples' free conversation at home settings. Results and conclusions: Several nonverbal elements, which had a significant influence for the conversation interaction of this couple, appeared in the data of this study. The wife interpreted aphasic person's nonverbal elements in the conversation as meaningful elements. The wife gave time and space for the aphasic person to participate in conversation. The aphasic speaker took advantage of the gestures in order to compensate speech loss. In fact, he almost completely relied on the substitutive and complementary gestures in conversation. He used the gestures in many ways and combined gestures skillfully to his limited verbal elements. A significant result in the study was that the aphasic speaker hardly showed any signs for verbal word search before expressing nonverbal elements. He started gesturing often seamlessly just before of his typical turn initiator verbal expressions yeah yes and yeah but or simultaneously with them. Aphasic person's expression were built fast and effortlessly despite the loss of speech. It can be said that aphasic person had adapted to his handicap caused by aphasia by taking advantage from gesturing.

Objective. The previous studies have focused mainly on deviant linguistic processing regarding dyslexia, while people's experiences and contextual factors have received less attention. This study gives voice to the dyslexic students who can tell about their own experiences about dyslexia. Additionally, the objective of this study is to examine what kind of difficulties the students face while studying and which strengths they have. This study can bring a new perspective and decrease prejudices towards dyslexia. Method. Focused interview was used as a method of this study. The interviews consisted of questions inspired by the previous literature. Eight students were interviewed, six of them were studying at the university and two of them were studying at the university of applied sciences. The interviews were recorded and transcribed. The transcriptions were analysed with qualitative content analysis. Results and conclusion. On the basis of the analysis the interviews included several positive aspects. Many of the participants told they were quite open about their own dyslexia. They were also used to observe their learning and they had found several useful ways to learn. Many of them used deep learning as their learning method. They had also coped several difficulties and they believed in themselves. Especially organizing big amount of information, learning foreign languages and organizing different studying was challenging for them. Several participants reported that their learning was quite slow. In this study dyslexia was a phenomenon, not only a limitation. All the students have their strengths and limitations, regardless if they have a dyslexia or not.

Aims. The purpose of this single-case study was to investigate the effects of intensive tablet-based treatment in overall language performance level and in reading and writing processes in mild aphasia. The communicative effectiveness and task performances on the tablet software were also studied. The tablet software included tasks where semantic, syntactic and phonological processing were required; written naming, sentence writing and reading comprehension. Previous studies have indicated improvements in language skills after computer-based treatment (Katz & Wertz, 1997; Wade, Mortley & Enderby, 2003). Especially reading and writing skills can be treated by the computer-based softwares (Katz, 2008). Methods & Procedures. In this single subject research the ABA design was used. The participant in this study was a 47 year old man who had a stroke 2.5 years earlier. He had a mild chronic aphasia with difficulties in writing, reading and naming. The data of this study was formed by linguistic tests and by a self-assessment method as the participant evaluated his communicative effectiveness (CETI). The methods used in the analysis of written and read narratives included assessing rate, authenticity and the types of errors. The analysis of written narratives also included assessing word classes and type-token –ratio. Based on the data by the tablet-based software the rate and the share of errors of task performances were assessed. Results & Conclusions. Based on the Western Aphasia Battery (WAB) results, the severity of the aphasia decreased but the change was not clinically significant. Naming improved but the change wasn't stable until the follow-up. The participant showed positive development in his written and reading production; he made less spelling and reading errors after the treatment. At the same time reading and writing processes became slower. The share of lexical verbs, adjectives, pronouns and numerals increased in written narratives. The communicative effectiveness improved. The task performance on the tablet software was faster during the fourth week compared to the first week. Also the amount of incorrect performances decreased or remained the same. Based on the results, an intensive self-monitored tablet-based language treatment was effective to the subject.

Objectives. Assessment of language development and differential diagnosis between typical bilingual language development and developmental language disorders in bilingual children is difficult due to lack of appropriate diagnostic tools and norms. Dynamic assessment has been proposed as a complementary method in which learning potential is assessed instead of current language skills. Graduated prompting as dynamic assessment method involves helping children with the tasks by presenting graduated prompts. The aim of the study was to add information about the dynamic assessment of language skills in preschool-age children acquiring Finnish as their second language and its applicability in the differential diagnosis. Methods. A dynamic assessment method was translated and adapted into Finnish and piloted with eight bilingual children aged between 4 to 6 years whose home language was not Finnish, Swedish or Sami language. Half of the children were typically developing bilinguals and half were bilinguals with diagnosed or suspected developmental language impairment. Children's language skills and learning of receptive and expressive vocabulary as well as sentence production were assessed. Test scores were analyzed quantitatively and compared between groups and matched pairs. The usefulness of the prompts was analyzed qualitatively. In addition, the usability and the suitability of the method for the assessment of bilingual children were examined. Results and conclusions. The typically developing children scored slightly higher in the dynamic measures of vocabulary. In the static pre- or post measures of vocabulary or in the measures of sentence production no such difference was found. The results of the vocabulary assessment were in line with previous studies stating dynamic assessment having potential as a differential diagnostic tool. Score differences were minor and the sample was small, thus the results cannot be generalized. The assessment method is short enough to be carried out in single assessment session but complicated to use and rate. The used tasks need be improved further. However, new dynamic assessment methods in Finnish can be developed based on the information gathered in the study.

Aim. In conversation mutual understanding is achieved through co-operation of each participant. Mutual understanding might be more at risk in conversation where one or more participants use augmentative and alternative communication (AAC). To be able to support people who use AAC and guide their communication partners, interventionists should understand how communication problems and challenges are being resolved in a natural conversation. The aim of this study is to describe how participants orient to problems in AAC conversation. Conversation partners' other-initiations of repair and the problems these initiations indicate are being studied. Method. The database consists of two videotaped conversations where one aided speaker, a 15-year-old boy with cerebral palsy, talks with a speech-language pathology student (conv 1) and with his speech-language pathologist (conv 2). The data was originally videotaped for speech therapy follow-up. Problems and how they were managed were studied using conversation analysis (CA) and one of its basic organizations, repair organization. CA enables detailed examination of natural interaction. Results and conclusions. Almost every other-initiation of repair fell upon the problems in aided speaker's turn and were initiated by conversation partners. These problems related broadly to speech understanding, more precisely to understandability of utterances. No problems of hearing were raised. Reasons underlying the trouble sources were most often conversation partner's difficulty in understanding the meaning of aided speaker's whole turn or part of a turn, extra words or other mistakes in selecting symbols, or vague reference. From all the conversation partners' other-initiations of repair interpretative means, candidate understandings, were used most often and the initiations of repair were at the same time pointing a problem and trying to resolve it. Interpretation seemed to be explicitly on display in both conversations. It was used to show understanding of AAC turn and to initiate repair. In order to be able to understand how to support AAC users' human agency and active participation in conversation, more research needs to be done on different conversations.

Target. There are currently few tools to evaluate young adults' linguistic abilities in the Finnish language. Previous studies have shown that nonword repetition, sentence repetition and grammaticality judgment are typically weak functions in language impairment in some languages. The aim of this study was to create a tool for evaluating grammaticality judgment and pilot that tool. The assessment tool developed here is based on Poll, Betz and Miller's (2010) study on identification of clinical markers of specific language impairment (SLI) in English-speaking adults. In addition, the studies of grammatical difficulties by Finnish-speaking children with specific language impairment were also considered when developing the new tool. Methods. Six young adults with the history of SLI and six young adults with typical language development, matched as closely as possible with the SLI persons, participated in this study. Participants were 19;2-20;8 years of age. This study started with creation of the new assessment tool. Data were then collected using the assessment tool. Altogether 108 sentences were created to evaluate grammaticality judgment. Out of these 50 sentences were translated from the study of English-speaking young adults, 48 sentences were created based on the studies of Finnish-speaking children having SLI and the remaining 10 sentences were training items. Participants listened to sentences and were asked to judge their grammaticality and by indicating whether the sentence was right or wrong. Data were analyzed mainly quantitatively due to the relatively small number of participants. Results and conclusions. The participants with SLI made more errors in this test than did their peers with typical language. However, the result was not found statistically significant. Participants with SLI also used more time running the test than their counterparts. SLI participants made most of the errors in sentences, which included accusative case or tense inflection. The results are similar to the study on English-speaking young adults. Therefore, examination on a larger test group is needed in the future.