Telepractice for the Delivery of Pediatric Feeding Services: A Survey of Practice Investigating Clinician Perceptions and Current Service Models in Australia.

The provision of speech-language pathology (SLP) services via telepractice is expanding. However, little is known about the use of telepractice to deliver pediatric feeding services. The current study aimed to investigate SLPs perceptions, and current use of, telepractice in pediatric feeding. An electronic survey was distributed to SLPs with pediatric feeding experience within Australia. Questions pertained to general demographics, feeding experience, telepractice experience and perceptions of telepractice. Most questions were multiple choice, with some short response questions. Eighty-four complete responses were received. Overall, 41% of the cohort were interested in providing telepractice services but only 20% reported experience delivering pediatric feeding services via telepractice. Most telepractice users reported commencing telepractice services within the last 12 months. Most clinicians identified a range of age groups and feeding services that they believed could be offered via telepractice and a range of benefits to telepractice feeding services were identified. Benefits included natural environment, reduced distance and travel, opportunities to increase services and increased supervision and support. Although most respondents reported access to technology, most had difficulty accessing this on a daily basis to establish regular telepractice services. Clinician concerns regarding the safety and efficacy of conducting pediatric feeding assessments via telepractice were also identified. Overall, although the delivery of pediatric feeding services via telepractice remains limited, many clinicians were interested in using telepractice and had positive perceptions regarding its use. Continued efforts to enhance clinician access to technology and further evidence for the efficacy of this service delivery model for pediatric feeding will aid clinical implementation.

A service evaluation of parent adherence with dysphagia management therapy guidelines: reports from family carers supporting children with complex needs in Greece.

Purpose: Many children with complex needs exhibit eating, drinking, and/or swallowing disorders (dysphagia). These children often have associated learning needs, and require assistance from carers for daily tasks such as eating and drinking. The aim of this study was to identify which strategies to manage dysphagia were challenging for family carers, and reasons for any non-adherence.Method: In this service evaluation researchers observed carers during mealtimes, and investigated carer opinions of strategies used to minimise the risks of dysphagia. Eight children with complex needs aged 3.4-7.5 years and their primary family caregiver participated.Results: Adherence with speech and language pathologists' dysphagia recommendations overall was over 50% in all but one case. For specific strategies, the highest adherence was observed for diet modifications of foods (89%), communication during the mealtime (83%), amount of food to present (81%), and the pacing of fluids and foods (81%). Lower levels of adherence were identified in relation to postural management (58%), environmental changes (58%), utensils (56%), and preparatory strategies (49%).Conclusions: Adherence with use of strategies to support mealtimes was over 50% in all but one case. Findings suggest that support is essential to promote safe mealtimes, reduce family carers' stress and increase knowledge, confidence, and adherence in implementing dysphagia guidelines in the family home. Implications for rehabilitationDifficulties with eating, drinking and swallowing (dysphagia) can impact on the parent-child mealtime experience.Mealtime strategies as recommended by a speech-language pathologist can support children who have difficulties eating, drinking, and swallowing.Some strategies to support eating, drinking, and swallowing are easier for carers to adhere to than others.

Patients' Perspectives on What Makes a Better Care Experience While Undergoing Treatment for Oropharyngeal Dysphagia Secondary to Head and Neck Cancer.

Patients' perceptions on what makes a better care experience for head and neck cancer (HNca) have not been widely sought. Patients' perceptions can play a crucial role in shaping quality care and client involvement. To investigate patients' perspectives on what makes a better care experience while undergoing rehabilitation for oropharyngeal dysphagia secondary to HNca. Qualitative data were collected in the form of semi-structured interviews from eight patients after they had undergone rehabilitation for HNca. The data were thematically analysed by two researchers independently. Six themes, plus subthemes, were identified. These themes were Supportive network is essential; Reassurance from staff professionalism; Access to service; Using own motivation and resilience; Receiving the right information and Ongoing shock and adjustment. Results are discussed in context of the literature and clinical implications and future research are recommended. Collation of patients' perspectives is valuable to increase insight into what makes a better rehabilitative journey for patients with HNca. Rehabilitation that is holistic, specialised and patient-specific is highly valued by patients with HNca.

Intervención logopédica en un caso de síndrome de Cornelia de Lange / Speech and language intervention in a Cornelia de Lange syndrome case

Se presenta a continuación la intervención logopédica realizada durante 2 años en un caso de síndrome de Cornelia de Lange (SCdL). El SCdL es una enfermedad rara, caracterizada por retraso pre y posnatal del crecimiento; presenta rasgos faciales característicos, malformaciones musculo esqueléticas en manos, pies, brazos y piernas y otras malformaciones físicas. Los niños afectados pueden presentar también retraso psicomotor (retrasos en la adquisición de las habilidades de la coordinación y de la actividad mental y muscular) y retraso mental de leve a severo. El rango y la severidad de los síntomas pueden variar de unos casos a otros. La mayor parte de la bibliografía acerca del síndrome hace referencia a las características físicas y a los síntomas, pero rara vez encontramos información que pueda orientar a los que nos dedicamos a la intervención para aplicar un programa de tratamiento. Esta escasez bibliográfica es lo que nos ha llevado a plantear el interés que podría suponer el hecho de presentar la intervención en un caso de estas características. A continuación se expone la descripción clínica del caso, la evaluación realizada y la intervención en las áreas de terapia miofuncional, comunicación y lenguaje. Se finaliza con la exposición de los resultados obtenidos en estas áreas de intervención y las conclusiones (AU)

The following case study reveals a speech therapy intervention carried out for two years in a particular case of Cornelia de Lange Syndrome (CdLS). CdLS is a rare genetic disorder characterised by a delay in pre and postnatal child development. It shows distinctive facial features and muscular anomalies – bones mutations in hands, feet, arms, legs and other physical abnormalities. The children affected may also display delayed psychomotor development (delay in the acquisition of abilities related to coordination, intellectual and muscular development) and -low to severe-mental impairment. The range and severity of symptoms may vary depending on each case. Most of the existing bibliography makes reference to the physical characteristics and symptoms, being barely information that supports the intervention of professionals applying treatment programs. This particular academic context has leaded us to focus our interest in exposing the intervention in a case of such characteristics. This is an extended case study about the clinic description of the case, evaluation and types of intervention in areas of my functional therapy, communication and language. We will finalize by exposing the results obtained in these areas of intervention, and bringing our own conclusion (AU)

Importance of patient's cooperation in surgical treatment for oral submucous fibrosis.

PURPOSE: The aim of this study was to investigate the results of surgical treatment for oral submucous fibrosis (OSF) in patients who did or did not cooperate with the rehabilitation regimen. PATIENTS AND METHODS: There were 54 patients who had surgical treatment of trismus caused by OSF. Split-thickness skin grafts were used to repair surgical defects after surgery on the fibrous bands. According to postoperative collaboration in the rehabilitation regimen, patients were defined as non-cooperative patients (group I) and cooperative patients (group II). Group I (n = 28) and group II (n = 26) were analyzed separately for changes in preoperative, intraoperative, and postoperative interincisal distances (ID) for at least 6 months after surgery. RESULTS: The mean preoperative ID was 18.9 mm (range, 8 to 25 mm) in group I and 18 mm (range, 7 to 25 mm) in group II. The intraoperative ID increased to an average of 39 mm in group I and 38.5 mm in group II. The mean final follow-up ID was 22 mm in group I and 36.1 mm in group II. When evaluating the changes of ID, only a statistically significant difference was found at final visit between groups. CONCLUSIONS: In our study, we found the patient's cooperation is the primary requirement for success in the treatment of OSF.