Chapter 3.3. Haptics and emotions in speech and language therapy sessions for people with post-stroke aphasia

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Niamh Ní Dhufaigh ◽  
Marie Haughey ◽  
Cliodhna Gillen

Abstract Background Communication disorders and dysphagia are debilitating sequelae associated with stroke. Speech and Language Therapy (SLT) has a pivotal role in stroke rehabilitation, and in improving outcomes. The research into dysphasia, dysphagia, and dysarthria post-stroke is extensive. In comparison, the research into cognitive-communication difficulties post-stroke is still emerging. Cognitive-communication difficulties (CCDs) are communication impairments resulting from underlying cognitive deficits due to neurological impairments1. The aim of this audit was to review SLT referrals in an Irish Stroke Rehabilitation Unit. Methods Single-centre retrospective review of all stroke admissions from January to December 2018. Communication outcomes were assessed using the Functional Independence Measure and Functional Assessment Measure (FIM+FAM)2 a 7-point disability rating scale. Standard Bayesian statistics were employed for analysis. Results SLT received referrals for 66% (n=41) of all stroke admissions (n=62). Mean age was 68 years (SD+/-14), compared with 70 years (SD+/-14) for patients not referred. 65% were female and 35% male. Patients requiring SLT had significantly longer length of stay (p=0.0072). 83% of referrals were for communication, 12% dysphagia, and 5% inappropriate. Of communication referrals, primary diagnoses were as follows: 17.5% dysarthria (n=6), 26.5% dysphasia (n=9) and 56% CCD (n=19). Patients with dysphasia showed greater improvement in FIMFAM scores (x̄=1.3) than those with CCD (x̄=0.9) or dysarthria (x̄=0.7). Patients with CCD comprised the largest cohort who required SLT on discharge (68%). Conclusion CCDs are highly prevalent and represented the largest subtype of communication disorders in this cohort. FIMFAM scores appear useful in assessing CCDs however they display insufficient sensitivity in capturing change within this population. This audit highlights the need for further interdisciplinary research, education and training into cognitive-communication difficulties with post-stroke populations.


Author(s):  
Carolina Bodea Hațegan ◽  
◽  
Dorina Talaș ◽  
Raluca Trifu ◽  
◽  
...  

In March 2020, due to the pandemic situation from our country, the National lockdown was imposed for almost two months. Speech and language therapy field was very affected in this period of time and harsh decisions were to be taken. Children who strongly needed therapy were in the situation to either go on with the rehabilitation process in an online setting or to wait and postpone therapy sessions. The aim of this research is to present the situation in a SLT (speech and language therapy) private specialized center and to underline the advantages and the disadvantages of SLT online therapy after one year (from March 2020, till March 2021). In the beginning of March 2020, 37 children attended SLT sessions in this private center, 2 of them were recently assessed and they were supposed to begin therapy exactly on the first lockdown day. From all of them, 20 children (54 %) switch to online therapy sessions progressively. Starting with April 2020, after a three weeks break, 9 children diagnosed with mild to moderate speech and language disorders, switch from face to face to on-line. In May, 6 more children and in June another 5 children were brought back to therapy, even if we remained in an online setting. The other children, 17 (46%), either stopped all therapy sessions or began therapy in other centers that organized onsite therapeutic sessions after the lockdown period of time. At this present moment, in March 2021, at one year distance, the SLT center offers SLT services exclusively online, both assessment and therapy and the number of cases asking directly for online therapy is increasing daily (in March 2021, N=31). Results of this study, organized as focus-groups with 3 parents, 3 children and 3 therapists underlined that online SLT is very efficient as long as parents` involvement is high. The main advantages listed by all persons in the research, even by children are: easier to be more consistent; the attendance in the SLT sessions is definitely higher, parents can participate directly in these activities, resources are easily to be found. Among disadvantages, the fact that parents have to be very involved in this therapeutic process seems to be the most frequently listed. In discussions and conclusions of this study a profile of the online SLT users is about to be depicted, a profile related to the one found in specialized literature from the field.


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