Communicating Across Cultures and Languages in the Health Care Setting. Claire Penn & Jennifer Watermeyer. Palgrave Macmillan, UK. 368 Pp. ISBN 978-1-137-58100-6

The book under review presents the challenging and creative research endeavours concerning some peculiar characteristics of multicultural and multilingual communication in South African healthcare settings. The authors of this work – Claire Penn, a professor and director of the Health Communication Research Unit, and Jennifer Watermeyer, an associate professor in the Department of Speech Pathology and Audiology at the University of the Witwatersrand, South Africa, – focus on bridging the gap between the voices of the lifeworld and the voices of medicine via communication characterized by the complexities and pitfalls within culturally and linguistically diverse health care contexts. The research under review is aimed at analyzing the cognitive space of professional medical communication in healthcare settings for applying the results in practice. Research of the cross-language interactions in healthcare facilities (using the evidence from South African medical settings) certainly contributes a lot to establishing an adequate cultural brokers’ role in the professional communication and to describing methods aimed at modifying interactions between a healthcare professional and a patient, which taken together lead to the improvement of medical communication in general. This book is a reasonably valuable source of essential knowledge for both healthcare professionals, linguists, discourse analysis researchers, medical educators and practitioners, and for those people who are interested in the specificities of communication research projects in terms of professional medical discourse on the global scale.

Speech Disorders in Dysgnathic Adult Patients in the Field of Severity of Primary Dysfunction

The normative functioning of the stomatognathic system and masticatory apparatus requires specific coordination between several structures such as teeth with good occlusion, tongue without ankyloglossia or thrusting, and well-balanced facial muscles. This study aimed to evaluate the influence of non-normative primary functions such as breathing, swallowing, biting and chewing on the consonant pronunciation outcome in adults affected with facial skeletal deformities. Moreover, the authors would like to promote a new kind of speech therapy-orthognathic speech therapy. A total of 181 adults affected by skeletal class II and III malocclusion were included, along with the relationship between the malocclusion, speech deficiency (20 phonemes tested) and primary function disorders, in the subjects before and after surgical correction. The impact of surgery on pronunciation and primary function improvement and types of Polish phonemes most often misarticulated by Polish adults were also examined. Patients underwent combined treatment and received a full speech pathology examination. The treatment improved speech (p < 0.05), and primary functions (p < 0.05). Palatal, alveolar (p < 0.05), fricatives (p < 0.05), and labiodental consonant pronunciation (p < 0.05) improved. The surgical correction of malocclusion leads to better oral motor control and articulation of Polish consonants in adults.

Speech development in children of preschool age with arthrogryposis multiplex congenital with upper limb deformities

BACKGROUND: The difficulties or gross disturbance in motor development, which are diagnosed in children at an early age, are one of the prognostic markers of further problems in their speech development. AIM: This study aimed to determine the speech development of children with arthrogryposis multiplex congenita with upper limb deformities. MATERIALS AND METHODS: Speech examination was conducted in 21 children with arthrogryposis multiplex congenita preschool age (average age: 5.16 1.49 years) from 2020 to 2021. Patients were divided into 2 groups: group 1 (10 people) with children of younger and middle preschool age (average age 3.81 0.63 years) and group 2 (11 people) with children of older and preparatory preschool age (average age 6.39 0.78 years). The speech examination results were exposed to statistical analysis. RESULTS: The majority of children with arthrogryposis multiplex congenita had speech pathology (90.5%), whereas general speech underdevelopment dominated over speech development delay (78.9% and 21.1%, respectively). A high frequency of perinatal hypoxic-ischemic encephalopathy in children with arthrogryposis multiplex congenita (80.9%), a complicated perinatal anamnesis (57.1%), and a delay in early motor or speech development (100% and 52.4%, respectively) links with speech disorder development in the future. Patients with arthrogryposis have a large percentage of congenital pathology of the articulatory apparatus structure (57.1%). Of the children, 76.2% were with a total form of arthrogryposis multiplex congenita, whereas 23.8% with an isolated upper extremity lesion. No statistically significant differences were determined in the form of speech pathology between patients with various forms of arthrogryposis multiplex congenita. Children of the first age group had speech disorders in 90% of cases, whereas 90.9% in group 2. Based on the form of speech pathology, patients with general speech underdevelopment and speech development delay were determined in group 1 (55.6% and 44.4%, respectively), whereas children with general speech underdevelopment in group 2 (100%). In the clinical form of speech pathology, dysarthria prevailed in children of both age groups (80%). CONCLUSIONS: Children with arthrogryposis multiplex congenita with upper limb deformities have a high incidence of speech disorders. Early speech examination and speech therapy eliminated all detected disturbances.

Beyond Services in the United States of America: Fulbright U.S. Scholar Experience in Vietnam

Purpose: This article addresses my experience as a speech-language pathologist in a cultural exchange and global outreach program in Vietnam. The importance and various types of cultural exchange and global outreach programs available through the U.S. Department of State, the current status of educational speech-language pathology programs in Vietnam, and a brief introduction of the country as well as its unique cultural characteristics are also discussed. Conclusions: As a Fulbright U.S. scholar, I resided 6 months in Hue, Vietnam, to provide education and consultation services to children who needed speech-language pathology services and their families. The speech pathology profession in Vietnam is significantly underdeveloped. However, several international nongovernmental organizations and foreign universities have assisted Vietnam in developing speech pathology and audiology professions. Among many opportunities to serve the needs of speech pathology and audiology preprofessional education and service delivery in Vietnam, one of the most prestigious opportunities is the Fulbright U.S. Scholar Program. It is my hope that my personal and professional experiences can encourage fellow speech-language pathology and audiology professors and practitioners to apply for a Fulbright scholarship to pursue a rich volunteer experience in a foreign country as well as to improve their cultural competency upon return to their own academic institutions.

Functional Communication Abilities in Youth With Cerebral Palsy: Association With Impairment Profiles and School-Based Therapy Goals

Purpose: The aim of this study was to examine the relationship between functional communication skills, underlying speech, language, and cognitive impairments and school-based speech pathology services in students with cerebral palsy (CP). Method: Thirty-five participants with CP who had Individualized Education Programs (IEPs) were classified according to the Communication Function Classification System (CFCS). Participants completed laboratory assessments of speech, receptive language, executive functioning, and nonverbal cognition. Each participant's speech and language IEP goals were coded into treatment units and then categorized into seven, mutually exclusive target goal areas. Nonparametric analyses were employed to examine differences among CFCS groups in the number of deficit areas and the number of goal areas from the IEP. Descriptive analyses were used to evaluate the extent to which deficit and goal areas in the IEP co-occurred by CFCS level. Results: Those in more involved CFCS levels demonstrated more severe speech, receptive language, and cognitive impairments. However, there were no significant differences in the number of deficit areas across CFCS groups. Regardless of CFCS level, there were no differences in the number of treatment goals specified in the IEP. Literacy was the only goal area addressed across all CFCS levels. Those in the most involved CFCS levels had augmentative and alternative communication (AAC) goals, but those with more moderate restrictions in functional communication who also had markedly reduced speech intelligibility did not typically have speech or AAC goals. Interpretation: Individuals with CP across CFCS levels demonstrate variability in underlying deficit profiles, suggesting that measures of both functional communication and of underlying deficits are necessary to provide a complete picture of communication needs. Literacy goals were common across all CFCS levels, but AAC goals were limited to the most severely involved individuals, suggesting that continuing education may be necessary to support speech-language pathologists in developing treatments involving the integration of AAC and speech to foster functional communication at school. Supplemental Material https://doi.org/10.23641/asha.16968073

Mental Health Practitioners’ Understanding of Speech Pathology in a Regional Australian Community

(1) Background: This study aimed to determine the level of knowledge and the perceptions of speech pathology held by a sample of regional mental health practitioners and to explore factors that facilitate understanding of the roles of speech pathologists in mental health. While mental health is recognised as an area of practice by Speech Pathology Australia, the inclusion of speech pathologists in mental health teams is limited. (2) Methods: An anonymous online survey was created using previously validated surveys and author generated questions and distributed to mental health practitioners in Central Queensland, Australia. (3) Results: Mental health practitioners had difficulty identifying speech pathology involvement when presented with case scenarios. Accuracy was poor for language-based cases, ranging from 28.81% to 37.29%. Participants who reported having worked with a speech pathologist were more likely to demonstrate higher scores on the areas of practice questions, [r(53) = 0.301, p = 0.028], and the language scenarios [r(58) = 0.506, p < 0.001]. They were also more likely to agree to statements regarding the connection between speech pathology and mental health, r(59) = 0.527, p < 0.001. (4) Conclusions: As found in this study, contact with speech pathologists is a strong predictor of mental health providers’ knowledge of the speech pathology profession. Thus, the challenge may be to increase this contact with mental health providers to promote inclusion of speech pathologists in the mental health domain.

Structural and functional characteristics of prediction in preschool children with speech impairment

The ability to predict is one of the important aspects of human mental development. There is a relationship between prognostic competence and the process of socialization. Psychological studies show that children with special educational needs, including children with general speech underdevelopment, when compared with their peers without speech pathology, are more susceptible to impaired socialization and the occurrence of school maladjustment. This affects the success of their schooling. Such children experience difficulties in complying with social norms in the implementation of their goals, since they cannot anticipate the consequences of a certain situation. This can lead to deviant behavior and failure at school. This article examines the features of the structural and functional characteristics of forecasting in preschoolers with general speech underdevelopment. It analyzes the research results given in the scientific literature, presents the results of the authors’ own experimental research conducted using the “Prognostic stories” technique developed by the teachers of the Department of Psychology and Pedagogy of Special Education of the Kazan (Volga region) Federal University, and a comparative analysis of the data obtained during the experiment. The study showed that preschool children with general speech underdevelopment have lower indicators in all predictive characteristics in comparison with normative peers, and also have specific prognosis features due to speech pathology and deficiencies in higher mental functions. The most important of these are the lack of cognitive predictive function and prediction of utterance. The disadvantages of the prognostic ability of preschoolers with speech pathology determine the risk of social maladjustment, which requires the attention of specialists in the field of special education. The results obtained expand the understanding of the state of development of the prognostic competence of preschoolers with general speech underdevelopment. They present a more complete picture of its specific features, and highlight the most significant disadvantages of the forecasting process for this category of children. This indicates the directions of work on the development of prognostic processes in preschoolers with general speech underdevelopment, as well as the prevention or minimization of the outcomes of school maladjustment.

Effectiveness of Allied Health Clinical Supervision Following the Implementation of an Organisational Framework

Background: Clinical supervision makes an important contribution to high quality patient care and professional wellbeing for the allied health workforce. However, there is limited research examining the longitudinal implementation of clinical supervision for allied health. The aim of this study was to determine the effectiveness of clinical supervision for allied health at a regional health service and clinicians’ perceptions of the implementation of an organisational clinical supervision framework.Methods: A cross-sectional study was conducted as a phase of an overarching participatory action research study. The MCSS-26 tool was used to measure clinical supervision effectiveness with additional open-ended questions included to explore the implementation of the clinical supervision framework. MCSS-26 findings were compared with an initial administration of the MCSS-26 5 years earlier. MCSS-26 data (total scores, summed domain and sub-scale scores) were analysed descriptively and reported as mean and standard deviation values. Differences between groups were analysed with independent-samples t-test (t) and one-way between groups ANOVA.Results: There were 125 responses to the survey (response rate 50%). The total MCSS-26 score was 78.5 (S.D. 14.5). The total MCSS-26 score was unchanged compared with the initial administration. There was a statistically significant difference in clinical supervision effectiveness between speech pathology and physiotherapy (F = 2.9, p = 0.03) and higher MCSS-26 scores for participants whose clinical supervisor was a senior clinician and those who chose their clinical supervisor. Seventy percent of participants perceived that the organisation’s clinical supervision framework was useful and provided structure and consistent expectations for clinical supervision.Conclusions: Clinical supervision was effective for allied health in this regional setting and clinical supervision effectiveness was maintained over a 5 year period. The implementation of an organisational clinical supervision framework may have positively impacted on the effectiveness of clinical supervision for some professions.

Orthognathic speech pathology: impacts of Class III malocclusion on speech

Summary Introduction Patients with dentofacial disharmonies (DFDs) seek orthodontic care and orthognathic surgery to address issues with mastication, esthetics, and speech. Speech distortions are seen 18 times more frequently in Class III DFD patients than the general population, with unclear causality. We hypothesize there are significant differences in spectral properties of stop (/t/ or /k/), fricative (/s/ or /ʃ/), and affricate (/tʃ/) consonants and that severity of Class III disharmony correlates with the degree of speech abnormality. Methods To understand how jaw disharmonies influence speech, orthodontic records and audio recordings were collected from Class III surgical candidates and reference subjects (n = 102 Class III, 62 controls). A speech pathologist evaluated subjects and recordings were quantitatively analysed by Spectral Moment Analysis for frequency distortions. Results A majority of Class III subjects exhibit speech distortions. A significant increase in the centroid frequency (M1) and spectral spread (M2) was seen in several consonants of Class III subjects compared to controls. Using regression analysis, correlations between Class III skeletal severity (assessed by cephalometric measures) and spectral distortion were found for /t/ and /k/ phones. Conclusions Class III DFD patients have a higher prevalence of articulation errors and significant spectral distortions in consonants relative to controls. This is the first demonstration that severity of malocclusion is quantitatively correlated with the degree of speech distortion for consonants, suggesting causation. These findings offer insight into the complex relationship between craniofacial structures and speech distortions.

A kinematic-acoustic analysis of gesture-speech coupling in persons with aphasia

Aphasia is a profound speech pathology hampering speech production and/or comprehension. People with Aphasia (PWA) use more manual gestures than neurotypicals. This intuitively invokes the idea of some kind of compensatory mechanism, but there is variable evidence of this gesture-boosting effect on speech processes. The status quo in gesture research with PWA is an emphasis on categorical analysis of gesture types, how often they are recruited, and whether they aid communication or speaking. However, there are increasingly louder calls for the investigation of gesture and speech as continuous entangled modes of expression. In neurotypical adults, expressive moments of gesture and speech are synchronized. It is unknown how this multimodal prosody is instantiated in PWA. In the current study we perform the first acoustic-kinematic gesture-speech analysis in persons of aphasia (Wernicke, Broca, Anomic) relative to age-matched controls, where we apply several multimodal signal processing methods (e.g., motion tracking). Specifically, we related the speech peaks (smoothed amplitude envelope change) with that of the nearest peaks in the gesture acceleration profile. We obtained that the magnitude of gesture vs. speech peaks are positively related across the groups, though more variably for PWA, and such coupling was related to less severe Aphasia-related symptoms in PWA. When comparing the temporal ordering of speech envelope versus acceleration peaks, no statistically reliable differences between controls and PWA were observed. We did however obtain when gesture kinematic peaks tended to anticipate speech peaks more, this was related to less severe aphasia-related symptoms. Finally, we show that both gesture and speech have slower quasi-rhythmic structure, indicating that next to speech, gesture is slowed down too. We conclude that future aphasia research will benefit from the study of gesture-speech interconnections.