Rehabilitation of the afasic patient in speech therapy

Aphasias are considered to be neurological linguistic disorders in which the comprehension and/or expression of oral and/or written language is compromised, thus having a significant potential impact on the quality of life of an individual and his / her family. Although much studied in its neurophysiological mechanism, aphasia is not always discussed in terms of rehabilitation. Therefore, this article aims to discuss the scientific production in speech therapy on the rehabilitation of aphasia. For this purpose, an Integrative Review of Literature was carried out, covering the period from 2000 to 2021 on the Scielo and BVS data platforms of articles available in full and in the Portuguese language, using as a descriptor the unitermo "aphasia", in which the articles found were submitted to the relevance tests I and II, in which the final sample made only those that passed the established criteria. A total of 236 articles were found on the Scielo platform, with only 29 discussing rehabilitation and only 5 on speech therapy. In the BVS platform, 98.901 articles were found, but only 86 were discussing deaf aphasia and were available, none of which addressed speech therapy rehabilitation. The electronic search reached a total of 5 relevant articles that included the theme of speech and hearing rehabilitation to the aphasic patient, all of them being from the Scielo platform. Thus, scientific scarcity on the subject of aphasia becomes evident, and it is necessary to invest in production that encapsulate the therapeutic behavior of the speech-language pathologist. As afasias são consideradas distúrbios linguísticos de cunho neurológico em que a compreensão e/ou expressão da linguagem oral e/ou escrita encontra-se comprometida, tendo desta maneira um potencial significativo de impacto na qualidade de vida de um indivíduo e sua família. Embora muito estudada em seu mecanismo neurofisiológico, as afasias nem sempre são discutidas sob o aspecto de reabilitação. Diante disso, este artigo objetiva discutir sobre a produção cientifica em fonoaudiologia sobre a reabilitação da afasia. Para tanto, foi realizada uma Revisão Integrativa da Literatura, contemplando o período de 2000 a 2021 nas plataformas de dados Scielo e BVS de artigos disponíveis na íntegra e no idioma em português, utilizando como descritor o unitermo “afasia”, em que os artigos encontrados foram submetidos aos testes de relevância I e II, em que fizeram a amostra final apenas aqueles que passaram pelos critérios estabelecidos. Foram encontrados na plataforma Scielo o total de 236 artigos, sendo que apenas 29 discutiam sobre reabilitação e apenas 5 sobre terapia fonoaudiológica. Na plataforma BVS foram encontrados 98.901 artigos, porém apenas 86 discutiam sobre afasia de fato e estavam disponíveis, sendo que nenhum abordava a reabilitação fonoaudiológica. A busca eletrônica alcançou o total de 5 artigos relevantes que contemplassem a temática de reabilitação fonoaudiológica ao paciente afásico, sendo todos da plataforma Scielo. Assim, torna-se evidente a escassez científica sobre o tema de afasia, sendo necessário investimentos para produção que embase a conduta terapêutica do profissional fonoaudiólogo.

The value of audio description for the therapy of speech-communicative disorders

The article aims at presenting the potential of audio description (AD) as an efficient tool to support the speech-language and social-communicative skills of children with developmental disorders. It includes information for both speech therapists and parents on what they may expect from AD, and how they can use it in their everyday work with children. It may also serve as a set of guidelines for AD creators for making their products more effective. The considerations assembled in the article are based on a literature review. Remarks on the possible uses of AD are presented in the context of various problems to be remedied during speech therapy of a child; they range from incorrect articulation of sounds, through hearing problems such as auditory processing disorder, to developmental disabilities, such as autism spectrum disorder (ASD) characterized by difficulties with social interaction and repetitive behaviors including pretending play. The existing evidence proves that audiovisual (AV) materials are an attractive starting point for exercises with a child. Video-modeling, in turn, has proven to be one of the best tools for therapy of individuals with ASD, allowing for better understanding of interpersonal interactions. Therefore, AV materials accompanied with an AD track – which itself is perceived as a tool for enhancing information processing by children – need to demonstrate similar value for mastering communicative competences. AD can be an effective tool in speech therapy. However, to meet the needs of practitioners, caregivers and beneficiaries in a useful manner, it must be prepared with care regarding both its content and form.

Intervención logopédica posoperatoria del frenillo lingual en niños, adolescentes y adultos. Revisión integradora de literatura

En los últimos años ha existido un aumento significativo en el diagnóstico de la anquiloglosia, las cirugías del frenillo lingual y las publicaciones científicas. Al respecto, es necesario que los profesionales de la salud conozcan el tratamiento fonoaudiológico en estos casos. El objetivo del estudio fue describir la terapia fonoaudiológica implementada en niños, adolescentes y adultos luego de la frenotomía, frenectomía o frenuloplastia lingual, mediante una revisión integradora de literatura. Para esto, durante el segundo trimestre del 2020 las bases de datos electrónicas PUBMED, LILACS, SciELO y Cochrane, fueron consultadas utilizando las palabras claves en inglés: “Ankyloglossia”, “Tongue Tie”, “Lingual Frenulum”, “Lingual Frenum”, “Surgical Procedures”, “Frenuloplasty”, “Lingual Frenulectomy”, “Speech Therapy” y “Myofunctional Therapy”. Se seleccionaron artículos originales relacionados al tema, y fue creado un protocolo específico para la extracción de los datos. Fueron encontrados 798 artículos. 39 se incluyeron luego de la lectura de los títulos y la eliminación de duplicados, 13 luego de lectura de los resúmenes y 7 luego de la revisión de los textos completos. Finalmente, tras un análisis de referencias cruzadas 10 estudios fueron incluidos en esta revisión. Se concluye la importancia del tratamiento fonoaudiológico en el abordaje multidisciplinario del frenillo lingual, abordando aspectos de movilidad lingual, habla y otras funciones orofaciales alteradas luego del procedimiento quirúrgico.

Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study

Objective: To describe Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method use for complementary feeding. Methods: Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method. Results: Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents. Conclusions: The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.

Mothers as Advocates of Social Inclusion for Children With Communication Disorders

Social inclusion is based on acceptance and belonging irrespective of any status, disability, or disadvantage. The ability to communicate empowers humans in their quest for social inclusion. However, children challenged by communication disorders struggle to form friendships and make inroads into social groups. Mothers, the primary caregivers in most instances, with their intimate knowledge of their children, are considered the best advocates. This study set out to identify strategies that mothers engage in to pave the way for successful social inclusion of children with communication disorders. An online survey was conducted in different geographical locations. Mothers with children aged 6-13 years who had received speech therapy or are currently receiving speech therapy were invited to participate. Data were analyzed using a mixed methods approach. Outcomes suggest that all mothers believe in social inclusion despite facing a range of inclusion and exclusionary practices. Undeterred by these responses, mothers advocate for social inclusion by engaging in a range of strategies.

MANAGEMENT DYSPHAGIA IN POST-STROKE PATIENTS RECOMMENDATIONS FOR INDONESIAN NURSING INTERVENTION STANDARDS: A LITERATURE REVIEW

Background: Dysphagia often occurs in post-stroke patients, causing aspiration that can result in disability or death. Nurses have an essential role to play in preventing these complications as they 24/7 care for patients. However, there is no written standard of nursing care regarding specific interventions of post-stroke dysphagia in reality. Objective: The purpose of this article is to conduct a literature review of interventions that can be made in patients with post-stroke dysphagia so that it can be a recommendation for Indonesian nursing standards. Design: Electronic literature searches PubMed, EBSCO (Medline), ProQuest, and ScienceDirect databases from January 2011 to October 2020. There was sixteen studies reviewed included in this systematic study were experimental, randomized controlled trials, or systematic reviews (which are also experimental designs, randomized controlled trials). The study focused on non-invasive interventions performed on post-stroke dysphagia patients. Results: Interventions in dysphagia found, namely: The use of food thickeners against the risk of aspiration resulted in the patient's swallowing ability significantly increased by 71.9% (p <0.01); Chin down intervention combined with thickening fluid provides a solution to improve the nutritional needs of patients dysphagia post-stroke; Tongue training interventions, swallowing training and speech therapy; Tongue stretching exercises that have a positive effect on tongue motility and oromotor function in post-stroke dysphagia patients; Intervention of Tongue resistance training that increases the strength of the tongue and reduces fluid residue in the vallecular; and early screening of dysphagia by nurses using formal guidelines to manage dysphagia patients thereby reducing chest infections and mortality. Conclusion: Nurses should not diagnose dysphagia, but can identify post-stroke dysphagia to determine the interventions necessary for nutrition management, hydration, and aspiration prevention. Interventions include early dysphagia screening within 24 hours after stroke, thickening nutrition according to nutritionist recommendations, laryngeal elevation exercises, peripheral stimulation, posture regulation, and education on eating and drinking.

Designing a Master's program in speech therapy education in the context of interaction with stakeholders

Introduction. The relevance of the study is due to the need to match the requirements of stakeholders to the level of preparedness of a graduate of a master's degree. The purpose of the research. The research is aimed at the development and scientific substantiation of the master's degree program in the field of speech therapy support for persons with communication disorders of various categories in terms of interaction with stakeholders. Methodology and research methods. The Master's program is based on the principles and provisions of practice-oriented and competence-based approaches that ensure the formation of students ' professional competencies and practical skills in solving real professional problems, both in practical classes and during industrial practice on the basis of stakeholders. The research used methods of design, content analysis, questionnaires, mathematical statistics (descriptive statistics, factor analysis). The results. The mechanism of designing the master's degree program is based on the inclusion of stakeholders in the process of forming professional competencies of graduates, the development of its structure, content and areas of implementation (educational process, scientific work, practice, final qualification work, career guidance). The conducted research with the participation of stakeholders (56 people: speech therapists, speech pathologists, psychologists, rehabilitologists, managers) allowed us to determine the four-factor structure of knowledge, skills and labor actions (professional competencies) necessary for a speech therapist when working with people with communication disorders of various categories: ability to plan and implement the content of correctional and developmental classes (percentage of dispersion – 29.4); the ability to design an adapted basic general education program and a special individual development program (percentage of dispersion – 24.5); the ability to implement speech therapy support in the rehabilitation work system (percentage of dispersion – 18.9); the ability to plan and conduct applied scientific research in education, including the diagnosis of persons with communication disorders of various categories (percentage of dispersion – 7.8). Practical significance. The results obtained can be used by the heads of universities focused on the development of interaction with stakeholders, can help to encourage the introduction of practices and strategies that take into account the influence of stakeholders in the development of management decisions and the organization of effective training of teachers in the master's program. They may be of interest to speech therapists-practitioners, scientific supervisors of master's programs.

Crossed Aphasia after Intracranial Hematoma in the Right Temporoparietal Lobe: A Case Report

Purpose: Aphasia in a dextral after right hemisphere injury is called crossed aphasia (CA). We are reporting a first case of transformation of motor aphasia to conduction aphasia after right hemisphere intracerebral hemorrhage (ICH) associated with arteriovenous malformation (AVM) with literature reviews.Methods: A case of a man in his 30s with CA following right hemisphere ICH in the temporal-parietal lobe associated with AVM was reviewed. We analyzed his brain images, initial linguistic characteristics, and changes in aphasia for 8 weeks of follow-up.Results: The initial Paradise Korean Western Aphasia Battery Revised (PK-WAB-R) was evaluated as aphasia quotient (AQ) 72, 64%ile; post evaluation was evaluated AQ 95, 98.9%ile after 8 weeks. The post-test repetition score was the patient score range, which can be attributed to impairment in phonological short-term memory. The patient is diagnosed anomalous CA based on Alexander et al., and we could predict that the language ability originates from both hemispheres based on Nagaraja et al. Considering the appearance of Gerstmann syndrome at the beginning of the onset, we could expect that the function of the dominant parietal lobe is partially crossed as well.Conclusion: Changes in aphasia were reported throughout the initial stage to the end of speech therapy. It is also important to note that literature review of Korean studies was analyzed in this study. It will be necessary to conduct a cognitive test in the early stage of onset to understand the language problems of crossed conduction aphasia to know the characteristics of the cognitive process.