The role of the therapeutic alliance in the success of interventions has been well demonstrated in areas related to speech-language pathology and audiology. Based on this knowledge, this article ...presents the theoretical foundations of the therapeutic alliance, distinguishing it from the therapeutic relationship. The central concept of shared decision making is presented, followed by factors that may influence the establishment and quality of the therapeutic alliance. A low-quality therapeutic alliance is associated with the possibility that the client will discontinue the intervention, hence the importance of paying special attention to this dimension. In situations where clinicians have difficulty establishing an alliance, it is their responsibility to identify how they may be contributing to this situation and reflect on their own actions in order to make the necessary corrections. KEYWORDS THERAPEUTIC ALLIANCE THERAPEUTIC RELATIONSHIP SHARED DECISION MAKING Le role de l'alliance therapeutique dans le succes des interventions est bien etabli dans les domaines connexes de l'orthophonie et de l'audiologie. En s'appuyant sur ces connaissances, le present article presente les fondements theoriques de l'alliance therapeutique, en la distinguant notamment de la relation therapeutique. Le concept central de la prise de decision partagee est presente, suivi des facteurs susceptibles d'influencer l'etablissement et la qualite de l'alliance therapeutique. Une alliance therapeutique de faible qualite est associee a la possibilite que le patient mette fin a l'intervention lui etant offerte, d'ou l'importance d'accorder une attention particuliere a cette dimension. Dans les situations ou les cliniciens ont de la difficulte a etablir une alliance, il est de leur responsabilite d'identifier de quelle faqon ils contribuent a cette situation et de reflechir sur leurs propres actions afin d'apporter les correctifs necessaires.
This scoping review aims to provide an overview of the literature investigating the efficacy of speech-language pathology (SLP) interventions in the treatment of globus pharyngeus (GP), identify gaps ...in knowledge, and guide future research.
Scoping review.
Search terms were selected for five databases (PubMed, Embase, Web of Science, CINAHL, and Google Scholar). Inclusion criteria were broad and focused on any SLP intervention used to treat GP. Title and abstract and then full-text screening were performed.
Of 420 unique abstracts identified, five studies met inclusion criteria. SLP interventions included explanation, education on normal swallow, laryngopharyngeal tension reduction exercises, “voice” exercises, neck/shoulder exercises, general relaxation, postural advice, diaphragmatic breathing, manual therapy, swallowing exercises, laryngeal hygiene, throat clearing suppression, stress management, and reassurance. All included studies reported statistically significant improvement in GP following SLP intervention based on the various outcome measures reported.
This scoping review yields very little high-quality evidence supporting the efficacy of SLP interventions in the treatment of GP. Further prospective studies with systematic investigations and the use of validated outcome measures are needed to study the efficacy of SLP interventions as either adjuvant or stand-alone treatment for GP.
Amaç: Hızlı-bozuk konuşma (HBK), uluslararası alan yazında olduǧu gibi, ülkemizde de dil ve konuşma terapisi alanında en az çalışılan konulardan biri olarak bilinmektedir. Tanımında yaşanan güçlükler ...nedeniyle kimi zaman görmezden gelinebilmektedir. Bu makalede amaç, HBK'nin kuramsal temelleri ve dinamik tanımı hakkında alanyazın çerçevesi kapsamında bilgi vermek, alanda çalışan uzmanların konu ile ilgili bilgi ve farkındalıklarını arttırarak yararlanacakları bir kaynak sunmaktır. Yöntem: Geleneksel derleme yöntemi ile tasarlanan bu çalışmada, HBK'nin kuramsal temelleri ve alanyazında en çok kabul gören tanımı bünyesindeki çalışmalar taranmıştır. HBK'nin biyolojik öǧelerini ve dil tabanlı altyapısını açıklayan yaklaşımlara deǧinilmiş, dinamik tanımı ve bu tanım kapsamındaki semptomları ele alınmıştır. Ayrıca metinde DKT'lerin yararlanabileceǧi önerilere yer verilmiştir. Sonuç ve Öneriler: Hızlı-bozuk konuşmanın nörolojik kanıtlarının yanı sıra varsayımsal olarak dilsel öǧeleri de içeren bir etiyolojiye sahip olduǧu görülmüştür. Ayrıca konuşmanın gözlenebilir davranışlarına odaklanan dinamik tanımı çerçevesinde yüksek ve/ya düzensiz konuşma hızı, aşırı normal akıcısızlıklar, aşırı hece çökmesi ve anormal durak, vurgu ve ritim semptomları dikkat çekmektedir. Hızlı-bozuk konuşmanın, üretimin dilbilgisel ve motor biçiminde meydana gelen ve anlaşılırlıǧı olumsuz etkileyen bir akıcılık bozukluǧu olduǧu sonucuna varılabilir. DKT'lerin HBK'yi deǧerlendirme kapsamında dinamik tanımdan yararlanmaları, bunun yanı sıra dilsel parçalarını da göz önünde bulundurmaları amp;ouml;nerilir.
Purpose: The purpose of this study was to review treatment studies of semantic feature analysis (SFA) for persons with aphasia. The review documents how SFA is used, appraises the quality of the ...included studies, and evaluates the efficacy of SFA. Method: The following electronic databases were systematically searched (last search February 2017): Academic Search Complete, CINAHL Plus, E-journals, Health Policy Reference Centre, MEDLINE, PsycARTICLES, PsycINFO, and SocINDEX. The quality of the included studies was rated. Clinical efficacy was determined by calculating effect sizes (Cohen's d) or percent of nonoverlapping data when d could not be calculated. Results: Twenty-one studies were reviewed reporting on 55 persons with aphasia. SFA was used in 6 different types of studies: confrontation naming of nouns, confrontation naming of verbs, connected speech/discourse, group, multilingual, and studies where SFA was compared with other approaches. The quality of included studies was high (Single Case Experimental Design Scale average range = 9.55 8.0-11). Naming of trained items improved for 45 participants (81.82%). Effect sizes indicated that there was a small treatment effect. Conclusions: SFA leads to positive outcomes despite the variability of treatment procedures, dosage, duration, and variations to the traditional SFA protocol. Further research is warranted to examine the efficacy of SFA and generalization effects in larger controlled studies.
BACKGROUNDSpeech therapy is important for ideal functional outcome after cleft palate surgery. Nationwide lockdown due to outbreak of COVID-19 in Nepal restricted the ability of patients to travel to ...nearby outreach centers for regular speech therapy. The objectives were to assess the feasibility and challenges of conducting online speech therapy with postpalatoplasty children during COVID-19 pandemic; and evaluate the ways to overcome them. METHODSPatients with cleft palate surgery done at least 3 months prior were given online speech therapy. Feasibility, advantages and challenges of online speech therapy were evaluated through interviewing the guardians and speech therapy providers. RESULTSA total of 89 patients were included in the study. Only 11.2% had secondary palatine procedures. Almost all the children (97.8%) had face to face speech therapy prior to study period. Best use of time, use of audiovisual aid, no need to travel and rapid progress were the most commonly perceived strengths of online speech therapy. The most frequent challenges were internet connectivity, unclear voice, lack of direct interaction and unstable power supply. Recommended ways to improve online speech therapy were cited as better internet connectivity, having a fixed schedule and availing free or affordable Wifi. CONCLUSIONSDespite the challenges, online speech therapy provided us with a way to reach out to the cleft palate children when face-to-face therapy was not possible due to COVID-19 pandemic. We see its role even during non-pandemic situations for the children who are unable to visit the speech therapy centers.
Jennifer L. Spielman
National Center for Voice and Speech, Denver Center for the Performing Arts, Colorado
Lorraine O. Ramig
University of Colorado, Boulder, and National Center for Voice and Speech, ...Denver Center for the Performing Arts
Brad H. Story
University of Arizona, Tucson
Cynthia Fox
National Center for Voice and Speech, Denver Center for the Performing Arts
Contact author: Shimon Sapir, Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa 39105, Israel. E-mail: sapir{at}research.haifa.ac.il .
Purpose: To evaluate the effects of intensive voice treatment targeting vocal loudness (the Lee Silverman Voice Treatment LSVT) on vowel articulation in dysarthric individuals with idiopathic Parkinson's disease (PD).
Method: A group of individuals with PD receiving LSVT ( n = 14) was compared to a group of individuals with PD not receiving LSVT ( n = 15) and a group of age-matched healthy individuals ( n = 14) on the variables vocal sound pressure level (VocSPL); various measures of the first (F1) and second (F2) formants of the vowels /i/, /u/, and /a/; vowel triangle area; and perceptual vowel ratings. The vowels were extracted from the words key, stew, and Bobby embedded in phrases. Perceptual vowel rating was performed by trained raters using a visual analog scale.
Results: Only VocSPL, F2 of the vowel /u/ (F2u), and the ratio F2i/F2u significantly differed between patients and healthy individuals pretreatment. These variables, along with perceptual vowel ratings, significantly changed (improved) in the group receiving LSVT only.
Conclusion: These results, along with previous findings, add further support to the generalized therapeutic impact of intensive voice treatment on orofacial functions (speech, swallowing, facial expression) and respiratory and laryngeal functions in individuals with PD.
KEY WORDS: Parkinson's disease, voice treatment, articulatory acoustics, vowels
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