Criteria for Assessing Therapy Outcome in Speech Pathology and Audiology

1977 ◽  
Vol 20 (1) ◽  
pp. 5-20 ◽  
Author(s):  
Franklin H. Silverman

Speech pathologists and audiologists function as both producers and consumers of information concerning therapy outcome. In both roles they have to know the questions that need to be answered to adequately evaluate a therapy method and the factors that have to be considered when interpreting answers to such questions. An approach (in the form of a work sheet) is described here that can be used for both identifying and systematically evaluating the validity, reliability, and generality of information regarding impacts of therapy methods on persons who have communicative disorders and for identifying additional information needed to complete such an evaluation. The approach is used to assess the impacts of a therapy method.

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S276-S276
Author(s):  
J Doherty ◽  
S Brennan ◽  
K Dinneen ◽  
C Muldoon ◽  
S Mc Kiernan ◽  
...  

Abstract Background Histological inflammation is known to be associated with increased risk of disease relapse in patients with ulcerative colitis (UC). Vedolizumab (VDZ) is a gut selective anti-integrin which inhibits intestinal immune cell-trafficking. Whether the degree of histological activity at the time of VDZ therapy initiation is associated with therapy outcome is not known. We aimed to determine if there is an association between histological activity at the time of VDZ initiation and outcome of therapy. Methods A retrospective review was performed to identify UC patients treated with VDZ who had undergone an endoscopic assessment prior to therapy commencement. Baseline demographic data, information on therapy outcome and Mayo endoscopic sub score (MES) was collected for all patients. Endoscopic biopsies were retrieved and were scored for histological activity using the Geboes Score (GS). For Kaplan Meir analyses of primary endpoint, the cohort was dichotomised around a GS grade of 5. Primary endpoint was VDZ therapy outcome defined as persistence on VDZ therapy over time. Secondary endpoints included association between GS and MES and the association between a combined endoscopic and histological endpoint (MES = 3 & GS grade 5) and VDZ therapy outcome. Results 33 patients were included [median age 44.3 years (range 17.2 -84.3); 36% male gender]. 24%, 43% and 33% of the cohort had proctitis, left-sided colitis and extensive colitis respectively. 67% of subjects had prior anti-TNF exposure. Median time from endoscopy to commencement of VDZ was 9 weeks. Median study follow-up was 68 weeks (range 6.1 – 228.7). 3%, 21%, 42% and 33% had MES of 0, 1, 2 and 3 respectively. GS grade was significantly associated with MES (p = 0.04) (Figure 1). GS grade was not associated with time to discontinuation of VDZ (p=0.64) (Figure 2). Combined endoscopic and histological endpoint was not associated with time to discontinuation of VDZ (p=0.43) (Figure 3). The presence of lamina propria eosinophils was not associated with time to discontinuation of VDZ (p=0.92). Conclusion GS grade is associated significantly with MES which has been demonstrated previously. Neither histological activity alone nor in combination endoscopic activity were associated with outcome of VDZ therapy. Assessment of histological activity does not appear to provide additional information when selecting patients for VDZ therapy.


2020 ◽  
Vol 15 (2) ◽  
pp. 233-244
Author(s):  
Peter Roger ◽  
Chris Code

A setting which presents special challenges for interpreter-mediated communication is the speech pathology clinic, particularly when the encounter involves the assessment of aphasia. Drawing on a corpus of five interpreter-mediated assessments of aphasia in speakers of a range of languages (Cantonese, Greek, Tagalog and Vietnamese), this paper presents the findings of an interactive framing analysis of the corpus, focusing on illustrative extracts from two of the encounters. Analysis reveals that while the interpreters are frequently oriented towards issues of ‘meaning’ or ‘content’, the speech pathologists are generally oriented to issues of ‘form’. This is evident from the fact that the speech pathologists frequently question the interpreters about the ways in which the speaker’s language is abnormal. The interpreters, however, tend to respond to such questions with reference to their impressions of the person’s intended meaning. It is argued that these differences in orientation can be explained by the different professional knowledge schemata of speech pathologists and interpreters and the fundamentally ‘uninterpretable’ nature of many of the speakers’ utterances. This lack of shared understanding makes the interaction inefficient, and frequently results in a situation where the person with aphasia is put ‘on hold’. The paper concludes with a discussion of some practical implications for the conduct of interpretermediated aphasia assessments.


2010 ◽  
Vol 34 (2) ◽  
pp. 227 ◽  
Author(s):  
Emma G. H. McLaughlin ◽  
Barbara J. Adamson ◽  
Michelle A. Lincoln ◽  
Julie F. Pallant ◽  
Cary L. Cooper

Sound, large scale and systematic research into why health professionals want to leave their jobs is needed. This study used psychometrically-sound tools and logistic regression analyses to determine why Australian speech pathologists were intending to leave their jobs or the profession. Based on data from 620 questionnaires, several variables were found to be significantly related to intent to leave. The speech pathologists intending to look for a new job were more likely to be under 34 years of age, and perceive low levels of job security and benefits of the profession. Those intending to leave the profession were more likely to spend greater than half their time at work on administrative duties, have a higher negative affect score, not have children under 18 years of age, and perceive that speech pathology did not offer benefits that met their professional needs. The findings of this study provide the first evidence regarding the reasons for turnover and attrition in the Australian speech pathology workforce, and can inform the development of strategies to retain a skilled and experienced allied health workforce. What is known about the topic?There is a recognised shortage of speech pathologists in Australia, and a growing need for their services. Despite this, there has been no large scale systematic investigation to clarify the reasons why Australian speech pathologists may be leaving their jobs or the profession. What does this paper add?This is the first large scale nationwide investigation into why Australian speech-language pathologists leave their jobs or the profession. Approximately 31% of Australian speech pathologists intended to change jobs and 13% intended to change professions in search of opportunities for promotion, better pay and more rewarding and interesting work. The traditional assumption that speech pathologists have been leaving the profession due to family responsibilities was not supported, as it appeared that speech pathologists without young children were more likely to explore roles outside the profession. What are the implications for practitioners?One way to address the issues raised in this study is for practising speech pathologists to increase their participation in industrial, organisational, educational and professional activities such as negotiating working conditions and lobbying. Student supervision, mentoring and professional supervision are important avenues for developing resilience and such skills that have not traditionally been given priority in the education of health professionals.


2016 ◽  
Vol 41 (4) ◽  
pp. 258-264 ◽  
Author(s):  
Bernice Mathisen ◽  
Susan Bennett ◽  
Christine Lockett ◽  
Katherine Beazley ◽  
Juanita Howlett ◽  
...  

This article reports on qualitative research conducted to evaluate parents’ perspectives of their experiences of Talking Matters Bendigo (TMB), a screening programme initiated between health and educational professionals in regional Victoria to improve access to speech pathologists for parents of preschool-aged children with speech, language and communication concerns. Drop-in clinics are conducted in three Bendigo schools monthly. The programme is a collaborative partnership between the Victorian Department of Education and Training, Maternal and Child Health and ‘Off to an Early Start’ (City of Greater Bendigo), Bendigo Health and the disciplines of Speech Pathology and Education at La Trobe University, Bendigo. La Trobe Education (Honours) student researchers interviewed a group of 10 parents attending TMB using face to face interviews and collected data using an online survey after parents attended a session. Thematic analysis of the data was completed and inter-reliability checks were completed by two external La Trobe PhD students to increase reliability and validity. Results indicated parents were satisfied with the information provided by the speech pathologists and they reported that they intended to utilise this new knowledge at home with their children. This study provides preliminary evidence that novel service delivery options such as TMB can be successful in engaging parents early in health literacy so that speech, language and communication problems in preschool-aged children can be identified, managed and even prevented.


Author(s):  
Lisa Holmes

Introduction: the case for changeThere are increasing mental health issues among young people, including higher education students. Millennial students face unique challenges with attention, critical thinking and managing stress. In addition, allied health students engage in multiple placements where they need to interact with real people in real time whilst being evaluated in assessment and treatment strategies. Some universities have been using wellness programs and mindfulness strategies to support student mental health across campuses for some time. However, as allied health students face unique challenges, there is a need for a particular focus on wellness at an individual allied health course level. The curriculum in allied health courses is determined by accreditation bodies and is comprehensive with little space for additional information. It is possible for short activities to be embedded in tutorials and the authors argue a focus on wellness is vital for the future allied health workforce.Methodology for pilot projectThis project used questionnaires to investigate student perceptions of a short program of activities to promote wellness and mindfulness in third year speech pathology students who were also engaging in clinical placements.Results and discussionStudents were positive about the activities, developed their own wellness plan and learnt new strategies to manage their mental health at university and in their future careers.Future directionsThis short program could easily be adapted in other allied health courses.


1996 ◽  
Vol 2 (1) ◽  
pp. 85
Author(s):  
Louise Bayley ◽  
Melissa Bevan ◽  
Sally Butzkueven ◽  
Jan Mackenzie

The current accreditation system existing in community health � CHASP � is concerned with finding ways of ensuring quality of service within community health centres, but falls short of assessing the quality of specific professional areas. A group of speech pathologists accepted an offer to prepare a demonstration document of Speech Pathology standards that could be incorporated into a Professional Accreditation Module. The standards document was presented to the Victorian Department of Health and Community Services with the aim of securing further funding for the completion of the project. Although, verbal feedback indicated in principle support for the development of Professional Accreditation Modules for all community health disciplines, no provision of resources was made to fully develop the project during the 1995-1996 budget. A description of the process of arriving at the draft set of 26 standards is presented and the outcomes and future directions are discussed.


2013 ◽  
Vol 36 (3) ◽  
pp. 316-334 ◽  
Author(s):  
Claire Salter

Speech pathology assessment within cross-cultural contexts, where the assessor and client differ in their cultural backgrounds, can create many challenges for assessment usage and implementation. With Australia being home to people from many cultures, this isa particular challenge for speech pathologists working in this country. This paper outlines the development of an assessment specifically for Aboriginal children living in a discrete region of the Kimberley in Western Australia. This assessment was developed in collaboration with local language experts as well as speech pathologists experienced in the area of assessment with Indigenous children. Nearly all parts of the assessment were administered by a local co-worker in the children’s first language, Kimberley or Fitzroy Valley Kriol. The paper outlines the specific components of the assessment as well as the approaches taken to ensure fair and accurate assessment of children’s communication skills. It highlights the benefits of collaborating with local co-workers and provides those working with Indigenous children in Australia with practical activities to consider.


2018 ◽  
Vol 42 (4) ◽  
pp. 420 ◽  
Author(s):  
Nicole Byrne

Objective The Internet provides the general public with information about speech pathology services, including client groups and service delivery models, as well as the professionals providing the services. Although this information assists the general public and other professionals to both access and understand speech pathology services, it also potentially provides information about speech pathology as a prospective career, including the types of people who are speech pathologists (i.e. demographics). The aim of the present study was to collect baseline data on how the speech pathology profession was presented via images on the Internet. Methods A pilot prospective observational study using content analysis methodology was conducted to analyse publicly available Internet images related to the speech pathology profession. The terms ‘Speech Pathology’ and ‘speech pathologist’ to represent both the profession and the professional were used, resulting in the identification of 200 images. These images were considered across a range of areas, including who was in the image (e.g. professional, client, significant other), the technology used and the types of intervention. Results The majority of images showed both a client and a professional (i.e. speech pathologist). While the professional was predominantly presented as female, the gender of the client was more evenly distributed. The clients were more likely to be preschool or school aged, however male speech pathologists were presented as providing therapy to selected age groups (i.e. school aged and younger adults). Images were predominantly of individual therapy and the few group images that were presented were all paediatric. Conclusion Current images of speech pathology continue to portray narrow professional demographics and client groups (e.g. paediatrics). Promoting images of wider scope to fully represent the depth and breadth of speech pathology professional practice may assist in attracting a more diverse group of people into the profession in the future. What is known about the topic? To date, research has not considered the promotional profile of allied health professionals on the Internet. There has been a lack of consideration of whether the way in which the professions are promoted may affect clients accessing allied health services or people entering careers. What does this paper add? This paper raises awareness of the lack of promotion of a diverse workforce in speech pathology and considers how this may affect changing the professional demographics in the future. It also provides a starting point for documentation in the form of a baseline for tracking future changes. It allows consideration of the fact that when designing health promotional and educational materials, it is crucial that diversity is displayed in the professional role, the client role and the setting in order to provide information and education to the general public about the health services provided. What are the implications for practitioners? The presentation of narrow demographics of both the professional and client may potentially affect people considering speech pathology as a future career. The appearance of narrow client demographics and diagnosis groups may also deter people from accessing services. For example, if the demonstrated images do not show older people accessing speech pathology services, then this may suggest that services are only for children. The results from the present case example are transferrable to other health professions with similar professional demographic profiles (e.g. occupational therapy). Consideration of the need to display a diverse client profile is relevant to all health and medical services, and demonstrates steps towards inclusiveness and increasing engagement of clients who may be currently less likely to access health services (including people who are Aboriginal or from a culturally and linguistically diverse background).


2019 ◽  
Vol 25 (9) ◽  
pp. 545-551 ◽  
Author(s):  
Clare L Burns ◽  
Elizabeth C Ward ◽  
Amy Gray ◽  
Lisa Baker ◽  
Brooke Cowie ◽  
...  

Introduction Timely assessment of swallowing disorders (dysphagia) by speech pathologists helps minimise patient risk, optimise quality of life, and limit healthcare costs. This study involved a multi-site implementation of a validated model for conducting adult clinical swallowing assessments via telepractice and examined its service outcomes, costs and consumer satisfaction. Methods Five hub-spoke telepractice services, encompassing 18 facilities were established across a public health service. Service implementation support, including training of the telepractice speech pathologists (T-SP) and healthcare support workers in each site, was facilitated by an experienced project officer. New referrals from spoke sites were managed by the hub T-SP as per published protocols for dysphagia assessments via telepractice. Data was collected on existing service models prior to implementation, and then patient demographics, referral information, session outcomes, costs and patient and T-SP satisfaction when using telepractice. Results The first 50 sessions were analysed. Referrals were predominantly for inpatients at spoke sites. Telepractice assessments were completed successfully, with only minor technical issues. Changes to patient management (i.e. food/fluid changes post assessment) to optimise safety or progress oral intake, was required for 64% of patients. Service and cost efficiencies were achieved with an average 2-day reduction in waiting time and an average cost benefit of $218 per session when using the telepractice service over standard care. High clinician and patient satisfaction was reported. Conclusion Telepractice services were successfully introduced across multiple sites, and achieved service and cost benefits with high consumer satisfaction.


1980 ◽  
Vol 6 (4) ◽  
pp. 11-13
Author(s):  
Roberta Pierce

In recent years, there has been a trend toward increased awareness of oral myofunctional disorders by members of the speech pathology profession. We will look briefly at the historical involvement of speech pathologists in the diagnosis and treatment of oral myofunctional disorders.


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