Speech and Language Pathology - Science topic

Is it possible to publish the proposal? Which Journals accept proposal?

thaks for all for contrbutions.

And here are more titles:

and of course

There are so many other, just let me know if you need more. Good luck!

Christina

I thank you both for your useful recommendations 

Speech and language disorders may have a very different origin. In a nutshell, while language deficits are related to the brain and how language is processed (production and comprehension), speech deficits may be a consequence of disruptions in the phonatory system or in the brain, where they may stem from more general motor deficits, more "language related" factors (e.g. dysarthria vs. apraxia), or psychological causes. Given that speech disorders may mask the presence or absence of language disorders, it is important to have a proper characterization of both. The nature of the deficit will have crucial consequences for the therapeutic approach to be undertaken.

Depending on the deficit, speech disorders can influence the development of children in different ways depending on how much they alter communicative capacities. In cases of dysfluency or stuttering, for instance, the development of social and communication skills may be compromised. This may have an impact in the school results and learning processes (cascade effect) and cause social and psychological distress.

Hence, it is crucial to properly assess not only language but speech disorders so that they can be remediated/compensated for.

Awesome suggestions. I have also read.

Foster, A.M., Worrall, L.E., Rose, M.L., & O'Halloran, R. (2013). Turning the tide: Putting acute aphasia management back on the agenda through evidence -based practice. Aphasiology, 27,(4), 420-443.

Glad to see I'm not the only one interested in this conversation.

Formant values allow vowel identification, but listeners most probably use the relative (not absolute) values of the first two formants. For instance, the neutral schwa vowel has a F2 equal to 3*F1. The absolute values for adult males are approx. 500 and 1500Hz, depending on the size of the vocal tract. For other speakers (female speakers, children...) the absolute values change, but their relative position of the frequency axis (F2=3*F1) is the important index. This "analysis strategy" could be seen as one of the elements in the process of speaker normalization.

Formant bandwith is proportional to the degree of nasal resonance, so this can also help to identify vowels in languages where nasal resonance is a distinctive vowel feature. Furthermore, loudness ("sonority") can be an index in that open vowels (such as [a:]) typically have more sound energy than closed vowels (such as [i']). 

Instruments that assess quality of life allow the measurement of the individual's perception about effect of an illness on their personal, social and professional relations .Somtimes a sigle tool like V-RQOL  many not be sufficient to assess the impact specific illnessess as  it is has been observed V-RQOL  has  lot  of significace in the assessment of patients following thyroplasty for unilateral vocal cord paralysis but not significant  in assessment alayngeal population So multiparameters like V-RQOL, VHI, VAPP can be used  for individuals with different vocal problems

Hi Brooke, I am a post graduate student at La Trobe University, Australia, and will be studying this area over the next few years. I am also a clinician with experience in adult rehabilitation. Please find attached a recent publication that found currently Australian speech -language pathologists largely feel underskilled and uncomfortable with counselling people with post stroke aphasia. However they describe to use a range of counselling approaches in their therapy in this group. Your questions of what counselling training is available to speech pathologists and what (training) does make for effective counselling in adult neurogenic clients (I my case people with post stroke aphasia) are questions I have begun to investigate.

I have read Dr Luterman's work and he sounds an inspiring gentleman!

I hope this helps?

Regards

Jas

Hi Mateja, our facility uses the LSVT - while you can do it twice a week (LSVT-X) for eight weeks, we have found it easier to do the 4 week program (less homework, shorter blocks!), and it sounds like that would work well for you. We have also used the LSVT with suitable patients with stroke and Friedreich's Ataxia. Our maintenance program post-LSVT is under development - details are available open access http://espace.library.uq.edu.au/view/UQ:345399 and we're progressing the work further in a current study. One last word - don't forget language in this group. Nick Miller has done some beautiful work describing the communication impairment in PD. Kind regards

I have a blog with over 100 evidence-based practice reviews of prosody interventions. Half are for children.  The address is clinical prosody.wordpress.com

Hi Barbara,

Have you read their follow-up paper? I believe it gives you the information you are looking for.

Ariel

Hello, I don't think learning to use an AAC device as an adult following surgery or a stroke for instance is like learning a second language. The device is just a means of access to the language the person has already learnt.

We find that if a child can be understood with poor speech and gestures etc this does undermine the use of AAC devices. Children need to feel  it is worth the extra effort and also have communicative partners to model the device (group work with other AAC users).

The most common fluency disorders are stuttering and cluttering. Cluttering is also described as a language disorder. Cluttering is usually not accompanied by fright or fear, or identification of problems with specific words or sounds. A person who clutters does not perceive the speech as deviant.

I have recently published two studies on this subject in Spine. We identified some patients with dysphagia before surgery but average levels of dysphagia before surgery were low. Most patients experienced dysphagia first weeks after surgery but one year after surgery, the levels were back to baseline. For further information and more detailed data, please read or download the articles. You can find them on my profile.

Hi Venessa,

I am an SLP but do not work in the area of child speech. I can provide some basic info, and maybe others with more experience specific to this area can clarify (or correct me) as needed.

What an SLP is interested in will depend on the context. Why is the assessment being done? Is this a screening, does a parent have a particular concern, something else? Are there any other developmental concerns besides speech? SLPs' scope of practice is quite broad and includes language, cognition, and swallowing as well as speech, so the nature of the assessment really depends on the concerns raised and how the child presents. There is, of course, a big difference between a 3-year-old child who can't produce an "r" sound and a child who is not saying anything.

Assuming the concern *seems* limited to speech -- e.g., a lisp, or perhaps a child with low intelligibility for his/her age -- an SLP would be interested in the following:

- assessing which speech sounds a child can articulate (perhaps using the Goldman Fristoe Test of Articulation, GFTA-2)

- checking the structure and function of the oromotor mechanism (e.g., checking whether the child has a submucosal cleft palate)

- performing a hearing screen or referring to Audiology for a hearing eval

- gathering a functional speech language sample by engaging the child in play or conversation for several minutes

- inquiring about the home, school, and other environments where the child spends a lot of time (e.g., is English the child's primary language?)

If the child is not producing a particular speech sound or sounds, we wonder whether this is solely a speech problem (i.e., the child knows what sound he wants to produce but is having difficulty producing it) or is in fact an issue of phonology (i.e., language). See here for some basics about this distinction: http://www.asha.org/public/speech/disorders/speechsounddisorders/

A more thorough evaluation would include assessing receptive vocabulary (e.g., Peabody Picture Vocabulary Test, PPVT), expressive vocabulary (e.g., Expressive Vocabulary Test, EVT), and evaluation of a broader range of language skills (e.g., CELF Preschool). The SLP might also ask a parent/caregiver to complete a checklist documenting which words a child produces and/or understands in functional contexts. If there are concerns about cognition or more global development, an SLP would want to be mindful of whether the child is exhibiting appropriate social/pragmatic skills, and might evaluate play.

Finally, since communication is so dependent on culture and context, an SLP wants to be mindful of whether the child has had exposure to a rich language environment. If you want more info about some of these concerns, try googling "dynamic assessment" and "dynamic assessment asha."

Hope this helps.

Lauryn

Thank you!

During the one year I worked in pediatric speech pathology, we used Sequenced Inventory of Communication Development to assess children in that age. Hawaii Early Learning Profiles are also useful. For intervention, I'm a fan of Stanley Greenspan's Floortime and DIR model approach. It uses mirroring and looking at waht pre-communicative stage an infant is at. It can be used by parents as well as professionals. I haven't work with children since 2005 so there may be new approaches.

There is a definite problem with local dialects in Spain which apparently has no parallel in Greece. Dialects which have generated a rich literature (like Galician in Western Spain and Catalan in Northeastern Spain) were suppressed under the centralism of the Franco dictatorship as of 1939. Texts in the Castilian dialect substituted for those in Galician, Catalan, and other dialects, which were forbidden. With the passing of Franco in 1975 and the institution of constitutional monarchy, Spain restored dialects everywhere. Any professor who wishes to teach in Barcelona (Catalonia), I understand, today needs to know how to communicate in Catalan. Therefore dialects in Spain have political and ideological implication that they may not have elsewhere. I know of no case where this situation impedes learning because the dialect-speakers are politically motivated.

Hi Deirdre,

We could chose to cook pizza in our own kitchen or purchase one from the pizza restaurant. The former gives satisfaction and freedom to follow our whims. I suppose in a way, IT is somewhat like pizzas.

I wrote and set up an information system that we have used for the past 6 years. I did not build for SLT but for haemato-oncology but the concept is the same. Perhaps the difference is, SLT will have sound data included.

It is still in use. Built it from scratch using client/server model using delphi and mysql (for the database) in 2006. Did it DIY style (without formal IT training) and took me about a year of sore butt to get it going. There are a lot of helpful individuals in various forums which are more than willing to help. That was before the era of researchgate. Now it is even better.

Our 800 bedded hospital did not have electronic patients record then and still hasn't. But we have intranet workstations that linked the entire establishment.

What was my need?

I wasn't interested to go paperless. As a clinician, I need fast information retrieval and updates. There are many personals involved; doctors, nurses, staff working in shifts and no one can remember every patients. Patient or relatives may call or walked in to state a new problem or progress and we need to get assess to the patients profile quickly and also to update. This may facilitate the next person whoever he is to follow the patients development. The consultant may not be directly involve but he too could get access to these informations as well. He may not agree to the plan and adjustment could be made. The hospital I worked in had a good centralized patient case records. Nevertheless it takes a couple of hours for the case records to come to the wards. Worse if the patient was just discharged or just went to the clinic whereby his or her records is still in the holding bay. It is also a problem in weekends or long public holidays, as they started enquiring why we are making the folder request when the patient is not admitted.

So I need a system that could provide information quickly to anywhere in the hospital and could be updated in real time.

What did I focused on?

Unlike the full fledged IT system, which put a lot of emphasise to biodata, admission,discharge and administrative procedures, I kept just minimal biodata enough for communication. Make sure there is room to keep as many phone numbers as possible. Mobile numbers keep changing.

I mainly focused on clinical data ie patients progress notes. I wasn't obsessed with statistics so most of my data entries were open. If you are keen with statistics then you may want to standardized your data entry with more close options.

What did I need?

Initially I shared folders across network. It contained files of patient profile written in words. I later went into microsoft access. The IT department got upset when they got to know. File transfer like this uses heavy bandwidth. Our intranet runs on old copper cables and frequently breakdown. If you are assessing your files located on a computer in one end of the hospital from another end (clinic) it causes heavy network traffic and congestion. They would only tolerate data packets not entire file. Someone I know at that time was using delphi (pascal) with mysql. Mysql is free for non-commercial works and still is. I purchased delphi developer under academic licence (around USD500). There are languages you could use now which comes free, such as java, Q language etc. It so happened I chose delphi. I bought one desktop (bare) to be the server and installed EasyPhP (free). It has mysql incorporated within. I wrote two applications. One is the server application and another is the client application. The server application sits in the server where it communicates with the mysql database. This was the hard part but perserverence is the key. The client application is installed in whichever workstation in the hospital which you want to work in. It will communicate with the server application to fullfil its task. By the way the academic licence did not allow networking. In 2010, as the project was running into its 5th year, I purchased the full licence to make it legal!

One thing I did was I kept the server in my daycare. Reason. In case of power failures especially during period of thunderstorms, the server desktop which is connected to a backup generator line, will still run. I eventually also included an APS which is essential to prevent data table from getting corrupted due to abrupt power disconnection. Happened several times. I had a version of client application kept in the server desktop that could read the datafile. So in such an event when the intranet is down, patients data is still accessible, but on a single computer. Better than total darkness. I understand that some of us will voice their concern of loose patients data security. The server should have been located in a secure place. There are pro and cons.

We have manually backed up the data on thumbdrives. I did not go into RAID. It cost money.

We installed Wifi and was working with notebooks running on windows. We were able to access data at bedside. Anything that could be assess via cables could also be assessed via Wifi. We were able to show our patients, their result trends while they lay in their beds. I believe (we were yet to try) it should not be a problem with window based netbook. Ipad or other google device will be totally a different story. The client application has to be rewritten for none window system. Not for delphi I am afraid.

I thought it will be nice if we could view the data from home when our junior officer is discussing a case over the phone. I had to draw the line. The data should be encrypted if it was to leave the hospital intranet but I was not prepared to go onto another learning curve. So it was confined only within the hospitals intranet.

It has since gone through 9 revision/upgrades. We eventually added a discharge/clinical summary to be given to patients. To overcome double work, we printed the clinical summary and pasted in onto the patients case sheet. The whole system was created based on what and how we were working. We did not have to adapt our work to a commercial system costing millions. A couple of thousands just to make slight changes.

For the last 10 years, there has been an ongoing exercise between the IT and various department. For now, the exercise has been focused on laboratory results. It has been slow. The trouble I sense was, that the IT personal took a while before he could understand his clients need, and the fussy client sought for perfection and keep making adjustment to the product. This delayed system implementation. In my case, I fully understand of my own limitation as a rookie programmer and was just SO HAPPY to see it launched. I eventually made the improvement during revision.

So we had a homemade pizza on a shoe string budget. You could have your pizza too. :)

If you do not have this text, I would suggest you review it:

Clinical Reasoning in the Health Professions, 3rd Edition, published in 2008. Joy Higgs is the Editor. This is a comprehensive text that addresses every profession, including speech-language pathology. You will have to do some inferencing, but I think this will be a good resource for you. I know when there are few references to the topic it is a paradox! In one sense, there isn't much to guide your thinking; in contrast, you are a pioneer cutting a new path for us by making these linkages. I would also suggest you look at the literature on systems theory and evaluating organizations. Along with the interaction among the particular professionals re: speech-language therapy, there is the influence of the system, the culture, in which the professionals interact. You might consider how collaboration is different based on the culture and processes of the given system.

suggest you look at the work done around the neighbour hood early years and early support.This was a joint project done with the dept of education and skills , dept of health and supported by surestart. Individual organisations suchas down syndrome educational trust and scope were involved. consultation was done on this topic , you also may find Peter Limbrick helpful with his work on the team around the child.

It depends what kind of cognitive deficit is being targeted, and what population you're looking at. There's a great paper from Bergquist and colleagues in Brain Injury (2008, Vol. 22, iss. 11, p. 891-897) which documents the successful outcomes of an internet-based cognitive rehabilitation program for adults with TBI that might interest you, if you haven't seen it already. I've also read plenty of successful telehealth applications to aphasia therapy.

A good assessment should begin with a detailed questionnaire about the child's developmental, medical, educational, and family history including the languages the child is exposed to and speaks. This should be followed by informal observation in a couple of different settings and the collection of a naturalistic communication (for nonverbal children) and/or language sample. If a child is school-age, you should be speaking to the teacher or getting the teacher's observations, samples of the child's school work etc... after you have assimilated all of this information, you can decide what standardized tests to administer for the specific population you need. When you're assessing a child with CP who cannot speak for motoric reasons, you need to find a way to adapt the assessment to allow a different response mode - these children have very good comprehension of language but often cannot express what they know due to their motor speech deficits. When assessing children with TBI, you need to work closely with your psychology colleagues to get a good understanding of the cognitive deficits. In designing treatment for any of these population, a functional approach is most effective. Setting intervention goals that are developmental and will meet the functional communication demands of the child's natural environment are crucial.