Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
1.
J Pak Med Assoc ; 72(3): 581-584, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1754324

ABSTRACT

Augmentative and Alternative Communication is an aided or unaided means of communication which supports existing communication abilities of an individual or replaces natural speech due to any speech and language disorder. The deficit could be developmental or acquired such as autism spectrum disorder, cerebral palsy, learning difficulties, dysarthria, dyspraxia or due to any acquired neurological condition such as aphasia and other degenerative disorders. Furthermore, it may be due to surgical procedures such as laryngectomy. Alternate means of communication have also been successfully used with COVID-19 patients. These tools may include pictures, symbols, signs or voice output devices. Parents of children with special needs and medical professionals have been reluctant in implementing the approach due to certain misconceptions. The aim of this review is to summarize the current evidence for the use of Augmentative and Alternative Communication with a range of disorders in relation to in relation to Pakistan.


Subject(s)
Communication Aids for Disabled , Communication Disorders , Language Therapy , Autism Spectrum Disorder/complications , COVID-19/complications , Child , Communication , Communication Disorders/etiology , Communication Disorders/rehabilitation , Humans , Language Therapy/instrumentation , Language Therapy/methods , Pakistan , Speech , Speech Therapy/instrumentation , Speech Therapy/methods
2.
J Integr Neurosci ; 21(1): 8, 2022 Jan 28.
Article in English | MEDLINE | ID: covidwho-1687835

ABSTRACT

We report on our remote speech therapy experience in post-stroke aphasia. The aim was to test the feasibility and utility of telerehabilitation to support future randomized controlled trials. Post-stroke aphasia is a common and disabling speech disorder, which significantly affects patients' and caregivers' health and quality of life. Due to COVID-19 pandemic, most of the conventional speech therapy approaches had to stop or "switch" into telerehabilitation procedures to ensure the safety of patients and operators but, concomitantly, the best rehabilitation level possible. Here, we planned a 5-month telespeech therapy programme, twice per week, of a patient with non-fluent aphasia following an intracerebral haemorrhage. Overall, treatment adherence based on the operator's assessments was high, and incomplete adherence for technical problems occurred very rarely. In line with the patient's feedback, acceptability was also positive, since he was constantly motivated during the sessions and the exercises performed autonomously, as confirmed by the speech therapist and caregiver, respectively. Moreover, despite the sequelae from the cerebrovascular event, evident in some writing tests due to the motor deficits in his right arm and the disadvantages typical of all telepractices, more relevant results were achieved during the telerehabilitation period compared to those of the "face-to-face" therapy before the COVID-19 outbreak. The telespeech therapy performed can be considered successful and the patient was able to return to work. Concluding, we support it as a feasible approach offering patients and their families the opportunity to continue the speech and language rehabilitation pathway, even at the time of pandemic.


Subject(s)
Aphasia/rehabilitation , Stroke Rehabilitation/methods , Stroke/complications , Telerehabilitation , Aphasia/etiology , COVID-19 , Humans , Language Therapy/methods , Male , Middle Aged , Pandemics , Speech Therapy/methods , Treatment Outcome
3.
Lang Speech Hear Serv Sch ; 53(2): 256-274, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1636484

ABSTRACT

PURPOSE: Although mobile apps are used extensively by speech-language pathologists, evidence for app-based treatments remains limited in quantity and quality. This study investigated the efficacy of app-based visual-acoustic biofeedback relative to nonbiofeedback treatment using a single-case randomization design. Because of COVID-19, all intervention was delivered via telepractice. METHOD: Participants were four children aged 9-10 years with residual errors affecting American English /ɹ/. Using a randomization design, individual sessions were randomly assigned to feature practice with or without biofeedback, all delivered using the speech app Speech Therapist's App for /r/ Treatment. Progress was assessed using blinded listener ratings of word probes administered at baseline, posttreatment, and immediately before and after each treatment session. RESULTS: All participants showed a clinically significant response to the overall treatment package, with effect sizes ranging from moderate to very large. One participant showed a significant advantage for biofeedback over nonbiofeedback treatment, although the order of treatment delivery poses a potential confound for interpretation in this case. CONCLUSIONS: While larger scale studies are needed, these results suggest that app-based treatment for residual errors can be effective when delivered via telepractice. These results are compatible with previous findings in the motor learning literature regarding the importance of treatment dose and the timing of feedback conditions. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.18461576.


Subject(s)
COVID-19 , Mobile Applications , Biofeedback, Psychology/methods , Child , Humans , Pilot Projects , Speech Therapy/methods
4.
Arch Phys Med Rehabil ; 102(9): 1840-1847, 2021 09.
Article in English | MEDLINE | ID: covidwho-1252450

ABSTRACT

This article outlines a multidisciplinary approach to implementing a telehealth program in the acute care hospital setting during the coronavirus disease 2019 (COVID-19) pandemic. Telehealth has been used in many practice areas, although it can be a particular challenge to establish in an acute care hospital given the fast-paced environment. However, the COVID-19 pandemic presented a unique situation. In-person treatment interactions became increasingly high risk for both patient and provider, and there was an emerging need to conserve personal protective equipment and limit exposure. In response to these developments, physical therapists, occupational therapists, and speech language pathologists treating an adult population turned to telehealth to supplement in-person treatment. This article outlines the clinical reasoning and practical application to implementing a telehealth program in an acute care hospital and includes regulations, identified successful strategies, barriers, considerations, decision-making algorithms, and discipline-specific interventions.


Subject(s)
COVID-19 , Hospitals, Rehabilitation , Infection Control/methods , Patient Care Team , Telerehabilitation/methods , Adult , Female , Health Plan Implementation , Humans , Male , Occupational Therapy/methods , Physical Therapy Modalities , Program Evaluation , SARS-CoV-2 , Speech Therapy/methods
5.
Int J Lang Commun Disord ; 56(3): 567-582, 2021 05.
Article in English | MEDLINE | ID: covidwho-1142848

ABSTRACT

BACKGROUND: There is an increasing number of technological resources available to speech and language therapists (SLTs) for use in clinical practice, but the factors that influence SLTs' selection and use of such resources are not well understood. In related fields, technology acceptance models have been employed to explain users' adoption of technology and to inform the advancement of empirically supported technological resources. AIMS: To determine the factors that influence SLTs' use of technology for clinical practice by testing a model of their technology acceptance and use. METHODS & PROCEDURES: We surveyed 209 practising SLTs in the United States representative of the speech and language membership of the American Speech-Language-Hearing Association (ASHA). Participants completed a 38-item electronic survey representing four categories: (1) technology use, (2) technology attitudes and factors influencing technology use, (3) employment information and (4) demographics. Items measuring technology attitudes served as indicators of the research model, which mapped the primary relationships of a technology acceptance model. Survey data were collected before the Covid-19 pandemic. OUTCOMES & RESULTS: The research model accounted for 66% of the variance in SLTs' behavioural intention to use technology, which significantly and positively predicted the amount of time they reportedly spent using technology in the workplace. Subjective norms and attitudes towards technology use directly predicted the intention to use technology. Perceived usefulness and ease of use indirectly predicted intention to use technology. Survey respondents reported using technology during 48% (SD = 24%) of their overall weekly work hours on average, with a large majority reporting using technology at least once per week for planning (89% of respondents), assessment (66% of respondents) or intervention (90% of respondents). CONCLUSIONS & IMPLICATIONS: These findings statistically explain the relationships between SLTs' attitudes and their intention to use technology for clinical practice, contributing to our understanding of why SLTs adopt certain technologies. We also detail the nature and frequency of technology use in the clinical practice of SLTs. Future directions for this work include further exploring use categories, employing direct measurements of technology use and exploring the impact of recent changes in SLT service delivery due to the Covid-19 pandemic on SLTs' technology attitudes. What this paper adds What is already known on the subject Existing research about the adoption and use of technological resources by SLTs indicates that they select tools based on convenience, cost and recommendations by others. What this paper adds to existing knowledge This study is the first to develop and test a research model of SLTs' technology attitudes. The findings from model testing demonstrate the significant predictors of SLTs' behavioural intention to use technology for clinical purposes. Intent of use is related to how much SLTs use technology in the workplace. What are the potential or actual clinical implications of this work? The present findings can inform interventions targeting the design and adoption of electronic SLT resources that are empirically supported.


Subject(s)
Allied Health Personnel/psychology , Language Therapy/methods , Speech Therapy/methods , Technology/statistics & numerical data , Telemedicine/statistics & numerical data , Adult , Attitude of Health Personnel , COVID-19 , Female , Humans , Male , SARS-CoV-2 , Surveys and Questionnaires , United States
6.
Arch Phys Med Rehabil ; 102(6): 1084-1090, 2021 06.
Article in English | MEDLINE | ID: covidwho-1111452

ABSTRACT

OBJECTIVE: To evaluate the presentations and outcomes of inpatients with coronavirus disease 2019 (COVID-19) presenting with dysphonia and dysphagia to investigate trends and inform potential pathways for ongoing care. DESIGN: Observational cohort study. SETTING: An inner-city National Health Service Hospital Trust in London, United Kingdom. PARTICIPANTS: All adult inpatients hospitalized with COVID-19 (N=164) who were referred to Speech and Language Therapy (SLT) for voice and/or swallowing assessment for 2 months starting in April 2020. INTERVENTIONS: SLT assessment, advice, and therapy for dysphonia and dysphagia. MAIN OUTCOME MEASURES: Evidence of delirium, neurologic presentation, intubation, tracheostomy, and proning history were collected, along with type of SLT provided and discharge outcomes. Therapy outcome measures were recorded for swallowing and tracheostomy pre- and post-SLT intervention and Grade Roughness Breathiness Asthenia Strain Scale for voice. RESULTS: Patients (N=164; 104 men) aged 56.8±16.7 years were included. Half (52.4%) had a tracheostomy, 78.7% had been intubated (mean, 15±6.6d), 13.4% had new neurologic impairment, and 69.5% were delirious. Individualized compensatory strategies were trialed in all and direct exercises with 11%. Baseline assessments showed marked impairments in dysphagia and voice, but there was significant improvement in all during the study (P<.0001). On average, patients started some oral intake 2 days after initial SLT assessment (interquartile range [IQR], 0-8) and were eating and drinking normally on discharge, but 29.3% (n=29) of those with dysphagia and 56.1% (n=37) of those with dysphonia remained impaired at hospital discharge. A total of 70.9% tracheostomized patients were decannulated, and the median time to decannulation was 19 days (IQR, 16-27). Among the 164 patients, 37.3% completed SLT input while inpatients, 23.5% were transferred to another hospital, 17.1% had voice, and 7.8% required community follow-up for dysphagia. CONCLUSIONS: Inpatients with COVID-19 present with significant impairments of voice and swallowing, justifying responsive SLT. Prolonged intubations and tracheostomies were the norm, and a minority had new neurologic presentations. Patients typically improved with assessment that enabled treatment with individualized compensatory strategies. Services preparing for COVID-19 should target resources for tracheostomy weaning and to enable responsive management of dysphagia and dysphonia with robust referral pathways.


Subject(s)
Deglutition Disorders/therapy , Deglutition/physiology , Speech Therapy/methods , Voice Quality/physiology , Adult , Aged , Aged, 80 and over , COVID-19 , Comorbidity , Deglutition Disorders/epidemiology , Deglutition Disorders/physiopathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Prospective Studies , United Kingdom/epidemiology , Young Adult
7.
Arch Phys Med Rehabil ; 102(5): 835-842, 2021 05.
Article in English | MEDLINE | ID: covidwho-912037

ABSTRACT

OBJECTIVE: To identify core practices for workforce management of communication and swallowing functions in coronavirus disease 2019 (COVID-19) positive patients within the intensive care unit (ICU). DESIGN: A modified Delphi methodology was used, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. SETTING: Electronic modified Delphi process. PARTICIPANTS: Speech-language pathologists (SLPs) (N=35) from 6 continents representing 12 countries. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly agree). Prioritization rank order of statements in a fourth round was also conducted. RESULTS: SLPs with a median of 15 years of ICU experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. CONCLUSIONS: A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic.


Subject(s)
COVID-19/rehabilitation , Communication Disorders/rehabilitation , Critical Care/standards , Deglutition Disorders/rehabilitation , Physical Therapy Modalities/standards , Speech Therapy/standards , COVID-19/complications , Communication Disorders/etiology , Consensus , Deglutition Disorders/etiology , Delphi Technique , Humans , Intensive Care Units/standards , Respiration, Artificial/adverse effects , SARS-CoV-2 , Speech Therapy/methods , Speech-Language Pathology/standards
8.
J Rehabil Med ; 52(9): jrm00100, 2020 09 16.
Article in English | MEDLINE | ID: covidwho-749062

ABSTRACT

OBJECTIVE: We present a case report that complements the conclusion of Stam et al. in their call to rehabilitation facilities to anticipate and prepare to address post intensive care syndrome in post-Covid-19 patients. METHODS: The case report presented here provides insight into treating mechanically ventilated post-Covid-19 patients. RESULTS: Early intervention with dysphagia therapy and speech therapy and ventilator-compatible speak-ing valves, provided within an interprofessional collaborative team, can mitigate the potentially negative consequences of prolonged intubation, long-term use of cuffed tracheostomy, and post intensive care syndrome resulting from Covid-19. CONCLUSION: Such a treatment approach can be used to address what is important to patients: to be able to speak with family and friends, eat what they want, and breathe spontaneously.


Subject(s)
Coronavirus Infections/rehabilitation , Deglutition Disorders/rehabilitation , Language Therapy/methods , Pneumonia, Viral/rehabilitation , Pulmonary Medicine/methods , Speech Therapy/methods , Betacoronavirus , COVID-19 , Coronavirus Infections/virology , Critical Care , Deglutition Disorders/etiology , Humans , Male , Middle Aged , Pandemics , Patient Care Team , Pneumonia, Viral/virology , Respiration , Respiration, Artificial/adverse effects , SARS-CoV-2 , Speech , Syndrome , Tracheostomy/adverse effects , Tracheostomy/methods
9.
Int J Pediatr Otorhinolaryngol ; 138: 110318, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-714003

ABSTRACT

OBJECTIVE: To study whether providing Speech and Language Pathology (SLP) interventions by telepractice (TP) could effectively improve speech performance in children with cleft palate (CCP). METHODS: Forty-three CCP were treated with TP intervention in 45 min sessions, 2 times per week for a period of one month. Children ages ranged 4-12 years (X = 7.04; SD = 2.59). All children presented with velopharyngeal insufficiency (VPI) and compensatory articulation (CA) after palatal repair. TP was provided in small groups (5-6 children) following the principles of the Whole Language Model (WLM). Severity of CA was evaluated by a standardized scale at the onset and at the end of the TP period. RESULTS: At the onset of the TP intervention period, 84% of the patients demonstrated severe CA. At the end of the TP period there was a significant improvement in severity of CA (p < 0.001). CONCLUSION: The results of this study suggests that TP can be a safe and reliable tool for improving CA. Considering that the COVID-19 pandemic will radically modify the delivery of Health Care services in the long term, alternate modes of service delivery should be studied and implemented.


Subject(s)
Betacoronavirus , Cleft Palate , Coronavirus Infections , Pandemics , Pneumonia, Viral , Speech Therapy , Speech-Language Pathology , COVID-19 , Child , Child, Preschool , Cleft Palate/complications , Humans , SARS-CoV-2 , Speech Therapy/methods , Speech-Language Pathology/methods , Velopharyngeal Insufficiency/etiology , Velopharyngeal Insufficiency/physiopathology
SELECTION OF CITATIONS
SEARCH DETAIL