The effects of symbolic gestural training on enhancing recovery of spoken naming in people with aphasia: A systematic review and meta-analysis (International Journal of Speech-Language Pathology, Apr 2024)

Abstract

Purpose: This study aimed to evaluate the effects of symbolic gestural training on enhancing recovery of spoken naming in people with aphasia (PWA) using a systematic review and meta-analysis.

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, article search was conducted from four databases: Web of Science Core Collection, Medline, PsycINFO, and EBSCO. A total of 45 participants from four studies investigating the symbolic gestural training effects on PWA and outcome measures of spoken naming were included.

Result: The meta-analysis showed a medium overall effect of symbolic gestural training on enhancing recovery of spoken naming in PWA. Subgroup analysis also revealed that the training effect was more remarkable in the gesture + verbal training paradigm than in the gesture-only training paradigm. However, the differences in the training effects between short and long duration, and training supplied with and without feedback, were nonsignificant.

Conclusion: This study illustrates the current state of the literature on symbolic gestural training in PWA, and serves as a reference for clinicians, patients, and health policy-makers regarding the application of symbolic gestural training in clinical or rehabilitation programs.

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Speech perception: Auditory and visual cue integration in children with and without phonological disorder in voiceless fricatives (Clinical Linguistics & Phonetics, Apr 2024)

Abstract

The literature reports contradictory results regarding the influence of visual cues on speech perception tasks in children with phonological disorder (PD). This study aimed to compare the performance of children with (n = 15) and without PD (n = 15) in audiovisual perception task in voiceless fricatives. Assuming that PD could be associated with an inability to integrate phonological information from two sensory sources, we presumed that children with PD would present difficulties in integrating auditory and visual cues compared to typical children. A syllable identification task was conducted. The stimuli were presented according to four conditions: auditory-only (AO); visual-only (VO); audiovisual congruent (AV+); and audiovisual incongruent (AV-). The percentages of correct answers and the respective reaction times in the AO, VO, and AV+ conditions were considered for the analysis. The correct percentage of auditory stimuli was considered for the AV- condition, as well as the percentage of perceptual preference: auditory, visual, and/or illusion (McGurk effect), with the respective reaction time. In comparing the four conditions, children with PD presented a lower number of correct answers and longer reaction time than children with typical development, mainly for the VO. Both groups showed a preference for auditory stimuli for the AV- condition. However, children with PD showed higher percentages for visual perceptual preference and the McGurk effect than typical children. The superiority of typical children over PD children in auditory-visual speech perception depends on type of stimuli and condition of presentation.

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Positive effects of speech and language therapy group interventions in primary progressive aphasia: A systematic review (International Journal of Language & Communication Disorders, Apr 2024)

Abstract

Background: Primary progressive aphasia (PPA) is a neurodegenerative condition characterised by a prominent and progressive deterioration in language abilities, which significantly impacts quality of life and interpersonal relationships. Speech and language therapy plays a crucial role in offering interventions. Group intervention is one mode of delivery that could benefit communication functioning and overall wellbeing of people with PPA (pwPPA) and their care partners. Group interventions are also more efficient than one-to-one intervention and may facilitate peer support.

Aims: The aim of this review was to systematically evaluate the current evidence for the effectiveness of speech and language therapy groups for pwPPA and their care partners. Specifically, this paper considered three questions:

• 1.What evidence-based speech and language therapy groups for pwPPA and their care partners have been reported to date?
• 2.Are group communication interventions effective in improving quality of life and communication function for pwPPA and their care partners?
• 3.Are group communication interventions that are designed for people with communication difficulties of other aetiologies (such as stroke) effective for pwPPA?

In addition, this review aimed to describe the structure and content of groups, including aims, disciplines involved, size and frequency of group meetings, and outcome measures.

Methods: MEDLINE, CINAHL and PsycINFO were used to retrieve articles of interest. A total of 10 studies published between 2009 and 2022 met the eligibility criteria and therefore were included in this study. Data were extracted from the articles regarding the structure and content of groups.

Main Contribution: Although evidence is currently limited, results suggest that speech and language therapy group intervention can improve specific linguistic processes, the use of communication strategies and psychosocial well-being. The importance of multidisciplinary input and care partners’ involvement in groups was highlighted, along with the benefits of creative non-verbal activities as tools for self-expression. There is also initial evidence that telehealth group provision and one-off group sessions may be feasible and can benefit psychosocial well-being. Lastly, intentional recruitment and explicit education on different aphasia types are described as important when pwPPA participate in groups with mixed diagnoses.

Conclusions: The literature on speech and language therapy group interventions for PPA shows promise of positive effects on communication function and psychosocial well-being of both pwPPA and their care partners. Speech and language therapists can consider these published interventions when designing and implementing similar groups, but more robust evidence is required to confirm the relative effectiveness of this approach.

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Management of complex adult airway pathology through a multidisciplinary approach: An 8-year case series (Clinical Otolaryngology, Apr 2024)

Key points

• Multidisciplinary team (MDT) management is important for patients with complex airway diagnoses given the involvement of a vital structure and a comorbid patient population. 86.8% of our cohort had a least one major comorbidity.
• Common airway diagnoses were subglottic stenosis (22.2%), tracheal stenosis (13.6%), cancer involving the airway (11.1%), vocal cord palsy (6.2%) and thyroid-related disease (6.2%). Less common airway issues included tracheomalacia (2.5%) and respiratory papillomatosis (2.5%).
• Surgical intervention was the most common recommendation (39.5%) followed by further investigation (25.9%), monitoring (watchful waiting) (23.5%), and medical intervention (6.2%).
• Overall, MDT meetings facilitate collaborative interventions between specialties. Joint team procedures improve patient management and efficacy in the healthcare system

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A scoping review of therapies targeting confidence in stroke survivors (Aphasiology, Apr 2024)

Abstract

Background & aims: Confidence is a crucial yet poorly understood concept in rehabilitation. Therapies enhancing confidence lack specificity and confidence outcome measures vary. This review aimed to explore therapy techniques designed to impact confidence in stroke survivors, identify outcome measures used to assess confidence and to define the core components of confidence treatments. Particular consideration was given to treatment of confidence in people living with communication disorders, such as aphasia. 

Methods: Databases were searched using the scoping review framework. Published, peer reviewed, English language articles focused on stroke rehabilitation with measurements and explorations of confidence/self-efficacy were included. Studies were allocated to treatment category groups based on authors’ descriptions of the intervention.

Results: Nine thousand and one records were screened, 516 assessed, and 26 studies included. Studies were categorised into intervention types: self-efficacy, self-management, impairment-based or technology-incorporated interventions, with a few unique, non-recurring approaches (such as drama therapy). Twenty-three quantitative and six qualitative measures were extracted. Quantitative measures included standardized assessments (scales or questionnaires), or study-specific measures. The most common measure was the “Stroke Self-Efficacy Questionnaire”.

Conclusion: With respect to treatment components, there were overlaps between many studies. There was not a specific approach that was clearly associated with enhanced confidence outcomes. Rather, interventions implemented elements of multiple approaches. There were a few therapies whose primary focus was improving confidence. Specifically, only three studies explicitly sought out to “regain confidence” or “change self-efficacy” or focus on self-efficacy outcomes. Other studies examined confidence as a secondary outcome. There was a pattern of using general stroke-specific confidence/self-efficacy related outcome measurement tools rather than context/skill specific confidence/self-efficacy measurement tools.  Though confidence is a crucial yet poorly understood concept in neurorehabilitation, this scoping review may contribute towards its development and maturation with the field.

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