MSc in Speech and Language Therapy
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7221
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Item Developmental Language Disorder: An Education Staff perspective(2021)This study investigates education staff’s current training, experience and knowledge of Developmental Language Disorder (DLD) and wider speech, language and communication needs (SLCN) in Jersey. DLD is a common but hidden disorder which makes is difficult to identify. Additionally, this is an under-researched area in proportion to its prevalence in the population. Consequently, children with DLD are currently not receiving the support that they deserve. Speech and Language Therapy (SLT) is a cost effective method of ensuring these children receive the interventions the require to help minimise further potential costs to the individual and society as a whole. 44 participants from a range of educational backgrounds completed a questionnaire asking about their background; their knowledge, training and experiences of SLCN; their awareness and understanding of DLD as well as their confidence in identifying and supporting the needs of a child with DLD; the ways in which they support language development in the classroom; and finally, about their engagements with the SLT service, the ways in which they value it and how support could be improved. It was found that more needs to be done to better support education staff in relation to SLCN. The research concludes that more need to be done to improve the collaborations between Speech and Language Therapists (SLTs) and both education staff and parents, improve training opportunities for education staff as well as make changes to service delivery, improve resources and employ more staff. There are no quick solutions that will solve the current problems in service delivery, research and awareness of DLD, but this research does recommend some ways to shape future research and clinical practice which hope to improve the situation that children with DLD helplessly find themselves in.Item A Survey of the Practices of Social Workers Working with Children with Adverse Childhood Experiences and Speech, Language, and Communication Needs(2020-01)There is evidence to suggest that children who have Adverse Childhood Experiences are at increased risk of having Speech, Language, and Communication Needs, physical health problems, and mental health issues compared to their non-maltreated peers (Law and Conway 1992; Felitti et al. 1998; Trocme et al. 2010; Lum et al. 2015; Sylvestre et al. 2016). Building resilience in children is essential for supporting children's health. Resilience develops through healthy relationships with adults, including parents, teachers, Speech Language Pathologists, and Social Worker (Schore 2003; Ellis and Dietz 2017). Once Social Workers identify children with Adverse Childhood Experiences, they can refer to Speech Language Pathology services. Speech Language Pathologists can provide early intervention for children with Adverse Childhood Experiences and Speech, Language, and Communication Needs to support their speech, language, and communication development. This may benefit other areas of development- cognitive, emotional, and physical as well (Fox and Rutter 2010; Guralnick 2011). This research study explored Social Worker's perspectives and knowledge of Adverse Childhood Experiences and Speech, Language, and Communication Needs in children, referral practices, multidisciplinary teams, and collaborative practices in Newfoundland and Labrador. An online survey was sent to a population of SWs in NL who have experience working with children. Quantitative and Qualitative data was collected and presented in Tables and Figures. Qualitative data were assigned codes and grouped into main themes. The data collected was linked to the research aims of the study. 57 Social Workers living in NL responded to the online survey. Results indicated that the Social Workers’ knowledge base of Adverse Childhood Experiences and Speech, Language, and Communication Needs is high. Respondents understand the impact that Adverse Childhood Experiences can have on a child's speech, language, and communication development. Respondents reported that multidisciplinary teams involving Speech Language Pathologists and Social Workers could benefit the services provided to children in Newfoundland and Labrador and enable better access to early intervention services. Respondents indicated that further learning opportunities' in the area of Adverse Childhood Experiences and Speech, Language, and Communication Needs would benefit their profession. Respondents stated that the current needs of children with Adverse Childhood Experiences and Speech, Language, and Communication Needs are not being met. The need for more referrals to the Speech Language Pathology service is indicated. The first recommendation of the survey findings is that when Social Workers identify children with Adverse Childhood Experiences, a Speech Language Pathologist should screen children for Speech Language, and Communication Needs. The second recommendation is for further learning opportunities involving Social Workers and Speech Language Pathologists to build more awareness of Speech, Language, and Communication Needs. The third recommendation is that Speech Language Pathologists have further access to children and families who have experienced adversity so that specialist Speech Language Pathology intervention can occur to meet each child's communication needs and to engage the family in therapy and goal setting.Item The Effects of the Five Basic Tastes on Oral Transit Time for People with Dementia: An Extended Research Proposal(2020-04)Background: Tastes in differing concentration levels heightens sensory input to the cortical swallowing centres. Taste stimulation is an intervention for dysphagia management that introduces a taste into the mouth, in order to modulate the timing of the swallow. This dissertation considers taste stimulation as an intervention directed to help people with dementia with swallowing difficulties. People with dementia often experience difficulties with the voluntary phases of the swallow, resulting in slow or absent initiations of the swallow, leaving individuals malnourished, dehydrated and at high risk of developing aspiration pneumonia. Taste has been identified as a sensory factor that can be manipulated to stimulate an initiation of the swallow, resulting in fewer hospital admissions and better quality of life for individuals and their families. Purpose: This paper aims to identify the taste and concentration level that decreases the oral transit time for people with dementia. Methods: The effects of taste on oral transit time will be measured using Ultrasound Tongue Imaging. A small pilot study was undertaken to determine the feasibility of this method in measuring oral transit time and to identify methodological improvements for transferring the method to a dementia population. All five basic tastes were observed in the small study with three concentration levels for each taste. The results from the pilot study indicated that the bitter taste could be omitted from testing in the research proposal as it had no impact on the swallow. Conclusions: The research proposal hypothesises that the most effective taste and concentration level for people with dementia will be a highly concentrated sour bolus. The results will go some way to improving dysphagia interventions for people with dementia, by advocating for taste stimulation to become a mandatory early intervention for all individuals diagnosed with dementia.Item An investigation into parent/caregiver perceptions of using the Picture Exchange Communication System with children with Autism Spectrum Disorder(2020-04)Around 30% of individual’s with Autism Spectrum Disorder (ASD) are suggested not to gain verbal communication skills. Therefore, use of Augmentative and Alternative Communication (AAC) systems or devices is vital to support them to communicate effectively and efficiently. The Picture Exchange Communication System (PECS) is an intervention and alternative means of communication that aims to teach individuals functional communication skills. A review of literature finds some evidence of PECS being effective. However, several studies focus on speech as a measure of effectiveness, rather than the impact on an individual’s overall functioning in their daily lives. Family members/caregivers have an active role in the therapy process and in enabling successful communication in everyday life, particularly with individual’s using AAC devices/systems. This extended research proposal focuses on building the data previously gathered about PECS from parents/caregivers in the Yoder and Stone (2006) study. It aims to explore parent/caregiver experiences of PECS, investigating further their perceptions of its effectiveness in the everyday lives of their children with ASD and factors they perceive to impact on implementation. Key themes identified from the interviews may be beneficial to inform other parents/caregivers about PECS and what it entails regarding implementation. It can inform clinical practise in speech and language therapy as well as other health and education professions. It is hoped information gained can be used to help guide new ways to promote acceptance of PECS and other AAC devices/systems in society. vii Overall, the proposed study aims to benefit individuals using PECS and improve their quality of life, by further supporting them to achieve their full communication potential, participate in their daily life and achieve their goals. Future research could include comparing experiences and perceptions of, for example, mothers and fathers, a variety of cultures as well as parents/caregivers of adults who use PECS.Item An Investigation into the Types of Adjectives Used to Label Voice(2020-04)Studies have explored the differences in adjectives used to describe men and women, as well as how adjective polarity changes depending upon the context in which it is used. This research has not been applied to the types of adjectives used to label voice and the distribution of these adjectives across gender and polarity within a selected typology. In this paper, adjectives used to label voice are examined to evaluate whether the use of these adjectives reflects gender stereotypes, as well as the distribution of these adjectives across polarity and gender within a typology. Using the supersense taxonomy developed by Tsvetkov et al. (2014), 171 adjectives were individually placed into one of the thirteen supersenses. Six of these supersenses, containing 98.4% of the female and male contextual entries, were further analyzed to determine if stereotypes were reflected in the collected data. Upon analyzing the individual adjectives within each supersense, both male and female stereotypes were found to be present when labeling voice.Item Speech and Language Therapists’ Perceptions of Universal/Targeted Service Delivery in Areas of Social Disadvantage in Scotland(2020-04)The evidence base has demonstrated a need for early intervention and prevention of language difficulties that can affect attainment in children/youth in areas of social disadvantage. Recognizing this need and other needs of disadvantaged children/youth, the Scottish Government has addressed these issues with policy that has helped create a new role for speech and language therapists (SLTs) in universal and targeted services (UTS). However, little is known about SLTs’ work in this area. This study investigated the nature of SLTs’ work when delivering UTS when working to close the poverty related attainment gap in Scotland. This research also studied SLTs’ perceptions, barriers, facilitators, and insights into improving these services. This mixed methods study recruited 28 SLTs Scotland wide. Quantitative data showed that the majority of participants were focussing on developing listening and attention, language, narrative, and phonological awareness skills in children/youth and were also upskilling parents/carers and teachers. To do this, SLTs in these services were employing treatments like Colourful Semantics and Adult-Child Interaction. Information about funding, clinical settings, treatment planning, and dosage was also found. Qualitative data derived from thematic analysis revealed main themes about who, what, and how SLTs were measuring outcomes; barriers to these services such as barriers within speech and language therapy services and to parent/carer engagement; facilitators to these services like relationships and partnership working; and improvements like service model enhancements. Together, these findings help contribute to clinical knowledge by adding to an emerging evidence base within Speech and Language Therapy (SLT).Item The effect of dyslexia on the production of speech errors, repairs and disfluencies(2020-06)Tests of verbal working memory are used to measure reading skills in individuals with dyslexia (Shaywitz et al. 2005; Ogino et al. 2017). The production of clear and fluent speech is also dependent on verbal working memory due to a limited capacity to retain and rehearse information and therefore less opportunity to check for errors prior to speech production (Jacquemot and Scott 2006). Despite these links, there is limited evidence regarding the association between dyslexia and the production of speech errors, repairs and disfluencies. The primary aim of the present study is to investigate the link between dyslexia and speech error production, while considering the effect of working memory capacity on speech errors, repairs and disfluencies. An additional aim of the study is to explore the effect of gender on working memory and speech errors. The working memory capacity of each participant is measured using three working memory tasks: reverse digit span, reorganising digits and non-word repetition. Speech errors are induced experimentally using a tongue-twister paradigm while speech repairs and disfluencies are naturally elicited through a spontaneous speech sample. The results are analysed using statistical analysis, exploring the relationship between working memory and speech errors, repairs and disfluencies, and investigating the difference between the speech errors produced in the dyslexia and control groups. It is concluded that individuals with dyslexia produce more speech errors, repairs and disfluencies than those without dyslexia, and that this is linked to verbal working memory. This contributes to evidence that tests of speech errors, repairs and disfluencies could be used as a predictor of dyslexia. The significance of these results, however, is dependent on the type of speech error elicitation task used.Item Are Nursing Staff Achieving Accurate Consistencies of Thickened Fluids Following IDDSI Implementation and What Factors Do They Perceive to Influence This? An Extended Proposal(2020-04)Thickened fluids are a popular management method for dysphagia as thicker fluids move more slowly meaning individuals with dysphagia have more time to protect their airway. However, research has shown that nursing staff do not always achieve accurate consistencies when thickening fluids and this can have negative impacts on patients’ health, including dehydration if fluids are too thick, and aspiration which can result in a chest infection if fluids are too thin, or too thick. It was proposed that the provision of consistent terminology would be a potential solution to this issue, and therefore the International Dysphagia Diet Standardisation Initiative (IDDSI) was introduced to provide globally standardised terminology for thickened fluid consistencies. The first phase of the proposed study intends to use a descriptive, non-experimental design to observe the percentage of fluids thickened inaccurately by nursing staff. There are other factors aside from inconsistent terminology that could impact upon the accuracy of consistency of thickened fluids such as subjective measurements used to check consistency, a lack of training in how to thicken fluids, a lack of understanding for the rationale of thickened fluids and a lack of compliance with recommendations for thickener. Therefore, the second phase of the proposed study will use interpretative phenomenological analysis to interview nursing staff to acquire their perspectives on factors that they feel affect their ability, competence and willingness to thicken fluids to accurate consistencies, as well as their opinion on the implementation of IDDSI within their setting. Results from this mixed methods study will suggest how often fluids are thickened to inaccurate consistencies by nursing staff and suggest what factors are influencing this. By gaining this knowledge, actions can be proposed that are likely to improve nursing staffs’ ability, competence and willingness to thicken fluids to accurate consistencies.