Speech Therapy: Treatment for individuals with speech defects and disorders that involves counseling and use of various exercises and aids to help the development of new speech habits.Speech: Communication through a system of conventional vocal symbols.Speech Disorders: Acquired or developmental conditions marked by an impaired ability to comprehend or generate spoken forms of language.Dysphonia: Difficulty and/or pain in PHONATION or speaking.Speech Perception: The process whereby an utterance is decoded into a representation in terms of linguistic units (sequences of phonetic segments which combine to form lexical and grammatical morphemes).Speech Production Measurement: Measurement of parameters of the speech product such as vocal tone, loudness, pitch, voice quality, articulation, resonance, phonation, phonetic structure and prosody.Velopharyngeal Insufficiency: Failure of the SOFT PALATE to reach the posterior pharyngeal wall to close the opening between the oral and nasal cavities. Incomplete velopharyngeal closure is primarily related to surgeries (ADENOIDECTOMY; CLEFT PALATE) or an incompetent PALATOPHARYNGEAL SPHINCTER. It is characterized by hypernasal speech.Articulation Disorders: Disorders of the quality of speech characterized by the substitution, omission, distortion, and addition of phonemes.Stomatognathic System: The mouth, teeth, jaws, pharynx, and related structures as they relate to mastication, deglutition, and speech.Voice Disorders: Pathological processes that affect voice production, usually involving VOCAL CORDS and the LARYNGEAL MUCOSA. Voice disorders can be caused by organic (anatomical), or functional (emotional or psychological) factors leading to DYSPHONIA; APHONIA; and defects in VOICE QUALITY, loudness, and pitch.Laryngeal Diseases: Pathological processes involving any part of the LARYNX which coordinates many functions such as voice production, breathing, swallowing, and coughing.Speech Intelligibility: Ability to make speech sounds that are recognizable.Speech Acoustics: The acoustic aspects of speech in terms of frequency, intensity, and time.Voice Quality: That component of SPEECH which gives the primary distinction to a given speaker's VOICE when pitch and loudness are excluded. It involves both phonatory and resonatory characteristics. Some of the descriptions of voice quality are harshness, breathiness and nasality.Stuttering: A disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual's age. This disturbance is characterized by frequent repetitions or prolongations of sounds or syllables. Various other types of speech dysfluencies may also be involved including interjections, broken words, audible or silent blocking, circumlocutions, words produced with an excess of physical tension, and monosyllabic whole word repetitions. Stuttering may occur as a developmental condition in childhood or as an acquired disorder which may be associated with BRAIN INFARCTIONS and other BRAIN DISEASES. (From DSM-IV, 1994)Occupational Therapy: Skilled treatment that helps individuals achieve independence in all facets of their lives. It assists in the development of skills needed for independent living.Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia.Oxprenolol: A beta-adrenergic antagonist used in the treatment of hypertension, angina pectoris, arrhythmias, and anxiety.Vocal Cords: A pair of cone-shaped elastic mucous membrane projecting from the laryngeal wall and forming a narrow slit between them. Each contains a thickened free edge (vocal ligament) extending from the THYROID CARTILAGE to the ARYTENOID CARTILAGE, and a VOCAL MUSCLE that shortens or relaxes the vocal cord to control sound production.Audiometry, Speech: Measurement of the ability to hear speech under various conditions of intensity and noise interference using sound-field as well as earphones and bone oscillators.Phonetics: The science or study of speech sounds and their production, transmission, and reception, and their analysis, classification, and transcription. (Random House Unabridged Dictionary, 2d ed)Speech Articulation Tests: Tests of accuracy in pronouncing speech sounds, e.g., Iowa Pressure Articulation Test, Deep Test of Articulation, Templin-Darley Tests of Articulation, Goldman-Fristoe Test of Articulation, Screening Speech Articulation Test, Arizona Articulation Proficiency Scale.Speech Discrimination Tests: Tests of the ability to hear and understand speech as determined by scoring the number of words in a word list repeated correctly.Physical Therapy Modalities: Therapeutic modalities frequently used in PHYSICAL THERAPY SPECIALTY by PHYSICAL THERAPISTS or physiotherapists to promote, maintain, or restore the physical and physiological well-being of an individual.Speech Recognition Software: Software capable of recognizing dictation and transcribing the spoken words into written text.Speech Reception Threshold Test: A test to determine the lowest sound intensity level at which fifty percent or more of the spondaic test words (words of two syllables having equal stress) are repeated correctly.Sound Spectrography: The graphic registration of the frequency and intensity of sounds, such as speech, infant crying, and animal vocalizations.Acoustic Stimulation: Use of sound to elicit a response in the nervous system.Cochlear Implants: Electronic hearing devices typically used for patients with normal outer and middle ear function, but defective inner ear function. In the COCHLEA, the hair cells (HAIR CELLS, VESTIBULAR) may be absent or damaged but there are residual nerve fibers. The device electrically stimulates the COCHLEAR NERVE to create sound sensation.Noise: Any sound which is unwanted or interferes with HEARING other sounds.Speech, Esophageal: A method of speech used after laryngectomy, with sound produced by vibration of the column of air in the esophagus against the contracting cricopharyngeal sphincter. (Dorland, 27th ed)Dysarthria: Disorders of speech articulation caused by imperfect coordination of pharynx, larynx, tongue, or face muscles. This may result from CRANIAL NERVE DISEASES; NEUROMUSCULAR DISEASES; CEREBELLAR DISEASES; BASAL GANGLIA DISEASES; BRAIN STEM diseases; or diseases of the corticobulbar tracts (see PYRAMIDAL TRACTS). The cortical language centers are intact in this condition. (From Adams et al., Principles of Neurology, 6th ed, p489)Language Therapy: Rehabilitation of persons with language disorders or training of children with language development disorders.Rehabilitation: Restoration of human functions to the maximum degree possible in a person or persons suffering from disease or injury.Community Integration: Policies and programs which ensure that DISPLACED PERSONS and chronic illnesses receive the support and SOCIAL SERVICES needed to live in their communities.National Institute on Aging (U.S.): Component of the NATIONAL INSTITUTES OF HEALTH. Through basic and clinical biomedical research and training, it conducts and supports research into the nature of the aging process and diseases associated with the later stages of life. The Institute was established in 1974.Academies and Institutes: Organizations representing specialized fields which are accepted as authoritative; may be non-governmental, university or an independent research organization, e.g., National Academy of Sciences, Brookings Institution, etc.Disabled Persons: Persons with physical or mental disabilities that affect or limit their activities of daily living and that may require special accommodations.Patents as Topic: Exclusive legal rights or privileges applied to inventions, plants, etc.Autistic Disorder: A disorder beginning in childhood. It is marked by the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interest. Manifestations of the disorder vary greatly depending on the developmental level and chronological age of the individual. (DSM-V)Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders.Speech-Language Pathology: The study of speech or language disorders and their diagnosis and correction.Audiology: The study of hearing and hearing impairment.Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive LANGUAGE DISORDERS, cognitive dysfunction (e.g., MENTAL RETARDATION), psychiatric conditions, and HEARING DISORDERS.Education, Graduate: Studies beyond the bachelor's degree at an institution having graduate programs for the purpose of preparing for entrance into a specific field, and obtaining a higher degree.CD-ROM: An optical disk storage system for computers on which data can be read or from which data can be retrieved but not entered or modified. A CD-ROM unit is almost identical to the compact disk playback device for home use.Brain Injuries: Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.ScotlandIndianaCycloparaffins: Alicyclic hydrocarbons in which three or more of the carbon atoms in each molecule are united in a ring structure and each of the ring carbon atoms is joined to two hydrogen atoms or alkyl groups. The simplest members are cyclopropane (C3H6), cyclobutane (C4H8), cyclohexane (C6H12), and derivatives of these such as methylcyclohexane (C6H11CH3). (From Sax, et al., Hawley's Condensed Chemical Dictionary, 11th ed)Language Development Disorders: Conditions characterized by language abilities (comprehension and expression of speech and writing) that are below the expected level for a given age, generally in the absence of an intellectual impairment. These conditions may be associated with DEAFNESS; BRAIN DISEASES; MENTAL DISORDERS; or environmental factors.Motor Skills Disorders: Marked impairments in the development of motor coordination such that the impairment interferes with activities of daily living. (From DSM-V)Linguistics: The science of language, including phonetics, phonology, morphology, syntax, semantics, pragmatics, and historical linguistics. (Random House Unabridged Dictionary, 2d ed)

Audit in the therapy professions: some constraints on progress. (1/196)

AIMS: To ascertain views about constraints on the progress of audit experienced by members of four of the therapy professions: physiotherapy, occupational therapy, speech and language therapy, and clinical psychology. METHODS: Interviews in six health service sites with a history of audit in these professions. 62 interviews were held with members of the four professions and 60 with other personnel with relevant involvement. Five main themes emerged as the constraints on progress: resources; expertise; relations between groups; organisational structures; and overall planning of audit activities. RESULTS: Concerns about resources focused on lack of time, insufficient finance, and lack of access to appropriate systems of information technology. Insufficient expertise was identified as a major constraint on progress. Guidance on designing instruments for collection of data was the main concern, but help with writing proposals, specifying and keeping to objectives, analysing data, and writing reports was also required. Although sources of guidance were sometimes available, more commonly this was not the case. Several aspects of relations between groups were reported as constraining the progress of audit. These included support and commitment, choice of audit topics, conflicts between staff, willingness to participate and change practice, and concerns about confidentiality. Organisational structures which constrained audit included weak links between heads of professional services and managers of provider units, the inhibiting effect of change, the weakening of professional coherence when therapists were split across directorates, and the ethos of regarding audit findings as business secrets. Lack of an overall plan for audit meant that while some resources were available, others equally necessary for successful completion of projects were not. CONCLUSION: Members of four of the therapy professions identified a wide range of constraints on the progress of audit. If their commitment to audit is to be maintained these constraints require resolution. It is suggested that such expert advice, but also that these are directed towards the particular needs of the four professions. Moreover, a forum is required within which all those with a stake in therapy audit can acknowledge and resolve the different agendas which they may have in the enterprise.  (+info)

Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an inner-London teaching hospital. (2/196)

BACKGROUND AND PURPOSE: In an inner-London teaching hospital, a randomized trial of "conventional" care versus early discharge to community-based therapy found no significant differences in clinical outcomes between patient groups. This report examines the economic consequences of the alternative strategies. METHODS: One hundred sixty-seven patients received the early discharge package, and 164 received conventional care. Patient utilization of health and social services was recorded over a 12-month period, and cost was determined using data from provider departments and other published sources. RESULTS: Inpatient stay after randomization was 12 days (intervention group) versus 18 days (controls) (P=0.0001). Average units of therapy per patient were as follows: physiotherapy, 22.4 (early discharge) versus 15.0 (conventional) (P=0.0006); occupational therapy, 29.0 versus 23.8 (P=0.002); speech therapy, 13. 7 versus 5.8 (P=0.0001). The early discharge group had more annual hospital physician contacts (P=0.015) and general practitioner clinic visits (P=0.019) but fewer incidences of day hospital attendance (P=0.04). Other differences in utilization were nonsignificant. Average annual costs per patient were pound sterling 6800 (early discharge) and pound sterling 7432 (conventional). The early discharge group had lower inpatient costs per patient (pound sterling 4862 [71% of total cost] versus pound sterling 6343 [85%] for controls) but higher non-inpatient costs (pound sterling 1938 [29%] versus pound sterling 1089 [15%]). Further analysis demonstrated that early discharge is unlikely to lead to financial savings; its main benefit is to release capacity for an expansion in stroke caseload. CONCLUSIONS: Overall results of this trial indicate that early discharge to community rehabilitation for stroke is cost-effective. It may provide a means of addressing the predicted increase in need for stroke care within existing hospital capacity.  (+info)

Improving outcomes for persons with aphasia in advanced community-based treatment programs. (3/196)

BACKGROUND AND PURPOSE: Studies have yet to document that community-based aphasia treatment programs routinely produce results comparable or superior to published research protocols. We explore this issue here in an outcome study of individuals with aphasia enrolled in 2 community-based, comparably managed and equipped therapy programs, which use a specially designed computer-based tool that is employed therapeutically in adherence to an extensive, detailed, and formally trained patient care algorithm. METHODS: Patients (n=60) were assessed before and after treatment with standardized instruments at both the impairment and the disability levels. Pretreatment and posttreatment means were calculated and compared, with statistical significance of differences established with the use of 1-tailed matched t tests. One-way ANOVAs were used to analyze the comparability of patient performance changes among various subgroups, eg, patients in acute versus chronic stages of aphasia, patients by aphasia diagnostic type at start of care, patients by severity level at start of care, and patients by treatment location. RESULTS: Analysis shows that patients spanned a wide range of aphasia diagnostic types, impairment severity levels at start of care, and times after onset. Patients' mean performance scores improved significantly in response to treatment in all measures assessed at both the impairment level and the functional communication level. Mean overall improvements ranged from 6.6% to 19.8%, with statistical significance ranging from P=0.0006 to P<0.0001. ANOVAs revealed no significant differences between improvements in patients in the acute versus chronic stages of aphasia, between those at different impairment severity levels at start of care, between those treated at different locations, or, at the functional level, between those with different diagnostic types of aphasia at start of care. CONCLUSIONS: Measures of both language impairment and functional communication can be broadly, positively, and significantly influenced by therapy services that are delivered to persons with aphasia in these community-based programs. The significant improvements are shown to be available to individuals with chronic as well as acute aphasia and independent of diagnostic type of aphasia, impairment severity at start of care, or geographic program location.  (+info)

Paradoxical vocal cord motion causing stridor after thyroidectomy. (4/196)

Two women developed stridor immediately after thyroidectomy as a result of paradoxical vocal cord motion. In both cases the cord function showed a normal pattern during vocalisation but paradoxical movement was seen at laryngoscopy during tidal breathing. The abnormality improved in both patients over time with speech therapy. Whilst the syndrome of paradoxical vocal cord motion is classically thought to have a largely psychological aetiology, subtle interference with laryngeal innervation at surgery is more likely to have been the cause in these cases.  (+info)

Piracetam improves activated blood flow and facilitates rehabilitation of poststroke aphasic patients. (5/196)

BACKGROUND AND PURPOSE: In a prospective, double-blind, placebo-controlled study, it was investigated whether piracetam improves language recovery in poststroke aphasia assessed by neuropsychological tests and activation PET measurement of cerebral blood flow. METHODS: Twenty-four stroke patients with aphasia were randomly allocated to 2 groups: 12 patients received 2400 mg piracetam twice daily, 12 placebo. Before and at the end of the 6-week treatment period in which both groups received intensive speech therapy, the patients were examined neuropsychologically and studied with H(2)(15)O PET at rest and during activation with a word-repetition task. Blood flow was analyzed in 14 language-activated brain regions defined on reconstructed surface views from MRI coregistered to the PET images. RESULTS: Before treatment, both groups were comparable with respect to performance in language tasks and to type and severity of aphasia. In the piracetam group, increase of activation effect was significantly higher (P:<0.05) in the left transverse temporal gyrus, left triangular part of inferior frontal gyrus, and left posterior superior temporal gyrus after the treatment period compared with the initial measures. The placebo group showed an increase of activation effect only in the left vocalization area. In the test battery, the piracetam group improved in 6 language functions, the placebo group only in 3 subtests. CONCLUSIONS: Piracetam as an adjuvant to speech therapy improves recovery of various language functions, and this effect is accompanied by a significant increase of task-related flow activation in eloquent areas of the left hemisphere.  (+info)

Randomised controlled trial of community based speech and language therapy in preschool children. (6/196)

OBJECTIVE: To compare routine speech and language therapy in preschool children with delayed speech and language against 12 months of "watchful waiting." DESIGN: Pragmatic randomised controlled trial. SETTING: 16 community clinics in Bristol. PARTICIPANTS: 159 preschool children with appreciable speech or language difficulties who fulfilled criteria for admission to speech and language therapy. MAIN OUTCOME MEASURES: Four quantitative measures of speech and language, assessed at 6 and 12 months; a binary variable indicating improvement, by 12 months, on the trial entry criterion. RESULTS: Improvement in auditory comprehension was significant in favour of therapy (adjusted difference in means 4.1, 95% confidence interval 0.5 to 7.6; P=0.025). No significant differences were observed for expressive language (1.4, -2.1 to 4.8; P=0.44); phonology error rate (-4.4, -12.0 to 3.3; P=0.26); language development (0.1, -0.4 to 0.6; P=0.73); or improvement on entry criterion (odds ratio 1.3, 0.67 to 2.4; P=0.46). At the end of the trial, 70% of all children still had substantial speech and language deficits. CONCLUSIONS: This study provides little evidence for the effectiveness of speech and language therapy compared with watchful waiting over 12 months. Providers of speech and language therapy should reconsider the appropriateness, timing, nature, and intensity of such therapy in preschool children. Continued research into more specific provision to subgroups of children is also needed to identify better treatment methods. The lack of resolution of difficulties for most of the children suggests that further research is needed to identify effective ways of helping this population of children.  (+info)

Reinforcement schedule thinning following treatment with functional communication training. (7/196)

We evaluated four methods for increasing the practicality of functional communication training (FCT) by decreasing the frequency of reinforcement for alternative behavior. Three participants whose problem behaviors were maintained by positive reinforcement were treated successfully with FCT in which reinforcement for alternative behavior was initially delivered on fixed-ratio (FR) 1 schedules. One participant was then exposed to increasing delays to reinforcement under FR 1, a graduated fixed-interval (FI) schedule, and a graduated multiple-schedule arrangement in which signaled periods of reinforcement and extinction were alternated. Results showed that (a) increasing delays resulted in extinction of the alternative behavior, (b) the FI schedule produced undesirably high rates of the alternative behavior, and (c) the multiple schedule resulted in moderate and stable levels of the alternative behavior as the duration of the extinction component was increased. The other 2 participants were exposed to graduated mixed-schedule (unsignaled alternation between reinforcement and extinction components) and multiple-schedule (signaled alternation between reinforcement and extinction components) arrangements in which the durations of the reinforcement and extinction components were modified. Results obtained for these 2 participants indicated that the use of discriminative stimuli in the multiple schedule facilitated reinforcement schedule thinning. Upon completion of treatment, problem behavior remained low (or at zero), whereas alternative behavior was maintained as well as differentiated during a multiple-schedule arrangement consisting of a 4-min extinction period followed by a 1-min reinforcement period.  (+info)

Constraint-induced therapy of chronic aphasia after stroke. (8/196)

Patients with chronic aphasia were assigned randomly to a group to receive either conventional aphasia therapy or constraint-induced (CI) aphasia therapy, a new therapeutic technique requiring intense practice over a relatively short period of consecutive days. CI aphasia therapy is realized in a communicative therapeutic environment constraining patients to practice systematically speech acts with which they have difficulty. Patients in both groups received the same amount of treatment (30 to 35 hours) as 10 days of massed-practice language exercises for the CI aphasia therapy group (3 hours per day minimum; 10 patients) or over a longer period of approximately 4 weeks for the conventional therapy group (7 patients). CI aphasia therapy led to significant and pronounced improvements on several standard clinical tests, on self-ratings, and on blinded-observer ratings of the patients' communicative effectiveness in everyday life. Patients who received the control intervention failed to achieve comparable improvements. Data suggest that the language skills of patients with chronic aphasia can be improved in a short period by use of an appropriate massed-practice technique that focuses on the patients' communicative needs.  (+info)

  • Clear speech Therapy and Hearing Aid centre is a speech Therapy and hearing aid dispensing clinic at santhosh nagar, I.s sadan x roads on the way to chandrayangutta road, Hyderabad. (practo.com)
  • I know this person is a relative so it might be okay to be loosey-goosey about particulars, but should he/she have to stop providing treatment and you want to find another SLP to provide therapy via Skype, you should at least know the guidelines! (metafilter.com)
  • Speech therapy is applicable as the treatment method of a wide range of diseases such as dyslexia and reading disability. (dysphasia.us)
  • Evaluations and therapy sessions differ depending on your needs so please contact us for a personalized evaluation and treatment plan. (speechtherapyworks.ca)
  • Now of course I'm scared that I've progressed so far that the insurance company will not deem this necessary, even though my neurologist, who prescribed this treatment, said I'd be treading new ground with my speech therapy, a treatment traditionally for the severely disabled. (wordpress.com)
  • V.O.I.C.E. Therapy establishing home programs to utilize during everyday life.as well as in therapy, to ensure proper vocal hygiene to reduce vocal fold abuse which may cause rough, breathy, or raspy voice tones of voice. (prsmichigan.com)
  • DAC will also "encourage speech therapy as part of the [university] curriculum and encourage the ministries of health, education and social affairs to improve conditions for people with speech problems. (cambodiadaily.com)
  • The four problems are that there is no [government] policy on the topic of speech therapy, no community awareness of their needs, no identification or referral for people who need the services and no in-country place for teaching local speech therapists," Mr. Yeoh said. (cambodiadaily.com)
  • That means that people who may stutter or lisp or who have developmental delays don't receive speech therapy, for example, said Anthony Manzanetti, chief of enforcement for the state agency. (calhospital.org)
  • Even though school is out for summer, I know there are many of us who do private speech therapy or do summer school (extended school year speech therapy) and it is so much fun to get to incorporate the 4th of July holiday into our speech therapy sessions! (heatherspeechtherapy.com)
  • Speech therapy can be done at our clinic or often times in home and can be very effective if sessions are held on a regular schedule. (speechtherapyworks.ca)