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Sommer CL, Aljaro KG, Palomares Aguilera M, Yu-Quibael V, Cordero K. Speech and Resonance Disorders in Children With Cleft Palate: Diagnostic Evaluation and Current Speech Therapy Modalities. J Craniofac Surg 2024:00001665-990000000-01674. [PMID: 38836795 DOI: 10.1097/scs.0000000000010363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/04/2024] [Indexed: 06/06/2024] Open
Abstract
This article will provide an overview of how speech and resonance can be impacted in children with cleft palate. The authors will outline evidence-based assessment and treatment approaches commonly used for children with cleft palate and provide information on current initiatives to provide speech therapy. The methods discussed will be the use of telehealth to provide access to speech therapy for patients in areas without speech-language pathologists and the use of speech therapy camps to offer intensive, limited-duration speech therapy for groups of children due to the lack of trained providers in certain geographical regions.
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Affiliation(s)
- Chelsea L Sommer
- Florida International University
- Nicklaus Children's Hospital, Miami, FL
| | | | - Mirta Palomares Aguilera
- Smile Train-South American Medical Advisory Council (SAMAC)
- Speech Therapy Unit, Alfredo Gantz Mann Foundation
- Speech Therapy Dr. Luis Calvo Mackenna Hospita, Santiago, Chile
| | | | - Kelly Cordero
- Phoenix Children's Center for Cleft and Craniofacial Care, Phoenix, AZ
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Tahmasebi N, Zarifian T, Ashtari A, Biglarian A. Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54426. [PMID: 38640014 PMCID: PMC11069098 DOI: 10.2196/54426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. OBJECTIVE This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. METHODS A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). RESULTS The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. CONCLUSIONS The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54426.
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Affiliation(s)
- Neda Tahmasebi
- Department of Speech Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Talieh Zarifian
- Department of Speech Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Atieh Ashtari
- Department of Speech Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Biglarian
- Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Abdi-Dezfuli A, Moradi N, Pamplona MDC, Soltani M, Moghtader M, Seyed Tabib M, Aghadoost S. Investigation of the effectiveness of articulation therapy through tele-practice on children with cleft palate in Khuzestan Province during COVID-19 pandemic. Int J Pediatr Otorhinolaryngol 2024; 179:111918. [PMID: 38518421 DOI: 10.1016/j.ijporl.2024.111918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION A cleft palate is a common type of facial malformation. Compensatory articulation errors are one of the important causes of unclear speech in children with cleft palate. Tele-practice (TP) helps to connect therapists and clients for assessment and therapy. Our goal is to investigate the effectiveness of articulation therapy through tele-practice on cleft palate children in Khuzestan Province during the COVID-19 pandemic. MATERIALS & METHODS Before starting the treatment, a 20-min speech sample was recorded individually from all the children. Speech intelligibility and the percentage of correct consonants were assessed for each speech sample. The control group received treatment sessions in person at the cleft palate center, and the other group received treatment via tele-practice using the ZOOM platform. Treatment sessions were provided in the form of 45-60-min group sessions, twice a week, for 5 weeks (10 sessions in total). After 10 treatment sessions, the speech sample was recorded again. The level of parental satisfaction was measured using a Likert 5-level survey. RESULTS The mean score of intelligibility of the two groups decreased (-1.4400 and 0.7200). The two groups' mean percentage of correct consonants increased. (26.09 and 17.90). In both groups, the mean score of parents' satisfaction with the treatment was high (3.44 and 3.84). The mean of difference before and after the speech intelligibility and the percentage of correct consonants variables in both groups was statistically significant (P = 0.001 and P = 0.002, respectively). In both groups, the satisfaction variable was not associated with a statistically significant difference (P = 0.067). CONCLUSION The effectiveness of in-person therapy over a certain period of time is higher than tele-practice. Nevertheless, the results demonstrated an increase in the intelligibility of speech and the percentage of correct consonants in both groups, thus proving the effectiveness of articulation therapy in correcting compensatory articulation errors in children with cleft palate through in-person and tele-practice.
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Affiliation(s)
- Ayda Abdi-Dezfuli
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Negin Moradi
- Department of Communication Sciences and Disorders, University of Wisconsin-River Falls, USA.
| | - Maria Del Carmen Pamplona
- Plastic and Reconstructive Surgery Division, Hospital General Dr. Manuel Gea González, Mexico City, Mexico; Hablarte e Integrarte AC, Mexico City, Mexico.
| | - Majid Soltani
- Musculoskeletal Rehabilitation Research Center, Department of Speech Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Maedeh Moghtader
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Maryam Seyed Tabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Samira Aghadoost
- Department of Speech Therapy, School of Rehabilitation at Tehran University of Medical Sciences, Tehran, Iran.
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Hayakawa T, Imura H, Inoue C, Mori T, Aihara Y, Tsujiuchi S, Niimi T, Natsume N. Efficacy of telepractice, an alternative therapy tool during the coronavirus disease 2019 pandemic, for speech disorders related to congenital anomalies. Congenit Anom (Kyoto) 2023; 63:206-210. [PMID: 37749073 DOI: 10.1111/cga.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/27/2023]
Abstract
Since telepractice regulation does not yet exist in Japan, we assessed telepractice efficacy and the level of satisfaction with telepractice versus that with face-to-face practice (FTFP) in speech therapy to establish effective telepractice in Japan. Changes in the number of therapy sessions and therapy levels were compared between telepractice and FTFP sessions conducted during the study period. Additionally, the patients' parents completed a questionnaire survey regarding telepractice. The mean number of sessions was not significantly different between the two types of therapy; the therapy levels, according to stepwise speech therapy, either increased or remained unchanged. The survey showed satisfaction with telepractice among all parents. Telepractice for cleft palate speech was delivered successfully with complete parental satisfaction.
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Affiliation(s)
- Toko Hayakawa
- Department of Health Science, Aichi Gakuin University, Nisshin, Japan
| | - Hideto Imura
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Chisako Inoue
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Tomoko Mori
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | | | - Shion Tsujiuchi
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Teruyuki Niimi
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Nagato Natsume
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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Hsu SC, Wong AMK. Association between interruption of intervention and language performance in young children with language delay-a cohort study during COVID-19 pandemic. Front Pediatr 2023; 11:1240354. [PMID: 37780049 PMCID: PMC10540636 DOI: 10.3389/fped.2023.1240354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/17/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction To assess the association between a three-month interruption of language intervention programs and the language performance of children with language delay during the COVID-19 pandemic, and to identify which children are more vulnerable to such interruptions. Materials and methods This is a retrospective study involving 33 children with language delay who experienced a three-month suspension of language interventions due to the COVID-19 pandemic. We collected their demographic data and language performance scores from the Comprehensive Developmental Inventory for Infants and Toddlers-Diagnostic test (CDIIT-DT) at four different time points. The scores were analyzed using a Wilcoxon Signed Ranks test. Results The median scores of language comprehension and overall language ability showed a decreasing trend during the interruption period. However, resuming interventions post-interruption showed a statistically significant increase in all language domains. Children in the borderline delay group (CDIIT-DT DQ scores between 71 and 85) were more likely to experience a decline in their language abilities during the interruption. Discussion This is the first study to reveal a decreasing trend in language performance during interruption periods, and highlighting the significance of post-interruption language interventions in facilitating improvements. Furthermore, our study brings attention to the heightened vulnerability of children exhibiting borderline language delay in overall language ability tests when faced with interruptions in language interventions.
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Affiliation(s)
- Shao-Chih Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabiltiation, New Taipei City Municipal Tucheng Hospital, Chang Gung Memorial Hospital, Tucheng branch, New Taipei City, Taiwan
| | - Alice May-Kuen Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabiltiation, New Taipei City Municipal Tucheng Hospital, Chang Gung Memorial Hospital, Tucheng branch, New Taipei City, Taiwan
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Guglani I, Sanskriti S, Joshi SH, Anjankar A. Speech-Language Therapy Through Telepractice During COVID-19 and Its Way Forward: A Scoping Review. Cureus 2023; 15:e44808. [PMID: 37809138 PMCID: PMC10560081 DOI: 10.7759/cureus.44808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
The overall burden of voice disorders is vast, and speech-language therapy has been in use for long to prevent, assess, diagnose, and treat different speech and language disorders. Due to the COVID-19 outbreak, these services are not readily accessible because of various precautionary measures that have been laid down by the government to check the blowout of infection; as a solution to this, there has been a rise in telepractice. The purpose of this review article is to study the usefulness of telepractice for speech-language therapy during the COVID-19 pandemic and its way forward. Search was performed in the PubMed database. A total of 102 articles were found, out of which 32 articles were included through a comprehensive inclusion and exclusion criteria. This study analyzes various papers on the use of telepractice during COVID-19 for speech-language therapy. The satisfaction was greater among women as compared to men because women could get the appointment done at home and they could easily manage their household chores. It has been recognized as an "attend anywhere" web-based platform that provides us with the 5 C's, namely, easy-to-access care, increased comfort, increased convenience, reduced cost, and higher confidentiality. Patients look for such sessions in the future, even when the pandemic is over. Telepractice has now been accepted as the new healthcare delivery model with multiple advantages and disadvantages. However, more research needs to be done on the moral and environmental aspects related to its use.
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Affiliation(s)
- Ishita Guglani
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanskriti Sanskriti
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shiv H Joshi
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashish Anjankar
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kilinc DD, Mansiz D. Myofunctional orofacial examination tests: a literature review. BMC Oral Health 2023; 23:350. [PMID: 37268963 DOI: 10.1186/s12903-023-03056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/17/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Myofunctional orofacial examination (MOE) is an important tool for the assessment of the stomatognathic system and orofacial functions, and the early diagnosis of orofacial myofunctional disorders. Therefore, the purpose of the study is to scan the literature and determine the most preferred test for myofunctional orofacial examination. MATERIALS AND METHODS A literature review was conducted to collect information. Pubmed and ScienceDirect database was explored by using keywords gained by MeSH (Medical Subject Headings). RESULTS Fifty-six studies were retrived from the search and all of the studies were screened and evaluated regarding the subject, aim, conclusions and the orofacial myofunctional examination test they used. It has been observed that traditional evaluation and inspection methods have been replaced by newer and methodological approaches in recent years. CONCLUSIONS Although the few tests used differ, 'Orofacial Examination Test With Scores' (OMES) was found to be the most preferred myofunctional orofacial evaluation method from ENT to cardiology.
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Affiliation(s)
| | - Duygu Mansiz
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey
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Bartamay Ş, Cangi ME, Baba K, Çavdar D, Erdem H. Is Articulation Assessment via Synchronous Telepractice as Reliable as In-Person Assessment? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1275-1295. [PMID: 36961961 DOI: 10.1044/2023_ajslp-22-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE This study aimed to determine whether articulation assessment via telepractice is as reliable as in-person assessment. METHOD Thirty-four children aged 4-11 years with speech sound disorder (SSD) participated in the study. The Articulation Subtest (SET) of the Turkish Articulation and Phonology Test (SST) was used to assess the children's articulation skills. The study's procedures comprised two stages. First, in the Baseline Pilot Stage, five speech-language pathologists (SLPs; four graduate SLPs and one SLP with a PhD degree) conducted in-person assessments on seven children, and their agreement was examined (α for five SLPs = .950; p < .0001). In the Main Assessment Stage, four SLPs assessed 27 children synchronously on four separate days through either online (two SLPs) or in-person (the other two SLPs) clinician roles, which changed daily. Online evaluators did not use microphones and headphones to avoid any advantage. The agreement among the four raters was examined by calculating the intraclass correlation coefficient. RESULTS The results revealed an excellent level of agreement regarding overall assessment between online and in-person clinicians (p < .0001). All articulation manners were acceptable, good, or excellent. However, some sounds' (α < .7 for /d/, /ɣ/, /b/; α < .8 for /p/, /ʃ/, /t/, /l/, /v/) reliability levels were relatively low compared with others. CONCLUSIONS There may be certain restrictiveness regarding discriminating visual or auditory clues related to certain phonemes in a telepractice environment. This restrictiveness may be related with sonority and with differentiation between minimal pairs where visual clues are limited.
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Affiliation(s)
- Şeyma Bartamay
- Speech and Language Therapy, Üsküdar University, İstanbul, Turkey
| | - M Emrah Cangi
- Speech and Language Therapy, University of Health Sciences, İstanbul, Turkey
| | - Kübra Baba
- Speech and Language Therapy, Üsküdar University, İstanbul, Turkey
| | - Derya Çavdar
- Speech and Language Therapy, Üsküdar University, İstanbul, Turkey
| | - Handan Erdem
- Speech and Language Therapy, Üsküdar University, İstanbul, Turkey
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De Taeye R, Van Lierde K, Alighieri C. Telepractice in the diagnosis and treatment of pediatric speech-language disorders: The opinions and experiences of speech-language pathologists. Int J Pediatr Otorhinolaryngol 2023; 169:111560. [PMID: 37116275 DOI: 10.1016/j.ijporl.2023.111560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
PURPOSE This prospective cross-sectional study aimed to investigate the opinions and experiences with telepractice (TP) of Dutch-speaking speech-language pathologists (SLPs) living in the Dutch-speaking part of Belgium (Flanders). This study will help to optimize care for children with speech-language disorders as we will gain more insight into the experienced barriers and facilitators while using TP for assessing and treating these disorders. METHOD Twenty-nine Dutch-speaking speech-language pathologists living in Flanders (age category 20-30 years: n = 16/29, 55.2%, 31-40 years: n = 10/29, 34.2%, 41-50 years: n = 2/29, 6.9%, 51-60 years: n = 1/29, 3.4%) were recruited through the social media. An online questionnaire was developed based on the available literature and administered to the SLPs. To compare the opinions and experiences of SLPs with TP, χ2 tests or Fisher's exact tests were used. RESULTS The study showed a statistically significant association between years of clinical experience of SLPs and their opinion that TP does not provide more options in a clinical setting compared to face-to-face contact. SLPs who had expertise in multiple domains experienced significantly more added value of TP during the corona pandemic than SLPs who had expertise in only one specific domain. Additionally, SLPs who worked in a private practice indicated significantly more difficulties in developing a therapeutic relationship due to a lack of personal contact than SLPs who worked in other settings. 51.7% (15/29) of the SLPs experienced technical barriers using TP. CONCLUSION Expertise in multiple domains of pediatric speech-language therapy resulted in experiencing more added value of TP during the corona pandemic, possibly because of the experience of multiple different and simultaneous advantages of TP in several domains. Additionally, SLPs in a private practice experienced more difficulties in developing a therapeutic relationship due to a lack of personal contact with their clients. This is in contrast to hospitals where children are often seen for a shorter period. Hence, there may be less chance of a negative perception of relationships with clients. Another conclusion is that treatment drop-out was not larger using TP compared to face-to-face therapy. However, SLPs experienced that the use of TP was not promoted/encouraged by their employer possibly because of technical barriers. It is hoped that the findings of this study will help SLPs and policymakers overthrow existing barriers and make telepractice a substantial, effective, and efficient service delivery model.
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Affiliation(s)
- Robin De Taeye
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Gent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Gent, Belgium
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Gent, Belgium.
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Alighieri C, Van Lierde K, Cammu H, Vanoost L, Bettens K. The retrospective acceptability of high intensity versus low intensity speech intervention in children with a cleft palate: A qualitative study from the parents' point of view using the Theoretical Framework of Acceptability. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:326-341. [PMID: 36189983 DOI: 10.1111/1460-6984.12788] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Increasing attention is paid to the effectiveness of high-intensity speech intervention in children with a cleft (lip and) palate (CP±L). It is, however, unknown if high-intensity intervention is acceptable to the intervention recipients. Parents have an integral role in supporting their children with intervention highlighting the importance of intervention acceptability to parents. AIMS To compare the retrospective acceptability of high-intensity speech intervention (10 1-hr speech therapy sessions divided over 2 weeks) with the retrospective acceptability of low-intensity speech intervention (10 1-hr speech therapy sessions divided over 10 weeks) for children with a CP±L from the parents' point of view. METHODS & PROCEDURES Twelve parents of 12 children, aged 6-0 years who received high-intensity speech intervention (n = 6) or low-intensity speech intervention (n = 6), were invited to participate in this study. Seven parents (n = 3 in the high-intensity group and n = 4 in the low-intensity group) agreed to participate (total response rate: 7/12, 58.33%). A qualitative study design using semi-structured interviews was applied. To investigate the retrospective acceptability of the two intervention intensities, deductive coding according to the Theoretical Framework of Acceptability (TFA) was used. OUTCOMES & RESULTS With regard to the TFA construct 'affective attitude', results demonstrated that parents had positive feelings about the provided speech intervention regardless of the intensity. Parents of children who received high-intensity speech intervention reported two specific benefits related to the high intervention intensity: (1) it improved their relationship with the speech-language pathologist and (2) it improved their child's ability to make self-corrections in his/her speech. Even though both high-intensive and low-intensity speech intervention were considered burdensome (TFA construct 'burden'), parents were less likely to drop out of high-intensity intervention because the total intervention period was kept short. CONCLUSIONS & IMPLICATIONS In conclusion, high-intensity speech intervention seemed acceptable to parents. More positive codes were identified for some of the TFA constructs in the high-intensity intervention group than in the low-intensity intervention group. Considering that some parents doubted their self-efficacy to participate in high-intensity speech intervention, speech-language pathologists need to counsel them so that they can adhere to the high intervention intensity. Future studies should investigate whether high-intensity speech intervention is also acceptable to the children who receive the intervention and to the speech-language pathologists who deliver the intervention. WHAT THIS PAPER ADDS What is already known on this subject Increasing attention is paid to the effectiveness of high-intensity speech intervention in children with a cleft (lip and) palate (CP±L). Different quantitative studies have shown positive speech outcomes after high-intensity cleft speech intervention. Despite this increasing attention to high-intensity speech intervention, it is unknown whether high-intensity intervention is also acceptable to the intervention recipients. This study compared the retrospective acceptability of high-intensity speech intervention (10 1-hour speech therapy sessions divided over 2 weeks) with the retrospective acceptability of low-intensity speech intervention (10 1-hour speech therapy sessions divided over 10 weeks) in children with a CP±L from the parents' point of view. What this paper adds to existing knowledge More positive codes were identified for some of the TFA constructs in the high-intensity intervention group than in the low-intensity intervention group. Nevertheless, some parents doubted their self-efficacy to participate in high-intensity speech intervention. What are the potential or actual clinical implications of this work? The findings of this study forces us to reconsider the traditional cleft speech intervention delivery models which usually consist of low-intensity intervention. Speech-language pathologists need to counsel parents and so that they can adhere to the high intervention intensity.
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Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Gent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Gent, Belgium
| | - Heleen Cammu
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Gent, Belgium
| | - Laure Vanoost
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Gent, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University, Gent, Belgium
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Tele-rehabilitation in voice disorders during the pandemic: a consensus paper from the French Society of Phoniatrics and Laryngology. Eur Arch Otorhinolaryngol 2022; 280:2411-2419. [PMID: 36525078 PMCID: PMC9756705 DOI: 10.1007/s00405-022-07779-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To establish a consensus protocol for telerehabilitation in speech therapy for voice disorders. METHODS The study was conducted according to a modified Delphi method. Twenty speech therapist or laryngologist experts of the French Society of Phoniatrics and Laryngology assessed 24 statements of voice telerehabilitation with a 10-point visual analog scale ranging from 1 (totally disagree) to 10 (totally agree). The statements were accepted if more than 80% of the experts rated the item with a score of ≥ 8/10. The statements with ≥ 8/10 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected. RESULTS The French Society of Phoniatrics and Laryngology experts validated 10, 6, and 2 statements after the first, second and third voting round, respectively. Seven statements did not reach agreement threshold and were rejected. The validated statements included recommendations for setting (N = 4), medical/speech history (N = 2), subjective voice evaluations (N = 3), objective voice quality measurements (N = 3), and voice rehabilitation (N = 5). The experts agreed for a follow-up consisting of combined telerehabilitation and in-office rehabilitation. The final protocol may be applied in context of pandemic but could be assessed out of pandemic period for patients located in rural regions. CONCLUSIONS This Delphi study established the first telerehabilitation protocol of the French Society of Phoniatrics and Laryngology for patients with voice disorders. Future controlled studies are needed to assess its feasibility, reliability, and the patient perception about telerehabilitation versus in-office rehabilitation.
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Smythe T, Freeze L, Cuthel A, Flowers M, Seghers F, Zia N, Bachani AM. Provision of rehabilitation for congenital conditions. Bull World Health Organ 2022; 100:717-725. [PMID: 36324557 PMCID: PMC9589394 DOI: 10.2471/blt.22.288147] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive, particularly children with disabilities. We describe the increasing prevalence of disability among children and adolescents. We evaluate the current situation regarding children with disabilities and rehabilitation in the context of health systems, particularly those in low- and middle-income countries. Within the newborn health agenda, congenital anomalies often require early intervention and rehabilitation. We provide Argentina as an example of a country where rehabilitation for congenital anomalies is integrated into the health system. We argue that congenital anomalies that require rehabilitation have the potential to strengthen rehabilitation systems and policies by: strengthening coordination between primary care and rehabilitation; identifying and understanding pathways that allow families to engage with services; providing human resources for rehabilitation; and building systems and resources that support assistive technology and rehabilitation. We propose ways for countries to prioritize and integrate early identification, referral and care for children with congenital anomalies to strengthen health systems for all. We identify opportunities to expand policy and planning and to design service delivery and workforce strategies through World Health Organization guidelines and frameworks for rehabilitation. We argue that the global health community must act to ensure that rehabilitation services to support functioning from birth are well established, accepted and integrated within health systems, and that disability is prioritized within child health. These steps would strengthen health systems, ensure functioning from birth and make rehabilitation accessible to all.
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Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, England
| | - Lindsey Freeze
- MiracleFeet, Chapel Hill, United States of America (USA)
| | - Anna Cuthel
- MiracleFeet, Chapel Hill, United States of America (USA)
| | | | | | - Nukhba Zia
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Abdulgafoor M Bachani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Massana C, Figueroa M. Telelogopedia en el contexto de la pandemia de la COVID-19: Análisis de las adaptaciones y las percepciones de los logopedas. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.77746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La telepráctica logopédica facilita los servicios en situaciones excepcionales como ha sido la pandemia de la COVID-19. A causa de las restricciones impuestas, los logopedas han tenido que adoptar nuevos enfoques en su práctica profesional. El objetivo de este estudio es analizar la percepción y la valoración que tiene el colectivo de logopedas de España respeto a la telelogopedia, describir la adaptación e identificar posibles problemáticas que hayan surgido mediante una encuesta en línea. La encuesta ha sido respondida por treinta y siete logopedas en activo. Los resultados nos muestran que la mayoría de las personas encuestadas han usado la telelogopedia (75.6%) y que su valoración respeto a ella ha aumentado durante desde el inicio de la pandemia. Tan sólo uno de los participantes había recibido formación sobre telelogopedia y dos la habían utilizado antes de la pandemia. El motivo principal de los logopedas para no realizar sesiones de telepráctica estaba relacionado con la tipología de paciente y/o una edad inadecuada. Se identifican las principales desventajas del uso de la telelogopedia y exponen propuestas para la práctica clínica.
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