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This thesis explores speech-language pathologists' (SLPs) perceptions of, experiences with, and perceived barriers to providing psychosocial support to couples impacted by aphasia. A survey was conducted, with 50 responses analyzed. All participants were licensed SLPs who work in the United States and have people with aphasia (PWA) on their caseload. Participants responded to a portion of survey questions, viewed five short videos of Relationship-Centered Communication Partner Training (RC-CPT), then answered a portion of repeated questions to measure the change in perceived confidence, comfort, knowledge, and experience. Results indicate that SLPs perceive counseling to be within their scope of practice and are aware of the psychological distress experienced by PWA. Additionally, SLPs reported increased confidence in counseling couples impacted by aphasia after watching the RC-CPT video vignettes. However, reported barriers to providing counseling to PWA and their significant others included lack of significant other availability, and time/caseload pressures. SLPs reported greater comfort in tasks such as coaching couples on communication strategies and less comfort on topics such as addressing relationship roles and responsibilities or helping couples set goals regarding relationship roles and responsibilities. These findings have implications for SLP training and practice, emphasizing the importance of addressing the psychosocial needs of both individuals and couples impacted by aphasia. Further research is needed to determine the impact of counseling training for SLPs and the development of effective training to increase SLPs' confidence and comfort in counseling couples affected by aphasia.

The majority of individuals in nursing homes have cognitive-communication impairments which impact quality of care because direct care providers, certified nursing assistants, (CNAs) are unsure how to respond to resident’s communication behaviors. One intervention that facilitates staff-resident communication in nursing homes is communication plans; however, the research to date about communication plans has not specifically involved CNAs. The purpose of this study, using a grounded theory qualitative approach, was to describe development, implementation and evaluation of communication care plans (CCPs) for residents with cognitive-communication impairments in nursing homes by CNAs who did and did not receive professional support. Communication care plans are communication plans with the addition of autobiographical information. Twenty residents and ten CNAs from two nursing homes participated in the study. Once CCPs were created, CNA participants in one facility received support each day. Following two weeks, CNAs participated in a semi-structured interview. Interviews were transcribed and analyzed using open, axial and selective coding. Findings revealed a core category, meeting resident’s needs through professional support and communication, which describes the progressive process these CNAs underwent to effectively communicate with residents in nursing homes using CCPs. Evolution of this process occurred as CNA participants became familiar with residents. An underlying component facilitating this familiarity was support during CCP implementation. Initially, these CNAs had negative views about nursing home care because they were unsure how to communicate with residents and received little support from higher levels of nursing authority. Over time and with application of CCPs, CNAs became familiar with residents and their communication behaviors. Application of specific communication strategies on CCPs required ongoing support from the investigator/speech-language pathologist which was evident by the comments between CNA participants from each facility. Participants from both facilities reported positive experiences during application of the autobiographical information on the CCPs. This personal information coupled with increased knowledge about resident’s specific communication abilities fostered the formation of a relationship between residents and CNAs. In summary, support during application of CCPs supplements CNAs’ abilities to meet residents’ needs.

Aims: The aims of this research were to describe the signs and symptoms of dysphagia in people who are living with HIV/AIDS and to see what participant variables such as CD4 count, age and diagnosis affect dysphagia. Methods: This study was a descriptive, cross-sectional, quasi non-experimental design. The sampling method that was used for this research was non-probability and convenient. These patients were referred to the speech therapy and audiology department from various multidisciplinary team members for dysphagia assessments. There were 106 participants in total. Eighty participants underwent only a clinical bedside assessment and 26 underwent a bedside assessment as well as a modified barium swallow. The Mann Assessment of Swallowing Ability (MASA) was used to conduct the clinical bedside assessments and a modified barium swallow (MBS) was used as an objective measure. The data was analysed using both descriptive and inferential statistics. These tests included the Wilcoxon signed rank test, Spearman Rho test, Kruskal-Wallis and Mann Whitney U-test. Results: Descriptively, the results revealed that participants with neurological conditions appeared to present with more severe signs and symptoms of dysphagia. The results from the Wilcoxon signed rank test showed that participants with a neurological disorder experienced more severe signs and symptoms of dysphagia, except with laryngeal elevation. The Wilcoxon signed rank test also showed that older participants experienced more dysarthria and oral transit difficulties. The results from the Kruskal-Wallis test highlighted that participants with a lower CD4 count had more significant respiration and voice difficulties. The results from the Mann-Whitney U test showed that participants who were on a HAART regimen experienced increased difficulty in the pharyngeal phase and aspirated more frequently. The Spearman-Rho test results showed that the MASA was seen as a valid bedside assessment tool for assessing adult dysphagia in an acute hospital setting. Discussions: Dysphagia does occur in the HIV/AIDS population in South Africa in participants who have neurological conditions as well as opportunistic infections. The SLP needs to play a key role in the assessment and management of these patients. The MASA is a good assessment tool to use in settings where objective measures are not available.

Neonatal abstinence syndrome (NAS) refers to the withdrawal infants exposed to opioids in utero may experience following birth. In recent years, the number of infants born who present with NAS has grown exponentially. This increase in the number of infants with NAS has led to a new population within the caseloads of speech-language pathologists (SLPs) who work in neonatal intensive care units (NICUs). SLPs’ knowledge base and skill set of assessment and treatment of swallowing and feeding disorders in infancy play a vital role in the treatment of infants with NAS in the NICU. A dearth of research exists regarding the specific nature of the feeding problems and skills of infants with NAS and whether SLP intervention for infants with NAS needs to differ from that of other infant NICU populations. Identifying how SLPs can best serve infants with NAS in the NICU is essential to their immediate well-being as well as the development of these infants. The purpose of this survey-based research study was to examine NICU SLPs’ perceptions of infants with NAS, and more specifically, how NAS affects the infants’ feeding skills, structural, and oral-motor characteristics. A questionnaire was developed based on an in-depth literature review to collect information on NAS, caseloads, treatment environment, and respondent demographics. The survey consisted of three sections: NAS (further divided into Assessment, Treatment, and Education), Environmental Description, and Respondent Demographics. The secure web-based questionnaire was distributed through SurveyMonkey™, an online survey platform. Survey research was conducted, and hospital-based speech-language pathologists within the USA acted as respondents. The findings will contribute to establishing a preliminary base of information on this topic. The results are expected to further inform the field as well as current practices in evidenced-based practice care for infants with NAS.

SAMMANFATTNING Det finns ett stort behov av psykosociala insatser för personer med afasi (PMA); docksaknar många logopeder kunskap om logopedisk psykosocial intervention för PMA. Enkunskapsöversikt i ämnet vore därför önskvärt. Syftet med studien är att sammanställaresultat från tidigare studier om hur logopeder arbetar kliniskt med psykosocialintervention för PMA. Studien är en litteraturöversikt och litteratursökningen utfördesmellan september och oktober 2020 i ett flertal databaser. Artiklarna behövde uppfyllaspecifika kriterier för att inkluderas. Åtta artiklar identifierades, varav tre beskrev tvåolika psykosociala interventioner för PMA. Resterande fem studier beskrev logopedersanvändning och inställning till psykosocial intervention. Psykosocial interventiontillämpades genom olika metoder inklusive psykoterapeutiska metoder; få renodladepsykosociala metoder identifierades. Resultaten visade att det finns en osäkerhet blandlogopederna gällande psykosocial intervention på grund av kunskapsbrist och oklarheteri arbetsfördelning mellan kurator, psykolog samt logoped. Vidare beskrevs en oklarhetgällande begreppet och definitionen av logopedisk psykosocial intervention. Samtligastudier kvalitetsgranskades och de två interventionsmetodernas evidensnivå bedömdes;båda interventionsstudierna visade på otillräcklig evidens. / ABSTRACTThere is a great need for psychosocial interventions for people with aphasia (PWA);however, many speech-language pathologists (SLP) lack knowledge about psychosocialintervention for PWA. Therefore, a comprehensive overview about the subject isrequired. The aim of this study is to compile and critically examine results fromprevious research about SLPs’ clinical work within psychosocial intervention for PWA.The study is a literature review, and the literature search was conducted duringSeptember and October 2020 using several databases. The articles needed to fulfillspecific criteria to be included. In total, eight articles were identified; three of themdescribed two psychosocial interventions for PWA, the remaining five studies describedhow psychosocial intervention is managed by SLPs and their attitude towardaddressing psychosocial needs for PWA. Psychosocial intervention was applied throughvarious methods, including psychotherapeutic methods, few pure psychosocial methodswere identified. The results indicate that the SLPs had low confidence due to lack ofknowledge and uncertainty of work allocation between counselor, psychologist andSLP. Furthermore, an ambiguity was described regarding the concept and definition ofpsychosocial intervention. The studies quality and the strength of the evidence wereassessed, both intervention studies showed insufficient level of evidence.

Objective: The purpose of this study was to determine speech-language pathologists’ (SLPs’) perceptions regarding the concept of severity of speech sound disorder (SSD). Methods: An online survey of 40 questions was created using REDCap® and disseminated to currently practicing SLPs across the United States. A total of 296 responses were completed, and data were analyzed using descriptive statistics and coding according to grounded theory. Results: The top five factors SLPs consider when determining SSD severity are types of errors, intelligibility, perceptual judgment, normative data, and percentile rankings. Most SLPs were unfamiliar with the International Classification of Functioning, Disability and Health (WHO, 2001), which was reflected in how they prioritized the ICF component of body function over activity/participation and personal factors. Conclusion: SLPs need a standard, biopsychosocial model for rating SSD severity, clinical training and continuing education on the ICF, and exposure to holistic tools for assessing children with SSD.

In neuro surgery, the expression awake surgery generally refers to tumour surgery in the brain while the patient is concious. At Akademiska Sjukhuset, Uppsala, it is today standard to perform awake surgery on tumours located in the dominant left hemisphere while awake. However, regarding awake surgery in the non-dominant right hemisphere it is not clear what functions should be tested and how this should be done. A test battery for awake surgery in the right hemisphere should be developed like the test that are used in awake surgery in the left hemisphere. Science recommends awake surgery in the right hemisphere which already being done around Europe. As patients with brain tumours have a good prognosis post operative it is important to retain, or ameliorate, their quality of life. This literature study’s main purpose is to present which functions, important for language and communication, are located in the right hemisphere. The study also intends to account for testing of these functions intraoperatively, after rightsided stroke and on persons with right hemisphere lesions. The functions are many in number, essential for maintaining the quality of life but some are difficult to test. According to the literature study, the functions that appeared most significant are neglect and pragmatic with its functional, social and communicative effects. More research on the right hemispherical functions and how they are organized is necessary. The work intends to be the basis for continued development of awake surgery tests in the right hemisphere in Akademiska Sjukhuset, Uppsala. / Inom neurokirurgin avser uttrycket vakenkirurgi oftast tumörkirurgi i hjärnan samtidigt som patienten är vid fullt medvetande under ingreppet. Vid Akademiska Sjukhuset i Uppsala är det standard att operera tumörer belägna i den språkligt dominanta vänstra hemisfären i vaket tillstånd medan man vid en del andra centra även förespråkar vakenkirurgi i den icke-språkligt dominanta högra hemisfären. Det är emellertid inte klarlagt vilka funktioner som i så fall bör testas och hur detta ska gå till. Ett testbatteri vid vakenkirurgi i höger hemisfär skulle behöva utvecklas likt det test som används vid tumörer i vänster hemisfär. Vakenkirurgi i höger hemisfär genomförs i dag på enstaka center i Europa. Då patienter med hjärntumörer kan ha en god prognos postoperativt är det angeläget att behålla, eller förbättra, deras livskvalitet. Denna litteraturstudies huvudsakliga syfte är att presentera vilka funktioner, viktiga för språk och kommunikation, som är lokaliserade i höger hemisfär. Studien redogör också för testning av dessa funktioner intraoperativt, efter högersidig stroke och på personer med högerhemisfäriska skador. Funktionerna är många till antalet, viktiga för att bibehålla livskvaliteten men en del även svårtestade. Enligt vår litteraturgenomgång är de funktioner som framstått som mest betydelsefulla neglekt och pragmatik med dess funktionella, sociala och kommuniktiva påverkan. Mer forskning om höger hemisfärs funktioner och hur dessa är organiserade behövs. Arbetet ämnar ligga till grund för fortsatt utveckling av vakenkirurgitest i höger hemisfär på Akademiska Sjukhuset i Uppsala.

Autism Spectrum Disorder (ASD) is a low-incidence disorder with high impacts on individuals, families, and society. School-based speech-language pathologists (SLPs) have tremendous responsibilities toward individuals with ASD, but pre-service SLPs are not adequately trained to fulfill these expectations. In order to reduce the widespread financial and social impact of ASD, school-based SLPs need to complete effective training to prepare them for the selection of established social-communication practices. One framework for the selection of individualized intervention is the Ziggurat Model (Aspy & Grossman, 2008). The following study used mixed methods to investigate the research question: “Does the ASD knowledge base of ASHA-certified school-based SLPs change when they complete an online training module based upon Aspy and Grossman’s Ziggurat Model? If so, what are those changes?” A pre-test post-test control group design demonstrated a significant difference in the experimental group’s and the control group’s pre-test post-test change scores, as demonstrated by an independent samples t-test (p=.039, 18df). Qualitative data analysis resulted in six themes. While the online training of Aspy and Grossman’s Ziggurat Model used in this study was an effective method with which to train school-based SLPs in using a comprehensive framework, more rigorous research is needed on this model relative to the selection of intervention.