📋 Wednesday ePoster Presentations 📋
Acute and critical care (e.g. palliative care, cancer care)
Collaborative and/or transdisciplinary practices
Communication access and communication rights
Dysphagia, feeding and swallowing
Global issues
Learning and education
Mental health
Practice education and student supervision
Professional support, supervision and mentoring
Workforce and professional issues
Wednesday, May 24, 2023 |
12:30 PM - 1:30 PM |
📇 Exhibition Hall (Federation Ballroom) 📇 |
Speaker
Dr Suzanne Hopf
Charles Sturt University
A comparison of the self-reported learning outcomes of speech-language pathology students attending either a virtual study abroad or standard virtual work-integrated learning experience.
Presentation summary
Introduction: Historically, cross-cultural work-integrated learning (WIL) has involved students undertaking in-person ‘study abroad’ or ‘overseas mobility programs’. However, the closing of international borders during the COVID-19 pandemic suspended such opportunities. ‘Virtual study abroad’ programmes via teleconference provide a potentially valid alternative to face-to-face experiences; however, there is currently no evidence for their equivalency.
Aim: To compare self-reported learning outcomes of speech-language pathology students attending either a virtual study abroad or standard virtual placement.
Methods: This quasi-experimental study compared the WIL experiences of two groups of novice speech pathology students who self-selected to either a virtual-study-abroad (placement (VSA: n = 14) or a standard-virtual-placement (SVP: n = 12). The WIL experience required that students complete supervised speech, language and literacy screening via telepractice for clients located in either Fiji (VSA group) or Australia (SVP group). Pre- and post-measures of the students’ assessment ‘confidence’ and ‘competence’ were collected via surveys and compared using non-parametric statistical analysis.
Results: Mann-Whitney U Tests found no significant between group differences in the pre-WIL assessment confidence and competence scores. From pre-WIL to post-WIL asessment confidence and competence measures changed significantly for both groups. The was no significant between groups difference in the degree of change experienced.
Conclusions: Virtual study abroad placements may offer an equivalent learning experience to standard virtual placements. Further evaluation of virtual study abroad placements is required to determine: (1) if such experiences may offer equivalent learning compared to in-person abroad placements, and (2) whether student-reported measures correlate with clinical educator evaluations.
Aim: To compare self-reported learning outcomes of speech-language pathology students attending either a virtual study abroad or standard virtual placement.
Methods: This quasi-experimental study compared the WIL experiences of two groups of novice speech pathology students who self-selected to either a virtual-study-abroad (placement (VSA: n = 14) or a standard-virtual-placement (SVP: n = 12). The WIL experience required that students complete supervised speech, language and literacy screening via telepractice for clients located in either Fiji (VSA group) or Australia (SVP group). Pre- and post-measures of the students’ assessment ‘confidence’ and ‘competence’ were collected via surveys and compared using non-parametric statistical analysis.
Results: Mann-Whitney U Tests found no significant between group differences in the pre-WIL assessment confidence and competence scores. From pre-WIL to post-WIL asessment confidence and competence measures changed significantly for both groups. The was no significant between groups difference in the degree of change experienced.
Conclusions: Virtual study abroad placements may offer an equivalent learning experience to standard virtual placements. Further evaluation of virtual study abroad placements is required to determine: (1) if such experiences may offer equivalent learning compared to in-person abroad placements, and (2) whether student-reported measures correlate with clinical educator evaluations.
Dr Rebecca Sutherland
Lecturer
University of Sydney
A systematic review of interventions for echolalia in autistic children
Presentation summary
Introduction: Echolalia, the repetition of others’ speech, is a common observation in people on the autism spectrum. While research has established that echolalia is functional and meaningful for many, some clinicians and researchers continue to characterise it as pathological and in need of reduction. The existing body of research is broad with various definitions and theories about echolalia, along with several purported interventions. The aim of this systematic review was to understand the range and impact of interventions for echolalia in autistic children, in terms of their level of echolalia and language outcomes.
Method: A systematic search was conducted according to the PRISMA guidelines. Predetermined inclusion and exclusion criteria were used for screening of the studies. A total of 14 studies met the inclusion criteria. Screening, data extraction and quality rating using the Scientific Merit Rating Scale (SMRS) were performed in duplicate.
Results: Ten interventions across the 14 studies were reported, ranging from behavioural to pharmacological interventions. Results indicated that interventions generally decreased levels of echolalia. However, there were considerable inconsistencies in the definitions and conceptualisations of echolalia, intervention administration, generalisation techniques, and the measures used. The quality of the studies was very low.
Conclusion: Interventions for echolalia vary widely in terms of administration and measurement. There is limited consensus on the definition of echolalia among the reviewed studies, and no evidence that echolalia was understood to be functional or meaningful to the autistic children, despite significant recent research that suggests that echolalia is a communication tool for many autistic children and adults. Further, the lack of methodological rigour makes it difficult to draw clinical conclusions about the interventions.
Method: A systematic search was conducted according to the PRISMA guidelines. Predetermined inclusion and exclusion criteria were used for screening of the studies. A total of 14 studies met the inclusion criteria. Screening, data extraction and quality rating using the Scientific Merit Rating Scale (SMRS) were performed in duplicate.
Results: Ten interventions across the 14 studies were reported, ranging from behavioural to pharmacological interventions. Results indicated that interventions generally decreased levels of echolalia. However, there were considerable inconsistencies in the definitions and conceptualisations of echolalia, intervention administration, generalisation techniques, and the measures used. The quality of the studies was very low.
Conclusion: Interventions for echolalia vary widely in terms of administration and measurement. There is limited consensus on the definition of echolalia among the reviewed studies, and no evidence that echolalia was understood to be functional or meaningful to the autistic children, despite significant recent research that suggests that echolalia is a communication tool for many autistic children and adults. Further, the lack of methodological rigour makes it difficult to draw clinical conclusions about the interventions.
Dr Natalie Berg
Australian Catholic University
Implementation of the NDIS for younger people living in residential aged care: Exploring the perceptions of speech pathologists
12:30 PM - 1:30 PMPresentation summary
Introduction/Rationale: The National Disability Insurance Scheme (NDIS) provides people under the age of 65, living in residential aged care (RAC), with improved access to speech pathology (SP) supports and services. Little is known about the provision of SP services, or the role speech pathologists (SPs) may have in supporting this group to participate in the NDIS.
Aim(s): This study explored the current practices and perceptions of SPs providing services to younger people (YP) living in Australian RAC.
Methods: Thirteen SPs participated in an online cross-sectional, mixed-methods survey. Descriptive statistics and manifest content analysis were used to analyse data.
Results: Participants reported providing assessment and/or intervention services for communication, and/or swallowing/mealtime difficulties to 197 YP, most of whom had acquired or progressive neurological disorders. Most participants supported YP to create and implement a NDIS plan, but few supported YP to access the scheme itself. The category of collaborative practice reflected the most prominent practice enabler. The categories of resources and knowledge reflected perceived barriers to SP practice.
Conclusion: Barriers to the provision of SP services to YP in RAC are inherent of the care environment itself (e.g., time pressured routines, limited staffing), insufficient resources (e.g., NDIS funding, availability of therapy assistants) and stakeholder knowledge of SP practice and/or the NDIS (e.g., staff, family, support coordinators). While collaborative practice facilitates SP services, there remains a need to address resource allocation and stakeholder knowledge, to further enable the provision of services that respect and respond to the needs and aspirations of these YP.
Aim(s): This study explored the current practices and perceptions of SPs providing services to younger people (YP) living in Australian RAC.
Methods: Thirteen SPs participated in an online cross-sectional, mixed-methods survey. Descriptive statistics and manifest content analysis were used to analyse data.
Results: Participants reported providing assessment and/or intervention services for communication, and/or swallowing/mealtime difficulties to 197 YP, most of whom had acquired or progressive neurological disorders. Most participants supported YP to create and implement a NDIS plan, but few supported YP to access the scheme itself. The category of collaborative practice reflected the most prominent practice enabler. The categories of resources and knowledge reflected perceived barriers to SP practice.
Conclusion: Barriers to the provision of SP services to YP in RAC are inherent of the care environment itself (e.g., time pressured routines, limited staffing), insufficient resources (e.g., NDIS funding, availability of therapy assistants) and stakeholder knowledge of SP practice and/or the NDIS (e.g., staff, family, support coordinators). While collaborative practice facilitates SP services, there remains a need to address resource allocation and stakeholder knowledge, to further enable the provision of services that respect and respond to the needs and aspirations of these YP.
Ms Catherine Blackburn
University of Canberra
A systematic review of interventions for echolalia in autistic children
12:30 PM - 1:30 PM
Dr Marie-Pier McSween
The University Of Queensland
Animal-assisted services for adults with acquired neurogenic communication disorders: a scoping review.
Presentation summary
Introduction/rationale: Animal-assisted services (AASs) have been receiving increasing interest for their potential to be used as complementary approaches to traditional speech therapy practices. AASs have been shown to maximize therapy gains in adults with acquired neurogenic communication disorders, however, the scope of this work has never been reviewed to meaningfully inform future research and clinical implementation efforts.
Aim: The aim of this review was to provide an overview of the scope of available research evidence incorporating AASs to benefit outcomes of adults with acquired neurogenic communication disorders.
Methods: Seven databases were searched using a systematic search strategy. Covidence online software was used to manage references and remove duplicates. Two independent reviewers screened titles, abstracts, and full texts against a set of pre-determined eligibility criteria. Data extraction was completed using the Template for Intervention Description and Replication checklist in conjunction with a standardized form developed for the purpose of this review.
Results: Twelve studies conducted between 1997 and 2022 were identified. Studies included between 1 and 46 participants, with either aphasia, apraxia of speech or cognitive-communication disorder as a result of stroke, traumatic brain injury or dementia. Animal-assisted therapy was used by the majority, with findings suggesting increased verbal and non-verbal communication, mood, motivation, participation, quality of life, and satisfaction.
Conclusions: Although there is increasing interest in this area, studies remain limited and include several limitations. There is a need for more thoroughly designed controlled trials and further investigation of implementation considerations to allow translation of this evidence into practice.
Keywords: Animal-assisted services, acquired neurogenic communication disorders.
Submission statement: The degree of response to speech and language therapy greatly varies between adults with acquired neurogenic communication disorders. This poster presentation will seek to develop clinician knowledge in the provision of novel and adjunct therapy approaches to maximize therapy gains of adults with acquired neurogenic communication disorders.
Aim: The aim of this review was to provide an overview of the scope of available research evidence incorporating AASs to benefit outcomes of adults with acquired neurogenic communication disorders.
Methods: Seven databases were searched using a systematic search strategy. Covidence online software was used to manage references and remove duplicates. Two independent reviewers screened titles, abstracts, and full texts against a set of pre-determined eligibility criteria. Data extraction was completed using the Template for Intervention Description and Replication checklist in conjunction with a standardized form developed for the purpose of this review.
Results: Twelve studies conducted between 1997 and 2022 were identified. Studies included between 1 and 46 participants, with either aphasia, apraxia of speech or cognitive-communication disorder as a result of stroke, traumatic brain injury or dementia. Animal-assisted therapy was used by the majority, with findings suggesting increased verbal and non-verbal communication, mood, motivation, participation, quality of life, and satisfaction.
Conclusions: Although there is increasing interest in this area, studies remain limited and include several limitations. There is a need for more thoroughly designed controlled trials and further investigation of implementation considerations to allow translation of this evidence into practice.
Keywords: Animal-assisted services, acquired neurogenic communication disorders.
Submission statement: The degree of response to speech and language therapy greatly varies between adults with acquired neurogenic communication disorders. This poster presentation will seek to develop clinician knowledge in the provision of novel and adjunct therapy approaches to maximize therapy gains of adults with acquired neurogenic communication disorders.
Mrs Stephanie Brennan
Speech Pathologist
St George Hospital
Exceptional care. Embedded excellence. The development of a novel training and learning pathway in the speciality of paediatric feeding.
12:30 PM - 1:30 PMPresentation summary
Introduction: The Speech Pathology profession has typically utilised competency-based tools to demonstrate that a clinician can work in areas of advanced scope of practice within a clinical setting. The current competency-based tools do not meet all the needs of supervising clinicians and learners working in specialised caseloads. Internationally, medical training programs have adopted Entrustable Professional Activities (EPAs) as an approach to competency-based assessment. EPAs are specific units of work that define a specific area within a profession, and once attained, clinicians can work independently and unsupervised in these areas. There is no identified literature of the application of EPAs within a competency-based system across speech pathology specialties. Method/Aim: The presentation will outline the development of a novel training and learning pathway for the specialty of paediatric feeding, including an EPA Assessment Matrix describing the range of case types seen in an acute setting, as well as an EPA Clinic Encounter Template that identifies 4 levels of clinical competence within a number of specific ‘clinical encounters’, providing a breakdown of the scope of knowledge and skills demonstrated at each level along with corresponding levels of supervision required. The application of the EPA pathway for training and learning will be discussed. Conclusions: EPA pathways enable clinical supervisors/ educators to evaluate the competence and confidence of clinicians in a clinical specialty across clinical caseload domains and clinical encounters, and provides a framework that is intuitive, practical, measurable and manageable in a busy clinical setting. The novel pathway developed aims to improve the effectiveness of teaching and training, reduce the burden on clinical supervisors and empower learner clinicians to take control of their learning and to use critical reflection to inform their learning and skill proficiency development in the specialty of paediatric feeding.
Miss Shue Yin Tan
Speech Pathologist
Ors Group
Learning and Gamification Characteristics of Speech Pathology Students
Presentation summary
Title
Learning and Gamification Characteristics of Speech Pathology Students
Background
In tertiary health education, use of digital technology is an emerging area in teaching and learning. However, its use in speech pathology (SP) education is limited. Reflection on how students interact and learn within digital teaching tools is an important pedagogical consideration. Studies in other fields (e.g., nursing) have used students’ gamification characteristics to predict learning success, suggesting these are important when designing digital teaching tools to facilitate user interest. To date, no research has studied the learning and gamification characteristics of SP students.
Aim
To explore the learning and gamification characteristics of undergraduate SP students.
Method
Using a descriptive, cross-sectional research design, an online survey was delivered to current students across all years of SP at the University of Newcastle. Students completed Likert-scale and multiple-choice questions around personality, gaming habits and profiles and learning style. Data from 43 surveys were analysed using descriptive statistics.
Results
Data collected found SP students to be predominantly female and aged 21-25. Characteristics included conscientiousness personality traits, and a strong preference for visual learning styles. The majority of students favoured games with greater aesthetics, and games where they could immerse in a ‘story’ and be creative.
Conclusion
When designing leaning activities, particularly those using digital technology, it is important to consider the learning and gamification profiles of the user. Reflecting on these characteristics would provide important information to structure learning activities to maximise student engagement, motivation and learning effectiveness. Understanding an individual’s learning and gamification profile has implications on both student- and client-learning.
Keywords
Gamification, teaching and learning, speech pathology students, health education
Submission Statement
This research may benefit educators and clinicians, reflecting on users’ learning and gamification characteristics. This knowledge allows the profession to respond to innovative, emerging pedagogical approaches to teaching and learning with students and clients.
Ms Annette Rotherham
The University of Queensland
Measuring successful conversations in couples with and without aphasia: A scoping review.
Presentation summary
Reflecting on the practice of Speech-language pathologists where traditionally only the communication of the communication impaired person is considered in assessment and outcome measurement. We respond by promoting more person and relationship-centred outcome measurement instruments that consider the perspectives of both communication partners when determining what makes conversation successful.
Introduction
Speech-language pathologists and researchers use numerous outcome measurement instruments to measure the effects of conversation therapy and communication partner training. However, there is no agreement about what constitutes "successful conversation" when measuring outcomes. This scoping review aimed to explore the construct of successful conversation through identifying existing outcome measurement instruments for conversation for couples with and without aphasia.
Methods:
A scoping review methodology was utilised using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR). Databases were searched for conversation treatment studies for couples with and without aphasia. Patient-reported outcome measures (PROMs) were extracted and described.
Results:
Following screening and full-text review, 24 studies where one person had aphasia and 22 studies with neurotypical couples were included. In studies of couples with aphasia, 40 different outcome measurement instruments were used. Of these, 13 were conversation PROMs describing the impact of aphasia on communication and strategies used; but only three measured outcomes from the perspective of the person with aphasia and their partner. In studies of neurotypical couples, 25 outcome measurement instruments were used. Of these, eight were PROMs measuring communication; all measured the perspectives of both communication partners and described feelings and communication patterns.
Discussion:
Successful conversation and communication are linked to relationship satisfaction for couples. The analysis of the PROMs used with neurotypical couples provides key items of behaviours and feelings that could also be applied to couples with aphasia. These findings will aid future research into PROM development for couple conversation in aphasia.
Aphasia, conversation, couples, outcome measurement,
Introduction
Speech-language pathologists and researchers use numerous outcome measurement instruments to measure the effects of conversation therapy and communication partner training. However, there is no agreement about what constitutes "successful conversation" when measuring outcomes. This scoping review aimed to explore the construct of successful conversation through identifying existing outcome measurement instruments for conversation for couples with and without aphasia.
Methods:
A scoping review methodology was utilised using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR). Databases were searched for conversation treatment studies for couples with and without aphasia. Patient-reported outcome measures (PROMs) were extracted and described.
Results:
Following screening and full-text review, 24 studies where one person had aphasia and 22 studies with neurotypical couples were included. In studies of couples with aphasia, 40 different outcome measurement instruments were used. Of these, 13 were conversation PROMs describing the impact of aphasia on communication and strategies used; but only three measured outcomes from the perspective of the person with aphasia and their partner. In studies of neurotypical couples, 25 outcome measurement instruments were used. Of these, eight were PROMs measuring communication; all measured the perspectives of both communication partners and described feelings and communication patterns.
Discussion:
Successful conversation and communication are linked to relationship satisfaction for couples. The analysis of the PROMs used with neurotypical couples provides key items of behaviours and feelings that could also be applied to couples with aphasia. These findings will aid future research into PROM development for couple conversation in aphasia.
Aphasia, conversation, couples, outcome measurement,
Dr Joanne Murray
Senior Lecturer
Flinders University
More than a mouth to clean: A multiple case study of patients’ oral healthcare in hospital
Presentation summary
Introduction: Hospitalised older patients have been found to have poor oral health yet oral healthcare is not adequately implemented in hospitals. The reporting literature on oral healthcare in hospitals has largely focused on staff perception of barriers but less is known of patient experience. Thus, there is a need to explore the lived experiences of older patients about oral healthcare in hospital.
Aim(s): The aims of this study were to explore older patients’ oral health status, their opinions about oral healthcare and their experiences with oral healthcare in a geriatric ward.
Methods: A mixed-methods, multiple case study was conducted. Seven patients were purposefully selected and participated in a semi-structured interview and oral health assessment using the Oral Health Assessment Tool (OHAT). The data were presented in the form of case summaries and were analysed descriptively.
Results: Each patient presented with one or more oral health problems on the OHAT, but not all patients self-reported problems with their mouth. Each patient valued oral healthcare, but the reasons patients gave for the importance of oral healthcare varied. Patients had established, individualised oral healthcare routines, which they brought with them to hospital.
Conclusions: There is a need for person-centred oral healthcare to address the unique nuances of patients’ values, needs and preferences when they enter hospital. Oral health histories may provide a means of facilitating person-centred oral healthcare and should be tested and validated for use with older patients in hospital.
Keywords - Geriatric; hospital; oral health; oral healthcare; person-centred care; nursing
Submission Statement: The authors reflected on current oral healthcare practice and responded with a tangible suggestion of how to facilitate person-centred oral healthcare for older patients in hospital. The authors respected the patients’ opinions and considered their insights to be a valuable contribution to the oral healthcare literature.
Aim(s): The aims of this study were to explore older patients’ oral health status, their opinions about oral healthcare and their experiences with oral healthcare in a geriatric ward.
Methods: A mixed-methods, multiple case study was conducted. Seven patients were purposefully selected and participated in a semi-structured interview and oral health assessment using the Oral Health Assessment Tool (OHAT). The data were presented in the form of case summaries and were analysed descriptively.
Results: Each patient presented with one or more oral health problems on the OHAT, but not all patients self-reported problems with their mouth. Each patient valued oral healthcare, but the reasons patients gave for the importance of oral healthcare varied. Patients had established, individualised oral healthcare routines, which they brought with them to hospital.
Conclusions: There is a need for person-centred oral healthcare to address the unique nuances of patients’ values, needs and preferences when they enter hospital. Oral health histories may provide a means of facilitating person-centred oral healthcare and should be tested and validated for use with older patients in hospital.
Keywords - Geriatric; hospital; oral health; oral healthcare; person-centred care; nursing
Submission Statement: The authors reflected on current oral healthcare practice and responded with a tangible suggestion of how to facilitate person-centred oral healthcare for older patients in hospital. The authors respected the patients’ opinions and considered their insights to be a valuable contribution to the oral healthcare literature.
Assoc. Professor Petrea Cornwell
Griffith University
Pocket MEC: A cognitive-communication screening test supported by Australian norms
Presentation summary
Introduction
Advances in knowledge about right hemisphere (RH) stroke are yet to be reflected in screening tests that can identify all profiles of cognitive-communication disorder (CCD) that may emerge. Speech pathologists frequently rely on informal measures and observations to reach a diagnosis, likely contributing to the low referral rates reported for this population.
Aims
This study reports on test-development of the Pocket MEC, a screening version of the Montreal Evaluation of Communication (MEC), through (1) exploration of perceptions of clinical utility of the MEC; and, establishing (2) inter-rater reliability, and (3) Australian norms for the Pocket MEC.
Methods
Speech pathologists, familiar with the MEC, rated subtests for retention in the Pocket MEC and identified aspects for improvement through online survey. People residing in Australia, ≥ 18 years of age with no prior neurological injury and proficient English were assessed on the Pocket MEC through convenience sampling.
Results
The MEC was rated valuable as a diagnostic tool (100%, n=8). Discourse production, verbal fluency, speech act interpretation and emotional prosody subtests were rated high on perceived clinical utility. Australian-accent audio samples and a reading comprehension task were recommended, and consequently included in the Pocket MEC. Forty-five participants (18.08 – 83.08 years of age, 11 - 22 years of education), of whom ten were bi/multilingual were assessed on the Pocket MEC (administration time 17.42 minutes). Good inter-rater reliability was found on 16 randomly selected tests.
Conclusions
The Pocket MEC is a time efficient screening test with good inter-rater reliability allowing for comparison against Australian norms. Validity for people with CCD secondary to acquired and progressive neurological conditions are to be established.
Keywords: Cognitive-communication disorder, Australian normative data, test development, right hemisphere stroke
Advances in knowledge about right hemisphere (RH) stroke are yet to be reflected in screening tests that can identify all profiles of cognitive-communication disorder (CCD) that may emerge. Speech pathologists frequently rely on informal measures and observations to reach a diagnosis, likely contributing to the low referral rates reported for this population.
Aims
This study reports on test-development of the Pocket MEC, a screening version of the Montreal Evaluation of Communication (MEC), through (1) exploration of perceptions of clinical utility of the MEC; and, establishing (2) inter-rater reliability, and (3) Australian norms for the Pocket MEC.
Methods
Speech pathologists, familiar with the MEC, rated subtests for retention in the Pocket MEC and identified aspects for improvement through online survey. People residing in Australia, ≥ 18 years of age with no prior neurological injury and proficient English were assessed on the Pocket MEC through convenience sampling.
Results
The MEC was rated valuable as a diagnostic tool (100%, n=8). Discourse production, verbal fluency, speech act interpretation and emotional prosody subtests were rated high on perceived clinical utility. Australian-accent audio samples and a reading comprehension task were recommended, and consequently included in the Pocket MEC. Forty-five participants (18.08 – 83.08 years of age, 11 - 22 years of education), of whom ten were bi/multilingual were assessed on the Pocket MEC (administration time 17.42 minutes). Good inter-rater reliability was found on 16 randomly selected tests.
Conclusions
The Pocket MEC is a time efficient screening test with good inter-rater reliability allowing for comparison against Australian norms. Validity for people with CCD secondary to acquired and progressive neurological conditions are to be established.
Keywords: Cognitive-communication disorder, Australian normative data, test development, right hemisphere stroke
Dr Joanne Murray
Senior Lecturer
Flinders University
Reliability of student ratings on measures of support and participation in conversation for people with dementia and their caregivers
Presentation summary
Introduction: Communication skills of people with dementia (PWD) progressively decline, contributing to feelings of isolation and strain on the dyadic relationship between PWD and their family caregivers. Communication Partner Training (CPT) addresses these dyadic difficulties, but few reliable outcome measures are available to evaluate the success of dyadic communication following CPT. Recent adaptation of aphasia tools in the form of Measure of Support in Conversation for Dementia (MSC-D) and Measure of Participation in Conversation for Dementia (MPC-D) provide promising measures of effectiveness.
Aims: To explore the reliability and feasibility of these tools when used by student speech pathologists ahead of establishing a student-led CPT service.
Methods: Five conversations between a PWD and their caregiver were video-recorded, then rated by eight speech pathology students using the MSC-D and MPC-D after a one-hour videoed training session. These ratings were compared with an experienced clinician’s ratings, rating duration and confidence levels.
Results: The reliability of these tools was low at both subscale and dyad level. Intraclass correlation coefficients ranged from poor (0.056) to fair (0.587). Students rated more reliably against MPC-D than MSC-D. Students took longer to rate each dyad than the clinician, and most reported only moderate confidence levels. Numerous contributing factors were identified, including conversation type, dementia severity, scale design, training protocol and personal influences of individual raters.
Conclusions: With poor reliability findings, the study identified the need for more intense training of speech pathology students and further research to clearly establish reliable and feasible measures of CPT effectiveness.
Keywords: Reliability; Measures; Communication Partner Training; Dementia; Students
Our research responds to the limited literature surrounding CPT effectiveness measures in dementia. Through exploring reliability and feasibility of new tools, we are respecting the dedication of PWD and their communication partners and reflecting on the training requirements of our student speech pathologists for contributing meaningfully to aged care services.
Aims: To explore the reliability and feasibility of these tools when used by student speech pathologists ahead of establishing a student-led CPT service.
Methods: Five conversations between a PWD and their caregiver were video-recorded, then rated by eight speech pathology students using the MSC-D and MPC-D after a one-hour videoed training session. These ratings were compared with an experienced clinician’s ratings, rating duration and confidence levels.
Results: The reliability of these tools was low at both subscale and dyad level. Intraclass correlation coefficients ranged from poor (0.056) to fair (0.587). Students rated more reliably against MPC-D than MSC-D. Students took longer to rate each dyad than the clinician, and most reported only moderate confidence levels. Numerous contributing factors were identified, including conversation type, dementia severity, scale design, training protocol and personal influences of individual raters.
Conclusions: With poor reliability findings, the study identified the need for more intense training of speech pathology students and further research to clearly establish reliable and feasible measures of CPT effectiveness.
Keywords: Reliability; Measures; Communication Partner Training; Dementia; Students
Our research responds to the limited literature surrounding CPT effectiveness measures in dementia. Through exploring reliability and feasibility of new tools, we are respecting the dedication of PWD and their communication partners and reflecting on the training requirements of our student speech pathologists for contributing meaningfully to aged care services.
Dr Jacqueline McKechnie
Assistant Professor
University Of Canberra
Service learning as an alternative to traditional clinical placements: Experiences of student speech pathologists.
12:30 PM - 1:30 PMPresentation summary
Introduction: Service learning is a collaborative approach to teaching and learning built around reciprocal relationships between universities and community organisations. By design, service-learning programs are mutually beneficial to students and communities. Recently, the University of Canberra established the ‘Good Start in Life’ (GSIL) service-learning program to address declining language and emergent literacy skills amongst preschool children in the ACT. GSIL is an interprofessional collaboration involving speech pathology students, early childhood educators (ECEs), and parents. Speech pathology students have worked to improve the quality of early learning environments in Canberra by providing specialist knowledge and professional coaching to parents and ECEs.
Aim: This study explores experiences and perceptions of speech pathology students involved in the GSIL service-learning program. Specifically, perceived benefits and challenges of the program in relation to student learning and clinical skill development.
Methods: Ten speech pathology Masters students who had participated in the GSIL program as part of their clinical placement contributed qualitative data during two focus groups. Data were transcribed and analysed inductively in NVivo using thematic analysis.
Results: Themes are still being anlaysed. Preliminary data indicates participation in service-learning programs may support student learning and clinical competency development. Reported benefits include: increased confidence coaching adults, responding to group dynamics, adapting communication styles, and increased knowledge of speech pathologists’ role in the community. Challenges included: physical demands of a community-based placement and difficulties managing service-provision across childcare centres.
Conclusions: Service-learning placements are a viable option for supporting student learning and may be suitable alternatives to traditional clinical placements.
Keywords - service learning, interprofessional collaboration, clinical education
Submission Statement: This project reflects the conference themes of respect and respond. Student speech pathologists engaged in community outreach services and interprofessional collaboration to deliver services that were needs-based and place-based.
Aim: This study explores experiences and perceptions of speech pathology students involved in the GSIL service-learning program. Specifically, perceived benefits and challenges of the program in relation to student learning and clinical skill development.
Methods: Ten speech pathology Masters students who had participated in the GSIL program as part of their clinical placement contributed qualitative data during two focus groups. Data were transcribed and analysed inductively in NVivo using thematic analysis.
Results: Themes are still being anlaysed. Preliminary data indicates participation in service-learning programs may support student learning and clinical competency development. Reported benefits include: increased confidence coaching adults, responding to group dynamics, adapting communication styles, and increased knowledge of speech pathologists’ role in the community. Challenges included: physical demands of a community-based placement and difficulties managing service-provision across childcare centres.
Conclusions: Service-learning placements are a viable option for supporting student learning and may be suitable alternatives to traditional clinical placements.
Keywords - service learning, interprofessional collaboration, clinical education
Submission Statement: This project reflects the conference themes of respect and respond. Student speech pathologists engaged in community outreach services and interprofessional collaboration to deliver services that were needs-based and place-based.
Ms Chantelle Hutchinson
Speech Pathologist
Neurorehab Allied Health Network
Speech Pathology Allied Health Assistant internships benefit the intern, the client and the organisation
Presentation summary
Introduction: Recruitment in allied health has become increasingly difficult. At the same time, students have found it difficult to obtain practical experience working with clients due to limited and modified clinical placements. The aim of offering Speech Pathology (SP) AHA Internships is to increase student skillset and interest in community rehabilitation, provide a quality and cost-effective option for NDIS clients requiring SP input and to increase the SP department’s capacity to participate in research and quality improvement (QI).
Methods: NeuroRehab Allied Health Network (NRAHN) created the SP AHA Internship at the beginning of 2022. Predominant roles of the interns include delivering 1:1 face-to-face and telehealth supports to clients requiring communication intervention, assisting in running the monthly dysphagia clinics, supporting clients with AAC device trials, assisting in the creation of aided communication aids and supporting the SP department’s quality improvement projects. SP AHA Interns are assigned a mentor from the SP team and are invited to team meetings, in-services and external PD courses hosted by NRAHN.
Results: We currently have two SP interns employed. The Interns have reported high job satisfaction and have valued gaining SP experience. SP AHA Interns have benefitted clients too. AHAs sessions are charged at less than half the cost of SP sessions so offer value of money. SP AHA Intern support with QI projects has also allowed fast tracking of new services.
Conclusions: SP AHA Internships are an innovative way to increase SP student skills and experience, offer choice to clients and facilitate efficient service delivery.
Keywords: speech pathology, student, AHA, internship, NDIS
This idea originated upon reflection about how AHAs can gain more valuable experience from their role and how NDIS clients can continue to access cost-efficient quality speech pathology services. The response was an internship model that aimed to be respectful to the intern, client and the organisation.
Methods: NeuroRehab Allied Health Network (NRAHN) created the SP AHA Internship at the beginning of 2022. Predominant roles of the interns include delivering 1:1 face-to-face and telehealth supports to clients requiring communication intervention, assisting in running the monthly dysphagia clinics, supporting clients with AAC device trials, assisting in the creation of aided communication aids and supporting the SP department’s quality improvement projects. SP AHA Interns are assigned a mentor from the SP team and are invited to team meetings, in-services and external PD courses hosted by NRAHN.
Results: We currently have two SP interns employed. The Interns have reported high job satisfaction and have valued gaining SP experience. SP AHA Interns have benefitted clients too. AHAs sessions are charged at less than half the cost of SP sessions so offer value of money. SP AHA Intern support with QI projects has also allowed fast tracking of new services.
Conclusions: SP AHA Internships are an innovative way to increase SP student skills and experience, offer choice to clients and facilitate efficient service delivery.
Keywords: speech pathology, student, AHA, internship, NDIS
This idea originated upon reflection about how AHAs can gain more valuable experience from their role and how NDIS clients can continue to access cost-efficient quality speech pathology services. The response was an internship model that aimed to be respectful to the intern, client and the organisation.
Ms Sally Zingelman
Phd Candidate
University Of Queensland
The profiles and outcomes of people with communication difficulties after stroke: a data linkage study
12:30 PM - 1:30 PMPresentation summary
Introduction: Communication difficulties are common following stroke and the negative impacts of speech and language impairments on psychosocial well-being and quality of life (QoL) are well documented. Despite this, factors influencing recovery and long-term outcomes are largely unexplored.
Aims: (1) To assess patient, clinical and system factors by post-stroke communication difficulties status. (2) To assess associations between communication gains in rehabilitation and long-term outcomes (QoL and hospital readmission). (3) To assess correlations between communication difficulties and mortality within a year post-stroke.
Methods: Retrospective, observational analysis of linked usual care data collected by the national stroke registry (Australian Stroke Clinical Registry), and the national rehabilitation integrated outcomes center (Australasian Rehabilitation Outcomes Centre). Descriptive statistics and multivariable, logistic, multilevel modelling analyses used.
Results: Of the 8,394 participants, 64% experienced post-stroke communication difficulties on admission to inpatient rehabilitation. Patient factors associated with communication difficulties included age (mean 73 years p<0.001) and stroke severity (ability to walk on admission 18% p<0.001). Long-term, reduced odds of reporting difficulties with mobility (OR 0.85, 95% CI: 0.81, 0.90), self-care (OR 0.91, 95% CI: 0.85, 0.97) and usual activities (OR 0.85, 95%CI: 0.78, 0.93) were reported. Survival within one-year post-stroke was reduced (OR 2.3, 95% CI: 1.85, 2.83).
Conclusions: Two in three patients with stroke have communication difficulties. Patients with communication difficulties required significantly longer inpatient stays, had more comorbidities impacting their rehabilitation, and required greater levels of social and nursing support at discharge. Improved QOL outcomes were observed for patients with communication difficulties who received inpatient rehabilitation.
Keywords: Rehabilitation, Stroke, Registry, Data-linkage, Aphasia, Dysarthria
Submission Statement: New knowledge of the characteristics of people with post-stroke communication difficulties, their support needs, and long-term outcomes will be presented. Delegates will be challenged to reflect on current practice and respond to the needs of the study population through appropriate clinical actions in acute and rehabilitation settings.
Aims: (1) To assess patient, clinical and system factors by post-stroke communication difficulties status. (2) To assess associations between communication gains in rehabilitation and long-term outcomes (QoL and hospital readmission). (3) To assess correlations between communication difficulties and mortality within a year post-stroke.
Methods: Retrospective, observational analysis of linked usual care data collected by the national stroke registry (Australian Stroke Clinical Registry), and the national rehabilitation integrated outcomes center (Australasian Rehabilitation Outcomes Centre). Descriptive statistics and multivariable, logistic, multilevel modelling analyses used.
Results: Of the 8,394 participants, 64% experienced post-stroke communication difficulties on admission to inpatient rehabilitation. Patient factors associated with communication difficulties included age (mean 73 years p<0.001) and stroke severity (ability to walk on admission 18% p<0.001). Long-term, reduced odds of reporting difficulties with mobility (OR 0.85, 95% CI: 0.81, 0.90), self-care (OR 0.91, 95% CI: 0.85, 0.97) and usual activities (OR 0.85, 95%CI: 0.78, 0.93) were reported. Survival within one-year post-stroke was reduced (OR 2.3, 95% CI: 1.85, 2.83).
Conclusions: Two in three patients with stroke have communication difficulties. Patients with communication difficulties required significantly longer inpatient stays, had more comorbidities impacting their rehabilitation, and required greater levels of social and nursing support at discharge. Improved QOL outcomes were observed for patients with communication difficulties who received inpatient rehabilitation.
Keywords: Rehabilitation, Stroke, Registry, Data-linkage, Aphasia, Dysarthria
Submission Statement: New knowledge of the characteristics of people with post-stroke communication difficulties, their support needs, and long-term outcomes will be presented. Delegates will be challenged to reflect on current practice and respond to the needs of the study population through appropriate clinical actions in acute and rehabilitation settings.
Miss Guinevere Buckland-Watts
University Of Canberra
The role of speech pathologists in treating children with trauma: a scoping review of current group social skills interventions
12:30 PM - 1:30 PMPresentation summary
Introduction: Early childhood trauma has a graded dose-response relationship with obesity, suicide attempts, cancer, substance misuse, and academic achievement in later life and costs an estimated $6.8 billion annually to treat. Social skills are a protective factor for childhood trauma and can reduce negative psychological, social, and health outcomes. Group social skills interventions have been found to reduce social isolation, behavioural problems and increase support-seeking behaviors and emotional regulation, through peer modeling. However, there are significant disparities in the methodology of current interventions and limited literature to guide clinicians when making best practice recommendations or decisions.
Aim: This scoping review aimed to evaluate current group interventions and determine their effectiveness in improving the social skills of children with trauma, aged 0-12.
Methods: Five databases were searched with predefined terms. Blind abstract and full-text screening was conducted and moderated. Nine studies were thematically analysed and critically appraised using tools from the Joanna Briggs Institute.
Results: The majority of retained studies reported statistically significant results. Several major themes were revealed in current interventions, including the use of modeling to practice social skills, the involvement of key stakeholders (parents, teachers, and non-traumatised peers), and the role of play in facilitating skill development.
Conclusions: Group social skills interventions are a viable option for treating social skills deficits associated with trauma, in children aged 0-12. However, evidence for current group social skills interventions is of low quality, due to methodological constraints. Further high-quality research is needed to replicate the findings in the current literature.
Aim: This scoping review aimed to evaluate current group interventions and determine their effectiveness in improving the social skills of children with trauma, aged 0-12.
Methods: Five databases were searched with predefined terms. Blind abstract and full-text screening was conducted and moderated. Nine studies were thematically analysed and critically appraised using tools from the Joanna Briggs Institute.
Results: The majority of retained studies reported statistically significant results. Several major themes were revealed in current interventions, including the use of modeling to practice social skills, the involvement of key stakeholders (parents, teachers, and non-traumatised peers), and the role of play in facilitating skill development.
Conclusions: Group social skills interventions are a viable option for treating social skills deficits associated with trauma, in children aged 0-12. However, evidence for current group social skills interventions is of low quality, due to methodological constraints. Further high-quality research is needed to replicate the findings in the current literature.
Ms Emily Wing-Tung Yun
Phd Student
The University Of Sydney
The Who, What, Why and How of Assessing Orofacial Dysfunction: A Scoping Review
12:30 PM - 1:30 PMPresentation summary
Introduction: In Australia, approximately 70% of speech-language pathologists (SLPs) complete an oro-motor assessment when assessing children with speech disorders. However, the assessment protocols used are variable and focus on oral structures and functions relevant to speech and swallowing only. The orofacial complex encompasses a broader range of functions; SLPs may play a key role in the comprehensive assessment of orofacial dysfunction in an interdisciplinary team approach.
Aim(s): To evaluate common assessment processes for orofacial dysfunction, including the involvement of SLPs and other professionals. This will provide a framework for thorough assessment of orofacial dysfunction and inspire changes in SLP clinical practice.
Methods: Five databases were systematically searched using keywords relating to “oral function”, “children” and “assessment”. Studies that included: a) participants aged 2-18 years with no diagnosed neurological or cognitive delay; b) direct assessments of oral functions; and c) aims to investigate orofacial dysfunction, were eligible for review. Grey literature describing assessments for orofacial dysfunction were also included.
Results: The systematic search yielded 3526 articles. After removing duplicates, 1798 papers were screened for inclusion in full-text review and data extraction. Data about professionals involved in assessment, assessment tools, orofacial functions assessed, and types of assessment tasks will be extracted, analysed and reported.
Conclusions: Results from this study will ascertain the scope of assessments for orofacial dysfunction by analysing reported assessment tools and protocols. SLPs can consider additional observations to incorporate in existing assessments to determine whether differences in speech and swallowing function are a component of an overarching orofacial dysfunction.
Keywords: orofacial myofunctional disorders, orofacial function, assessment
Submission Statement: This presentation will draw attention to the complexities and inconsistencies when assessing for oral dysfunction. SLPs will be encouraged to reflect on their clinical practise, and to make additional observations and adjustments to existing assessment processes to identify oral dysfunction more broadly in their caseload.
Aim(s): To evaluate common assessment processes for orofacial dysfunction, including the involvement of SLPs and other professionals. This will provide a framework for thorough assessment of orofacial dysfunction and inspire changes in SLP clinical practice.
Methods: Five databases were systematically searched using keywords relating to “oral function”, “children” and “assessment”. Studies that included: a) participants aged 2-18 years with no diagnosed neurological or cognitive delay; b) direct assessments of oral functions; and c) aims to investigate orofacial dysfunction, were eligible for review. Grey literature describing assessments for orofacial dysfunction were also included.
Results: The systematic search yielded 3526 articles. After removing duplicates, 1798 papers were screened for inclusion in full-text review and data extraction. Data about professionals involved in assessment, assessment tools, orofacial functions assessed, and types of assessment tasks will be extracted, analysed and reported.
Conclusions: Results from this study will ascertain the scope of assessments for orofacial dysfunction by analysing reported assessment tools and protocols. SLPs can consider additional observations to incorporate in existing assessments to determine whether differences in speech and swallowing function are a component of an overarching orofacial dysfunction.
Keywords: orofacial myofunctional disorders, orofacial function, assessment
Submission Statement: This presentation will draw attention to the complexities and inconsistencies when assessing for oral dysfunction. SLPs will be encouraged to reflect on their clinical practise, and to make additional observations and adjustments to existing assessment processes to identify oral dysfunction more broadly in their caseload.
Ms Yingying He
Speech Pathologist
West Wimmera Health Service
Thickened fluids in rural residential aged care facilities – What influences successful preparation?
Presentation summary
Introduction
Thickened fluids are frequently recommended to manage dysphagia in residential aged care facilities. Their classification is guided by the recently implemented International Dysphagia Diet Standardisation Initiative (IDDSI) framework. Few studies have included direct observation of thickening fluids, or investigated adherence to recommended consistencies in rural health settings.
Aim(s)
1) To quantify adherence to IDDSI guidelines, 2) to identify factors influencing manually prepared fluids, and 3) explore staff perceptions of thickening fluids.
Methods
Nurses and personal care workers from ten rural residential aged care facilities completed a survey exploring perceptions of current processes, and confidence relating to manual fluid thickening. A speech pathologist observed staff thickening water to a requested thickness and temperature (hot or cold), then assessed it against IDDSI guidelines. Outcomes were analysed using descriptive statistics.
Results
47 (26%) staff completed the survey. Challenges included time constraints and knowledge of drink preparation. Regular staff education on thickening drinks and encouragement from various staff assisted successful thickening. Nearly 30% of participants were not familiar with IDDSI. 40 (22%) staff were observed. 71% of prepared water met IDDSI guidelines for their target thickness level. The individual thickness and temperature levels requested did not appear to affect the participants’ ability to prepare water that met IDDSI guidelines.
Conclusions
Addressing barriers and regular education around IDDSI and the process of thickening drinks are recommended to support staff confidence and accuracy of drink preparation. Working with management of residential aged care facilities to increase staff’s learning opportunities will be beneficial.
Thickened fluids are frequently recommended to manage dysphagia in residential aged care facilities. Their classification is guided by the recently implemented International Dysphagia Diet Standardisation Initiative (IDDSI) framework. Few studies have included direct observation of thickening fluids, or investigated adherence to recommended consistencies in rural health settings.
Aim(s)
1) To quantify adherence to IDDSI guidelines, 2) to identify factors influencing manually prepared fluids, and 3) explore staff perceptions of thickening fluids.
Methods
Nurses and personal care workers from ten rural residential aged care facilities completed a survey exploring perceptions of current processes, and confidence relating to manual fluid thickening. A speech pathologist observed staff thickening water to a requested thickness and temperature (hot or cold), then assessed it against IDDSI guidelines. Outcomes were analysed using descriptive statistics.
Results
47 (26%) staff completed the survey. Challenges included time constraints and knowledge of drink preparation. Regular staff education on thickening drinks and encouragement from various staff assisted successful thickening. Nearly 30% of participants were not familiar with IDDSI. 40 (22%) staff were observed. 71% of prepared water met IDDSI guidelines for their target thickness level. The individual thickness and temperature levels requested did not appear to affect the participants’ ability to prepare water that met IDDSI guidelines.
Conclusions
Addressing barriers and regular education around IDDSI and the process of thickening drinks are recommended to support staff confidence and accuracy of drink preparation. Working with management of residential aged care facilities to increase staff’s learning opportunities will be beneficial.