Evaluation and Treatment of Post-Extubation Dysphagia: The Importance of the Speech Pathologist in the Intensive Care Unit

Purpose: Post-extubation dysphagia is associated with negative health outcomes including pneumonia, prolonged hospital stay, in-hospital mortality, and inability to discharge home. The purpose of this review article is to summarize published research on screening, evaluating, and treating post-extubation dysphagia. Method: Review of published literature on post-extubation dysphagia to shape best practice guidelines for speech pathologists. Results: Current research on post-extubation dysphagia focuses heavily on screening and evaluation. There are limited data on targeted treatment methods for post-extubation dysphagia. Conclusions: Speech pathologists play a critical role in helping patients safely return to oral alimentation following prolonged endotracheal intubation. Speech pathologists should use the available research to shape best practice guidelines within their facility for who, when, and how to evaluate for dysphagia following extubation.

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.

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.

Multimodal Evaluation of Voice Outcome in Early Glottic Cancers Treated With Definitive Radiotherapy

Background/Aim: We employed a multimodal evaluation of voice outcome (MEVO) model to assess long-term voice outcome in early glottic cancer (EGC) patients treated with primary radiotherapy (RT). The model consisted of objective and subjective vocal evaluation during follow-up, by a dedicated Speech Pathologist and Speech Therapist. Patients and Methods: MEVO methodology includes Self-perception Voice Handicap Index (VHI-30), evaluation of parameters Grade (G), Roughness (R), Breathiness (B), Asthenia (A) and Strain (S) according to GRBAS scale, objective analysis and aerodynamics using the PRAAT software and laryngeal evaluation with videostroboscope (VS). Results: The MEVO methodology was described and tested on a sample of 10 EGCs submitted to definitive RT (total dose 66-70 Gy). Mean follow-up was 48.9 months (range=9-115). VHI was mild-moderate in 90% of patients; overall voice function (GRBAS) was normal-mildly impaired in 70% of patients; VS evaluation showed normal vocal cord motion in 90% of patients, but complete glottic closure in 60%. PRAAT scores confirmed these findings. Conclusion: A multidimensional voice evaluation is time consuming, but useful to objectify vocal impact of radiotherapy. The MEVO model allowed to quantify vocal dysfunction, showing a good objective vocal outcome.

The Will Club for Stuttering and Modus Operandi of Training Adult Persons Who Stutter: A Descriptive Analysis, Riyadh, Saudi Arabia

Background: Speech fluency disorders determined by a variety of complex biological and environmental interactions are common problems of children, adolescents, adults and older adults around the world and need therapeutic interventions for improving the quality of life of those who stutter. Objective: This descriptive study aims to mainly focus on training course and techniques along with various associated challenges faced by persons who stutter. Methods: Training module was tailored and customized by five trainers including psychiatrist, speech therapist, speech pathologist, psychologist and behavioral therapist to meet the therapeutic needs of chronic adult stutterers who were invited to take 2-week training course concerning stuttering. Results: The will club for stuttering has well defined mission, vision, values and goals, modus operandi and techniques, and well appreciated by trainees/participants in their success stories. Stuttering is associated with many challenges, which were identified proactively and discussed using training exercises and techniques/methods during training course that comprised of preparatory, application, confrontation, and sustainability phases. Conclusion: Two-week training course directed towards adult stutterers facing many challenges which were discussed extensively and trainers found their effective solutions through exercises and multi-dimensional techniques dispersed in several phases of the program module.

Dyslexia and the Speech Pathologist

Dyslexia is a complex condition. Timely identification of this disorder is imperative to its optimal management. Students benefit most when the skill sets of specialists trained to recognize markers and characteristics of dyslexia are effectively utilized. This chapter provides a real-life case study describing the process by which a student with a language literacy disorder such as dyslexia was assessed by a speech-language pathologist (SLP). Supporting literature is embedded throughout the case study to enhance learning and support the decisions made by the SLP. The role that the SLP can take in working with students with language literacy disorders such as dyslexia is also discussed. Therefore, the aims of this chapter are threefold: to (a) provide guidance for SLPs who may work with students with language literacy disorders such as dyslexia; (b) educate parents of children, with language literacy disorders such as dyslexia, about SLPs; and (c) support teachers and educational professionals by providing information about professionals who can serve as a resource for students.

FORMATION OF BACHELOR STUDENTS’ COMMUNICATIVE COMPETENCES WHEN STUDYING THE COURSE “SPEECH CULTURE OF A SPEECH PATHOLOGIST” (ON THE MATERIAL OF STYLE DIFFERENTIATION OF LANGUAGE)

Актуальность исследования определяется необходимостью устранения двух видов противоречий в образовательном процессе высшей школы: 1) между уровнем сформированности коммуникативной компетенции выпускников школ и требованиями, предъявляемыми к студентам-бакалаврам; 2) между необходимостью внедрения компетентностного подхода и отсутствием единых представлений о понятийном аппарате новой парадигмы, методических средствах ее обеспечения применительно к разным компетенциям и компетентностям. Цель исследования – разработка методической модели для формирования коммуникативной компетенции студентов-бакалавров при изучении курса «Речевая культура дефектолога» (на материале стилевой дифференциации языка). В основе разрабатываемой компетентностной методической модели – концепция типологизации материала на всех выделяемых уровнях: формальном, содержательном, прагматическом, организационно-технологическом, оценочном и прогностическом. Раскрывается содержание каждого уровня. Применительно к каждому уровню выделяются ведущие формируемые компоненты коммуникативной компетенции: языковой, дискурсивно-стилистический, риторико-прагматический и этикетно-речевой. В результате делается вывод о значимости разработки компетентностной методической модели в расширении педагогического инструментария компетентностного подхода. Отмечается возможность применения данной модели для повышения уровня коммуникативной компетенции студентов не только в ходе преподавания «Речевой культуры дефектолога», но и других дисциплин лингвистического цикла. Указывается, что разработанная модель может способствовать устранению выделенных противоречий образовательного процесса. В итоге намечаются перспективы дальнейших исследований. The author defines the relevance of the study by the need to eliminate two types of contradictions in the educational process of higher education: 1) between the level of formation of the communicative competence of school graduates and the requirements for bachelor students; 2) between the need to introduce a competency-based approach and the lack of shared sense about the conceptual apparatus of the new paradigm, methodological means of its provision in relation to different competences and competencies. The purpose of this study is to develop a methodological model of the formation of bachelor students’ communicative competence while studying the course “Speech culture of a speech pathologist” (based on the material of style differentiation of the language). The basis of the developed competence-based methodological model is the concept of classification of the material at all distinguished levels: formal, substantive, pragmatic, organizational and technological, evaluative and prognostic. The author reveals the content of each level and identifies the leading formed components of communicative competence for each of them: linguistic, discursive and stylistic, rhetorical and pragmatic, etiquette and speech. As a result, the author concludes about the importance of developing a competence-based methodological model in expanding the pedagogical tools of the competence-based approach. The researcher notes the possibility of using this model to increase the level of communicative competence of students not only in the course of teaching “Speech culture of a speech pathologist”, but in other disciplines of the linguistic cycle. The author points out that the developed model can help eliminate the identified contradictions in educational process. In conclusion, the researcher outlines the prospects for further research.