A pilot study verifying the effectiveness of high-frequency repetitive transcranial magnetic stimulation in combination with intensive speech-language-hearing therapy in patients with chronic aphasia

BACKGROUND: A lot of research on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with aphasia in the chronic stage deals with low-frequency stimulation, and reports on high-frequency stimulation (HF-rTMS) are scarce. OBJECTIVE: The purpose of this study was to evaluate retrospectively the effectiveness of high-frequency rTMS in combination with intensive speech-language-hearing therapy (ST) following the identification of the stimulation site using functional magnetic resonance imaging (fMRI) before, after the procedure and at 3 months in patients with aphasia in the chronic stage. METHODS: 20 patients with aphasia in the chronic stage who met the eligibility criteria for rTMS therapy and who underwent HF-rTMS for the first time were included in the present study. All patients received fMRI before hospitalization, and the stimulation site was decided accordingly. RESULTS: There was a significant improvement in all patients, rTMS to the left hemisphere, fluent and non-fluent groups by the evaluation of pre- and post- treatment by hospitalization. All groups had a significant improvement in total Standard Language Test of Aphasia score at 3 months when compared with the time of hospitalization. CONCLUSIONS: The current study indicates that HF-rTMS in combination with intensive ST is an effective therapeutic approach for patients with aphasia in the chronic stage.

Developing the educational guidelines and model core curriculum for speech-language-hearing therapists in Japan

Children with autism and language developmental delays have unique needs when it comes to language learning. Speech-language-hearing therapists (SLHTs) are qualified to fulfil these needs, as one of the areas of their expertise, providing necessary treatment and support. Unfortunately, however, the existing number of SLHTs is not sufficient to meet the growing demand for these types of professionals in Japan. A reason for this is likely to be the low pass rate for qualifying therapists. As such, if researchers can find a way to increase this pass rate, the number of qualified SLHTs would increase and demand would be met. This is the goal of Professor Chizuko Uchiyama and her team based at the Department of Speech, Language and Hearing Therapy, Mejiro University, Japan, and Japanese Association of Speech-Language-Hearing Therapists. Chizuko, who is herself a trained SLHT, created a model core curriculum (MCC) that was completed in 2018 and complies with specific training rules and guidelines for SLHTs and also takes into account the educational content that is anticipated to be needed in the future. The goals of this work are to improve the training education provided to SLHTs, thereby increasing the national examination pass-rate for qualified therapists of this kind and producing high-quality SLHTs. This will ultimately ensure there is an adequate number of qualified SLHTs to fulfill growing demand and lead to a higher standard of education and care for children with autism and language development delays. The larger impact of this will be enhanced societal welfare and benefits for people with communication and hearing problems.

Photobiomodulation in speech-language-hearing therapy: a profile of professional practice and the level of information of Brazilian speech-language-hearing therapists

ABSTRACT Purpose: to know the profile of Brazilian speech-language-hearing (SLH) therapists and their level of information on the use of low-level laser photobiomodulation. Methods: an observational, cross-sectional, quantitative study conducted with a self-administered online questionnaire related to the professional education, work, and knowledge of SLH therapists on low-level laser photobiomodulation. Two hundred sixty-one speech-language-hearing therapists of both sexes participated in the research. The data were analyzed with descriptive and inferential statistics. Results: the speech-language-hearing therapists had graduated predominantly 10 to 20 years before, their highest degree was mainly specialization, and most of them worked in the fields of oral-motor functions, dysphagia, voice, language, and audiology. Most of them knew photobiomodulation and its use in SLH therapists; also, they agreed on using a low-level laser as a therapeutic resource. Even so, most did not use it in clinical practice, although those who did, reported greater patient adherence. Statistical significance was verified for the association between laser use and access to resolution number 541 of the Federal Speech-Language-Hearing Council, time in the profession, main specialization, and required qualification. Conclusion: the participating speech-language-hearing therapists showed knowledge on low-level laser photobiomodulation and its applicability. However, most of these professionals did not use the resource yet.

Therapeutic effects of photobiomodulation in the speech-language-hearing clinic: an integrative literature review

ABSTRACT Purpose: to conduct a literature review on the therapeutic effects of photobiomodulation applicable to speech-language-hearing therapy. Methods: the databases searched were the Cochrane Library, Virtual Health Library, Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, and Web of Science/ISI.The selected articles were original ones whose abstracts were available and that evaluated the therapeutic effect of photobiomodulation in situations related to speech-language-hearing practice. Results: the sample comprised 23 articles, most of them being indexed in PubMed. The fields of health with the largest number of publications were Physical Therapy and Medicine. The sample size ranged from1 to 99 people, aged 15 to 77 years, and the most applied wavelength was the infrared one. Most of the studies had positive photobiomodulation application results - although in a few publications the effects of this treatment modality were assessed in a combination with rehabilitation exercises. Conclusion: photobiomodulation benefits different disorders treated by speech-language-hearing therapists, however, there is a broad methodological diversity, lacking specific protocols for the ideal dosimetry for each disorder.

Treatment indicators influence speech therapy discharge time

ABSTRACT Purpose To compare the treatment time for acquired neurological disorders of communication and the reason for discharge of users of a medium complexity care service for two periods: before and after implementation of treatment indicators. Methods A retrospective cohort study was carried out involving the analysis of medical records of users of the Adult Language Sector of the Speech and Hearing Therapy Service of the Integrated Rehabilitation Center, seen before and after treatment indicators implementation. Results 129 electronic medical records of users who remained under treatment until discharge from speech therapy in the two studied periods were analyzed. The mean duration of speech therapy for these users was 10.9 months for the first period and 7.8 months for the second period. After implementation of the indicators with regular reassessments, 72 out of the 89 users continued with treatment. There was a statistically significant difference in the therapy average time and reason for discharge before and after treatment indicators implementation. Conclusion After treatment indicators implementation, there was a reduction of the average speech therapy treatment time for communication disorders and an increase of speech therapy discharge percentage of users seen in a Brazilian service of medium complexity.

Validity and reliability of the questionnaire that measures the perception of speech-language-hearing therapists regarding the use of information and communication technologies (ICTs) in speech-language-hearing evaluation and intervention processes

ABSTRACT Purpose: to study the validity and reliability of the questionnaire that measures the perception of speech-language-hearing therapists, regarding the use of information and communication technologies (ICTs) in evaluation and intervention processes. Methods: a descriptive, cross-sectional, observational, nonexperimental study. A total of 123 professionals from the Region of Valparaíso, Chile, with degrees in speech-language-hearing therapy, participated in the study. They answered the questionnaire that measures their opinion and knowledge on the use of ICTs. Results: the questionnaire had an adequate level of stability, as the Cronbach's α and Guttman's λ6 coefficient values were respectively 0.85 and 0.95. When studying each item, adequate levels of stability were obtained. On the other hand, the corrected homogeneity index (CHI) yielded values lower than 0.2 for items A8, A9, A17, A18, A26, A27, A42, A43, and A46, which suggests not considering them due to a lack of correlation between these items and the overall questionnaire score. Regarding content validity, assessed with the Question Appraisal System, 100% of the questions presented no major semantic problems. Conclusion: the results of the study indicate that the ICT questionnaire is valid and reliable.

Self-perception of voice in transgender people

ABSTRACT Purpose: to describe the transgender people’s self-perception of voice. Methods: a total of 60 people participated in this cross-sectional study. They attended a reference outpatient center for the health of lesbians, gays, bisexuals, and transgender people. The data collection consisted of self-administered questionnaires, a participant’s profile questionnaire, and a voice self-assessment questionnaire. Results: most of the interviewees were young people who had never visited a speech-language-hearing therapist with the Public Health System (Sistema Único de Saúde); in general, they expressed interest in having such attention. The answers revealed an impact in the axes assessed, namely: “use of the voice in social life”, “mischaracterization of gender, due to the voice”, and “indication of dysphonia". Voice symptom characteristic of dysphonia was also identified in some people. Conclusion: transgender people are unsatisfied with their voices, which is an element that hinders the perception of the identified gender. It also has repercussions in their social, emotional, labor, and interpersonal lives. Hence, it is important to include speech-language-hearing therapy in the transgendering process, which is desired by most of the transgender people.

Remote speech-language-hearing follow-up: monitoring cochlear implant users in the immediate postoperative period

ABSTRACT Purpose: to verify whether the complementary remote speech-language-hearing follow-up is an effective tool in the monitoring of cochlear implant users in the immediate postoperative period. Methods: a total of 26 relatives participated in the study, divided into two groups: with and without remote speech-language-hearing follow-up. By the time the device was activated, they were given instructions on four subjects: the device, family, school, and speech-language-hearing therapy. After one week, the group with remote speech-language-hearing follow-up started receiving such care via mobile phone. In the in-person follow-up visit, a questionnaire was administered (containing questions on the guidance given), as well as an interview with the parents/guardians that received the remote follow-up. The data obtained from the questionnaire were analyzed with Fisher’s exact test, with 5% significance. The qualitative data were analyzed based on Bardin’s theme content analysis technique. Results: there was a significant difference in the quantitative results between the groups regarding “device” and “school”. In the qualitative data, it was verified that the remote speech-language-hearing follow-up furnished greater assurance to the relatives of the cochlear implant users, helping them in the therapeutic process and at school. Conclusion: the complementary remote speech-language-hearing follow-up proved to be an effective tool in the subjects researched, especially regarding the handling of the device and guidance to school.

Speech-language-hearing therapy and clinical listening in a mental health team: perception of parents of children with autism spectrum disorder

ABSTRACT Purpose: to analyze the effects of clinical listening in the discourse of parents of children with autism about the speech-language-hearing work in the team of a Children and Youth Psychosocial Attention Center (Centro de Atenção Psicossocial Infanto-Juvenil). Methods: a descriptive case study research with nine parents of children with autism. Results: the parents recognize, in the therapeutic experience with the speech-language-hearing therapist, changes in the quality of communication and relationship with their children, becoming more linguistically open and interesting figures to their children, because they understand the communication dynamics and feel ready to develop it. The parents incorporated the idea that it is through a shared playing that their children develop both subjectively and cognitively. They realize that the change and interaction with and between their children, as proposed by the speech-language-hearing therapy, generate care and enlarge the social repertoire of communication. Conclusion: speech-language-hearing therapy was considered as belonging and fundamental to the field of mental health in the work with children with autism, which reinforces the listening offered to the parents by the team.