Childhood Apraxia of Speech: Clinical Decision Making From a Motor-Based Perspective

2020 ◽  
Vol 5 (4) ◽  
pp. 831-842 ◽  
Author(s):  
Ruth Stoeckel ◽  
Susan Caspari
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Personal Information ◽  
Clinical Decision ◽  
Response To Therapy ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Assessment And Treatment

Purpose This article uses two case studies to illustrate clinical decision making using the best available evidence to approach the assessment and intervention for children with childhood apraxia of speech. The cases represent children seen in the authors' clinical practice, with personal information altered or omitted to protect the identity of the individuals. The case discussions exemplify choices that may be made for children of different ages, highlighting common elements across ages, as well as treatment aspects that may differ by age. Conclusions While research regarding best practice for assessment and treatment for childhood apraxia of speech has not been conclusive and, in fact, at times has been equivocal, there is empirical evidence from which to develop a rationale for assessment and treatment decisions. Accountability is important even as decisions are being made based on the best available evidence. In each case study, modifications in treatment depended on data that allowed the clinician to evaluate the children's response to therapy and adapt accordingly.

Clinical decision making in spastic bilateral CP – Planning interventions using clinical gait analysis: A case study

2015 ◽  
Vol 42 ◽  
pp. S37
Author(s):  
M. Alvela ◽  
M. Bergmann ◽  
M.-L. Ööpik ◽  
Ü. Kruus ◽  
K. Englas ◽  
...  
Keyword(s):  
Decision Making ◽  
Gait Analysis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Clinical Gait Analysis

scholarly journals My Client Knows That He's About to Stutter: How Can We Address Stuttering Anticipation during Therapy with Young People Who Stutter?

2018 ◽  
Vol 39 (04) ◽  
pp. 356-370 ◽  
Author(s):  
Hope Gerlach ◽  
Naomi Rodgers ◽  
Patricia Zebrowski ◽  
Eric Jackson
Keyword(s):  
Decision Making ◽  
Young People ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Hypothetical Case ◽  
Clinical Tool ◽  
Goal Development ◽  
Internal Experience

AbstractStuttering anticipation is endorsed by many people who stutter as a core aspect of the stuttering experience. Anticipation is primarily a covert phenomenon and people who stutter respond to anticipation in a variety of ways. At the same time as anticipation occurs and develops internally, for many individuals the “knowing” or “feeling” that they are about to stutter is a primary contributor to the chronicity of the disorder. In this article, we offer a roadmap for both understanding the phenomenon of anticipation and its relevance to stuttering development. We introduce the Stuttering Anticipation Scale (SAS)—a 25-item clinical tool that can be used to explore a client's internal experience of anticipation to drive goal development and clinical decision making. We ground this discussion in a hypothetical case study of “Ryan,” a 14-year-old who stutters, to demonstrate how clinicians might use the SAS to address anticipation in therapy with young people who stutter.

No incentives, no innovation

2009 ◽  
Vol 91 (1) ◽  
pp. 10-12
Author(s):  
Jon Hackett
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Bottom Up ◽  
High Profile ◽  
No Innovation

While the NHS has expressed a commitment to innovation with a succession of dedicated 'arms length bodies,' there are numerous high-profile cases in which advances on the ground have not received as much support as they might. In his recent Next Stage Review report, Lord Darzi has emphasised a commitment to clinical decision-making at all levels of the NHS but whether this will involve embracing best practice from the bottom up remains to be seen. For this article I spoke to two surgeons, whose sometimes controversial innovations were admired by many, about the obstacles they faced.

Clinical Decision Making in the ICU: Dysphagia Screening, Assessment, and Treatment

2019 ◽  
Vol 40 (03) ◽  
pp. 170-187 ◽  
Author(s):  
Martin B. Brodsky ◽  
Emily B. Mayfield ◽  
Roxann Diez Gross
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Clinical Decision ◽  
Level Of Care ◽  
Assessment And Treatment ◽  
Proper Training ◽  
Screening Assessment

AbstractClinicians often perceive the intensive care unit as among the most intimidating environments in patient care. With the proper training, acquisition of skill, and approach to clinical care, feelings of intimidation may be overcome with the great rewards this level of care has to offer. This review—spanning the ages of birth to senescence and covering oral/nasal endotracheal intubation and tracheostomy—presents a clinically relevant, directly applicable review of screening, assessment, and treatment of dysphagia in the patients who are critically ill for clinical speech–language pathologists and identifies gaps in the clinical peer-reviewed literature for researchers.

scholarly journals Novel Neurotechnological Interventions for Pediatric Drug-Resistant Epilepsy: Physician Perspectives

2020 ◽  
pp. 088307382096693
Author(s):  
Patrick J. McDonald ◽  
Viorica Hrincu ◽  
Mary B. Connolly ◽  
Mark J. Harrison ◽  
George M. Ibrahim ◽  
...  
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Qualitative Content Analysis ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Drug Resistant ◽  
Ethical Considerations ◽  
Pediatric Drug ◽  
Drug Resistant Epilepsy

This qualitative study investigated factors that guide physicians’ choices for minimally invasive and neuromodulatory interventions as alternatives to conventional surgery or medical management for pediatric drug-resistant epilepsy. North American physicians were recruited to one of 4 focus groups at national conferences. Discussions were analyzed using qualitative content analysis. A pragmatic neuroethics framework was applied to interpret results. Discussions revealed 2 major thematic branches: (1) clinical decision making and (2) ethical considerations. Under clinical decision making, physicians emphasized scientific evidence and patient candidacy when assessing neurotechnologies for patients. Ongoing seizures without intervention was important for safety and neurodevelopment. Under ethical considerations, resource allocation, among other financial considerations for technology adoption, were considerable sources of pressure on decision making. Access to neurotechnology was a salient theme differentiating Canadian and American contexts. When assessing novel neurotechnological interventions for pediatric drug-resistant epilepsy, physicians balance clinical and ethical factors to guide decision making and best practice.

scholarly journals Best practice guidelines for management of spinal disorders in skeletal dysplasia

2020 ◽  
Author(s):  
Klane White ◽  
Michael B Bober ◽  
Tae-Joon Cho ◽  
Michael J Goldberg ◽  
Julie Hoover-Fong ◽  
...  
Keyword(s):  
Decision Making ◽  
Practice Guidelines ◽  
Skeletal Dysplasia ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Case Series ◽  
Clinical Decision ◽  
Spinal Disorders ◽  
Best Practice Guidelines ◽  
Group A

Abstract Background: Disorders of the spine present a common and difficult management concern in patients with skeletal dysplasia. Due to the rarity of these conditions however, the literature, largely consisting of small, single institution case series, is sparse in regard to well-designed studies to support clinical decision making in these situations. Methods: Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, “best practice” guidelines in the care of spinal disorders in patients with skeletal dysplasia. Results: Starting with 33 statements, the group a developed a list of 31 “best practice” guidelines. Conclusions: The guidelines are presented and discussed to provide context for clinicians in their decision making in this often-challenging realm of care.

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