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Prinsloo P, Dada S, Bastable K, Raghavendra P, Granlund M. The application of the family of participation-related constructs (fPRC) framework to AAC intervention outcomes in children with complex communication needs: a scoping review. Augment Altern Commun 2024; 40:182-195. [PMID: 37994791 DOI: 10.1080/07434618.2023.2276701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/20/2023] [Accepted: 09/24/2023] [Indexed: 11/24/2023] Open
Abstract
Participation is a fundamental human right, and being able to communicate is an essential component of participation in various life situations, such as at school, with peers, and in the community. Augmentative and alternative communication (AAC) interventions aim to facilitate communication and social interaction, independence, and participation in all aspects of life. The purpose of this study was to summarize and map the AAC intervention outcomes for children with complex communication needs onto the Family of Participation-Related Constructs (fPRC) framework. The scoping review identified 270 studies for inclusion, and the data gathered was extracted and mapped onto the fPRC framework. The results indicate that although many studies have reported on participation-related constructs such as activity competence and context, there is still insufficient focus on attendance and involvement, sense of self, and environment constructs. Hence, future research in the field of AAC is needed on the various constructs of participation proposed by the fPRC framework.
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Affiliation(s)
- Pauline Prinsloo
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Kirsty Bastable
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Parimala Raghavendra
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Mats Granlund
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
- Jönköping University and Centre for Augmentative and Alternative Communication, University of Pretoria, Jonkoping, Sweden
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Stagge F, Lanzi AM, Saylor AK, Cohen ML. Montreal Cognitive Assessment Scores Do Not Associate With Communication Challenges Reported by Adults With Alzheimer's Disease or Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1902-1910. [PMID: 38713811 DOI: 10.1044/2024_ajslp-23-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
PURPOSES Screening for cognitive-communication challenges in people with Alzheimer's disease (AD) or Parkinson's disease (PD) may benefit from multiple kinds of information about the client (e.g., patient-reported, performance-based). The purposes of this report are (a) to describe, using recently published score range descriptors (e.g., "mild," "moderate"), the patient-reported communication challenges of people with AD or PD using the Communicative Participation Item Bank (CPIB) and the Aphasia Communication Outcome Measure (ACOM); and (b) to examine the relationships between the performance-based Montreal Cognitive Assessment (MoCA), a cognitive screener, and patient-reported CPIB and ACOM scores. METHOD Participants were a convenience sample of 49 community-dwelling adults with AD or PD. Participants completed the measures in person as part of a larger assessment battery. RESULTS MoCA total scores ranged from 7 to 28. CPIB T-scores fell in the following ranges: 31% were "within normal limits," 57% reflected "mildly" restricted participation, and 12% reflected "moderately" restricted participation. ACOM T-scores fell in the following ranges: 50% were either "within normal limits" or reflected "mild" impairment, 29% reflected "mild-moderately" impaired functional communication, and 21% reflected "moderately" impaired functional communication. There were only weak and nonsignificant correlations between T-scores on the ACOM or CPIB and scores on the MoCA, and there were no group differences on the ACOM or CPIB between individuals who screened positive versus negative on the MoCA. CONCLUSION When screening individuals with AD or PD, patient-reported communication challenges seem to be complementary to information provided by the MoCA and perhaps most useful in screening for mild communication challenges.
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Affiliation(s)
- Faith Stagge
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Alyssa M Lanzi
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Anna K Saylor
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Matthew L Cohen
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
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Jewell CC, Harnish SM, Brello J, Lanzi AM, Cohen ML. Poststroke Communication Ability Predicts Patient-Informant Discrepancies in Reported Activities and Participation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1854-1867. [PMID: 38625105 DOI: 10.1044/2024_ajslp-23-00322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Participation in life situations has been identified by people with aphasia (PWA) as an ultimate outcome of rehabilitation and is often measured with patient-reported outcome measures (PROMs) or informant-reported measures. It is known that PWA and informants do not always produce similar scores on measures of activities and participation. However, systematic differences between PWA and informants and the causes of these differences are not well understood. Here, we investigated these differences as a function of language impairment, perceived level of activity and participation success, and depressive symptoms. METHOD Participants were 29 PWA-informant dyads who completed a performance-based language assessment and three measures related to different aspects of activities and participation. Outcome variables were PWA-informant difference scores in the activities and participation measures. RESULTS PWA ratings of activities and participation were not statistically significantly associated with performance-based language severity. Hierarchical regression models with both language impairment and informant-reported scores as predictor variables explained 53%-71% of the variance in PWA-informant difference scores (all p < .05). In particular, mild communication challenges were associated with the PWA reporting significantly worse participation than the informant perceived. In contrast, more severe communication challenges were associated with the PWA reporting significantly better participation than the informant perceived. DISCUSSION These findings highlight the importance of measuring participation by PROM. The PWA's experience of participation is not related to their level of language impairment and is predictably different from their care partners' perspective. As others have also reported, "mild" aphasia is not so mild to the PWA. Similarly, "severe" may not be so severe to the PWA. Further research is needed to connect these findings with counseling and caregiver education. Research on response processes (e.g., response shift) is also warranted.
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Affiliation(s)
- Courtney C Jewell
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, Newark
| | - Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, Newark
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Kokotek LE, Washington KN, Cunningham BJ, Acquavita SP. Speech-Language Outcomes in the COVID-19 Milieu for Multilingual Jamaican Preschoolers and Considerations for Telepractice Assessments. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1698-1717. [PMID: 38573244 PMCID: PMC11253648 DOI: 10.1044/2024_ajslp-23-00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/26/2023] [Accepted: 02/08/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE The purpose of this study was to characterize the communicative participation and functional speech intelligibility (i.e., how children use communication and how well they are understood across everyday life) of typically developing (TD) bilingual Jamaican preschoolers and those with functionally defined speech sound disorders (fSSDs) in the COVID-19 milieu. Findings were also compared to an existing corpus of baseline data to document and explore differences in children's speech-language outcomes secondary to pandemic-related social restrictions. METHOD Thirty bilingual Jamaican preschoolers, 21 TD and nine with fSSDs, were assessed during the pandemic via telepractice. Association and univariate mean testing were completed to characterize children's communicative participation and functional speech intelligibility. Data were then compared to an existing corpus of baseline data (collected in person between 2013 and 2019), which included direct child assessment and parent reports and consisted of TD (n = 226) Jamaican Creole-English-speaking preschoolers and those with fSSDs (n = 39) to compare performance profiles across data sets. All participants attended schools in Kingston, Jamaica. RESULTS Measures of communicative participation remained stable in the context of the COVID-19 milieu for children in the TD and fSSD groups, but functional speech intelligibility outcomes for children with fSSDs deviated between in-person findings collected from children pre-pandemic. Between-groups differences were also found on measures of speech production accuracy but were no longer significant when considering telepractice as a covariate. CONCLUSIONS Findings from this investigation serve to characterize the communicative participation and functional speech intelligibility of TD bilingual Jamaican preschoolers and those with fSSDs in the COVID-19 milieu. By extension, the results comparing data from preschoolers collected during the pandemic to an existing corpus of baseline data from a different group of preschoolers provide critical insights about multilingual children's speech-language outcomes in the context of acutely changing environmental circumstances. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25461505.
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Affiliation(s)
- Leslie E. Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Karla N. Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Communicative Sciences and Disorders, New York University, NY
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Schatz S, Gutiérrez GR. Enhancing socio-communicative functions in an MCI patient with intra-nasal insulin: a case report. Front Psychiatry 2024; 15:1326702. [PMID: 39006824 PMCID: PMC11239438 DOI: 10.3389/fpsyt.2024.1326702] [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: 11/11/2023] [Accepted: 05/28/2024] [Indexed: 07/16/2024] Open
Abstract
This report examines extended intra-nasal insulin treatment [INI] for an Insulin Resistant early Mild Cognitive Impairment [MCI] patient. Patient [EJ] also had medial temporal lobe [MTL] damage, poor short-term memory, significant irritability, and social and linguistic withdrawal at treatment start. Compared to baseline, nine months INI treatment increased grey matter volume, lowered beta-amyloid levels, and improved MCI and FAS scores. Patient also increased pragmatic capacities in social conversation and procedural memory. These findings align with results from prior clinical trials on INI and suggest that treatment can slow neurodegenerative disease progression in early MCI patients.
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Affiliation(s)
- Sara Schatz
- International Studies, The Ohio State University, Columbus, OH, United States
- Department of Evolution, Ecology, and Organismal Biology, The Ohio State University, Columbus, OH, United States
| | - Grace Rose Gutiérrez
- Department of Evolution, Ecology, and Organismal Biology, The Ohio State University, Columbus, OH, United States
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Harding S, Burr S, Cleland J, Stringer H, Wren Y. Outcome measures for children with speech sound disorder: an umbrella review. BMJ Open 2024; 14:e081446. [PMID: 38684261 PMCID: PMC11086453 DOI: 10.1136/bmjopen-2023-081446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Speech sound disorder (SSD) describes a 'persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication'. There is a need to establish which care pathways are most effective and efficient for children with SSD. Comparison of care pathways requires clearly defined, evidence-based, interventions and agreement on how to measure the outcomes. At present, no definitive list of assessments, interventions or outcomes exists. The objective of this umbrella review paper is to provide a rigorous and detailed list of assessments, interventions and outcomes which target SSD in children. DESIGN In December 2022, a systematic search of Ovid Medline, OVID Embase, CINAHL, PsycInfo and Cochrane and a number of grey literature platforms were undertaken. 18 reviews were included, and subsequently 415 primary research articles were assessed for data related to assessments, interventions or outcomes. The AMSTAR (Assessing the Methodological Quality of Systematic Reviews) framework was used to assess the quality of the retained reviews. SETTING Reviews were retained which took place in any setting. PARTICIPANTS The population is children of any age with a diagnosis of SSD of unknown origin. PRIMARY AND SECONDARY OUTCOME MEASURES Reviews reporting outcomes, assessment and interventions for children with SSD. RESULTS Extraction and analysis identified 37 assessments, 46 interventions and 30 outcome measures used in research reporting of SSD. Not all of the listed outcomes were linked to specific outcome measurement tools, but these were measurable through the use of one or more of the assessments extracted from the retained reviews. CONCLUSIONS The findings of this review will be used to develop a Core Outcome Set for children with SSD. The findings are part of a rigorous process essential for advancing healthcare research and practice in the specific area of speech and language therapy for children with SSD. PROSPERO REGISTRATION NUMBER CRD42022316284.
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Affiliation(s)
- Sam Harding
- Southmead Hospital, Bristol, UK
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Westbury on Trym, UK
| | - Sam Burr
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Westbury on Trym, UK
| | - Joanne Cleland
- Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Helen Stringer
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Westbury on Trym, UK
- Bristol Dental School, University of Bristol, Bristol, UK
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Alons E, Brauner L, Luinge M, Terwee CB, van Ewijk L, Gerrits E. Identifying Relevant Concepts for the Development of a Communicative Participation Item Bank for Children and Adolescents: A Systematic Review of Existing Instruments. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1186-1205. [PMID: 38358947 DOI: 10.1044/2024_jslhr-23-00376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE This study aims to systematically identify items that measure communicative participation from measurement instruments that measure (aspects of) communication and/or participation in children and adolescents (5-18 years old) with communication disorders, for developing an item bank. METHOD A systematic literature search was performed in MEDLINE and Embase to search for patient-reported outcome measures (PROMs) or parent reports measuring aspects of communication and/or participation in children and adolescents. The individual items of the included measurement instruments were reviewed on whether they measure communicative participation. The items were then classified into one of the International Classification of Functioning, Disability and Health (ICF) for Children and Youth (World Health Organization, 2007) domains of activities and participation. RESULTS A total of 29 instruments were found, nine PROMs and 20 parent reports. One hundred forty-five items were identified that measure communicative participation. From these 145 items, 74 were retrieved from PROMs (51%), and 71 were retrieved from parent reports (49%). The majority of items were classified in ICF Domain 7, interpersonal interactions and relationships (73.8%), followed by Domain 8, major life areas (13.8%), and Domain 9, community, social, and civic life (8.3%). Only a few items were found in Domains 5 and 6, and none was found in Domains 1, 2, and 4. CONCLUSIONS We identified 145 items potentially useful for developing an item bank addressing communicative participation in children and adolescents with communication disorders. However, item development in collaboration with the target population is needed to ensure that these items fully reflect the construct.
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Affiliation(s)
- Eline Alons
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
| | - Laurien Brauner
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
| | - Margreet Luinge
- Centre of Expertise Healthy Ageing and Youth, Education and Society, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit, the Netherlands
- Methodology Program, Amsterdam Public Health Research Institute, the Netherlands
| | - Lizet van Ewijk
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Ellen Gerrits
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
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Allison KM, Doherty KM. Relation of Speech-Language Profile and Communication Modality to Participation of Children With Cerebral Palsy. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1040-1050. [PMID: 38215219 DOI: 10.1044/2023_ajslp-23-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
PURPOSE This study aimed to examine the contribution of speech motor impairment (SMI), language impairment, and communication modality to communicative and overall participation outcomes in school-age children with cerebral palsy (CP). METHOD Eighty-one caregivers of children with CP provided information about their child's speech and language skills, communication modality, and participation through a web-based survey. Caregiver responses to two validated scales were used to quantify children's communicative participation and overall participation. Children were classified into four speech-language profile groups and three communication modality groups for comparison, based on caregiver-reported information regarding their child's communication skills. RESULTS Children with CP who had co-occurring SMI and language impairment had significantly lower levels of communicative participation and involvement in activities overall, compared to children with SMI alone. Among children with SMI, augmentative and alternative communication (AAC) use was associated with greater overall frequency of participation and involvement in life activities. CONCLUSION Children with CP who have both SMI and language impairment and those who are nonspeaking communicators should be prioritized early for communication interventions focused on maximizing participation, including consideration of AAC.
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Affiliation(s)
- Kristen M Allison
- Department of Communication Sciences & Disorders, Northeastern University, Boston, MA
| | - Kayla M Doherty
- Department of Communication Sciences & Disorders, Northeastern University, Boston, MA
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Baylor C, Cook KJ, McAuliffe MJ. "Take Us Into Account": Perspectives of Family Members of People With Parkinson's Disease Regarding Speech-Language Pathology Intervention. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:736-755. [PMID: 38092050 DOI: 10.1044/2023_ajslp-23-00273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE While communication changes associated with Parkinson's disease (PD) have been documented, research on the impact of these changes on family members is just beginning to emerge. With this new focus on family, questions arise as to how well speech-language pathology services address their needs communicating with their loved one with PD. The purpose of this study was to explore the experiences of family members of people with PD (PwPD) and their recommendations for speech-language pathology services that incorporated their needs. METHOD Seventeen spouses/partners of PwPD participated in focus groups that were recorded, transcribed, and analyzed using thematic analyses. RESULTS Three themes emerged, all focusing around the central tenet that the experiences of family members, and hence their need for speech-language pathology support, transitioned through the stages of PD progression. Theme 1 summarized increasing burdens on family to manage communication as PD progressed beyond a brief period of independent strategy use by PwPD. Theme 2 highlighted multifactorial contributors to communication burdens on families, with cognitive impairments being the most underrecognized. Theme 3 illustrated how families wanted more intervention options from speech-language pathologists (SLPs) that included them, but with a tailored approach for PD stages and personal preferences. CONCLUSIONS When SLPs provide families with either generic communication strategies or strategies that do not fit the individualized needs of PwPD and their families, we may inadvertently be increasing the burden on families. There is a need for systematic, evidence-based, family-centered interventions that include, but go beyond, current speech-focused interventions to meet the shared communication needs of PwPD and their families.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Kate J Cook
- School of Psychology, Speech and Hearing | Te Kura Mahi ā Hirikapo, University of Canterbury, Christchurch, New Zealand
| | - Megan J McAuliffe
- School of Psychology, Speech and Hearing | Te Kura Mahi ā Hirikapo, University of Canterbury, Christchurch, New Zealand
- New Zealand Institute of Language, Brain & Behaviour, University of Canterbury, Christchurch
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Baylor C, Linna Jin J, Mach H, Britton D. Communicative participation outcomes in individuals with Parkinson's disease receiving standard care speech-language therapy services in community settings. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:808-827. [PMID: 37855252 DOI: 10.1111/1460-6984.12965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/22/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The Communicative Participation Item Bank (CPIB) is a patient-reported outcome measure (PROM) designed to measure the extent of interference, or difficulty, experienced by adults with communication disorders participating in their day-to-day communication activities. To date, there is limited evidence regarding sensitivity of the CPIB for capturing change with intervention in people with Parkinson's disease (PwPD). AIMS The purpose of this study was to examine the following measurement properties of the CPIB in PwPD who received community-based, standard care, speech-language therapy focusing on motor speech concerns: Change over time between treatment and observation groups, comparison to patient-defined ideal and satisfactory targets, comparison of static short form to computerised adaptive testing (CAT), comparison of self to proxy-rated scores, and comparison to other common PROMs. METHODS AND PROCEDURES Forty-six PwPD (20 treatment/26 observation) completed data collection upon enrolment (pre-treatment) and 6 months later. In addition to the CPIB, PROMs included the Voice Handicap Index 10-item short form (VHI-10), PROMIS Global Health-Related Quality of Life, Levels of Speech Usage, self-rated speech severity, and Patient Health Questionnaire-9 (PHQ-9). Participants also engaged in qualitative interviews. Forty-four family members completed proxy CPIB ratings. OUTCOMES AND RESULTS There were no significant differences between treatment and observation groups on the CPIB pre-treatment, but there were significant differences post-treatment. The differences appeared to be largely due to significant gains in the treatment group. No participants reached their ideal CPIB target, and few reached their satisfactory target. Static CPIB short form and CAT scores were not significantly different, with an average of five CAT items administered per participant. Overall group similarities between patient and proxy scores may have obscured wide variability across individual patient-proxy pairs. Associations between CPIB and VHI-10, health-related quality of life, self-reported speech severity, and depression ranged from weak to moderate. CONCLUSIONS AND IMPLICATIONS The CPIB appears to be sensitive to capturing change with intervention, and similar results are obtained with the static short form and CAT formats. One clinical caution is that even with gains observed in the treatment group, no participants obtained their ideal communicative participation goals, and few obtained a satisfactory level of communicative participation. Thus, while current interventions are beneficial, they may not meet the full range of clients' communication needs. While responding to the CPIB through a proxy rater may be feasible, caution is warranted due to concerns about maintaining the autonomy of PwPD. WHAT THIS PAPER ADDS What is already known on this subject The communication disorders associated with Parkinson's disease (PD) can have a negative impact on quality of life and life participation as measured by patient (or person)-reported outcome measures (PROMs). The Communicative Participation Item Bank (CPIB) is one PROM available to use with adults with communication disorders. However, little is known about whether the CPIB captures changes in communicative participation as a result of standard care treatment for people with Parkinson's disease (PwPD). Use of computerised adaptive testing (CAT), proxy report and comparison to targeted participation outcomes have not been explored. What this study adds to existing knowledge As a result of this study, we know that the CPIB captured differences between treatment and observation groups after community-based, standard care speech therapy intervention focusing on motor speech production in PwPD. Static short form and CAT scores did not differ significantly, so the CAT option provides better efficiency requiring, on average, five items to administer compared to the 10-item short form. Proxy and PwPD scores did not differ as a group, but wide variability was noted. What are the potential or actual clinical implications of this work? The CPIB may be a clinically sensitive instrument for capturing changes in communicative participation after treatment. No participants met their ideal CPIB target, and few reached their satisfactory target, suggesting that while current interventions contribute to gains in communicative participation, there are still unmet needs that may call for support and interventions addressing the more complex array of factors affecting communicative participation outcomes for PwPD.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Jingyu Linna Jin
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Helen Mach
- Department Communication Sciences and Disorders, University of Delaware, Newark, Delaware, USA
| | - Deanna Britton
- Department of Speech and Hearing Sciences, Portland State University, Oregon Health and Science University, Portland, Oregon, USA
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Çağlar NA, Erbaş AN, Tığrak A, Özcebe E. Validity and Reliability Study of the Turkish Version of Focus on the Outcomes of Communication Under Six-34. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:586-594. [PMID: 38259144 DOI: 10.1044/2023_jslhr-22-00667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
PURPOSE Speech and language disorders can negatively affect preschool children's communicative participation skills. Focus on the Outcomes of Communication Under Six-34 (FOCUS-34) is a valid and reliable scale that evaluates communicative participation in preschool children with speech and language disorders. This study aimed to establish the Turkish version of FOCUS-34 (FOCUS-34-TR) and investigate its validity and reliability. METHOD A total of 175 children with language disorders, speech sound disorders, and fluency disorders (aged 20-72 months) and their parents were included in the study. Parents were asked to complete the demographic information form, the FOCUS-34-TR scale, and the Ages and Stages Questionnaires: Social-Emotional (ASQ-SE) Turkish version. The construct validity, convergent and divergent validity, internal consistency, and test-retest reliability of the scale were investigated. RESULTS The FOCUS-34-TR had high values for internal consistency (α = .97) and test-retest reliability (r = .95). The correlations between the FOCUS-34-TR total score and its subscales were between .77 and .90. A moderately significant negative correlation was found between the FOCUS-34-TR scale and the ASQ-SE. CONCLUSION The Turkish version of FOCUS-34 is a valid and reliable scale that can be used in clinics and for research purposes to evaluate the communicative participation skills of Turkish-speaking preschool children with speech and language disorders.
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Affiliation(s)
- Nazmiye Atila Çağlar
- Department of Speech and Language Therapy, Ankara Yıldırım Beyazıt University, Turkey
| | - Ayşın Noyan Erbaş
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Arcan Tığrak
- Department of Primary Education, Dumlupınar University, Kütahya, Turkey
| | - Esra Özcebe
- Department of Audiology, Istanbul University, Turkey
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Jin JL, Baylor C, Teixeira J, Yorkston K, Nuara M. Reframing transgender communication in gender-affirming communication care: Comfort and confidence are the main goals. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-15. [PMID: 37907084 DOI: 10.1080/17549507.2023.2259124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE To understand the communicative participation experiences of transgender people through a qualitative inquiry, and to address similarities and differences in experiences across genders. METHOD This study was a secondary analysis of interview data gathered for modifying the Communicative Participation Item Bank for use with transgender populations. Fourteen transgender participants attended individual qualitative interviews. During the interview, participants shared their communication experiences in various situations and the availability of social supports related to communication. Qualitative content analysis was used to develop themes and subthemes from the data. RESULT Three themes emerged from the data: the participants' priorities for comfort, safety, and authenticity; the use of an internal "checklist" to optimise their communication; and changes in attitudes towards communication over time. Across themes, participants shared core communication experiences regardless of gender identities. CONCLUSION The findings support prior research on voice-related communication experiences of transgender people. A key finding is the notion that communication success is influenced by sociocultural contexts and the physical environment beyond their communication presentation. To achieve targeted comfort and satisfaction in communication, healthcare professionals need to consider the transgender client's communication contexts, and incorporate a life-participation approach to gender-affirming voice and communication training.
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Affiliation(s)
- Jingyu Linna Jin
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Jeffrey Teixeira
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Michael Nuara
- Facial Plastic and Reconstructive Surgery, Virginia Mason Franciscan Health, Seattle, WA, USA
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Page AD, Schroeder JR, Knowles T, Jog M, Adams SG. A Comparison of Voice Amplifiers and Personal Communication Systems for Hypophonia: An Exploration of Communicative Participation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1850-1865. [PMID: 36958017 DOI: 10.1044/2023_ajslp-22-00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE The primary purpose of this study was to evaluate how individuals with hypophonia (HP; also referred to as HP participants) and their primary communication partners (PCPs; also referred to as PCP participants) rate communicative participation before and after experience with a speech amplification device. A secondary purpose was to evaluate pre- and post-device effects on self-rated communicative participation for each of the three speech amplification devices trialed outside of the laboratory. METHOD Seventeen individuals with HP and their PCPs participated in a crossover design study that compared three different amplification devices: a wired belt-pack amplifier, a wireless stationary amplifier, and a personal frequency modulation (FM) system. Both the individuals with HP and their PCPs self-rated communicative participation at baseline and after trialing each device following 1-week device trial periods at home. Patient-reported outcome measures included the Communicative Effectiveness Survey (CES) and the Voice Activity and Participation Profile (VAPP). Following study completion, participants indicated whether they would like to select a specific device to continue using. RESULTS Overall, HP participants rated communicative participation following device use higher than that in the pre-device condition, with the FM system resulting in the overall highest VAPP ratings and second highest CES ratings. Furthermore, HP and PCP participants rated these measures similarly. Finally, HP participants who selected a device to continue using self-reported lower total communicative effectiveness scores and greater voice activity limitations and participation restrictions at baseline in comparison to the nonselectors. CONCLUSIONS This study contributes to an increased understanding of how communicative participation is experienced within this clinical population resulting from speech amplification. It is suggested that the inclusion of participation-based outcome measurement is essential to ensure a multidimensional and comprehensive approach to device prescription for individuals with HP.
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Affiliation(s)
- Allyson D Page
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Jessi-Rae Schroeder
- Health & Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Thea Knowles
- Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Scott G Adams
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
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Peters B, Wiedrick J, Baylor C. Effects of Aided Communication on Communicative Participation for People With Amyotrophic Lateral Sclerosis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1450-1465. [PMID: 37335771 PMCID: PMC10473367 DOI: 10.1044/2023_ajslp-22-00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE Many people with amyotrophic lateral sclerosis (PALS) experience speech changes, which may interfere with participation in communication situations. This study was designed to investigate the effects of aided communication on self-rated communicative participation among PALS and the relationship between speech function and communicative participation for PALS at various stages of speech impairment and communication aid use. METHOD Participants with amyotrophic lateral sclerosis completed an online questionnaire in which they identified their current communication methods, rated their speech function, and rated their communicative participation in various situations on a modified version of the Communicative Participation Item Bank short form. PALS who reported using aided communication rated their communicative participation under two conditions: with unaided communication only and with access to all of their communication methods. RESULTS Communication aids appeared to support communicative participation for many participants with dysarthria. Across all levels of speech function, PALS who use aided communication reported better participation under the all-methods condition than the unaided-only condition, with the largest benefits for participants with anarthria (Revised ALS Functional Rating Scale [ALSFRS-R] speech rating = 0). Communicative participation ratings worsened with more severe speech impairment under both conditions for most levels of speech function, but PALS with anarthria (ALSFRS-R speech rating = 0) reported better participation under the all-methods condition than those who used residual speech in combination with non speech methods (ALSFRS-R speech rating = 1). CONCLUSIONS Aided communication can help PALS continue to participate in various communication situations as their speech function deteriorates. Variability in self-rated communicative participation, even for PALS at the same level of speech function, highlights the need for an individualized approach and consideration of personal and environmental factors in augmentative and alternative communication intervention. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22782986.
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Affiliation(s)
- Betts Peters
- Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, Portland
- Systems Science Program, Portland State University, OR
| | - Jack Wiedrick
- Biostatistics & Design Program, Oregon Health & Science University, Portland
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Borrie SA, Yoho SE, Healy EW, Barrett TS. The Application of Time-Frequency Masking To Improve Intelligibility of Dysarthric Speech in Background Noise. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1853-1866. [PMID: 36944186 PMCID: PMC10457087 DOI: 10.1044/2023_jslhr-22-00558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Background noise reduces speech intelligibility. Time-frequency (T-F) masking is an established signal processing technique that improves intelligibility of neurotypical speech in background noise. Here, we investigated a novel application of T-F masking, assessing its potential to improve intelligibility of neurologically degraded speech in background noise. METHOD Listener participants (N = 422) completed an intelligibility task either in the laboratory or online, listening to and transcribing audio recordings of neurotypical (control) and neurologically degraded (dysarthria) speech under three different processing types: speech in quiet (quiet), speech mixed with cafeteria noise (noise), and speech mixed with cafeteria noise and then subsequently processed by an ideal quantized mask (IQM) to remove the noise. RESULTS We observed significant reductions in intelligibility of dysarthric speech, even at highly favorable signal-to-noise ratios (+11 to +23 dB) that did not impact neurotypical speech. We also observed significant intelligibility improvements from speech in noise to IQM-processed speech for both control and dysarthric speech across a wide range of noise levels. Furthermore, the overall benefit of IQM processing for dysarthric speech was comparable with that of the control speech in background noise, as was the intelligibility data collected in the laboratory versus online. CONCLUSIONS This study demonstrates proof of concept, validating the application of T-F masks to a neurologically degraded speech signal. Given that intelligibility challenges greatly impact communication, and thus the lives of people with dysarthria and their communication partners, the development of clinical tools to enhance intelligibility in this clinical population is critical.
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Affiliation(s)
- Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Sarah E. Yoho
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Eric W. Healy
- Department of Speech and Hearing Science, The Ohio State University, Columbus
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Kokotek LE, Cunningham BJ, Washington KN. Construct validity of the focus on the outcomes of communication under six (FOCUS) total and profile scores for multilingual preschoolers: Considering functional speech skills. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:245-255. [PMID: 35220834 PMCID: PMC10078616 DOI: 10.1080/17549507.2022.2037709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE To conduct an exploratory study to establish construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS) in the Jamaican context for FOCUS Total and Profile scores. METHOD Parents of a representative sample of 3-to-6-year-old Jamaican Creole (JC)-English-speaking simultaneous bilingual children completed the FOCUS in English, and the Intelligibility in Context Scale (ICS) in JC and in English. Children completed the Diagnostic Evaluation of Articulation and Phonology (DEAP) in both languages. Percent phonemes, consonants, and vowels correct were calculated using single word responses to DEAP items. Pearson correlations were completed to describe relationships between measurement scores. RESULT Convergent validity was found for FOCUS Total and ICS/JC scores. Convergent and divergent validity were found for specific FOCUS Profile scores and ICS/JC scores. Minimal evidence of convergent validity was found with FOCUS Total scores and transcription-based measures of speech production in JC and in English. Convergent and divergent validity were found between specific FOCUS Profile scores and some transcription-based measures of speech production in JC and in English. CONCLUSION This study provides evidence of construct validity for FOCUS Total and Profile scores. It also provides validity evidence for FOCUS scores in a multilingual context using a representative sample of children that serves to broaden the range of applicability of the FOCUS.
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Affiliation(s)
- Leslie E. Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, London, Ontario, CA
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, CA
| | - Karla N. Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Communicative Sciences and Disorders, New York University, New York, New York, USA
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Kokotek LE, Washington KN. Characterizing Communicative Participation in Multilingual Jamaican Preschoolers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:658-674. [PMID: 36827540 PMCID: PMC10171857 DOI: 10.1044/2022_ajslp-22-00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/07/2022] [Accepted: 12/02/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE This study characterized communicative participation and related aspects of functional communication for Jamaican Creole (JC)-English-speaking preschoolers with and without functionally defined speech sound disorders (fSSDs). This study included parent reports and direct assessment measures from an existing corpus of baseline data collected prior to the COVID-19 pandemic. METHOD The communicative participation of typically developing (TD; n = 226) bilingual JC-English-speaking preschoolers and those with fSSDs (n = 39) was documented using the Focus on the Outcomes of Communication Under Six (FOCUS). Functional speech intelligibility was recorded using the Intelligibility in Context Scale (ICS) in English and JC (ICS-JC). Objective measures of speech production were collected through direct child assessment in both languages and then transcribed and calculated for percent of consonants (PCC), vowels (PVC), and phonemes correct (PPC). Within-group relationships were explored using association testing, and differences between groups were explored through multivariate analyses. RESULTS FOCUS scores and ICS and ICS-JC scores were found to be minimally to moderately related for Jamaican preschoolers in the TD group (r = .28-.34, p < .002) and strongly related in the fSSD group (r = .56-.60, p < .002). No relations were observed between the FOCUS scores and PCC/PVC/PPC in either language. There was a statistically significant difference between all FOCUS scores for Jamaican preschoolers in the TD and fSSD groups (p ≤ .002). CONCLUSIONS These findings provide additional evidence for using the FOCUS beyond documenting change in communicative participation to support clinical decision-making in planning and developing speech-language interventions. This study also documents an important characterization of JC-English-speaking children with and without fSSDs, offering data on children's abilities that can be used in future comparisons of communicative participation and speech functioning observed during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Leslie E. Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Karla N. Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Communicative Sciences and Disorders, New York University, NY
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Ter Wal N, van Ewijk L, Dijkhuis L, Visser-Meily JMA, Terwee CB, Gerrits E. Everyday Barriers in Communicative Participation According to People With Communication Problems. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1033-1050. [PMID: 36787154 DOI: 10.1044/2022_jslhr-22-00405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE The purpose of this study was to gain a comprehensive understanding of participation situations that are challenging for people with communication problems, to provide input for the further development of potential items for the Communicative Participation Item Bank (CPIB). METHOD A purposive sampling strategy was used to include a diverse group of people with communication problems. Diaries were used as a sensitizing exercise for inductive in-depth interviews. In these interviews, elements of communicative participation situations (concepts) were elicited that participants themselves experienced as difficult because of their communication problem. A thematic content analysis was used to identify overarching themes. In addition, new items were formulated based on the raw codes of the transcripts and linked to the International Classification of Functioning, Disability and Health Activity and Participation domains to examine the distribution of items across the breadth of the construct of communicative participation. RESULTS Eighteen interviews yielded 44 different concepts. They were clustered in six themes, which capture the person, location, topic, mode, moment, and pace of communication. In total, 103 new items measuring communicative participation were formulated. Most of these items relate to International Classification of Functioning, Disability and Health Activity and Participation domains "interpersonal interactions and relationships," "major life areas," and "community, social, and civic life." CONCLUSIONS This study resulted in an overview of self-reported barriers in daily communicative participation experienced by people with communication problems. These communicative participation situations can be captured within 44 concepts, which are covered by six themes. Future work should investigate if the newly written items can be added to the CPIB. The concepts and the themes can be used in designing and delivering a participation-focused intervention for this population.
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Affiliation(s)
- Nicole Ter Wal
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences (ILS), Utrecht University, the Netherlands
| | - Lizet van Ewijk
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Lotti Dijkhuis
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht, the Netherlands
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and Utrecht University, and De Hoogstraat Rehabilitation, the Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Ellen Gerrits
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences (ILS), Utrecht University, the Netherlands
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Spreer M, Dawal B. Partizipation/Teilhabe von Jugendlichen mit kommunikativen Beeinträchtigungen. SPRACHE · STIMME · GEHÖR 2023. [DOI: 10.1055/a-1962-8141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Wunderlich A, Newesely G, Reheis J. Communicative participation with public authorities: Experiences of people with aphasia, people who stutter, and employees of public authorities. JOURNAL OF COMMUNICATION DISORDERS 2023; 102:106314. [PMID: 36801532 DOI: 10.1016/j.jcomdis.2023.106314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Several studies have examined the communicative participation of people with communication disorders (PWCD). Hindering and facilitating factors were analyzed in different population groups considering various private and public communication contexts. However, knowledge about (a) the experiences of persons with different communication disorders, (b) communication with public authorities, and (c) the perspective of communication partners in this area remains limited. Therefore, this study aimed to explore the communicative participation of PWCD with public authorities. We analyzed communicative experiences (hindering and facilitating factors) and suggestions for improving communicative access described by persons with aphasia (PWA) and persons who stutter (PWS) as well as by employees of public authorities (EPA). METHODS In semi-structured interviews, PWA (n = 8), PWS (n = 9), and EPA (n = 11) reported specific communicative encounters with public authorities. The interviews were analyzed using qualitative content analysis, focusing on hindering/facilitating experiences and suggestions for improvement. RESULTS The personal experiences of the participants during authority encounters were represented by the interwoven themes of familiarity and awareness, attitudes and behavior, and support and autonomy. The perspectives of the three groups overlap in several areas; however, the results also indicate specific differences between PWA and PWS as well as between PWCD and EPA. CONCLUSION The results indicate a need to improve awareness/knowledge about communication disorders and communicative behavior in EPA. Moreover, PWCD should actively engage in encounters with authorities. In both groups, awareness must be raised about how each communication partner can contribute to successful communication, and avenues to achieve this goal must be demonstrated.
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Affiliation(s)
| | - Georg Newesely
- University of Applied Sciences Tyrol, Innsbruck, Austria
| | - Johanna Reheis
- University of Applied Sciences Tyrol, Innsbruck, Austria
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Söderhielm K, Eriksson K, Möller M. Communicative participation in goal-setting meetings for patients with aphasia after stroke. A study using patients' and healthcare professionals' self-ratings. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:342-356. [PMID: 36218168 DOI: 10.1111/1460-6984.12791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/18/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Communicative participation poses a challenge in meetings between healthcare professionals (HCPs) and people with aphasia (PwA). How communication is affected by aphasia in group meetings, where several healthcare professionals participate together with the patient, is largely unexplored. The aim of this study was to investigate self-rated communicative participation during goal-setting meetings among PwA compared to patients without aphasia and to investigate whether communicative participation among PwA was associated with self-rated knowledge about aphasia among HCPs. A further aim was to investigate if there was a difference in the use of communication strategies among HCPs in the respective situations. METHODS Nine PwA and nine control patients without aphasia rated their experience of communication during a goal-setting meeting. Thirty-eight HCPs rated their knowledge about aphasia and communication, and their use of communication strategies during goal-setting meetings. RESULTS The PwA reported being listened to by the HCPs as well as being able to comprehend the meeting. PwA with more severe language impairment did not report a lower level of communicative participation compared to PwA with milder impairment. Half of the patients from both groups indicated some difficulty asking questions during the meeting. Patients' ratings of communication were not correlated to HCPs' knowledge of communication strategies. There was a significant difference in self-rated use of communication strategies among HCPs for the two conditions, although the individual variation was large. CONCLUSION Results from both PwA and controls imply that patients may need more support to be able to ask questions in meetings with HCPs. Although self-ratings increase the ecological validity of the study of participation, further studies could benefit from using video observations in combination with self-reported experience, since awareness might influence results. WHAT THIS PAPER ADS What is already known on this subject Aphasia is an acquired language disorder that affects patient-provider communication. In stroke rehabilitation, person-centred goal setting is a key component. If healthcare professionals (HCPs) are not able to use adequate communication strategies, a lack of accessible communication can become a barrier to person-centredness. There are evidence-based communication strategies which can be used to overcome this barrier. What this paper adds to existing knowledge This study aimed to investigate communicative participation during goal-setting meetings from the perspective of patients with aphasia and HCPs. To our knowledge, this is the first study where persons with aphasia are asked to rate communicative participation in goal-setting meetings. To broaden the perspective on communication and goal setting, ratings of patients with aphasia are compared to ratings by patients with stroke but no aphasia. The results of this study indicate that there is room for improvement regarding communication during goal-setting meetings. However, asking direct questions on communicative participation to persons with severe aphasia may not be feasible. What are the potential or actual clinical implications of this work? The results of this study imply that both patients with and without aphasia may need more support to be able to express themselves during goal-setting meetings. There also seems to be a need for further education on aphasia and communication strategies among rehabilitation professionals.
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Affiliation(s)
- Kajsa Söderhielm
- Department of Rehabilitation Medicine Stockholm, Danderyd University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Science & Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Karin Eriksson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Geriatrics, Pulmonary Disease and Allergology, Gothenburg, Sweden
| | - Marika Möller
- Department of Rehabilitation Medicine Stockholm, Danderyd University Hospital, Stockholm, Sweden
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
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Singer I, de Wit E, Gorter JW, Luinge M, Gerrits E. A systematic scoping review on contextual factors associated with communicative participation among children with developmental language disorder. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:482-515. [PMID: 36239148 DOI: 10.1111/1460-6984.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Variations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant. AIMS To investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school-aged children with DLD, and to identify possible gaps in knowledge about this subject. METHODS & PROCEDURES A scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools. MAIN CONTRIBUTION The methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio-cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non-verbal abilities were not found to be of influence, and the role of socio-emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio-economical family characteristics with communicative participation is inconclusive. CONCLUSIONS & IMPLICATIONS Limited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co-occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes. WHAT THIS PAPER ADDS What is already known on this subject Children with DLD experience varying degrees of communicative participation restrictions. Insight into contextual factors that influence communicative participation can help to identify children at risk and inform family and child-centred therapy. Systematic research on contextual factors that facilitate or hinder communicative participation in children with DLD is currently lacking. What this paper adds to existing knowledge Knowledge of protective factors can guide the development of interventions for children and young people with DLD that boost resilience and facilitate communicative participation, while insight into the risk factors can help professionals identify the most vulnerable children and develop interventions that can lift or neutralize barriers present in the life of these children. Specific groups potentially at risk are young boys, children with co-morbid mobility impairment, children with conduct problems, and children reaching adolescence. In contrast, potentially protective factors are reaching school age and being prosocial. In addition, the development of socio-cognitive skills may be beneficial for the communicative participation of children with DLD. What are the potential or actual clinical implications of this work? To support communicative participation, it is important that professionals who work with children with DLD understand which groups are at risk for communicative participation restrictions, and which factors can foster resilience. In the absence of evidence-based instruments for the systematic assessment of personal and environmental factors, consulting parents and children on the contextual factors that they perceive as important remains critical.
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Affiliation(s)
- Ingrid Singer
- Research group Speech and Language Therapy, HU University of Applied Sciences Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
| | - Ellen de Wit
- Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | | | - Margreet Luinge
- Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | - Ellen Gerrits
- Research group Speech and Language Therapy, HU University of Applied Sciences Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
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Teixeira J, Jin JL, Baylor C, Nuara M. Modifying the Communicative Participation Item Bank (CPIB) for individuals receiving gender-affirming communication care: Stakeholder feedback from cognitive interviews. JOURNAL OF COMMUNICATION DISORDERS 2023; 102:106312. [PMID: 36791644 DOI: 10.1016/j.jcomdis.2023.106312] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The Communicative Participation Item Bank (CPIB) is a person-reported outcome measure designed for adults with communication disorders. The CPIB has not been validated for use with clients seeking gender-affirming communication care. The purpose of this study was to determine modifications needed to the CPIB for it to be appropriate for transgender respondents. METHODS Individual qualitative cognitive interviews were conducted with 14 transgender adults (seven assigned male at birth, six assigned female at birth, one intersex / assigned female at birth). As participants completed the CPIB, they were asked to 'think out loud' to share their reactions to the items, reasons for their item responses, and any recommendations for changing the CPIB. Interviews were recorded, transcribed, and analyzed to identify common and salient trends in participants' feedback. RESULTS The most salient change participants required was in the CPIB item stem. The original stem ("Does your condition interfere with….") is inappropriate for transgender clients because referring to being transgender as a 'condition' is unacceptable. A new stem ("How difficult is it for you to ….") was acceptable to participants. The original CPIB uses the phrase 'family and friends' to refer to safe and comfortable communication partners. Participants in this study reported that this does not reflect the experiences of many transgender people who are not accepted by their biological families. The recommended alternate wording is "people who know you well." The items reflected situations that were relevant to participants, and wording was acceptable with few exceptions. Participants suggested they would have responded to the CPIB items differently earlier in their transition, with their scores improving over time. CONCLUSIONS The original CPIB questionnaire should not be used with transgender clients due to unacceptable wording. The modified items generated from this study require psychometric calibration for a new CPIB version for clients seeking gender-affirming communication care.
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Affiliation(s)
- Jeffrey Teixeira
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, United States.
| | - Jingyu Linna Jin
- Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195, United States
| | - Carolyn Baylor
- Facial Plastic and Reconstructive Surgery, Virginia Mason Franciscan Health, 1100 9th Ave, Seattle, WA 98101, United States
| | - Michael Nuara
- Facial Plastic and Reconstructive Surgery, Virginia Mason Franciscan Health, 1100 9th Ave, Seattle, WA 98101, United States
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Ryan SE, Shepherd TA, Renzoni AM, D'Alessandro D, Oh A. Functional impact of augmentative and alternative communication scale: development of an outcome measure for educators of students with complex communication needs. Disabil Rehabil Assist Technol 2023; 18:215-226. [PMID: 33155882 DOI: 10.1080/17483107.2020.1842917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The study aim was to develop and assess the measurement properties of the Functional Impact of Augmentative and Alternative Communication - Educator (FIAAC-E) scale - an educator-reported measure designed to detect change in factors associated with communicative participation in students who use augmentative and alternative communication (AAC). METHODS The study had three phases. In phase 1 (content validity), 22 content specialists independently rated the relevancy of 22 dimensions proposed for the new scale. In phase 2 (item generation, face validity), 8 educators independently completed a preliminary version of the FIAAC-E scale and flagged items that were unclear. Next, these educators adjusted the wording of unclear items during consensus-building sessions. In phase 3 (item reduction, reliability, convergent validity), 62 educators completed an online survey that included the revised FIAAC-E scale. Survey data were used to shorten the scale, estimate its reliability, and evaluate support for its convergent validity. RESULTS In phase 1, the 11 dimensions ranked most highly by content specialists were selected for inclusion in the preliminary scale. In phase 2, educators reviewed 113 items and revised 33 to improve clarity. In phase 3, correlational statistics informed the selection of 77 items for the shortened scale. Subsequent data analyses indicated acceptable levels of internal consistency and test-retest reliability and support for convergent validity of the preliminary measure. CONCLUSION The study provides emerging evidence that supports the FIAAC-E scale as a reliable way to evaluate communicative participation in children and youth who use AAC systems at school.Implications for rehabilitationUsing a reliable means to measure the effectiveness of AAC for children and youth at school may reveal important factors that influence successful communicative, academic, and social participation in school.The FIAAC-E scale is a promising educator-reported questionnaire to inform the development of communication goals and monitor progress towards meeting these goals for students with complex communication needs.
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Affiliation(s)
- Stephen E Ryan
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Tracy A Shepherd
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada
| | - Anne Marie Renzoni
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada
| | - Danielle D'Alessandro
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Anna Oh
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada
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van Sluis KE, Passchier E, van Son RJJH, van der Molen L, Stuiver M, van den Brekel MWM, Van den Steen L, Kalf JG, van Nuffelen G. Dutch translation and validation of the Communicative Participation Item Bank (CPIB)-short form. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:124-137. [PMID: 36063423 PMCID: PMC10087551 DOI: 10.1111/1460-6984.12775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/23/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Several conditions and diseases can result in speech problems that can have a negative impact on everyday functioning, referred to as communicative participation. Subjective problems with acquired speech problems are often assessed with the speech handicap index (SHI). To assess generic participation problems, the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) questionnaire is frequently used. The English questionnaire Communicative Participation Item Bank-short form (CPIB short form) is a 10-item valid, reliable instrument that assesses communicative participation. In the absence of a Dutch equivalent, translation and validation of the CPIB short form was required. AIMS To translate the CPIB short form into Dutch, and to determine its psychometric properties for the group of adults with speech problems resulting from a neurological aetiology or head and neck cancer. METHODS & PROCEDURES Translation of the CPIB short form was performed following the instructions of the European Organisation for Research and Treatment for Cancer (EORTC). In a cross-sectional multi-centre study, participants completed the Dutch CPIB short form together with the SHI and USER-P, and the CPIB a second time after 2 weeks. We assessed internal consistency and test-retest reliability of the CPIB. Construct validity was assessed based on correlations with SHI, USER-P and speech assessments. OUTCOMES & RESULTS In the validation study, 122 participants were included: 51 with dysarthria due to different neurological disorders, 48 with speech problems due to head and neck cancer treatment and 23 healthy controls. Internal consistency of the items was high (Cronbach's alpha = 0.962), the intraclass correlation coefficient (ICC) for test-retest reliability was high 0.908 (95% CI = 0.870-0.935). Construct validity was supported by a strong correlation between the Dutch CPIB short form and the SHI total score (SHI total rs = 0.887) and a moderate correlation between the Dutch CPIB-10 and the USER-P subscales (USER-P Frequency rs = 0.365; USER-P restrictions and USER-P satisfaction rs = 0.546). A moderate correlation was found between the Dutch CPIB-10 and the speech performance assessments (degree of distortedness r = -0.0557; p ≤ 0.001; degree of intelligibility r = 0.0562). CONCLUSIONS & IMPLICATIONS The Dutch CPIB short form provides a valid and reliable tool for clinical practice and research purposes. It allows clinicians to start using this PROM in clinical and research practice to systematically investigate the impact of the speech problems on communicative participation in a Dutch-speaking population. WHAT THIS PAPER ADDS What is already known on the subject Communicative participation allows people to take part in life situations, but can be affected by acquired speech problems. The CPIB is a patient-reported outcome measure for the assessment of this concept. For the English language the 46-item bank and a 10-item short form is available. What this paper adds to existing knowledge This paper describes the process of translation of the CPIB short form into Dutch, and confirms its reproducibility and validity. What are the potential or actual clinical implications of this work? With this validated Dutch version of the CPIB short form available, professionals can implement this tool in clinical and research practice to systematically evaluate communicative participation.
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Affiliation(s)
- Klaske E. van Sluis
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Amsterdam Center for Language and CommunicationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Ellen Passchier
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Center for Quality of Life and Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamthe Netherlands
| | - Rob J. J. H. van Son
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Amsterdam Center for Language and CommunicationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Lisette van der Molen
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Amsterdam Center for Language and CommunicationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Martijn Stuiver
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Center for Quality of Life and Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamthe Netherlands
- Center of Expertise Urban VitalityFaculty of HealthAmsterdam University of Applied SciencesAmsterdamthe Netherlands
| | - Michiel W. M. van den Brekel
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Amsterdam Center for Language and CommunicationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Leen Van den Steen
- Department of Otolaryngology and Head and Neck Surgery—Rehabilitation Center for Communication DisordersAntwerp University HospitalAntwerpBelgium
- Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
| | - Johanna G. Kalf
- Department of Rehabilitation, Radboud University Medical CenterDonders Institute for Brain, Cognition and BehaviourNijmegenthe Netherlands
| | - Gwen van Nuffelen
- Department of Otolaryngology and Head and Neck Surgery—Rehabilitation Center for Communication DisordersAntwerp University HospitalAntwerpBelgium
- Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
- Department of Speech, Language and Hearing Sciences, Faculty of Medicine and Health SciencesUniversity of GhentGhentBelgium
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Hula WD, Victorson D, Nandakumar R, Kisala PA, Tulsky DS. Establishing severity levels for patient-reported measures of functional communication, participation, and perceived cognitive function for adults with acquired cognitive and language disorders. Qual Life Res 2022; 32:1659-1670. [PMID: 36572789 PMCID: PMC10172211 DOI: 10.1007/s11136-022-03337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To empirically assign severity levels (e.g., mild, moderate) to four relatively new patient-reported outcome measures (PROMs) for adults with acquired cognitive/language disorders. They include the Communicative Participation Item Bank, the Aphasia Communication Outcome Measure, and Neuro-QoL's item banks of Cognitive Function (v2.0) and Ability to Participate in Social Roles and Activities (v1.0). METHOD We conducted 17 focus groups that comprised 22 adults with an acquired cognitive/language disorder from stroke, Parkinson's disease, or traumatic brain injury; 30 care partners of an adult with an acquired cognitive/language disorder; and 42 speech-language pathologists who had experience assessing/treating individuals with those and other cognitive/language disorders. In a small, moderated focus-group format, participants completed "PROM-bookmarking" procedures: They discussed hypothetical vignettes based on PROM item responses about people with cognitive/language disorders and had to reach consensus regarding whether their symptoms/function should be categorized as within normal limits or mild, moderate, or severe challenges. RESULTS There was generally good agreement among the stakeholder groups about how to classify vignettes, particularly when they reflected very high or low functioning. People with aphasia described a larger range of functional communication challenges as "mild" compared to other stakeholder types. Based on a consensus across groups, we present severity levels for specific score ranges for each PROM. CONCLUSION Standardized, stakeholder-informed severity levels that aid interpretation of PROM scores can help clinicians and researchers derive better clinical meaning from those scores, for example, by identifying important clinical windows of opportunity and assessing when symptoms have returned to a "normal" range.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA. .,Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - William D Hula
- Geriatric Research, Education, and Clinical Center, VA Health Care System, and Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Victorson
- School of Medicine Department of Medical Social Science, Northwestern University, Chicago, IL, 60611, USA
| | - Ratna Nandakumar
- University of Delaware School of Education, Newark, DE, 19713, USA
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
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Ribeiro VV, Santos MADC, de Almeida AAF, Behlau M. Validation of the Self-assessment of Communication Competence (SACCom) in Brazilian Portuguese Through Item Response Theory. J Voice 2022:S0892-1997(22)00216-8. [PMID: 36088205 DOI: 10.1016/j.jvoice.2022.07.013] [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: 05/26/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the validity of the Self-assessment of Communication Competence - SACCom by analyzing the communication competency of adult individuals using the item response theory (IRT). METHODS Overall, 778 individuals who responded to SACCom participated in this study. The initial version consisted of 20 polytomous items regarding communication skills. Polytomous answer keys to each item were ordered as follows: 1 - no, 2 - more or less, and 3 - yes. The IRT and the gradual response model, a 2-parameter logistic model for polytomous items, were used for validation. RESULTS Due to problems in the preliminary analysis using the item characteristic curve (ICC), answer keys to SACCom items were reorganized in an ordinal dichotomous way. Response 1 was coded as 0 - no, while responses 2 and 3 were coded as 1 - yes. Item 9 of the ICC was problematic and did not add information to the instrument; hence, this item was excluded. SACCom, in its dichotomous format with 19 items, was unidimensional according to the eigenvalues graph and tetrachoric correlation analysis. The Cronbach's alpha coefficient showed an internal consistency value of 0.711. All item-total correlations were greater than 0.284. Item discrimination parameters ranged from a = 0.563 to a = 1.505, and the difficulty of the items ranged between b = -2.725 and b = 0.612. The likelihood ratio test showed that the model without restrictions best fit the data. ICC gleaned more information for individuals with lower communication skills. CONCLUSION The 19-item, dichotomous SACCom is valid for the analysis of communication skills according to the IRT.
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Affiliation(s)
- Vanessa Veis Ribeiro
- Speech-Language Pathology Course, Universidade de Brasília - UnB. Campus Universitário, Centro Metropolitano, Brasília, Distrito Federal, Brazil.
| | | | - Anna Alice Figueiredo de Almeida
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB. Cidade Universitária, Conjunto Presidente Castelo Branco III, João Pessoa, Paraíba, Brazil
| | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP and Centro de Estudos da Voz - CEV, São Paulo, Brazil
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Masuku KP, Mupawose A. Students’ experiences of using a writing-intense programme to facilitate critical thinking skills on an online clinical training platform: A pilot study. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e7. [PMID: 36073079 PMCID: PMC9453138 DOI: 10.4102/sajcd.v69i2.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/01/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) and the subsequent lockdown altered traditional clinical training for speech language pathology students, thus forcing training institutions to implement innovative and responsive clinical training strategies in the midst of the pandemic. As such, a writing-intense programme was piloted in an online clinical training programme with second-year speech language pathology students.Objectives: This study explored speech language pathology students’ experiences with a writing programme used during an online clinical training programme implemented during the COVID-19 pandemic.Method: The study used a qualitative survey design. Purposive convenient sampling was used to recruit 29 second-year speech language pathology students. Online student reflections guided by 10 open-ended questions were used to elicit responses from students. Data were analysed using deductive thematic analysis.Results: Findings revealed that the written component of the programme facilitated the acquisition of clinical knowledge and improved clinical processes of writing among students. Feedback that students received on their written tasks improved learning. The clinical component of the course enabled students to learn in a less stressful environment and helped them gain confidence in their knowledge and clinical skills. Connectivity challenges and the lack of motivation from some students negatively impacted the programme.Conclusion: Using a writing programme to clinically train students can have positive effects in applying theory to clinical application because it affords students time to consolidate and process theory with practice as the jump from first year to second year can be cognitively taxing. A writing-intense programme can also improve students’ writing skills.
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Affiliation(s)
- Khetsiwe P Masuku
- Department of Speech Pathology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Speech Impairment in Cerebellar Ataxia Affects Naturalness More Than Intelligibility. THE CEREBELLUM 2022:10.1007/s12311-022-01427-y. [PMID: 35670895 DOI: 10.1007/s12311-022-01427-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
The purpose of this analysis was to document intelligibility and naturalness in ataxia, a neurological condition that results from cerebellar damage. The cerebellum is important for normal speech production to scale and coordinate articulatory and laryngeal movements. The disruption of these cerebellar mechanisms has unique implications for how intelligibility and naturalness are affected in ataxia. The results of research on speech in ataxia have important clinical implications for assessment and treatment of individuals with ataxic dysarthria. Speech samples from 27 participants with ataxia and 28 age- and sex-matched control participants were assessed by nine speech-language pathology graduate students for intelligibility and naturalness. Intelligibility was measured as the percentage of words transcribed correctly, and naturalness was assessed as a subjective rating on a seven-point interval scale. Both intra- and inter-rater reliability were moderate to high for both intelligibility and naturalness. Speech intelligibility and naturalness were robustly decreased in the ataxia group compared to the control group; however, the difference was greater for measures of speech naturalness. There were robust relationships among dysarthria severity, length of diagnosis, and speech naturalness in speakers with ataxia, but there were no other robust effects for age, sex, or impact on quality of life for intelligibility or naturalness. Speech naturalness was more impaired than intelligibility in speakers with ataxia. Impaired naturalness can have debilitating consequences for communicative participation, effectiveness, and quality of life. Assessment and treatment for ataxic dysarthria should include aspects of prosodic control for speech naturalness.
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Campbell P, Rooney S, Nicoll A, Brady MC, Smith CH, Deane KHO, Herd CP, Tomlinson CL, Clarke CE, Sackley CM. Speech and language therapy interventions for speech problems in Parkinson's disease. Hippokratia 2022. [DOI: 10.1002/14651858.cd015009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit; Glasgow Caledonian University; Glasgow UK
| | - Scott Rooney
- Nursing, Midwifery and Allied Health Professions Research Unit; Glasgow Caledonian University; Glasgow UK
| | - Avril Nicoll
- Health Services Research Unit; University of Aberdeen; Aberdeen UK
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit; Glasgow Caledonian University; Glasgow UK
| | - Christina H Smith
- Division of Psychology and Language Sciences; University College London; London UK
| | | | - Clare P Herd
- Institute of Applied Health Research; University of Birmingham; Birmingham UK
| | - Claire L Tomlinson
- Birmingham Clinical Trials Unit; University of Birmingham; Birmingham UK
| | - Carl E Clarke
- Department of Neurology; City Hospital, Sandwell and West Birmingham Hospitals NHS Trust; Birmingham UK
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Finnimore A, Theodoros D, Rumbach A. The Impact of PD Check-In, a Model for Supported Self-Managed Maintenance of Speech on the Quality of Life of People with Parkinson's Disease: A Phase 1 Study. Brain Sci 2022; 12:433. [PMID: 35447964 PMCID: PMC9030296 DOI: 10.3390/brainsci12040433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Quality of life (QoL) for people with Parkinson’s Disease (PD) is diminished by speech and communication changes. The impact of PD Check-In, an intervention for supported self-managed maintenance of speech following LSVT LOUD®, on QoL of people with PD was investigated. Sixteen people with PD and dysarthria completed LSVT LOUD followed by PD Check-Ins up until 24 months post-treatment. Self-rated QoL and voice handicap scales were used to determine the psychosocial and perceived impact of PD Check-In on the speech and voice of people with PD. The perceived impact of PD Check-In on speech and voice was also sought from 15 communication partners (CPs). A significant treatment effect for time was identified for the Dysarthria Impact Profile (DIP), Voice Handicap Index (VHI), and Voice Handicap Index-Partner (VHI-P) (p < 0.05). There was no significant effect for time for the Parkinson’s Disease Questionnaire (PDQ-39). Planned comparisons of timepoints for DIP, VHI, and VHI-P showed no significant differences (p > 0.01). Comparison of perceived voice handicap by people with PD and CPs revealed no significant differences (p > 0.01). The impact of PD Check-In on QoL of people with PD and CPs for 24 months post-LSVT-LOUD is unclear. Self-reported outcome measures alone do not fully capture changes in QoL in PD.
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Affiliation(s)
- Ann Finnimore
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (D.T.); (A.R.)
- Speech Pathology Department, The Prince Charles Hospital, Metro North Hospital & Health Service, Brisbane, QLD 4032, Australia
| | - Deborah Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (D.T.); (A.R.)
| | - Anna Rumbach
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (D.T.); (A.R.)
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Page AD, Yorkston KM. Communicative Participation in Dysarthria: Perspectives for Management. Brain Sci 2022; 12:brainsci12040420. [PMID: 35447952 PMCID: PMC9031517 DOI: 10.3390/brainsci12040420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/27/2023] Open
Abstract
Communicative participation is restricted in many conditions associated with dysarthria. This position paper defines and describes the construct of communicative participation. In it, the emergence of this construct is reviewed, along with the predictors of and variables associated with communicative participation in the dysarthrias. In doing so, the features that make communicative participation unique and distinct from other measures of dysarthria are highlighted, through emphasizing how communicative participation cannot be predicted solely from other components of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), including levels of impairment or activity limitations. Next, the empirical literature related to the measurement of communicative participation and how this research relates to dysarthria management is presented. Finally, the development of robust clinical measures of communicative participation and approaches to management is described from the point of view of the clinician. We argue that communicative participation should be a primary focus of treatment planning and intervention to provide patient-centered, holistic, and value-based clinical interventions which are responsive to the needs of individuals living with dysarthria.
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Affiliation(s)
- Allyson D. Page
- School of Communication Sciences and Disorders, Western University, London, ON N6G 1H1, Canada
- Correspondence:
| | - Kathryn M. Yorkston
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA 98105-6246, USA;
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Dahl KL, Bolognone RK, Childes JM, Pryor RL, Graville DJ, Palmer AD. Characteristics associated with communicative participation after total laryngectomy. JOURNAL OF COMMUNICATION DISORDERS 2022; 96:106184. [PMID: 35091361 DOI: 10.1016/j.jcomdis.2022.106184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to identify individual characteristics that are associated with communicative participation after total laryngectomy (TL). METHODS This study was a single-institution investigation of individuals who had undergone TL. Data were collected at a single timepoint via patient self-report and medical record review. Thirty-five participants completed a questionnaire containing a communication survey as well as several published, validated instruments. Independent variables included characteristics related to demographics, health and medical history, social network composition, and communication. The dependent variable was communicative participation, which was assessed using the Communicative Participation Item Bank (CPIB). Correlations between the independent variables and CPIB scores were calculated to assess the influence of these characteristics on communicative participation. The study participants were subdivided into three distinct groups based on whether their primary method of communication was spoken or non-spoken and the frequency of using alternate methods of communication. Outcomes across the three groups were then compared. A follow-up survey was also conducted to examine the impact of "stay at home" orders during the COVID-19 pandemic of 2020-21. RESULTS There were significant correlations between communicative participation and some non-communication-related characteristics. Reduced communicative participation was associated with younger age, less time since TL, a history of reconstructive surgery, poorer self-rated health, more depressive symptoms, worse quality of life, and a weaker social network of friends. Several communication-related characteristics were also associated with CPIB scores. Increased communicative participation was associated with using fewer non-spoken communication methods, higher levels of satisfaction with speech and communication, and better communicative effectiveness. There were significant differences between the three groups for communicative effectiveness and satisfaction with speech. The three groups did not differ significantly for satisfaction with communication or communicative participation. There were no significant differences in CPIB scores measured before and during the pandemic. CONCLUSIONS Communicative participation is a complex measure that may be affected by a variety of factors related to demographics, health, social network status, and communication. Despite poorer communicative effectiveness and lower levels of satisfaction, individuals who use non-spoken methods of communication after TL did not demonstrate worse communicative participation than those using spoken methods. Surprisingly, CPIB scores did not decline as a result of social distancing.
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Affiliation(s)
- Kimberly L Dahl
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Rachel K Bolognone
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Jana M Childes
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Rebecca L Pryor
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Donna J Graville
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Andrew D Palmer
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
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Borrie SA, Wynn CJ, Berisha V, Barrett TS. From Speech Acoustics to Communicative Participation in Dysarthria: Toward a Causal Framework. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:405-418. [PMID: 34958608 PMCID: PMC9132139 DOI: 10.1044/2021_jslhr-21-00306] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/10/2021] [Accepted: 09/21/2021] [Indexed: 05/19/2023]
Abstract
PURPOSE We proposed and tested a causal instantiation of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework, linking acoustics, intelligibility, and communicative participation in the context of dysarthria. METHOD Speech samples and communicative participation scores were collected from individuals with dysarthria (n = 32). Speech was analyzed for two acoustic metrics (i.e., articulatory precision and speech rate), and an objective measure of intelligibility was generated from listener transcripts. Mediation analysis was used to evaluate pathways of effect between acoustics, intelligibility, and communicative participation. RESULTS We observed a strong relationship between articulatory precision and intelligibility and a moderate relationship between intelligibility and communicative participation. Collectively, data supported a significant relationship between articulatory precision and communicative participation, which was almost entirely mediated through intelligibility. These relationships were not significant when speech rate was specified as the acoustic variable of interest. CONCLUSION The statistical corroboration of our causal instantiation of the ICF framework with articulatory acoustics affords important support toward the development of a comprehensive causal framework to understand and, ultimately, address restricted communicative participation in dysarthria.
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Affiliation(s)
- Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Camille J. Wynn
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Visar Berisha
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
- College of Health Solutions, Arizona State University, Phoenix
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Silva-Ríos AP, Del Campo Rivas MN. Valoración de la Calidad de la Práctica Fonoaudiológica en Atención Primaria de Salud. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.72617] [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
El estudio de la calidad representa un tema relevante para usuarios, gestores y profesionales del sistema de salud. La incorporación de fonoaudiólogos a la Atención Primaria de Salud (APS) hace necesario indagar los parámetros que configuran una práctica de calidad desde la perspectiva de la provisión de servicios. El objetivo de este trabajo es validar el contenido de una matriz de calidad de la práctica fonoaudiológica en APS a través del juicio de expertos. Se calculó razón de validez de contenido (CVR), coeficiente de concordancia (W) de Kendal e índice de validez de contenido (CVI). La matriz contempló tres dimensiones: estructura, proceso y resultados. El 84% de los reactivos generados presentó una CVR positiva. Las dimensiones proceso y resultado presentaron un W de Kendal estadísticamente significativo (p<0,05). El CVI total de la prueba fue 0,55. La matriz creada explora dominios de contenido vinculados a la calidad de los servicios de fonoaudiología en APS. El estudio y gestión de la calidad representa una oportunidad para mejorar la práctica fonoaudiológica en APS.
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Olthof-Nefkens MWLJ, Derksen EWC, Lambregts B, de Swart BJM, Nijhuis-van der Sanden MWG, Kalf JG. Clinimetric Evaluation of the Experienced Communication in Dementia Questionnaire. THE GERONTOLOGIST 2021; 63:40-51. [PMID: 34962993 PMCID: PMC9872762 DOI: 10.1093/geront/gnab187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Tools to measure self-perceived communication between persons with early-stage dementia and their caregivers are lacking. Therefore, we developed a questionnaire for Experienced Communication in Dementia (ECD) with a patient version (ECD-P) and a caregiver version (ECD-C), which contains items on (a) caregiver competence, (b) social communication, (c) communication difficulties, and (d) experienced emotions. This article describes the feasibility and clinimetric evaluation of this instrument. RESEARCH DESIGN AND METHODS A prospective observational cohort study was conducted with 57 dyads (community-dwelling person with dementia and primary caregiver). ECD-P, ECD-C, and measures on quality of life, caregiver burden, cognitive functioning, physical functioning, and functional independence were administered. After 2 weeks, the dyads filled out the ECD again. Feasibility (completion time and missing values per item), internal consistency (Cronbach's α), test-retest reliability (intraclass correlation coefficients [ICCs]), and construct validity (hypotheses testing with Spearman's r) were evaluated. RESULTS Mean completion time was 10 min per questionnaire. ICCs for test-retest reliability ranged from 0.67 to 0.78, except for ECD-P2 (ICC = 0.31). Internal consistency ranged from α = 0.75 to 0.82 for ECD-P1 and all parts of ECD-C, except for ECD-P2 (α = 0.66). Correlation coefficients for convergent validity ranged from r = 0.31 to 0.69 and correlation coefficients for divergent validity were r < 0.20 and statistically insignificant. DISCUSSION AND IMPLICATIONS Pending future research, the ECD, except part ECD-P2, seems to be a promising tool to measure experienced communication between persons with early-stage dementia and their caregivers.
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Affiliation(s)
- Maria W L J Olthof-Nefkens
- Address correspondence to: Maria W. L. J. Olthof-Nefkens, MSc, Radboudumc, Department of Rehabilitation, PO Box 9101, Internal code 907, 6500 HB Nijmegen, The Netherlands. E-mail:
| | - Els W C Derksen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands,Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Britt Lambregts
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands,Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bert J M de Swart
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands,Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johanna G Kalf
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
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Yorkston K, Baylor CR, Eadie T, Kapsner-Smith M. Perceptions regarding communicative participation in individuals receiving botulinum toxin injections for laryngeal dystonia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1296-1315. [PMID: 34453393 DOI: 10.1111/1460-6984.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Laryngeal dystonia (LD), or spasmodic dysphonia (SD), is a neurological disorder characterized by focal dystonia or involuntary spasms of the laryngeal muscles and associated voice symptoms. It is typically treated with injection of botulinum toxin (BoNT) that weakens the affected muscles. AIMS The primary purpose of this qualitative study was to explore participants' experience of living with LD and BoNT treatment. The secondary purpose was to examine those experiences as a function of participants' scores on the Communicative Participation Item Bank (CPIB). Results will enhance our understanding of restrictions in communicative participation, assist in planning intervention targeting these restrictions and aid in clinical interpretation of CPIB scores. METHODS & PROCEDURES Semi-structured interviews using a phenomenological tradition and focusing on BoNT treatment and communicative participation were conducted with 26 people with LD who are on established BoNT treatment regimens. Interviews were recorded, transcribed, coded and analysed inductively. Participants were categorized by CPIB scores into groups ranging from none to extensive participation restrictions. Both self- and expert ratings of voice were obtained. OUTCOMES & RESULTS Participants with different levels of CPIB scores had different experiences related to communicative participation in the context of BoNT treatment. These differences were organized into the following topics: BoNT and voice; attitudes toward participation; coping strategies; and advice. For all participants except those in the least restricted and most restricted groups, expert ratings of voice did not relate to CPIB scores. CONCLUSIONS & IMPLICATIONS Although most participants report improved voice with BoNT treatment, many participants experienced lingering restrictions in communicative participation, some to a severe extent. Participants reported coping with these restrictions in many ways; some of these strategies were more successful than others. Those with restricted participation recommended more support for daily life and the emotional toll of LD, as well as support for family members. This support might be offered by speech-language pathologists. WHAT THIS PAPER ADDS What is already known on the subject Participants with different levels of CPIB scores had different experiences related to communicative participation in the context of BoNT treatment. What this study adds to the existing knowledge Although most participants report improved voice with BoNT treatment, many participants experienced lingering restrictions in communicative participation, some to a severe extent. What are the potential or actual clinical implications of this work? SLP services that take a participation-focused approach to intervention and use multi-factorial approaches to help clients maximize their life participation in the context of LD are well within the SLP scope of practice. SLPs can help clients find and use their optimal voices within the constraints of the dystonia and BoNT effects.
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Affiliation(s)
- Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Carolyn R Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Mara Kapsner-Smith
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
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Baylor C, Merati AL, Eadie T, Kapsner-Smith M, Meyer TK, Britton D, Mach H, Patel S, Yorkston K. Sensitivity of the Communicative Participation Item Bank for Measuring Patient-Reported Outcomes After Treatment of Unilateral Vocal Fold Immobility. JAMA Otolaryngol Head Neck Surg 2021; 147:933-942. [PMID: 34529046 DOI: 10.1001/jamaoto.2021.2358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The Communicative Participation Item Bank (CPIB) is a patient-reported outcome measure assessing the association between communication disorders and participation in daily communication. To our knowledge, no prior research has examined whether CPIB scores change after treatment of unilateral vocal fold immobility (UVFI). Objective To compare CPIB scores before and after treatment of UVFI and with patient-defined target treatment outcomes and other common clinical outcomes after UVFI intervention. Design, Setting, and Participants This single-group case series recruited a convenience sample of community-dwelling patients aged 18 years or older from an urban academic medical center who had a diagnosis of UVFI and planned to receive intervention for UVFI. The study was conducted from March 2014 to March 2019. Exposures Intervention for UVFI according to clinicians' recommendations. The treatment type was not controlled for this study. Main Outcomes and Measures Patients' self-reported communicative participation was assessed by obtaining CPIB scores before and after treatment of UVFI, with scores calibrated to the standardized T scale. Pearson correlations between the CPIB general short form and computerized adaptive format, the Voice Handicap Index-10 (VHI-10), and self-rated and clinician-rated voice severity were also evaluated. Results The sample included 25 participants, of whom 17 (68%) were male, 8 (32%) were female, and the mean (SD) age was 54.9 (17.0) years. Significant changes after treatment were observed in all quantitative outcomes including the primary outcome of the CPIB; the mean T score before treatment was 40.95 (95% CI, 37.49-44.41) and after treatment was 53.23 (95% CI, 48.41-58.04) (mean difference, -13.04 [95% CI, -7.30 to -18.79]; Cohen d, 0.96). The Pearson correlation between the CPIB general short form and computerized adaptive testing scores at pretreatment was r = 0.93 and at posttreatment, r = 0.95. Computerized adaptive testing showed efficiency advantages, with typically 5 to 6 items required for administration compared with 10 items for the short form. The correlation between the CPIB and VHI-10 was moderate before treatment (r = -0.70) and strong after treatment (r = -0.91). Moderate correlations were observed between the CPIB and clinician-rated voice quality before (r = -0.52) and after (r = -0.46) treatment and between CPIB and self-rated voice quality before (r = -0.56) and after (r = -0.62) treatment. Conclusions and Relevance The results of this case series suggest that the CPIB is relevant for clinical use to assess changes in communicative participation among patients with UVFI before and after they receive treatment.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Albert L Merati
- Department of Otolaryngology, Head and Neck Surgery, University of Washington, Seattle
| | - Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Mara Kapsner-Smith
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Tanya K Meyer
- Department of Otolaryngology, Head and Neck Surgery, University of Washington, Seattle
| | - Deanna Britton
- Department of Rehabilitation Medicine, University of Washington, Seattle.,Department of Speech and Hearing Sciences, Portland State University, Portland, Oregon.,Oregon Health & Science University, Portland
| | - Helen Mach
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Sapna Patel
- Department of Otolaryngology, Head and Neck Surgery, University of Washington, Seattle
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Harvey DY, Parchure S, Hamilton RH. Factors predicting long-term recovery from post-stroke aphasia. APHASIOLOGY 2021; 36:1351-1372. [PMID: 36685216 PMCID: PMC9855303 DOI: 10.1080/02687038.2021.1966374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 08/05/2021] [Indexed: 06/17/2023]
Abstract
BACKGROUND It remains widely accepted that spontaneous recovery from aphasia is largely limited to the first related factors. This has direct implications for acute and chronic interventions for aphasia. few months following stroke. A few recent studies challenge this view, revealing that some individuals' language abilities improve even during the chronic stage. AIMS To identify prognostic indicators of long-term aphasia recovery. METHODS & PROCEDURES Eighteen people with aphasia initially evaluated in the chronic stage were retested at least one year later. The Western Aphasia Battery-Revised (WAB-R) Aphasia Quotient (AQ) was used to quantify changes in language impairment. Prognostic factors included those related to the patient (demographic, psychosocial), stroke (lesion volume and location), and treatment (medical, rehabilitative). OUTCOMES & RESULTS Twelve participants improved and 6 remained stable or declined. Linear regression analysis revealed that lesion volume predicted long-term language gains, with smaller lesions yielding greater improvements. Individuals who did not improve were more likely to have lesions encompassing critical frontal and temporoparietal cortical regions and interconnecting white matter pathways. Exploratory regression analysis of psychosocial and treatment-related factors revealed a positive relationship between improvement and satisfaction with life participation, and a negative relationship between improvement and perceived impairment severity. Critically, psychosocial and treatment-related factors significantly improved model fit over lesion volume, suggesting that these factors add predictive value to determining long-term aphasia prognosis. CONCLUSIONS Long-term aphasia recovery is multidetermined by a combination of stroke-, psychosocial-, and treatment-related factors. This has direct implications for acute and chronic interventions for aphasia.
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Affiliation(s)
- Denise Y. Harvey
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | - Shreya Parchure
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Roy H. Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
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Bornman J, Louw B. A model for cross-cultural translation and adaptation of speech-language pathology assessment measures: Application to the Focus on the Outcomes of Communication Under Six (FOCUS ©). INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:382-393. [PMID: 33501853 DOI: 10.1080/17549507.2020.1831065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE In the absence of a gold standard, this study illustrates the process involved in the cross-cultural translation and adaptation of the FOCUS© and its shortened version, FOCUS-34© (the Parent Form and Instruction Sheet, as well as the Clinician Form and Instruction Sheet), while also determining the social validity and clinical applicability of the translated measure. The target language used as example was Afrikaans, one of the 11 official languages of South Africa. METHOD A two-phase cross-cultural translation model was employed in which Phase 1 (comprising a six-step blind back-translation procedure) was sequentially followed by Phase 2 (social validation and clinical applicability of the measure, using focus groups with stakeholders). RESULT The extensive process followed in Phase 1 resulted in a clear and appropriate translation acceptable to both stakeholder groups (parents and speech-language pathologists). Both groups questioned the meaning of certain concepts, explored cultural differences and requested the extension of some items. Parents also shared their emotional reactions towards assessment, while therapists focussed on editorial changes to the measures. CONCLUSION A framework is proposed for cross-cultural translation and adaptation of assessment measures with suitability in the speech-language pathology discipline.
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Affiliation(s)
- Juan Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Brenda Louw
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
- Department Audiology and Speech-Language Pathology, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN, USA
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Hearing, Speech, Language, and Communicative Participation in Patients With Apert Syndrome: Analysis of Correlation With Fibroblast Growth Factor Receptor 2 Mutation. J Craniofac Surg 2021; 33:243-250. [PMID: 34310431 DOI: 10.1097/scs.0000000000008019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Apert syndrome (AS) is caused by the heterozygous presence of 1 of 2 specific missense mutations of the fibroblast growth factor receptor 2 (FGFR2) gene. The 2 adjacent substitutions, designated p.Ser252Trp (S252W) and p.Pro253Arg (P253R), account for more than 98% of cases. Previous research has identified elevated hearing difficulties and incidence of cleft palate in this population. However, the influence of FGFR2 genotype on the speech, language, and communicative participation of children with AS has yet to be examined. METHODS A retrospective case note analysis was completed for all patients with a genetically-confirmed Apert mutation who attended the Oxford Craniofacial Unit over a 43-year period (1978-2020). Medical records were analyzed for speech, language, hearing, and communication data in detail. The therapy outcome measures, based on the World Health Organization International Classification of Functioning, Disability, and Health was used to classify patient's communicative participation. RESULTS The authors identified 55 AS patients with genetically-confirmed mutation of the FGFR2 gene. One patient with a S252F mutation was excluded. There were 31 patients with the S252W mutation (male = 14; female = 17), age range of last hearing assessment (1-18 years), 64% (18/28) of patients had a cleft palate (including bifid uvula), 15 patients had conductive hearing loss, 1 patient had mixed hearing loss, 18 had otitis media with effusion (4 of whom had a cleft palate); 88% (21/24) of patients had receptive language difficulties, 88% (22/25) of patients had expressive language difficulties, 96% (27/28) of patients had a speech sound disorder. There were 23 patients with the P253R mutation (male = 13; female = 10); age range of last hearing assessment (1-13 years), 35% (8/23) patients had a cleft palate (including bifid uvula), 14 patients had a conductive hearing loss, 17 had otitis media with effusion (2 of whom had a cleft palate). Results indicated that 85% (17/20) of patients had receptive language difficulties, 80% (16/20) had expressive language difficulties, 100% (21/21) had a speech sound disorder. The S252W mutation was significantly-associated with the presence of cleft palate (including bifid uvula) (P = 0.05).Data about the cumulative impact of all of these factors for communicative participation using the therapy outcome measures were available for 47 patients: (30 S252W; 17 P253R). Patients with a S252W mutation had significantly more severe difficulties with communicative participation when compared to individuals with a P253R mutation (P = 0.0005) Cochran-Armitage trend test. CONCLUSIONS Speech, language, communicative participation, and hearing difficulties are pervasive in patients with AS. The severity and functional impact of these difficulties are magnified in patients with the S252W mutation. Results reinforce the importance of considering patients with AS according to genotype.
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Baylor C, Eadie T, Yorkston K. The Communicative Participation Item Bank: Evaluating, and Reevaluating, Its Use across Communication Disorders in Adults. Semin Speech Lang 2021; 42:225-239. [PMID: 34261165 DOI: 10.1055/s-0041-1729947] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Patient-reported outcomes (PROs) are essential in patient-centered, evidence-based practice in speech-language pathology. PROs respect individuals who live with communication disorders as key stakeholders providing a critically unique perspective on consequences of communication disorders, and whether interventions bring about meaningful changes. Some PROs focus on specific communication symptoms such as voice or language symptom severity, while others focus on broader constructs such as quality of life. Many PROs target specific diagnostic groups. This article presents the Communicative Participation Item Bank (CPIB), a PRO that measures communicative participation restrictions. The CPIB was based on the concept of participation, or engagement in life situations, as defined in the World Health Organization's International Classification of Functioning, Disability, and Health. It was designed to be relevant for adults across different communication disorders to facilitate clinical and research activities that may involve either comparing or aggregating data across communication disorders. The CPIB follows current PRO development protocols including systematic guidance from stakeholders through cognitive interviews, and the measurement methods of Item Response Theory that allow precise and adaptive assessment. This article reviews use of the CPIB across different diagnostic groups, and identifies needs for future efforts to expand the relevance of the CPIB further.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
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Jin JL, Baylor C, Yorkston K. Predicting Communicative Participation in Adults Across Communication Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1301-1313. [PMID: 33656912 PMCID: PMC8702843 DOI: 10.1044/2020_ajslp-20-00100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/01/2020] [Accepted: 10/20/2020] [Indexed: 05/29/2023]
Abstract
Purpose The purpose of this study was to explore the extent to which communicative participation differs across diagnoses and if there are common predictor variables for communicative participation across diagnoses. Method Survey data on self-report variables including communicative participation were collected from 141 community-dwelling adults with communication disorders due to Parkinson's disease, cerebrovascular accident, spasmodic dysphonia, or vocal fold immobility (VFI). Analysis of covariance was used to determine communicative participation differences between diagnoses, with age, sex, and hearing status as covariates. Sequential entry linear regression was used to examine associations between communicative participation and variables representing a range of psychosocial constructs across diagnoses. Results The VFI group had the least favorable communicative participation differing significantly from Parkinson's disease and spasmodic dysphonia groups. Self-rated speech/voice severity, self-rated effort, mental health, perceived social support, and resilience contributed to variance in communicative participation when pooled across diagnoses. The relationship between communicative participation and the variables of effort and resilience differed significantly when diagnosis was considered. Conclusions The findings suggest that communicative participation restrictions may vary across some diagnoses but not others. People with VFI appear to differ from other diagnosis groups in the extent of participation restrictions. Effort and resilience may play different roles in contributing to communicative participation in different disorders, but constructs such as social support, severity, and mental health appear to have consistent relationships with communicative participation across diagnoses. The findings can help clinicians identify psychosocial factors beyond the impairment that impact clients' communication in daily situations.
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Affiliation(s)
- Jingyu Linna Jin
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Levy ES, Chang YM, Hwang K, McAuliffe MJ. Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2301-2316. [PMID: 33656916 DOI: 10.1044/2020_jslhr-20-00301] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria (n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding (n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children. Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.
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Affiliation(s)
- Erika S Levy
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Younghwa M Chang
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - KyungHae Hwang
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Megan J McAuliffe
- School of Psychology, Speech and Hearing and New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
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Connaghan KP, Wertheim C, Laures-Gore JS, Russell S, Patel R. An exploratory study of student, speech-language pathologist and emergency worker impressions of speakers with dysarthria. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:265-274. [PMID: 32664751 DOI: 10.1080/17549507.2020.1768286] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To explore the influence of listener profession on impressions of speakers with dysarthria with varying intelligibility using semantic differential scales. Method: Three listener groups (undergraduate students, emergency workers, speech-language pathologists (SLPs); n = 38) rated non-speech attributes of six adults with dysarthria that ranged from low to high speech intelligibility. Participants rated 22 bipolar adjective pairs and listening effort on visual analogue scales. Following factor analysis of the semantic differential scales, listener impression and effort ratings were compared across listening groups and speaker intelligibility. RESULT Repeated measures ANOVA revealed that neither impressions nor effort ratings differed across listener groups. However, impressions significantly decreased and listening effort significantly increased with reduced intelligibility. Analysis of the semantic differential scale items revealed two factors (Capability, Personality) that predicted 52% of the variance. Listener impressions were significantly higher for Personality than Capability. Conclusion: Preliminary findings suggest that speakers with dysarthria with reduced intelligibility are at risk to be negatively judged, particularly on their physical and mental capability. This study demonstrates the promise of employing semantic differential scales to investigate listener impressions and therefore the daily communication experiences of speakers with dysarthria. SLPs should consider patient experience of negative impressions when designing treatment.
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Affiliation(s)
- Kathryn P Connaghan
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | - Chelsea Wertheim
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | | | | | - Rupal Patel
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
- College of Communication and Information Science, Northeastern University, Boston, MA, USA
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Boster JB, Spitzley AM, Castle TW, Jewell AR, Corso CL, McCarthy JW. Music Improves Social and Participation Outcomes for Individuals With Communication Disorders: A Systematic Review. J Music Ther 2021; 58:12-42. [PMID: 32978945 DOI: 10.1093/jmt/thaa015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
There is increasing interest in exploring the benefits of music in rehabilitation settings. In the field of speech-language pathology, an ultimate goal for individuals with communication disorders is to foster participation across multiple contexts. The goal of this systematic review was to explore social and participation outcomes for individuals with communication disorders who received arts-based interventions. A systematic search of the literature yielded 86 studies, which were coded and summarized in terms of participants, arts-based intervention, social and participation variables, outcome, and quality of evidence. The majority of identified studies (N = 71) utilized music. Results indicated that music-based interventions can improve social and participation outcomes, such as frequency of responses, initiation of communication, turn-taking, joint attention, and group participation for children and adults with autism spectrum disorder and developmental and acquired communication disorders; however, future research is needed to expand the use of varied arts-based interventions targeting a larger breadth of social and participation outcomes.
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Bryans LA, Palmer AD, Anderson S, Schindler J, Graville DJ. The impact of Lee Silverman Voice Treatment (LSVT LOUD®) on voice, communication, and participation: Findings from a prospective, longitudinal study. JOURNAL OF COMMUNICATION DISORDERS 2021; 89:106031. [PMID: 33259945 DOI: 10.1016/j.jcomdis.2020.106031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Lee Silverman Voice Treatment (LSVT LOUD®), an intensive 4-week program of voice therapy, is regarded as the most well-researched, efficacious treatment for hypokinetic dysarthria in individuals with Parkinson's disease (PD). Although numerous studies have published acoustic and perceptual findings, there is comparatively little information about the impact of LSVT LOUD® on functional communication outcomes. METHODS This prospective, longitudinal study investigated the impact of treatment on daily communication in 25 individuals with PD. Three validated communication measures (the Voice Handicap Index, the Communicative Effectiveness Scale, and the Communicative Participation Item Bank) were given before and after treatment and again 4-8 weeks and 3-6 months following treatment. Communication partners were also asked to rate communication effectiveness at all four timepoints. RESULTS Significant improvements were found for all three self-reported scales which remained above baseline across all post-treatment timepoints. In addition, self-reported communicative effectiveness was significantly correlated with the assessments of communication partners. Particular benefits were reported for more complex communicative activities such as asking questions, giving detailed information, communicating in noisy situations, and speaking in groups. CONCLUSIONS Overall, the findings suggested that LSVT LOUD® promotes an increased sense of personal control over the communication difficulties resulting from PD by decreasing voice handicap and improving communication effectiveness and communicative participation. For individuals with PD, LSVT LOUD® may reduce the risk of social isolation by improving communication and facilitating social participation. LEARNING OUTCOMES As a result of this activity, the participant will be able to (1) describe the impact of PD on voice and communication, (2) discuss how these characteristics may be associated with more global measures of functional communication and particularly communicative participation, (3) explain which aspects of functional communication were affected by LSVT LOUD® as assessed by study participants and their communication partners.
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Affiliation(s)
- Linda A Bryans
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
| | - Andrew D Palmer
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
| | - Shannon Anderson
- Dept. of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA.
| | - Joshua Schindler
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
| | - Donna J Graville
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
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Whillans C, Lawrie M, Cardell EA, Kelly C, Wenke R. A systematic review of group intervention for acquired dysarthria in adults. Disabil Rehabil 2020; 44:3002-3018. [PMID: 33356634 DOI: 10.1080/09638288.2020.1859629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing. MATERIALS AND METHODS A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University's Critical Review Form, and the TIDieR template for intervention description and replication. RESULTS 21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson's disease (PD) (97%; n = 321). Treatment approaches included singing therapy (n = 10), loudness therapy (n = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) (n = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches. CONCLUSION There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment.IMPLICATIONS FOR REHABILITATIONGroup therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson's disease.Studies' employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures.Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD.PROSPERO registration number: CRD42015029374.
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Affiliation(s)
- Chelsea Whillans
- Speech Pathology & Audiology Services, Gold Coast Health, Southport, Australia
| | - Melissa Lawrie
- Speech Pathology & Audiology Services, Gold Coast Health, Southport, Australia.,School of Allied Health Sciences, Griffith University, Southport, Australia
| | - Elizabeth A Cardell
- School of Allied Health Sciences, Griffith University, Southport, Australia.,Menzies Institute Queensland, Southport, Australia
| | - Crystal Kelly
- School of Allied Health Sciences, Griffith University, Southport, Australia
| | - Rachel Wenke
- Speech Pathology & Audiology Services, Gold Coast Health, Southport, Australia.,School of Allied Health Sciences, Griffith University, Southport, Australia
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Nguyen-Feng VN, Asplund A, Frazier PA, Misono S. Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders. JAMA Otolaryngol Head Neck Surg 2020; 147:2774498. [PMID: 33355630 PMCID: PMC7758827 DOI: 10.1001/jamaoto.2020.4956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/02/2020] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Communicative participation can be conceptualized as taking part in life situations in which people are socially engaged. Communicative participation is an important aspect in the lives of patients with voice disorders, although it has not been formally assessed among a broad sample of patients with voice disorders. The associations between communicative participation and associated concepts (vocal impairment, psychosocial distress, and voice-specific perceived control) are unknown yet important for integrated treatment approaches. OBJECTIVE The primary objective was to examine the associations between communicative participation and vocal impairment, psychosocial distress, and voice-specific perceived control. The secondary objective was to examine whether perceived control moderates the association of distress with communicative participation and vocal impairment, the latter of which would replicate previous research. The hypotheses were that communicative participation would be associated with lower vocal impairment, lower distress, and higher perceived control and that higher perceived control would moderate the association between communicative participation and both vocal impairment and psychosocial distress. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from June 2014 to May 2017 among a consecutive sample of adult patients with voice disorders at an academic voice clinic affiliated with the University of Minnesota. Of the 744 patients approached to participate in the survey study, 590 patients agreed. Data analysis was performed from January to June 2020. MAIN OUTCOMES AND MEASURES Communicative participation (measured by the 10-item general short form of the Communicative Participation Item Bank), vocal impairment (measured by the 10-item version of the Voice Handicap Index), psychosocial distress (measured by the 18-item version of the Brief Symptom Inventory), and voice-specific perceived control (measured by the 8-item present control subscale of the Perceived Control Over Stressful Events Scale). RESULTS The sample comprised 590 patients (mean [SD] age, 51.9 [17.1] years; 390 women [66.1%]) with voice disorders. Communicative participation was associated with lower vocal impairment (r = -0.73; 95% CI, -0.77 to -0.69), lower overall psychosocial distress (r = -0.22; 95% CI, -0.30 to -0.14), and higher voice-specific perceived control (r = 0.30; 95% CI, 0.23-0.37). Moderation analyses indicated that communicative participation was negatively associated with distress at all levels of perceived control and, replicating previous findings, greater vocal impairment was associated with higher psychosocial distress only in patients with lower perceived control. CONCLUSIONS AND RELEVANCE In this study, communicative participation was associated with, but distinct from, vocal impairment and was also associated with psychosocial distress and voice-specific perceived control. The study's results suggest that communicative participation is an important addition to voice research and clinical care.
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Affiliation(s)
| | - Alexa Asplund
- Department of Psychology, University of Minnesota Duluth, Duluth
| | | | - Stephanie Misono
- Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Twin Cities, Minneapolis
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Barnish MS, Barran SM. A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease. BMC Neurol 2020; 20:371. [PMID: 33038925 PMCID: PMC7547481 DOI: 10.1186/s12883-020-01938-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status. METHODS Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists. RESULTS Fifty-six studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains. CONCLUSIONS This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.
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Affiliation(s)
- Maxwell S. Barnish
- Peninsula Technology Assessment Group (PenTAG), Institute of Health Research, University of Exeter Medical School, Exeter, UK
- Evidence Synthesis and Modelling for Health Improvement (ESMI), University of Exeter Medical School, Exeter, UK
| | - Susannah M. Barran
- Children and Young People’s Speech and Language Therapy, Evelina London Community Children’s Services, Mary Sheridan Health Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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