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Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/22
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Item Feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing following prophylactic swallowing rehabilitation in head and neck cancer(Wiley, 2019-03-20) Patterson, Joanne; Toft, Kate; McAuley, Fiona; King, Emma; McLachlan, Kirsty; Roe, Justin W. G.; Wells, MaryObjectives: Investigate the feasibility and outcomes of fibreoptic endoscopic evalua‐tion of swallowing (FEES) following a programme of prophylactic swallowing exer‐cises in head and neck cancer (HNC) patients treated with radiotherapy.Design: Prospective, single cohort, feasibility study.Setting: Three head and neck cancer centres in Scotland.Participants: Pre‐radiotherapy HNC patients who consented to participate in a pro‐phylactic swallowing intervention.Outcome measures: Fibreoptic endoscopic evaluation of swallowing recruitment and retention rates, assessment acceptability and compliance, qualitative process evaluation.Results: Higher rates of recruitment and retention were achieved in centres where FEES equipment was available on‐site. Travel and anticipated discomfort were barri‐ers to recruitment. Data completion was high for all rating scales, with good reliabil‐ity. Following radiotherapy, swallowing safety significantly deteriorated for liquid boluses (P = 0.005‐0.03); pharyngeal residue increased for liquid and semi‐solid bo‐luses. Pharyngo‐laryngeal oedema was present pre‐treatment and significantly in‐creased post‐radiotherapy (P = 0.001). Patients generally reported positive experience of FEES for their own learning and establishing a baseline.Conclusions: Fibreoptic endoscopic evaluation of swallowing is an acceptable method of assessing patients for a prophylactic swallowing intervention and offers some ad‐ditional information missing from VF. Barriers have been identified and should be taken into account in order to maximise recruitment for future trials.Item Systematic review of ultrasound visual biofeedback in intervention for speech sound disorders(Wiley, 2019-06-10) Sugden, Eleanor; Lloyd, Susan; Lam, Jenny; Cleland, JoanneBackground As cost and access barriers to ultrasound technology have decreased, interest in using ultrasound visual biofeedback (U-VBF) as a tool for remediating speech sound disorders (SSD) has increased. A growing body of research has investigated U-VBF in intervention for developmental SSD; however, diversity in study design, participant characteristics, clinical methods and outcomes complicate the interpretation of this literature. Thus, there is a need for a synthesis and review of the evidence base for using U-VBF in intervention for SSD.Item The use of electropalatography in the treatment of speech disorders in children with Down Syndrome: a randomised controlled trial(2018-07-24) Wood, Sara; Timmins, Claire; Wishart, Jennifer; Hardcastle, William J.; Cleland, JoanneBackground: Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. Aims: This study aimed to evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. Methods: Twenty-seven children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or ‘treatment as usual’ over a 12 week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP: Dodd et al. 2002) and re-assessed immediately post- and 3- and 6-month post-intervention to measure percent consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time-points. Percent intelligibility was also calculated using the Children’s Speech Intelligibility Measure (CSIM: Wilcox and Morris 1999). Results: Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3- and 6-month post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared to the other groups. Statistical testing showed significant differences between groups in DEAP scores across time-points although the majority did not survive post hoc evaluation. Intelligibility across time-points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time-points, no statistically significant group differences emerged. Conclusions and implications: EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapyItem Electropalatographic therapy for children and young people with Down's syndrome(2009-12) Cleland, JoanneArticulation disorders in Down's syndrome (DS) are prevalent and often intractable. Individuals with DS generally prefer visual to auditory methods of learning and may therefore find it beneficial to be given a visual model during speech intervention, such as that provided by electropalatography (EPG). In this study, participants with Down's syndrome, aged 10:1 to 18:9, received 24 individualized therapy sessions using EPG. Simultaneous acoustic and EPG recordings were made pre- and post-intervention during 10 repetitions of a word list containing lingua-palatal consonants. Participants also completed the DEAP phonology sub-test at both time points. Post-treatment, all participants showed qualitative and quantifiable differences in EPG patterns and improvements in DEAP percentage consonants correct. EPG assessment and therapy appears a positive approach for identifying and improving articulatory patterns in children with DS. © 2009 Informa UK, LtdItem Widening access to electropalatography for children with persistent sound system disorders.(American Speech-Language-Hearing Association, 1999-11) Gibbon, Fiona; Stewart, Fiona; Hardcastle, William J.Previous studies have demonstrated the value of using electropalatography (EPG) to assess, diagnose, and treat persistent sound system disorders in children. However, the application of EPG research has been limited in clinical contexts because most speech-language pathologists do not have access to the technique. This article provides an overview of recent EPG research on persistent sound system disorders and describes a network that has been established to widen access to EPG. The use of EPG via the network is illustrated in the case description of an 8-year-old boy, Robbie, who presented with a persisting speech disorder. The network was used because the clinician treating Robbie did not have an EPG. The main perceptual feature of Robbie's speech before EPG treatment was the deviant phonological process of backing /t/ and /d/ targets to velar place of articulation. EPG was used to assess articulatory patterns before treatment, to provide visual feedback as part of a treatment program, and to record changes in tongue-palate contact patterns as treatment progressed. Robbie achieved normal /t/ and /d/ articulatory patterns after treatment and was subsequently discharged. Factors that could have contributed to the successful outcome in this case are discussed, and areas requiring further research are identified.