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The art and practice of being a clinician working with individuals who stammer
Published in Trudy Stewart, Stammering Resources for Adults and Teenagers, 2020
As valid as these attributes and undergraduate/Shapiro’s model of development may be, neither address fundamental questions which a clinician who is starting to work in the field of dysfluency might ask: How should I be while working with a client who has a stammer? When should I challenge, probe, reflect on what has been said?What sort of relationship is effective with this client?Is this any different from how I am when I work with any other client?Does it make any difference how I am with a client to the therapy process? One might consider such questions as unnecessary and possibly the result of clinical inexperience. However, they are important, as research clearly shows that how a clinician is with a client does make a difference. In fact, it is considered to be one of, if not the most important factor in determining good therapeutic outcomes, and this is regardless of the management approach being used (Van Riper 1975, Cooper and Cooper 1985, Shapiro 1999).
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Speech refers to the process of articulation and pronunciation; i.e., speech is the motor process resulting in sound production. It involves the bulbar muscles and the physical ability to form words. It depends on a respiratory input, and using the muscles of the tongue, lips, jaw, and vocal tract in a very precise and coordinated way to produce the recognizable sounds that make up language. Speech consists of articulation (how speech sounds are made), voice (use of the vocal folds and breathing to produce sound), and fluency is the flow of speech. Fluent speech is smooth, unhesitant, and effortless. Any break or irregularity that affects the flow of speech is called dysfluency. Occasional dysfluency is common in normal persons, especially when one is stressed, nervous, excited, or tired. The average person may have dysfluencies at a rate between 7 percent and 10 percent of their speech. These dysfluencies are usually word or phrase repetitions, fillers (urn, ah), or interjections. Dysfluencies at a rate greater than 10 percent of speech are indicators of speech disorder.
Developmental Stuttering
Published in Ivanka V. Asenova, Brain Lateralization and Developmental Disorders, 2018
Within this perspective, functional models of DS that explain dysfluency with a failure of effective integration between motor, linguistic and cognitive processes are most popular [27, 88, 112, 114, 118, 152]. According to their basic postulates, normal fluency depends on successful and efficient implementation of operations in each component of the processing system. For this reason, the damage in each of the system’s components or disturbance of their interactions may be a potential source of dysfluency. The possibility of existence of different specific loci of the functional deficit in the process of generating speech fluency presupposes the existence of different types of stuttering. In fact, the idea that DS is a complex multidimensional disorder which is characterized by a variety of pathological manifestations (emotional, behavioral and cognitive), and is caused by the complex interactions of genetic and environmental factors (physiological, psychosocial and/or psycholinguistic), finds increasing acceptance [4, 28, 41, 81, 124].
Telehealth rehabilitation for adults with cochlear implants in response to the Covid-19 pandemic: platform selection and case studies
Published in Cochlear Implants International, 2022
Julie M. Carter, Catherine F. Killan, Jillian J. Ridgwell
Telehealth has been used for other client groups within speech and language therapy, including those with dysfluency (O’Brian et al., 2008), dysphagia (Burns et al., 2019), and acquired communication impairment (Pitt et al., 2019). However, adults with severe-to-profound hearing impairment experience unique communication challenges. These can include increased reliance on lip-reading, greater dependence on good sound quality, in some cases a need for sign-language support, and access to written material to supplement spoken conversation. Therefore methods used for telehealth in typically-hearing client groups may not be directly applicable to CI service users. It is also important to consider the technical limitations of telehealth platforms, as these can affect the accessibility of online interventions for elderly and hearing-impaired adults (Meyer et al., 2019). Finally, the delivery of any healthcare intervention online must comply with information governance guidance, ensuring online security and patient confidentiality.
Parents' attendance, participation and engagement in children’s developmental rehabilitation services: Part 1. Contextualizing the journey to child health and happiness
Published in Disability and Rehabilitation, 2020
Michelle Phoenix, Susan M. Jack, Peter L. Rosenbaum, Cheryl Missiuna
Six participants described their children as having ‘narrow’ speech issues with no other complications related to their health or development. These children typically had difficulties with speech sound production (e.g., couldn’t say the/k/sound) or dysfluency, but never received a ‘formal diagnosis’ from a doctor. These children and families stood in sharp contrast to families who described traumatic birth experiences with extended stays in the Neonatal Intensive Care Unit, frequent hospitalizations due to pneumonia or need for surgeries (e.g., gastrostomy tube surgery), near-death experiences of the child, risk for seizures, prolonged investigation for a diagnosis, and ongoing daily care needs related to the child’s limited self-care skills. Parents were frequently emotional when talking about these health complexities, that often took priority over the child’s particular area of developmental delay (e.g., delayed expressive language) and related therapy services. One father of a child with Cerebral Palsy recounted multiple illnesses and hospitalizations:
The effect of voice disorders on lexical tone variation: Exploratory study in an African language
Published in International Journal of Speech-Language Pathology, 2020
Gail Jones, Anita van der Merwe, Lynda Olinger, Mia le Roux, Jeannie van der Linde
Experimental participants. Five participants (P1–P5) with voice disorders were in the experimental arm of the study. Purposive sampling took place at out-patient clinics of public sector hospitals in urban areas of Gauteng (province in South Africa). Participants met the following inclusion criteria: presence of a voice disorder as diagnosed by an ear, nose and throat (ENT) specialist using a flexible laryngeal endoscope at the time of the study; a mild to severe dysphonic voice as judged in consensus by two speech-language pathologists (first author and a colleague) with 3 years’ experience in treating voice disorders in a hospital context and using the GRBASI (G = grade, R = roughness, B = breathiness, A = asthenia, S = strain and I = instability) rating scale (De Bodt, Wuyts, Van de Heyning, & Croux, 1997); no other speech disorder (dysfluency or articulation errors) or oral structural (abnormal occlusion, use of dentures, tongue thrust, abnormality of the hard or soft palate, asymmetrical position of the lips, tongue, jaw, velum or face during rest and movement) impairments as judged by the first author during an interview. Experimental participant information is summarised in Table I.