Reflections and Analysis to Improve Clinical Practice: a Student Music Therapist's Journey with a Preschool Child with Special Needs

<p>This qualitative study critically examines the researcher' music therapy clinical practice with a preschool child with global developmental delay. The researcher/student music therapist critically examined and refined her clinical practice using an action research model. Each cycle consisted of a plan, action, data collection, reflection, and analysis. The researcher was the main participant. The child, his mother and a speech language therapist were co-participants with different roles. The child and his mother participated in the sessions. The speech-language therapist observed three sessions through a window. Feedback from the child' mother and the speech-language therapist contributed to the reflective data. Important issues that developed through the cycles related to early intervention techniques (having fun, being playful and spontaneous, and being in close proximity). Other important issues that developed were, the use of the voice and guitar; confidence; professionalism with parents and other health professionals; self-awareness; and the understanding of early childhood development (especially in the area of communication). Related literature on aspects of music therapy practice, music therapy in early intervention, music therapy and communication, and action research are described. These results cannot be generalised. However, they may firstly, illustrate relevant trends in early intervention, and secondly, enable the researcher to adapt skills learnt to use in future practice in early intervention.</p>

Reflections and Analysis to Improve Clinical Practice: a Student Music Therapist's Journey with a Preschool Child with Special Needs

<p>This qualitative study critically examines the researcher' music therapy clinical practice with a preschool child with global developmental delay. The researcher/student music therapist critically examined and refined her clinical practice using an action research model. Each cycle consisted of a plan, action, data collection, reflection, and analysis. The researcher was the main participant. The child, his mother and a speech language therapist were co-participants with different roles. The child and his mother participated in the sessions. The speech-language therapist observed three sessions through a window. Feedback from the child' mother and the speech-language therapist contributed to the reflective data. Important issues that developed through the cycles related to early intervention techniques (having fun, being playful and spontaneous, and being in close proximity). Other important issues that developed were, the use of the voice and guitar; confidence; professionalism with parents and other health professionals; self-awareness; and the understanding of early childhood development (especially in the area of communication). Related literature on aspects of music therapy practice, music therapy in early intervention, music therapy and communication, and action research are described. These results cannot be generalised. However, they may firstly, illustrate relevant trends in early intervention, and secondly, enable the researcher to adapt skills learnt to use in future practice in early intervention.</p>

Corticobasal syndrome: a practical guide

Corticobasal syndrome is a disorder of movement, cognition and behaviour with several possible underlying pathologies, including corticobasal degeneration. It presents insidiously and is slowly progressive. Clinicians should consider the diagnosis in people presenting with any combination of extrapyramidal features (with poor response to levodopa), apraxia or other parietal signs, aphasia and alien-limb phenomena. Neuroimaging showing asymmetrical perirolandic cortical changes supports the diagnosis, while advanced neuroimaging may give insight into the underlying pathology. Identifying corticobasal syndrome carries some management implications (especially if protein-based treatments arise in the future) and prognostic significance. Its treatment is largely symptomatic and is best undertaken within a multidisciplinary setting, including a neurologist, physiotherapist, occupational therapist, speech language therapist, psychiatrist and, ultimately, a palliative care clinician. Corticobasal syndrome can be a confusing entity for neurologists, not least because it has over time evolved from being considered predominantly as a movement disorder to a condition spanning a wide range of cognitive and motor manifestations. In this practical review, we attempt to disentangle this syndrome and provide clarity around diagnosis, its underlying pathological substrates, key clinical features and potential treatments.

INTERDISCIPLINARY APPROACH IN AUDIOLOGY – AN EXPERIENCE OF PEDIATRIC AMPLIFICATION

The aim of the study was to develop an algorithm for the interaction between an audiologist and speech-language therapist in initial amplification for hearing impaired children. Methods. 219 children aged 2 months to 16 years with hearing impairments were divided into 2 groups. The experimental group consisted of children who got a special course of medical, psychological and pedagogical rehabilitation at the stage of initial fitting, based on the new algorithm of interdisciplinary interaction between an audiologist and a speech-language therapist. The control group included children with traditional procedure of hearing aids fitting, in which the audiologist didnt interact with the speech therapist. Results. An algorithm for the interaction of an audiologist and speech-language therapist included 3 stages of hearing aids fitting (preparation, initial fitting, adaptation and fine tuning of hearing aids), the tasks of each specialist at these stages were identified, including the parents involvement in the process of fitting, a development of the protocol for the exchange of information between specialists. The algorithm was implemented in a special course of medical-psychological-pedagogical rehabilitation in the Center of Pediatric Audiology. It was found that in 1 month after the primary fitting among children who underwent this course, significantly more children used hearing aids for more than 8 hours a day and reached the integral criterion of effective hearing aids fitting compared with the control group. These children also took less time to adjust their hearing aid settings during repeated fitting sessions. Conclusion. A structured interdisciplinary interaction between an audiologist and speech-language therapist at the stage of initial amplification significantly increases the effectiveness of medical technology for restoring hearing function in children.

Abordarea interdisciplinară a despicăturilor facio-labio-palatine

Labio-maxillo-palatine clefts represent the most common congenital anomaly of all congenital malformations of the face and they are the most frequent cause of rhinolic disorders. The complexity of the therapeutic approach is determined by nutrition and eating problems, hearing and ENT problems, dento-facial and orthodontic abnormalities, breathing disorders, phonation disorders, reduced speech intelligibility, various physiognomic disorders. The presented case study emphasizes the need of an interdisciplinary approach to labio-maxillo-palatine clefts and follows the recovery process from a multidisciplinary perspective. The conclusions of the paper support the idea that the recovery process of the child with facio-labio-palatine cleft is a complex, long-termed one and the concern of the speech and language therapist to expand his field of activity is justified because this disorder involves pre and post surgery intervention and the therapist supports the entire process in all the mentioned areas.

Potencionální vlivy na percepci a produkci řeči v důsledku opatření souvisejícími s prevencí SARS CoV-2 (COVID-19). Pohled logopeda

The aim of this article is to emphasise some issues arising from the measures undertaken in the prevention of SARS CoV-2 (COVID-19), as commented from the perspective of a speech and language therapist. The consequences mentioned in the article may affect not only the speech and language therapist’s diagnosis and intervention, but also the everyday activities of educators and special educators, psychologists, or parents engaged in the verbal transmission of information or complex communication behaviour. The article focuses on the connection of the selected phenomena we identify in the context of the multimodal notion of perception, comprehension, and production of speech, which we adopt with regard to the paradigm shift of providing modern speech language therapy in various (educational, clinical, or counselling) environments. In order to do so, this paper employs the scientific results of phoniatrics, audiology, neurology, stomatology and orthodontics, psychology, and other disciplines connected to speech perception and production of verbal and nonverbal communication.

The approach of speech proficiency in edentulous patients- “Solution to Elocution”

Speech is considered as a basic fundamental means of communication, which makes the human being superior than other forms of life. Speech and language therapist judgement of speech is consider as the most perfect because the assessment is mainly subjective and it depends on the perception of individual. This will involve both assessment of the intelligibility and quality of the patient’s speech, and observation of the visible aspects of articulation. The best way is to use perpetual assessment, to highlight potential areas of difficulty, then objective, instrumental assessment of these areas, to confirm the nature and severity of their involvement. Correlation of the vocal signal changes with the characteristics of the prosthesis and the specific types of errors in the prosthetic act would be an essential achievement in the way of improving the outcome of the prosthetic action. It is the responsibility of the prosthodontist to construct dentures as accurately as possible, so as to improve speech sound production with dentures, minimize the period of adaptation and thereby, increase the self-confidence of the patient. For this its very important to have knowledge about assessment of speech. Since past many years clinicians have faced problems in assessing speech. In this article clinical application of speech test in relation to complete dentures have been highlighted.

‘I Like Thinking on My Feet’

As a speech and language therapist, Helen Pearson has had to find innovative ways to offer her services remotely during the pandemic. Karen Hart finds out what drives her busy working life and what she likes to do in her spare time.