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Yes / Randomised controlled trials of non-pharmacological interventions in children's therapy are rare. This is, in part, due to the challenges of the acceptability of common trial designs to therapists and service users. This study investigated the acceptability of participation in cluster randomised controlled trials to therapists and service users. A national electronic survey of UK occupational therapists, physiotherapists, speech and language therapists, service managers, and parents of children who use their services. Participants were recruited by NHS Trusts sharing a link to an online questionnaire with children's therapists in their Trust and with parents via Trust social media channels. National professional and parent networks also recruited to the survey. We aimed for a sample size of 325 therapists, 30 service managers, and 60 parents. Trial participation was operationalised as three behaviours undertaken by both therapists and parents: agreeing to take part in a trial, discussing a trial, and sharing information with a research team. Acceptability of the behaviours was measured using an online questionnaire based on the Theoretical Framework of Acceptability constructs: affective attitude, self-efficacy, and burden. The general acceptability of trials was measured using the acceptability constructs of intervention coherence and perceived effectiveness. Data were collected from June to September 2020. Numerical data were analysed using descriptive statistics and textual data by descriptive summary. A total of 345 survey responses were recorded. Following exclusions, 249 therapists and 40 parents provided data which was 69.6% (289/415) of the target sample size. It was not possible to track the number of people invited to take the survey nor those who viewed, but did not complete, the online questionnaire for calculation of response rates. A completion rate (participants who completed the last page of the survey divided by the participants who completed the first, mandatory, page of the survey) of 42.9% was achieved. Of the three specified trial behaviours, 140/249 (56.2%) therapists were least confident about agreeing to take part in a trial. Therapists (135/249, 52.6%) reported some confidence they could discuss a trial with a parent and child at an appointment. One hundred twenty of 249 (48.2%) therapists reported confidence in sharing information with a research team through questionnaires and interviews or sharing routine health data. Therapists (140/249, 56.2%) felt that taking part in the trial would take a lot of effort and resources. Support and resources, confidence with intervention allocation, and sense of control and professional autonomy over clinical practice were factors that positively affected the acceptability of trials. Of the 40 parents, twelve provided complete data. Most parents (18/40, 45%) agreed that it was clear how trials improve children's therapies and outcomes and that a cluster randomised trial made sense to them in their therapy situation (12/29, 30%). Using trials to evaluate therapy interventions is, in principle, acceptable to therapists, but their willingness to participate in trials is variable. The willingness to participate may be particularly influenced by their views related to the burden associated with trials, intervention allocation, and professional autonomy. / The study was funded and supported by the UK Occupational Therapy Research Foundation, a division of the Royal College of Occupational Therapists, as part of the 2018–2021 Research Priority Grant.

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.

The diploma thesis focuses on the role of teacher assistant in the nursery class. Its aim is to capture the activities that the assistant teacher performs in this class through qualitative research. The main aim of the research was to describe the activities of the teacher assistant that support pupils directly in the logopedic class of the kindergarten. The research was carried out at the nursery class of the kindergarten. The case studies of five pupils were processed on the basis of documentary analysis and observation and teacher assistant activities were categorized. It has been found that pupils has disruptive communication skills that has been shown since the beginning of development and, besides communication skills, involves in other areas of development. Teacher assistant pays attention to all pupils in the class. Activities that encourage them to engage in education and all kindergarten activities do not differ in content. His work focuses mainly on ensuring understanding, orientation and involvement of pupils in every situation. KEYWORDS Teacher Assistant, Pupil with Special Educational Needs, Speech and Language Disorders, Nursery School, Class for children with speech and language disorders, Special Education

Abstract Children with hearing disorders face particular challenges in developing their vocabulary. They often have difficulty in acquiring spoken language at the same rate as their normal hearing peers, despite progress regarding hearing aid technology.Aim. The main aim of this study was to describe aspects of expressive vocabulary for school-age children with mild to moderately severe hearing impairment (HI-group), and to compare with results for a group of normal hearing children (NH-group) of the same age. One aim was also to test whether there were differences, between children with hearing impairment and normal hearing children, in the ability to repeat non-words and sentences and to compare these results within each group with results on two newly constructed vocabulary tests. An additional aim was also to investigate whether background factors, such as age of diagnosis, age of hearing aid fitting and amount of hearing aid use, were related to results on vocabulary tests.Method: 24 children age 7-11 with mild to moderately severe bilateral hearing impairment, and 82 normal hearing children of similar age, were included in this cross-sectional study. Assessments of picture naming, word definition, repetition of nonwords and repetition of sentences were performed with all participants. Age, hearing, use of hearing aid and parents' level of education were included in the analyzes.Results: The HI-group performed significantly below the results of the NH-group regarding picture naming, word definition, nonword repetition and repetition of sentences. The HI-group also produced significantly more words with deficiencies in phonological structure, than the NH-group, during picture naming. In the HI-group there was a significant positive correlation between amount of hearing aid use per day and nonword repetition. Age of diagnose and age of hearing aid fitting did not show statistically significant associations with outcomes on the language tests in this study.Conclusion: Despite the technical development of hearing aids, the expressive vocabulary in school-aged children with bilateral, mild to moderately severe, hearing impairment, does not reach the same level as in normal-hearing peers, although there is a variation within the group. Amount of hearing aid use seems to be important for the ability to perceive new words.

Millions of dollars are spent annually in Canada providing school health support services (SHSS) to children with developmental delays and disabilities (DD) as an important support for inclusive education. However, there is limited information about how allied health professionals (AHP) work together with educators to integrate therapy strategies into educational programming for children with DD. This study examines the strategies AHPs, in Ontario perceived to be successful and are implementing with educators to support participation outcomes for children with DD in the primary grades. This study also describes AHPs’ vision for the future in order to improve their work practices to support participation of children with DD at school. Recognizing that the literature on SHSS has emphasized challenges to providing services to children with DD and collaboration with educators; this study actively employed appreciative inquiry (Preskill, & Catsambas, 2006). Individual in-depth interviews with 15 AHPs (11 OTs, 1 PT, 3 SLPs) were conducted via face-to-face, telephone or video conference. Participants were asked to describe how they viewed participation at school for children with DD, their role in supporting it, the strategies they used to work with educators to support this participation and their vision for the future. AHPs in this study viewed participation of children with DD at school as (a) being in the classroom to provide the opportunity for meaningful engagement with peers and (b) working on similar activities as peers to promote membership and belonging at school. Participants implemented their role to support participation of children with DD by providing equipment, modifying or adapting activities, educating and providing resources to educators. Successful strategies AHPs used to work with educators to facilitate participation of children with DD at school included: finding a key person, developing trust and rapport with an educator, engaging in shared planning with an educator, seeking feedback from educators about their recommendations and listening to educators regarding information about the child with a DD. AHPs also identified their vision for the future in supporting participation of children with DD. Their vision included being a resource to teachers, by consulting to a whole class and being a member of the educational team. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-09-11 00:13:12.132

This study looks at what happens in informal conversations between three people with learning difficulties (intellectual impairment) and a range of non-disabled partners. It takes a participatory approach using data collected by the participants with learning difficulties who chose their communication partners; these partners included family and staff who were paid to support them. The study uses descriptive statistics to highlight areas where there was apparent asymmetry in the conversations. Conversation Analysis combined with features taken from Systemic Functional Linguistics is then used to look in detail at some of these aspects. Important features identified include turn design, repair, and the use of evaluative language and the contribution of non-verbal aspects in particular eye gaze, gesture and the use of artefacts. The study highlights possible strategies for assessing and supporting more effective and equitable interaction for those with learning difficulties and communication impairment and identifies features that should be considered when training professionals working in the field of learning difficulties.

A narrativa oral de história trata-se de uma habilidade de grande complexidade uma vez que requer preservação de capacidades linguísticas e cognitivas. O desempenho em tarefa de narração tem contribuído para a identificação de diferentes subgrupos clínicos com alterações de linguagem, como o quadro de atraso no desenvolvimento da linguagem (ADL). Essa população caracteriza-se ao longo do desenvolvimento da linguagem por um ritmo lento para novas aquisições. A habilidade narrativa é descrita em crianças com ADL por produções de histórias mais curtas e com menor complexidade. Contudo, poucas pesquisas abordam a narrativa oral desta população específica, e sobre à influência de programas de intervenção. Desta forma, o presente estudo teve como objetivo comparar o desempenho em tarefa de narrativa oral de histórias de crianças com histórico de ADL antes e após serem submetidas a um programa de intervenção fonoaudiológica. Participaram deste estudo 10 crianças com ADL e 10 crianças com desenvolvimento típico de linguagem, pareadas quanto ao sexo e idade cronológica. Cada grupo foi composto por indivíduos de ambos os sexos, com idade cronológica entre cinco e seis anos. Os participantes de ambos os grupos foram avaliados antes e após a intervenção, nos níveis macro e microestruturais da narrativa oral, utilizando como instrumento de análise: (a) índice de complexidade da narrativa (b) nível de coerência global da narrativa; (c) análise de construção dos episódios que compõem a narrativa. Além da (d) produtividade e (e) complexidade linguística da narrativa. Após a avaliação, as crianças com ADL foram submetidas ao programa de intervenção fonoaudiológica da narrativa. O referido programa foi composto por três fases com objetivos distintos: (a) elementos estruturais da narrativa-apresentar a criança; (b) elaboração da narrativa; (c) contagem de histórias de forma independente. O programa foi organizado em dez sessões de intervenção. Os resultados permitiram concluir que os indivíduos com ADL apresentaram melhora em seu desempenho após intervenção na narrativa oral em relação aqueles com desenvolvimento típico. Foi constatada diferença significativa entre os desempenhos pré e pós intervenção para o grupo com ADL em todos os aspectos macro e microestruturais (exceto total de C-Units). O desempenho do grupo com desenvolvimento típico de linguagem foi mais discreto, não foram observadas diferenças significantes para desafios, resolução e coerência da narrativa e total de palavras, total de C-Units, extensão média dos enunciados e C-Units complexos. / Oral storytelling is a skill of great complexity as it requires preservation of linguistic and cognitive abilities. The performance in narrative task has been contributing to the identification of different clinical subgroups with language alterations, such as late talking condition. This population is characterized throughout language development by late onset or at a slow pace for new acquisitions. Narrative ability is described on children in late talking condition for shorter and less complex storytelling. However, few studies address the oral narrative of this specific population, and the influence of interventional programs. Thus, this study had the aim to compare the performance in task of oral narrative of children in late talking condition before and after being submitted to a speech-language intervention program. The participants were 10 children late talkers and 10 children with typical language development, matched for sex and chronological age. Each group consisted individuals of both sexes, with a chronological age between five and six years. Participants of both groups were evaluated before and after intervention at the macro and microstructural levels of the oral narrative using as an analytical tool: (a) narrative complexity index; (b) level of global narrative coherence; (c) construction analysis of the episodes; (d) productivity and (e) linguistic complexity of the narrative. After the evaluation, the late talkers were submitted to the speech-language intervention program of the narrative. The program was composed by three phases with distinct objectives: (a) structural elements of the narrative; (b) elaboration of the narrative; (c) storytelling independently. The program was organized in ten interventional sessions. The results allowed to conclude that late talkers showed improvement in their performance after intervention in the oral narrative in relation to those with typical development. It was observed a significant difference between the pre and post intervention performances for late talkers group in all macro and microstructural aspects (except total of C-Units). The performance of the group with typical language development was more discreet, no significant differences were found in challenges, resolution and coherence of the narrative and total words, total C-Units, mean length of utterances and complex C-Units.

Made available in DSpace on 2016-04-27T18:11:50Z (GMT). No. of bitstreams: 1 Maria Rosirene Lima Pereira.pdf: 637232 bytes, checksum: 7b60a25fa7d591ed21bc866ac85b01cb (MD5) Previous issue date: 2011-02-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: This work focuses on theoretical and clinical issues involving holophrase from the perspective of the subject constituted in and through language, to direct our attention to the mentally handicapped in its alienation to the Other. Aim: To investigate the holophrastic speech of a teenager with mental debility. Method: The speech data of this adolescent were extracted from clinical material of therapy sessions, supplemented by their clinical and symbolic history. The data analysis was supported by the Language Symptoms Organization Model. In particular, there has been the observation of the use, by the speech therapist, of the target procedure of sanction, in its impact on the recognition or denial of the subject and the signifier, coupled with listening to the speech of the teenager. This way, the holophrastic speech had its enigmatic specificity questioned from the uniqueness of the clinical material, whether in the data literalness, in listening to the sound and amorphous mass that constitutes it. Results and Conclusions: The results support the hypothesis that holophrastic speech, to the speech therapy clinical practice, would be the agglutination of unintelligible segments that are presented as an amorphous mass and noise formed by an admixture of signifiers, heard as distorted, welded or without pause between each other. Despite their structural and functional specificity, holophrastic speech has its operation submitted to the order of language itself, in articulation with the individual event of the subject with mental debility talk / Introdução: este trabalho debruça-se sobre questões teóricas e clínicas que envolvem a holófrase, sob a ótica do sujeito constituído na e pela linguagem para dirigir o olhar ao débil mental em sua alienação ao Outro. Objetivo: investigar a fala holofrásica de uma adolescente com debilidade mental. Método: Os dados de fala dessa adolescente foram extraídos do material clínico de sessões terapêuticas, complementados por sua história simbólica e clínica. A análise desses dados foi subsidiada pelo modelo teórico de multiestratificação dos sintomas de linguagem. Em particular, deu-se a observação do alçamento, pelo fonoaudiólogo, do metaprocedimento da sanção, em sua incidência sobre o reconhecimento ou negação do sujeito e do significante, aliado à escuta da fala da adolescente. Por essa via, a fala holofrásica teve sua especificidade enigmática interrogada a partir da singularidade do material clínico, seja na literalidade do dado, seja na escuta à massa amorfa e sonora que a constitui. Resultados e Conclusões: os resultados dão suporte à hipótese de que a fala holofrásica, para a clínica fonoaudiológica, seria a aglutinação de segmentos ininteligíveis que se apresentam como massa amorfa e sonora formada por uma miscigenação de significantes, escutados como distorcidos, soldados ou sem pausa entre si. Apesar de sua especificidade funcional e estrutural, a fala holofrásica tem seu funcionamento submetido à ordem própria da língua, em articulação ao acontecimento individual da fala do sujeito com debilidade mental

Made available in DSpace on 2016-04-27T18:12:19Z (GMT). No. of bitstreams: 1 Mariana Busnardo.pdf: 282500 bytes, checksum: 0691e2a68639f6bb55fee7ccf802a9b2 (MD5) Previous issue date: 2007-02-28 / The present work has as a goal to focus look and a listening to the deaf citizen by means of its writing, in detriment of the lack, of the error, emphasizing itself exactly the express, the profit, the marks that in the writing, there is a singular citizen. The interest for this research appeared due to the great number of complaints about the relationship of the deaf people with writing and, mainly, for the fact of that the traditional theories concerning the acquisition of writing abilities did not consider this question; waving towards a previous question, the constitution of these citizens. The work will be structured in the following way: an initial chapter, where elements of the education of the deaf people will be brought with the intention to point out historically the relations established between "deaf world" and "listener world", prioritizing the weight that this singularity (deafness) had in the acceptance of these citizens. A second chapter, where the writing will be focused, presenting some of its meanings and functions, relating them with the demands of the deaf citizens, to search clues on the reasons of this relation to be credited as "problematic" by the listeners. The third chapter will display an effective dialogue with literal productions of two deaf citizens. For this, open interviews that had been carried through with intention to know the life history of each one and the relation that each of them considers to have with the writing will be discussed. The second step will be the analysis of texts produced by these citizens, that, as it was previously said, will have as an objective to get to know these citizens better, as well as the relation that they keep with writing, in order to be able to understand how its process of authorship in relation to this happens or has the chance to happen / O presente trabalho tem como objetivo direcionar um olhar e uma escuta ao sujeito surdo por meio de sua escrita, em detrimento da falta, do erro, enfatizando-se justamente o expresso, o ganho, as marcas de que ali, no escrito, há um sujeito singular. O interesse por essa pesquisa surgiu devido ao grande número de queixas quanto ao relacionamento dos surdos com a escrita e, principalmente, pelo fato de que as teorias tradicionais acerca da aquisição da escrita não dão conta dessa questão; acenando para uma questão anterior, de constituição desses sujeitos. O trabalho será estruturado da seguinte maneira: um capítulo inicial, em que elementos da educação dos surdos serão trazidos com o intuito de situar historicamente as relações estabelecidas entre mundo surdo e mundo ouvinte , priorizando o peso que essa singularidade (surdez) teve na aceitação desses sujeitos. Um segundo capítulo, em que a escrita será focalizada, apresentando alguns de seus significados e funções, relacionando-os com as demandas dos sujeitos surdos, para buscar pistas sobre os motivos dessa relação ser dita problemática pelos ouvintes. O terceiro capítulo contará com um diálogo efetivo com produções textuais de dois sujeitos surdos. Para tanto, serão discutidas entrevistas abertas que foram realizadas com o intuito de conhecer a história de vida de cada um e a relação que cada um deles considera ter com a escrita. O segundo passo será a análise de textos produzidos por esses sujeitos, análise esta que, como dito anteriormente, terá como objetivo conhecer melhor esses sujeitos, assim como a relação que mantêm com a escrita, a fim de podermos entender como se dá ou pode vir a se dar seu processo de autoria em relação a esta