Dysphagia is a common and severe symptom of traumatic brain injury (TBI) affecting up to 78% of patients. It is associated with pneumonia, increased morbidity, and mortality. Although subdural ...hematoma (SDH) accounts for over 50% of TBI, the occurrence of dysphagia in this subtype has not been investigated yet.
All patients with SDH admitted to the author's institution between the years 2007 and 2020 were included in the study. Patients with SDH and clinical suspicion for dysphagia received a clinical swallowing assessment by a speech and language pathologist (SLP). Furthermore, the severity of dysphagia was rated according to swallowing disorder scale. Functional outcome was evaluated by the Glasgow outcome scale (GOS).
Out of 545 patients with SDH, 71 patients had dysphagia (13%). The prevalence of dysphagia was significantly lower in the surgical arm compared to the conservative arm (11.8 vs. 21.8%; OR 0.23;
= 0.02). Independent predictors for dysphagia were GCS <13 at admission (OR 4.17;
< 0.001), cardiovascular disease (OR 2.29;
= 0.002), and pneumonia (OR 2.88;
= 0.002), whereas the operation was a protective factor (OR 0.2;
< 0.001). In a subgroup analysis, right-sided SDH was an additional predictor for dysphagia (OR 2.7;
< 0.001). Overall, patients with dysphagia improved significantly under the SLP treatment from the initial diagnosis to hospital discharge (
< 0.01). However, a subgroup of patients with the most severe grade of dysphagia showed no significant improvement. Patients with dysphagia had significantly worse outcomes (GOS 1-3) compared to those without dysphagia (48.8 vs. 26.4%;
< 0.001).
Dysphagia is a frequent symptom in SDH, and the early identification of dysphagia is crucial regarding the initiation of treatment and functional outcome. Surgery is effective in preventing dysphagia and should be considered in high-risked patients.
Background
Previous research, although scarce, has indicated that the general public is still relatively unaware of developmental language disorder (DLD), one of the most common (neuro)developmental ...disorders. Raising awareness would increase timely involvement in intervention procedures.
Aims
To examine public awareness of DLD in the neighbouring countries of Croatia, Italy and Slovenia, as well as to assess the influence of age, gender and education level on that awareness. Also, to investigate public knowledge about the professionals who recognize DLD and to compare the awareness of DLD with that of other (neuro)developmental disorders in childhood.
Methods & Procedures
A convenience sample of adults living in the countries of the Adriatic region—Croatia (N = 92), Italy (N = 105) and Slovenia (N = 90)—were asked to fill out a paper‐and‐pencil questionnaire (public survey) developed within the Working Group 3 of the COST Action IS1406. Responses were analysed quantitatively as a function of age, gender, education level and country using the t‐test and analysis of variance (ANOVA).
Outcomes & Results
Public awareness of DLD is still unsatisfactory in all three countries. Around 70% of respondents reported having heard of DLD; however, only around 20% of Croatian, 40% of Italian and 5% of Slovenian respondents provided an adequate definition of DLD. Differences in research and clinical traditions may explain the observed variations amongst the three countries. Education level was the only variable that was significantly associated with an awareness of DLD in Croatia and Italy: there, more educated people showed a higher awareness and more correct knowledge, which was not found in the Slovenian sample. Respondents generally perceived speech and language pathologists (SLPs) as the professionals responsible for recognizing DLD. Finally, people possess the highest awareness of autism spectrum disorder (ASD), while the awareness of DLD and other (neuro)developmental disorders is equally low.
Conclusions & Implications
Public awareness of DLD varies substantially among the three countries, but there is space for improvement in each of them. The findings of this study build on the existing data from the international group of collaborators, and argue for well‐planned, systematic awareness‐raising activities in the region.
WHAT THIS PAPER ADDS
What is already known on the subject
DLD is one of the most common (neuro)developmental disorders, yet it is not well known to the general public. This low awareness hinders timely recognition and adequate intervention, which can have negative psychosocial and emotional consequences for affected individuals. It is known that the awareness of any disorder can depend on one's demographic characteristics, but levels of awareness of DLD are still not examined in detail.
What this study adds to existing knowledge
Public awareness of DLD is moderate in Croatia, Italy and Slovenia, but many individuals who report having heard of it appear to misunderstand what it actually is. Of various demographic factors tested, only education significantly influenced public awareness in Croatia and Italy, where more educated people possess greater knowledge. Moreover, respondents generally perceived SLPs as professionals responsible for recognizing DLD.
What are the potential or actual clinical implications of this work?
Professionals and researchers should focus on raising DLD awareness in the general public of these three countries, and may need to target different demographic groups accordingly.
Childhood apraxia of speech (CAS) is difficult to diagnose because there is little agreement on objective clinical markers. Since studies of phonological development in French-speaking children are ...scarce, there are even fewer recognised markers in French as compared to English. This study aims to determine if a set of operationalised, quantitative measures derived from clinical markers of CAS in English corroborate with clinical CAS diagnosis in French-speaking children. This research contributes to improving differential diagnosis of CAS and phonological disorder cross-linguistically.
We collected data from five children diagnosed with CAS, nine children diagnosed with phonological disorder, and 75 typically-developing children aged 5.10-9.2 years old. All children were assessed on three speech production tasks: picture-naming, non-word repetition, and diadochokinesis. We extracted 20 quantitative measures corresponding to commonly accepted clinical features of CAS.
Similar to English-speaking children, French-speaking children with CAS exhibited a high number of vowel errors, consonant and cluster errors, consonant epentheses, devoicing errors, slow diadochokinesis rate, more inconsistency and increased errors with longer words. Contrary to studies on English, these children with CAS did not produce intrusive schwas or vowels.
This multiple-case study highlights the need for cross-linguistic diagnostic criteria for CAS.
The growing number of elderly multilingual speakers suffering from strokes and aphasia requires a change in the services of speech and language pathologists (SLPs), who will be serving culturally and ...linguistically diverse individuals to an increasing extent. Two American studies have shown that a majority of SLPs who work with multilingual adults in the US felt that their academic and clinical training had left them insufficiently prepared for working with multilingual persons with aphasia (MPWAs). This insecurity may have considerable negative consequences for MPWAs and their families. Little is known about the generalizability of these studies; hence the objective of the present study is to investigate whether the US situation is comparable to a European country with different demographics. A web-based questionnaire was administered to SLPs in Norway, examining multiple factors regarding work setting, professional training, clinical tools and procedures, and service delivery issues with MPWAs. Overall, the results are in line with Centeno's, showing that SLPs make sensible decisions to serve MPWAs despite inadequate education programmes, shortcomings in clinical training, and limited clinical resources. The results are discussed in terms of their implications for professional education and the measures needed to minimize present shortcomings in service delivery to MPWAs.
Purpose: This study examined speech and language pathologists' (SLPs') perceptions and practices of communication partner training with high-tech speech generating devices (SGDs).
Method: Fifteen ...SLPs were recruited throughout Sweden. The SLPs answered a study-specific questionnaire on communication partner training in relation to communication partners to children with severe cerebral palsy and intellectual disability. The results were analysed with descriptive statistics (closed-ended questions, responses on Likert scales) and content analysis (open-ended question) using ICF-CY.
Results: Twelve SLPs completed the survey. Half had no or one training session with communication partners in the last year. One-third never used documents for goal-setting. Half seldom or never taught communication partner strategies. Three quarters only used verbal instructions. The main obstacles were environmental factors.
Conclusions: This study contributes valuable knowledge about high-tech SGD interventions targeting communication partners. The high-tech SGD intervention may benefit from goal-setting, extended number of training sessions and a range of instructional approaches.
Implications for Rehabilitation
Speech and language pathologist (SLPs) reported that children with severe cerebral palsy and intellectual disability (SSPI) can benefit from speech generating device (SGD) communication.
Communication partner strategies and goal-setting supports the development of communication with SGD. SLPs seldom taught stakeholder communication partner strategies and instruments for goal-setting.
Because stakeholders may vary in their way of learning SLPs need to use a variety of instructional approaches. SLPs used few instructional approaches, typically verbal information.
Introducción: el docente es un profesional que presenta riesgo para el desarrollo de patologías vocales consideradas enfermedades laborales. En Viña del Mar, el Instituto de seguridad del trabajo ...(IST) es un centro de referencia para las atenciones médicas de enfermedades laborales. El objetivo del estudio consiste en establecer la incidencia y prevalencia de profesores de Viña del Mar, Chile, que concurrieron al IST con quejas vocales entre 2012 y 2017.
Metodología: se adoptó un enfoque cuantitativo, retrospectivo, descriptivo, correlacional y de diseño no experimental. La muestra estuvo conformada por 186 profesores que presentaron quejas vocales relacionadas con su desempeño laboral.
Resultados: 167 docentes mujeres y 19 docentes hombres consultaron por problemas vocales; 64.5% docentes de la muestra realizan clases en educación básica. Ningún docente universitario accedió al IST con este tipo de queja. El diagnóstico más recurrente fue de disfonías orgánico-funcionales (75,8%), de las cuales 69,5% fueron dirigidas a terapia vocal en el IST. 14,1% de los docentes fueron diagnosticados con disfonía funcional (también fueron enviados a terapia); sin embargo, 9,4% de los casos, al no cumplir con las características de origen exclusivamente laboral, no recibieron terapia fonoaudiológica en el IST.
Conclusión: el docente chileno en la V Región presenta un bajo nivel de consulta por patologías vocales. Los docentes de educación básica son los que más buscan terapia profesional para su voz y la mayor cantidad de afecciones se relacionan con un deficiente conocimiento de técnicas y/o hábitos vocales inadecuados. Es necesaria una inversión mayor en promoción y prevención vocal para este grupo profesional.
To determine the level of understanding and use of augmentative and alternative communication devices in Pakistani speech pathologists..
The cross-sectional survey was conducted from January to June ...2015 in six major cities of Pakistan: Islamabad, Rawalpindi, Lahore, Karachi, Quetta and Peshawar. It comprised speech and language pathologists who were asked to fill a questionnaire that consisted of10 questions. Data was analysed using SPSS17. Result: Overall calculated mean and standard error of mean from the respondents who agreed and strongly agreed regarding understanding, opinion-assessment and treatment about augmentative and alternative communication was153±36.373 and 12.124 respectively.
Of the 132 subjects, 68(51.5%) were in the education group and 64(48.5%) in the control group. Postintervention, 11(16.2%) women in the education group and 37(57.8%)in the control group developed severe preeclampsia. Subsequently, 44(64.7%) in the education group had no preeclampsia. The corresponding number in the control group was 15(23.4%).
Speech pathologists had understanding of assessing and working with individuals using augmentative and alternative communication.
COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the ...bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted).
Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests).
Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients.
Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both.
The purpose of this paper is to describe the content and process of a literacy and language support model that was implemented with young children from marginalised communities, where no access to ...speech and language pathologist (SLP) services exists. The importance of language for literacy development is emphasised with explicit strategies for classroom application.
The SLP introduced an intervention programme to Early Childhood Development (ECD) kindergarten teachers, as part of a pre- and post-test literacy study. The strategies included oral reading, one-on-one reading and paired-reading. The participants provided informed consent. The intervention was presented to the experimental (Exp) group during the study process and to the comparison group after the study was completed.
Post-intervention findings revealed a significant improvement in the Exp group scores on concepts about print. The ECD teachers reported a difference in the children's awareness of printed materials, confirming that the approaches introduced by the SLP are central in teachers' instruction. This finding supports the contribution that emergent literacy and language support models would have for children, especially those from marginalised communities, where access to resources are limited. Furthermore, the collaboration between SLP and the ECD staff will strengthen these support structures. Thus, explicit early intervention develops skills for school-readiness and academic success; this forms part of the solution in providing early access to language and literacy programmes in developing countries.
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