Simulation-based Learning Experiences in Stuttering Management Delivered Online: What Do Students, Clinical Educators and Simulated Patients Think?

Speech pathology students are required to demonstrate competency across a range of practice areas. There are, however, limited opportunities for students to access clinical placements in the area of stuttering. Simulation-based learning (SBL) activities have proven to be effective in increasing students' clinical experience in this area. Due to the COVID-19 pandemic, the delivery of in-person SBL programs was not feasible, resulting in a shift to online provision. The aim of this study was to investigate the perceptions of students, clinical educators and simulated patients who participated in an online adult stuttering SBL experience. Ten first-year graduate entry Masters program speech pathology students participated in the study alongside four clinical educators and four simulated patients. The experience involved two online SBL sessions and one online tutorial via videoconferencing from separate locations. Each participant group engaged in focus group interviews exploring their perceptions of the online SBL activity. Thematic network analysis of the focus group interview data was conducted. Overall interpretation of the data from the perspectives of students, clinical educators and simulated patients revealed an overarching global theme that online SBL offers a positive, comfortable and comparable experience to enable students to build client-centred, clinical and telepractice skills. The positive outcomes of this study suggest that together with in-person clinical experiences, online SBL has an important role in the education of speech pathology students. © 2022 Adriana Penman, Monique Waite, Anne E. Hill, Taliesha-Jayne Leslie, Brooke-Mai Whelan & Andrea Whitehead. This Open Access article is distributed under the terms of the Creative Commons Attribution Attribution-Non-Commercial No Derivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is unaltered.

Webcam delivery in the treatment of stuttering - Efficacy and recommendations for action

Telemedicine services are expected to be part of standard care in voice, speech and language therapy. This follows on from the special regulations for the provision of videotherapy in force due to the COVID-19 pandemic. In this article, international publications on the effectiveness of video therapy compared to conventional face-to-face therapy in the field of stuttering intervention are presented. The focus is on three therapy concepts (Camperdown Program, Kasseler Stottertherapie, and Lidcombe Program), whose underlying therapy forms were evaluated with the recommendation grade A in the context of the S3-guideline for Speech Fluency Disorders (DGPP, 2016). Results show that video-based stuttering therapy using these approaches is just as effective as conducting them via face-to-face therapy. Recommendations for video-based stuttering therapy include technical equipment, individual patient suitability, and changing interaction patterns. © 2022 Urban und Fischer Verlag Jena. All rights reserved.

Patient Satisfaction With Telemedicine Versus In-Person Speech-Language Therapy: A Systematic Review

Introduction: Telemedicine has become a popular option to provide speech-language pathology (SLP) services during the COVID-19 global pandemic. We sought to systematically review the literature to evaluate patient satisfaction with telemedicine vs in-person visits for SLP services. Method(s): A systematic review was performed in Embase, MEDLINE, AMED, and Scopus databases. Search terms included variations of speech-language pathology, telemedicine, and video. The initial search yielded 549 studies. Of these studies, 37 met criteria for full-text screening. Inclusion criteria included (1) age >18 years and (2) patient satisfaction as an outcome measure. Case reports were excluded. Result(s): Twenty-nine studies met inclusion criteria;8 studies used validated satisfaction questionnaires, 17 used nonvalidated questionnaires, and 4 used qualitative interviews. Of the 29 studies, 3 were randomized controlled trials (RCT). Of the 26 non-RCTs, 24 reported >50% overall satisfaction with televisits. Six studies evaluated patient preference for inperson vs televisits;all studies reported >50% of patients having no preference. Eleven studies evaluated willingness to reengage in telemedicine, and all reported that >50% of patients were willing to reengage with telemedicine. Of the RCTs, 2 used the same validated survey, the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction- General (FACIT-TS-G), for patients undergoing posttreatment laryngectomy and swallow rehabilitation therapy. Both studies revealed that patients rated televisits with significantly higher satisfaction for the overall results of therapy (P<.02). A third of the RCTs, which focused on patients with chronic stuttering, found telemedicine was more frequently described as extremely convenient (P=.018). Conclusion(s): Although most studies evaluating patient satisfaction with SLP interventions via telemedicine reported greater than 50% overall satisfaction, there was frequent use of nonvalidated measures of patient satisfaction (17 of 29). Use of validated measures is warranted for evaluating patient satisfaction.

The Effects of the COVID-19 Pandemic on Pre-School Age Children: A Retrospective Study

Objective: The purpose of this study was to investigate the effect of pandemic conditions on the mental problems of pre-school age children. Methods: The file data of pre-school age children (aged 72 months or less) presenting to a child and adolescent psychiatry clinic between March 30, 2020, and March 30, 2021, were examined retrospectively. Results: Boys constituted 67.9% of the 249 children included in the study, and girls 32.1%. The youngest patient was aged 5 months, and the oldest, 72 months. The mean age of the entire patient group was 42.82 ± 14.84 months. Mean age among boys was 42.44 ± 15.06 months, and mean age among girls was 43.61 ± 14.43 months (P = .561). Presentation symptoms frequently involved neurodevelopmental problems. Analy-sis showed that 76.7% of cases were not attending any educational institution. At least one diagnosis based on DSM-5 diagnostic criteria was present in 83.5% of cases. The most frequent diagnoses were general developmental delay (22.1%), developmental language disorder (16.5%), autism spectrum disorder (ASD) (14.5%), attention deficit hyperactivity disorder (11.6%), and childhood-onset fluency disorder (stuttering) (7.6%). Gender comparisons showed that ASD was significantly more common in boys than in girls (P = .004). Conclusion: The results of this study indicate a higher rate of diagnosis than in studies performed before the pandemic. In addition, presentations due to certain neurodevelopmental disorders seen more frequently in boys also increased among girls during the pandemic. Our study results will be useful in guiding the development of protective mental health services for pre-school children.

Epilepsy and Diagnostic Dilemmas: The Role of Language and Speech-Related Seizures.

Although the impact of epilepsy on expressive language is heavily discussed, researched, and scientifically grounded, a limited volume of research points in the opposite direction. What about the causal relationship between disorder-related language activities and epileptic seizures? What are the possible diagnostic dilemmas that experts in the field of speech-language pathology, neurology, and related fields face? How far has research gone in investigating psychogenic nonepileptic seizures, the misdiagnosis of which can be a thorny issue for clinicians and a detrimental factor for the patients' health? In order to address these questions, the study at hand focuses on a common, ever-intensified (by the COVID-19 pandemic) speech disorder-stuttering, and explores the pathophysiological and psychogenic background of the phenomenon. It also looks at the role of stuttering as a contributing factor to the appearance of epileptic seizures, in the hope of drawing attention to the complexity and importance of precise detection of stuttering-induced epilepsy, as a specific subcategory of language-induced epilepsy.

No other choice: Speech-Language Pathologists' attitudes toward using telepractice to administer the Lidcombe Program during a pandemic.

PURPOSE: Telepractice has been shown to be a viable modality for the delivery of stuttering treatment. Since the advent of COVID-19, speech-language pathologists must adapt in-clinic treatments for online presentation. This research aimed to gather information from speech-language pathologists on their experiences of telepractice to deliver the Lidcombe Program to treat stuttering in young children. METHODS: This paper presents the findings of an online survey that polled the clinical experiences of 106 speech-language pathologists who were delivering the Lidcombe Program via telepractice during COVID-19. RESULTS: The majority of respondents were experienced clinicians from the United States and Canada who had attended a Lidcombe Program workshop. Prior to COVID-19, 80 % had provided some clinical services online (up to 10 % of the time), and at the start of COVID-19 public lockdown orders, 77 % viewed telepractice as both a necessity and an opportunity. Three months after the public lockdown orders, the large majority, 94 %, said that they would continue to use both telepractice and in-clinic treatment in the future. Technology issues, concerns about establishing the clinical relationship, and identification of mild stuttering featured as challenges of telepractice service delivery, while benefits included time efficiency, flexibility of scheduling, and improved clinical processes. CONCLUSION: Respondents reported that the Lidcombe Program was easily translatable to telepractice and the majority intend to continue telepractice in the future.

Telepractice in School-Age Children Who Stutter: A Controlled Before and After Study to Evaluate the Efficacy Of MIDA-SP.

The COVID-19 pandemic necessitated a general reorganization of rehabilitation services in Italy. The lockdown in Italy led to the use of telepractice for the delivery of speech therapy, including stuttering. The aim of the present work was to evaluate the effectiveness of the Multidimensional, Integrated, Differentiated, Art-Mediated Stuttering Program (MIDA-SP; Tomaiuoli et al., 2012), delivered online for school-age children who stutter. A non-randomized controlled pre- and post-treatment study included an experimental group (11 children) receiving a telepractice adaptation of MIDA-SP and a historical control group (11 children) receiving in-person MIDA-SP. Both groups had been assessed with the Stuttering Severity Instrument - Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering (OASES-S) pre- and post-treatment. No statistically significant differences were found between the two modes of delivery. These findings suggest that MIDA-SP treatment delivered via telepractice is effective for school-age children who stutter.

Is social distancing a boon or bane for persons who stutter during COVID-19 pandemic?

The Covid-19 pandemic is an ongoing crisis and is colloquially known as the corona virus pandemic. As no specific treatment protocol are available for this viral infection, social distancing is considered as one of the remedies to prevent the infection. This study aimed to investigate the anxiety issues in persons who stutter (PWS). A total of 110 (55 PWS and 55 Neuro-typical Adults) were enrolled for the study. A questionnaire comprising of two parts on social anxiety and consequences of social distancing was administered on the participants. The results showed that PWS felt more socially anxious. PWS opined that they were comfortable during the corona virus lockdown period, as the situation demanded them to speak minimally to strangers. Neuro-typical adults, on the other hand, reported that they did not observe any change with respect to the social communication skills during lockdown.

Controlling emerging zoonoses at the animal-human interface.

BACKGROUND: For many emerging or re-emerging pathogens, cases in humans arise from a mixture of introductions (via zoonotic spillover from animal reservoirs or geographic spillover from endemic regions) and secondary human-to-human transmission. Interventions aiming to reduce incidence of these infections can be focused on preventing spillover or reducing human-to-human transmission, or sometimes both at once, and typically are governed by resource constraints that require policymakers to make choices. Despite increasing emphasis on using mathematical models to inform disease control policies, little attention has been paid to guiding rational disease control at the animal-human interface. METHODS: We introduce a modeling framework to analyze the impacts of different disease control policies, focusing on pathogens exhibiting subcritical transmission among humans (i.e. pathogens that cannot establish sustained human-to-human transmission). We quantify the relative effectiveness of measures to reduce spillover (e.g. reducing contact with animal hosts), human-to-human transmission (e.g. case isolation), or both at once (e.g. vaccination), across a range of epidemiological contexts. RESULTS: We provide guidelines for choosing which mode of control to prioritize in different epidemiological scenarios and considering different levels of resource and relative costs. We contextualize our analysis with current zoonotic pathogens and other subcritical pathogens, such as post-elimination measles, and control policies that have been applied. CONCLUSIONS: Our work provides a model-based, theoretical foundation to understand and guide policy for subcritical zoonoses, integrating across disciplinary and species boundaries in a manner consistent with One Health principles.

Stuttering and Word-Finding Difficulties in a Patient With COVID-19 Presenting to the Emergency Department.

Coronavirus disease 2019 (COVID-19) was designated as a global pandemic by the World Health Organization (WHO) on March 11, 2020. The Cochrane Database of Systematic Reviews documents that COVID-19 has a wide range of common symptoms, which have made it difficult to characterize the disease. To date, the neurological symptoms of stuttering and word-finding difficulties have not been reported in confirmed COVID-19 cases. This case report describes the clinical course of a 53-year-old female that presented to the emergency department (ED) twice with varying symptoms consistent with COVID-19. At the second ED visit, she complained of new-onset stuttering and word-finding difficulties and tested positive for COVID-19 using the polymerase chain reaction (PCR) nasopharynx test. When contacted, the patient stated that her speech issues persisted at least seven days after discharge from her second ED visit. As a result, the virus may cause symptoms of an acute neurological event and should be taken into diagnostic consideration. These neurological findings may be explained by the recent discovery of the COVID-19 spike protein's ability to destabilize the blood-brain barrier (BBB) and enter the central nervous system (CNS). Increased classification of unrecognized COVID-19 symptoms and complications may aid in the characterization, surveillance, and prevention of the disease.