| 1. |
- Elm, Lovisa, et al.
(author)
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Clinical practices in Swedish speech-language pathology for children with (developmental) language disorder
- 2024
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In: Clinical Linguistics & Phonetics. - : TAYLOR & FRANCIS INC. - 0269-9206 .- 1464-5076.
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Journal article (peer-reviewed)abstract
- In Sweden, treatment for children with (developmental) language disorder ((D)LD) is traditionally carried out at a speech-language pathology (SLP) clinic, and based on formal language tests, which may not entirely represent the child's everyday language and communication skills. SLP services that include video recordings have shown positive outcomes in terms of providing information about children's linguistic and communicative abilities in everyday life, but little is known about the use of video in clinical practice. The aim of this study is therefore to investigate how Swedish SLPs link their clinical practices (assessment, treatment, and evaluation of treatment outcome) to the everyday language and communication abilities of children with (D)LD. A further aim is to explore SLPs' utilisation of video recordings as a part of their clinical practices with the target group. A web-based questionnaire was distributed to SLPs in Sweden, who work with children with (D)LD. Results demonstrate that Swedish SLPs perceive that their intervention is in alignment with children's everyday language and communication needs to a fairly high degree. However, an exception is assessment, which is considered to have a weaker alignment with children's everyday communication abilities. The use of video recordings for clinical purposes is very limited. It is suggested here that incorporating video recordings from children's everyday life would be an easy and time-efficient way to strengthen the ecological validity of SLP practices for children with (D)LD.
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| 2. |
- Elm, Lovisa, et al.
(author)
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Swedish speech and language pathologists reflect on how their clinical practises align to everyday language and communication skills of children with developmental language disorder
- 2024
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In: Logopedics, Phoniatrics, Vocology. - : TAYLOR & FRANCIS LTD. - 1401-5439 .- 1651-2022.
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Journal article (peer-reviewed)abstract
- This study aims to extend current knowledge about the possibilities and challenges encountered by Swedish speech and language pathologists (SLPs) in targeting everyday language and communication in children with developmental language disorder (DLD). To explore this matter, unstructured focus groups were conducted where 15 SLPs, working with children with DLD, shared their views on the alignment between their clinical practices and children's everyday lives. Thematic analysis was used to analyse the data, which resulted in five themes: It's everyday life that matters; As an SLP, you're not a part of the child's everyday life; How do we merge the different worlds?; Resources at home vary, and The employer sets the framework for clinical practices. The SLPs stressed the importance of targeting everyday skills and needs, but they experienced themselves as being detached from the children's daily context. Collaboration with caregivers and (pre)school staff was emphasised; however, the resources and capacity of the caregivers and staff varied, and this was experienced as a challenge for providing the most appropriate care. Some children and their families were situated in a multifaceted context and needed more extensive care, and this group was described as increasing. However, the services that the SLPs were able to offer varied and were largely regulated by organisational constraints. Individualised services are crucial for ensuring a positive development for children with DLD and for empowering caregivers to be effective collaborative partners in intervention. Therefore, it is essential for SLPs to have the time and resources to ensure high-quality care.
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| 3. |
- Hengen, Johanna, et al.
(author)
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Perception of Ones Own Voice After Hearing-Aid Fitting for Naive Hearing-Aid Users and Hearing-Aid Refitting for Experienced Hearing-Aid Users
- 2020
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In: TRENDS IN HEARING. - : SAGE PUBLICATIONS INC. - 2331-2165. ; 24
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Journal article (peer-reviewed)abstract
- Dissatisfaction with the sound of ones own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing (n = 70), Experienced hearing-aid users replacing their old hearing aids (n = 70), and an unaided control group (n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of ones own voice.
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| 4. |
- Lundeborg Hammarström, Inger, et al.
(author)
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Consonants lost : a Swedish girl with protracted phonological development
- 2022
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In: Clinical Linguistics & Phonetics. - : Taylor & Francis Inc. - 0269-9206 .- 1464-5076. ; 36:9, s. 820-831
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Journal article (peer-reviewed)abstract
- This paper addresses the phonology of a Swedish girl, aged 3 years 10 months, with extensive phonological difficulties that include an unusual phonological pattern. She had relatively well-developed phonological building blocks in terms of features, stress pattern and word length (number of syllables), but had extensive difficulties regarding syllable and word shapes, with frequent deletions of both segments and whole syllables. Word-initial position was dominated by non-continuant consonants, both voiced and voiceless, with extensive deletion. Word-medial position was dominated by voiceless obstruents, with extensive use of [j] in place of voiced consonants. Word-final position was similar to word-medial, but with more deletion than [j]. Non-initial stressed syllables resemble word-initial syllables. Consonant clusters mirrored singletons, i.e. with similar substitution patterns or deletions. We present a non-linear analysis of her speech production, and a plan for intervention targeting her special difficulties.
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| 5. |
- Lundeborg Hammarström, Inger, 1956-, et al.
(author)
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Scandcleft Project Trial 2—Comparison of Speech Outcome in 1- and 2-Stage Palatal Closure in 5-Year-Olds With UCLP
- 2020
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In: Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 57:4, s. 458-469
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Journal article (peer-reviewed)abstract
- Objective: To investigate in-depth speech results in the Scandcleft Trial 2 with comparisons between surgical protocols and centers and with benchmarks from peers without cleft palate. Design: A prospective randomized clinical trial. Setting: Two Swedish and one Finnish Cleft Palate center. Participants: One hundred twelve participants were 5-years-old born with unilateral cleft lip and palate randomized to either lip repair and soft palate closure at 4 months and hard palate closure at 12 months or lip repair at 3 to 4 months (Arm A), or a closure of both the soft and hard palate at 12 months (Arm C). Main Outcome Measures: A composite measure dichotomized into velopharyngeal competency (VPC) or velopharyngeal incompetency (VPI), overall assessment of velopharyngeal function (VPC-Rate), percentage of consonants correct (PCC score), and consonant errors. In addition, number of speech therapy visits, average hearing thresholds, and secondary surgeries were documented to assess burden of treatment. Results: Across the trial, 53.5% demonstrated VPC and 46.5% VPI with no significant differences between arms or centers. In total, 27% reached age-appropriate PCC scores with no statistically significant difference between the arms. The Finnish center had significantly higher PCC scores, the Swedish centers had higher percentages of oral consonant errors. Number of speech therapy visits was significantly higher in the Finnish center. Conclusion: At age 5, poor speech outcomes with some differences between participating centers were seen but could not be attributed to surgical protocol. As one center had very few participants, the results from that center should be interpreted with caution. © 2019, American Cleft Palate-Craniofacial Association.
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| 6. |
- Myrberg, Karin, et al.
(author)
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An evaluation of a prescribed joint book reading intervention for preschool children with speech, language and communication needs
- 2023
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In: International Journal of Speech-Language Pathology. - : Taylor & Francis. - 1754-9507 .- 1754-9515. ; 25:5, s. 645-655
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Journal article (peer-reviewed)abstract
- Purpose: The aims of the present study were twofold: first, to investigate reading and screen time habits in a large clinical sample of caregivers of children with speech, language and communication needs (SLCN) before and after an 8 week intervention focussed on daily joint book reading and, second, to capture the caregivers' experiences of the activity.Method: Preschool aged children with SLCN and their caregivers were consecutively recruited during their first visit to the department of Speech and Language Pathology, Gavle County Hospital, Sweden. They participated in a survey-based interview before and after receiving an intervention with recommendations of at least 10 minutes of daily book reading with an interactional focus, as an add-on to ordinary speech-language pathology services. The results were analysed using descriptive statistics of the answers to the questions in the interview, as well as a thematic analysis of free-text comments.Result: The 135 families who participated in the pre-intervention interview survey reported variable reading frequency and screen time. The post-intervention interview survey was completed by 107 families. The results demonstrated significant increases in reading frequency and reading time, and a significant decrease in screen time per day. Caregivers also reported positive experiences of the daily interactive book reading.Conclusion: The results of this study demonstrate that a speech-language pathologist-(SLP) managed, caregiver-led book reading intervention is feasible and might have a positive impact on reading, other factors related to reading, and screen time in families of children with SLCN.
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| 7. |
- Persson, Christina, 1959, et al.
(author)
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Longitudinal Speech Outcome at 5 and 10 Years in UCLP: Influence of Speech Therapy and Secondary Velopharyngeal Surgery
- 2024
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In: CLEFT PALATE CRANIOFACIAL JOURNAL. - : SAGE PUBLICATIONS INC. - 1055-6656 .- 1545-1569.
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Journal article (peer-reviewed)abstract
- Objective: To investigate speech development of children aged 5 and 10 years with repaired unilateral cleft lip and palate (UCLP) and identify speech characteristics when speech proficiency is not at 'peer level' at 10 years. Estimate how the number of speech therapy visits are related to speech proficiency at 10 years, and what factors are predictive of whether a child's speech proficiency at 10 years is at 'peer level' or not. Design: Longitudinal complete datasets from the Scandcleft project Participants: 320 children from nine cleft palate teams in five countries, operated on with one out of four surgical methods. Interventions: Secondary velopharyngeal surgery (VP-surgery) and number of speech therapy visits (ST-visits), a proxy for speech intervention. Main Outcome Measures: 'Peer level' of percentage of consonants correct (PCC, > 91%) and the composite score of velopharyngeal competence (VPC-Sum, 0-1). Results: Speech proficiency improved, with only 23% of the participants at 'peer level' at 5 years, compared to 56% at 10 years. A poorer PCC score was the most sensitive marker for the 44% below 'peer level' at 10-year-of-age. The best predictor of 'peer level' speech proficiency at 10 years was speech proficiency at 5 years. A high number of ST-visits received did not improve the probability of achieving 'peer level' speech, and many children seemed to have received excessive amounts of ST-visits without substantial improvement. Conclusions: It is important to strive for speech at 'peer level' before age 5. Criteria for speech therapy intervention and for methods used needs to be evidence-based.
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| 8. |
- Willadsen, E., et al.
(author)
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Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: Speech proficiency at 10 years of age
- 2023
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In: International journal of language and communication disorders. - : WILEY. - 1368-2822 .- 1460-6984. ; 58:3, s. 892-909
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Journal article (peer-reviewed)abstract
- Background & AimTo assess consonant proficiency and velopharyngeal function in 10-year-old children born with unilateral cleft lip and palate (UCLP) within the Scandcleft project. Methods & ProceduresThree parallel group, randomized, clinical trials were undertaken as an international multicentre study by nine cleft teams in five countries. Three different surgical protocols for primary palate repair (Arm B-Lip and soft palate closure at 3-4 months, hard palate closure at 36 months, Arm C-Lip closure at 3-4 months, hard and soft palate closure at 12 months, and Arm D-Lip closure at 3-4 months combined with a single-layer closure of the hard palate using a vomer flap, soft palate closure at 12 months) were tested against a common procedure (Arm A-Lip and soft palate closure at 3-4 months followed by hard palate closure at 12 months) in the total cohort of 431 children born with a non-syndromic UCLP. Speech audio and video recordings of 399 children were available and perceptually analysed. Percentage of consonants correct (PCC) from a naming test, an overall rating of velopharyngeal competence (VPC) (VPC-Rate), and a composite measure (VPC-Sum) were reported. Outcomes & ResultsThe mean levels of consonant proficiency (PCC score) in the trial arms were 86-92% and between 58% and 83% of the children had VPC (VPC-Sum). Only 50-73% of the participants had a consonant proficiency level with their peers. Girls performed better throughout. Long delay of the hard palate repair (Arm B) indicated lower PCC and simultaneous hard and soft palate closure higher (Arm C). However, the proportion of participants with primary VPC (not including velopharyngeal surgeries) was highest in Arm B (68%) and lowest in Arm C (47%). Conclusions & ImplicationsThe speech outcome in terms of PCC and VPC was low across the trials. The different protocols had their pros and cons and there is no obvious evidence to recommend any of the protocols as superior. Aspects other than primary surgical method, such as time after velopharyngeal surgery, surgical experience, hearing level, language difficulties and speech therapy, need to be thoroughly reviewed for a better understanding of what has affected speech outcome at 10 years. WHAT THIS PAPER ADDSWhat is already known on the subjectSpeech outcomes at 10 years of age in children treated for UCLP are sparse and contradictory. Previous studies have examined speech outcomes and the relationship with surgical intervention in 5-year-olds. What this study adds to the existing knowledgeSpeech outcomes based on standardized assessment in a large group of 10-year-old children born with UCLP and surgically treated according to different protocols are presented. While speech therapy had been provided, a large proportion of the children across treatment protocols still needed further speech therapy. What are the potential or actual clinical implications of this work?Aspects other than surgery and speech function might add to the understanding of what affects speech outcome. Effective speech therapy should be available for children in addition to primary surgical repair of the cleft and secondary surgeries if needed.
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