Made available in DSpace on 2016-06-02T19:46:02Z (GMT). No. of bitstreams: 1 2177.pdf: 1504779 bytes, checksum: c84b2b35395302db94ba0dd38cba2746 (MD5) Previous issue date: 2008-05-30 / Universidade Federal de Minas Gerais / The capability to use the language is essential for the acquisition of the symbolic systems and to improve the interpersonal relationships; his/her full development depends on the cognitive abilities and social adaptative skills. When an implication happens in this natural course, it is common to appear alterations in the communicative process. The speech pathologist s intervention in group, when using Augmentative and Alternative Communication as an intervention procedure, makes possible the complete use of the social interactions in the development of the language abilities. The objective of the present study was to plan, to apply and to evaluate an intervention program about Augmentative and Alternative Communication in a group inserted on a naturalistic model in one Special Education School. The ten students who participated in the research had a diagnosis of intellectual disabilities. Three of them were the target subjects. In order to be the target, they had to be non verbal. In the group of seven children there were some who were verbal and others nonverbal ones. All of the ten participants were capable to accomplish voluntary motor actions and they did not participate in other intervention group that used Augmentative and Alternative Communication. The chronological age of the group varied between 6 and 14 years old. To verify the effects of the intervention Program on Augmentative and Alternative Communication in the participants communicative behavior, a Multiple Baseline design across subjects was used. The sub-test Pragmatic from Test of Infantile Language ABFW and the Test of Receptive and Expressive Language were also used. The Results demonstrated that during the Baseline, none of the participants obtained success in relation to the use of the communication pictures. However, when the intervention process was started, the children presented increase in the use of pictures as an alternative to communicate their needs. At the end of the data collection all children were able to use the picture exchanging program. The Pre and Post results related to the Pragmatics Evaluation revealed that all the participants from each group improved their communicative abilities. It is important to emphasize that some of them improved their verbal behaviors and the ones who did not have conditions to improve their oral communication, started to use the pictures to communicate their needs associated with gestures and vocalizations. The application of Pre and Post Test on Receptive and Expressive Language Test, evidenced changes when the expressive language is analyzed. Some participants acquired abilities related to language verbal expression, even thought this was not the study main focus. We concluded that when the System of Augmentative and Alternative Communication was employed, the development of the communicative abilities occurred, improving the participants' communication performance during the interactions. Therefore, it is evident the importance of the speech pathologist s intervention in group situations and the use of the Communicative Alternative and Augmentative Systems to develop communication skills in children with intellectual disabilities. / A capacidade de utilizar a linguagem é essencial para adquirir os sistemas simbólicos e aprimorar os relacionamentos interpessoais; seu pleno desenvolvimento depende das habilidades cognitivas e sócio-adaptativas. Quando ocorre um comprometimento nesse curso natural, é comum surgirem alterações nos processos comunicativos. A intervenção fonoaudiológica em grupo, ao utilizar Sistemas de Comunicação Alternativa/Ampliada como procedimento de intervenção, possibilita o completo aproveitamento das interações sociais no desenvolvimento das habilidades de linguagem. O presente estudo teve por objetivo planejar, aplicar e avaliar um programa de intervenção sobre comunicação Alternativa/Ampliada em grupo inserido numa abordagem naturalística em uma Escola de Educação Especial. Participaram da pesquisa dez alunos, com diagnóstico de Deficiência Intelectual, sendo três considerados alvos por serem não verbais, e outros sete colegas de classe. Neste grupo de sete crianças, havia aquelas que eram verbais e outras não-verbais. Todos eram capazes de realizar atos motores voluntários e não participavam de outro grupo de intervenção que utilizasse Sistemas de Comunicação Alternativa/Ampliada. A idade cronológica do grupo variava entre 6 e 14 anos. Para verificar os efeitos da intervenção (Programa de CAA) no comportamento dos participantes da pesquisa, foi utilizado um delineamento de Linha de Base Múltipla cruzando com sujeitos; além disso, utilizou-se o Teste de Linguagem Infantil ABFW (subteste: Pragmática) e o Teste de Linguagem Receptiva e Expressiva. Nos dados obtidos durante o processo de intervenção, verificamos que, na fase de Linha de Base, nenhum dos participantes obteve êxito em relação ao uso das figuras de comunicação. Ao iniciarmos o processo de intervenção, as crianças apresentaram melhora crescente quanto ao uso das figuras pictográficas, sendo que ao final do estudo todas conseguiam comunicar-se por meio de intercâmbio de figuras. Nos resultados do Pré e Pós-teste, em relação à avaliação da Pragmática, todos os participantes do grupo obtiveram melhoras significativas em suas habilidade comunicativas. Cabe ressaltar que alguns melhoraram a utilização dos meios verbais e aqueles que não possuíam condições de desenvolver a comunicação oral, passaram a usar as figuras pictográficas aliadas aos gestos e vocalizações. No Teste de Linguagem Receptiva e Expressiva, as mudanças mais significativas são evidenciadas ao analisarmos a linguagem expressiva. A maioria dos participantes adquiriu habilidades no que tange a expressão verbal da linguagem, mesmo não sendo esse o foco do estudo aqui apresentado. Concluímos que, ao utilizar o Sistema de Comunicação Alternativa/Ampliada, ocorreu o desenvolvimento de habilidades comunicativas, tais como: troca de turnos, atos comunicativos, que levaram a uma melhora significativa das interações dos participantes. Dessa forma, ficou evidente a importância da intervenção fonoaudiológica em grupo por meio da utilização de um de um Sistema Alternativo de Comunicação.

It would be favorable, during the clinical assessment of language in multilingual children, if the speech-language-pathologist (SLP)spoke all the languages of the child. This is, however, not always possible, hence the need for interpreter-mediation. Furthermore, it would be desirable if the interpreters used in clinical assessments of language are specifically trained. There are only a few studies concerning interpreter-mediated clinical assessment of language and cognition using Conversation Analysis as a method, and no studies of interpreter-mediated clinical assessment of language in multilingual children. The purpose of this study was therefore to investigate the interaction between the SLP, interpreter and child, in interpreter-mediated clinical assessments of language in multilingual children, with a specific focus on the SLP and the interpreter. Participants of the study were two licensed S LPs, three interpreters and two multilingual children and their caregivers. The study was based on three video recordings of clinical encounters and four semi-structured interviews. The video recordings were translated, transcribed and analyzed using the theory and method of Conversation Analysis, and the interviews were transcribed and analyzed. Analysis of the video recordings resulted in the discovery of three phenomena; the importance of preunderstanding of the working process of SLP, the importance of responsibility during interpreter-mediated clinical assessment of language, and finally communication and language approach. Analysis of the semi-structured interviews resulted in the discovery of four phenomena, which, in addition to the ones already discovered during the video recordings, also included the importance of dialects. Strategies and challenges that the SLP and interpreter faced could be revealed from the phenomena discovered in the video recordings and the semi-structured interviews. It was suggested in the conclusion that challenges were caused by expectations on the interpreter, a lack of preunderstanding of the working process of the SLP, uncertainty regarding the responsibilities of the interpreter versus the SLP, and finally, the demands of a high level of language competence. Strategies that were used within the discovered phenomena were partially consciously applied by the SLP and interpreter. However, there is a great need for further knowledge and awareness of the processes involved in this clinical context, in order to obtain reliable and satisfactory interpreter-mediated clinical assessments of language. Lastly, it was discussed that the patient safety might be compromised if no consideration is taken regarding the investigated challenges and strategies.

This survey research explores neonatal intensive care unit speech-language pathologists’ perceptions of infants with neonatal abstinence syndrome; specifically, how NAS affects infants’ feeding skills, along with structural and oral-motor characteristics. The findings of this research will contribute to this population’s information base. The results are expected to inform the field and current evidence-based practice care for infants with NAS.Learner Outcome(s): Explain Neonatal Abstinence Syndrome (NAS) Describe infants with NAS and how NAS affects the infants’ feeding skills from the perspective of Neonatal Intensive Care Unit (NICU) Speech-Language Pathologists (SLPs) Identify how SLPs in the NICU participate in intervention for infants with NAS and their families

It is important to know patients’ expectations and experiences concerning their medical visits in order to facilitate health care improvements (Socialstyrelsen, 2006; Sveriges kommuner och landsting, n.d.). There are however no studies available dealing with Swedish caretakers’ expectations of their children’s first contact with a speech and language pathologist (SLP), nor studies dealing with whether or not their expectations were met and their experiences of the visit. Thus the aim of the present study was to acquire knowledge about this to determine whether or not the given health care is satisfying and if there are any areas in need of improvement. The material consisted of two questionnaires and a telephone interview. In total, 20 caretakers filled out the questionnaire prior to the visit. Of these, 15 also filled out the questionnaire after the visit and 8 participated in the interview. The results of the study show that the caretakers’ expectations were met to a high degree and that they were highly satisfied with the visit. Moreover, this contentment seemed to coincide with their experience of met expectations. The caretakers expected the SLP to share an evaluation of the child’s speech and language and to give much information (e.g. about the child’s speech and language and communicative adjustments), that the child’s pre-school would be contacted and that the caretakers would be provided with material for home exercises, advice and support. Of great importance for a positive experience was also the SLP’s personality and that there was enough time during the visit. The level of worry and the perceived need for SLP consultations decreased after the visit. The caretakers’ expectations were not met regarding information about the purpose of the testing, the level of difficulty of a specific test, pre-school contacts, material for home exercises, waiting times and support. The information about the presence and level of difficulties as well as a possible diagnosis were not clear to several of the participants. The results show that there are certain aspects that are important in order for first contacts with a SLP to reach a high quality. Among these are the SLP’s approach and that the SLP provides an assessment, good advice and material for home exercises. There are however some areas in need of improvement that should be considered by SLPs, for example regarding waiting times, support, preschool contacts and information about the children’s difficulties. The results and conclusions emanating from this study should however be treated with some caution due to a low number of participants. / Det är viktigt att undersöka patienters förväntningar inför och upplevelser av vårdbesök för att möjliggöra förbättringar inom hälso- och sjukvården (Socialstyrelsen, 2006; Sveriges kommuner och landsting, u.å.). Det saknas studier angående vad vårdnadshavare till svenska barn har för förväntningar inför sina barns nybesök hos logoped för utredning av tal och språk, huruvida förväntningarna infrias samt hur de upplever besöket efteråt. Syftet med föreliggande studie var således att få mer kunskap om detta för att utröna om den vård som ges är tillfredställande och om det finns möjliga förbättringsområden. Material för datainsamling utgjordes av en enkät som besvarades inför besöket, en enkät som besvarades efter besöket samt en intervju via telefon efter besöket. Totalt deltog 20 vårdnadshavare som svarade på enkäten inför besöket, av dessa 20 besvarade 15 deltagare enkäten efter besöket och åtta deltog i telefonintervjun.    Studiens resultat visade att vårdnadshavarnas förväntningar motsvarades i hög grad. De var även i hög grad nöjda med besöket och denna nöjdhet förefaller sammanhänga med deras upplevelse av motsvarade förväntningar. Vårdnadshavarna förväntade sig att logopeden skulle delge en bedömning av barnets tal och språk och ge mycket information (t.ex. om barnets tal och språk samt kommunikativa anpassningar), att kontakt skulle tas med barnets förskola samt att vårdnadshavarna skulle få material för hemträning, tips och råd och stöd med att komma igång med träningen. Av stor vikt för upplevelsen, utöver ovan nämnda aspekter, var även hur logopeden var som person, hur denne bemötte barnet och vårdnadshavaren samt att tid fanns under besöket. Deltagarnas oro och upplevda behov av logopedkontakt minskades efter besöket. Deltagarnas förväntningar motsvarades inte beträffande information om testernas syfte, ett tests svårighetsgrad, kontakt med förskolan, material för hemträning samt väntetider och stöd. Information om förekomst av svårigheter hos barnet samt eventuell diagnos och grad av svårigheter upplevdes inte som tydlig för ett flertal deltagare.  Resultaten pekar på att det finns vissa aspekter som troligtvis bidrar till att logopediska nybesök uppnår en god kvalitet, bland annat logopedens bemötande samt att logopeden ger en bedömning, tips och råd samt material för hemträning. Det finns dock även några förbättringsområden som logopeder bör beakta, exempelvis beträffande väntetider, stöd, kontakt med förskolan och information om barnets svårigheter. Resultat och slutsatser bör dock tolkas med försiktighet på grund av lågt deltagarantal.

This study examined healthcare professionals’ perceptions on feeding difficulties experienced by infants with NOWS, the involvement of SLP in care, knowledge and experience levels of professionals, and trends in education and follow up care. A 34-question survey was developed to obtain data from participants involved in the care of exposed infants using the secure webbased RedCap™ platform. Nonparametric inferential statistics and descriptive analysis were used to interpret data. Feeding difficulties in infants exposed were reported by all respondents with SLP involvement reported by 42.2%. Results found that 51.9% of respondents were confident in their ability to educate families about feeding difficult with 60% reported inadequate time to provide education. Discharge follow up was inconsistent amongst facilities. The study supports early involvement of SLPs to address feeding difficulties and improve education.

Normally swallowing occurs completely without effort. Should the act of swallowing for some reason be impaired, it becomes difficult to eat and drink. Dysphagia is the medical term for eating and swallowing disorders. Dysphagia is common in people with dementia, but the prevalence is not yet fully evaluated. The most common cause of death in people with dementia is aspiration pneumonia, which can be caused by dysphagia. In Sweden investigation and treatment of dysphagia are performed by speech and language pathologists (SLPs) but few of them work with dementia care. This study aims to identify the prevalence of dysphagia in people with dementia, living in a nursing home. The screening methods SSA-S and LtL were used to test the swallowing of 38 participants between 68-96 years of age (M = 86 years). To examine the participants’ oral health the risk assessment tool ROAG was used. When tested with the water swallowing test SSA-S 71,1% of the participants showed signs of aspiration, 36,8% had an oral transit time over 5 seconds, measured with LtL and 92% of the participants had an affected oral health, showing one or more symptoms of severity grade 2 according to ROAG. When adding up the results from the two screening tests a total of 86,8% of the participants showed signs of some kind of swallowing difficulty. Correlation analysis did not show any statistically significant correlations between SSA-S, oral transit time, oral health, or age. The present study found that there is a great need for interventions from speech and language pathologists in people with dementia. / Normalt sker sväljning helt utan ansträngning. Skulle sväljningen av någon anledning inte fungera som den ska, blir det svårt att äta och dricka. Den medicinska termen för ät- och sväljsvårigheter är dysfagi. Dysfagi är vanligt hos personer med demens men det är ännu inte helt kartlagt hur vanligt det är. Hos personer med demens är den vanligaste dödsorsaken aspirationspneumoni, vilket kan orsakas av dysfagi. I Sverige är det logopeder som utreder och behandlar dysfagi men det är få som är verksamma inom demensvården. Den här studien syftar till att kartlägga förekomst av dysfagi hos personer med demenssjukdom boende på ett vård- och omsorgsboende. Med screeningmetoderna SSA-S och LtL genomfördes undersökningar av sväljförmågan hos 38 personer mellan 68-96 års ålder (M = 86 år). För att undersöka deltagarnas munhälsa användes riskbedömningsverktyget ROAG. Av deltagarna fick 71,1 % utslag på vattensväljningstestet SSA-S, 36,8 % hade en oral transporttid över 5 sekunder, mätt med LtL och 92 % av deltagarna hade en nedsatt munhälsa med ett eller flera symptom av grad 2 i munhålan, enligt ROAG. Vid sammanräkning av resultaten från de två screeningtesten uppvisade totalt 86,8 % av deltagarna tecken på någon form av sväljsvårighet. Korrelationsberäkningar visade inga statistiskt signifikanta samband mellan resultat på SSA-S, oral transporttid, munhälsa eller ålder. Studien visar på ett stort behov av logopediska insatser hos gruppen personer med demenssjukdom.