Self-perceived affective, behavioral, and cognitive reactions associated with voice use in people with Parkinson's disease: a pilot study

PURPOSE

This study aimed to compare the affective, behavioral, and cognitive reactions related to vocal function in people with Parkinson's disease (PWPD) and healthy controls using the Behavior Assessment Battery - Voice (BAB-Voice). The test's internal consistency was also described.

METHODS

31 PWPD and 19 healthy controls were recruited from September 2020 to March 2021. Participants completed four BAB-Voice subtests: Speech Situation Checklist - Emotional Reaction (SSC-ER), the Speech Situation Checklist - Speech Disruption (SSC-SD), Behavior Checklist (BCL), and Communication Attitude Test for Adults (BigCAT), describing the experienced negative emotional reaction, voice disruptions, coping behaviors, and negative attitude regarding communication respectively. Subtest scores were calculated and analyzed.

RESULTS

The scores of the PWPD were significantly different from those of the controls (Pillai's Trace = 0.344, F[4] = 5.508, p = .001, ηp2 = .344): PWPD showed more negative emotions and voice problems, more coping behaviors, and more negative speech-related attitude compared to healthy controls. All subtests showed excellent internal consistency.

CONCLUSIONS

The BAB-Voice proved a tool with a good internal consistency that measured different psychosocial reactions in PWPD versus controls. PWPD exhibited significantly more negative emotions and voice problems in specific speech situations, more coping behaviors, and a more negative speech-related attitude. The specificity of information obtained from the BAB-Voice may aid in improving the treatment planning of voice disorders in PWPD.

Advancing Workplace Diversity Through the Culturally Responsive Teamwork Framework

Purpose Diversification of the profession is an important element of combating racism, bias, and prejudice in the speech-language pathology workforce at national and systemic levels. However, national and systemic change needs to be combined with equipping individual speech-language pathologists to adapt to the challenges that they face to engaging in culturally responsive practice. This paper presents four interacting levels of practice within the Culturally Responsive Teamwork Framework (CRTF): (a) intrapersonal practices, (b) interpersonal practices, (c) intraprofessional practices, and (d) the interprofessional practices. Conclusion CRTF is a practical, strengths-based framework that draws on international research and expertise to expand personal and professional practice and describe critical behaviors within the workplace that can be used to promote principles of evidence-based practice and social justice, especially when working with people from nondominant cultural or linguistic groups.

Intelligibility Enhancement Assessment and Intervention: a single-case experimental design with two multilingual university students

Speech-language pathologists (SLPs) may be approached by multilingual speakers wishing to improve their intelligibility in English. Intelligibility is an essential element of spoken language proficiency and is particularly important for multilingual international students given their need to express complex ideas in an additional language. Intelligibility Enhancement aims to improve the intelligibility and acceptability of consonants, vowels and prosody with multilingual speakers who are learning to speak English. This study aimed to describe the Intelligibility Enhancement Assessment and Intervention Protocols and determine whether the intervention changed multilingual university students' English intelligibility. A multiple-baseline single-case experimental design was applied with direct inter-subject replication across two female participants whose home languages were Vietnamese and Putonghua (Mandarin). English intelligibility was assessed at multiple intervals pre, post and during intervention. The intervention protocol consisted of 11 weekly 1-h sessions with an SLP targeting English consonants, vowels and prosody. Following intervention, both participants displayed increased performance across most measures. For example, the Vietnamese participant's percentage of consonants correct (PCC) increased from 62.5% to 85.0% in probe keywords. Effect sizes, when comparing baseline and withdrawal phases, were 5.5 for PCC, 4.6 for final consonants, 2.3 for consonant clusters and 1.6 for syllables indicating improvements in all variables measured. Her speech rate reduced, word stress increased in accuracy and she perceived less difficulty communicating in English. These promising results suggest further testing of the Intelligibility Enhancement Protocols is warranted to determine effectiveness as an intervention for multilingual speakers.

Speech-language pathologists' support for multilingual speakers' English intelligibility and participation informed by the ICF

PURPOSE

To use the ICF to classify characteristics and aspirations of multilingual university students and faculty who seek speech-language pathologists' support for intelligibility in English and to identify activities, facilitators, and barriers that impact participation in society.

METHOD

A retrospective record review was conducted on files of 175 clients attending a university clinic for intelligibility enhancement (accent modification). Participants came from 35 countries and spoke 28 different home languages.

RESULTS

Assessment and intervention for intelligibility enhancement involved consideration of ICF components of Body Functions and Structures (e.g., articulating phonemes, rate, prosody), Environmental Factors (e.g., support), and Personal Factors (e.g., motivation). Consonant substitutions and deletions were common, although participants were often unaware of these. For example, only 25.6% of participants reported English dental fricatives (/θ/ and /ð/) were difficult to pronounce; however, 94.9% substituted them with other phonemes such as [t] and [d]. The combination of substitutions/deletions, fast speech rate, low speaking volume, and differences in word stress exacerbated poor intelligibility. More time conversing in English was associated with greater confidence and less difficulty communicating in English, although more time knowing English was not. Difficult communication situations were reported to be conversing over the phone, talking to strangers, and communicating in English on professional fieldwork placements. Participants were motivated to seek intelligibility enhancement for academic, employment, and social reasons.

CONCLUSIONS

To ensure multilingual speakers are able to participate fully in society, intelligibility enhancement requires a multi-pronged approach where speech and environmental characteristics interweave.