A clinical training model for students: intensive treatment of stuttering using prolonged speech.

PURPOSE: This study describes a practical model for improving the quality of Speech-Language Pathology (SLP) education on a clinical setting in a Bulgarian University. During this study, adults who stutter (AWS) received intensive treatment (IT) to increase fluent speech. The intensive treatment was delivered by students trained in the SLP Master's degree program "Logopedics Management in Fluency and Voice Disorders". METHODS: The La Trobe University intensive program of prolonged speech was implemented. SLP students were trained and delivered the IT for AWS, under supervision in all stages. The treatment followed a clinical modeling pattern. RESULTS: The primary outcomes were measured according to (i) percent of syllables stuttered (%SS) within and outside the stuttering research center of the university; (ii) self-reported inventory scores; and (iii) speech naturalness score evaluations from pre-treatment, immediately following treatment, 11 months post-treatment, and 18 months after the intensive treatment using stutter-free speech samples. The outcomes were reported for the overall IT program delivered by the SLP Master students. CONCLUSION: The treatment delivered by students can ensure objective speech outcomes. The evidence-based practice model allowed students to develop and master specific clinical skills in establishing fluent speech by applying a prolonged speech technique. During the IT experience, students began to incorporate elements of evidence-based practice (EBP), clinical expertise, and consider values held by AWS. After four outcome-sessions, the AWS developed self-consciousness about the quality of their prolonged speech during controlled fluent patterns. The participants produced objective speech fluency data and statistically significant differences before and immediately after the IT regarding %SS and overall speech naturalness.

A clinical training model for students: intensive treatment of stuttering using prolonged speech

ABSTRACT Purpose This study describes a practical model for improving the quality of Speech-Language Pathology (SLP) education on a clinical setting in a Bulgarian University. During this study, adults who stutter (AWS) received intensive treatment (IT) to increase fluent speech. The intensive treatment was delivered by students trained in the SLP Master's degree program "Logopedics Management in Fluency and Voice Disorders". Methods The La Trobe University intensive program of prolonged speech was implemented. SLP students were trained and delivered the IT for AWS, under supervision in all stages. The treatment followed a clinical modeling pattern. Results The primary outcomes were measured according to (i) percent of syllables stuttered (%SS) within and outside the stuttering research center of the university; (ii) self-reported inventory scores; and (iii) speech naturalness score evaluations from pre-treatment, immediately following treatment, 11 months post-treatment, and 18 months after the intensive treatment using stutter-free speech samples. The outcomes were reported for the overall IT program delivered by the SLP Master students. Conclusion The treatment delivered by students can ensure objective speech outcomes. The evidence-based practice model allowed students to develop and master specific clinical skills in establishing fluent speech by applying a prolonged speech technique. During the IT experience, students began to incorporate elements of evidence-based practice (EBP), clinical expertise, and consider values held by AWS. After four outcome-sessions, the AWS developed self-consciousness about the quality of their prolonged speech during controlled fluent patterns. The participants produced objective speech fluency data and statistically significant differences before and immediately after the IT regarding %SS and overall speech naturalness.

Intensive non-avoidance group therapy with stutterer adults: preliminary results.

PURPOSE: The purpose of the present study was to evaluate and document the use and efficacy of intensive non-avoidance group treatment for Bulgarian adults who stutter (AWS), to specify that changes are adopted in different speech situations (in the stabilization phase), and to demonstrate that changes are maintained after intensive therapy. METHODS: Participants were AWS (n=15, 12 males) with an average age of 25.2 years) Bulgarian native-speakers. Twelve participants were University students and three were clients with tertiary education in different areas. All participants were enrolled in First (overall effect) and Second (interim effect) Stages of Intensive Non-Avoidance Treatment for Stuttering. Van Riper's stuttering modification therapy approach was employed; the latter considers a non-avoidance treatment for stuttering. The treatment was conducted in participants' native Bulgarian language. RESULTS: AWS, as a group (n=15), significantly decreased the number of stuttered utterances after intensive treatment; findings were consistent for participants with moderate as well as severe stuttering. Likewise, there was a significant decrease in duration (in seconds) of disfluencies after treatment; findings were consistent for participants with moderate as well as severe stuttering. Eighty percent of AWS used cancellation immediately and six months after treatment, 65% mastered preparatory sets immediately and six months after treatment, 35% exhibited pull-outs immediately after treatment and 55%, six months post-treatment. CONCLUSION: These preliminary findings were taken to suggest that intensive non-avoidance treatment for stuttering can be successfully employed with Bulgarian adults who stutter. Special focus was on the positive fluency changes that occurred during the course of therapy regarding the duration of disfluencies in seconds, and index of disfluencies.

Intensive non-avoidance group therapy with stutterer adults: preliminary results / Terapia intensiva de enfrentamento em grupo com adultos gagos: resultados preliminares

PURPOSE: The purpose of the present study was to evaluate and document the use and efficacy of intensive non-avoidance group treatment for Bulgarian adults who stutter (AWS), to specify that changes are adopted in different speech situations (in the stabilization phase), and to demonstrate that changes are maintained after intensive therapy. METHODS: Participants were AWS (n=15, 12 males) with an average age of 25.2 years) Bulgarian native-speakers. Twelve participants were University students and three were clients with tertiary education in different areas. All participants were enrolled in First (overall effect) and Second (interim effect) Stages of Intensive Non-Avoidance Treatment for Stuttering. Van Riper's stuttering modification therapy approach was employed; the latter considers a non-avoidance treatment for stuttering. The treatment was conducted in participants' native Bulgarian language. RESULTS: AWS, as a group (n=15), significantly decreased the number of stuttered utterances after intensive treatment; findings were consistent for participants with moderate as well as severe stuttering. Likewise, there was a significant decrease in duration (in seconds) of disfluencies after treatment; findings were consistent for participants with moderate as well as severe stuttering. Eighty percent of AWS used cancellation immediately and six months after treatment, 65% mastered preparatory sets immediately and six months after treatment, 35% exhibited pull-outs immediately after treatment and 55%, six months post-treatment. CONCLUSION: These preliminary findings were taken to suggest that intensive non-avoidance treatment for stuttering can be successfully employed with Bulgarian adults who stutter. Special focus was on the positive fluency changes that occurred during the course of therapy regarding the duration of disfluencies in seconds, and index of disfluencies. .

OBJETIVO: O objetivo deste estudo foi avaliar e documentar o uso e a eficácia do tratamento intensivo de enfrentamento em grupo em adultos com gagueira (ACG) búlgaros, especificar quais mudanças são adotadas em diferentes situações de fala (em fase de estabilização), e demonstrar que as mudanças são mantidas após a terapia intensiva. MÉTODOS: Os participantes eram ACG (n = 15, 12 do sexo masculino, com idade média de 25,2 anos), falantes nativos de búlgaro. Doze participantes eram estudantes universitários e três tinham ensino superior em diferentes áreas. Todos os participantes foram inscritos no Primeiro (efeito total) e Segundo (efeito provisório) Estágios do Tratamento Intensivo de Enfrentamento para Gagueira. A abordagem empregada foi a terapia de modificação da gagueira de Van Riper, considerado um tratamento de enfrentamento para a gagueira. O tratamento foi realizado em búlgaro, língua nativa dos participantes. RESULTADOS: Como um grupo, os ACG (n = 15) apresentaram uma diminuição significativa no número de elocuções gaguejadas após tratamento intensivo. Estes resultados foram consistentes para os participantes com gagueira moderada e grave. Da mesma forma, houve uma diminuição significativa na duração (em segundos) das rupturas após o tratamento, sendo estes resultados também consistentes para os participantes com gagueira moderada e grave. Oitenta por cento dos ACG utilizaram o cancelamento imediatamente e seis meses após o tratamento, 65% dominaram os movimentos preparatórios imediatamente e seis meses após o tratamento, 35% apresentaram uso da técnica do pull-out imediatamente após o tratamento, e 55% o apresentaram seis meses após o tratamento. CONCLUSÃO: Estes resultados preliminares sugerem que o tratamento ...

Education of speech and language therapists/logopedists in selected Central and Southeastern European countries: challenges and new horizons.

OBJECTIVE: To provide an overview of student training in speech and language therapy/logopedics (SLT) in selected Central and Southeastern European countries (Poland, Slovenia, Bulgaria, Czech Republic, Serbia, Bosnia and Herzegovina and Turkey). METHOD: Data were collected using a special questionnaire developed by Söderpalm and supplemented by Georgieva. Results from 23 SLT programs in the seven countries were collected and organized. RESULTS: In all these countries, SLT has roots in special education or health and is centralized in the university environment. The training programs have positive accreditation provided by the national agencies of accreditation and evaluation. Results were examined specifically for evidence of the new paradigm of evidence-based practice (EBP) according to the revised International Association of Logopedics and Phoniatrics (IALP) guidelines and the application of research-based teaching in SLT. The professional bodies that govern clinical practice in public health and/or educational fields are in the process of EBP implementation. Most speech and language therapists/logopedists in the selected countries work in an educational setting, clinical organization and/or hospital as well as in social day care centers. Except in Turkey, private practices are not regulated by the law. CONCLUSIONS: In the seven countries examined in this survey, SLT is progressing as a professional discipline but must be supported by government funding of SLT education and services to relevant populations.

Linking teaching and research in the field of public health: the Bulgarian experience / Vinculando ensino e pesquisa na área de saúde pública: a experiência búlgara

We describe our perception of the link between teaching and research at South West University (SWU) in Blagoevgrad, Bulgaria. This analysis is based on a reflection of the existing curricula and research infrastructure at the Faculty of Public Health and Sports (FPHS) and a literature review of currently explored concepts and definitions connected to linking teaching and research. The research was conducted from April to December 2011 and was financed by the university. On the basis of our review we have proposed a framework for integrating teaching, research, and practice for the FPHS. We describe the key prerequisites for linking research and teaching and its clinical representation in Bachelor and Master's degree programs with the aim of encouraging critical thinking and clinical problem-solving skills in students and teachers.

O texto descreve nossa percepção do vínculo entre ensino e pesquisa na South West University (SWU) em Blagoevgrad, Bulgaria. Essa análise é baseada em uma reflexão sobre o currículo e infraestrutura de pesquisa existentes na Faculdade de Saúde Pública e Esportes (Faculty of Public Health and Sports - FPHS) e em uma revisão da literatura referente aos conceitos e definições atualmente explorados na conexão entre ensino e pesquisa. A pesquisa foi conduzida entre abril e dezembro de 2011, e foi financiada pela universidade. Com base na revisão, foi feita umaa proposta para integração de ensino, pesquisa e prática na FPHS. São descritos os pré-requisitos essenciais para vincular ensino e pesquisa e sua representação clínica em programas de graduação e pós-graduação no nível de Mestrado, com o objetivo de incentivar o pensamento crítico e as habilidades de resolução de problemas clínicos em estudantes e docentes.

Education of logopedists or speech-language pathologists in Bulgaria, Greece, Macedonia, Poland and Russia.

This article provides an overview of student training programs in logopedics in Bulgaria, Greece, Macedonia, Poland and the Russian Federation. The data were collected using a special questionnaire developed by Söderpalm in 2006 and supplemented by the author. Bachelor's, master's and PhD programs in the field of pure logopedics no longer exist in some countries. In other locations, logopedics is included as a part of special education student training. In all cases, student education in logopedics is centralized in the universities. Educational programs are accredited by national agencies for accreditation or evaluation or by the respective Ministries of Education.

Identification of cluttering and stuttering by the public in four countries.

The investigators sought to explore and compare the identification of cluttering vs stuttering in four different country samples. After reading lay definitions of the two fluency disorders in their own language, convenience samples of 60-90 adult respondents from Turkey, Bulgaria, Russia, and the US identified 51-119 children or adults who either cluttered, stuttered, or both. They also indicated whether or not they, themselves, cluttered or stuttered. The majority of respondents in all four samples identified at least one person who cluttered, stuttered, or cluttered and stuttered. The average respondent identified one person with a fluency disorder, most likely a stutterer, less likely a clutterer, and least likely a clutterer-stutterer. Both similarities and differences characterized those identified in the three groups, e.g., the sex ratios were not the same. As with stuttering, the public apparently is aware of cluttering individuals and can identify such persons.

Experiência e relato pessoal sobre pesquisa de cooperação internacional - Brasil, Bulgária e Turquia - que avalia as atitudes em relação à gagueira / Experience and personal report about an international cooperation research- Brazil, Bulgaria and Turkey - attitudes toward stuttering

TEMA: as pessoas gagas são freqüentemente consideradas como sendo tímidas, nervosas, introvertidas e assustadas. Muitos gagos são submetidos a situações constrangedoras em decorrência da ridicularização ou da discriminação e preconceito ilegal. OBJETIVO: até o momento não existe nenhum instrumento, largamente aceito e padronizado, para medir as atitudes públicas sobre a gagueira. Em 1999 foi iniciado o Projeto de Atitudes em Relação à Gagueira (IPATS) que foi uma iniciativa para desenvolver um instrumento de avaliação de opinião, que foi chamado de Pesquisa de Opinião Pública dos Atributos Humanos (POSHA). MÉTODO: a experiência aqui apresentada compara os resultados obtidos em três países - Brazil, a Bulgária e a Turquia, como representantes da América do Sul, da Europa e do Oriente Médio. Os participantes foram agrupados segundo seu país e língua de origem. Todos os questionários foram respondidos na língua de origem do participante. RESULTADOS E CONCLUSAO: esse estudo piloto sugere que algumas diferenças de atitudes entre os participantes podem ser explicadas pela influência da interação entre a nacionalidade, cultura, etnia, religião e língua materna. A contribuição específica de cada um desses componentes não pode ser determinada. A continuidade do projeto envolverá a análise comparativa entre os resultados dos países de língua materna não inglesa e os de língua materna inglesa.

[Experience and personal report about an international cooperation research--Brazil, Bulgaria and Turkey--Attitudes Toward Stuttering]. / Experiência e relato pessoal sobre pesquisa de cooperaçõ internacional--Brasil, Bulgáiria E Turquia--que avalia as atitudes em relação à gagueira.

BACKGROUND: People typically regard stutterers as shy, nervous, introverted, and fearful, a so-called "stuttering stereotype". Many stutterers are also subjected to teasing and bullying or to illegal discrimination. AIM: Currently, there are no widely-accepted, standardized instruments used to measure public attitudes toward stuttering around the world. Accordingly, an International Project on Attitudes Toward Stuttering (IPATS) initiative was launched in 1999 to develop such an instrument, named the Public Opinion Survey of Human Attributes (POSHA). METHOD: This study compares selected results from three groups of adults from countries in South America (Brazil), Eastern Europe (Bulgaria), and the Middle East (Turkey). Respondents were pooled into three groups according to place-of-residence variable by country and a survey language variable. All of the respondents completed the questionnaire in the primary language of their countries. RESULTS AND CONCLUSION: This pilot study suggests that some attitude differences among respondents may be explained by an interaction of national, cultural, ethnic, religious, or language differences, although the relative contribution of each component cannot be determined. In a subsequent tier of survey analyses, ratings by these respondents will be compared with the ratings of respondents from other countries completing the survey in English.