Introduction: Patient reported outcome measures (PROMs) are becoming widely accepted as evidence-based practice (EBP) in healthcare. Within the field of speech-language pathology (SLP), there is no synthesis of validated PROMs available to guide clinical practice.

Aims: This scoping review aims to systematically identify and evaluate English-validated, condition-specific PROMs across adult SLP practice areas.

Methods: A systematic scoping review methodology was utilised. A comprehensive literature search was performed to identify studies published until 18th February 2022 from MEDLINE, Embase, CINAHL, PsycInfo, Scopus, Cochrane Collaboration and Web of Science. Abstracts and full texts were screened in Covidence and relevant studies that validated PROMs in the English language were extracted and assessed using the ‘Checklist to operationalize measurement characteristics of patient-reported outcome measures’ by two independent reviewers (Francis et al., 2016).

Results: After abstract and full-text screening, 71 validated PROMS were identified across seven SLP practice areas including PROMS which exclusively measured voice (n=19), swallowing (n=15), language (n=11), and fluency (n=8) with fewer condition specific PROMs exclusively related to speech, cognitive-communication and laryngectomy and none identified for augmentative and alternative communication. Ten PROMS were found which measured >1 practice area. Quality ratings were variable, with an average score of approximately 11 out of 18 on the Francis et al., checklist.

Conclusion: A range of clinically useful validated PROMs were identified to guide Speech Pathologists in measuring patient perceptions across a range of adult SLP conditions. Opportunities for further development in areas of SLP practice with limited PROMs currently available are also highlighted.

Submission statement: Our presentation highlights the importance of responding in practice by collaborating with health consumers to obtain their views regarding their condition through patient-reported outcome measures, and respecting the value these measures bring. It further encourages practitioners to reflect on their current use of patient-reported outcome measures.

Keywords: Patient-reported outcome measures, Consumer engagement, adult, assessment

Introduction: In Australia, receipt of aphasia services in the chronic stage is not routine (Rose et al., 2014) despite evidence for ongoing benefit (Fridriksson & Hillis, 2021) and stakeholder desire (Worrall et al., 2011). Exploring stakeholder experiences will elucidate factors impacting longer-term therapy access and adherence.This study represents the first phase of an experience-based codesign project developing a novel smartphone and website application for aphasia self-management.

Aim: To identify barriers to- and facilitators of- aphasia therapy for community-dwelling individuals with chronic post-stroke aphasia.

Methods: Interviews and focus groups were conducted online with 13 participants with chronic post-stroke aphasia, 8 significant others, and 10 allied health professionals. Participants were recruited from regional and metropolitan Australia. Data were submitted to qualitative content analysis.

Results: Content analysis identified 724 codes that were classified as barriers (405) or facilitators (319) and organised into categories and sub-categories across 9 themes: (1) Finding, accessing and/or obtaining aphasia services; (2) Client factors; (3) Client’s personal support network; (4) Structure of the health service and system; (5) Health professionals; (6) Therapy and the therapeutic process; (7) Self-managed therapy; (8) Technology; and (9) Aphasia in the wider community (barriers only).

Conclusions: Barriers and facilitators identified by key stakeholders will inform the codesign of an aphasia self-management application that is highly responsive to user needs. These factors should also be considered by speech pathologists, health professionals, and policy-makers responsible for therapy and discharge planning, referral, and the development and provision of community services.

Keywords - chronic aphasia, lived experience, therapy, codesign

Submission Statement: This study supported individuals with lived experience to reflect on interactions with health services as a first step in the codesign of an aphasia self-management ‘app’. Respect for the lived experience is central to successful codesign, and active involvement of these stakeholders will engender a solution responsive to their needs.

Background
Early supported discharge (ESD) allows many stroke survivors to return home while undergoing rehabilitation. There is limited research into stroke survivors’ experiences with and perception of ESD and home-based therapy. More specifically, the experiences of stroke survivors who receive home-based speech pathology (SP) services, including services from a Therapy Assistant (TA), are not known.

Aims
This study explored the perceptions, experiences and therapeutic preferences of stroke survivors who completed home-based SP rehabilitation following ESD.

Methods
Individuals (n=10), with dysarthria and/or oral stage dysphagia post stroke were randomised to an intensive therapy (five days / week) or usual care group (two - three days / week) and received three weeks of home-based treatment. Post treatment, the participants completed a structured interview or written questionnaire. The data were analysed using qualitative content analysis.

Results
Participants reported high levels of confidence during and improvements in their speech and swallowing after therapy. They gave positive accounts of the staff, setting, program and higher intensity treatment. There were mixed views on the used of TAs and difficulties with home practice.

Conclusion
Stroke survivors, in an early phase of recovery, valued and benefitted from home-based speech pathology intervention targeting dysarthria and dysphagia, regardless of the involvement of a therapy assistant. Regular, intensive, and flexible home-based therapeutic exercises and communication practice with someone outside of the family is recommended. Further investigation into the therapeutic preferences of stroke survivors, the use of TAs and the ease and impact of regular practice is required.

Keywords - stroke assistant rehabilitation dysphagia dysarthria

Submission Statement: The use of therapy assistants in healthcare is now commonplace however there is little research investigating stroke survivors’ experiences with speech and swallowing rehabilitation. This presentation reflects on the experiences of 10 stroke survivors over the first three-weeks of rehabilitation on discharge home from hospital.

Introduction/or rationale

Motor speech therapy is effective in clients with ABI (Gandhi et al., 2020). Maintaining engagement in rehabilitation requires sustained motivation from clients and clinicians (Balaam et al., 2011). However, there is often poor understanding and application of motivational theories in motor speech therapy.

Current research has explored the application of motivational theories within physical rehabilitation, however this has not extended into motor speech literature. Three motivational theories will be explored: Goal-Setting Theory (Locke & Latham, 2002), Social Cognitive Theory (Bandura, 1986) and Self-Determination theory (Deci & Ryan, 2002).


Aim(s)

This study aims to explore the perceptions of clients with dysarthria and clinicians to identify gaps where motivational theories can be incorporated into therapy to increase engagement and long-term outcomes.


Methods

A review of the motivational theories within rehabilitation literature informed the survey design.
5 clients with ABI and dysarthria and 5 clinicians were surveyed on their perceptions of long-term motor speech practice and motivation.


Results

Clients and clinicians identified gaps in service delivery and consistently stated it was difficult to maintain motivation and a sense of purpose in their motor speech practice.


Conclusions

There is a need to integrate motivational theories into motor speech therapy to promote necessary and long-term practice. This practical paper provides insights into key aspects of motivation that can be incorporated into motor speech therapy to support sustained engagement and outcomes. These findings informed a motor speech group design to address the current gaps by integrating overt learnings on motivation into therapy.


Keywords - motor speech, ABI, motivation

Submission Statement: This practical paper links to the theme as it reflects on the current practice in motor speech therapy and respects client perceptions of their current experiences. A motor speech therapy group was designed to respond to the needs of clients and integrate overt learnings on motivation to promote long-term outcomes.

There is a growing body of literature exploring pet ownership for people experiencing reduced psychosocial wellbeing, including older adults and people with Dementia. Pets can facilitate independence and social interaction by providing emotional support and companionship however, the responsibility of care can cause emotional distress. People with communication disorders also experience reduced psychosocial wellbeing, although not much is known regarding the benefits and barriers of communicating with and about a pet.

This study aims to explore the experiences of pet ownership for people with communication disorders on psychosocial wellbeing, pet care and human-pet relationships.

A patient and public involvement (PPI) approach between researchers and people with communication disorders from Aphasia SA and the Hospital Research Foundation Group for Parkinson’s will be followed to design and implement the research. PhotoVoice and Semi-Structured Interviews will be undertaken with 10-14 participants with Aphasia and Parkinson’s Disease. Thematic Analysis will identify emerging themes, which will be mapped to the ICF Framework.

From October 2022, the PPI process will collect preliminary data. From January to April 2023, co-occurring data collection and analysis will identify and expand upon emergent themes. From April to September 2023, these themes will be mapped to the ICF.

This study proposes to contribute new knowledge on the experiences of pet ownership for people with communication disorders, from which future research can build upon. The primary objective is to facilitate future development of best practice guidelines for healthcare professionals on supporting pet owners with communication disorders.

Communication Disorders; Aphasia; Hypokinetic Dysarthria; Parkinson’s Disease; Pet Ownership; ICF Framework

This study is built upon the themes of Respect and Respond by incorporating aspects of Public and Patient Involvement. The forefront of the research relies on respecting participant’s lived experiences and perspectives, and responds to ideas generated by members of Aphasia SA and conversations within the Parkinson’s Disease community.

"Introduction
Monash Health speech pathologists teamed up with Monash University engineering students, people with aphasia and volunteers to create a free online clinical tool, Project QWERTY. Projectqwerty.com is a website designed for people with aphasia, targeting spelling and typing skills based on the principals of neuroplasticity and errorless learning.

Aim
To create an online therapy tool for writing skills that is responsive to the users’ needs.

Methods
The team undertook a project involving:
- Building the students’ knowledge of aphasia and insight into the lived experience of people with aphasia.
- Designing an aphasia friendly website, respectful of the users’ age and premorbid function.
- Establishing partnerships with stakeholders to create a beta website. The website then underwent a build-break-improve cycle reflecting consumer feedback.
- Using open source coding to facilitate ongoing improvements.

Results
Throughout the feedback cycle, Project QWERTY users indicated that they value the ability to customise the words they want to practise, reflecting their everyday activities. As such, this feature was integrated as a core component of the website. A minimum viable product was created and the website launched during Aphasia Awareness Month (June 2022). The website has had over 3,400 new users following the launch.

Conclusions
The website is now freely available for people with aphasia to use on their computer or tablet. It provides a platform for independent practice outside of the traditional therapy setting and is customisable to respond to users’ needs.

Keywords
- Aphasia
- Therapy
- Technology
- Team
- Spelling
- Consumers

Submission statement
Project QWERTY was born through reflecting on the gaps in aphasia therapy tools. The team responded by collaborating with Monash University and consumers to create a website addressing this gap. A key feature of Project QWERTY is the ability to customise practice, respecting the diverse needs of consumers."

ntroduction: Multisyllabic words comprise about 90% of the English language but can be challenging to say. Segmenting words horizontally is commonly used to increase articulation accuracy and fluency, but research suggests vertical cueing may be more beneficial.
Aims: To compare no cueing (NC), horizontal cueing (HC), and vertical cueing (VC) on speakers’ and listeners’ perception of ease of production for multisyllabic words.

Methods: Six Australian speakers read three blocks of five multisyllabic words using different cueing methods (NC, HC, VC) and rated ease of each production from 1 (extremely easy) to 6 (extremely hard). Audio recordings of these productions were then presented to 45 listeners. Listeners rated ease of speakers' productions using the same scale.

Results: VC words were significantly longer in duration (M=.89) than HC (M=.70), or NC (M=.72) words, but speakers rated HC words as easiest to say (M=2.5); NC words were rated as hardest (ps<.05). Listeners perceived HC words as significantly easier for speakers to say (M=3.05) than VC (M=3.42) or NC (M=3.20) words (ps<.05). Listeners perceived females as speaking ‘more easily’ than males. Interestingly, listeners rated speakers as having significantly more difficulty saying words than speakers rated difficulty of their production.

Conclusions: Both speakers and listeners rated HC words as easiest to say, supporting that horizontal cueing facilitates multisyllabic word production. Vertical cueing was only supported by speakers as easier than NC. increased duration may have impacted listener ratings for VC words. These cueing methods could be used to address different client goals.

Keywords: speech, cueing; multisyllabic, speakers, listeners, production

Submission Statement: This study was undertaken after a clinician reflected on how an adult with acquired verbal dyspraxia found vertical cueing helpful. Results prompt reflection on the difference between words being perceived as easier to say by listeners, versus feeling easier to say for speakers. Whose communication needs are we responding to?

Introduction
Intelligibility Enhancement is an intervention approach aimed at improving the intelligibility of multilingual speakers’ consonants, vowels, and prosody when they are speaking a language other than their home language. Previous research with Vietnamese and Mandarin speakers using a single-case experimental design (SCED) has demonstrated the effectiveness of the Intelligibility Enhancement Assessment and Intervention Protocols. Further research is required to examine its effectiveness with speakers of other/non-Asian languages.

Implementation
The participant was a 56-year-old multilingual female, whose home language was Spanish who believed her intelligibility was impacting her promotion prospects. She required a high level of intelligibility in English because she was employed to support university students. English intelligibility was assessed pre-, post- and during intervention with speech pathology students. Intelligibility Enhancement intervention consisted of 12 weekly 1-hour sessions targeting consonants, vowels, and prosody.

Outcomes
Pre-assessment revealed systematic variations in English pronunciation consistent with expectations of differences between Spanish and Australian English phonetic inventories and phonotactics (e.g., devoicing, stopping of fricatives). Post-intervention changes in intelligibility include percentage of consonants correct, production of final consonants, consonant clusters, and syllables, acceptability of speech rate, volume, and word stress, and self-perceptions of intelligibility, confidence, and ease communicating in English within her workplace.

Conclusion
Intelligibility Enhancement is relevant for speakers of a wide range of languages and the Intelligibility Enhancement Assessment and Intervention Protocols can be applied with fidelity within clinical education programs. This study extends the evidence base for the Intelligibility Enhancement Protocols paving the way for larger-scaled research (e.g., randomised controlled trial).

Keywords: Intelligibility Enhancement; multilingual; single-case experimental design (SCED); Spanish

Submission statement: Delegates will be encouraged to reflect on evidence-based methods for supporting multilingual speakers’ intelligibility, respecting clients’ motivations for seeking intervention, and the need to provide responsive services in an increasingly diverse community.