9th CPLOL CONGRESS BOOK OF ABSTRACTS

Transcription

BOOK OF
ABSTRACTS
9 CPLOL
CONGRESS
th
Open the doors to communication
May 8-9, 2015
Florence Italy
www.cplolcongress2015.eu
Book of Abstracts
9th CPLOL Congress
May 8-9, 2015, Florence, Italy
CPLOL, 2015
Book editor
Baiba Trinite
Language editors
Michèle Kaufmann-Meyer
Maria Vlassopoulos
Translation
Maria Rosaria Broggi
Graphic design
Uvetamex
© CPLOL, 2015
Standing Liaison Committee of E.U. Speech and Language Therapists and Logopedists
145 Bd Magenta, F-75010 Paris
www.cplol.eu
ISBN
978-2-9552505-0-1
EAN9782955250501
BOOK OF
ABSTRACTS
9 CPLOL
CONGRESS
th
Open the doors to communication
May 8-9, 2015
Florence, Italy
Executive Committee CPLOL 2013-2016
President: Michèle Kaufmann-Meyer
Secretary General: Ulrika Guldstrand
Vice President, Education: Maria Vlassopoulos
Vice President, Professional Practice: Catarina Olim
Vice President, Congress: Baiba Trinite
Vice President Recognition: Raffaella Citro
Treasurer: Frédérique Schneider
Congress president
Michèle Kaufmann-Meyer (Switzerland)
Host president
Tiziana Rossetto
Scientific committee
Chair: Baiba Trinite (Latvia)
Child language
Kristina Hansson (Sweden)
Rositsa Iossifova (Bulgaria)
Maria Vlassopoulos (Greece)
Child Non-Language
Vilma Makauskiene (Lithuania)
Thora Masdottir (Iceland)
Heike Münch (Austria)
Adult language
Jean-Laurent Astier (France)
Fofi Constantinidou (Cyprus)
Mary Overton Venet (Switzerland)
Adult non-language
Raffaella Citro (Italy)
Hanneke Kalf (Netherlands)
Youri Maryn (Belgium)
Education
Bauke Leijenaar (Netherlands)
Anne-Lise Rygvold (Norway)
Irene Vernero (Italy)
Organizing committee
Raffaella Citro (Italy)
Anna Giulia De Cagno (Italy)
Gianfranca Errica (Italy)
Ulrika Guldstrand (Sweden)
Catarina Olim (Portugal)
Sara Panizzolo (Italy)
Frédérique Schneider (France)
Baiba Trinite (Latvia)
Maria Vlassopoulos (Greece)
Organizing secretariat
Italy Destination Labs
An Uvet American Express division
Via La Marmora 36
50121 Florence - Italy
CONTENTS
Welcome addresses
5
Invited speakers
7
Honorary speech
7
Keynote speeches
8
Invited sessions
11
Oral presentations
13
Workshops
99
Round table discussion
111
Poster presentations
Authors’ Index
115
203
4
President of CPLOL
Dear Friends and Colleagues,
It is my privilege and great pleasure, as President of the Standing Liaison Committee of E.U.
Speech and Language Therapists and Logopedists (CPLOL), to invite and welcome you to
the 9th European Congress of Speech and Language Therapy which will be held at the
Palazzo degli Affari in Florence, Italy, from May 8th to May 9th 2015.
CPLOL represents 35 national associations of SLTs with approximately 80,000 professionals
from 30 European countries. Our main goal is to represent all professionals across Europe
and promote Speech and Language Therapy on the scientific, academic and clinical arena.
The European Congress of CPLOL is a major event for the logopedic community and attracts a vast number of European
as well as worldwide clinicians, researchers, academics and professionals from the field of communication rehabilitation
and related areas.
Florence is the capital and the most populous city of the province of Tuscany. Due to Florence’s artistic and architectural heritage, it was ranked as one of the most beautiful cities in the world and declared a World Heritage Site by UNESCO in 1982. It is considered the birthplace of Renaissance and offers a multitude of historical and cultural attractions.
A renowned fashion city, a place of culinary delights and with its proximity to the famous Tuscan vineyards, it certainly
offers its visitors the opportunity to live the “italianità”*.
The Congress Organizing Committee in collaboration with Uvet American Express and the Scientific Committee are
working fervently to present a stimulating scientific program with keynote lectures, and a wide variety of sessions,
workshops and poster presentations that will appeal to the eclectic community of multilinguistic, multicultural and
diversified attendees. In addition, the Congress always gives wonderful opportunities for social networking events, for
professional exchanges, as well as cultural and culinary diversions.
I am looking forward to this event and to the opportunity to share it with friends and colleagues from our wonderful
community of Speech and Language Therapists across all frontiers.
Let us “OPEN THE DOORS TO COMMUNICATION” together and share the passion!
* Italian character
Tiziana Rossetto
President of Federazione Logopedisti Italiani
Dear Friends and Colleagues,
The Federazione Logopedisti Italiani has welcomed the opportunity to host the 9th CPLOL
Congress in Italy with great excitement and pride.
In 2015 the appointment will see the European Community of Speech and Language Therapists
aware of the professional role and the sophisticated skills needed to meet the new challenges
of the European Health systems in complex times.
Answers and solutions already belong to the professional community who has been promoting
and adopting methods and solutions based on accuracy and scientific vidences for the
protection and the quality of the treatments.
As a demonstration that Europe does not only mean EURO, the European single currency,
the Federazione Logopedisti Italiani, FLI, welcomes you to Italy and to the city which mainly
represents it for culture, history, places of excellence and cultural innovations: Florence.
The 9th CPLOL Congress is held in conjunction with the World Expo, Feeding the Planet, Energy for Life, a unique event
and a once-in-a-lifetime experience which will leave a lasting impression on those who will also take the opportunity of
visiting it.
The Italian Association, FLI, will also give its contribution to the European Congress by jointly holding its national conference “feeding the mind, quality for life” by sharing the best practices of Speech and Language Therapy and reinterpreting the main Expo theme.
With these perspectives of scientific and cultural opportunities and aiming at sharing this cultural and educational space
with new professional objectives Italy waits for you!
See you in Florence – Arrivederci a Firenze!
5
Baiba Trinite
Chair of the Scientific Committee
Vice President of CPLOL
Dear Colleagues,
The Scientific Congress is the reference point for each individual researcher and for speech
and language therapy in general.
In this volume, I have the privilege to present more than 300 abstracts from 39 different
countries around the world, which were submitted to the congress.
Throughout the process, I have tried to find answers to the question: “What are you,
European Speech and Language Therapy, in the year 2015?”
My answer is definite, convincing and clear. European Speech and Language Therapy, you
are diverse, covering different fields of SLT and finding contact points with related disciplines.
You are reflective, looking deeply inside disorders, searching for explanations of causes,
symptoms, and the best therapy techniques.
You are international, demonstrating that scientists do not have borders and that we can create scientific networks,
not only between European countries, but also through transcontinental communication. Finally, you are young – many
young researchers are taking their first steps on the old stage of European speech therapy, and for them the Florence
congress will always be remembered as their initiation.
I hope the 9th CPLOL Scientific Congress will be a springboard for all young and talented people wishing to join their
lives with speech therapy, a place where they can find ideas for future studies; and for experienced researchers and
professionals, the Congress may provide a scientific platform where theory meets practice and new ideas will be possible. Thus the spirit of speech therapy will be an inspiration for everyone.
I would like to thank all people involved in the hard work of congress preparation – members of the scientific and organizing committees, FLI and Uvetamex. We created a perfect team!
The doors have been opened to communication and communication opens the doors to science, experience and collaboration!
6
INVITED SPEAKERS
Dorothy Bishop
United Kingdom
Dorothy Bishop is Professor of Developmental Neuropsychology at the University of Oxford.
She is funded by the Wellcome Trust on a Principal Research Fellowship and heads a
programme of research into children’s communication impairments.
Dorothy’s interest in cognitive disorders was stimulated when she studied Experimental
Psychology at Oxford University in the early 1970s, and she went on to train as a clinical
psychologist at the Institute of Psychiatry in London.
She was fortunate in receiving long-term research funding, first from the Medical Research
Council and subsequently from the Wellcome Trust, and this allowed her to adopt an
unusually broad approach to the study of children’s language disorders.
Dorothy has authored two books and edited four others, and published over 200 papers in scientific journals.
She has developed widely-used assessments of children’s language, including the Test for Reception of Grammar, and
the Children’s Communication Checklist.
Dorothy is a Fellow of Royal Society, a Fellow of the Academy of Medical Sciences, and a Fellow of the British Academy, and has Honorary Doctorates from the Universities of Newcastle upon Tyne, Western Australia and Lund, Sweden.
She holds a supernumerary fellowship at St John’s College, Oxford.
Honorary speech
Why do some children find language so hard to learn?
Theoretical accounts of children’s language difficulties have been polarised between those that postulate auditory
processing deficits, and those that focus on poor grammatical competence. I will discuss evidence from a study that
used computerised training to look at learning in children with unexplained language difficulties. We contrasted learning of new vocabulary vs. learning to respond to simple reversible sentences that included a spatial preposition (e.g.,
“the duck is above the ball”). Our results indicated that children’s comprehension problems are not explicable in terms
of auditory processing problems. Nor did children seem to lack grammatical knowledge: their problems on the prepositions task reflected performance rather than competence limitations. The overall pattern of results agreed well with the
hypothesis that there is a problem with procedural learning in children with specific language impairment. Poor sentence comprehension arises when the child has to hold material in memory while translating a sequence of words into
meaning. Declarative learning – which is involved in learning associations between sounds and meanings – is relatively
spared. Implications of these findings for therapy will be discussed.
7
Virginia Volterra
Italy
Virginia Volterra, formerly Director of the Institute of Cognitive Science and Technologies
of CNR (1998-2001), is currently associated to the same Institute. She has explored early
language development in typically and atypically developing children providing insights
into the role of gesture. She pioneered sign language research in Italy. Author of more
than 200 publications with national and international publishers, she has been named
Honorary Fellow of University College London.
Keynote speech
From action to language: recent theoretical perspectives and empirical evidence
The presentation focuses on early stages of development exploring the emergence of the language system from action in
infancy and its evolution toward the adult system.
In the late 1970s, when systematic studies on language acquisition began, the findings on the role of action and gesture
in the acquisition and development of language did not raise any particular interest in a wider audience. In more recent
years a new theoretical framework emerging from different disciplines and perspectives (evolutionary, neuro-physiological,
linguistic) made this approach to the ontogeny of language extremely relevant.
Recent findings on the tight link between actions, gestures, and spoken words in young children support and are in accordance with hypotheses put forward by these different new theoretical perspectives.
8
Jean-Luc Nespoulous
France
Currently: Professor Emeritus, University of Toulouse, Honorary President of the “Société
de Neuropsychologie de Langue Française”.
M.A in English and M.A in General Linguistics (1970). PhD in Linguistics (1973) with a thesis
on agrammatism in Broca’s Aphasia.
Appointed “Assistant Professor” in the Department of Language Sciences (University of
Toulouse) until 1980, he then leaves Toulouse to co-found, in 1982, with Pr. André Roch
Lecours the “Théophile Alajouanine Laboratory” at the University of Montreal, Canada
nowadays CRIUGM). In 1986, in that same university, he is appointed “Full Professor’ of
Neuropsycholinguistics in the Department of Linguistics and Philology.
Back to Toulouse in 1988, he founds, in 1990, the “Neuropsycholinguistics Laboratory
Jacques-Lordat” (Université de Toulouse-Le Mirail) within the Department of Language
Sciences of that university.
He very actively participates in the launching, in 1990, of the Toulouse Network in Cognitive Sciences (PRESCOT) sponsored by the C.N.R.S (“Cognisciences Project”).
In 2000, he founds the “Toulouse Brain Sciences Institute” (ISCT) and remains its Director until 2007.
In 2007, he finally founds the “Interdisciplinary Research Unit OCTOGONE” gathering, for the first time in Toulouse
researchers from both linguistics and psychology (n= 50).
“Silver Medal” from the CNRS in 2004 CNRS for his contribution to the development of Cognitive Sciences and Interdisciplinarity, he retires in 2010 at the end of his mandate as “Senior member” of the “Institut Universitaire de France” in
the chair of Cognitive Neuropsycholinguistics.
Keynote speech
Communication despite aphasia
…and what if aphasic patients communicated better than they talk1
If linguistic competence does require the mastery of the phonological and lexical structural units of a natural language
together with their morphosyntactic rules, “in situ” communicative competence (Cherry, 1957, Hymes 1966) needs the
calling up of several adaptative strategies in order to ensure adequately, with a high degree of cognitive flexibility, the
felicitous transfer of information.
If such a statement universally applies to any interactive speech acts (Austin, 1962 ; Searle, 1969…) between normalspeaking subjects, it is all the more valid when one comes to consider communication involving someone suffering from
a language deficit (here “aphasia“) and fighting to “by-pass” it as much as possible.
Within the context of our presentation, we will focus more on the latter than on the former perspective, in an attempt to
shed light upon adaptative (palliative) strategies developed by both the patient and his human environment in everyday
semiotic practice (Nespoulous, 1973, 2014). To these intrinsic, and largely spontaneous, strategies may/ must be obviously added extrinsic strategies, whether induced by the speech therapist or relying on the modern technological tools
of “augmentative communication” and “information/access for all” (Nespoulous & Virbel, 2007).
The notion of “shared handicap” will be developed and particular emphasis will be laid upon the necessity, for speech
therapists, to resort to a functional, cognitive - but pragmatically “situated” -- neuropsycholinguistic approach of acquired aphasia.
References
Austin, J. How to do things with words, Oxford, Oxford University Press, 1962.
Cherry, C. On human communication, Cambridge (Mass.), The M.I.T Press, 1957.
Hymes, D.H. «Two types of linguistic relativity», in W. Bright (Ed.) Sociolinguistics, The Hague, Mouton, 114-158, 1966.
Nespoulous, J-L. Etude linguistique de divers phénomènes d’agrammatisme, Thèse pour le Doctorat de 3ème cycle,
Université de Toulouse-Le Mirail, 1973.
Nespoulous, J-L. «L’aphasie: du déficit à la mise en place de stratégies palliatives», in J-M. Mazaux., X. de Boissezon.,
P. Pradat-Diehl. & V. Brun (Eds.)., Communiquer malgré l’aphasie, Montpellier, Sauramps Médical, 11-19, 2014.
1. Cf. « Aphasics communicate better than they talk ». (p. 173). Holland, A. « Some practical considerations in aphasia rehabilitation », in M. Sullivan &
M.S. Kommers (Eds.) Rationale for adult aphasia therapy, Lincoln, University of Nebraska Medical Center Print Shop, 167-180, 1977.
9
Jois Stansfield
United Kingdom
Jois Stansfield is a speech and language therapist with academic and clinical posts in
England, Canada and Scotland, working with a range of client groups, notably intellectual
impairment and dysfluency. Since 2003 she has held the post of professor of Speech
Pathology at Manchester Metropolitan University, where she teaches clinical education,
ethics and fluency classes and supervises Honours projects for Psychology and Speech
Pathology and Speech Pathology and Therapy undergraduate students. In addition she
contributes evidence based practice and project development units at MSc level and
is currently leading the development of an all on-line Masters of Research in Health
and Social Care degree.
Research interests include ethical issues in research and practice; communication in intellectual impairment; stuttering;
student education; SLT service evaluation; and SLT history. Her PhD students are investigating autism, dysphagia, hearing impairment, intellectual impairment; older children with language difficulties; psychological responses to ill health
and speech therapy clinical decision making. She was one of the steering group members of the CPLOL led multi-partner EU project NetQues, developing benchmark competences for SLT graduates across Europe. Other recent research
has focused on identifying training requirements for competence in dysphagia management for new SLT graduates; the
experiences of parents with intellectual impairments and the ways in which they can be supported to communicate with
authority figures and she has recently completed a commissioned project producing an on-line history of the UK professional body (RCSLT).
Keynote speech
Education, effective practice and ethics in speech and language therapy
The paper traces speech and language therapy educational approaches in the 20th century, then draws from research on
SLT education carried out in the UK in the late 1990s, relating this to the EU wide NetQues project completed in 2014,
to identify the areas of practice considered essential for a newly graduating SLT today to be considered capable of effective practice, i.e. ‘competent’.
Speech and language therapy students begin by bringing a combination of cognitive abilities, linguistic and interpersonal skills and personal motivations to the programmes of education they enter. They develop a range of profession
specific knowledge, clinical skills and a values base through a wide range of learning opportunities during their studies.
This enables them to succeed in their chosen field and join the speech and language therapy community. A number of
models of competence in SLT practice are presented and these are related to current approaches to SLT education for
practice.
It is argued that personal characteristics and values underpin the application of knowledge and skill aspects of clinical
work, that values can be learned and these are at the heart of effective, competent practice. However, there is a complex and constantly changing relationship between these aspects of competence, which is directly influenced by the
context in which a therapist works. Case studies are used as exemplars of clinical decision making in practice.
Ethical practice is expected of all SLTs and the paper goes on to discuss the bases of ethical reasoning in speech and
language therapy, how this reasoning can be supported and what to do when ethical practice or professional competence are in question.
The paper concludes by considering how social mores change over time and how cultural diversity across Europe
may challenge SLT’s values and notions of propriety. It returns to the NetQues outcomes and country snapshots and
the implications of the European Union’s official motto, ‘United in diversity’ for speech and language education and
practice.
10
Katherine Verdolini Abbott
United States of America
Dr. Verdolini Abbott is Professor Communication Science and Disorders and Otolaryngology
at the University of Pittsburgh in Pittsburgh, Pennsylvania (USA). She is also a faculty member
in the McGowan Institute for Regenerative Medicine at the University of Pittsburgh, and in
the Center for the Neural Basis of Cognition at Carnegie-Mellon University and the University
of Pittsburgh. She has received continuous funding since 1997 from the National Institutes
of Health (USA) for her research in voice and voice disorders. Her research interests have
focused on the effects of hydration and dehydration on voice, voice production biomechanics,
models of perceptual-motor learning applied to voice, physical pathways in mind-body
connections in voice, interactions between breathing and laryngeal function, and exercise physiology. She is a Fellow
of the American Speech-Language-Hearing Association (ASHA), from which she also received the highest Honors in
2009. She is former Editor of the Journal of Speech, Language, and Hearing Research, and also G. Paul Moore Lecturer
at the 2011 Voice Foundation Symposium in Philadelphia. She recently completed a Master of Divinity degree from
Pittsburgh Theological Seminary, and has interests in spirituality and health.
Invited session
Emerging models of pediatric voice therapy: voice conservation, be gone!
Many conditions may affect children’s voices. However, by far the most common conditions are those attributable to
voice use patterns, such as nodules. The first-line approach for the treatment of such phonotraumatic conditions is
overwhelmingly behavioral. Traditional models of behavioral intervention have emphasized voice conservation. The
logic is that if voice use caused the problem, a reduction in voice use should help to cure it. On the surface, the logic
is sensible. However, at a deeper level, it is flawed in two ways. First, we are communication specialists. As such, it is
paradoxical for us to address a communication problem by asking a person to communicate less. With this approach,
our patients are either impaired either by their disease or by their treatment. Second, new data on the biology of laryngeal injury and wound healing suggest that some forms of tissue mobilization – for example those found in resonant
voice and some other voicing patterns – may actually be reparative for acute and possibly chronic vocal fold injury. This
presentation will review the biological data and apply them to emerging models of voice therapy for children. Attention
will also be given to theoretical factors in perceptual-motor learning in children, which should also shape our therapies.
Brief examples will be provided of how both biomechanical and learning variables are integrated in a new model of
pediatric voice therapy, Adventures in Voice.
11
Arlene A. Pietranton
Arlene A. Pietranton, PhD, CAE serves as Chief Executive Officer of the American
Speech-Language-Hearing Association (ASHA), the professional scientific, and
credentialing association for over 173,000: audiologists; speech-language pathologists;
speech, language, and hearing scientists; and student, international and support personnel
affiliates. ASHA’s staff of 260 individuals are based in the association’s Gold LEED certified
national office located in Rockville, MD.
Before working at ASHA Arlene was on staff at The George Washington University Medical
Center in Washington, DC where she held several clinical and administrative positions as
a speech-language pathologist and member of the medical center administration. She is
an ASHA Fellow and past president of the District of Columbia Speech-Language-Hearing Association.
Arlene is active in the American Society of Association Executives (ASAE) and has actively collaborated with association
executives throughout North America, Europe, Australia and Asia on association management and governance. She is
an ASAE Fellow and the immediate past Chairperson of the ASAE Board of Directors.
Arlene earned her Bachelor of Arts in biology, Master of Arts in speech-language pathology, and PhD in psychology
from the George Washington University. She resides in Washington, DC with her husband and two adult daughters.
Her interests include international history and culture, reading, theater, travel, skiing and spending time with family and
friends.
Judith L. Page
Judith L. Page, PhD, CCC-SLP, associate professor in the Division of Communication
Sciences and Disorders at the University of Kentucky, served as Program Director for
Communication Sciences and Disorders for 17 years and Chair of the Department of
Rehabilitation Sciences for 10 years. Her clinical, teaching, and research areas include
research methods, AAC, service delivery in the public schools, and language intervention
strategies for individuals with complex communication needs.
Judy is an ASHA Fellow and is currently president-elect of the American
Speech-Language-Hearing Association (ASHA). In this role she serves on ASHA’s Board
of Directors, ASHA’s Financial Planning Board, and the American Speech-Language-Hearing Foundation’s Board of
Trustees. Previous ASHA activities include service as member and chair of both the Council on Academic Accreditation in Audiology and Speech-Language Pathology and the Council for Clinical Certification in Audiology and SpeechLanguage Pathology, service as an accreditation site visitor, and appointments to several other ASHA committees.
Judy is a past president of the Kentucky Speech-Language-Hearing Association, former chair of the Kentucky Board of
Speech-Language Pathology and Audiology, and former secretary of the Council of State Association Presidents.
Judy earned three degrees in speech-language pathology: a bachelor’s from the University of Minnesota, a master’s degree from the University of Illinois, and a PhD from Purdue University. She resides in Lexington, KY with her partner and
several four-legged children. Her interests include choral music, reading, travel, theater, mid-century modern design,
and spending time with friends.
Invited session
Speech-language-pathology in the usa and asha: their history and their future
Arlene A. Pietranton, Judith L. Page
Associations play a vital role to the success of any profession. Through the professional standards we develop, the
resources and public awareness materials we disseminate, and the continuing professional development we provide –
associations truly help to make the world better, safer and smarter. This session will provide a brief history of the profession of Speech-Language Pathology in the United States and the professional, scientific and credentialing association
ASHA (the American Speech-Language-Hearing Association). ASHA’s current organizational and research priorities
and its external collaborations will be described. And recent research findings on factors that are characteristic of high
performing association Boards will also be shared.
12
ORAL
PRESENTATIONS
13
01.1
SENTENCE REPETITION AS A TOOL OF SLI IDENTIFICATION:
THE CASE OF CYPRIOT GREEK
Eleni Theodorou - Cyprus Acquisition Team, University of Cyprus, Nicosia, Cyprus
Maria Kambanaros - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Kleanthes Grohmann - Cyprus Acquisition Team, University of Cyprus, Nicosia, Cyprus
Objective: Researchers have recognized the utility of a sentence repetition task (SRT) in assessing
children’s language ability, and due to this, several diagnostic and screening tests incorporate it
as a subtest. The objectives of this study are:
1. to evaluate the performance of Greek Cypriot children with Specific Language Impairment (SLI)
on α SRT,
2. to examine the diagnostic accuracy, namely specificity and sensitivity levels of the task,
3. to determine whether children’s performance on the SRT is correlated with their performance
on language tests that are used by speech and language therapists (SLTs) in Cyprus.
Methods: Thirty-eight Greek Cypriot children aged 5 to 9 years participated in this study. The
children were divided into two groups: a group including children with SLI (n=16) and a chronological age-matched control group (n=22). The SRT explored the recall of sentences that included
subject and object relative clauses, embedded that-clauses, adjunct because-clauses, negative
sentences, and subjunctive clauses.
Results: Data analysis showed that the SRT yielded significant differences in performance of
children with SLI and those who are typically developing. Children with SLI performed significantly
worse than controls. Analysis of diagnostic accuracy showed good levels of both specificity and
sensitivity (80%). Furthermore, the task was found to correlate with measurements included in the
battery of diagnostic tests (e.g. DVIQ: Morphosyntax, BST: Subordinated clauses).
Conclusions: Both the accuracy level of the task and its correlation with measurements that assessed different language components indicated that the SRT can be used by SLTs for diagnostic
accuracy in the context of SLI.
Keywords: SLI, sentence repetition, Cypriot Greek, identification accuracy
01.2
A SWEDISH TEST FOR LANGUAGE SCREENING AT AGE 4
Ann Lavesson - Department of speech- and language pathology, Skåne University Hospital, Lund, Sweden
Martin Lövdén - Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Kristina Hansson - Department of Clinical Sciences, Logopedics, Phoniatrica & Audiology, Lund University, Lund, Sweden
Objective: In Sweden the most comprehensive screening including language is carried out at age
4 by health nurses. Protocols presently in use focus mainly on phonology and often fail to identify children with more severe language difficulties. The purpose of our project was to construct
a standardized screening test based on research on clinical markers of language impairment to
identify children who need language intervention.
Methods: A test containing different types of tasks was constructed. Health nurses at different child health centers used the test for language screening at the 4-year check-up with 342
children. The population was unselected and 24% of the children were multilingual, which is
representative of Swedish demography. A preliminary cut-off score was selected for referral to a
Speech-Language Therapist (SLT).
Results: 42 children were referred to an SLT and were assessed with respect to expressive phonology, grammar and sentence comprehension.
14
In 31 cases the referrals were judged as adequate. Based on the information so far sensitivity
is .94 and specificity .96. Multilingualism did not correlate with total score and correlation with
gender was very weak. To identify possible false negatives, a follow-up questionnaire to parents
whose child has reached the age of 5½-6 will be finalized in April 2015.
Conclusions: The test seems to have satisfactory properties to be able to identify children who
need to see an SLT at age 4 and to be appropriate to use for both mono- and multilingual children.
Keywords: Language impairment, language screening, sensitivity, specificity
01.3
DIAGNOSTIC ACCURACY OF TWO LANGUAGE DEVELOPMENT
TESTS IN TURKISH
Orhan Selçuk Güven - Research, Education and Training Center for Speech and Language Therapy, Anadolu University,
Eskisehir, Turkey
Objective: The purpose of the study is twofold: a) to define data-based cutoff score(s) to identify
language disorders in children and b) to investigate the diagnostic accuracy of two tests (TEDİL
and TODİL) based on the cutoff scores.
Methods: The Turkish Early Language Development Test (TEDİL; Topbaş & Güven, 2011) is an
adaptation of the Test of Early Language Development-3 and the Turkish School Age Language
Development Test (TODİL; Topbaş & Güven, in press) is an adaptation of the Test of Language
Development-Primary:4. In the study, for TEDİL (N=1431) and TODİL (N=1231) in total 2662 children’s data was used. The sample is quite representative and in order to do this, different demographic aspects (such as gender, age, ethnicity) have been considered. According to the results
for both tests, as a data-based cutoff score -1.00 sd or 85 quotient has been found. In this study,
in addition to a minimum degree of sensitivity and specificity, minimum positive and negative likelihood ratios have also been considered as a criteria.
Results: According to the results, both TEDİL and TODİL have sufficient degrees on the identification of monolingual children with or without primary and secondary language impairment. On the
other hand, both tests have been found insufficient for the identification of typically developing
bilingual children.
Conclusions: Despite its high accuracy on the identification of monolingual typically and atypically developing children, these tests need to be used carefully in typically developing bilingual
children.
Keywords: Developmental language tests, language disorders, diagnostic accuracy, sensitivity,
specificity
01.4
VALIDATING A PHONOLOGY ASSESSMENT AND DOCUMENTING
PHONOLOGICAL PROCESSES FOR SINHALA-SPEAKING CHILDREN
BETWEEN 2 TO 6 YEARS IN SRI LANKA
Shyamani Hettiarachchi - Department of Disability Studies, Faculty of Medicine, University of Kelaniya & Curtin University,
Colombo, Sri Lanka
Objective: 1. to develop and validate test items for a Sinhala speech assessment on children
aged between 2;0 to 6;0, 2. to document the typical phoneme acquisition and phonological
15
processes in Sinhala-speaking children aged between 2;0 to 6;0.
Methods: The ‘Sinhala Speech and Phonology Assessment’ was devised by the researchers
based mainly on the Diagnostic Evaluation of Articulation and Phonology (Dodd et al., 2002) and
administered to 250 Sinhala-speaking children between the ages of 3;0 to 5;00 years (50 children
per age band of 3;0 to 3;5, 3;6 to 3;11, 4;0 to 4;5, 4;6 to 4;11, 5;0 to 5;5 and 5;6 to 6;0). The use of
the test items will be determined by measures of content validity, test-retest reliability and interrater reliability.
To determine phoneme and phonological acquisition, the speech data were phonetically transcribed and quantitative and qualitative analyses undertaken. Using the Phonological Assessment
of Child Speech (PACS, Grunwell, 1985) as a guide, individual phonetic and phonemic inventories were compiled for each participant. The consonant sounds were analyzed according to two
phonetic features: place of articulation and manner of articulation. The criterion for mastery of a
sound (vowels and consonants) was the production of it in the assessment either spontaneously
or in imitation in at least two word-positions (Dodd et al., 2002). Although most studies on English
have looked at speech sounds in word-initial and final positions (e.g. Dodd et al., 2002; Smit et
al., 1990), as the occurrence of consonants in word-final position in Sinhala is limited (Disanayaka,
1991), mastery of a sound in word-initial and word-medial or final was deemed permissible in the
Sinhala data. The quantitative measures will include Percent Consonants Correct (PCC), Percent
Vowels Correct (PVC) and Percent Phonemes Correct (PPC) and statistical analyses using t-tests
and one-way ANOVAs. Qualitative analyses will be undertaken through a comparison of the data
with norms for English2 used in clinical practice at present.
Results: There was a significant effect of age on phoneme acquisition and on phonological processes. There were ‘universal’ and ‘language-specific’ in both the rate and order of speech sound
acquisition and the patterns of phonological processes in Sinhala compared to norms for English. Comparable typical phonological patterns to English included consonant harmony, fronting,
stopping and cluster reduction, although the speech sounds substituted differed between the two
languages. In contrast, the language-specific phonological processes included lateralization and
denasalisation of prenasalised stops.
Conclusions: The test items included were able to generate target phonemes and phonological
processes in participants between 2;0 to 6;0 years. The findings indicated language-specific and
language-universal speech acquisition patterns and phonological processes, highlighting the necessity for language-specific norms and speech assessments. This has important clinical implications for child clients in Europe and across the world, particularly for children from ethnic minority
communities.
Keywords: Phoneme, phonological processes, norms, Sinhala, English, assessment
01.5
BISYLLABLE AND TRISYLLABLE NONWORD REPETITION TEST:
CORRELATION WITH AUDITORY PERCEPTUAL, ORAL-MOTOR
SKILLS AND PHONOLOGICAL MEMORY
Silvia Piazzalunga - Università degli Studi di Milano, Milano, Italy
Lisa Previtali - Università degli Studi di Milano, Milano, Italy
Antonio Schindler - Università degli Studi di Milano, Milano, Italy
Objective: NonWord Repetition (NWR) test is typically suggested as a relatively pure index of
phonological short-term memory, both in typically developing and children with specific language
impairment (SLI). Since the contribution of motor and auditory perceptual abilities has often been
disregarded, our research aims to quantify the possible role of these skills in NWR.
Methods: A cohort of Italian-speaking and typically developing children (36-83 months) were assessed on a battery of standard tests (auditory perceptual, oral motor, and phonological memory
16
tasks) and a novel NWR test with articulatory complexity, specifically validated for Italian children.
Parental education was also taken into account as one possible explanatory variable. We investigated the relationship between the NWR test and other variables by running pairwise correlations
(Spearman’s coefficient).
Results: 375 children were enrolled in the study. The analysis showed a positive correlation between NWR and auditory perceptual, oral motor and phonological memory tasks (0.31<r<0.61,
ρ=0.0001). Parental education showed a non-significant linear correlation.
Conclusions: Results indicated that NWR is a complex task, not only correlated with phonological
memory, but also with oral motor and auditory perceptual abilities, whereas it seems apparently
independent of parental education. These findings provide important theoretical contributions for
language development theories, and they could change the attitude in clinical observations, facilitating the identification of different etiological profiles.
01.6
A PILOT STUDY ON THE VALIDITY OF TWO VOCABULARY TESTS IN
THE GREEK LANGUAGE
Vasiliki Zarokanellou - Department of Speech Therapy, TEI of Western Greece, Patra, Greece
Maria Vlassopoulos - Medical School of Athens, University of Athens, Athens, Greece
Objective: The Expressive One Word Picture Vocabulary Test-Revised (EOWPVTR) and the Peabody Vocabulary Test III (PPVT-III) are two well-known and used English and American English
tests. The purpose of this study was to examine the validity of both these tests in the Greek language.
Methods: The PPVT-III form A was translated and back-translated by two bilingual speech-pathologists, while the EOWPVT-R was translated, back-translated and modified for the Greek language.
All participants of this study were monolingual typically developing children who lived in Athens.
The PPVT-IIIA was administered to 26 children, aged 8.6-9.11 years old. Initially, the EOWPVT-R
was administered to two groups of 26 pupils aged 7.0-8.5 and 8.6-9.11 years old and additionally
to a third group of 25 children, aged 7.0-9.11 years old. This final group was also tested with the
ATHINA TEST, a standardized Greek test, which requires the production of a definition of twenty
Greek words. All testing was conducted by an experienced speech-pathologist. Written permission from the participants’ parents was necessary for participation in the study.
Results: The mean values and standard deviations of the chronological age and of the lexical age
equivalents of each group were calculated. For the comparison between the chronological age
and lexical age of each group, the P paired t- test was used (p=0.01). The results show that the
translated PPVT-IIIA cannot be used without significant adaptation in the Greek language, while
the adapted and translated EOWPVT-R seems to be a valid instrument for the Greek language.
Conclusions: The importance of cultural specificity in vocabulary development was re-affirmed in
this pilot study. Significant modifications are required in tests, which are translated, adapted and
used from one language to the other.
Keywords: Screening, lexical development
17
02.1
VOCABULARY IN SIMULTANEOUS AND SEQUENTIAL BILINGUAL
FIRST GRADERS
Elin Thordardottir - McGill University and CRIR-Institut Raymond Dewar, Montreal, Canada
Objective: Previous research has indicated that simultaneous bilingual preschoolers need as little
as 50% exposure to a language to score within normal limits (WNL) compared to monolinguals.
School entry brings important changes in the language environment. This ongoing study examines the relationship between exposure and performance in bilingual children in their second year
of school.
Methods: Participants were 38 first graders in French schools in Montreal, Quebec: 18 simultaneous and 8 sequential bilinguals, and 12 French monolinguals. English was the other language
of most of the children. The groups did not differ on age (mean 82.8 months (SD 5.5) or maternal
education (18.2 years (SD 2.06), but differed on the percentage of their waking hours since birth
spent with French speakers (assessed by detailed parent report questionnaire (sim: 66.5% (SD
21), seq: 21.2 % (SD 14), monol: 99.8% (SD 0.2). All children were developing without concerns
as per parent report and all had normal-range cognitive development (mean Leiter International
standard score 111.4 (SD 21). Children were tested individually on French receptive (EVIP, French
PPVT) and expressive (Canadian CELF-4) vocabulary.
Results: For the group as a whole, overall percentage of French exposure correlated significantly
with performance (EVIP: r=.610, p<.000; CELF expr: r=.366, p=.025). ANOVAs revealed significant
group differences on both receptive (p=.001) and expressive (p=.029) vocabulary, with post hoc
tests revealing both bilingual groups scoring lower than monolinguals, but not significantly from
each other.
Conclusions: Amount of exposure remains an important influence on the language attainment of
bilingual children in first grade. Early exposure did not lead to better French results overall: sequential learners did not differ from simultaneous learners in spite of markedly less overall exposure.
Keywords: Multilingualism, assessment and prevention
02.2
REPETITION TASKS AS POTENTIAL CLINICAL MARKERS OF SLI IN
MONOLINGUAL AND BILINGUAL CHILDREN
Natalia Meir - Department of English Literature and Linguistics, Bar-Ilan University, Ramat-Gan, Israel
Sharon Armon-Lotem - Department of English Literature and Linguistics, Bar-Ilan University, Ramat-Gan, Israel
Objective: Verbal working memory is an area of weakness in children with Specific Language
Impairment (SLI) (Montgomery, 2002). The present study investigates verbal working memory of
bilingual children with and without SLI and the predictive validity of repetition tasks for diagnosing
SLI among bilingual children.
Methods: Four groups of children aged 5;6 - 7;1 years participated: 45 Russian-Hebrew bilinguals
(15 with SLI) and 32 Hebrew monolinguals (12 with SLI). All children met the exclusionary criteria
for SLI (Leonard, 2000). The four groups were matched on age, socio-economic status and nonverbal IQ; the bilinguals were matched on length of exposure to L2/Hebrew. Children with SLI had
reported history of SLI and language proficiency (LP) score below the cut-off point (for bilingual
children in both languages).
Three repetition tasks were used in Hebrew: (1) Forward Digit Span (FWD-S); (2) Non-Word Repetition (NWR); and (3) Sentence Repetition (SR).
18
Results: The effects of bilingualism and SLI were explored using two-way ANOVAs. An effect for
SLI was observed for all three tasks (p<.001), an effect of bilingualism was observed for tasks with
greater linguistic processing: NWR (p<.05) and SR (p<.05); with no interaction between the two
variables. Monolingual and bilingual children with SLI performed similarly on all three measures.
The predictive accuracy ranged between 71% for NWR, 73% for FWD and 87% for SR.
Conclusions: The findings support the claim that children with SLI exhibit a deficit in verbal working memory and extend it to bilingual children with SLI. The results indicate that speaking two
languages has no aggravating effect for bilingual children with SLI. Repetition tasks (FWD-S, SR
and NWR) are valuable diagnostic markers of SLI in both monolingual and bilingual children.
Keywords: Multilingualism, Specific language impairment
02.3
FIRST AND SECOND LANGUAGE LEARNERS’ LINGUISTIC PROFILES:
TYPICAL AND IMPAIRED DEVELOPMENT
Sini Smolander - Child Language Research Center, University of Oulu, Oulu, Finland
- Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
Marja Laasonen - Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
Eva Arkkila - Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
Sari Kunnari - Child Language Research Center, University of Oulu, Oulu, Finland
Objective: The present study is part of the Helsinki longitudinal SLI study (HelSLI), in which approximately 150 3-to-6-year-old sequentially bilingual and 250 monolinguals with language impairment (Bi-LI and Mono-LI), as well as 160 typically developing children (Bi-TD and Mono-TD),
are studied both cross-sectionally and longitudinally. Here, their linguistic profiles are investigated
in order to shed light on the linguistic characteristics of L2 learners with an immigrant background
that reflect language impairment.
Methods: The current data is a cross-sectional subsample of the HelSLI study data, with 65
Mono-LI and 65 Bi-LI children included. They will be compared to a group of 80 Mono-TD and
Bi-TD children. Bilinguals in this study are children with one language at home and Finnish as their
L2 in the kindergarden, preferably for at least two years. A large assessment battery will be used
to profile the childrens’ L2 skills.
Results: Implications of the findings on linguistic profiles will be discussed and their relevance to
the identification of language impairment in L2 learners will be evaluated. Based on the literature
and tentative results, we hypothesize that Bi-TD children, especially at such a young age, will
demonstrate some similar characteristics of language development as children with LI.
Conclusions: In order to develop identification of LI, normative data on L2 development is needed
to pave the way for avoiding under- and over-diagnosing. The present study will point out the
most reliable assessment tools available, as well as suggest the need for new ones. Since we also
hypothesize that the developmental routes will diverge only later on, the longitudinal approach of
the larger project will later delineate the difference between typical and impaired language development.
Keywords: Multilingualism, developmental language disorders, specific language impairment
19
02.4
PRIMARY LANGUAGE IMPAIRMENT IN MULTILINGUAL CHILDREN:
IDENTIFYING GAPS IN KNOWLEDGE
Wiebke Scharff Rethfeldt - LOGOCOM Institute, Bremen, Germany
Helen Grech - Department of Communication Therapy, University of Malta, Msida, Malta
Eva-Kristina Salameh - Logopedmottagningen Sprakens Hus, Skanes Universitetssjukhus, Malmö, Sweden
Mirjam Blumenthal - Kentalis Academie, Koninklijke Kentalis, Sint-Michielsgestel, Netherlands
Objective: This presentation discusses the challenges of professionals involved in the management of children in Europe with primary language impairment (PLI), who are exposed to more than
one language. The multidisciplinary team under whose care these children fall includes primarily
speech language pathologists (SLTs), special education teachers, psychologists and children’s
guardians. The focus is on the state-of-the-art knowledge related to the European context of terminology and diagnostics of PLI in multilingual children.
Methods: Given the multicultural make-up of society in EU member states, the EU-funded
MULTI-SLI project has brought together SLTs, psychologists, specialized teachers and other
members of multidisciplinary teams from seven EU-countries, facing similar challenges, particularly in relation to the language diversity that exists in Europe. The EU-project (2013-2015) has
been initiated to facilitate the exchange between professionals, their institutions, and informing
applied researchers on core challenges faced by all involved stakeholders around the child, aiming to identify solutions and best practices in order to bridge the gap between theory and clinical
practice.
Results: Gaps in research and challenges faced by practitioners are identified, particularly in relation to the language diversity that exists in Europe. Differences and common diagnostic terminology and criteria that are applied in schools and institutions, where these children are provided
with speech language therapy and educational support are presented. We will show that the term
SLI is widely used even though it is understood differently across EU-countries.
Conclusions: In conclusion, the exclusive and/or inclusive criteria, as well as the term specific
when referring to specific language impairment (SLI) in multilingual children, need revision, for
they may not be applied as to monolingual children. This is relevant to experts establishing international guidelines for clinical and culturally appropriate interventions in multilingual children.
Keywords: Specific language impairment, multilingualism, Europe
02.5
ROMA PUPILS IN PRIMARY EDUCATION: IMPLICATIONS FOR
SPEECH AND LANGUAGE SERVICES
Christina Haupt - University of Applied Sciences, Hochschule Osnabrueck, Osnabrueck, Germany
Judy Clegg - The University of Sheffield, Sheffield, United Kingdom
Joy Stackhouse - The University of Sheffield, Sheffield, United Kingdom
Objective: In the UK, Roma pupils (RP) experience difficulties in accessing education & their
educational achievement is below national expectations. Little is known about the barriers hindering their access & attainment. This paper summarises the findings from a recent study on the
challenges of RPs in engaging with British primary education, the relation between their English
language (EL) skills & educational attainment & implications arising for Speech & Language Services (SLS).
Methods: The research project comprised two phases: (1) Seventeen teaching staff (TS) across
three inner-city primary schools completed questionnaires, 11 participated in semi-structured
follow-up interviews on their experiences of working with RPs. (2) Eighteen Slovak RPs (5-11
years old) were interviewed, their EL skills assessed & their English grades examined.
20
Results: TS identified challenges in four categories which limited RPs’ access to learning: communication, socio-cultural, organisational & institutional barriers.
RPs expressed a high interest in learning & the EL. Their EL skills & educational attainment varied,
but were overall below age expectations; for older RPs the gap was wider.
Conclusions: The findings highlight the need to involve SLS with the increasing RP-population,
not only to identify their possible speech & language needs, but also in supporting and training
TS to differentiate language difficulty from difference. Further, SLSs’ involvement in the design &
implementation of school-based language support programmes is desirable in order to support
RPs & their families.
Keywords: Roma pupils, primary education, language skills, attainment
02.6
THE BILINGUAL PARENTS’ QUESTIONNAIRE (BIPAQ) IN A CLINICAL
SETTING: DIAGNOSIS AND TREATMENT
Hadar Oz - Bar Ilan University, Ramat Gan, Israel
Sharon Armon-Lotem - Bar Ilan University, Ramat Gan, Israel
Objective: Speech and language pathologists (SLPs) experience difficulties diagnosing sequential
bilingual children (SBC) who are delayed in their second language (L2). These difficulties result in
over- and under-diagnosis of Language Impairment (LI). A bilingual parents’ questionnaire (BIPAQ) [1], was used among children with clinical referral (CR) to differentiate SBC with and without
SLI and provide them with an effective treatment plan tailored to their needs.
Methods: 120 SBC (ages 3-7) participated: 60 children with CR (CRCs) due to language performance difficulties and 60 children who were never referred to SLP’s (Non-CRCs). BIPAQ was
administered to all parents and post-treatment evaluations were collected from the SLPs. Only
20 CRCs were diagnosed post-treatment with LI. Using a ROC curve analysis, a cut-off point
was identified among the CRCs. Using this cut-off point, 8 of the 60 non-CRCs were within the LI
range: 6 of these children had very low standardized scores in both languages.
Results: A follow-up treatment study provided CRCs in the non-LI range with enhanced exposure
to L2-Hebrew in small groups. 12 meetings led to a significant improvement in their vocabulary,
comprehension of narrative and situations, relating to emotions and desires of narratives’ characters and length and complexity of utterances, placing them within L2 norms.
Conclusions: In sum, over 50% of CRCs were not diagnosed by BIPAQ as LI, despite their difficulties with L2. A group treatment, based on the developmental-natural approach, helped them
close the gap.
Keywords: Bilingual children assessment, parents’ questionnaire, SLP group treatment
03.1
INTELLIGIBILITY IN CONTEXT SCALE: A SCREENING TOOL FOR
MULTILINGUAL CHILDREN IN 60 LANGUAGES
Sharynne McLeod - Research Institute for Professional Practice, Learning and Education, Charles Sturt University, Bathurst,
Australia
Objective: The Intelligibility in Context Scale (ICS) is a free parent-report screening tool that has
been translated into more than 60 languages. The 7-item scale was informed by the ICF-CY
(WHO, 2007).
21
Methods: The ICS has been normed on 804 Australian children and validated on 120 Englishspeaking children from Australia and 74 Cantonese-speaking children from Hong Kong.
Results: Significant differences were identified for sex, age, and concerns about speech. No significant differences were identified for the number of languages spoken. The ICS had high internal
consistency, good test-retest reliability, and criterion validity.
Conclusions: Additional validation, norming, and clinical studies have been conducted in Croatia,
Fiji, Iceland, Jamaica, Germany, Slovenia, South Africa, Sweden and more studies are underway.
The ICS is a promising screening measure of functional intelligibility.
Keywords: Intelligibility, speech, assessment, multilingual, children
03.2
THE CONTRIBUTION OF PERCENTAGE CONSONANTS CORRECT
(PCC) AND INTELLIGIBILITY TO SEVERITY OF DEVELOPMENTAL
SPEECH SOUND DISORDERS
Anniek J.C. van Doornik-van der Zee - Opleiding voor Logopedie, Utrecht University of Applied Sciences, Utrecht, Netherlands
Hayo H.R. Terband - Utrecht Institute of Linguistics-OTS, Utrecht University, Utrecht, Netherlands
Objective: In SSD, severity is a combination of segmental speech characteristics and intelligibility.
In light of the ICF conceptual framework, the present study compared several intelligibility
measures on the level of Impairment and Participation to an overall measure of intelligibility as
rated by listeners who were unfamiliar to the child. The overall measure of intelligibility was used
as a reference of severity in SSD.
Methods: 37 children (age 48-103 months, 20 male and 17 female) with developmental speech
sound disorder (SSD, n=13) and typical speech development (TD, n=24) participated in the study.
Speech data were collected in several speech tasks and spontaneous speech. Percentage Phonemes Correct (PCC) were calculated. The intelligibility as a participation measure was rated by
parents using the Dutch version of the Intelligibility in Context Scale (ICS-NL; McLeod, Harrison, &
McCormack, 2012). The evaluations of a panel of 22 listeners on intelligibility were involved as the
outcome measure in a correlational study.
Results: A multiple regression analysis over all children (TD and SSD) indicated that 61% (n = 35,
R2 = .606, p < .0001) of the variability in general intelligibility could be explained by a combination
of PCCN (PCC scores on the nonwordtask) and ICS-NL. The percentage of total variance rose to
69% (n = 22, R2 = .69, p < .0001) in the TD-group, and 76% (n = 11, R2 = .762, p < .004) in the
SSD-group.
Conclusions: The present study is a promising first step towards a severity measure for developmental speech sound disorders that can be used in everyday practice. Consequently, PCCN +
ICS-NL are proposed as a measure to express the severity of developmental SSD.
Keywords: Developmental speech sound disorder, PCC, intelligibility, severity measures
22
03.3
PERCEPTUAL SPEECH ASSESSMENT OF CHILDREN WITH CLEFT
LIP AND/OR PALATE
Kadi Ird - Tartu University, Tartu, Estonia
Tiina Suvi - Tartu University, Tartu, Estonia
Triin Jagomägi - Tartu University Hospital, Tartu, Estonia
Lagle Lehes - Tartu University Hospital, Tartu, Estonia
Marika Padrik - Tartu University, Tartu, Estonia
Objective: Children who have craniofacial anomalies are at high risk of developing abnormal
speech patterns. To improve the quality of speech assessment, there is an urgent need to implement a standardized Estonian protocol. The main purpose of this preliminary study is to develop
the methodology for perceptual assessment of speech in patients with CLP.
Methods: Original research material for documentation of Estonian speaking CLP children was
developed in 2013. It is based on the Scandcleft and Americleft methodology. The linguistic material takes into account all the peculiarities of phonetics in the Estonian language, as a Finno-Ugric
language. In addition, we asked CLP parents to complete a questionnaire regarding their child’s
development, availability and effectiveness of the treatment and the impact of CLP on family life.
We studied thirteen children, ages 6 to 12 years divided into two age groups.
Results: We described the types of speech and resonance errors in Estonian CLP children. The
analysis of conversational speech and repetition of specially selected sentences are required to
accurately assess CLP speech issues. We found that contrast/minimal pairs of words and single
words have greater sensibility to CLP related speech disorders. We developed the first version of
an Estonian CLP protocol.
Conclusions: This was a small study, and further research based on a larger group of patients is
needed to improve and adjust the protocol. Scheduled to begin in January 2015, we will have the
possibilities to compare and verify the reliability of the results obtained with the perceptual protocol to the results of instrumental studies.
Keywords: CLP children, perceptual speech assessment, standardized protocol
03.4
EARLY INTERVENTION FOR INFANTS WITH CLEFT LIP AND PALATE,
USING THE ‘PARENT FOCUSED APPROACH’
Mie Cocquyt - Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium
Inge Zink - UZ Leuven, MUCLA
Sarah Sierens - Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium
Nadjmi Nasser - Antwerp University, University Hospital Antwerp, Craniofacial Association, Antwerp
Maurice Mommaerts - University Hospital Brussels, Vrije Universiteit Brussel
Objective: About 1 in 700 children is born with cleft lip and/or palate (CLP). The malformation is
already often discovered prenatally. This means that parents are better prepared when they see
the unusual face of their baby right after birth. However they need emotional support and correct
information about the treatment, which preferably focuses on optimal growth of the mid-face and
normal speech and language development. Cleft lip and palate form an established risk for communication problems. Once a delay has emerged, all subsequent phases will be delayed. Therefore, a preventive approach in treatment is designated. The aim of our study is to improve the
intervention in speech and language for this target group.
23
Methods: We developed a customized programme: the ‘Parent Focused Approach’ (PFA), for the
prevention and early detection of communication problems in children with cleft lip and palate.
In this approach the parents learn to offer ‘reinforced stimulation’ in interactions during the daily
activities with their child.
The PFA is based on the principles of the Hanen Centre in Toronto, through the principles of Ward,
Girolametto, Montfort, Golding-Kushner, Jansonius, Tan and Njiokiktjien. It contains 3 pillars of
communicative behaviour: 1. parent-child interaction, 2. early social and communicative skills, 3.
receptive and expressive language skills. The impact of the PFA was examined in a randomized
control/intervention design in children from 6 to 30 months. To learn more about the long term
outcome, we followed the children till all speech problems were resolved.
Results: None of the children showed severe compensatory articulation, and none of them needed a pharyngoplasty. The stimulation of intensive looking and listening behaviour appears to be
critical.
Conclusions: The PFA is found to be a valuable intervention in order to prevent or limit the common speech problems in this target group.
Keywords: Prevention, phonological disorder, developmental language disorder, cleft, early intervention, Parent Focused Approach
03.5
SPEECH-LANGUAGE AND NEURORADIOLOGICAL CHARACTERISTICS
OF ITALIAN CHILDREN AFFECTED BY IDIOPHATIC CAS
Anna Chilosi - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Simona Fiori - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Irene Lorenzini - Scuola Normale Superiore, Laboratorio di Linguistica, Pisa, Italy
Barbara Cerri - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Renata Salvadorini - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Lorena Cittadoni - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Lucia Pfanner - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Paola Cipriani - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Objectives: The aim of the present study is to investigate the clinical and neuroradiological characteristics of 32 Italian children affected by idiopathic CAS, in order to gather information on possible behavioural and neuroanatomical markers of the disorder.
Method: Each participant underwent a comprehensive neurological, oral-motor, and speech and
language assessment. The protocol included evaluation of gross and fine motor development, assessment of oral-motor skills, accuracy and consistency of speech, diadochokinesis, and lexical
and grammar organization. MRI data was acquired using a 1.5 T MR scanner (GE, Signa Horizon
1.5, Milwaukee, WI, USA).
Results: Speech and language profiles are characterized by a very restricted phonetic inventory,
high percentage of inaccurate and inconsistent productions and impaired diadochokinesis in a
maximum performance repetition task. These symptoms are associated in 83% of patients to
signs of oral non-verbal apraxia. Most children present a severe language delay with persistent
lexical and grammar impairment.
Conventional structural and spectroscopic MRI do not reveal any major brain abnormalities.
These results suggest that CAS is a multi-level dysfunction affecting speech- programming as well
as speech-motor and language abilities. Its etiology may probably be due to subtle neuroanatomical brain abnormalities that are not detectable with standard clinical MRI sequencing methods.
Keywords: Childhood apraxia of speech, magnetic resonance imaging
24
04.1
DOES INCREASING PATIENT’S AWARENESS OF VOICE CHANGE
THEIR PERCEPTION OF PROBLEM?
Rehab Awad - Lewisham and Greenwich NHS Trust, University Hospital Lewisham, London, United Kingdom
Objective: To examine if providing therapy, which includes increasing patient’s awareness of voice
use and of vocal hygiene, changes their perception of the voice problem and hence there is an
inherent biasness in the final VHI scores.
Methods: 212 patients who completed a voice therapy course were asked at the final assessment
to fill in a VHI with what they think they felt before start of treatment. These were called estimate
VHI (VHIest) and were compared to the initial VHI scores obtained before therapy commenced.
Results: Comparing the estimated VHI scores (VHIest) with their respective initial VHI (VHIint)
scores [for all patients who were treated, n = 212] statistically, they proved to be significantly different. A linear regression model was established with a correlation coefficient (R= 0.94 at 99%
confidence level). This model proves the relationship between the variables and can be used to
calculate one variable knowing the other.
Conclusions: There is a significant difference between patients’ initial perception of the voice
disorder and their final perception caused by increased awareness due to vocal advice and voice
therapy. This is shown in the difference in scores of initial VHI and estimated VHI.
Keywords: Voice disorders, self-assessment questionnaire, Voice Handicap Index, pre- and postvoice therapy assessment
04.2
AGREEMENT BETWEEN SELF-PERCEIVED VOICE SYMPTOMS AND
OBJECTIVE VOICE ANALYSIS AMONG FUTURE TEACHERS
Giovanna Tamborrino - Università degli Studi di Torino, Dipartimento di Scienze Chirurgiche, Torino, Italy
Lady Catherine Cantor Cutiva - Erasmus Medical Center, Erasmus Medical Center, Rotterdam, Netherlands
Anna Accornero - Università degli Studi di Torino, Dipartimento di Scienze Chirurgiche, Torino, Italy
Objective: To assess agreement between self-perceived voice complaints and objective voice
analysis; to determine factors associated with self-reported voice complaints among future teachers.
Methods: We conducted a cross-sectional study among 106 future teachers in 2 locations of a
public university in Torino, Italy. The participants filled out a questionnaire on voice complaints
and their associated factors. Then, future teachers recorded a voice sample, which was analyzed
using the PRAAT software. We determined the agreement between self-reported voice complaints
and four objective parameters of voice (fundamental frequency, jitter, shimmer and maximum phonation time) by the receiver operating characteristic curves. Multivariate logistic regression analysis was used to identify variables associated with self-reported voice complaints.
Results: The four objective parameters of voice showed a slight discrimination between those
future teachers with hoarseness and those without hoarseness. Maximum phonation time showed
a fair discrimination between those with current voice complaints and those without voice complaints. Talking loudly was an important associated factor of hoarseness among future teachers.
Conclusions: Self-reports of voice complaints and objective voice analysis showed significant
differences and may offer complementary information about voice quality and functioning among
future teachers.
Keywords: Voice disorders
25
04.3
THE AVQI WITH EXTENDED REPRESENTATIVITY: EXTERNAL
VALIDITY AND DIAGNOSTIC PRECISION WITH 1058 VOICE SAMPLES
Ben Barsties - Deutsche Stimmklinik, Hamburg, Germany
Youri Maryn - Department of Otorhinolaryngology and Head & Neck Surgery, Sint Augustinus, Antwerp, Belgium
Objective: The Acoustic Voice Quality Index (i.e., AVQI) is a six-factor acoustic model based on
linear regression analysis to measure objectively overall voice quality in concatenated continuous speech and sustained phonation segments. The new model of AVQI was found to be more
representative and ecologically valid, because the internal consistency of AVQI was balanced out
through equal proportions of the two speech tasks. The present investigation aimed to explore its
external validation and diagnostic precision in a large dataset.
Methods: An expert panel of 12 speech-language therapists (i.e. professional experience in perceptual
judgment of voice abnormalities ranging from 5 to 40 years) rated the overall voice quality of 1058
concatenated voice samples (i.e. 34 syllables of continuous speech and 3 sec. sustained vowel
[a:]) varying from normophonia to severe dysphonia across various organic and non-organic etiologies.
The Spearman rank-order correlation coefficient (i.e. rs) and the coefficient of determination (i.e.
r2s ) were used to measure concurrent validity. The AVQI’s diagnostic accuracy was evaluated
with several estimates of its receiver operating characteristics (i.e. ROC).
Results: Finally, 8 of the 12 experts were chosen because of acceptable reliability (kappa > 0.41).
Then, the G-scores of the 8 raters (i.e. G-mean) was taken as the perceptual dysphonia severity
level for every voice sample. A strong correlation was identified between AVQI and G-mean (rs =
0.815, p= 0.000). It indicated that 66.4 % of G-mean’s variation was explained by AVQI (i.e. r2s =
0.664). Additionally, the ROC-results showed again best diagnostic outcome at a cut-off score of
AVQI=2.43 (i.e. sensitivity= 0.785, specificity= 0.932).
Conclusions: This study highlights the external validation and diagnostic precision of the extended version of the AVQI as a robust and ecologically valid measurement to objectify overall voice
quality.
Keywords: Voice quality, voice assessment, acoustic voice quality index
04.4
PSYCHOPATHOLOGICAL CORRELATES OF FUNCTIONAL DYSPHONIAS:
NEW DIAGNOSTIC AND REHABILITATIVE PERSPECTIVES
Carlo Robotti - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Giulia Bertino - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Chiara Chialva - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Silvia Migliazzi - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Vera Abbiati - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Valentina Ciappolino - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Roberto Pagani - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Rosa Panigati - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Natascia Brondino - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Edgardo Caverzasi - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Marco Benazzo - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Objective: Several psychopathological mechanisms and personality traits potentially involved in
the etiopathogenesis of functional dysphonia (FD) have so far been investigated. To date, however,
26
the actual role played by these factors remains to be fully understood. Therefore the aim of this
study was to evaluate the psychopathological and personological substrate of hyperfunctional
and hypofunctional dysphonias, in comparison to a control group, and to investigate its implications in diagnosis and rehabilitation.
Methods: We recruited 106 patients affected by FD (84 hyperfunctional and 22 hypofunctional) attending our Centre from June 2011 to December 2012 and 53 healthy controls. All subjects underwent a careful otolaryngological and speech therapy examination, followed by videolaryngostroboscopy, acoustic and aerodynamic voice evaluation. Moreover, patients and healthy subjects
filled self-reported questionnaires developed to screen specific personological and psychopathological traits.
Results: Higher levels of depressive symptoms were found in hypofunctional patients compared
to hyperfunctional and healthy subjects, while no significant differences were found in reference
to anxiety symptoms and psychopathological characteristics. The Novelty Seeking (NS) score,
related to the dopaminergic tone, was found to be higher among hyperfunctional patient and to be
a potential predictor of FD objective and subjective severity.
Conclusions: Our results remark the importance of psychological and personological factors in
the development of FD and stress the need for an integrated approach towards functional dysphonic patients.
Keywords: Voice disorders
04.5
EVALUATING CHILDREN’S DYSPHONIA: ARE THERE DIFFERENCES
BETWEEN MOTHERS AND FATHERS?
Ofer Amir - Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel
Michael Wolf - Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
Liron Mick - Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel
Omer Levi - Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel
Adi Primov-Fever - Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
Background: Subjective self-evaluation is an essential component of a multi-dimensional voice
evaluation. Various tools are available for quantifying self-evaluation of voice among adults. Yet,
standardized tools for evaluating voice handicap among children are needed.
Objective: This study was aimed, first, to validate the Hebrew version of the Pediatric Voice
Handicap Index (pVHI). Second, our study examined, for the first time, differences between mothers and fathers in evaluating their child’s dysphonia.
Methods: The pVHI was translated and adapted to Hebrew. The translated version was administered to a group of 141 parents of children (58 parents of dysphonic children, and 83 parents of
non-dysphonic children). Validity and reliability of the questionnaire were tested, as well as group
differences. Following, a subset of the participants was examined, for evaluating differences between the responses of mothers (n=46) and fathers (n=46) of the same child.
Results: Statistical analyses revealed high reliability of the Hebrew pVHI (Cronbach’s alpha=0.97).
In general, parents of dysphonic children rated their children significantly higher (more severely)
than parents of non-dysphonic children (p<0.001). Mothers of dysphonic children rated their
children higher than the fathers, on all subscales (0.001p<0.047). In contrast, no significant differences were found between mothers and fathers of the non-dysphonic children (p>0.05).
Conclusions: The Hebrew version of the pVHI questionnaire is a reliable tool for quantifying parents’ perception of their child’s voice handicap. Moreover, this study provides evidence, showing
that mothers of dysphonic children evaluate their children’s voice handicap more severely than
fathers do, whereas both parents of non-dysphonic children perform this evaluation similarly.
Keywords: Voice, dysphonia, children, self-evaluation, pVHI, parents
27
04.6
VOICE IN CONTACT CENTER OPERATORS
Catarina Olim - Arte & Fala Research Center, Escola Superior de Saúde Egas Moniz, Lisboa, Portugal
Sónia Lima - Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
Célia Soares - Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
Objective: This work aims at contributing to a diagnosis of the factors that affect voice quality and
the degree of Voice Handicap Index experienced by contact center operators (CCO) of 25 Portuguese organizations.
Methods: This is a preliminary study conducted before an action of vocal training on prevention,
with a sample of 100 CCO. We used a questionnaire of demographic characteristics for the identification of risk factors and the VHI9 for Voice Handicap Index.
Results: About 52% of CCO have reported vocal handicap and it was found that there was a
stronger relationship with physical and autoperception dimensions related risk factors, such as
gender (women=0,063t), older (0,05U), more working hours (0,047U), tobacco, alcohol and coffee (0,000t).
Conclusions: Indicators were found to meet the training needs in the area of health and vocal
technique, such as biological conditions and professional lifestyles. The suitability of these actions
contributes to the voice professional’s certification.
Keywords: Voice Handicap Index, VHI9, Contact Center Operators, vocal risk factors
05.1
CONSENSUS ON RED FLAGS AND TERMINOLOGY OF ATYPICAL
SPEECH AND LANGUAGE DEVELOPMENT
Margot I. Visser-Bochane - Research and Innovation Group in Health Care and Nursing / Research and Innovation Group Child, Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
Ellen Gerrits - Research Group Speech and Language Therapy, HU University of Applied Sciences, Utrecht, Netherlands
Sijmen A. Reijneveld - Department of Health Sciences, University Hospital Groningen, Groningen, Netherlands
Cees P. van der Schans - Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
Margreet R. Luinge - Research and Innovation Group in Health Care and Nursing / Research and Innovation Group Child,
Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
Objective: Atypical speech and language development is one of the most common developmental problems in young children. However, consensus lacks on clinical signs and on diagnostic
terminology. The aim of our study is to gain consensus on the clinical signs that identify speech
and language problems in children from one to six years of age, and on the terminology regarding
persistent speech and language problems.
Methods: We conducted a three-round Delphi study in the Netherlands with a national panel
(n=24) of speech and language therapists and linguists. The panel members responded on web
based questionnaires covering clinical signs and terminology. Consensus was defined as ≥70% of
the experts agreeing on an issue. Between round two and three, we performed an extended round
on terminology with experts (n=247) recruited via social media.
Results: Round one revealed a list of 161 clinical signs and 16 terms (prefixes, descriptors and
nouns) to label persistent speech and language problems. In the second round we gained consensus on 34 signs identified as red flags, and on the prefix ‘developmental’ (70%), the descriptor
‘language’ (100%) and the noun ‘disorder’ (74%). The extended round revealed a preference for
the prefix ‘primary’ (65%) to ‘specific’. The third round revealed consensus (74%) on the prefix
‘primary’.
Conclusions: The Delphi study resulted in consensus on 34 red flags across the linguistic domains, and in consensus on the diagnostic label ‘primary developmental language disorder’ referring to persistent speech and language problems.
Keywords: Developmental language disorders, screening, prevention
28
05.2
INTERRELATION BETWEEN SPECIFIC LANGUAGE IMPAIRMENT AND
SPECIFIC LEARNING DISORDER: A SYSTEMATIC REVIEW OF THE
LITERATURE
Sara Rinaldi - A.U.L.S.S. 15 ‘Alta Padovana’, Padova, Italy
Anna Giulia De Cagno - A.S.L. Roma D, Roma, Italy
Objective: The aim of the present study is to understand the existing correlations between the
proficiency of preschool children with Specific Language Impairment (SLI) and the abilities of
school-aged children with Specific Learning Disorder (SLD).
Methods: We conducted a systematic review of the literature by consulting PubMed, PsychInfo
and Cochrane Library. Based on the clinical queries we indicated four research strands, established eligibility criteria for the studies, and provided an analytic grid for data analysis of the
included studies.
Results: None of the assessed studies fulfilled all the eligibility criteria. Nine interesting studies were, however, identified and analyzed: they not only confirmed the association between the
disorders, but also helped validate the hypothesis of the central role of phonological processing in
the relationship between SLI and SLD, indicating, moreover, that phonological processing did not
have an exclusive role, because other language abilities, such as semantics, syntax and narrative
skills, could influence the correlation between SLI and SLD.
Conclusions: Current scientific research does not allow us to define the prognostic factors that
cause the development of SLD in children with SLI, nor the importance of SLI as a risk factor in
SLD children. It is important to consider the specific functioning profile of the disorders and their
sub-types, and to conduct research aimed at defining the importance of the proficiency involved
in the interrelation between SLI and SLD.
Keywords: Specific language impairment, specific learning disorder, correlations, risk factors,
prognosis
05.3
PERINATAL CEREBRAL WHITE MATTER INJURIES INFLUENCE
EARLY COMMUNICATION AND LANGUAGE DEVELOPMENT
Blazenka Brozovic - Department of Speech and Language Pathology, University of Zagreb, Zagreb, Croatia
Objective: Cerebral white matter injuries, periventricular ischaemic (PVL) and hemorrhagic lesions
(PVH) are predominant types of perinatal brain lesions. It is traditionally considered that because
of phenomena of developmental brain plasticity perinatal brain lesions should not have considerable impact on the developmental course. The aim of this study was to explore the effect of early
periventricular white matter injuries on early communication and language development.
Methods: Subjects were 30 children aged 2 to 3 with early perinatal brain lesion and 30 healthy
control subjects, matched by age and gender. Different aspects of early communication and
language development were assessed: the acquisition of different communicative functions and
forms, as well as gestural development and use. The early language evaluation included the assessment of language comprehension together with several aspects of expressive speech and
language skills (articulation, oral praxis and the size and composition of the expressive vocabulary).
Results: Despite having normal general development, 50% of the subjects with brain lesion had
communicative and/or language delay and 30% of the subjects had some form of articulation
29
disorder. However in the control group of subjects, communicative and language disorders were
not detected and 17% of the subjects had only selective articulation disorders.
Conclusions: Subjects with perinatal brain lesions of cerebral white matter are at high risk of early
communication and language disorders. If not recognized and treated early, the communicative
and language consequences of early brain lesions in the long run can have a negative impact on
the child’s overall development as well.
Keywords: Developmental language disorders
05.4
VOCABULARY AND GRAMMAR ACQUISITION IN TURKISH THROUGH
CDI-TR: THE COMPARISON OF TYPICALLY DEVELOPING (TD) &
LANGUAGE DELAYED CHILDREN (LD)
Ilknur Mavis - Department of Speech and Language Therapy, Faculty of Health Sciences, Anadolu University, Eskisehir, Turkey
Selen Ölmez - Metin Uğur Sarıkaya Özel Eğitim ve Rehabilitasyon Merkezi, Mersin, Turkey
MB-CDI (The Mac Arthur-Bates Communicative Development Inventory) is a scale designed to
assess the language development of children between 8 and 30 months via caregiver reports
(Fenson et al., 2000). It is a recently standardized tool in Turkish with the forms, TIGE-1 & TIGE-2
(Acarlar et al., 2012). Accordingly, our aim was to assess 60 typically developing children (TDG)
between 24-36 months and 35 children with delayed language (DL) between 30-48 months in
terms of vocabulary and grammar acquisition according to TIGE parental reports. The receptive
and expressive language of the children was first assessed by a standardized language test in
Turkish: TEDİL (Topbaş and Güven, 2012). As a result, it was found that TDG produced 63.5%,
whereas DL group used the 15.4% of the whole word production. TDG produced 65% whereas
DLG used the 13% of the whole verb production. TDG produced 59%, whereas DLG used the
17.2% of the whole noun production. The finding of MLU=5.24 normally predicted 35-36 months,
which is the very age equivalent for TDG but MLU= 2.99 predicted only 25-26 months for the DL
group, though they are approximately 48 months. The utterances of DL children seemed to be
simple, since most of the structures started to emerge between 42-48 months. It is well known
that language delay can be an indicator for several neurodevelopmental problems, so it should
be taken seriously and further diagnostic investigation is recommended (Buschmann et al., 2009).
Children who are late to talk in preschool tend to have weaker language skills at school entry.
Parental reports have the potential to be representative of a child’s true language behaviour, if only
parents are sensitive and accurate observers.
05.5
DEVELOPING ASSESSMENT TOOLS FOR THE IDENTIFICATION OF
LANGUAGE IMPAIRMENT IN MONOLINGUAL AND MULTILINGUAL
CHILDREN
Seyhun Topbas - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Ayse Aydin - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Deniz Kazanoglu - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Dilber Kacar-Kutukcu - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Objective: Detailed language profiles of monolingual and bilingual Turkish children with LI were
limited due to several reasons, such as lack of standardized tests, misdiagnoses, staff and lack of
30
awareness about SLI. In the light of these, a national project has been conducted to examine several language measures of LI children derived from psychometric tests and spontaneous language
samples by quantitative and qualitative methods. Alongside with the national project, several
tasks have been developed within the COST Action IS0804. The purpose of this talk is to present
the developmental process of two tests, namely the LITMUS-Sentence Repetition Test-Turkish
and Turkish Nonword Repetition Test-Revised and to report the results of this research.
Methods: A total of 43 children participated in this study (from 15 TD-MO, 15-TD-SLI & 13 TD-BIchildren). Bilingual group’s L1 was Turkish, while their L2 was German. All of the bilingual children
were exposed to German when they were 3 years old. Comparative and correlational statistics on
tasks that are adapted and standardized in Turkish (TELD-3 & TOLDP: 4) and the newly developed
LITMUS-Sentence Repetition Test-TR, and Nonword repetition Test will be presented. Sensitivity,
specificity and predictivity were calculated.
Results: In general both the LITMUS-SRep: Turkish and Turkish-NWR discriminated the SLI group
from TD-MO and BI-TD children. The sensitivity (89%) and specificity (86.5%) values of the tests
very high and the clinical predictivity was 90% for SLI.
Conclusions: Although the current sub-group findings reflected the performance of a small group
of children, it suggests that both tests are valid and reliable tools to assess repetition skills of
Turkish-speaking children. They can be used clinically as useful supplemental tools with other
normative standardized tests.
Keywords: Language impairment, SLI, Turkish, assessment
The Turkish project is granted by TÜBİTAK, no 109K001 2009-2013. In coordination with COST
Action ISo804-Language Impairment in a Multilingual Society: Linguistic Patterns and the Road to
Assessment
05.6
CAN WE PREDICT READING AND SPELLING FROM KINDERGARTEN
PHONOLOGICAL AWARENESS?
Sabien Van Dycke - Arteveldehogeschool Department Audiology and Speech Therapy, University Ghent, Ghent, Belgium
Objective: In this study we aim to look at the relationship between phonological awareness in
kindergarten and spelling and reading skills in grade 4.
Background and Methodology: Several studies demonstrate the importance of phonological
skills in the early reading and writing process, however the prediction for more advanced skills
is less clear. Therefore 176 children from kindergarten were tested with the subtest phonological
awareness of the CELF-4NL. (Kort & al., 2008), the DAS (De Backer & al, 1991) and the PFB (Elen,
2006). All children were receiving mainstream education and were between 4;10 and 5;11 years
old. We followed them till grade 4 on language-, reading-, spelling- and mathematical skills by using standardized tests (LVS, EMT, AVI, VST).
Results: For spelling, our data revealed that a significant correlation was found between phonological awareness and the LVS (r=.35, p<001), as well as between phonological awareness (CELF4-NL) and the spelling of existing words (VST) (r=.18, p<.05) in grade 4. .
For reading there was a significant correlation between phonological awareness (CELF-4-NL) and
the reading of existing words (EMT; r= .214, p<.05) and between phonological awareness and text
reading proficiency (AVI; r=.197, p<.05).
Conclusion: As in previous studies (Elbro & Scarborough, 2003), we confirmed the importance of
phonological awareness for reading accuracy and added the prediction for spelling skills in grade
3. Implications for assessment and interventions will be discussed.
Keywords: Phonological awareness, spelling, reading
31
06.1
CONNECTION OF PHONOLOGICAL DISORDERS WITH PHONOLOGICAL
PROCESSES
Monika Posilovic - The SUVAG Polyclinic, Zagreb, Croatia
Objective: The objectives of the research were to determine which phonological processes usually occur as errors in children with phonological disorder, and whether there is coherency in the
appearance of phonological processes in children with phonological disorder in the Croatian
language. Also, one of the objectives was to compare the results with the results from research
conducted in English-speaking countries.
Two hypotheses were made. In the first hypothesis, it was expected that substitution and cluster
reduction are going to be the most common phonological processes that occur in children with
phonological disorder. The second one claimed that there is coherency in the phonological processes of children with phonological disorders in the Croatian language.
Methods: The study included fourteen children with expressive language difficulties, of which
eight were boys and six girls with chronological ages from 5.5 to 6.11 years. Children included in
the study all had phonological difficulties within the language disorder, typical intellectual functioning, and no organic or sensory difficulties that could interfere with articulation.
The children were tested with three different tests: Articulation test (Vuletić, 1990), Repetition of
words and pseudowords (Vuletić, 1990) and a brief sample of spontaneous speech. In the brief
sample of spontaneous speech, the examiner asked the children short questions about their day
for about 5 minutes, so the subject of the conversation was always the same.
Results: The results from the three tasks were processed separately, and were analysed with descriptive statistics.
The obtained results showed that in most cases children use substitution and cluster reduction,
while coalescence and assimilation did not appear. With these results, the first hypothesis, that
the phonological processes that will most often occur in children with phonological disorder will
be substitution and cluster reduction, can be approved.
Also through the observation of the results it was shown that there is coherency in the appearance
of phonological disorders in the Croatian language. The systematic quality appearance of the
same phonological errors and their combinations in words and pseudowords that were presented
to children during the test were observed. Therefore, the second hypothesis, which confirms
systematicity of phonological processes in children with phonological disorders in the Croatian
language, also proved to be true and is accepted.
Conclusions: The results show that the most common phonological process that children with
phonological disorder use in the Croatian language is substitution, and that there is a pattern of
appearance in these phonological processes.
Comparing the results obtained in this study with the results obtained in English-speaking countries, the conclusion was that there are differences in the types of phonological processes that
children use. In English-speaking countries the most common phonological process is cluster
reduction, which in the Croatian language stands in the second place in terms of frequency.
Because of the small sample, the results obtained in this study cannot be generalized. It will take
a larger and more representative sample to lead to more accurate and clearer conclusions about
phonological processes in the Croatian language.
Keywords: Phonological disorder, phonological process, substitution, cluster reduction
32
06.2
IS MORPHOLOGY A CLINICAL MARKER OF SLI IN ICELANDIC?
Context: Morphological accuracy is a clinical marker of Specific Language Impairment (SLI) in
English-speaking children, particularly around age 5. In more highly inflected languages, children
with SLI perform less well than peers with typical development (TD) in morphology; however,
overall accuracy is often quite high and diagnostic accuracy remains an uncertainty. This study
examines the diagnostic accuracy of morphological correctness in children age 4 to 14 years who
speak Icelandic, a highly inflected language.
Methods: Participants were 29 children with SLI (aged 48 to 173 months) and 27 children with TD
(aged 48 to 169 months). Conversational language samples were coded for accuracy of verb person, tense, and mood, and for case, gender and number marking of nouns, adjectives and pronouns. Other errors encountered included incorrect choice of words, word order, word omissions.
Results: Scatter plots and curve estimation comparing the entire groups with SLI and TD showed
that Mean Length of Utterance (MLU) increased linearly with age for both groups. Morphological
accuracy, in particular person marking, increased as a function of MLU and age in both groups
and was overall high (85 to 100%). Children with SLI performed worse overall, but the difference
diminished with age, with both groups ultimately performing at 98-100%. With the children divided into 3 equivalent age groups (4-5 years, 9-10 years, 12-14 years), t-tests found significant SLITD group differences for different measures across age. However, overlap between groups was
important. For some measures, a criterion of low performance can be proposed that suggests the
presence of SLI; however high scores do not rule out SLI.
Conclusions: The measurement of morphological accuracy in Icelandic is a time-consuming procedure that is not particularly useful as a diagnostic marker of SLI.
06.3
EXECUTIVE FUNCTIONS (EF) AND LANGUAGE STRENGTHENING
NARRATIVE TRAINING IN PRESCHOOLERS
Anna Pierro - Faculty of Medicine and Dentistry, University “La Sapienza” of Rome,(RM), Seat of Ariccia (RM), Italy
Simonetta Saltarelli - Neuropsychiatry Service, ASL Roma H, Velletri (RM), Italy
Elisabetta Voltan - Private practice, Genzano di Roma (RM), Italy
Objective: Executive functions, text comprehension and narrative skills are cognitive processes
that work together during the elaboration of a text and, particularly speaking, EFs are core to the
whole elaborative process. EF’s strengthening also improves other cognitive processes such as
language skills (lexical, syntactic and semantic), school readiness and inferential ability.
Methods: Narration was chosen as an instrument to strengthen the EFs, creating a narrative training, specific for preschoolers, which unfolds in 15 group meetings.
The choice fell on stories illustrated with a simple and immediate graphic and narrative style: the
stories of Julio Bunny. Starting from these stories, practical cards were produced and used in the
narration and in specific exercises for the EFs.
The work is developed in different phases:
- a pilot phase with 18 children who had already fulfilled language therapy for developmental disorders of various kinds
- a phase, currently in progress, with 20 children treated by the Neuropsychiatry Service
- a phase, scheduled for January 2015, with 20 children of a Nursery School.
Results: The results of the pilot phase were very positive for what concerns the text, lexical and
33
morphosyntactic comprehension. The 18% of results with a Warning Request (RA) and the 20%
with a Request of Immediate Intervention (RII) of the first test turned into a 3% of RA and a 5% of
RII after the training.
Conclusions: Narrative training is a very efficient instrument, very easy to make and inexpensive,
that can be regularly used in language therapy.
Keywords: Specific language impairment, developmental language disorders, prevention
06.4
IDENTIFICATION OF ARGUMENTS IN TRANSITIVE SENTENCES IN
HUNGARIAN CHILDREN WITH AND WITHOUT SLI
Bence Kas - Research Institute for Linguistics, Hungarian Academy of Sciences, Budapest, Hungary
Ágnes Lukács - Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
Katalin Szentkuti-Kiss - Research Institute for Linguistics, Hungarian Academy of Sciences, Budapest, Hungary
Objective: Children with SLI are known to exhibit difficulties in the acquisition of grammar, which
is largely influenced by the type of language. Our main aims are (i) to discover the morphosyntactic symptoms of SLI in Hungarian, (ii) to identify qualitative differences from typical development,
(iii) to discover the correspondences between morphosyntactic difficulties and other processing
factors, (iv) and to evaluate theories of SLI.
Methods: Our method was a picture selection task with sentences presented orally by the examiner. The participants were 29 children with SLI between 5;1 – 12;5 years and 29 control children
between 3;3 – 9;10 years matched individually on receptive vocabulary scores.
Results: The results showed that word order highly influences the identification of arguments in
simple transitive sentences in both groups, with SVO and SOV types being the two most prominent word orders in all children. Children with SLI showed significant weakness in the identification of arguments in simple transitive sentences. Although their pattern of performance is generally similar to the control children’s patterns, sentences with the object preceding the subject pose
particular difficulties for them.
Conclusions: As the difficulties of sentence comprehension in children with SLI were strongly
correlated to frequency differences in language use and weaknesses in working memory, these
results support the input processing accounts of SLI (e.g. Leonard, 2007). The comprehension
difficulty of sentences with S-O order might be a good candidate for a clinical marker of SLI in
Hungarian.
Keywords: Specific language impairment, morphosyntax, Hungarian
06.5
SYNTACTIC STAGNATION IN SLI: DISCOURSE AS THE MISSING LINK
Dagmar Bittner - Centre for General Linguistics, ZAS, Berlin, Germany
Peter Jordens - MPI for Psycholinguistics, MPI, Nijmegen, Netherlands
Objective: Studies on the development of narrative skills in SLI children found that interventions
concerning the macrostructure of narratives, i.e. the production of goal, attempt, outcome, also
led to improvements in microstructural features of the narratives (Ringmann 2014). Seemingly,
the improvements on global structuring gave place to the application of linguistic knowledge on
discourse coherence which has been present before. If this is true, it would change the dominant
perspective on the children’s problems in producing coherent texts.
34
Methods: In order to investigate this in more detail, we conducted analyses of the spontaneous
speech of a German-speaking SLI child from age 3;6-5;5. Analyses focused on the initial constituent of main clauses and the following V2-position of the finite verb. In German, the initial position
of main clauses functions as information structural link to the previous linguistic context. It can
contain exactly one but all types of syntactic phrases.
Analyses concerned:
a) the emergence of V2
b) the type of syntactic constituents produced by the child
c) the type of constituents in initial position
d) the way in which utterances having non-subject constituents in initial position are connected
with the previous linguistic context.
Analyses c) + d) include parallel analyses of 2 TD children aged 2;6-3;0.
Results: Analysis a) showed emergence of V2 in the SLI child between age 3;6-3;10. Therefore,
all other analyses of this child’s data started at age 4;0. Analyses b-d) gave rise to the following
picture: All types of constituents are present in the SLI child’s production from age 4;5 on. In initial
position there is a higher proportion of pronominalized subjects and deictic adverbials and a lower
proportion of object phrases and wh-words in the SLI child than in the TD children. However, the
main bulk of OVS-utterances and of wh-questions is related to the previous linguistic context in
both the SLI child and the TD children.
Conclusions: In our view, the latter finding indicates that the SLI child has acquired the basic linguistic knowledge concerning discourse coherence. We will argue that the SVO-plateau typical for
German SLI children after having acquired the V2-position of finite verb is not caused by a lack of
grammatical knowledge, e.g. the CP-position (Hamann et al. 2001), but by time related limitations
on processing and integrating complex linguistic information (Kolk 1998).
Keywords: SLI
06.6
ACQUISITION AND SLT ASSESSMENT OF REFERENTIAL PROCESSES
DURING NARRATION
Hilaire-Debove Géraldine - LURCO/UNADREO, Université Claude Bernard Lyon 1 (ISTR), Paris, France
Sophie Kern - Laboratoire DDL UMR5596, Université Lumière Lyon 2 et CNRS, Lyon, France
Objective: Telling a story is a complex linguistic activity which requires the narrator to make reference to characters with specific linguistic tools mastered with difficulty by children with SLI.
Our study focuses on the acquisition of linguistic tools that children use to refer to characters
when telling a story. This study investigates the acquisition of these tools by children over time
and presents a standardized measure for assessing how well children master these tools (an SLT
assessment).
Methods: Stories were elicited from the booklet “Frog, Where are You?” (Mayer, 1969). 350
French children aged from 4 to 11 years participated in the study.
Results: When telling a story, children aged 4 and older use nominal forms in order to introduce a
referent. Children do not use an indefinite article before the age of 7 years. Some children younger
than 7 use left out dislocations (“the dog... it”). But children older than 7 use subordinates instead.
When continuously referring to the same character, the use of personal pronouns is preferred very
early on. This preferrence increases significantly with age. The ability to use personal pronouns as
verb complements also increases with age. Elliptic forms appear around 8 years.
For reintroducing characters, simple nominal or dislocated forms are preferred for all ages. Moreover, the errors in the usage of personal pronouns (subjects and objects) are relatively rare and
decrease significantly between the ages of 5 and 8.
Conclusions: These results show that children gradually learn to use the appropriate linguistic
35
tools when telling a story, in order to refer to a character. Furthermore, this study shows that the
analysis of children’s storytelling abilities provides a useful means to investigate linguistic impairments in children. Two case studies (a child with SLI and another one with ASD) will serve as
illustrations.
Keywords: Specific language disorders, developmental language disorders
07.1
DEVELOPMENT AND IMPLEMENTATION OF A ‘ROLE AND
COMPETENCY PROFILE’ FOR SLT STUDENTS
Philine Berns - College for Speech and Language Therapy, University for Applied Sciences, Rotterdam, Netherlands
Objective: Development of a ‘role and competency profile’ for SLT-students and its implementation in a bachelor degree SLT program.
Methods: Since 2004 all universities for SLT in the Netherlands use a nationally agreed student
competency profile (Compass; NVLF, 2005). It describes 9 competencies, linked to roles and professional situations. Every competency consists of five levels. The fifth level describes the niveau
of the starting professional.
In Rotterdam University for Applied Sciences a new SLT curriculum has been developed. One of
the purposes was to develop a competency profile according to the CanMEDS framework (Frank,
2005). Consults with SLT-lecturers and with SLT-professionals led to the development of COLORRS: a profile in which 7 roles are described. We rearranged the competencies from our national profile to fit in our framework of roles and reordered them in three levels of competence.
In 2013 we started our new curriculum, including the COLORRS, in the first year of our program.
In 2014 we implemented it in the second and third year.
Results: COLORRS is an important framework for our curriculum now. Advantages and disadvantages in working with roles are becoming clearer as we have been using the framework for two
years now. Implementation never stops: we continue to explore what goes well and where there
are misfits. The result of this investigation can lead to rewriting some of the competencies or roles
or to rearrange the levels we described.
Conclusions: It is possible to modify a nationally agreed student competency profile into a framework that is used in one particular SLT-program.
It seems that a framework describing roles instead of competencies as a starting point is more
understandable for students.
Keywords: Quality of education
07.2
MEASURING EBP COMPETENCIES OF SLT STUDENTS, LECTURERS
AND PRACTITIONERS; WHERE ARE THE GAPS?
Karin Neijenhuis - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Joan Verhoef - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Erica Witkamp - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Connie Dekker-Van Doorn - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Objective: Education in evidence-based practice (EBP) has become more integrated in the SLT
curriculum, as there is a development from offering separate EBP courses towards integrating an
EBP-attitude across all courses in a curriculum. We measured EBP performance and attitudes
36
to benchmark the current level of our students. Lecturers and practitioners underwent the same
measurements in order to identify possible gaps in EBP performance between these groups. Finally, EBP performance and attitudes of SLTs will be compared to other health professions.
Methods: The Dutch Modified Fresno test (DMF; Spek et al., 2012; Ramos et al., 2003), measuring knowledge and skills in EBP, is administered to SLT-students, their lecturers and practitioners.
Different versions were developed for allied health care and nursing degree programs. Subjects
also completed a questionnaire on motivational beliefs of EBP (Spek et al., 2013).
Results: In the presentation, scores on the DMF from 44 students, 13 lecturers and 18 practitioners will be compared. Preliminary results show that students’ scores have a smaller range than
those from lecturers. Furthermore, correlations between performance (DMF) and attitude (questionnaire) will be correlated.
Conclusions: There are gaps in EBP competencies between students, lecturers and practitioners.
Now that education in EBP is fully integrated and accepted in the SLT curriculum, it is time to pay
attention to closing the gaps between lecturers and practitioners. Otherwise, without continuing
education, these competencies could possibly diminish.
Keywords: Evidence-based practice, education
07.3
THE GERONTOLOGY SPEECH THERAPY SYLLABUS
Michalina Kleczek-Marek - Institute of Polish Language, University of Silesia, Katowice, Poland
Danuta Pluta-Wojciechowska - Institute of Polish Language, University of Silesia, Katowice, Poland
Objective: The object of this work is to prepare the gerontology speech therapy syllabus. The
authors have analyzed predictions for society structure. It is expected that in a few decades there
will be more and more people over 65 years, including people with speech disorders resulting
from various age-related diseases. This is a new challenge, not only for speech therapy.
Methods: The authors propose gerontology speech therapy, as a new method for speech disorders analysis and speech therapist education. The base of the gerontology speech therapy distinction is associated with the specifics of working with old people. Gerontology speech therapy’s
name originates from the words: gerontology and speech therapy.
Results: Gerontology speech therapy is a speech therapy branch or an analysis method of a field
of knowledge and practice, which relates to speech therapy procedures for old or aging people
with speech disorders or with a risk of speech disorders, based on the pathological factors,
which are related to neurological, psychiatric, oncology, peripheral or socio-psychological nature. Among the speech disorders, which can be located within the scope of gerontology speech
therapy, are for example: aphasia, pragnosia, speech disorders in neurodegenerative diseases,
as well as speech disorders determined by the peripheral speech organs, illnesses like larynx or
tongue cancer. Other speech disorders can be found among old people, which are related with
stuttering, cluttering, hearing loss or hypoacusis.
Conclusions: The authors show the most important issues related to a separate field of the
speech therapist syllabus. The programme of speech therapists’ skills improvement is presented.
The content of the described syllabus is focused on 3 main parts: medical, social and speech
therapy blocks.
Keywords: Neurodegenerative disorders, speech disorders, aging, gerontology
37
07.4
A MODEL FOR THE DEVELOPMENT OF COMPETENCIES IN DYSPHAGIA
John Lancaster - Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
Susan Guthrie - Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
Jois Stansfield - Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
Objective: To develop a consensus model for dysphagia competency development. For newly
qualified (NQ) SLTs in north-west England.
Methods: The study had 3 phases. A literature review and interviews of experts in the UK were
conducted to identify best practice for dysphagia competency development. SLTs working in the
north-west of England and SLT students were then surveyed to illuminate current competency development approaches. A Delphi consultation of stakeholders and clinicians then explored models
for achieving competency in NQ SLTs. Purposive sampling ensured representation of a range of
clinical contexts and SLT experience.
Results: A consensus model has evolved with processes to achieve dysphagia competencies.
SLT students achieve theoretical knowledge and gain practical skills post qualification. Discussion of how to overcome barriers present across the geographical area of the study has led to
recommendations for models of supervision and frameworks appropriate to developing student
and qualified SLTs’ skills in different service contexts.
Conclusions: Models for achieving competency can vary across different service contexts, but
a consensus for a protocol for feasible supervision, assessment and development of dysphagia
competencies has been defined with alternatives to account for different contexts. This links to
new RCSLT guidance on dysphagia competence development from initial SLT education onwards.
Keywords: Initial education, competency-based learning, quality of education, dysphagia
07.5
NARROWING THE GAP BETWEEN RESEARCH AND EVIDENCE-BASED
CLINICAL PRACTICE: STUDENT TO GRADUATE TO EXPERT CLINICIAN
Victoria Joffe - City University London, London, United Kingdom
Emma Pagnamenta - Royal College of Speech and Language Therapists, London, United Kingdom
Objective: The critical appraisal of research, its application to clinical practice and the ability to
gather data to evaluate practice are core requirements for practising speech and language therapists (SLTs), as recognised by the standards of proficiency set by the Health and Care Professions
Council in the UK. The training and awareness-raising of these essential skills start early in the
initial education of SLT students, but their advancement continues as an important part of professional development for the SLT. The aim of the presentation is to provide a UK perspective on the
initial training and continuing development of critical appraisal and research skills throughout the
trajectory of the SLT from student, to graduate to expert clinician.
Methods: The presentation will outline the increased exposure given to the area of clinical research and evidence-based practice by the Royal College of Speech and Language Therapists,
the professional body for SLTs in the UK, including an evaluation of recent initiatives, for example,
recruitment of a research manager, and research champions. Feedback on these changes will
be gathered through questionnaires, focus groups and interviews. An analysis of the curriculum
related to evidence-based practice and research in the initial education of SLTs across higher
education institutions in the UK will also be conducted through questionnaires.
Results: Key areas of further need for support in evidence-based practice in student
38
and practising SLTs for the profession will be identified.
Conclusions: There has been an increased awareness of clinical research and evidence based
practice in the field of Speech and Language Therapy in the UK. The potential impact of strengthening SLTs’ understanding and use of clinical research in routine clinical practice to improve outcomes for service users will be highlighted.
Keywords: Education, continuing professional development, research, evidence-based practice
07.6
THE REFLECTION OF ACQUIRED PROFESSIONAL COMPETENCIES IN
THE RESEARCH TOPICS OF GRADUATE SPEECH AND LANGUAGE
THERAPISTS
Sarmite Tubele - Faculty of Education, Psychology and Arts, University of Latvia, Riga, Latvia
Baiba Trinite - Faculty of Education and Social Work, University of Liepaja, Liepaja, Latvia
Objective: The aim of the presentation is to analyse the correlation of the main competencies of
SLT stated in the NetQues project with research topics of graduate SLTs of the three higher educational institutions in Latvia (University of Latvia, University of Liepaja and Riga Teacher Training
and Management Academy).
Methods: Quantitative and qualitative analysis of the research topics.
Results: The content of the presentation deals with eight years of experience consulting, supervising and reviewing research topics of speech and language therapists in initial education and
some consequences in Master education. Some analysis of the Netques project outcomes for
competencies of newly qualified SLT is done and the correlation with research topics is stated.
Conclusions: The conclusions state that there is a correlation between NetQues competencies
for newly qualified SLT and content of research topics. The main interest of the students of initial
SLT programs in Latvia is linked to the pedagogical approach in speech therapy, although clinical
research of SLT graduates is done within health care as well. The choice of health related topics
by graduate students is linked to the competencies and working place of the supervisor of the
research.
Keywords: Professional competencies of SLT, research topics of graduate SLT.
08.1
DYSPHAGIA IN NEUROMUSCULAR DISEASES: TOWARDS A COMMON
SCREENING TOOL
Federica Lucia Galli - Neurorehabilitation Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Michela Coccia - Neurorehabilitation Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Francesco Logullo - Neurologic Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Savina Bramucci - Neurorehabilitation Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Leandro Provinciali - Neurologic Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Marianna Capecci - Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
Maria Gabriella Ceravolo - Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
Objective: Dysphagia is frequently observed in neuromuscular diseases (ND) and significantly
influences the patient’s outcome. Despite clinical relevance, there are few descriptions
and screening’s assessment proposals. The present study is aimed at both describing dysphagia’s characteristics in ND and identifying significant clinical tests.
39
Methods: Subjects: 144 consecutive ND subjects divided into two groups (motor neuron diseases-MND and myopathies). Assessment: clinical-functional evaluation of the oral and pharyngeal
swallowing phases, the 3OZ Water Swallow Test (WST) and the Dysphagia Outcome Severity
Scale (DOSS), performed by the speech therapist.
Results: Dysphagia occurs in 68% of ND patients (80% in MND and 61% in myopathies).
Comparing clinical signs of dysphagia within MND and the myopathies groups, it has been found
that MND are associated with a higher occurrence of dysarthria, loss of strength of the lips,
tongue fasciculation and atrophy. The risk of having a 3OZ positive test is 5.7 times higher and
the DOSS is significantly worse. Within the myopathies group, subjects suffering from myotonic
dystrophy type 1 (DM1), have a greater occurrence of dysphonia, mandibular deficiency motility,
abnormal oral clearance and bolus formation. The risk of having a 3OZ positive test is 3.5 times
higher and the DOSS is significantly worse.
Conclusions: Dysphagia affects significantly ND patients. Its prevalence and clinical picture
depends on the underlying disease. The collected data provide the basis for a ND screening tool
that may allow an early and effective detection of dysphagia.
Keywords: Dysphagia, neurodegenerative disorders
08.2
THE ROLE OF SPEECH THERAPIST IN RADIOLOGICAL DIAGNOSIS OF
DYSPHAGIA. USEFULNESS IN THE CLINICAL PRACTICE
Lucia Del Vecchio - Department of Sciences Anesthetic, Surgical and Emergency, Second University of Naples, Naples, Italy
Alfonso Reginelli - Department of Internal and Experimental Medicine, Second University of Naples, Naples, Italy
Maria Valeria Di Martino - Rehabilitation Professional Service, Azienda Ospedaliera Dei Colli - Monaldi Hospital, Naples, Italy
Objective: Our aim is to present the role of the speech therapist in the radiological diagnosis of
dysphagia.
Methods: A total of 321 patients with oropharyngeal dysphagia were assessed with videofluoromanometric (VFM) investigation by a multidisciplinary team including a radiologist, a gastrointestinal surgeon and a speech therapist.
The role of the speech therapist in the diagnostic workup is divided in three phases:
1. collection of the medical and swallowing history
2. research of elements capable of guiding dietary interventions and speech therapy rehabilitation
during VFM
3. instruction regarding type and consistency of food so the patient may safely eat and, where
necessary, indications regarding posture and compensatory mechanisms.
Results: VFM in 76/321 patients (23.7%) showed aspiration.
The solution of dysphagia was obtained in: N 17 patients with aspiration before swallowing
(100%), N 24 patients with aspiration during swallowing (75%), N 20 cases with aspiration after
swallowing (95%). In 6/70 cases (7.9%) there were multiple aspiration and compensatory postures
not sought in these patients. N 5 patients with bolus transit disorder (100%).
Conclusions: An early and accurate diagnosis of oropharyngeal dysphagia means being able to
effectively intervene with speech therapy techniques, improve the patients’ quality of life and minimize complications. The results of our study show the importance of the speech therapist during
the radiological examination to supplement the instrumental report with information about the
types of foods that are allowed and which ones to avoid, the possible postures of compensation
and / or speech therapy techniques to be adopted in the rehabilitation programme.
Keywords: Dysphagia, radiological examination, speech therapist
40
08.3
THE ROLE OF CERVICAL ISOMETRIC EXERCISES IN CERVICAL SPINE
ALIGNMENT FOR DYSPHAGIC ADULT PATIENTS WITH CEREBRAL
PARALYSIS. A RANDOMIED CONTROL STUDY
Soultana L. Papadopoulou - Physical Medicine and Rehabilitation Clinic, Medical School, Ioannina Greece, Greece
Objective: Cerebral paralysis can cause cervical spine scoliosis, kyphosis or hyperlordosis. This
study aims to evaluate the use of cervical isometric exercises in dysphagic adult patients with cervical spine alignment disorders due to cerebral paralysis.
Methods: This is a prospective randomized controlled study of dysphagic adult patients with
acute cerebral paralysis. Patients were excluded if they had previous cervical spine surgery, history of spinal deformity or known dysphagia. In addition to the regular therapeutic approach,
cervical isometric exercises in all 4 directions were conducted daily for 10 minutes by a random
group of patients. Patients had videofluoroscopic swallowing study (VFSS) to evaluate deglutition
(0=normal, 1=penetration, 2=aspiration) and cervical spine radiographs in erect (sitting or standing) position to measure C2-C7 scoliotic and lordotic Cobb angle at 2 time points. Changes of
radiographic indices, as well as VFSS, were calculated and correlated.
Results: Seventy consecutive patients with cerebral origin paralysis (41 with stroke, 19 with traumatic brain injury and 10 with other causes) and a mean (SD) age of 52±15 years were included
in the study. Fifty-seven of them conducted cervical exercises in addition to their therapeutic
program. The mean time between the first and second evaluation was 227±183 days. At the initial
evaluation, scoliotic curve >10° of the cervical spine with the convex to the hemiplegic side was
noticed in 18 (19%) patients, while another 18 (19%) patients showed kyphotic cervical deformity
(reversal of normal lordosis). Hyperlordosis was seen in 10 (11%) patients. At the last follow-up,
patients had improved (p<0.001) cervical alignment, in both coronal and sagittal plane, and deglutition. Patients who conducted cervical exercises had more pronounced correction (p<0.05) of
cervical alignment in both planes and of deglutition.
Conclusions: Dysphagic adult patients with cerebral paralysis in rehabilitation phase, who underwent cervical isometric exercises, showed more significant correction of cervical alignment, both
in the coronal and sagittal plane, and more pronounced improvement in deglutition, compared to
patients who did not execute cervical isometric exercises.
Keywords: Cervical isometric exercises, kyphosis, lordosis, deglutition disorders
08.4
SPEECH-THERAPY AFTER PLASTIC AND RECONSTRUCTIVE SURGERY
OF THE FACE. A NEW APPROACH TO FACIAL REHABILITATION
Martin Frederic - Cabinet D’Orthophonie Philippe Auguste, Hopital Europeen Georges Pompidou - Paris, Paris, France
Plastic and reconstructive surgery is often associated with an adapted functional re-education.
Advances in surgery, pre-operative models and advanced neuroscience research should lead the
speech therapists to evolve their techniques to answer the new surgical requirements. We intend
to give a lecture in three stages:
- History of reconstructive surgery of the face, from the “broken faces” of the First World War up
to face transplantation;
- Re-training: assessment, restoration of speech, facial expressions, chewing, swallowing, reinforcement of sensorimotor and cortical control, therapeutic touch, psychological and ethical
aspects, reintegration;
41
- Outcomes of two original studies: (1) Validation of a re-training protocol by “mirror effect” on 26
patients with facial paralysis, who underwent lengthening temporalis myoplasty (LTM); (2) Outcome on the functioning and quality of life for 6 cases of face transplantation. What lessons may
be learnt from facial neuromuscular retraining.
08.5
THE IMPORTANCE OF INTERDISCIPLINARY TRAININING FOR LEARNING
THE CORRECT EVALUATION AND TREATMENT OF DYSPHAGIA: THE
EXPERIENCE OF THE PIACENZA DYSPHAGIA TEAM
Roberto Antenucci - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Rossella Raggi - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Cecilia Cardinali - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Barbara Olizzi - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Michela Benvenuti - Otorinolaringoiatria, AUSL Piacenza, Piacenza, Italy
Giulia Bellini - Cure Primarie, AUSL Piacenza, Piacenza, Italy
Giulia Giovanardi - IRCCS Fondazione Maugeri, Fondazione Maugeri, Montescano (PV), Italy
Domenico Nicolotti - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Objective: Dysphagia is still not very well-known despite the serious risks patients are exposed
to. An interdisciplinary team organized a training course within the public hospital in Piacenza.
The objectives were to comprehend the dimensions of the problem and to know how to evaluate
signs and symptoms of dysphagia.
Method: The training course was addressed to the majority of the hospital staff. Instructors were
physiatrists, phoniatrist-otolaryngologists, lung specialists, nutritionists, geriatricians, neuropsychologists, speech therapists, physical therapists and nurses. The course required classroom
taught lessons and practical lessons. In order to verify the pre-existing skills and the efficiency of
the course, an anonymous pretest identical to the final evaluation test was carried out.
Results: 516 participants attended the course in 15 different editions. The average percentage of
right answers at the pre-test was 41.3±5%. A low percentage of correct answers, about instrumental evaluation, B.M.I., cuffed tubes management, drugs administration and posture, was highlighted. In the final evaluation test the average of right answers was 85.4±4%. Learning effectiveness is statistically significant.
Conclusion: Participants knowledge on evaluation and treatment of dysphagia improved. The
attendees judged that the course was very effective for their continuing education. The explanation of the low percentage of correct answers is unclear (perhaps a lack of being checked over or
a lack of training). The acceptance ratings confirm the need for interdisciplinary, theoretical and
practical training for dysphagia addressed to all health care workers.
Keywords: Dysphagia, interdisciplinary treatment, hospital staff training
08.6
FIVE YEARS OF ACTIVITY OF THE INTERDISCIPLINARY TEAM FOR
SWALLOWING DISORDERS OF SENIGALLIA (CENTRAL ITALY)
Patrizia Lopez - Azienda Sanitaria Area Vasta 2 Marche,Senigallia (AN), Italy
Objective: To illustrate five years of activity of the interdisciplinary team for swallowing disorders
of Senigallia (Central Italy).
42
Methods: The design consisted of retrospective analysis. 1,613 subjects with dysphagia were assessed in the period January 2009 - December 2013 by the Outpatient Dysphagia Clinic (ODC).
The dysphagia assessment was performed after a request from the GPs (outpatients) or the ward
clinicians (hospital in-patients) through: Bedside Swallowing Evaluation (BSE), Cervical Auscultation (CA), Dysphagia Outcome Severity Scale (DOSS), and Malnutrition Universal Screening Tool
(MUST). The ODC staff also provided nutritional advice and follow-up. When indicated, early supported discharge from the ward was arranged by a multidisciplinary team (GP, medical specialist,
speech and language pathologist, dietician, and nurse care-manager).
Results: In the period under consideration, we assessed 1,613 patients (787 males and 826
females), mean age 83.2 yrs. (range 8 – 102 yrs.). The main causes of dysphagia were: dementia
(55%), stroke (14%), presbiphagia (13%), GERD (10%), neoplasm (5%), other pathologies (3%).
Since 2009, the number of patients benefitting from early supported discharge programmes progressively increased.
Conclusion: The multidisciplinary approach of dysphagia offers a more appropriate and effective
management of patients with swallowing disorders. Such an approach may reduce the number
of re-hospitalizations due to dehydration, malnutrition, and aspiration pneumonia. This strategy is
affordable, and could be replicated in other similar settings.
Keywords: Dysphagia, swallowing assessment, dietary modifications, early supported discharge
09.1
LEARNING WORDS: THE EFFECTIVENESS OF VOCABULARY TRAINING
IN PRE-SCHOOLERS WITH SPECIFIC LANGUAGE IMPAIRMENT
Esther Ottow-Henning - Royal Auris, Research & Development, Gouda, Netherlands
Astrid Kruythoff - NSDSK, Research & Development, Amsterdam, Netherlands
Floor Cohen Tervaert - NSDSK, Research & Development, Amsterdam, Netherlands
Karin Wiefferink - NSDSK, Research & Development, Amsterdam, Netherlands
Ellen Gerrits - HU University of Applied Sciences, Faculty of Health Care, Utrecht, Netherlands
Objective: The purpose of this study was to determine the effects of a protocolled oral vocabulary
intervention on the number of new words learned by pre-schoolers with specific language impairment (SLI). The vocabulary intervention protocol was based on the principle of ‘focused stimulation’ (Girolametto et al, 1996) and included various strategies like multiple exposures to words,
using words in different contexts and using prompts and gestures (Steele & Mills, 2001).
Methods: In a randomized-controlled trial using a pretest-intervention-posttest design we compared word learning effects of an experimental protocolled vocabulary intervention to care as
usual. Both interventions were provided three times a week, for a total of four weeks. Participants
were 63 children with SLI aged 2-4 years. They were randomly assigned to the experimental
group (n=32) and usual care (control) group (n=31). In both the experimental and the control group
the objective was for children to learn 25 selected target words. Expressive knowledge of the 25
target words and 25 control words was measured with a picture naming task before, immediately
after the intervention, and in a delayed posttest, one month later.
Results: Preliminary results show that children in the experimental intervention group on average
master more target words immediately after the intervention than children in the control group (6
vs 3 new target words; (F(1,61)=11,30, p=.001). No significant differences were found in control
words: children in both groups on average learned two new control words.
Conclusions: Protocolled vocabulary intervention seems more effective than care as usual.
Keywords: Specific language impairment, vocabulary intervention, evidence-based practice, word
learning
43
09.2
THE EFFECT OF PHONOLOGICAL INTERVENTION IN DUTCH SLI
Annelies Bron, Annette Scheper - Royal Dutch Kentalis, Speech and Language Centre, Eindhoven, Netherlands
Objective: At Royal Dutch Kentalis young children with severe phonological disorders are diagnosed and treated intensively in the Speech and Language Centre. These children with SLI are
referred to Kentalis because their speech does not improve satisfactorily, despite regular speech
and language therapy. Our research focuses on the effectiveness of specific phonological therapy.
Methods: In this study 50 children with a phonological disorder are treated. A standardised
method for phonological analysis is used in order to determine the acquired grade of contrast in
phonological development and the occurrence of phonological simplification processes.
PCC (Shriberg & Kwiatkowski, 1982) and PMLU (Ingram, 2002) are used as measures to examine
the severity of the disorder and whether specific phonological treatment is successful. The ability to produce grammatically correct and complex utterances and narrate a more cohesive story
is analysed in a story generation task (Frog story, Mayer, 1969). All children are tested both at the
start of the treatment and 6 months after.
Results: The results show that most children grow substantially in their phonological skills. Significant improvements are found for grade of contrast, frequency of phonological simplification
processes, PCC and PMLU.
It is also shown that growth in PCC coincides with growth in PMLU. Better phonological representations seem to lead to the use of more complex word forms. When a child’s phonology grows,
the child can use longer sentences and more plot elements when narrating a story.
Conclusions: For children with severe phonological disorders, specific phonological therapy helps
to improve intelligible speech. Their language system grows at both word and sentence level,
leading to better language skills.
Keywords: Specific language impairment, phonological disorders
09.3
A PILOT STUDY AMONG FRENCH YOUNG OFFENDERS. ASSESSMENT
OF ORAL LANGUAGE IMPAIRMENT IN RELATION TO PROGRESSION
THROUGH THE PRISON SYSTEM
Agnes Witko - ISTR Institut des Sciences et Techniques de la Réadaptation - Département Orthophonie,
Université Claude Bernard, Lyon (69), France
Lucille Blondet - ISTR Institut des Sciences et Techniques de la Réadaptation - Département Orthophonie,
Claire Guiraud - ISTR Institut des Sciences et Techniques de la Réadaptation - Département Orthophonie,
Objective: Numerous studies in the United Kingdom (Bryan, 2004, 2007, 2011), the United States
(Sanger et al. (2001) and Australia (Snow & Powell, 2004, 2008, 2011) have shown that the prevalence of language impairment is much higher amongst young offenders than in the general population. To our knowledge, no such study has ever been undertaken in France. The goal of this pilot
study was to bring greatly needed information on language difficulties among a small group of
young offenders going through the French prison system and to raise awareness on their communication difficulties.
Methods: Formal and functional oral language assessment was conducted on a small sample of 19
subjects. Productive and receptive tasks were used to investigate the two sides of language faculty.
Six core tasks were used as markers for language difficulties.
44
Language production measures: morphology and syntax were measured using a sentence repetition task (L2MA-R, Chevrie-Muller & al., 2011), a sentence completion task and a discourse task
using a reminder of an oral story (Exalang 11-15, Lenfant & al., 2009).
Language reception measures: receptive vocabulary (EVIP, Dunn & Theriault-Whalen, 1993) was
measured using a French adaptation of the PPVT (Dunn & Dunn, 1981), a comprehension of instructions test and a short debate, both based on functional situations (Exalang 11-15, Lenfant et
al, 2009).
Further analysis was used to compare language difficulties and progression through the prison
system.
Results: Some subjects did not complete the protocol. However, main results are as follows:
1. 15 out of 19 subjects scored below 1.65 SD or below C10 on one or several of the six core
tasks.
2. A comparison made between subgroups shows that, among the 19 subjects assessed, those
with the most difficulties on the receptive vocabulary task and the narration task are those who
spent more time serving a punitive sentence within the prison and those less likely to live in a
responsibility unit.
Conclusion: This study confirmed that a high level of oral language difficulties was present in the
population assessed. It was also partially confirmed that these difficulties may have an impact on
young offenders’ progression inside the prison system. Issues regarding the assessment of oral
language abilities in teenagers and the relevance of the protocol used in this study are discussed.
The limitations of the study and indications for further research are also explored to consider a
further study on a larger sample.
Keywords: Pilot study, young offender institution, young offenders, oral language, speech and
language impairment
09.4
EFFICACY OF EARLY INTERVENTION FOR CHILDREN WITH SPECIFIC
LANGUAGE IMPAIRMENT
Bernadette A.M. Vermeij - NSDSK, Research Department, Amsterdam, Netherlands
Karin Wiefferink - NSDSK, Research Department, Amsterdam, Netherlands
Rosanne B. van der Zee - NSDSK, Research Department, Amsterdam, Netherlands
Noelle Uilenburg - NSDSK, Research Department, Amsterdam, Netherlands
Objective: The aim of this study was to gain insight in the efficacy of early intervention for children
with Specific Language Impairment (SLI) on their language development.
Methods: 75 language impaired children (age 25-45 months) visited a treatment group of the NSDSK in Amsterdam. The language development of these children was tested at the start and the
end of the intervention, with standardized language tests. Approximately half of the parents also
participated in a parent programme in which they learned skills to improve communication with
their child.
Results: The results showed that both expressive language and receptive language of the children
significantly improved, on both sentence and word level. Participation of the parents in the language course had a positive influence on expressive language of the children. The duration of the
group treatment also had a positive influence on expressive language. Conclusions: The language development of the children that visited a treatment group of the
NSDSK improved significantly. The longer the children went to the treatment group, the better the
results.
Keywords: SLI, early intervention, efficacy
45
09.5
COMMUNICATIE VIA SCHERM (CVS), A DIGITAL PROGRAM FOR
SPECIFIC LANGUAGE INTERVENTION WHICH DESCRIBES
A SYSTEMATICALLY USE OF BARRIER GAMES IN THERAPY IN
CHILDREN WITH SLI
Francis van Tilburg - Centre for Speech and Language Disorders, Royal Dutch Kentalis, Utrecht, Netherlands
Annette Scheper - Centre for Speech and Language Disorders, Royal Dutch Kentalis, Utrecht, Netherlands
Objective: The Royal Dutch Kentalis, Centre for Speech and Language Disorders developed
”Communicatie via Scherm” (CvS), a digital program for specific language intervention which describes a systematic use of barrier games in therapy in children with SLI (Van Tilburg & Scheper,
2014). Goals of this intervention are to develop the child’s metalinguistic skills, to increase the use
of content words, and to improve their conversational skills. CvS uses a barrier between adult
and child. The child practises alternately his listening and verbal skills. After each turn, the child
receives feedback in a metalinguistic way from the SLT.
Methods: The effectiveness of CvS is investigated in an early efficacy study with a one group
pretest-posttest design (N=9) (Bekkenutte, 2013). Participants are diagnosed with SLI.
Results: In the posttest condition, children use significantly more self-corrections, they show
more independent turntaking behaviour, and use significantly more nouns and lexical verbs to
enrich the content of their language production.
Conclusions: CvS seems to be effective in the language therapy of children with SLI. The specific
interactional setting the barrier brings seems to be an adequate way for children to become aware
of their communication behaviour and to improve their metalinguistic and communicative skills.
To substantiate the effects of CvS, there is need for more scientific research. Conclusions of new
research could contribute to develop CvS into an evidence based intervention, which is of essential need in the field of language therapy for children with SLI.
Keywords: Barrier games, metalinguistic skills, conversational skills, SLI
09.6
INTERPROFESSIONAL COLLABORATION AND THE USE OF ASSISTIVE
TECHNOLOGY TOOLS IN SLP FOR DEVELOPMENTAL LANGUAGE
DISORDERS
Cristian Leorin - Department of Neurosciences, University of Padova, Padova, Italy
Manuela Susigan - U.O.C. - O.R.L., Hospital San Donà di Piave, Venezia, Italy
Carlo Fantozzi - Department of Information Engineering, University of Padova, Padova, Italy
Valentina Rigato - Department of Neurosciences, University of Padova, Padova, Italy
Diego Vescovi - Department of Information Engineering, University of Padova, Padova, Italy
Objective: (1) to present the design methodology and outcomes of a professional tool intended to
both improve the overall effectiveness of language disorder treatments and stimulate child engagement through individually customized mobile apps; (2) to promote the use of tablets and SLP
apps; (3) to describe a good practice of inter-professional collaboration with an external academic
body (Department of Information Engineering, University of Padua).
Methods: The app-tool was created to assist young patients with the construction of clauses. Its
interactive and auditory-visual feedback construction was designed to help children in the expansion of arguments and stress of morphology.
The app was tested with a sample group of pre-school children with SLD and secondary
46
language disorders. The experimental phase included an initial assessment, a questionnaire for
the SLPs, followed by a treatment period and a final evaluation.
Results: The app-tool increased the motivation and attention of children during SLP therapy. Accuracy of the answers was improved. The interprofessional collaboration played a significant role
in the step-by-step development of the SLP tools.
Conclusions: The use of mobile apps may significantly improve the effectiveness of SLP treatments provided that: 1. SLP designs the therapy plan for each patient as a result of clinical assessment; 2. the app is used to achieve the rehabilitation outcomes. The interprofessional collaboration provides a higher level of customization and specificity.
Keywords: Language disorder, assistive technology, app, interprofessional collaboration, interdisciplinary learning
10.1
RELATIONSHIP BETWEEN DYSARTHRIA AND QUALITY OF LIFE IN
PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS
Sarah Feroldi - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Daniela Ginocchio - NeuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Christian Lunetta - NeuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Valeria Sansone - NeuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Antonio Schindler - Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
Objective: To evaluate dysarthria and dysarthria-related quality of life (QOL) in patients with
Amyotrophic Lateral Sclerosis (ALS) and to analyze its relationship with patients’ age, disease
duration, motor functions, depression and general QOL.
Methods: N=43 ALS patients. Inclusion criteria: Mini Mental State Examination ≥24. Dysarthria
severity and characteristics, ALS severity, depression, dysarthria-related and generic QOL were
evaluated with Therapy Outcome Measure (TOM), Robertson Profile, ALS Functioning Rating
Scale (ALSFRS-revised), Beck Depression Inventory, the QOL of the dysarthric speaker (QOLDyS), ALS Assessment Questionnaire (ALSAQ-40) and Short Form-36 (SF-36) questionnaire.
Results: Dysarthria affected 31/43 patients (13 mild-moderate, 18 severe). Robertson Profile and
QOL-DyS were more compromised in dysarthric patients (p<0.001). We found significant correlations between QOL-DyS and all the subscales of the Robertson Profile (r=0.812) and of the TOM
(r=0.705). QOL-DyS showed a strong correlation with ALSAQ-40 communication and eating items
(r=0.857) with a difference between dysarthric and non-dysarthric (p<0.001). QOL-DyS correlates
also with ALSFRS-r bulbar (r=0.616) and respiratory subscore (r=0.421). QOL-DyS showed no
correlation with SF-36, patient’s age, disease duration, mental health or depression.
Conclusions: Dysarthria severity affects QOL according to QOL-DyS scores. QOL-DyS should be
used in clinical practice to better investigate dysarthria-related QOL in ALS patients as well.
Keywords: Dysarthria, neurodegenerative disorders
47
10.2
IDIOPATHIC PARKINSON’S DISEASE OROMOTOR PERFORMANCE AND
INFLUENCING FACTORS
Isabel Guimaraes - School of Health Sciences at Alcoitão (ESSA), Alcoitao-Alcabideche, Portugal
Rita Cardoso - Campus Neurológico Sénior (CNS), Torres Vedras, Portugal
Serge Pinto - Laboratoire Parole et Langage, Aix-en-Provence, France
Joaquim J. Ferreira - Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
Objective: (1) To determine and identify the nature and pattern of oromotor movements specifically reflexes, respiration, lips, palate, laryngeal, tongue and intelligibility in Idiopathic Parkinson’s
Disease (PD) patients according to gender. (2) To predict which variables: age, PD disease duration, sight, hearing, teeth, mood, posture and oral sensory feedback, are associated with oromotor performance.
Methods: Idiopathic PD patients were assessed using the Frenchay Dysarthria Assessment version two (FDA-2). The total possible FDA-2 score is 104 corresponding to the worst patients’
performance. For statistical analysis, Student’s test for comparative purposes and multiple linear
regression to find which variable combinations are associated most with the key dependent measure (FDA total score) were used. For both tests, the critical level of significance was 5%.
Results: 80 Idiopatic Parkinson’s Disease patients, 44 males (mean age=66±1.5) and 36 females
(mean age=67.6±1.9), with a PD duration of 11.9±1.1 and 9.9±1.2 years, respectively, were included. FDA-2 total score according to gender was 40.4±4.3 and 46.8±4.1 for males and females
respectively. Although females present a worst oromotor performance than males, the difference
was not statistically significant. The results of the multiple regression analysis indicate that the
overall model is a highly significant predictor (p<.001) model of the FDA total score accounting
for 44% of its variance (R squared=.441). Moreover, t and p-values within the model show that
only PD disease duration and mood variables are significant independent predictors. Beta weight
coefficients show that the best predictor in the model is disease duration (.495) followed by mood
(.246), hearing (.133), age (.117), teeth (.110), posture (.067), oral sensory feedback (.063) and
sight (-.078).
Conclusions: The results of this study failed to indicate a statistically significant difference between PD females and males. The combining predictor of 8 variables is a highly significant model
accounting for 44% explanation of the nature and pattern of PD oromotor movements. The data
collected will provide important reference information for speech-language therapists with the
purpose of oromotor dysfunction diagnosis in PD patients.
Keywords: Parkinson’s Disease, oromotor pattern, influencing factors
10.3
DYSPHAGIA AND DYSARTHRIA IN FACIAL ONSET SENSORY MOTOR
NEURONPATHY (FOSMN) SYNDROME: A CASE REPORT
Federica Bianchi - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Daniela Ginocchio - NEuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Gabriele Mora - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Miriam Vedrodyova - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Objective: To observe the impact of percutaneus endoscopic gastrostomy (PEG) placement on
dysarthria and dysphagia progression in a malnourished patient with facial onset sensorimotor
48
neuronopathy (FOSMN) syndrome.
Methods: A 53 year-old men underwent speech and swallowing assessment before and one year
after PEG placement. Fiberoptic endoscopic evaluation of swallowing with semisolids and liquids
was performed. Dysphagia severity was rated through the Penetration Aspiration Scale (PAS) and
Dysphagia Outcome and Severity Scale. Presence and severity of dysarthria were investigated using Roberson Dysarthria Profile Self-assessment of dysphagia and dysarthria related quality of life
(Swal-QOL and QOL-DyS) were completed
Results: One year after PEG placement the patient’s body mass index increased from 19.7 to
20.7. Swallow safety for semisolid and sequential liquid swallow remained the same, while it improved for liquid single bolus (PAS 8 to 1). The Robertson Profile showed mild dysarthria in both
examinations. The subtest of muscular strength and diadochokinesis rate increased in the last
examination. QOL-DyS worsened in speech characteristic and perceived reaction of others. SwalQOL worsened in social activity, but improved in symptoms.
Conclusion: Dysphagia and malnutrition detection and early PEG placement with the maintenance of hedonic feeding had positive effects on nutritional status, dysphagia and dysarthria
symptoms and related QOL at one year follow-up. Therefore early speech and language pathology care should be considered in clinical practice with FOSMN patients. Further studies are
needed
Keywords: Dysphagia, dysarthria, neurodegenerative disorders
10.4
SPEECH THERAPIST’S ROLE IN THE MANAGEMENT OF PATIENTS WITH
PARKINSON’S DISEASE INSPIRED BY THE “CHRONIC CARE MODEL”
(CCM)
Laura Fuschetto - Department of Neuroscience, Università di Siena, Siena, Italy
Santi Centorrino - Rehabilition Unit, Campostaggia Hospital USL 7 Siena, Siena, Italy
Objective: The health care system needs to find strategies to manage chronic diseases. One possible answer is CCM based on a fruitful interaction between the informed patient and the professional team. We want to verify the speech therapist’s possible role through the perspective of
CCM applicable to the treatment of patients with Parkinson’s disease.
Methods: R.P., woman aged 66, with a diagnosis of PD for 8 years, received phono-articulatory
treatment once a week for five weeks. Evaluation was divided into three parts: voice, articulation,
quality of life. Tests used: GIRBAS scale, electro-acoustic analysis of the speech signal with Praat
Software , Voice Handicap Index , Profilo di valutazione della disartria , Unified Parkinson’s Disease Rating Scale, Parkinson’s Disease Questionnaire. During the sessions the patient received
training demonstrations to perform at home and printed materials with training in writing. At the
end of five weeks, weekly telephone monitoring and monthly follow-up were made.
Results: The parametric changes observed in the month following treatment were positive (voice
breaks from 19 to 0, jitter from 1.508% to 0.65%, shimmer from 14.89% to 13.4%, NHR from
0.46% to 0,17% dB, HNR from 4,350 to 9,923) but have not been reflected in the following
months. The psychological impact of the improvements perceived by the patient has had positive
feedback on the quality of life.
Conclusions: The experiment has highlighted the importance of a strong therapeutic alliance
between chronic patient and speech therapist in view of a protracted duration of the take-over.
The feedback from the patient was positive and made it possible to establish a relationship based
on “active collaboration” reducing the risk of therapy addiction. Speech therapists can assume a
specific role in the CCM. It would be useful to check the impact of the disease and the quality of
life for a greater number of patients.
Keywords: Professional practice
49
10.5
COGNITIVE TRAINING CENTERED ON MOTOR TASKS FOR PATIENTS
WITH EXECUTIVE DISORDER AND IMPAIRED AWARENESS
Rossella Raggi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Emilia Bozzini - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Roberto Antenucci - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda
(PC), Piacenza, Italy
Maria Paola Gruppi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda
Carlotta Binelli - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Maria Teresa Pollini - CDD Villa Igea, Lodi, Italy
Barbara Olizzi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Cecilia Cardinali - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Paola Patroni - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Monica Orsi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC), Piacenza, Italy
Domenico Nicolotti - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda
Objective: This study describes a training protocol for the remediation of executive functioning,
based on the Inner Speech Training approach. It was realized by the whole interdisciplinary rehabilitation team, steered and supervised by the neuropsychologist. The compensatory intervention
consisted of a self-instructional procedure that required reading and verbalizing a plan of behaviour before and during execution of the training task; after that, the instructions gradually became
internalized. Disturbances of executive functioning represent significant obstacles to functional
recovery, because poor self-control, impaired awareness and planning ability prevent the selection
and filtering of steps, which are necessary for learning new strategies.
Methods: Two patients with sub-acute stroke participated; the protocol was centered on the
recovery of transfers and safety in walking. Prepared cards facilitated gradual self-verbalization
of strategies. In order to improve awareness and self-monitoring, figurative cards were prepared
in order to allow self-evaluation before and after execution of the training with the physiotherapist’s feedback and, during the day, with the speech therapist’s feedback. For self-monitoring, a
specific graphic of the protocol trend was realized. The training program lasted for 3 weeks with 5
sessions per week.
Results: The training protocol, centered on motor tasks, improved intellectual and emergent
awareness, allowing the recovery of functional abilities.
Conclusions: This training protocol for the remediation of executive functioning based on the
Inner Speech Training approach, improved patients’ performances on specific tasks, which the
whole rehabilitation team selected in advance and adjusted with appropriate cards.
Keywords: Executive function, Inner Speech Training approach, interdisciplinary treatment
50
10.6
DYSARTHRIA ASSESSMENT SHOULD BE CARRIED OUT EXCLUSIVELY
THROUGH THE EXECUTION OF SPEECH TASKS
Daria Protti - Centro Traumatologico Ortopedico Torino (CTO), Citta’ della Salute e della Scienza di Torino, Turin, Italy
Patrizia Cancialosi - Centro Traumatologico Ortopedico Torino (CTO), Citta’ della Salute e della Scienza di Torino, Turin, Italy
Objective: To investigate the effectiveness of the use of non-speech oral motor tasks in the clinical assessment of dysarthria.
According to the task-dependent theory, the brain has a separate sensory-motor system for
speech production. Clinically this implies that a dysarthric patient might show a different level of
impairment in the execution of speech and non-speech tasks. Therefore, dysarthria assessment
should not include non-speech tasks, such as oral praxis and articulatory diadochokinesis. A
clinical trial was performed to test whether what is sustained by the task-dependent theory can be
found empirically in Italian patients with dysarthria
Methods: A study group of 28 dysarthric patients was selected (testing is still in progress, and
a larger group will shortly be involved), and each patient was assessed with two protocols: one
composed of speech tasks only, and one consisting of speech and non-speech tasks. The correlation existing between the scores obtained in speech and non-speech tasks was investigated.
Results: We found a statistically significant difference between the abilities exhibited by dysarthric
patients in performing speech and non-speech oral motor tasks.
Conclusions: Findings seem to confirm the task-dependent theory: a neural system exists, dedicated to the control of speech production; therefore the clinical assessment of dysarthric speech
should be carried out exclusively with speech tasks.
Keywords: Speech disorders, dysarthria
11.1
CHANGES IN PARENTS’ CONCEPTIONS OF THEIR ROLES IN
SUPPORTING CHILDREN’S LANGUAGE DEVELOPMENT: IMPLICATIONS
FOR SLT POLICY, PRACTICE AND THINKING
Karen Davies - NHS England, Manchester Metropolitan University, Manchester, United Kingdom
Objective: The aim of this paper is to present new evidence of (i) parents’ and SLTs’ conception of
their own roles, and the roles of each other, during speech and language therapy intervention, (ii)
longitudinal evidence of changes in parents’ conceptions of their role as interveners as they work
with SLTs.
Methods: A two phase, mixed methods study was conducted using semi structured interviews
and questionnaires with a total of sixty-five parents of pre-school children referred to speech
and language therapy and seventy-two SLTs in England. Initially, fifteen parents and twelve SLTs
participated in semi structured interviews investigating conception of roles, generating qualitative data used to design a cross sectional survey. A smaller subset of ten parents participated in a
longitudinal study over nine months to track any changes in their conceptions of their roles during
intervention. The qualitative data were analysed using thematic network analysis to identify initial
themes and framework analysis for comparison of themes over time. Descriptive and correlation
analysis were used to interrogate the questionnaire data.
Results: Findings suggested that, before involvement with SLT, parents did not have a firm conception of their role in supporting their children’s language learning and did not anticipate adopting an intervener role. During intervention, some parents described changing their conception
51
of roles and adopting an increasingly involved role as implementer and adaptor of intervention.
Moreover, in some cases, they described substantial changes in their approach to parenting, suggesting wider changes in their conception of their parenting role.
SLTs’ conception of their own roles were clearly formulated as assessor, intervener and negotiator,
but varied in the extent to which they regarded parents as co-workers in intervention. SLTs expressed their conception of the intervener role in one of two ways: either as ‘planning and treating’ or ‘advising and coaching’. SLTs who adopted an ‘advice and coach role’ spoke of seeking to
develop parents’ thinking about what they could do and parents’ sense of empowerment in relation to their child’s language. Although these SLTs did not express their role in terms of being an
‘educator of parents’ they were, in practice, seeking to change parents’ conception of their role,
which was welcomed by parents.
Conclusions: Policy statements about parents’ agency, choice and co-production in health typically present parents’ preferences as fixed. However, as this research shows, parents may change
their conception of their role as they work with SLTs. This has important implications for SLTs’
practice, in adopting a coaching, or parent education, role to enhance parental understanding of
supporting their children’s language development. This should prompt the profession to extend
the professional discourse to include the parent educator role more explicitly as part of therapy
intervention.
Keywords: Conception of roles, parents as interveners, SLTs as educators
11.2
PARENTS’ AND TEACHERS’ PERCEPTIONS ABOUT
LANGUAGE-DISORDERED CHILDREN’S BEHAVIOUR DIFFICULTIES
Maria Vlassopoulos - 1 Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Evdokia Lagakou - 1 Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Ioanna Tsipra - 1 Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Helen Lazaratou - 1 Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
st
st
st
st
Objective: Recent research has concluded that language disorder in children is part of a more
encompassing group of neurodevelopmental disorders, which may in part explain why many of
these disorders co-occur in the same individual. The purpose of this study is to investigate how
both teachers and parents view the behaviour of children with a diagnosis of language disorder
and whether there is agreement in these groups’ perceptions of the children’s behaviour difficulties.
Methods: Participants in the study were the parents and teachers of 272 pre-schoolers (Mean age
4.2 years, SD 0.9) with a diagnosis of language disorder. Parents were requested to complete the
Child Behaviour Checklist (Achenbach 1991), whereas 40 teachers completed the parallel Teachers Report Form (C-TRF) for a sample of these children.
Results: Parents noted Internalizing problems (eg. attention problems, anxiety and depression) in
approximately 24% of the sample, Externalizing problems (eg. emotional reactiveness and aggression) in 13%, and Total problems in 17.5%. On the contrary, teachers found that 20% had
Internalizing problems and 29% had Externalizing problems, with a further 15% exhibiting Total
problems. When teachers’ and parents’ reports were matched, it was found that teachers reported significantly more attention problems (<0.001) and aggressive behaviour (<0.001) than the
parents.
Conclusions: In this study parents report a high incidence of behaviour difficulties in their children
with language disorder. Discrepancies were found however between the parent and teacher reports. This lack of agreement may be justified by the different settings (home/school), where factors such as the child’s frustration with communication and need for more individualized attention,
may lead to more aggressive behaviour or increased difficulties attending to tasks. The impor52
tance of multiple sources of data collection is highlighted in order to assess a child’s functioning
in various settings. Furthermore this study notes the high percentages of concomitant behaviour
problems (<50%) reported by both teachers and parents of language disordered children, despite
disagreement about type.
Keywords: Language disorder; children; behaviour difficulties; parent, teacher reports
11.3
INDICATIONS OF PARENTS’ ADHERENCE IN THE ENCOUNTER WITH
SLTS REGARDING HOME TRAINING ACTIVITIES
Dorthe Hansen - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Catherine E. Brouwer - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Objective: The study contributes to an understanding of Speech Language Therapists’ (SLTs)
methods for instruction and how these may provide opportunities for interactionally establishing agreement with parents on treatment plans regarding children with Developmental Language
Disorders.
Methods: Video recordings were made of five different encounters in which parents were instructed by SLTs on how to perform language activities with their child at home. Employing ethnomethodological conversation analysis we transcribed and analyzed the recordings in detail.
Results: The analysis showed that indications of parents’ adherence can be identified in the
encounter itself. To what extent these are explicit or implicit is directly contingent on the method
of instruction: In cases where parents are presented with a list of directives, it does not become
sequentially relevant for them to have influence on the actual treatment plan. Here, indications of
agreement are implicit, weak or non-existent. Contrarily, when parents during an instructive sequence are invited to react, sequential opportunity is provided to explicitly agree on the treatment
plan, thus showing explicit agreement to adhere.
Conclusions: When being invited to react and contribute to the SLT’s suggestions for language
activities to be performed at home, parents provide important information about their future adherence. This information is the basis for evaluating the need for an adjustment of the treatment
plan.
Keywords: DLD, parents, instruction, adherence, CA
11.4
PARENT PSYCHOEDUCATIONAL PROGRAMME FOR THE
COMMUNICATION DEVELOPMENT OF PRESCHOOL CHILDREN WITH
LANGUAGE DISORDERS
Paraskevi Meravoglou - 1 Psychiatric Clinic, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Evdokia Lagakou - 1 Psychiatric Clinic, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Maria Vlassopoulos - 1 Psychiatric Clinic, Medical School, National and Kapodistrian University of Athens, Athens, Greece
st
st
st
A structured psychoeducational programme, which is addressed to parents of preschool children
2 to 4 years of age with language delay or disorders, is presented. It is a pilot programme conducted at the Community Mental Health Centre of the 1st Psychiatric Department of the University of Athens in Greece. The programme is based on the principles of the Parent Hanen Program
“It takes two to talk”. Nevertheless certain modifications were necessary in order to address the
needs and expectations of parents in a Greek community.
53
Objective: The specific programme is based on the premise that it is highly recommended
to provide indirect services to preschool children with language disorders by enlisting parent
commitment and participation in a psychoeducational group. Within a child centered and preventive framework, the main goals of the programme are to educate parents to better understand
language development and the factors that influence it, to encourage them to apply strategies to
help their children develop communication skills in everyday situations and to support parents by
providing them the chance to share ideas and concerns with other parents in the same situation.
Methods: The programme is jointly conducted by a school psychologist and a speech therapist. The selection criteria, the assessment process, the sessions’ content as well as preliminary
qualitative programme evaluation data are presented. Culture-specific modifications made to the
Hanen Parent Program are also presented.
Results: Parental reports emphasize improvement in their skills to approach and communicate
with their preschool child leading to positive outcomes as far as the child’s verbal expression and
communicative intent are concerned. Furthermore there are positive outcomes reported in family
functioning.
Conclusions: Preliminary qualitative evaluation of this programme was consistent with international research in the field of indirect intervention. It is noted that the modifications made to the
original Hanen Program were necessary for its implementation in a Greek community.
Keywords: Parent psychoeducational programme, developmental language disorders, preschool
children, prevention
11.5
THE FUNCTIONING OF REITERATION PROCESSES IN
ADOLESCENT-SPEECH THERAPIST INTERACTION
Gwendoline Fox - Institut des Sciences du Langage et de la Communication, Chaire de Logopédie, Université de Neuchâtel,
Neuchâtel, Switzerland
Audrey Sublon - Institut des Sciences du Langage et de la Communication, Chaire de Logopédie, Université de Neuchâtel,
Geneviève de Weck - Institut des Sciences du Langage et de la Communication, Chaire de Logopédie, Université de
Neuchâtel, Neuchâtel, Switzerland
Objective: Many studies have shown that reiteration (recast, repetition...) plays an important role
in language acquisition. Yet, most focus on young children’s acquisition; there is very little work on
reiteration with adolescents, notably with language disorders. It is thus very difficult to have a full
view of how it helps young speakers to become ‘fully expert’. Reiteration is also seen as a feedback provided by adults to support children, which has a methodological consequence that studies usually restrain their observations to adults’ reiteration of child speech, and possibly children’s
reaction to this reiteration.
Using a corpus of adolescents with SLI-speech therapist dyads, we propose a typology of all observable reiteration types, to design a method including more varied reiteration forms and applicable to interactions with children or adolescents, in order to better grasp the functioning and role
of interactional processes at play during speech therapy.
Methods: We study the reiterations found in interactions of 3 dyads (adolescents aged 12 to 16)
during therapy and classify them according to factors like who produces the reiteration, auto- vs.
hetero-reiteration, inside or across turns, formal feature.
Results: Results show, inter alia, that reiteration occurs significantly more in the therapists’ uses
(38%), but it is also substantial in the adolescents’ data (25%). Moreover, 2 main reiteration types
with different purposes can be distinguished: 45% are used by the speaker to formulate his own
discourse within a single turn and 55% occur across turns and serve to co-construct the dialog.
Finally, auto-reiteration is very present (66% overall), even across turns (37%).
54
Conclusions: This suggests that reiteration is in fact multifaceted and contributes to young speakers’ acquisition in other ways than just as a support device.
Keywords: Developmental language disorders, speech therapy, adolescents, interaction, reiteration processes
11.6
SPEECH PRODUCTION FOR CHILDREN BETWEEN 13 AND 22 MONTHS
AND ITS RELATIONSHIP TO SOCIOECONOMIC, OBSTETRIC
AND PSYCHOSOCIAL VARIABLES
Ana Paula Ramos Souza - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Universidade Federal de Santa Maria, Santa Maria, Brazil
Anelise Henrich Crestani - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Anaelena Bragança Moraes - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Objective: To analyze the relationship between the vocabulary of children between 13 and 22
months and socioeconomic, obstetric and psychosocial variables.
Methods: The sample consisted of 46 mother-infant dyads. The data was collected through an
interview which investigated socioeconomic and obstetric variables and by implementing an
Inventory of Anxiety and Depression to ascertain the maternal mood. Between 13 and 16 months
the children were assessed for vocabulary development through mothers’ spontaneous memories
and observation of child behaviour. Between 17 and 22 months a checklist was used to assess
the extent of the vocabulary words into categories.
Results: The most extensive vocabulary, manifested both in the total number of words as well as
the vocabulary gain between the first and second age group investigated was related to the fact
that the mother has an occupational activity (p = 0.002) between 17 and 22 months, and was
related to higher maternal education between 13 and 16 months (p = 0.029).
Conclusion: Maternal education and the fact that the child’s mother has an occupation can be
considered protective factors to risk and as favoring the development of children’s language acquisition.
12.1
SET OF OBSERVATIONAL MEASURES FOR RATING SUPPORT
AND PARTICIPATION IN CONVERSATION: ITALIAN VALIDATION
Marta Rinaudo - Universita’ degli Studi di Torino, Turin, Italy
Giulia Rabino - Universita’ degli Studi di Torino, Turin, Italy
Ermelinda Massari - Universita’ degli Studi di Torino, Turin, Italy
Laura Bergamasco - Universita’ degli Studi di Torino, Turin, Italy
Patrizia Steni - Department of Rehabilitation, ASL TO 1 / Universita’ degli Studi di Torino, Turin, Italy
Rossella Muò - Department of Rehabilitation, ASL TO 1 / Universita’ degli Studi di Torino, Turin, Italy
Objective: Conversation partners play a key role in supporting communication of people with
aphasia, acting as “communication ramps”. MSC-MPC Scales evaluated communicative abilities of the dyad person with aphasia and conversation partner. MSC-MPC Scales have not been
translated and validated into Italian yet. Aim of the study is to validate the Italian version of MSCMPC Scales.
55
Methods: MSC-MPC Scales translation followed the back-translation procedure. 16 patients with
non-fluent aphasia were videotaped while communicating with both a trained and an untrained
conversational partner; one expert and two non-expert raters separately evaluated 32 videos.
Inter- and intra-rater reliability were calculated with ICC and Spearman’s test. Correlations with IASHA-FACS, Pragmatic Protocol and with aphasia severity were also calculated with Spearman’s
and Pearson’s test.
Results: Inter-rater reliability correlations were strong/very strong (ICC>.66); a difference between
expert and non-expert raters was highlighted. Intra-rater reliability was very strong (ρs>.90). The
Italian version of MSC-MPC Scales showed strong correlations with aphasia severity (ρs>.65),
functional communication (ρs>.75) and pragmatic abilities (ρp>.80); correlations with linguistic
performances were weaker (ρs>.30).
Conclusions: MSC-MPC Scales are a valid and reliable instrument. A sensibility to the examiner’s
expertise can be highlighted. The use of MSC-MPC Scales is recommended to take also into account conversation partners’ abilities in supporting and facilitating conversation.
Keywords: Aphasia
12.2
DEVELOPMENT OF THE DUTCH STROKE AND APHASIA QUALITY OF
LIFE SCALE
Lizet van Ewijk - Department of Speech and Language Therapy, Utrecht University of Applied Sciences, Utrecht, Netherlands
Lotte Versteegde - Department of Speech and Language Therapy, Utrecht University of Applied Sciences, Utrecht, Netherlands
Evelijn Raven-Takken - Department of Speech and Language Therapy, Utrecht University of Applied Sciences, Utrecht, Netherlands
Ellen Gerrits - Centre for Innovation in Healthcare, Research group Speech and Language Therapy, Utrecht University of Applied
Sciences, Utrecht, Netherlands
Objective: Development of a valid and reliable health related quality of life (HQOL) scale for Dutch
aphasic individuals, the SAQoL-39NL.
Methods: The English SAQoL-39g (Hilari et al., 2009) was translated into Dutch following the
guidelines for the process of cross-cultural adaptation of self-report measures described by Beaton et al. (2000). Psychometric properties (acceptability, internal consistency, test-retest reliability
and construct validity) were investigated (n=50 chronic aphasic individuals).
Results: Overall the results show that the SAQoL-39NL is an acceptable, valid and reliable scale
for measuring HRQL in chronic aphasia. Internal consistency (cronbach’s alpha = 0.89) and validity (moderate intercorrelations between domains) were found to be acceptable. Test-retest reliability was excellent (ICC=0.93). Furthermore, the results were very similar to those found for the
original SAQoL-39g.
Conclusions: The SAQoL-39NL proves to be a reliable, valid and acceptable instrument to measure HQOL in people suffering from chronic aphasia. It can be used in the Netherlands by clinicians and researchers to evaluate HRQL in the areas of treatment and service evaluation, clinical
audit and treatment prioritisation of people with stroke and aphasia. Furthermore, as the SAQoL39g was used for translation, it allows for an international comparison of services and patients.
Keywords: Aphasia
56
12.3
A STANDARDIZATION STUDY OF THE ITALIAN VERSION OF FRENCHAY
APHASIA SCREENING TEST IN APHASIC PATIENTS AND CONTROL
SUBJECTS
Jessica Bonelli - Department of Neuroscience, University of Siena, Siena, Italy
Santi Centorrino - Rehabilitation Unit, Usl 7, Siena, Italy
Fabio Ferretti - University of Siena, A.O.U.S Le Scotte, Siena, Italy
Giovanna Carlucci - Stroke Unit, A.O.U Careggi, Firenze, Italy
Objective: The Frenchay Aphasia Screening Test (FAST) appears to be the most widely used and
thoroughly evaluated tool found within the stroke research literature. The purpose of this study
was to develop an Italian version (I-FAST) of the Frenchay Aphasia Screening Test and to test the
reliability and validity of the I-FAST.
Methods: The “River Scene” of stimulus set in the original version of FAST was adapted for IFAST. The test structure and language domains (comprehension, expression, reading and writing)
were unchanged. We standardized I-FAST in 186 non-aphasic Italian normal adults (MA 52.37,
SD 19.877) and 102 Italian aphasic patients (MA 70.10, SD 13.105). The presence of aphasia was
documented with a standard clinical logopaedic or neurologic examination. We analyzed I-FAST
internal consistency and intra-/inter-rater reliabilities and I-FAST validity. The I-FAST cut-off values
were established with ROC Curve.
Results: In Rasch Analysis MEAN INFIT(MNSQ) was 1,00/(ZSTD) 0,1 for tested subjects validity
(normals and aphasics); for I-FAST validity MEAN INFIT (MNSQ) was 0.96/(ZSTD) -0,3. Subjects
reliability 0,84; I-FAST reliability 0,98. Cronbach’s α 0,931. The I-FAST cut-offs established with
ROC Curve are 24 points for the complete version and 16 points for the reduced version (I-FAST-R).
Conclusions: Analysis suggests the usefulness of I-FAST as a reliable and valid screening tool for
the detection of aphasia and tracking of its progress for Italian subjects.
Keywords: Aphasia
12.4
PERCEIVED BENEFITS OF AND BARRIERS TO MOBILE TECHNOLOGY IN
REHABILITATION OF ADULTS WITH ACQUIRED NEUROGENIC
COMMUNICATION DISORDERS: A QUALITATIVE STUDY AMONG
FLEMISH SPEECH-LANGUAGE PATHOLOGISTS
Katrien Colman - Department of Speech-Language Therapy & Audiology, Thomas More University College, Antwerp, Belgium
Objective: Smartphones and tablet PCs offer a unique platform to support people with acquired
neurologic speech and language disorders. This study explores the experienced barriers to and
the benefits of the use of mobile technology in a group of Flemish speech-language therapists, in
order to gain a better understanding of necessary future developments of these technologies.
Results: Results revealed that therapists compared mobile technology to low-tech devices to
describe the benefits of the first category: portability, compact stimulus storage, visually attractive
material ready to use and speech output. The group described mobile technology as a means to
increase independence and participation in society. The use of mobile technology in therapy can
be carried over and used in daily life and will help the patient to manage daily activities. Cognitive
impairment and fear to use technology were perceived as major barriers. Participants stressed
that mobile technology might never completely replace the speech-language pathologist.
57
Conclusions: Future research is needed to confirm these findings in a larger group of speechlanguage therapists. Also patients will need to be included in a separate focus group. This talk will
be illustrated with apps that can be used for clinical training and for the support of communication
in the daily life of adults with acquired neurologic speech and language disorders.
Keywords: Mobile technology, apps, barriers, benefits, acquired neurologic speech and language
disorders
12.5
VISUO-SPATIAL ORIENTATION TRAINING IN THE REHABILITATION OF
NEGLECT: A MULTIPLE CASE REPORT
Cecilia Cardinali - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Emilia Bozzini - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Barbara Olizzi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Monica Orsi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Paola Patroni - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Rossella Raggi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Maria Paola Gruppi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Carlotta Binneli - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Roberto Antenucci - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Domenico Nicolotti - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Objective: Unilateral Spatial Neglect (USN) is the patient’s impaired ability to report, respond or
orient to novel or meaningful stimuli presented to the side opposite a brain lesion. It is a strong
predictor of poor functional recovery in stroke patients. Visuo-spatial orientation training is a
technique used in the rehabilitation of USN. Several researchers have reported positive results on
a number of different exercises, varying both materials and tasks. The aim of this study was to
investigate the real generalization of the training effects on the patient’s functional recovery in a
series of single cases of neglect.
Methods: USN was evaluated in 5 neglect patients by Line Barrage, symbol/letter Cancellation
Test, Geometric Shape Copy, Raven CPM, Clock Test, and FAB. Barthel Index, ADL, IADL, and
C. Bergego Scale were administered in order to evaluate the abilities in everyday life. The training
program lasted 6 weeks with 5 sessions per week; top-down approaches to rehabilitation were
used. The patients underwent the same neuropsychological evaluation six month after the end of
the treatment.
Results: All the patients showed improved performances in visuo-spatial orientation tasks and in
ecological settings. The follow-up assessment revealed that recovery remained constant.
Conclusions: Visuo-spatial orientation training was an effective method for neglect treatment
and the effects generalized, so as to improve patient’s ability in everyday life. Functional recovery
remained stable after finishing the treatment.
Keywords: Neglect, neuropsychological rehabilitation, visuo-spatial orientation training
58
12.6
PROTOCOL OF ECOSYSTEMIC ASSESSMENT OF COMMUNICATION IN
APHASIA
Aurélie Iché, Christophe Rives - Cabinet d’Orthophonie Libéral 11 rue Eugène Lozes 31500, Paul Sabatier Toulouse III,
Toulouse, France
The constraints in communication due to speech-language impairments penalize the quality of
life of the aphasic patient. The functional approach to aphasia, in particular the eco-systemic approach, allows us to better understand the handicaps related to the environment associating them
to the evaluation and SLT treatments, in order to help the conversation partners, to achieve an
effective communication, adapted to the language impairment.
The PTECCA (Protocole Toulousain d’Evaluation de la Communication du Couple Aphasique =
PTECCA) has been created to comply with such an eco-systemic approach. It allows us to simultaneously identify the behaviours of two conversation partners and suggest some adjustments,
adapted to their communication profiles and to the aphasic symptoms. It is composed of a grid of
general observation and a set of ecologic evidences, created to allow the two partners to interact.
Some trials of eco-systemic treatment have started, oriented by the results obtained in the PTECCA.
The establishment of the PTECCA has occurred through different steps and with different teams.
Some modifications based on the results of the trials were related to the evidences, the quotation method and the grid itself. Furthermore, some parallel studies helped to validate the interest
of such a tool. During the test, the SLT is just an observer and fills in, in real time, the grid for the
qualitative conversational analysis that simultaneously assesses the communication behaviours
of the two conversational partners. The test sequence is filmed. The results are reported on a star
diagram.
The PTECCA falls within an «evaluation process» that does not refer to a set of rules, but that
evaluates the qualitative aspects of communication, typical for each pair observed. The experiments conducted have shown the pertinence of such an analysis device and the possibility to
develop eco-systemic treatments based on the obtained profiles, thus reducingthe impact of the
shared communication handicap between the aphasic person and his/her environment.
Keywords: Aphasia, eco-systemic approach, functional evaluation, communication handicap,
rehabilitation
13.1
AUDITORY PROCESSING DISORDERS (APD): A DISTINCT CLINICAL
DISORDER OR NOT?
Ellen de Wit - Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences Groningen,
Groningen, Netherlands
Objective: Children with (suspected) auditory processing disorders (APD) may experience difficulties with listening in the presence of background noise despite normal hearing thresholds.
For academics and clinicians it is not clear if APD should be considered as a uni- or multimodal
disorder. The aim of this study was to examine the characteristics associated with APD and to
determine whether APD can be considered a distinct clinical disorder.
Methods: In this systematic review, six electronic databases were searched for peer-reviewed
studies using the key words auditory processing, auditory diseases, central [Mesh], and auditory perceptual. Two reviewers independently assessed relevant studies by inclusion criteria and
reviewed methodological quality of the included studies by using ASHA’s levels-of-evidence
scheme.
59
Results: In total, 3078 citations were screened by title and 502 studies by abstracts. Forty-one
studies met the inclusion criteria of which three studies were excluded on the basis of a weak internal validity. Finally, 38 studies were included from which only one was classified as a study with
strong methodological quality. Differences between children with (suspected) APD and typically
developing children were found in auditory, visual, and cognitive functioning as well as in communication, language, reading, and auditory brain measures such as auditory ERP and otoacoustic
emissions.
Conclusions: There is no evidence to conclude that APD can be considered a unique and identifiable clinical disorder. The characteristics of children with (suspected) APD are not specific to
the auditory modality. The listening difficulties may be a consequence of cognitive, language, and
attention issues, rather than bottom-up auditory problems.
Keywords: Specific language impairment, developmental language disorders, cognitive impairment, psychiatric disorders, hearing impairment
13.2
VERBAL WORKING MEMORY AND SPEECH COMPREHENSION IN
CHILDREN WITH HEARING IMPAIRMENT, SPECIFIC LANGUAGE
IMPAIRMENT AND TYPICAL CHILDREN
Annette Esbensen - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Pia Thomsen - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Objective: An investigation of Danish 7-12 year old children with hearing impairment (HI) (20-70
dBHL bilateral sensorineural), children with specific language impairment (SLI) and typical children, to get an understanding of how verbal working memory relates to speech comprehension.
Methods: Experimental. 83 participants (19 children with HI, 28 children with SLI and 36 typical
children) were presented with two verbal working memory tasks (a backwards digit span task and
a Danish version of the competing language processing task (clpt)) and a speech comprehension
task (Trog2).
Results: All digits and sentences from the backward digit span task and clpt were recorded in a
sound studio and played to the children, in the test situation, with a MP3-player and mini loudspeaker. The sentences from Trog-2 were not recorded beforehand. The backward digit span task
contains 8 blocks and is scored in terms of span and recall time. There are 6 blocks with the total
of 42 sentences in our Danish version of the clpt. The results are scored in terms of span, recall
time, number of true answers of semantic value and number of true answers of memory (whether
or not the children were able to remember the last word of each sentence).
Conclusions: The study is the only study (to our knowledge) completed in Denmark in terms of
investigating the interplay between cognition (e.g. verbal working memory capacity) and language
(speech comprehension) in Danish children with hearing impairment and children with SLI. The
study is beneficial towards our main goal of getting improved cognitive related language assessments and interventions for Danish children with hearing impairments and/or severe language
difficulties.
Keywords: Hearing impairment, speech comprehension, verbal working memory, specific language impairment, verbal working memory span, cognition
60
13.3
PROMOTING CHILD-CENTERED APPROACHES TO SPEECH/LANGUAGE
THERAPY WITH CHILDREN WITH COCHLEAR IMPLANTS
Areti Okalidou - University of Macedonia, Greece
Children with cochlear implants, once implanted, are able to gain access to language-specific
interactions and learn to function via both incidental and formal learning. Therapy goals are dynamic and focus on developing all aspects of language at once, phonology, semantics, morphosyntax and pragmatics, thereby integrating them into a meaningful whole. The paper addresses
the advantages of child-centered approaches for young preschoolers, using holistic language and
hybrid techniques of language stimulation in naturalistic settings. It illustrates the therapy steps
of child-centered approach to speech/language therapy, demonstrating techniques for providing
holistic language, indirect language stimulation and facilitative play and discussing their outcomes
via video play. Furthermore, a hybrid approach is demonstrated via child-therapist dialogues in
context-induced play whereby techniques such as focused stimulation, trills, auditory commands
are mixed in conversational turn-taking in order to target specific therapy goals. Conclusions highlight the benefits of the approach for children with cochlear implants.
13.4
SOCIAL CONVERSATIONAL SKILLS DEVELOPMENT IN EARLY
IMPLANTED CHILDREN
Letizia Guerzoni - Department of Otolaryngology, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
Objective: The aims of this study were: (1) to investigate the effect of age at CI activation on the
social conversational skills development of implanted children under 2 years old; (2) to examine
the role of age at deafness diagnosis and maternal educational level on social conversational
skills.
Methods: 22 deaf children who received CI before they were 24 months old (average: 11.7
months; SD +/-2.5) were included in the study. The Italian version of the Social Conversational
Skills rating scale was used to assess the social conversational skills. The questionnaire was
administered 12 months after CI activation. The scores were matched for correlation with age at
CI activation, age at deafness diagnosis and maternal education level. Data from CI children were
compared with normative data of the Italian version of the Social Conversational Skills rating scale
(ASCB). To perform this comparison the scores of each child were transformed into Z-scores
based on the mean score and the standard deviation of the normative data for the child’s age in
months.
Results: Social conversational skills scores were correlated with chronological age at CI activation
with 12 months of CI use. The maternal education level did not show a positive significant effect
on the development of social conversational skills.
Conclusions: Performing implantation in children with profound hearing loss under 2 years of age
may provide a good opportunity to develop pragmatic skills similar to those of their peers with
normal hearing.
61
13.5
THE USE OF THE VERBOTONAL METHOD IN CREATIVE
EXPRESSION IN PROCESS OF REHABILITATION
Adinda Dulcic - SUVAG, Polyclinic, Zagreb, Croatia
Koraljka Bakota - SUVAG, Polyclinic, Zagreb, Croatia
Katarina Pavicic Dokoza - SUVAG, Polyclinic, Zagreb, Croatia
The verbotonal method in its parts incorporates the important elements for stimulating creativity in
children with hearing and language disorders. In this way at the same time it increases cognitive,
psychological/emotional, language-speech, tactile, visual, sensory and motor abilities. Of particular importance in stimulating creativity is the fact that children with difficulties develop positive
attitudes towards themselves; the difficulty is not in the foreground any more, but on the contrary,
the child’s ability to be creative is developed. In the SUVAG Polyclinic the verbotonal method with
its procedures in the process of rehabilitation of hearing and speech impaired children stimulates
children to use all their sensorial potentials to build as good communication as possible and to
develop all their creative potentials. In this paper the achievements of hearing and/or speech impaired children rehabilitated through the use of the verbotonal method in their creative expression
will be demonstrated.
The aim of the educational and rehabilitation verbotonal approach is to stimulate creativity in
children with difficulties and to improve auditory skills, memory, spoken language, articulation and
communication skills. The goal of the project was to stage a performance in which the students
would show the achievements of this educational and rehabilitation programme. Procedures were
as follow: body movement stimulations, musical stimulations, stimulation of verbal communication
through dramatization and recognition of students in art/visual domain.
From these activities children gain:
- an opportunity to use specific talents and appreciate that everyone can provide
something different to enhance the whole,
- a sense of fulfilment when their contribution goes on display,
- an opportunity to express their thoughts and creativity, including a need to refine
and clarify their explanations to each other (better verbal expression).
From these activities speech and language therapists and parents gain:
- the ability to identify academic and social strengths and weaknesses in individual
children,
- a better definition of rehabilitation strategies in general and often in specific,
- an evaluation of children’s verbal and nonverbal skills,
- the development of practical support for parents with a view to engage them in this part of their
children’s development.
62
13.6
CENTRAL AUDITORY PROCESSING IN FRENCH-SPEAKING SLI
Bernadette Piérart - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain,
Louvain-la-Neuve, Belgium
Laurent Demanez - Service ORL du Centre Hospitalier Universitaire de l’Université de Liège, Université de Liège, Liège, Belgium
Elsa Lecocq - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
Cécile Marque - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
Kalliopi Valassis - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
The purpose of this research is to examine the central auditory processing skills of 41 Frenchspeaking SLI children (syndrome phonological-syntactical) aged between 6;8 and 13;11 years.
The children were examined by means of the BAC (Batterie d’audition centrale, Demanez, 2003),
a French pediatric tool (5 tests) designed to assess temporal processing deficits, a test of identification of linguistic familiar noises (Piérart, in press) and a test of linguistic gnosis and articulatory
praxis (Piérart, 2011). The peripheral hearing of the children has been verified (tonal audiometry
and typanometry). The results of the SLI children were below the level of 5 years on all the central
auditory processing tests and at their age level in the non verbal noises recognition. Their results
on the linguistic test were also below the expected level. The results will be discussed in terms of
maturation of central auditory processing. The specifically linguistic nature of the disorders will be
also discussed.
14.1
AN INVESTIGATION INTO THE EFFECTS OF FATHER’S PERCEPTION
OF COMMUNICATION-FLUENCY ABILITIES OF THEIR CHILDREN
WHO STUTTER ON THE DEVELOPMENT OF CHILDREN’S THERAPY
PROCESS
Anna Bovoli - Special Primary school, Primary Education, Katerini, Greece
Objective: Most speech and language therapists express the need to explore more about how a
variety of parental variables do or do not relate to the therapy outcome of childhood stuttering.
Furthermore, research has shown that there are gender differences, most notably fathers tended
to overestimate their children’s performance in relation to actual therapy outcomes. Our aims in
this study are: a) to investigate fathers’ understanding of the current level of their children’s communication and fluency ability, and b) how this affects their children’s therapy outcome.
Methods: After the initial parental interview, the present study investigated 26 fathers’ questionnaires whose children stutter within 4 months of stuttering onset. Fathers completed an assessment measure, the Speech and Language Assessment Scale (SLAS) (Hadley & Rice, 1993).
Results: This study showed that a) the majority of fathers demonstrated that they cannot accurately judge the communicative proficiency of their children and as a result of this, imposed unrealistic models and expectations on their children communicative/fluency abilities and b) fathers’
inappropriate expectations towards their children who stammer affected therapy outcome.
Conclusions: Even though fathers’ questionnaires measure what they think, rather than what they
do, this investigation serves as a starting point to discuss the need to explore more about how a
variety of variables, such as father’s judgment , do or do not relate to the recovery, exacerbation
or maintenance of their children’s stuttering. Also, in relation to clinical practice, it empowers us,
allowing us to see how closely fathers appear to be to their children’s abilities at the time of stuttering and how this affects therapy outcome.
63
14.2
SPONTANEOUS RECOVERY IN STUTTERING. WHEN TO START
THERAPY AND HOW TO MONITOR FLUENCY DEVELOPMENT IN
CHILDREN WHO STUTTER?
Mark Pertijs - Department Speech and Language Therapy, University of Applied Sciences Utrecht, Utrecht, Netherlands
Objective: Formulating evidence-based guideline recommendations for speech and language
therapists to decide when to start therapy for children, adolescents and adults who stutter.
Methods: An evidence-based clinical guideline on stuttering has been developed in the Netherlands by a board of speech therapists, fluency specialists and persons who stutter. The guideline
was developed under the authority of the Dutch Association of Speech and Language Therapists
(NVLF) and in cooperation with CBO Dutch Institute for Healthcare Improvement. The Evidencebased Guideline Development Circle (EBRO) and the Grading of Recommendations Assessment,
Development and Evaluation (GRADE) Working Group approach (Guyatt et al., 2010) were used
to develop the guideline. “When to start therapy?” was one of the main questions the guideline
board had to answer.
Results: Eight recommendations about the moment when to start therapy and how to monitor for
signs of spontaneous recovery in children who stutter have been formulated.
Conclusions: Recovery rates for spontaneous recovery in children who stutter reach from 50%
to 94%. Best practice is to start treatment one year after the first signs of stuttering have been observed. The Dutch Evidence-based Clinical Guideline on Stuttering (Pertijs et al., 2014) describes
a systematic approach about the process of decision making concerning the issue when to start
therapy and how to monitor for signs of spontaneous recovery. This approach integrates the best
available scientific evidence, clinical reasoning and shared decision making in order to guide
parents of children who stutter and speech therapists to take appropriate decisions about the moment when to start therapy.
Keywords: Stuttering therapy guideline
14.3
THE DUTCH EVIDENCE-BASED GUIDELINE FOR THE MANAGEMENT
AND TREATMENT OF STUTTERING
Leonoor Oonk - University of Applied Sciences Utrecht, Utrecht, Netherlands
Mark Pertijs - University of Applied Sciences Utrecht, Utrecht, Netherlands
Objective: To create an evidence-based guideline for speech and language therapists in the Netherlands for the management and treatment of stuttering.
Methods: The Dutch Association of Speech and Language Therapists (NVLF) installed a working
group with the task to create an evidence-based guideline for the management and treatment of
stuttering. The working group consisted of speech therapists, fluency specialists and persons who
stutter.
The working group identified seven main issues:
(1) For young children who begin to stutter, when to start therapy; (2) What is the validity and the
reliability of the diagnostics instruments for stuttering; What is the effect of stuttering therapy in (3)
preschool children, (4) school-aged children and (5) adolescents/adults; (6) When should a speech
and language therapist consider referral of the patient to another specialist; (7) How to organize
maintenance/follow-up therapy.
These issues have been addressed using the Grading of Recommendations Assessment,
64
Development and Evaluation (GRADE) Working Group approach (Guyatt et al., 2010).
Results: For the questions posed, 25 recommendations were formulated. The guideline was
authorized in October 2014 by the Dutch Association of Speech and Language Therapists (NVLF)
and the Dutch Association of Fluency Specialists (NVST).
Conclusions: This newly developed evidence-based guideline for the management and treatment of stuttering will be an important tool to improve the quality of care for people that stutter.
Because the evidence is based on international literature, the Dutch guideline could serve as a
starting point for other countries in creating their own guideline on stuttering.
Keywords: Guideline, stuttering
14.4
THE ADULT’S EXPERIENCE OF STUTTERING AND VOICE HANDICAP:
PRELIMINARY DATA ON EUROPEAN PORTUGUESE
Jaqueline Carmona - Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
Objective: The purpose of this investigation is to: (a) obtain preliminary data on Overall Assessment of the Speaker’s Experience of Stuttering (OASES) and on Voice Handicap Index (VHI) in
a group of Portuguese speakers with stuttering complaints, compared with a matched group of
speakers without stuttering complaints.
Methods: The OASES was translated into European Portuguese (EP) following the specific standard criteria for health specific quality of life related instruments (HRQoL). The European Portuguese VHI version was used. Fifty-one adults filled in the two instruments. Amongst those,
twenty two were persons who stutter with a mean age of 36.14±3.17 and twenty nine were nonstutterers with a mean age of 38.3± 2.56. Age differences between groups were not statistically
significant. Student’s T-test was used and the critical level of significance was 5%.
Results: The persons who stutter show a higher overall total mean on OASES (217.64±46.73) and
VHI (25.73±22.70) than non-stutterers (152.45±37.79) and (8.59±8.99) respectively. Differences
between the groups for both OASES and VHI are statistically significant (p<0.05).
Conclusions: The preliminary results indicate that adults who stutter have worse experiences and
voice handicaps than non-stutterers. This study is the first attempt to gather knowledge about the
experience of stuttering and voice handicap in European Portuguese adults who stutter.
Keywords: Quality of life related instruments, stuttering, adults
14.5
NEGATIVE STEREOTYPES ON STUTTERING IN ITALY: THE POSHA-S
AS AN INVESTIGATIVE TOOL
Emilia Capparelli - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
Donatella Tomaiuoli - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
- Sapienza University of Rome, Rome, Italy
Francesca Del Gado - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
Paola Falcone - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
Kenneth O. St Louis - West Virginia University, West Virginia University, Morgantown, United States
Objective: This work presents the results of a research carried out on Italian public opinion on the
theme of stuttering, aimed to describe and analyze opinions and attitudes on the disorder, evaluating in particular the degree of influence that demographic variables, such as gender, age and
65
educational level have on the general impression that subjects develop of the disorder
Methods: This study was conducted by administering a written version of the POSHA-S (Public Opinion Survey of Human Attributes- Stuttering) questionnaire on a sample group consisting
of 300 non-stutterers from northern, central and southern regions of Italy, aged between 18 and
60 with varying educational backgrounds. The interviewees have had no direct contact – either
through family, work and/or profession – with stutterers, in order to ensure that their opinions are
not a reflection of these circumstances.
Results: This work describes data about the negative stereotypes on stuttering, highlighting the
differences among the three regions examined and the correlation between low level of information about the disorder and negative opinion regarding it.
Conclusions: The study reveals a public opinion which is on average little or poorly informed
about the disorder, that does not have correct ideas about the disorder and has rather negative
convictions about the disorder and its bearer (negative stereotype). It is therefore important to
inform and sensitize public opinion, in order to fight negative stereotypes, creating in turn more
favourable environmental conditions for stutterers that will contribute to an improvement in their
quality of life.
Keywords: Stuttering, public opinion, negative stereotypes
14.6
VERBAL FLUENCY IN ADULTS WITH DEPRESSION
Raluca Soare (Trifu) - Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Carolina Bodea Hategan - Babes-Bolyai University, Cluj Napoca, Romania
Doiana Cozman - Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Objective: Depression is particularly associated with impairments in cognitive and executive processes. Performance on a verbal fluency task could be particularly sensitive to depression due the
deficits associated with depression: attention, concentration, retrieval and speed. Verbal fluency is
the ability of an individual to produce a set of items in a limited period of time, based on a certain
given criterion. The aim of this study was to assess the semantic and phonemic verbal fluency in
patients with depression, compared with non depressive persons.
Methods: The neurological structure deficits in depression are addressed through COWAT. Phonemic verbal fluency is assessed through three sound/phoneme (FAS /CTL) tests, through which
participants are asked to say as many words as they can. For each phoneme the participant has
1 minute to express the words. No repetition and no names are allowed. Semantic verbal fluency
is constrained by a category. In this study we used fruits. We used COWAT for depressive and
control (N=20) groups. The experimental and control groups are paired groups based on socioeconomic factors, education level and gender. The patients diagnosed with depression (according
to ICD-10) were inpatients of Cluj Psychiatric Wards, but both groups were previously tested with
the Romanian version of DASS – 21R for accuracy of the data and avoidance of misdiagnosis.
Results: Individuals with depression perform poorer than the control group, both in phonemic and
semantic verbal fluency tasks. But, depressives’ scores are different in the phonemic and semantic tasks. Phonemic verbal fluency scores are lower. Results are sensitive to the evaluation period
- poorer at admission, better before discharge.
Conclusions: Verbal fluency task is a valid indicator for cognitive and executive dysfunctions in
depressive patients. Word production in depression is affected and correlated with severity of depression. Future studies should address the differences between depressed patients and others
groups in terms of language.
Acknowledgements: This paper is published under project no. POSDRU/159/1.5/S/138776.
Keywords: Verbal fluency, depression, executive and cognitive functions, phonemic fluency, semantic fluency
66
15.1
PROSPECTIVE EVALUATION OF OROFACIAL FUNCTIONS IN
HEALTHY AND NUTRITIONALLY DISTURBED CHILDREN AND ADULTS
Heike Münch - Medical University of Graz, University Hospital Graz, Graz, Austria
Objective: For developing orofacial functions - in addition to nutritive function - food intake and
the choice of food play a major role during maturation. For patients diagnosed with anorexia
nervosa (AN), food intake is an abusive form of trying to solve problems that otherwise seem
insoluble. In certain cases of logopedic observation, primary and secondary functions of patients
with AN appear significantly different than those of people without an eating disorder. The aim of
this pilot study was to collect data related to the conglomerate of symptoms of those orofacial
dysfunctions.
Methods: In the setting of a prospective examination the orofacial functions of patients during
orthodontic treatment, suspected with orofacial functions (group 1), and patients diagnosed with
AN (group 2) were evaluated. For this research purpose the diagnostic material OFD_01 was created by the author.
Results: Results of the study indicate that, concerning the primary and secondary functions,
some variables are significantly different in each patient group. Significant differences between
the two groups were found concerning voice (p=0.024), taste “sweet” (p=0.049), chewing pattern
“food medium” (p=0.036), “food soft” (p=0.023). Tubes significantly influence voice (p=0.04) and
vocal parameters (p=0.004).
Conclusions: The results indicate that OFD_01 makes it possible to show differences between the
two groups of patients.
Based on the results, it can be said that patients with AN do not show all of the typical symptoms
related to orofacial dysfunctions.
Functions that are acquired during the developmental process do not change due to a very limited
food intake. However, certain orofacial functions can very well be impaired. To determine whether
a targeted logopedical therapy could improve these impaired functions, and if it could therefore
also have a positive effect on the quality of life of patients with AN, an intervention study would be
necessary.
15.2
PEDIATRIC DYSPHAGIA AND CHARGE SYNDROME
Elisabetta Sforza - Università Cattolica del Sacro Cuore, Rome, Italy
Giuseppe Zampino - Università Cattolica del Sacro Cuore, Rome, Italy
Antonella Cerchiari - Ospedale Pediatrico Bambin Gesù,-Roma e Palidoro, Roma, Italy
Objective: Children with CHARGE syndrome are often affected by considerable swallowing and
feeding difficulties that last for a long period. This study aims to investigate the prevalence and
nature of these difficulties in a population of 15 children with CHARGE syndrome and to analyze
the correlation between the major and minor clinical features of the syndrome and the degree of
dysfunction of the swallowing skills.
Methods: Fifteen CHARGE children were taken into consideration from the Reference Center for
Rare and Congenital Diseases of the University Hospital A. Gemelli in Rome. In every child the
presence of major and minor features of the syndrome was duly noted. Subsequently, the percentages of the features in our sample and those reported in the international literature was rigorously verified. Every child considered in our work arrived at the DH dysphagia Children’s Hospital
Bambino Gesù in Palidoro due to the presence of the feeding/swallowing disorder.
67
In the facility, we evaluated the level of development of the feeding skills, taking into account the
child’s age. Thirteen children were subjected to further diagnosis for the study of aspiration (VFSS,
salivogram test). Finally, we analyzed the correlation between the clinical features of the syndrome
and the degree of dysfunction of the oro-facial-swallowing ability of our sample making no distinction of diagnosis (possible presence of deletion or mutation of the gene CDH7 in the chromosomal region 8q12).
Results: The percentages of the major characteristics of our sample correspond to the percentages reported in the international literature, whereas they partly correspond for the minor features.
It is essential to note that the percentages of the characteristic “growth retardation” deviate from
the standards because they are presumably related to an early diet with alternative pathway.
It was possible to correlate the presence of dysphagia with the information contained in the case
history and it was found that children with dysphagia in our sample had: 11/13 cardiopathy, 6/13
not cuffed tracheal cannula, 8/13 GERD, 12/13 impairment of swallowing and breathing apparatus, 5/13 cleft of the oral cavity, 10/13 abnormal C.N. The assessment of the feeding and swallowing abilities showed different dietary levels. From the data we collected, we can estimate that
the feeding and swallowing disorders in CHARGE syndrome have a prevalence of 100%, while the
aspiration has a prevalence of about 80%.
Conclusions: The clinical assessment and rehabilitation reasoning of the young CHARGE patient
does not require the use of standardized protocols, but it must be based on data such as those
shown in this study. Knowing the reasons and consequences of the feeding and swallowing disorders in the CHARGE syndrome, as well as in other rare diseases, is paramount when drafting a
detailed assessment of the child. It is itself an accurate source of information when choosing the
right and effective rehabilitation method.
Keywords: Pediatric dysphagia, CHARGE syndrome, rare syndromes.
15.3
L-C.O.S.E. PROTOCOL ON ORAL SKILLS IN PRETERM INFANTS:
STUDY ON ITS INTER- AND INTRA- RATER RELIABILITY
Marta Majoli - Genoa, Italy
Monica Panella - ASLBI-Biella, Ospedale degli infermi, Biella, Italy
Valentina Porazzi - Novara, Italy
Antonio Schindler - Dipartimento di Scienze Biomediche e Cliniche, Ospedale Luigi Sacco, Milan, Italy
Odoardo Picciolini - Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Cristiana Assi - Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Objective: To introduce a new assessment tool that allows the investigation of oral skills in preterm infants and to identify the presence of feeding problems of both oral and swallowing type;
and to verify its reliability.
Methods: Using the new protocol “Little Child Oral Stimulation and Evaluation”, the oral skills of
a sample of 50 preterm infants (gestational age > 30 weeks), hospitalized in a NICU, were evaluated and videotaped. This tool provides the use of cervical auscultation and the execution of the
neuromotor buccofacial evaluation with the stimulation and detection of 11 oral reflexes. Statistical analysis allowed us to measure the degree of reliability of the tool. Intra-rater reliability was
assessed by comparing the scores given to the 50 videos twice by the same evaluator in a certain
timeframe, while inter-rater was evaluated by comparing the examiner’s scores with those assigned by two other evaluators. Data was collected by evaluating the children’ skills and a statistical correlation analysis allowed us to identify the main factors that influence preterm infants’ oral
skills.
Results: The L-C.O.S.E. protocol’s reliability is excellent, with a Spearman Index between 0.90
and 0.97 depending on the examiner. Oral skills seem mainly affected by the behavioral state, the
68
use of alternative feeding ways, and the level of growth and baby maturation.
Conclusions: L-C.O.S.E. is useful and reliable in the preterm infant’s evaluation.
It allows a systematic assessment of oral and feeding skills, considering its influencing factors.
It also allows rehabilitation planning in specific tasks and defines the achieved results through
the quantitative comparison of assessments carried out even after a short time. However, further
studies are required both to validate the tool and to assess its applicability in a lower gestational
age.
Keywords: Dysphagia, preterm infants, oral feeding assessment
15.4
THE ORAL-MOTOR SKILLS IN THE FIRST 48 HOURS OF LIFE:
COMPARISON BETWEEN INFANTS BORN AT TERM AND INFANTS
BORN PRETERM
Monica Panella - ASLBI-Biella, Ospedale degli Infermi, Biella, Italy
Marta Majoli - Genova, Italy
Gian Vincenzo Zuccotti - Azienda Ospedaliera - Istituti Clinici di Perfezionamento, Ospedale dei Bambini Vittore Buzzi, Milano, Italy
Antonio Schindler - Dipartimento di Scienze Biomediche e Cliniche, Ospedale Luigi Sacco, Milano, Italy
Objective: To compare a group of term infants and a group of pre-term infants on the scores
obtained through the application of the new protocol for oral reflexes evaluation (L.-C.O.S.E.); to
compare the scores obtained through the protocol by term infants with less than 39 weeks of gestation and those with more than 39 weeks of gestation, infants less than a day old and more than
a day old, in different behavioral states, born from eutocic (natural) or distocic (surgical) childbirth,
with low birthweight (SGA) and with normal birthweight (AGA), males and females.
Methods: Following a period of specific training about the use of the protocol L.-C.O.S.E, , at the
Simple Structure of Neonatology of A.O. Luigi Sacco of Milano, a group of 60 term infants were
selected with a gestational age over 37 weeks, both male and female, in conditions of physiology, who were assessed with the protocol L.-C.O.S.E. At the Neonatal Intensive Care Unit of the
Ospedale Maggiore Policlinico of Milano, a sample of 50 pre-term infants was also selected, who
were admitted to T.I.N., with gestational age over 30 weeks, both male and female, without clinical
instability, medical complications such as chronic dysgenesis, metabolic disorders, malformation
syndromes, with stable cardiovascular and respiratory systems, autonomous from the respiratory
point of view, who were also assessed with the protocol L.-C.O.S.E.
Results: A significant statistical difference emerged between the scores of the group of term
infants compared to the pre-term infants (p=0.043). A significant statistical difference emerged
only between SGA and AGA infants (p=0.039).
Conclusions: Preterm infants show lower scores compared to term infants, as well as SGA compared to AGA infants.
Keywords: Dysphagia, term infants, pre-term infants, L.-C.O.S.E, assessment, oral reflexes
69
15.5
EVALUATING A GUIDELINE FOR PRIMARY HEALTHCARE; ATYPICAL
SPEECH & LANGUAGE DEVELOPMENT IN 2-YEAR OLDS
E.P. Dieleman - Research Group Child, Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
I.I. Staal - GGD Zeeland, Primary Youth Healthcare, Goes, Netherlands
M.R. Luinge - Research Group Child, Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
Introduction: For Primary Healthcare (PH) an instrument for screening and follow-up was developed (2012) to identify problems in speech & language development at a young age (24 to 30
months) in order to give them care and interventions. The aim of the study is to transform this
practice based method into an evidence guideline. The study incorporates several elements: (1)
to verify if identifying speech and language problems through PH is correct, (2) which background
variables influence the progress of speech & language development and (3) to verify if children
benefit from screening and follow-up.
Methods: The design is a prospective cohort study. PH asked parents to participate, 61 children
failed the screening and 61 children (same age, sex and region) did not.
The children (N=122) are all tested twice in their home environment: (T0) immediately after the PHcontact and (T1) a year later. Children are examined on speech & language development, social
interaction and quality of life.
Results: The following results are from T0. The hypothesis was to find language problems in 50%
of the test subjects, however 57% of the children showed problems. These findings are categorised in language production (52%), language understanding (38%) and interaction skills (38%).
Conclusion: Several two year old children seem to be more at risk for language problems when
looking at specific background variables, such as being born prematurely, having low birth weight,
being a silent baby and having hearing problems. We will be able to present more results during
the conference in May.
15.6
THE POSTURAL MOTOR APPROACH OF ARTICULATION IN THE
OROPHARYNGEAL MUSCULAR DISORDER
Gisèle Martinot-Randoux - Centre Psychologique et Logopédique de l’Universitete, CPLU, Université de Liège, Liège, Belgique
Objective: In the presence of mechanical and functional speech and language disorders, speech
and language rehabilitation must not be reduced to a mere linguistic or laryngeal re-education.
The main purpose is to restore the mobilization of muscular tissues and restore neural information
in order to allow an automatic correction of the systems concerned.
Methods: After an attentive growth pattern anamnesis, we assess the functional and structural readjustments occurring during a patient’s development, then we use eutony techniques, muscular
chains, hand therapy techniques and neuro-sensory rebalancing. We use a direct approach implying a re-evaluation of the overall tonic and postural attitude: lingual, mandibular and oropharyngeal. It is based on theoretical models proposed by J. Talmant (Modèle de la fonction respiratoire),
J. Delaire, (Modèle de l’organisation de l’architecture cranio-faciale) and transposes these models
into a global postural body organization of the subject.
Conclusion: This approach leads to a rapid correction, sometimes instantaneous, in the distribution of the muscle tone, required for respiratory, vocal, articulatory functions, as well as for postural attitudes. It also changes the aspect of soft oro-facial tissues. These techniques also activate
behavioural modifications in self-representation.
Keywords: Language, oro-pharyngeal musculature, postural and motor readjustment
70
16.1
UNITED IN DIVERSITY: NETQUES TUNING - IS EUROPEAN SLT
EDUCATION SINGING IN HARMONY?
Aileen Patterson - CPLOL, France
Anja Lowit - Faculty of Humanities and Social Sciences / Reader, Speech and Language Therapy School of Psychological Sciences
and Health Strathclyde University, United Kingdom
Baiba Trinite - Voice and Speech Research Laboratory, Faculty of Education and Social Work, Liepaja University, Latvia
Objective: To identify the challenges in delivering a coherent SLT education “fit for purpose”
across Europe and their potential solutions, through exploring results of the NetQues project.
Methods: 65 partners from across Europe were recruited into a multilateral academic and professional network for Tuning European SLT Education Programmes (NetQues). Multinational teams
identified current practices, common themes, curricula and delivery of prequalification SLT programmes. Each of the lines of the European Tuning Methodology was built into the design of the
project. Ethnographic and survey research methods were adopted. A comprehensive set of SLT
competences was agreed upon by the European network and translated into 24 EU languages by
SLT partners. Two EU wide surveys were conducted:
- A. a departmental survey of a sample of educational institutions offering SLT programmes in
each EU country (survey)
- B. a biennial survey of national statistics of educational programmes in each country
Results: Competences identified (benchmark statements), glossary of terminology, snapshots
of country profiles and examples of good practice were identified to support the education of
SLTs across Europe, including education providers, approval/accreditation policy makers and key
stakeholders engaged in ensuring quality standards within the profession and its pre-qualification
education.
Conclusions: While differences and diversity may present challenges, all countries aspire to
develop competent and caring professionals able to practise safely and effectively with relevant
up-to-date knowledge and skills upon admission to a clearly identifiable unique profession. A
good tune sung in harmony is greater than each individual part on its own - and in SLT education
we have a wonderful tune to sing out loud.
Keywords: Pre-qualification education; tuning; benchmarks; competences; difference; unity; diversity
The NetQues project was undertaken with support from the European Union. The project has been
co-funded by the European Commission’s ERASMUS Lifelong Learning Programme through the
Education Audiovisual & Culture Executive Agency. This presentation reflects the views only of the
author, and the Commission cannot be held responsible for any use which may be made of the
information contained therein.
71
16.2
PROMOTING INTERNATIONALIZATION IN THE ‘EUREGIO’: EVIDENCE
FROM A GERMAN-DUTCH BACHELOR VARIANT IN NIJMEGEN
Joost de Beer - HAN University of Applied Sciences and Tilburg University, Nijmegen and Tilburg, Netherlands
Antje Orgassa - School for Speech and Language Therapy, Hogeschool van Arnhem en Nijmegen, Nijmegen, Netherlands
Uta Jaeger-Begheijn - School for Speech and Language Therapy, Hogeschool van Arnhem en Nijmegen, Nijmegen, Netherlands
Jeanine Coopmans - School for Speech and Language Therapy, Hogeschool van Arnhem en Nijmegen, Nijmegen, Netherlands
Objective: The internationalization of higher education is a key priority for the Dutch Ministry of
Education (Nuffic, 2014). The department of speech and language therapy at the Hogeschool
van Arnhem en Nijmegen adds to this priority through the development of an euregional GermanDutch bachelor variant. Nijmegen, as it is situated at the German-Dutch border, has a long history of incoming German students, some of which continue their careers as SLTs and lecturers in
the Netherlands. Conversely, there is a substantial amount of Dutch SLTs and families living and
working in Germany. The ongoing bi-cultural movement has led to the only euregional variant of
its kind in 2013, preparing students for both health systems. The aim of the present paper is to
discuss the challenges involved and its implemention for current SLT practices.
Challenges: Knowledge of the speech and language systems of the host countries is essential to
the work of an SLT. Students must therefore achieve B2 language competence levels in, respectively, German or Dutch. In order to establish institutional policy plans, various forms of internationalization, such as deploying English lectures, participating in European projects, offering
intercultural skills modules are also offered.
Implementation: Irrespective of these obstacles, there is evidence (Gaalen et al., 2014) demonstrating that raising international awareness can yield standard learning outcomes in addition to
intercultural and multilingual outcomes (Gaalen et al., 2014). We assume that this does also account for our German-Dutch variant. We think this variant may increase international awareness
and self-reflective behavior towards clients with various cultural backgrounds.
16.3
SPEECH AND LANGUAGE THERAPY IN MOZAMBIQUE: EXPECTATIONS
AND CHALLENGES IN THE MAKING OF A NEW PROFESSION
Júlio Velho - Instituto Superior de Ciências da Saúde, Maputo, Mozambique
Carla Courelas - Instituto Superior de Ciências da Saúde, Maputo, Mozambique
Ana Cláudia Lopes - Instituto Superior de Ciências da Saúde, Maputo, Mozambique
Methods: This paper reports the initial processes adopted in Mozambique to develop training in
speech and language therapy. First, the authors describe the development process of the initial
course curriculum. Second, the authors will portray the most relevant factors in the adaptation of
the profession to the Mozambique context from the experience obtained from teaching the first
students’ class. The collected data was discussed taking into account the information already
published referring other African profession realities.
Results: The most frequent pathologies and the populations that would mostly benefit from the
speech and language therapy intervention were identified. The authors also recognized economic,
social, cultural and linguistic factors that interfere with training and professional practice.
Conclusions: This is the first speech and language therapist course in the country and was the
result of the collaboration between two universities, one in Portugal and one in Mozambique.
Country-specific issues affect the training and work of specialists who provide services in speech
72
and language therapy in Mozambique are discussed. The obtained results give new insights about
future changes, expectations and perspectives in this process.
Keywords: Professional issues; professional practice.
16.4
SPEECH AND LANGUAGE THERAPY FOR SPEECH AND LANGUAGE
THERAPISTS: A COURSE OF REFLECTION, AWARENESS
AND MUTUAL HELP
Lidia Rodríguez-García - Faculty of Occupational Therapy, Speech and Language Therapy and Nursing,
University of Castilla-La Mancha, Talavera-Toledo, Spain
Objective: Speech and language therapy students, as experts in human communication, have to
be aware of their own communication skills, voice quality, speech and fluency, oral and written
competence and some possible disorders. Sometimes explicit training is required, so the Faculty
of Occupational Therapy, Speech and Language Therapy and Nursing of the University of CastillaLa Mancha, Spain has programmed a course to help students to play both roles: SLT and patient.
This paper emphasizes the development and improvement of communicative skills to become
experts and a reference in human communication in the associated areas, through which they will
help their future patients.
Methods: This course, called Speech and Language Therapy for Speech and Language Therapists, gives the students the opportunity to reflect on their own skills, to evaluate the main areas
related to communication, speech, voice, hearing and swallowing and, finally to plan intervention,
if required. Students work on their own difficulties on their own, in pairs and with the mutual help
of the whole class group (according to the problem-based learning process). They perform, at the
same time, as students, patients and speech and language therapists, so they can experience the
feelings, emotions, progress, scaffold help, adaptation and new requirements during the whole
process, as future patients or therapists would do. Specific and generic competences (instrumental, inter/intrapersonal and systemic) are developed in the process.
Results: Communication is a continuous and long-life learning process for SLTs, as they will always have to adapt their skills to new patients, groups, families, other professionals, future students, audiences and so on.
Conclusions: Students made quite a positive evaluation of the experience, underlining the importance of the reflection-action process, the emotional awareness during the whole process and its
benefits in a personal and professional way.
Keywords: Problem based learning, SLT, evaluation, communication skills, voice training, interpersonal/intrapersonal and emotional competences
73
16.5
THE IMPORTANCE OF THE EU DAY FOR PANHELLENIC ASSOCIATION
OF LOGOPEDISTS IN ASSOCIATION WITH A FUTURE EVIDENCE
BASED PRACTICE IN GREECE
Maria Rapti - PAL (Panhellenic Association of Logopedists), Athens, Greece
Ellianna Mantaka-Brinkmann - PAL (Panhellenic Association of Logopedists), Athens, Greece
Rea Marselos - PAL (Panhellenic Association of Logopedists), Athens, Greece
Athanasia Maneta - PAL (Panhellenic Association of Logopedists), Athens, Greece
Vasiliki Dessyla - PAL (Panhellenic Association of Logopedists), Athens, Greece
Eleni Makri - PAL (Panhellenic Association of Logopedists), Athens, Greece
Objective: Taking into consideration the theme of next year’s EU day- acquired neurological communication disorders- it is an opportunity to promote research and evidence based practice, by
using both quantitative and qualitative methods to identify the strengths and the weaknesses of
the work of SLTs within the country. The aim is also to report on significant issues related to the
public health sector in Greece.
Method: A questionnaire will be distributed based on The Quality of Life Questionnaire to people
with acquired neurological communication disorders and to their helpers or family members.
Results: Through the results from the collection of the questionnaire, we will be able to give some
information about the quality of life of people with acquired neurological disorders, their families
and the health system, but also the work of SLTs.
Conclusion: According to the guidelines of CPLOL for the EU day, apart from increasing public
awareness of a wide range of communication disorders and of the SLTs’ role - their evaluations,
methods and therapeutic processes- it is also a common goal for SLTs that are working together
to make a dynamic impact on promoting health and well-being in children and/or adults with communication disorders in Greece and as result in Europe. Based on the above principles, this pilot
study will provide information about the work of SLTs, the strengths and weaknesses of the SLT
services in Greece in relation to acquired neurological disorders, the positive effects of a mutual
effort made, as well as the importance of always keeping our doors open to communication with
others.
Keywords: Quality of life, questionnaire, acquired neurological communication disorders
16.6
ROAD (RÉÉDUCATION ORTHOPHONIQUE À DISTANCE):
E-REHABILITATION THROUGH LMS (LEARNING MANAGEMENT
SYSTEM) FOR A NEW SPEECH AND LANGUAGE THERAPY APPROACH
Pascaline Dufournier - Cabinet Libéral, Université de Lyon 2, Clermont Ferrand, France
Objective: The contribution of ITC in training is nowadays recognized worldwide. Is the idea of a
device for Open & Distance Learning (ODL) in e-speech therapy conceivable, and does it promote
a new rehabilitation approach in speech and language therapy for learning disabilities?
The applicability of such an approach for ODL in speech and language therapy must not be
considered as a replacement for the actual therapy session through an on-line technical device,
but must be conceived as a new speech and language therapy practice adapted and enriched by
media innovation represented by e-therapy and e-practice.
Thanks to a first clinical trial conducted in 2008-2009, whose results proved the effectiveness of
e-speech therapy, an action research was launched 4 years ago, consisting of the evaluation of
74
clinical quality (qualitative measures) of the speech and language session through remote control devices, as well as of the e-speech therapy (quantitative measures). Does distance allow the
maintenance of the clinical characteristics of speech and language therapy and does it guarantee
the effectiveness of treatment?
Methods: A partnership between the Northern University (Université Laval and Sherbrook in Québec) promotes ROAD in French-speaking contexts and ensures the localization of the device in
French-speaking regions taking into account cultural differences in order to assess its validity. The
construction, dissemination and analysis of the qualitative questionnaires exploring the characteristics of clinical speech and language therapy in presence and in the e-therapy aimed to validate
the treatment approach of e-speech therapy. This study aims to evaluate the effectiveness of espeech therapy through instrumental speech and language tests adapted for each country, at the
beginning of the trial and after 6 months rehabilitation.
The results expressed in percentiles allow the generalization of the quantitative aspects and the
discussion on the effectiveness of rehabilitation, regardless of the type of treated pathologies.
Results: The results obtained have proved to be effective from an academic point of view.
Nevertheless, practicing this kind of rehabilitation has raised issues that will have to be taken
into account in designing an on-line rehabilitation device. These results suggest that speech and
language therapy may be feasable and also effective from a distance. The medium of the internet does not reduce the dual relationship. It of course modifies it, but such a difference does not
impair the rehabilitation benefits. Nevertheless, an effective device must be designed to cope
with the technological and pedagogical difficulties. On-line rehabilitation cannot be conceived as
a mere Skype rehabilitation session. Despite the benefits it brings, it cannot be enough and does
not exploit the many rehabilitation advantages proposed by the distance devices, when they are
well designed.
Conclusions: ROAD is a new and open approach to treatment accessibility, which guarantees
quality, respecting the principle of triple concordance among objetives, choice of methods and
choice of the evaluation system (Poumay, 2007). Today TCI speech and language therapy cannot
give up such tools; the clinical trials (2005-2008) show clear benefits deriving from an e-speech
therapy platform.
Keywords: FOAD (Open and Distance Learning), TCI, Speech and Language Therapy, ROAD (Distance Speech Therapy)
17.1
DOES A SEMI-OCCLUDED VOCAL TRACT INFLUENCE THE
MAXIMUM PHONATION TIME OF NORMOPHONIC VOICE
CLINICIANS?
Youri Maryn - European Institute for ENT, Sint-Augustinus Hospital, Antwerp, Belgium
Background: First, semi-occlusion of the vocal tract (i.e., SOVT) has shown to have a favourable
effect on vocal fold physiology across a multitude of studies. Second, the maximum phonation
time (i.e., MPT) is a highly feasible and well-established voice therapy outcomes measure. However, the influence of SOVT on MPT data is still unclear, hence the present study exploring the
influence of different SOVT exercises on the MPT of normophonic voice clinicians.
Method: Twenty-two speech-language pathologists specializing in voice disorders management
were asked to sustain the following four phonation types for as long as possible: (1) the vowel [a:],
(2) the nasal consonant [m:], (4) the bilabial fricative [β:], and (d) phonation into silicone tube with
the distal end 2 cm under water (i.e., tube2cm). Phonation times were measured with a chronometer. Differences between phonation types were investigated with related-samples Wilcoxon
signed-ranks test.
Results: Mean MPT of the four phonation types can be ordered as following (from shortest to
75
longest): [m:], [a:], [β:] and tube2cm. Except for the comparison between the data of [a:] and [m:],
all comparisons showed significant differences in MPT.
Conclusions: The present study adds proof to earlier studies indicating beneficial influence of
semi-occlusion in vocal fold physiology.
17.2
VOICE QUALITY IN CHARISMATIC LEADERSHIP
Diogo Pinto - Arte & Fala Research Center, Escola Superior de Saúde Egas Moniz, Lisboa, Portugal
Objective: The aim of this study is understand if the enhancement of voice quality increases the
perception of the leader as charismatic. Through this study we can reference voice quality as an
attribute to analyze charismatic leadership
Methods: We recorded the vocal performance of a manager before and after a training program
in vocal technique. The resulting speeches were presented to two groups of participants that
evaluated the impact in affect – measured using Positive and Negative Affect Schedule – and the
perception of charisma – measured using a sub scale of Conger-Kanungo Scale of Charismatic
Leadership.
Results: The results showed that an improved voice quality results in a higher perception of charisma. Voice quality also leads to an increase in the positive affect of followers. In turn, a positive
affect results in higher levels of charisma, and the reverse is also true.
Conclusions: We suggest that this research may serve as the basis for a particular issue in the
training of leaders, usually neglected: the voice quality. The enhancement of this emerges as a
way to increase the perception of charisma in leaders.
Keywords: Voice, speech, leadership, charisma, communication
17.3
LONG-TERM FUNCTIONAL RESULTS AFTER OPEN PARTIAL
HORIZONTAL LARYNGECTOMY TYPE IIA AND TYPE IIIA:
A COMPARISON STUDY
Nicole Pizzorni - Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
Marco Fantini - Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Turin, Italy
Erika Crosetti - Department of Otorhinolaryngology, Ospedale Martini, Turin, Italy
Andy Bertolin - Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
Giuseppe Rizzotto - Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
Giovanni Succo - Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Turin, Italy
Antonio Schindler - Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
Objective: Open partial horizontal laryngectomies (OPHL) are conservative surgical techniques for
the treatment of selected laryngeal carcinomas. The differences between different OPHL’s subtypes are related to inferior limits of excision. The aim of the study is to compare long-term functional outcomes in patients who underwent type IIa and type IIIa OPHL, in order to get insights on
the impact of surgical extension on swallowing, voice and quality of life (QOL).
Methods: Twenty-three patients who underwent OPHL type IIa and 18 patients who underwent
OPHL type IIIa were recruited at least 6 months after surgery. The two groups were comparable
for age, sex, marital status, job, educational degree, distance from surgery and neck dissection.
76
Each patient underwent FEES with 5 ml liquids, semisolids and ½ biscuit. Neoglottis’ motility and
vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis and
voice perceptual assessment were performed. The onset of pulmonary complications and the preand post-surgery weight variation were recorded. Generic, voice- and swallowing-related QOL
were assessed. The data were statistically compared using Mann-Whitney U test or Fisher exact
tests, as appropriate.
Results: Significant differences between the two groups were found only for the Pooling score
with solid bolus and for the I parameter of the INFVo scale, with patients of the OPHL type IIIa’s
group showing worse performances than OPHL type IIa’s group. No statistically significant difference was found for both general, voice-related and swallowing-related QOL.
Conclusions: Patients who underwent OPHL type IIa and type IIIa show comparable long-term
functional outcomes, suggesting that the difference in the extent of resection between the two
surgical techniques do not significantly impact on voice, swallowing and QOL.
Keywords: Head & neck oncology, dysphagia, voice disorders
17.4
TV VOICE-OVER. A EUROPEAN PORTUGUESE PERSPECTIVE
Isabel Guimaraes - School of Health Sciences at Alcoitao, University, Alcoitao-Alcabideche, Portugal
Objective: What are the journalists’ health habits, voice and speech disorders, voice education
and experience at a broadcast TV in Portugal? Is there any significant difference between TV journalists’ voice and non-professional voice users while reading?
Methods: Portuguese TV journalists were analyzed, using a semi structured interview, to determine health related problems; voice and speech disorders; education on voice; working experience on TV voice-over. From those, 22 females were selected and subdivided into two groups
(novice and experienced) and compared to 11 nonprofessional voice users. Reading aloud a
paragraph from the standard passage ‘The story of Arthur the rat’ was used to determine acoustic
and temporal measures using Praat software
Results: Fifty nine TV journalists, aged between 21 and 45 years old show: (a) 66% females; (b)
GERD, allergies and sinusitis were the most common health related problems; (c) 30.5% smokers;
(d) 11.9% dysphonic phonotraumatic episodes and 5.1% misarticulations; (e) 69.5% short term
voice education; (f) 42.4% with one year or less of TV news experience. Females’ voices while
reading aloud showed only statistically significant differences (p≤0.05) on temporal measures
(speech reading rate and pauses duration and number) according to professional voice experience.
Conclusions: Portuguese TV journalists show a high percentage of health related problems, low
level of specific voice education and different temporal voice characteristics while reading aloud
Keywords: Voiceover; professional voice user
17.5
PERCEPTUAL AND OBJECTIVE ACOUSTIC CHANGES OF VOICE
QUALITY IN ADULTS, FOLLOWING COCHLEAR IMPLANTATION
Elisavet Papadopoulou - University College London, UCL EAR Institute, London, United Kingdom
Objective: The voice quality characteristics of adults with severe to profound sensorineural hearing loss differ considerably from those of speakers with normal hearing. Frequently, their voice
quality is described by professionals as ‘’breathy’’, ‘’hoarse’’, ‘’creaky’’ and ‘’rough’’.
77
After cochlear implant, auditory control of voice is possible and their voice quality is improved.
This study aimed to track perceptual and objective acoustic changes of voice quality in adults
with severe to profound sensorineural hearing loss, four weeks after their cochlear implant was
switched on.
Methods: 5 adults with severe to profound sensorineural hearing loss between the ages of 18-60
years examined at two different times (pre- and post-CI). Voice recording materials: the electrolaryngograph method and the speech studio software (objective measurements) for the laryngographic and acoustic analysis of voice sample, the GRBAS scale (subjective measurements) for
the perceptual evaluation and analysis of voice quality. Voice sample: sustained vowels /ee/, /ah/,
/oo/, a reading passage (The Story of Arthur the Rat) for connected speech.
Results: The results of the statistical analysis (SPPS software) showed that the perceptual and
objective acoustic changes in voice quality were not significant for all voice parameters, which
were measured, 4 weeks after the cochlear implant was switched on. The correlations of the perceptual voice judgements among the three professional raters were not consistent for all GRBAS
scales. Finally, the relationships between objective and subjective voice measurements were low.
Conclusions: A bigger sample population and voice assessment over a period of 6 months after
cochlear implantation may be good indications for significant improvements in voice quality.
The low correlation between ratings may imply the different linguistic and cultural backgrounds
of the three professional raters. Finally, the objective and subjective voice analysis do not show
the same tendencies, since the voice materials which were used for the vowels and connected
speech may have an impact on them.
Keywords: Voice disorders, hearing impairment
17.6
HELP ME SING! INSTRUMENT FOR THE IMPROVEMENT OF THE SINGER
In this presentation the characteristics and details of the instrument “Help me Sing” as well as its
mode of use will be presented. The objective of this instrument is to enhance the singer’s vocal
performance or rehabilitation of the pathology, through an indirect intervention, promoting the
continuity of intervention at home, reinforcing the technique already learned in the context of the
session.
Singers, as professional voice users, are the most affected by vocal problems (Lopez & Bouzas,
2010). Singers require a special consideration in the diagnosis and treatment of vocal problems,
as they have to maintain a higher level of phonatory agility, strength and power, to repeatedly
execute complex laryngeal maneuvers (Zeitels, Hillman, Desloge, Mauri, & Doyle, 2002). Therefore, this instrument has as its objectives: postural alignment, tone, breathing and support, vocal
registers, resonance, intensity/vocal projection, all of which components are necessary for a good
vocal performance by the singer. Although the instrument is mainly intended to professional adult
singers, non-professional singers can also use it. The vocal exercise pictograms with musical
scales, has the music scales represented on them, which a singer with musical training can play
on the piano and a singer without musical training can use the audio CD.
The speech therapist as well as the singing teacher, in addition to being professional voice users, also have it as an element of their work, but the goals and paths that they follow are different (Ferreira, 1993). So, it is important to have speech therapists specialized in the singing voice
to collaborate with the singing teacher in the transmission of knowledge of anatomy and vocal
physiology, because, on the one hand, the singing teacher does not take into account the organic
and functional aspects of the voice, and on the other hand, the speech therapist puts to one side
the artistic component of the voice.
The achievement of a pictographic instrument accompanied by audio files, will allow the singer to
78
reach the maximum of autonomy and that makes the therapeutic intervention more effective.
Keywords: Voice, singers, adults, education for health, speech therapist
18.1
SPECIFIC LANGUAGE IMPAIRMENT, DYSPHASIA…:
WHAT’S IN A NAME?!
Ruth Vanderswalmen - University College Arteveldehogeschool and Ghent University, Ghent, Belgium
Eveline Vogels - University College Arteveldehogeschool and Ghent University, Ghent, Belgium
Sabien Van Dycke - University College Arteveldehogeschool and Ghent University, Ghent, Belgium
Objective: Are the different terms to determine (speech) language disorders in children (SLI, dysphasia, …) used as synonyms, if we look at definitions, criteria, prevalence, etc? Which variables
affect the use of these terms?
Methods: Different terms are used to determine language disorders in children e.g. dysphasia,
SLI. This study is based on a literature research. Also an online survey was completed by 111
Flemish speech-language pathologists working in different areas.
Results: Several ANOVAs were performed. The term ‘SLI’ was used significantly more often by
speech-language therapists with a Masters degree (F (1,96) = 14.25, p = .00). No significant differences were found for other terminologies in relation to degree. Dysphasia is used significantly
more in rehabilitation centers (F (2,98) = 9.27, p = .00), while developmental speech-language
disorders is used significantly more in special education (F (2,98) = 7.63, p = .00). In private practice the term ‘language delay’ is used significantly more (F (2,98) = 5.42, p = .01). This term is less
used by speech-language pathologists who treat children with language problems more often.
The use of the terms speech-language disorder and dysphasia was also determined by the location in Belgium. 89% of the speech-language pathologists ask for less ambiguity in the use of
terms.
Conclusion: In the literature the terms developmental language disorder, SLI and dysphasia are
most commonly used. Some authors use them as synonyms, when we look at definition, criteria,
prevalence, but others do not. Nine out of 10 speech-language pathologists are disturbed by the
lack of clarity. Degree, setting, number of clients treated with this disorder and residence are variables that influence the choice of terminology. Implications will be discussed.
Keyword: Specific language impairment
18.2
LANGUAGE DIFFICULTIES AND BEHAVIORAL PROBLEMS IN
PRESCHOOL CHILDREN
Margarita Stankova - New Bulgarian University, Sofia, Bulgaria
Violeta Boyanova - New Bulgarian University, Sofia, Bulgaria
Raina Markova - New Bulgarian University, Sofia, Bulgaria
Veneta Vasileva - New Bulgarian University, Sofia, Bulgaria
Objective: The report includes a study of two groups - children with specific language disorders
and children with typical language development. The aim of the study is to find connections between language abilities and emotional and behavioral problems.
Methods: Bulgarian version of CBCL, 1.5 - 5 years of age (Achenbach, Rescorla), and Method for
Diagnosis and Prevention of Language (Stoyanova, Yosifova, Poppandova, Netsova).
79
Results: The results show significant differences between children with language disorder and
children with typical language development in preschool age in the following scales: emotional
reactivity, anxiety, withdrawn, attention problems and aggression.
Conclusions: Disorders in language development influence the appearance and expression of
behavioral and emotional problems in preschool age.
Keywords: specific language disorders, emotional and behavioral problems
18.3
SPEECH AND LANGUAGE DISORDERS IN SCHIZOPHRENIA WITH
VERY EARLY ONSET (VEOS)
Tomasz Wozniak - Institute of Logopedics and Applied Linguistics, University of Maria Curie-Sklodowska, Lublin, Poland
In recent times, the early childhood form of schizophrenia is considered for cases of psychosis in
individuals under 13 years of age (Remschmidt 2002).
Schizophrenia in children under 13 years of age occurs rarely - that is, in one in 10,000 cases.
Among the symptoms of schizophrenic psychosis in this form of the disease, we also observe language communication disorders. However, these disorders are different from schizophasia symptoms in adults (cf. A. Sims, 1995).
Psychiatric studies show such phenomena as neologisms, echolalia, phonographism, perseveration, incorrect use of pronouns, domination of monologue in the utterances of children with
schizophrenia (Sulestrowska 1989).
This paper presents the results of linguistic studies in the communication of 20 patients with
VEOS. The study focuses on dialogue reactions, narrative skills, comprehension and memory of
text. The results indicate that VEOS is a neurodevelopmental disorder that delays and changes
the normal acquisition of speech. Dialogue is dominated by blocking communication, both narrative comprehension skills and building narratives operate on a much lower level, and memory of
the text is even more impaired. The studies did not confirm the prevalence of speech disorders
described by psychiatrists. The test results lead to the conclusion that speech-language therapists should be involved in the treatment of children with schizophrenia. It is important that apart
from pharmacotherapy and psychotherapy, the professional stimulation of language development
is used (Wozniak 2008).
Keywords: Children language disorders, schizophrenia, schizophasia
18.4
PARENT’S IMPRESSION OF CHILDREN’S TALKATIVENESS AND
TALK’S LENGTH IN INTERACTIONS OF CHILDREN WITH ADHD AND
THEIR PEERS
Rahmati Somayeh - University of Neuchâtel, Neuchâtel, Switzerland
Genevieve de Weck - University of Neuchâtel, Neuchâtel, Switzerland
Objective: Several studies report the presence of pragmatic language impairment (PLI) in children
with Attention Deficit/Hyperactivity Disorder (ADHD). A common symptom mentioned among
others for ADHD and for PLI is the elusive symptom of talkativeness. However, numerous conversational features (talk’s length, turn-taking, topic management) may lead to an impression of
talkativeness (Bishop, 1994). Thereby, this study aims to investigate the similarities/specificities of
pragmatic behavior focusing on the talk’s length (e.g. word, timing) in interactions between chil80
dren with ADHD and children with typical development (TD).
Methods: For this purpose, 14 French-speaking children (9;8-12;4) with/without a diagnosis of
ADHD (age-matched) were observed in interaction with their peers. The subjects were matched
for absence/presence of ADHD and PLI by checklists and by a battery of tests for the structural
language level. The interactions took place during a show-preparation setting and snack-time.
Data was transcribed indicating the starting and ending time of each speech turn. The number
of words and utterances per turn was quantified. The parent’s impression of talkativeness was
extracted from parent’s answers throughout the two checklists for PLI and ADHD.
Results: Quantitative data analysis showed different talk durations according to the setting and
population. Although children with ADHD obtained the highest ranking of talkativeness in parent’s
evaluations, it did not match with the quantitative measures of talk’s length.
Conclusions: Findings suggest that despite the talk’s length other factors may contribute to the
impression of talkativeness. As a clinical implication this study may give a deeper overview of the
«talkative» behavior of children with ADHD and bring evidences for considering them in clinical
assessment and guidance.
Keywords: Talkativeness, peer interaction, ADHD
18.5
APPLICABILITY OF THE SOCIAL-CONVERSATIONAL SKILLS RATING
SCALE-ITALIAN VERSION IN CHILDREN WITH LANGUAGE DISORDER
Renata Salvadorini - IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy
Francesco Mozzanica - Luigi Sacco Hospital, Department of Clinical Sciences, University of Medicine, Milano, Italy
Stefania Bargagna - IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy
Objective: The aim of the study is to evaluate conversational skills in a sample of language disordered children, aged from 36 to 48 months.
Methods: In order to analyse the conversational abilities of language disordered children, aged
from 36 to 48 months, a cohort of patients composed of 18 patients, 15 males and 4 females,
with a mean age of 45 months, was enrolled. Their conversational abilities were evaluated using
the Social-Conversational Skills Rating Scale-Italian version (ASCB). This latter is a parent-administered questionnaire which evaluates pragmatic skills and consists of 25 questions divided into
two scales: Assertiveness and Responsiveness. On the basis of the questionnaire results, patients
were divided into 4 conversational profiles. The number of uttered words was also measured.
Results: Children with language disorders obtained low ratings for both assertiveness and responsiveness. A significant difference in words production was demonstrated among the 4 conversational profiles. A significant relationship between the type of conversational profile and the
type of the language disorder was also demonstrated.
Conclusions: The development of social-conversational skills appears related with the type of
language disorder and with vocabulary development. The ASCB appears useful in the evaluation
and in the treatment planning of patients with language disorders.
Keywords: Socio-conversational skills, language disorder, counselling
81
18.6
THE RELATIONSHIP BETWEEN LANGUAGE AND SPEECH
DIFFICULTIES AND READING LEARNING PATTERNS IN MULTILINGUAL
SUBTRACTIVE CONTEXTS
Eniko-Zsuzsánna Boér - Lycée Français de Budapest, Budapest, Hongrie
Objective: Through 3 case studies we are going to present the cognitive-speech pattern evolution
during the first 6 months of the reading learning process in 3 multilingual children (aged 6 years)
presenting language impairments in their mother tongue (Hungarian) and with poor French-speaking skills.
Methods: As diagnostic methods, training and rehabilitation, the speech and language therapy
protocol (H) and BSEDS 5-6 (F) were used, and for the reading methods Murail-Bulle (F) and
Meixner-Játékház (H).
Results: The acquisition patterns of graphophonemic matching (generalization, development of
mental images, matching between a mental image and its representation) will be presented during
the congress. The research is still on going.
Conclusion: The three children in these cases present serious difficulties in acquiring written language skills: despite a slower graphophonemic matching, they prefer the assembling model to the
addressing one, whose installation is prevented by the lack of a passive vocabulary, which results
in poor comprehension. Multilingual contexts transform the nature of speech and language therapy intervention, mainly in oral language rehabilitation for the mother tongue and for the acquisition
of written skills in French.
Keywords: Multilingual contexts, specific language disorders, dyslexia, specific developmental
learning disorders
19.1
SIMILAR OR DIFFERENT? INTERNATIONALLY ADOPTED CHILDREN’S
LANGUAGE AND READING COMPREHENSION
Anne-Lise Rygvold - Department of Special Needs Education, University of Oslo, Oslo, Norway
Objective: Internationally adopted children’s language and reading development between four
and thirteen years of age compared to non-adopted Norwegian peers.
Methods: The design of the study is longitudinal and started out with 40 adoptees from Asia
and South America, adoption age between 2 and 38 months, and 79 monolingual Norwegianborn controls. At four years of age the children’s language and cognitive skills were assessed. In
the children’s second year at school, language skills, reading strategy and comprehension were
measured. At present the informants are in the 8th grade and the last follow-up of language and
reading skills is ongoing.
Results: The results from the four year assessment revealed small differences between the adoptees and controls on language skills. Only language comprehension scores showed significant
differences between the groups. In the 2nd grade the adoptees had caught up with their peers on
oral comprehension measures, but scored significantly lower than them on reading comprehension.
The research question for the ongoing assessment is whether or not the adoptees have caught up
with the controls on reading comprehension in the 8th grade. Preliminary results will be presented.
Conclusions: Language comprehension seems to be a vulnerable skill for internationally adopted
children. They seem to be more at risk for language difficulties than their non-adopted peers are.
Determining what explains the results on the adoptees’ oral and reading comprehension
82
is elusive, but theoretically many factors could complicate the acquisition of a second first language, including age at adoption, pre-adoption conditions and the abrupt change of language
and culture.
Keywords: Language and reading comprehension, internationally adopted children
19.2
METAPHONOLOGICAL GROUP TRAINING: ENHANCEMENT
EXPERIENCES AS PREREQUISITES FOR READING AND WRITING
Andrea Brogi - Neuroscience and surgical, medical science department, Siena University, Siena, Italy
Alessandro Malandrini - Neuroscience and surgical, medical science department, Siena University, Siena, Italy
Objective: It has been shown that almost the 30% of patients with specific language disorder develop a specific learning disability. Recent studies point out that metaphonology can be a useful
instrument in the management of specific language disorder patients and therefore in the prevention of specific learning disability. A new concept of metaphonological training has been created,
in order to enhance global metaphonological skills as a basis for correct learning development.
This training is composed of 80 games created and built particularly for this purpose.
Methods: A group of 10 patients with specific language disorder participated in this study: One
was attending the second year of primary school and the others were attending the last year of
preschool. Patients were first evaluated with a CMF test; then, the same test was used to re-evaluate them after four months to verify the training efficacy.
Results: The CMF test administered after the metaphonological enhancement showed that six
children out of 8 improved their skills.
Conclusions: The results obtained showed that a specific metaphonological enhancement conducted during the last year of preschool improves metaphonological tasks and consequently
decreases the probability of a further development into specific learning disability. Although this
preliminary study underlines the preventive importance that this particular training could have, it
cannot demonstrate with absolute certainty that it would totally prevent a specific learning disability, which needs further investigation through a follow-up of a series of cases.
Keywords: Specific language impairment, phonological disorders, dyslexia and specific developmental learning disorders
19.3
THE EFFECTIVENESS OF SPEECH LANGUAGE THERAPY IN
PROMOTING SCHOOL SUCCESS: CASE STUDY
OF AN EDUCATIONAL TERRITORY OF PRIORITY INTERVENTION
Rui Loureiro - Agrupamento de Escolas Professor Óscar Lopes, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
Orquídea Coelho - Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Porto, Portugal
Objective: Over time, the problems of the community have always influenced the dynamics of
a school. However, currently, more and more community members delegate school authority a decisive role in solving various problems. Educational Territory of Priority Intervention, a Portuguese
designated term, that refers to low socio-economic status background schools, are examples
of schools that are embedded in socio-economically disadvantaged areas, where students have
predominantly low level success, particularly in terms of Portuguese language acquisition and
83
language competence. In this context, these schools may require increased human resources,
including Speech Language Therapists, aiming to develop child’s speech, language and communication needs that underlie their difficulties in literacy development.
The study aims were: to identify the perception of Primary Education Teachers about the importance of Speech Language Therapist intervention in this context, to identify their opinion on the
influence of language and speech disorders in the acquisition of the reading and writing process
and to identify their perception about the association between the etiology of these disorders and
the school context characteristics. Also, a sample of 82 students from primary school was measured in their development in semantics, morphology, syntax and phonology after intervention, as
well as the existence of differences in results by school year and Portuguese language grades.
Methods: This research is descriptive and exploratory, based on a case study developed in a low
socio-economic status background school. The analysis of the data collected was based on a
combined approach, using qualitative and quantitative methodologies, like content analysis and
descriptive and inferential statistics.
Results: Qualitative results showed that teachers value the role of the Speech Language Therapists in schools. The results also demonstrated that teachers acknowledged the relation between
the high incidence of language and speech disorders and literacy difficulties. The quantitative
results evaluated that more than 70% of students increased their percentile in all areas of Portuguese language after intervention and 57% increased their Portuguese language grades by at
least one level. Statistical tests confirmed the association between the differences in development
and the variables school year and Portuguese language grades.
Conclusions: These results indicate the effectiveness of speech language therapy intervention in
promoting school success. Considering the high incidence of problems in language and knowing
its influence on academic success, it is the responsibility of schools to create an inclusive space,
as a promoter of success for all students.
Keywords: Speech language therapy, language, intervention, effectiveness
19.4
“RUN THE RAN!”: RAPID AUTOMATIZED NAMING TRAINING MAY
IMPROVE READING DECODING? A PILOT STUDY
Chiara Pecini - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Silvia Bonetti - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Silvia Spoglianti - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Maria Chiara DiLieto - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Francesca Guaran - UO NPI, ASL 10, San Donà di Piave, Italy
Filippo Gasperini - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Paola Cristofani - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Sara Mazzotti - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Renata Salvadorini - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Daniela Brizzolara - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Anna Chilosi - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Claudio Vio - UO NPI, ASL 10, San Donà di Piave, Italy
Objective: It is well known that in developmental dyslexia (DD), deficits in rapid automatized naming (RAN) are strongly associated with speed reading deficits, across ages, languages and severity of the impairment (Norton & Wolf, 2012; Landerl et al., 2013). Nevertheless, few studies have
attempted to improve RAN speed in order to ameliorate reading (Kyrby et al., 2012). Moreover
children with isolated deficits in RAN are not treated early because the most obvious deficit, that
in phonological processing, on which interventions are often based, may not be present (Wolf &
Bowers, 2000). In fact especially in languages with regular orthographies, such as Italian, isolated
84
deficits in RAN and in reading speed are frequently observed (Wimmer, 1993; Zoccolotti et al.,
1999; Brizzolara et al., 2006; Chilosi et al., 2009).
The present study aimed to increase rapid automatized naming in pre-school children with RAN
deficits or in children with DD and a prevalent speed deficit in reading decoding.
Methods: RAN speed was trained through “Run the RAN” (Ridinet, Anastasis, Bologna, IT), a
new computerized auto-adaptive software for home-based rehabilitation. It required the naming
of black and white pictures presented at increasing speed on a computer screen. Training lasted
for 2 /3 months and required about 10 minutes of exercise each day. As the child reached a goal
speed, difficulty (rate, pictures type, pictures size) increased. An expert psychologist monitored
the training and met the child once a week to increase compliance and eventually change the
training parameters. All children (n=15), aged between 5 and 11 years, were evaluated pre- and
post-training by a neuropsychological battery assessing lexical fluency, metaphonological abilities,
visual attention, inhibition, reading decoding speed and accuracy and reading comprehension.
Results: Preliminary results are encouraging as training with ‘’Run the RAN’’ was associated
to improvements in naming speed, visual attention, inhibition and, most importantly, in reading
speed of texts or words.
High compliance and motivation were obtained as DD children were asked to improve reading by
playing a computer game not requiring reading exercises.
Conclusions: ‘’Run the RAN’’, a training procedure aimed at improving the main cognitive processes underlying reading, may represent a new tool for early intervention in children with or at
risk of reading speed deficits.
Keywords: RAN, developmental dyslexia, training
19.5
THE CAPABILITY APPROACH APPLIED TO DEVELOPMENTAL
DYSLEXIA AND WORK
Joost de Beer
- HAN University of Applied Sciences and Tilburg University, Hogeschool van Arnhem en Nijmegen
and Tilburg University, Nijmegen and Tilburg, Netherlands
Objective: To describe the work experiences of adults with developmental dyslexia (DD) in the
framework of the Capability Approach, using the core-set of work-capabilities of Van der Klink et
al. (2012).
Method: The Capability Approach (CA) (Sen, 1992) has been used as the central framework in this
study. In the CA literature two capabilities have been depicted as overarching: the capability to be
healthy (Venkatapuram, 2011) and the capability to receive proper education (Terzi, 2005). These
capabilities both have high relevance for work participation of people with DD. For work Van der
Klink et al. (2012) have identified a core-set of seven capabilities, operationalized in a questionnaire. An example of a capability is: building meaningful work relations with others. This coreset was used as a framework in 30 in-depth interviews with 30 people diagnosed with DD, who
worked for at least 12 hours a week. In the interviewguide the questions for the capabilities had a
similar structure as in the questionnaire: how important is the capability for you, does your work
offer you the opportunities to realize it, do you actually realize it, and what role plays DD in that
process? The interviews are analyzed with support of Atlas-ti 6.
Results: Preliminary analyses indicate that the seven capabilities are equally important to all participants. However, big differences exist in the possibilities to realize the capabilities in the current
work. Differences are associated with personal factors such as age, experience, coping and compensation strategies, motivation, and perseverance. But also with environmental factors like social
support and understanding DD and its impact by employers.
Conclusion: With the core-set of work capabilities it is possible to describe the impact of DD on
work participation. The set also indicates for intervention targeted on both the personal and the
contextual level.
Keywords: Developmental dyslexia, work/employment, participation, Capability Approach
85
19.6
STUTTERING AND SPECIFIC READING DISORDER: ANALYSIS OF A
SCHOOL-AGE CLINICAL POPULATION
Eleonora Pasqua - Clinical Center, CRC Balbuzie, Rome, Italy
- Università La Sapienza, Rome, Italy
Emilia Capparelli - Clinical Center, CRC Balbuzie, Rome, Italy
Roberta Siddi - Clinical Center, CRC Balbuzie, Rome, Italy
Biancamaria Venuti - Clinical Center, CRC Balbuzie, Rome, Italy
Donatella Tomaiuoli - Clinical Center, CRC Balbuzie, Rome, Italy
Objective: Children with stuttering may tend to read more slowly when compared to the normative sample, due to slowing down/ atypia resulting from dysfluencies produced.
For this reason, generally speaking, reading characteristics in children with stuttering are not considered reliable indicators of a possible specific learning difficulty during assessment, in spite of
the fact that a high comorbidity is reported between the two disorders (around 10-15%).
The aim of the study is to investigate the quality of reading in stuttering subjects and in subjects
with comorbidity between stuttering and dyslexia, with particular regard to possible modifications
of dysfluencies during reading; to analyze the possible qualitative and quantitative modifications
of the dysfluencies during reading between the two samples and to understand how such variations in dysfluencies correlate with reading disorder.
Methods: This work analyzed reading quality in a school-age clinical sample undergoing treatment for stuttering at the Centro CRC in Roma over a four-year period 2011-2014.
All the children were subjected to a multidisciplinary assessment regarding the level of overall
development, neuropsychological and learning skills, and a multidimensional assessment of stuttering.
It was therefore possible to compare subgroups of children, the ones with stuttering only and
those with a comorbidity between stuttering and reading disorder.
In particular, an analysis of the dysfluencies produced by the two subgroups was carried out during reading tests and compared to those produced during spontaneous speech.
Results: An analysis of the results obtained has allowed us to:
- confirm the presence of a high comorbidity between the two cores difficulties, often unidentified;
- highlight in children with stuttering and dyslexia comorbidity, the specific features of the dysfluencies produced during reading and those produced during spontaneous speech; this evidence
has allowed us to define new assessment indicators able to predict learning difficulty in children
with stuttering.
Conclusions: Stuttering can “mask” conditions of reading difficulties that can significantly compromise school performance. The study therefore has highlighted the importance of always
carrying out an accurate assessment of stuttering children’s reading, with the aim of planning an
integrated response that takes into account cases of comorbidity.
Keywords: Stuttering, dyslexia, comorbidity, reading abilities
86
20.1
DEVELOPING TOOLS FOR TEACHERS OF INTERNAL
APPRENTICESHIP SLT
Willy Voor in t holt - Hanze University of Applied Sciences, Hanze University of Applied Sciences, Groningen, Netherlands
Aafke van der Schaaf - Hanze University of Applied Sciences, Hanze University of Applied Sciences, Groningen, Netherlands
Susanne Kohlleppel - Hanze University of Applied Sciences, Hanze University of Applied Sciences, Groningen, Netherlands
Objective: Preparing SLT students for clinical placements is a challenging task for educators. At
Hanze University of Applied Sciences, SLT students are required to do an internal apprenticeship in their 2nd and 3rd year in ‘de leerwerkplaats’. They form a small practice, of approximately
twelve students, in which they learn to examine and treat patients, practice clinical reasoning
skills and develop a professional and reflective attitude. SLT teachers worked together to develop
a toolbox with examples of relevant, usable and effective educational tools that will support their
students’ development. This also contributes to the professional development of teachers and
their knowledge concerning the design and implementation of new materials.
Methods: Through an iterative process of analysing, prototyping, experimenting, observing,
reflecting and formative evaluation, the educational tools were designed and improved. Regarding our SLT programme, students, teachers and researchers were all involved to improve teaching
strategies and methods for internal apprenticeship in ‘de leerwerkplaats’.
Results: Integrative cognitive skills and metacognitive skills, both known to be important components of clinical reasoning, were not easily activated in ‘de leerwerkplaats’ according to both
students and teachers. The developing of, experimenting with and reflecting on educational tools
gave students improved cognitive and metacognitive learning experiences. At the same time, it
gave teachers more insights about the didactics of experiential learning in internal apprenticeships and provided them with effective and usable tools.
Conclusions: The collaborative design and cyclical development of educational tools in the context of ‘de leerwerkplaats’ has proven to be effective. It improved students’ awareness of cognitive and metacognitive learning, as well as teachers awareness of didactic possibilities. The tools
form the start of a toolbox with flexible elements, which teachers can use to mentor their students
during internal apprenticeship and prepare them for clinical placements.
Motto of this presentation will be: Be brave. Take risks. Nothing can substitute experience. Paolo
Coelho
Keywords: Internal apprenticeships, metacognitive learning, SLT teachers, educational tools
20.2
CONTINUUM OF SPEECH-LANGUAGE PATHOLOGY SERVICE DELIVERY
Lemmietta McNeilly - American Speech-Language-Hearing Association, N/A, Rockville, United States
Tommie Robinson Jr. - Children’s National Health System
Objective: To describe the value of SLP services and functional communication outcomes, review
the elements of collaborative practice and describe effective utilization of support personnel.
Methods: The focus of service delivery is maximization of the patient/ student/ client functioning in a variety of settings including home, school/work and community. Resources that educate
other SLPs, health professionals, individuals and their families about the value of SLP services
and reporting outcomes including patient satisfaction. Data on speech-language services delivered using telepractice and using support personnel are being collected to see the impact on
patient outcomes.
Results: SLPs work with support personnel and collaborate with professionals in other
87
professions to meet the communication needs of individuals. The numbers of SLPs that deliver
services via telepractice are increasing.
Conclusions: Practicing at the “top of the license” is a concept that guides SLPs to engage in
clinical practice that requires the knowledge and skills of a SLP and to delegate those practices
that can effectively be executed by someone with less education or different skills i.e. support
personnel. SLPs that practice at the top of their licenses consult with other professionals, assess
individuals, design treatment plans that meet the functional needs of individuals with communication disorders. They also educate or supervise other professionals and support personnel in the
practice of communication skills. SLPs communicate the value of SLP services to others.
Keywords: Support personnel, telepractice, collaborative practice
20.3
A SOCIAL THEATRE PROJECT WITH APHASIC PEOPLE AND SPEECH
AND LANGUAGE STUDENTS: EDUCATIONAL IMPLICATIONS
Federica Morra - University of Turin, Turin, Italy
Rossella Muò - ASL TO1, Rehabilitation Department, Turin, Italy
Lorena La Rocca - Carlo Molo Onlus Foundation, Center for Aphasia CIRP, Turin, Italy
Stefano Monte - Carlo Molo Onlus Foundation, Center for Aphasia CIRP, Turin, Italy
Roberto Albera - University of Turin, Turin, Italy
Paola Guglielmino - University of Turin, Turin, Italy
Objectives: National and International SLTs Association’s Guidelines, Documents and Projects on
SLTs education highlight the importance of supporting the acquisition of both specific and generic
competences for SLT students. In particular, intrapersonal and interpersonal communication skills
have been recently acknowledged as essential for newly qualified SLTs. Turin University supported the CIRP Aphasia Center Project “Theater and Aphasia: good practices for the cure” for
SLT students. Aim of the project was to verify the increase of SLT students’ verbal and non-verbal
communicative, empathic, relational competences with persons with aphasia involved in a social
theatre project (Teatro Babel).
Methods: Five SLT students and the Teatro Babel group were involved in the qualitative and retrospective study. Two grids were used to observe changes and improvements.
Results: Our qualitative data showed progressively increased non-verbal communication competences and improved emotional-relational abilities; all student participants answered a questionnaire which showed good relational competences, emotional self-control and communication
abilities to take care of persons with aphasia compared to non-participating students matched for
course years.
Conclusions: Our results suggested that the Project can be considered a useful tool to develop
communicative, behavioural and relational competences and attitudes, essential for qualified professionals and highly recommended by SLT Associations.
88
20.4
SLT INTERVENTION IN THE ECONOMIC CONTEXT OF EUROPEAN
COUNTRIES: DIFFICULTIES AND STRATEGIES. A PILOT STUDY BY
CPLOL
Ellianna Mantaka-Brinkmann - CPLOL, Professional Practice Commission, Paris, France
Mette Thomsen - CPLOL, Professional Practice Commission, Paris, France
Christine Grignard - CPLOL, Professional Practice Commission, Paris, France
Tiziana Rossetto - CPLOL, Professional Practice Commission, Paris, France
Angela Pommersheim - CPLOL, Professional Practice Commission, Paris, France
Mateja Gacnik - CPLOL, Professional Practice Commission, Paris, France
Raffaella Citro - CPLOL, Professional Practice Commission, Paris, France
Pinar Ege - CPLOL, Professional Practice Commission, Paris, France
Objective: The economic situation working group was established in May 2012 within the Professional Practice Commission. The purpose of the group was to gather data on SLT practice in
relation to the economic situation in member countries. The study was devised to ultimately reach
the SLTs in each country, to investigate their financial situation, financial support available to them
and how they can achieve the most efficient practice within the confines of their means. This pilot
study was conducted by the delegates of the Professional Practice Commission.
Methods: A questionnaire was prepared by the working group to investigate issues, such as the
position of the SLTs within the system, the referral system in their country, available governmental
and/or private insurance coverage, employment opportunities for the SLTs, what SLTs think about
some of these issues, etc. While some questions required multiple choice answers, some were
open-ended and required lengthy responses by the SLTs. The questionnaire was sent to the members of the Professional Practice Commission. Their answers will be analyzed and reported in this
study. Subsequently, the questionnaire will be proposed to all SLTs in all member countries.
Results: This study will shed light on the economic situation in each member country in relation to
the practice of SLTs. The results will be informative about the similarities and differences among
the countries in terms of economic tools and opportunities available to the professionals, how the
situation in each country can be altered to improve economic and assessment/treatment efficiency, how the SLTs view the situation they are in.
Conclusions: Sharing the results by all concerned parties in each country, might improve the collaboration between public and, private institutions and SLTs for the benefit of all European citizens.
Keywords: Professional practice, efficiency, economic situation
20.5
LOGOPEDIA PROLINGUA: INTERDISCIPLINARY PROJECT FOR
PROMOTION, INNOVATION AND INTERNATIONALIZATION OF SLT IN
SPAIN
Lidia Rodríguez-Garcia - Faculty of Speech and Language Therapy, University of Castilla-La Mancha, Talavera-Toledo, Spain
Objective: Logopedia Prolingua is an innovation project to promote internationalization of SLT in
Spain. It is a multidisciplinary and inter-university project, coordinated by the University of Valladolid and the University of Castilla-La Mancha. Among its purposes: To promote international and
multilingual dimensions in SLT initial training in Spanish Higher Education.
Methods: The project is structured in three phases and five work packages, according to Netques
Project in which we have participated. WP1: Coordination. WP2: Prolingua languages. WP3:
89
Prolingua Mobility. WP4: Institutional Prolingua. WP5. Exploitation. The project has received
partial financing, supported by: Proyectos de Innovación Docente, 2013-15, Vicerrectorado de Innovación. Universidad de Valladolid, Spain.
Results: For two years we have developed different actions. First of all the active participation
of two Spanish universities in Netques Project, coordinated by CPLOL. Speech and Language
Therapy Meetings have been celebrated in the University of Valladolid and University of CastillaLa Mancha. In addition, two subjects were taught in the English language: (1) English for SLT, VU,
and (2) Designing materials for Speech and Language Therapy, UCLM. Different actions in coordination with professionals and scientific institutions have been developed. Regarding the mandatory work students have to elaborate in order to get their Degree in SLT, bilingual dimensions for
final SLT projects have been introduced. Moreover, integration of students from abroad has been
facilitated. Finally, a further dimension of internationalization has been created in the Spanish Association of SLT, that is, the Vice-presidency of International Relations.
Conclusions: During the 2013-14 academic year, the use of professional SLT terminology has
been promoted in SLT students. Active, interprofessional and motivated teamwork has been consolidated. To promote the international dimension of the participant universities, more institutional
support is required.
Keywords: Innovation project, SLT higher education, SLT meetings, international relations
20.6
INTERPROFESSIONAL EDUCATION TODAY FOR THE HEALTH
PROFESSIONALS OF TOMORROW
Claudy Cobben-Crefcoeur - ZUYD, University of Applied Sciences, Heerlen, Netherlands
Objective: A project team of the Faculty of Health at Zuyd University of Applied Sciences (The
Netherlands) developed in a systematic way a frame work for interprofessional education (IPE)
competencies. They are the basis for interprofessional education within all the health programs
(nursing, speech therapy, occupational therapy, physiotherapy, medical technology, arts therapy
and midwifery) at Zuyd. In 2015 these IP competencies will be implemented step by step into all
health programs.
Methods: The IPE project team executed all preparatory work during two years. In line with the
Model of Implementation (R.Grol & M. Wensing, 2006) a bottom up implementation plan was
made up. This implementation plan guides the project team and the staff as well in a substantial
and consequent way. All the project steps will be explained and illustrated.
Results: An IPE competency framework that consists of so called “Zuyd Building Blocks”.
These blocks represent all the competencies (knowledge, skills and attitudes) you may expect
from a health professional (for example, speech therapist) for tomorrow. They will be implemented
within several health programs at Zuyd University to equip future professionals in a sound manner.
The speech therapy program is one of the early adapters of these competencies.
Conclusions: The need for (health) professionals with interprofessional knowledge, attitudes and
skills is articulated by health organisations all over the world. Good practices show how it could
be or how it should be. Nevertheless it is not an easy project to implement these competencies
within several health programs of Zuyd University of Applied Sciences in a satisfactory way. It
requests a sustainable approach, longterm vision, teamwork, team joy and perseverance. But it is
worth it.
Keywords: Interprofessional education (IPE), health professional, future professionals
90
21.1
COMMUNICATION DISORDERS IN TRAUMATIC BRAIN INJURY
Zahra Ghayoumi - University of Social Welfare and Rehabilitation, Tehran, Iran
Fariba Yadegari - University of Social Welfare and Rehabilitation, Tehran, Iran
Behrooz Mahmoodi-Bakhtiari - University of Tehran, Tehran, Iran
Objective: As discourse production is a sophisticated linguistic and cognitive task, it is usually expected that individuals with traumatic brain injury (TBI) show difficulties in this aspect of
communication. So, clinical examination of discourse has become a useful tool for evaluation of
communication skills after the TBI. There are some different genres of discourse. Among them,
persuasive discourse is considered to be a more cognitively demanding task. However, there is a
lack of studies in the area of persuasive discourse in adults with TBI.
The aim of this study was to evaluate the performance of adults with TBI on a task of spoken persuasive discourse to determine impaired linguistic measures.
Methods: 13 TBI non-aphasic Persian speaking persons aged 19-40 years (age mean: 25.54;
months post-onset mean: 25.75; days of coma-mean: 56.15; GCS mean: 8.23; MMSE- mean:
26.77) and 20 adults matched by age were included in the study. None of the participants had a
history of psychiatric or neurological illness, except their TBI. The spoken persuasive discourse
task was performed by asking all participants to express their opinion on a topic. Analyzing the
discourses, the two groups were compared on some measures of micro- and macrolinguistic
aspects.
Results: The TBI group produced significantly different discourses in terms of evaluated measures
of microlinguistic and macrolinguistic compared to the control group.
Conclusions: As it is important to consider discourse impairment of brain injured persons along
with their other clinical impairments and considering the fact that persuasive discourse is crucial
in academic and social contexts, the persuasive discourse task could be a useful tool for speech/
language pathologists wishing to evaluate communication disorders in individuals with TBI.
Keywords: Traumatic head injury, acquired communication disorders
21.2
SCREENING OF COGNITIVE COMMUNICATION DISORDER IN
PATIENTS WITH EXECUTIVE DYSFUNCTION
Julia Buettner - Department
of Speech and Language Therapy & Faculty of Linguistics, Hospital for Neurology
and Rehabilitation Schoen Klinik Bad Aibling & Ludwig Maximilians University of Munich, Munich, Germany
Objective: Cognitive Communication Disorders are characterised by inconclusive discourse
behaviour and text coherence. Impairments are linked to dysfunction in executive abilities and
can affect daily living. The purpose of this study was a) to correlate the interaction of executive
functions and results of a newly developed text screening tool (MAKRO), b) to compare patients’
MAKRO scores versus healthy controls and c) to evaluate a treatment approach based on individual screening results.
Methods: In a prospective cohort study (n=41) patients’ MAKRO scores were compared to those
of matched healthy controls and correlated with cognitive abilities of the executive system, such
as planning (Tower of London, ToL), working memory and verbal fluency. The patients suffered
from traumatic head injury or cerebrovascular disease with damage to the (pre)frontal lobes. In
addition, a subgroup (n=8) received a 3 week training focusing on improvement of macrostructural
planning and monitoring abilities.
Results: Patients performed poorer than controls on the screening results (z= -5,33, p< 0.001).
91
Those with better preserved executive abilities showed lesser impairments on the discourse level.
The ToL had the strongest impact on the production tasks. After treatment, the patients significantly improved both in terms of planning abilities and MAKRO results (z= -2,37; p< 0.05).
Conclusions: MAKRO allows not only for the distinctive screening of higher-linguistic abilities, but
also provides effective treatment approaches in patients with executive dysfunctions.
Keywords: Traumatic head injury, cognitive impairment
21.3
READING SKILLS IN INCARCERATED ADULTS: THE ADULT
READING QUESTIONNAIRE AS A SCREENING TOOL FOR SPECIAL
NEEDS EDUCATION
Arve Asbjørnsen - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Terje Manger - Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
Ole-Johan Eikeland - Eikeland Education and Research, NA, Bergen, Norway
Objective: The prevalence of learning challenges are increased among incarcerated adults and
reliable screening procedures for special learning needs are important for guidance and program
planning. The Adult Reading Questionnaire (ARQ) was developed to assess reading and spelling
skills in adults at risk of dyslexia with focus on the four factors Reading, Word finding, Attention
and Hyperactivity. The main objective of the present study was to test if the ARQ is useful as a
screening tool for reading and spelling skills among incarcerated adults, and to assess if it could
reliably identify adults with dyslexia.
Methods: 1541 incarcerated adults (5.4 % females) completed a Norwegian translation of the
ARQ as a part of a survey of basic skills, educational needs, and motives for education. Dyslexia
had been diagnosed in 29 % of the participants.
Results: The ARQ yielded a Cronbach’s α of 0.88, which reflects that the scale may contain more
than one factor. The four factor model yielded acceptable model fit, but a simplified model yielded
better fit, and reliably differentiated between participants with and without a dyslexia diagnosis
(specificity = .80; sensitivity =.65).
Conclusions: The ARQ appears to be a valid and reliable screening procedure for reading skills
for adults, but further validation studies are needed. The first experiences with the test items in
Norwegian are promising, and the ARQ appears to be a valuable screening procedure. As the
ARQ has yielded similar results in a UK sample, the scale seems to be of value independent of
language.
Keywords: Dyslexia, adult education, special needs assessment, prison education
21.4
ASSISTIVE TECHNOLOGIES DURING THE SPEECH THERAPY
TREATMENT OF PATIENTS AFFECTED BY DEMENTIA
Alessandro Croce - Università degli Studi di Torino, Torino, Italy
Federica Polato - Università degli Studi di Torino, Torino, Italy
Rossella Muò - ASL TO1, Dipartimento di Riabilitazione, Servizio di Logopedia, Torino, Italy
Patrizia Steni - ASL TO1, Dipartimento di Riabilitazione, Servizio di Logopedia, Torino, Italy
Objective: To evaluate the effectiveness of the use of Assistive Technologies (AT) during treatment
of patients affected by chronic progressive cognitive impairment (CPCI).
92
Methods: Case series study on 12 patients. Inclusion criteria: medical diagnosis of CPCI or mild
cognitive impairment, age <90 years and aided by cooperative caregiver.
Exclusion criteria: comorbidity with psychiatric disorders, not reactive to CPCI.
To ensure the adequacy of the matching process between patient and AT, as well as the related
post-delivery services (training and monitoring), the recommendations of Assistive Technology
Assessment Process (Scherer, 1998) were complied with. Specific standardized instruments were
used to assess the care needs of patients, their predisposition to the use of AT and the therapy
outcome (in terms of QOL improvement).
Results: The main areas of intervention concerned the support to memory, communication skills
and leisure through the use of computing devices like PCs, tablets and smartphones. The adopted protocol proved to be useful and applicable and the outcome assessment instruments showed
good levels of satisfaction with the aid proposed. However, the QOL improvement detected was
minimal. The short period of time available for training and monitoring, and incomplete compliance to the project by some caregivers, had a negative impact on the results.
Conclusions: The study confirmed the efficacy of AT in improving the QOL of patients and has
proved the importance of using standardized and validated tools to support clinicians in all stages
of treatment in order to achieve high standards of intervention.
Keywords: Neurodegenerative disorders, cognitive impairment, psychiatric disorders
21.5
WORKING MEMORY AND SYNTACTIC CAPACITY IN ALZHEIMER’S
PATIENTS
Frédérique Gayraud - Laboratoire Dynamique du Langage, CNRS & Université de Lyon, Lyon, France
Camille Frouin - Laboratoire Dynamique du Langage, CNRS & Université de Lyon, Lyon, France
Objective: The objective of this study was to examine the relationship between working memory
and the ability to repeat sentences of varying complexity in Alzheimer’s patients. Although Alzheimer’s patients’ syntactic capacity is relatively preserved (Kempler, Curtiss, & Jackson, 1987),
sentence production undergoes simplification due to their reduced working memory capacity
(Kemper et al., 1993). Relative clauses, especially center-embedded object relative clauses are
known to be very complex because (i) they disrupt the subject of the main clause and its verb,
and (ii) disrupt the canonical order of the sentence.
Methods: 30 French-speaking Alzheimer’s patients and a control group matched for age, sex and
education level participated in the study. Short-term and working memory scores were collected.
Participants were also asked to repeat 24 sentences of varying complexity (1 or 2 clause(s), word
order, type of branching), strictly controlled for length, frequency and AoA.
Results: The percentage of correctly repeated sentences was significantly lower in patients compared to controls. In addition, working memory scores were significantly correlated with sentence
repetition scores, but only for center-embedded relative sentences or those involving non-canonical word order. No significant correlation was observed for simple or completive sentences. In
addition we qualitatively analyzed the simplification processes used by the patients.
Conclusions: In conclusion, we discuss the various methods used to assess working memory as
well as the sentence repetition task to assess syntactic capacities in Alzheimer’s patients.
Keywords: Working memory, syntax, Alzheimer’s disease, speech production, sentence repetition
task
93
21.6
ALZHEIMER’S DISEASE: ECOSYSTEMIC THERAPY OF
COMMUNICATION DISORDERS, BEHAVIOUR DISORDERS AND THE
PRESCRIPTION OF NEUROLEPTICS
Thierry Rousseau - Laboratoire Unadréo de Recherche Clinique en Orthophonie (LURCO), Université d’Angers, Sablé sur
Sarthe, France
Harmonie Génot - DUEFO et Laboratoire Unadréo de Recherche Clinique en Orthophonie (LURCO), Université Paris VI Pierre et
Marie Curie, Paris, France
Camille Huaut - DUEFO et Laboratoire Unadréo de Recherche Clinique en Orthophonie (LURCO), Université Paris VI Pierre et
Objective: Behaviour disorders of Alzheimer’s patients are often very perturbing, as they may be
due to the patient’s isolation and of medication which has undesirable effects. These behaviour
disorders may equally be related to factors related to the illness itself, or to environmental factors.
What could the effect of an ecosystemic therapy of communication disorders have on the behaviour disorders and the prescription of neuroleptics?
Methods: 36 institutionalized patients were distributed randomly into two equal groups in terms of
impairment, each composed of 1 mildly impaired, 3 moderately impaired and 14 severely impaired
patients. The patients of one of the groups received an ecosystemic communication therapy for
5 months. The weekly sessions were set to facilitate and enable language emissions according
to the patients’ remaining capacities, as well as to optimize their communication environment,
adapting the communication situations, the themes of discussions and the behaviour of the
people interacting with them.
Results: Unlike the control patients, those who benefited from speech and language therapy had
enhanced communication skills both quantitatively and qualitatively according to the GECCO.
Despite these results, the size of the sample and the duration of the study do not allow statistical
objectivity of the role of ecosystemic therapy on the behaviour disorders nor on the prescription of
neuroleptics.
Conclusions: This study shows the significance of speech and language therapy with regards to
the cognitive stimulation, moral support, well-being, pleasure and the communication skills of Alzheimer patients, as well as its significance for the family environment and the caregivers. In order
to validate these results statistically, a study should be conducted on a wider group of individuals
and for a longer period of time.
22.1
BEHAVIORAL AND COGNITIVE PATTERNS OF SOCIAL (PRAGMATIC)
COMMUNICATION DISORDER
Giovanni Masciarelli - LOGOGEN, Center for SLT and Neuropsychological Rehabilitation, Rome, Italy
Enrico Lurato - LOGOGEN, Center for SLT and Neuropsychological Rehabilitation, Rome, Italy
Maria Rosa Paterniti - Corso di Laurea in Logopedia, Università degli Studi di Palermo, Palermo, Italy
Objective: Social (pragmatic) communication disorder is a new diagnosis of the DSM V characterized by significant problems using verbal and non verbal communication for social purposes. This
study has been conducted in order to investigate what behavioral and cognitive features are common or different between individuals with the same disorder.
Methods: Nine multiple single-cases were studied: three preschool children, three school aged
children and three adolescents. Each participant was assessed with a standardized
comprehensive battery of cognitive and learning tests and with the Children’s Communication
94
Checklist – second edition (CCC-2).
Results: All subjects showed a significant difference between verbal IQ and performance IQ with
specific deficits in verbal abilities associated with pragmatic impairment. All subjects showed impairments on measures of syntactic comprehension and in making inferences from oral discourse
but, intriguingly, the results in naming and verbal fluency tests were in the normal range. Half of
the subjects showed impairment on measures of verbal working memory, but all subjects obtained results in the average range on measures of visual and spatial abilities. From an academic
point of view, our subjects showed a deficit in reading comprehension, even if half of the subjects
showed normal values on measures of accuracy and fluency of reading. Spelling errors were present in three of the six subjects, but all subjects showed a deficit in math problems and on speed
of calculation, even if not all subjects showed evidence of procedural deficit in mental and written
calculation.
Conclusions: Results are convergent with the idea that the core deficit of social pragmatic communication disorder is in the social use of language, however different pathological patterns may
be expressed. Practical implications of these results are discussed in a rehabilitation perspective.
Keywords: Pragmatic language impairment, verbal comprehension, executive functions, learning
disabilities
22.2
EARLY COMMUNICATION IN CHILDREN WITH AUTISM SPECTRUM
DISORDER AND IN TYPICALLY DEVELOPING CHILDREN
Objective: To explore similarities and differences in the characteristics and complexity of early
communicative behaviour of children with autism spectrum disorder (ASD) and typically developing children. Diversity and complexity of communicative functions and forms was studied.
Methods: 20 subjects, aged between 1.5 and 4 years, of which 10 have ASD and 10 are typically
developing, were filmed during unstructured interaction and play with the parent. Groups were
matched according to gender and expressive vocabulary size, estimated with the MacArthurBates Communicative Development Inventories. The collected corpus of spontaneous utterances
and communicative acts was transcribed and analysed with regard to the type and frequency of
different communicative functions directed towards a parent during 15-minute play. Additionally,
the diversity and number of communicative functions and forms, expressed during everyday communication was assessed by a structured questionnaire presented in the form of parental
interview.
Results: Results show many quantitative and qualitative differences in the initiation of communication as well as in the number and type of communicative functions and means of communication produced by these two groups of subjects. Pattern of communicative functions/speech acts
in the group of children with autism differs from that of typically developing younger children of
similar expressive language level.
Conclusions: Analysis of functional language use already at the early stages of language acquisition can significantly contribute to the early recognition of autism spectrum disorder.
Keywords: Autistic spectrum disorders
95
22.3
PRAGMATIC COMPETENCE IN CHILDREN WITH NOONAN
SYNDROME, MEASURED WITH THE CCC-2 QUESTIONNAIRE
Magnhild Selås - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Noonan syndrome is a relatively rare syndrome caused by mutations in the RAS/mapk-pathway in
the cell signaling system, giving a wide range of medical and psychological symptoms like stubbornness, irritability, and communication problems (Pierpont, Tworog‐Dube, & Roberts, 2013).
This paper presents parts of a larger study, focusing on different aspects of linguistic abilities
among 15 children aged 6-15 with Noonan syndrome (NS). Here, the results from the pragmatic
part of the study are presented. The parents of the participants have filled out the Children’s Communication Checklist, second version (CCC-2)(Bishop, 2003). The CCC-2 calculates ten scores
and two composite scores: a social interaction deviance composite (SIDC) and a general communication composite (GCC). These results from these two composite scores show that there is
no typical linguistic behavior among children with NS. Using only the linguistic scores to make a
pragmatic composite, shows that all but one of the participants have pragmatic competence below average. The findings indicate that there is not one linguistic profile including all of the participants, but that it is common to show poorer pragmatic skills than typically developing children.
Bishop, D. V. (2003). The Children’s Communication Checklist: Harcourt Assessment London.
Pierpont, E. I., Tworog‐Dube, E., & Roberts, A. E. (2013). Learning and memory in children with
Noonan syndrome. American Journal of Medical Genetics Part A, 161(9), 2250-2257.
22.4
LANGUAGE DEVELOPMENT IN CHILDREN AGED 7 TO 11 YEARS
OLD WITH AUTISM SPECTRUM DISORDERS: A CROSS-SECTIONAL
STUDY
Francesca Pevere - Associazione “La Nostra Famiglia”, Pasian di Prato, Udine, Italy
Andrea Marini - Università degli Studi di Udine, Udine, Italy
Objective: To describe the structural language skills, on production and comprehension, of children aged 7 to 11 years old with autism spectrum disorders (ASD) and global and performance IQ
above 85. Finally this cross-sectional study will support the hypothesis of an overlap between the
etiology of speech and language impairments (SLI) and ASD.
Methods: Children aged 7 to 11 years old with autism spectrum disorders (ASD group, n=35),
with global and performance IQ above 85, were compared to peers with normal development
(group C, n=70). The production and comprehension of the children’s language, on lexical, grammatical and pragmatic-narrative levels, was assessed using the Batteria di Valutazione del Linguaggio in età evolutiva BVL 4-12 (Marini et al., in press). The sub-tests of non-words repetition
(NWR) and the mean length of utterance (MLU) were considered as indices of language maturation.
Results: The two linguistic maturation indices considered (NWR and MLU) demonstrate a significant language impairment of ASD compared to group C. The three language levels (lexical, grammatical and pragmatic-narrative) and the two modalities (production and comprehension) analyzed are more compromised in children with ASD than those with normal development.
Conclusions: This research highlights a faithful correspondence between the indices of linguistic
maturation and the performances achieved on language tests, in children with an SLI phenotype.
The ASD group obtained significantly lower performances than group C both in the NWR and
96
MLU. Consistent with this finding, the performances of the ASD group showed deficits on the lexical, grammatical and pragmatic narrative levels, both in production and comprehension.
Keywords: Autistic spectrum disorders, specific language impairment
22.5
INTENSIVE INTERACTION IN SPEECH THERAPY: EVIDENCE
OF INTENSIVE INTERACTION USE IN CHILDREN WITH AUTISM
Ioannis Vogindroukas - Medicopedagogical Center, Psychiatric Hospital Thessaloniki, Thessaloniki, Greece
Nikolaos Chelas Evripidis - REIST, Ioannina, Greece
Konstantinos Paparizos - REIST, Kastoria, Greece
Kristia Christou - Orizontas, Limasol, Cyprus
Objective: Intensive Interaction (II) was developed by teachers Dave Hewett and Melanie Nind
(at Harperbury Hospital School) for people with severe learning disabilities who are socially withdrawn, or who appear unable to understand or enjoy human social interaction (Nind & Hewett
1994). Intensive Interaction was developed alongside the idea of ‘Augmented Mothering’, first
put forward by psychologist Dr Gary Ephraim whilst working at Levensden Hospital in the 1980s
(Ephraim 1982). According to the British Institute of Learning Disabilities ‘Intensive Interaction is a
fun process. The communication partner is guided by what we know about how communication
ordinarily develops for young children. S/he applies this knowledge in a way that is sensitive and
respectful to the person with learning disability, whatever their age’ (www.bild.org.uk).
Methods: The fundamentals of the approach and the quantitative and qualitative results of using II
in 3 children with autism in Greece are presented in this workshop. Video recording is used for the
analysis of the results and a discussion about the cultural differences, the frequency of the sessions and collaboration with parents will take place.
Results: Recently the II approach is widely used in children with autistic spectrum disorder and
there is considerable research evidence about the positive outcomes of using the II approach
(Watson & Knight, 1991; Nind, 1996; Lovell et al, 1998; Kellett, 2000; Cameron & Bell, 2001; Kellett, 2003; Kellett, 2004; Kellett, 2005; Leaning & Watson, 2006 ; Barber, 2008; Samuel et al, 2008;
Zeedyk et al, 2009a; Zeedyk et al, 2009b; Argyropoulou, & Papoudi, 2012). Our results show the
increasing of collaboration, social interaction, eye contact and speech use.
Conclusions: The II is a suitable method for children with autism spectrum disorder.
Keywords: Intensive Interaction, autism, speech therapy
22.6
SPEECH AND LANGUAGE THERAPY AND MUSIC THERAPY: USING A
COLLABORATIVE APPROACH TO DEVELOP ATTENTION AND
COMMUNICATION SKILLS IN YOUNG PEOPLE WITH AUTISTIC SPECTRUM DISORDER AND LEARNING DISABILITIES
Helen Sutherland - East London Foundation NHS Trust, Child Health HQ, Edgware Community Hospital, London, United Kingdom
Alexandra Georgaki - Mapledown School, Claremont Rd, Cricklewood, Mapledown School, London, United Kingdom
Objective: To explore how collaborative Speech and Language Therapy (SLT) and Music Therapy
can promote attention and communication skills in young people with a diagnosis of Autistic
Spectrum Disorder (ASD) and severe learning difficulties.
97
Methods: An informal pilot project was completed in July 2014, trialling a collaborative approach
between Speech and Language Therapy (SLT) and Music Therapy, using specific therapeutic
practises from both fields. Techniques included rhythmic tapping, singing (of pre-composed and
improvised material) and story-telling. Informal observations indicated areas of particular benefit
for participants, warranting further in-depth research which is currently being undertaken.
The therapeutic method is being replicated with data collection taking place at baseline and
post-therapy phases. The Pre-Verbal Communication Schedule (PVCS) is being used to measure
communication skills. Video recording is being used during each therapy session to enable more
extensive descriptive and qualitative analysis. The period of therapy will last 10 weeks, and is due
to be completed in December 2014. The participants are a small group of Year 7 students (N=4)
with ASD and severe learning difficulties.
Over the course of the therapy programme, a structure of activities will be developed which, along
with appropriate training, can be given to teaching staff to enable them to carry out similar work in
the classroom under the guidance of therapists in the school.
Results: Data from the pilot project indicated improvements in the areas of:
1. Language awareness, which includes:
a.Awareness of vocal sounds;
b.Awareness that vocal sounds carry meaning; and
c.Acknowledgment and response when anticipated vocal sounds are absent.
2. Attention;
3. Anticipation; and
4. Increased vocalisation.
This study is gathering more in-depth data to measure changes in these aspects, and any additional areas of development.
Work on this project to date indicates that teaching staff who are supporting students during
therapy sessions are demonstrating potential to continue similar work in the classroom, using a
specific structure of activities with training and guidance from therapists.
Conclusions: The preliminary conclusions arising from the pilot project data and work conducted
on this project to date are as follows:
1. Combined use of SLT and Music Therapy practices is effective in improving communication
skills in students with ASD and severe learning difficulties. Joint commissioning of services for this
client group should be considered during service planning.
2. Particular therapeutic practices are well-suited to collaborative SLT and Music Therapy work.
These practices have core similarities, examples of which include:
a.The use of rhythmic cuing
b.The use of voice for communication or as a sensory tool, or both. This is seen in the
SLT’s use of prosody during story-telling and the Music Therapist’s use of melody, pitch,
timbre, volume etc. during singing.
c.The principles of mirroring and inclusion, whereby therapists acknowledge and include
verbal and non-verbal actions of the students, and incorporate these into the group
activity (e.g. during musical improvisation and during inclusive story-telling).
3. Analysis of the fundamental similarities between SLT and Music Therapy practices used during
the sessions against areas of observed progress can yield information about underlying mechanisms of change and inform clinical practice in both fields.
4. The therapeutic activities can be introduced to appropriately trained and experienced teaching
staff as a specific structure of activities to carry out in class. As well as supporting generalisation
of skills for students post-therapy, this has implications in extending the benefits of this approach
to a wider group of students e.g. those on the waiting list for therapy. Further research exploring
longer term outcomes for students who receive this support post-therapy is indicated.
Keywords: Speech and Language Therapy, Music Therapy; collaborative working, Autistic Spectrum Disorder, communication, attention
98
WORKSHOPS
99
W1
PARENT TRAINING EFFICACY: A CONTROLLED STUDY ON FAMILIES
OF DEAF COCHLEAR-IMPLANTED CHILDREN
Gabriella Traisci - Department of Sense Organs, Università “La Sapienza”, Roma, Italy
Ersilia Bosco - Department of Sense Organs, Università “La Sapienza”, Roma, Italy
Raffaella Citro - Private Practice, Salerno, Italy
Maria Nicastri - Department of Sense Organs, Università “La Sapienza”, Roma, Italy
Sara Panizzolo - Azienda Ospedaliera dei Colli, Ospedale Monaldi, Napoli, Italy
Monica Rea - Department of Clinical Psychology, Università “La Sapienza”, Roma, Italy
Objective: To assess the efficacy of a training course aimed to enhance the communication skills
of normally hearing parents with their deaf children.
Methods: Before and after attending a parent training course, 5 families of 5 deaf implanted children were assessed using the Parent Stress Index and the Parents Preference Test. Children’s
oral language comprehension and production was evaluated using the MacArthur-Bates Communicative Development Inventory. The course followed the It takes Two to Talk model. Families
took part in 12 sessions, focused on empowering parents’ responsiveness, while reducing inappropriate directive and controlling interactions. 5 families of 5 deaf implanted children, matched
for gender, chronological age, hearing age and linguistic skills with the children of the experimental group, formed the untrained control group.
Results: A reduction of the two dimensions that express the difficulty to relate to their own child
was found through the PSI in trained mothers, while incrementing in the mothers of the control
group. A higher level of flexibility in fathers and contingency in mothers was recorded in the
trained group through the PPT. Language increased more in children of trained families than in
children of the control group.
Conclusions: Although considering limits due to the very small sample, parents seem to benefit
from a well-designed training, where they can learn successful strategies to empower their skills
and promote communication. This is in line with international evidences on parent training. The
research of the more effective modalities to actively involve parents in their deaf children’s rehabilitation process must be a common effort by all clinicians to allow any child achieve the best
possible outcome.
Keywords: Hearing impairment
W2
“CHE BELLA GIORNATA”: A NEW HABILITATIVE TOOL FOR INFANTS
AND TODDLERS WITH HEARING LOSS
Ersilia Bosco - Department of Sense Organs, University ‘Sapienza’, Rome, Italy
Letizia Guerzoni - ENT Department, “G da Saliceto” Hospital, Piacenza, Italy
Maria Nicastri - Department of Sense Organs, University ‘Sapienza’, Rome, Italy
Ilaria Patelli - ENT Department, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
Christine Rocca - Mary Hare School, Mary Hare School, London, United Kingdom
Gabriella Traisci - Department of Sense Organs, University ‘Sapienza’, Rome, Italy
Objective: To show the implementation of a rehabilitation tool “Che bella giornata!”, that takes
advantage of the playful aspects of music and songs, to help both professionals and parents to
develop listening and communication skills of infants and young toddlers with hearing aids or cochlear implant, during their daily interactions and routines; to assess the preliminary impact of the
100
new tool on parents and children.
Methods: Four Centers cooperated to implement “Che bella giornata!” The tool is directed at
children aged 3 to 36 months and structured in three parts: (1) an illustrated book that narrates the
child’s daily schedule with songs for each fundamental routine; (2) activities and simple games
suggested for each moment selected for infants (3-18 months) and toddlers (19-36 months), to
guide parents and professionals to effectively communicate during the day with their children; (3)
a section containing simple and clear descriptions of the normal steps that each child follows
during his growth and checklists to monitor the child’s progress and discuss it with professionals.
A questionnaire was implemented to measure the ease, the perceived benefit, acceptance and
satisfaction of the tool which was filled out by parents of 20 deaf children after tool’s use.
Results: All parents expressed high levels of satisfaction in tool use and the progressive increase
of the children’s engagement in daily interactions throughout the months.
Conclusions: “Che bella giornata!” is well accepted. Parents express the usefulness of the tool
when considering the natural use of music and songs during the interaction with their children, in
improving their mode of communication with children during the day and in having a clear idea
and certainty about what they are doing and which will be the next step in the normal developmental stages, consequently allaying their anxiety and their demands on the child.
Keywords: Deaf, infant, toddler, daily routine, music
W3
A CROSSLINGUISTIC STUDY OF PHONOLOGICAL DEVELOPMENT:
RESEARCH FINDINGS AND TOOLS FOR SPEECH THERAPY
May B. Bernhardt - School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
Daniel Bérubé - Faculty of Education, Université de St.-Boniface, Winnipeg, Canada
Inger Lundeborghammarström - KE/Dpt of Neuroscience/ Division of Logopedics, Linköping University, Linköping, Sweden
Martina Ozbic - Pedagoška fakulteta, University of Ljubljana, Lljubljana, Slovenia
Joseph Stemberger - Department of Linguistics, University of British Columbia, Vancouver, Canada
Objective: An international crosslinguistic study on phonological development has two objectives:
(1) to document phonological acquisition of word structures, consonants and vowels in children
with typical versus protracted phonological development (TD, PPD), and (2) to develop assessment tools in a variety of languages for elicitation and analysis of speech samples for intervention
planning.
Methods: A nonlinear phonological framework provides a focus on a child’s strengths and needs
across the phonological hierarchy, from the phrase to features. The research teams: (1) developed
speech elicitation tools of 100 words per language; (2) collected and transcribed audio-recorded
data from preschoolers (TD, PDD); and (3) utilized software (Phon) to analyse data.
Results: Results show that children are subject to similar phonological constraints across languages. However, the inventories of the language (word length, stress, syllable structure, consonants, and vowels) and the relative frequencies of structures and phonemes provide different
opportunities for mismatch (error) patterns.
Conclusions: Two authors will present research findings; the other two will demontrate the assessment tools and introduce a webinar on speech sample analysis and creation of fun-ological
therapy activities. Distribution of project tools and findings will be discussed.
Keywords: Phonological development, nonlinear phonology
101
W4
BUILDING RESEARCH CAPACITY IN SLT ACROSS THE EU THROUGH
MENTORSHIP: A NEW STRATEGIC APPROACH
Hazel Roddam - University of Central Lancashire, Preston, United Kingdom
Mette Thomsen - University College Capital, University, Copenhagen, Denmark
Objective: The Evidence-Based Practice agenda poses significant challenges for Speech and
Language Therapists (SLTs) in clinical practice. In addition to skills for understanding and implementing research, SLTs face many gaps in the evidence base e.g. normative data sets for speech
acquisition in many languages and intervention studies validated for local populations. At the
same time SLTs across EU have developed effective ways of working in their own settings that
may merit systematic evaluation. Supporting clinicians to undertake service evaluation and smallscale research is advocated as a way of building capability for individuals as well as capacity for
the profession. Models of mentorship are recognised as an effective way to establish baseline
competences for individuals to engage with the research agenda. This workshop aims to explore
the potential for a cross-EU network of SLT researchers and clinicians to trial and evaluate models
of research mentorship.
Methods: This session will open with illustrative examples of regional and national research
mentorship. We will adopt a structured process (adapted Nominal Group Technique) for a consensus priority-setting exercise. Participants will contribute to an options mapping activity, including
prioritising the action points generated by the group.
Results: The workshop discussions will be recorded as a full list of items and agreed priorities for
future action.
Conclusions: The workshop output will comprise recommendations for research mentorship,
including proposals for a relevant role for CPLOL to facilitate this.
W5.1
EARLY PREDICTIONS OF DEVELOPMENTAL DYSLEXIA. FROM THE
BERGEN LONGITUDINAL DYSLEXIA STUDY
Turid Helland - The Bergen Logopedic Research Group, University of Bergen, Bergen, Norway
Frøydis Morken - The Bergen Logopedic Research Group, University of Bergen, Bergen, Norway
Objective: The Bergen Longitudinal Dyslexia Study followed children at risk of dyslexia and
matched controls from when they were 5-15 years old. Main aims: (1) to identify early at-risk factors; (2) to assess brain function and neurocognitive skills in different phases of literacy development; (3) to assess the effect of evidence-based literacy training.
Methods: Parents and pre-school teachers of 109 children completed a research-based risk index
questionnaire (RI-5), allowing the identification of an at-risk and a control group. Selected participants were followed longitudinally, and were subjected to literacy and neurocognitive tests. A
subgroup was also brainscanned. There were three intensive training periods during the first three
years. At 11, the children could be regrouped into dyslexia/typical.
Results:
- RI-5 correlated significantly with literacy tests at 8 and 11 years, L2-tests at 11 years and grades
in L1, L2 and mathematics at 15 years.
- An equal number of boys and girls developed dyslexia, but early signs were less obvious in the
girls.
- Brain networks associated with language and attention showed different activation patterns in
102
at-risk/dyslexia groups than in controls/typical readers.
- Visual memory and language processing skills in kindergarten/first grade and verbal long term
memory in second/third grade predicted later literacy skills.
- The dyslexia group reached the lower end of the normal range, indicating that the training had
effect.
Conclusions:
- Risk of dyslexia can and should be identified at an early age.
- An identified risk of dyslexia must be met with evidence-based literacy training.
- Any teacher suspecting a child of having dyslexia must immediately initiate assessment and
intervention.
Keywords: Dyslexia and specific developmental learning disorders, screening, prevention, specific language impairment
W5.2
PREDICTING DYSLEXIA FROM A QUESTIONNAIRE GIVEN
TO CARETAKERS OF FIVE-YEAR OLD CHILDREN
Turid Helland - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Lise øen Jones - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Frøydis Morken - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Marte Røssland - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Line Amundsen - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Wenche A.Helland - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Objective: The present study focused on the RI-5, which proved to be a valid predictor of developmental dyslexia, cp the Bergen Longitudinal Dyslexia Study (Helland, Plante & Hughdal, 2011).
A risk index is calculated on the basis of information on health, laterality, motor skills, language,
special needs education, and heritage in 5-year old children. Our aims were (1) to replicate the
original RI-5 findings; (2) to match with the Children’s Communication Checklist, 2nd edition
(CCC-2) and the observation tool Early registration of language skills (TRAS). We hypothesized
that the RI-5 would identify about 20% of the children to be at-risk of developmental dyslexia, and
that in essence the three tools would identify different language problems.
Methods: 81 RI-5 questionnaires of 33 girls and 48 boys were completed by parents and preschool teachers. On the basis of the cutoff scores used in the longitudinal study, an at-risk group
of 6 girls and 8 boys (17%) was identified.
Results: The RI-5 results compared to our earlier findings of a significant difference between the
at-risk group and the control group (p<.001), and of a similar caretaker response patterns. Furthermore, although there was a moderate covariance between the scores of the three assessment
tools, at large they identified different risk groups.
Conclusions: RI-5 seemed to define children at risk of dyslexia in a reliable way across a time
span of 10 years. The three assessment tools complemented each other for a clinical first step
mapping of five-year olds with possible developmental verbal or literacy problems, with an expected lower percentage defined as impaired after individual assessments.
Keywords: Screening, prevention, developmental language disorders, dyslexia and specific developmental learning disorders
103
W5.3
EARLY REGISTERING OF LANGUAGE SKILLS IN 5-YEAR-OLDS
Lise Jones, Turid Helland - University of Bergen, University of Bergen, Bergen, Norway
Lea Garsol - University of Bergen, University of Bergen, Bergen, Norway
Steffen Nilsen - University of Bergen, University of Bergen, Bergen, Norway
Wenche A. Helland - University of Bergen, University of Bergen, Bergen, Norway
Objective: This study focuses on language skills of five-year-olds in Norwegian kindergartens by
using the screening instrument TRAS (Early registration of language skills). The study examines
central areas of language that have been shown to be important in language development. The
study analyses gender differences, and differences between a risk and control group within these
areas. Furthermore, the study analyses how children with low scores on TRAS are within the risk
limit of the instruments The Children’s Communication Checklist Second Edition (CCC-2) and Risk
Index by the age of 5 (RI-5).
Methods: 94 children from 16 kindergartens in Bergen municipality participated in the study. The
sample included 56 boys (59.4%) and 38 girls (40.6%). The average age of the children was 62.9
months. A TRAS risk group was identified by using the 15 percentile (N=13) with a control group
consisting of children over the 15 percentile matched on gender and native tongue.
Results: Within linguistic awareness, the difference was significant in favor of the girls. Between
the risk and control group there were significant differences within the subcategories communication, attention, language comprehension, and word and sentence production in TRAS. Moderate significant correlations were found between TRAS and CCC-2 (r=.47**) and TRAS and RI-5
(r=.46**). A Chi-Square test revealed that a low score in TRAS predicts that the children also are in
the risk group of CCC-2, while the association was not significant for RI-5.
Conclusions: Boys had in general poorer results than girls on TRAS. The analyses show that a
low score in TRAS predicts that the children also are in the risk group of CCC-2, while this association was not significant for RI-5.
Keywords: Language development, specific language impairment, preschoolers, gender differences, early mapping
W5.4
INVESTIGATING COMMUNICATION IN 5-YEAR-OLDS
Wenche A Helland - Section of Mental Health Research, The Bergen Logopedic Research Group, University of Bergen/ Helse
Fonna Hospital, Stord/ Bergen, Norway
Lise Ø Jones - The Bergen Logopedic Research Group, Department of Biological and Medical Psychology, University of Bergen,
Bergen, Norway
Kjersti B Vasshaug - The Bergen Logopedic Research Group, Department of Biological and Medical Psychology, University of
Bergen, Bergen, Norway
Synnøve T Fisketjøn - The Bergen Logopedic Research Group, Department of Biological and Medical Psychology, University of
Bergen, Bergen, Norway
Turid Helland - The Bergen Logopedic Research Group, Department of Biological and Medical Psychology, University of Bergen,
Bergen, Norway
Objective: This study is part of a research project assessing language and communicative competence in Norwegian five-year-olds using two questionnaires and one observation scheme completed by parents and teachers. The present study focused on the results from one of the questionnaires: the Children’s Communication Checklist, Second Edition (CCC-2; Bishop, 2011), which
aims to identify children with communication problems regarding structural or pragmatic aspects
of language.
104
Methods: The sample consisted of 99 children (60 males; 39 females) recruited from different kindergartens in a major Norwegian city. The CCC-2, TRAS (Early registration of language) and RI-5
(Risk index by the age of 5) were completed by caretakers.
Results: Twenty three children were identified as language impaired (LI): nineteen children displayed difficulties with the structural aspects of language and four children had a language profile
indicating pragmatic language impairment. The LI group scored significantly lower than the rest
of the sample on an overall measure of communication, the General Communication Composite
(GCC), as well as on all the subtests of the CCC-2. No significant differences were found between
boys and girls on the GCC. However, in the LI group the majority were boys. Children with Norwegian as their first language scored significantly better than children with Norwegian as their second language. A significant correlation was found between the three instruments CCC-2, TRAS
and RI-5.
Conclusions: A relatively large group of children was identified with communication problems
as measured by the CCC-2. Combining the three instruments, CCC-2, TRAS and RI-5 could be
effective in identifying children who are suspected of a broad spectrum of language problems.
A further individual assessment would presumably result in a lower percentage being defined as
impaired.
Keywords: Language impairment, CCC-2, 5-year-olds, pragmatics
W5.5
THE LINGUISTIC COMPETENCE OF CHILDREN BORN WITH CLEFT
LIP AND PALATE MALFORMATION
Åse Sivertsen - Haukeland University Hospital, Bergen, Norway
Nina Helen Pedersen - Statped Vest, Bergen, Norway
Turid Helland - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Objective: This is an interdisciplinary study aiming at getting a better understanding of speech
production and perception of children born with cleft lip and palate malformation. This study
wants to broaden the field of study from articulation to speech production and –perception.
Methods: The children in the study are six years old and have either cleft lip or cleft palate, or a
combination of these. They have been tested with articulatory tests (Svante-N), linguistic tests
(CELF-4), cognitive tests (Raven’s matrices, Rey Osterrieth complex figure test), laterality tests
(Aston index), dichotic listening, parental reports about communication (Children’s Communication Checklist- 2nd version) and dyslexia (RI 5), and information about additional medical diagnoses. The study wants to invite all the children in West Norway born in autumn 2008 and spring
2009, with all categories of clefts.
Results: This paper will present preliminary results of this study, focusing on the results from the
CCC-2 and CELF-4.
Conclusions: The aim is to get a better understanding of the complexity of difficulties these children may face, to give them the best treatment possible.
Keywords: Cleft lip and palate malformation, speech production, speech perception
105
W6
PARENTAL GUIDANCE AS PART OF STUTTERING THERAPY OF
YOUNG CHILDREN: JUSTIFICATION, CONTENT, ORGANISATION AND
EFFECTS
Ronny Boey - Centre for Stuttering Therapy, Antwerp, Belgium
Objective: To present a parental guidance program as part of a social cognitive therapy for stuttering children: justification, content, organisation and effects.
Methods: (a) an analysis of parental reactions of 1549 stuttering children and the impact on the
stuttering behavior of the child will be taken as data to justify the need of a parental training program. (b) Based on the principles of behavior learning processes (conditioning and modeling) the
content of the program will be clarified. (c) Measures and reports of effects will be reported.
Results: About 200 groups of 4 or 5 couples of parents were given a parental guidance program.
Measures and reports indicate the effects on (a) the stuttering behaviour of the child, (b) the influence on precipitating factors, (c) on the environment and (d) on the parental behaviour itself.
Conclusions: Stuttering treatment for young children needs a parental guidance program to be
effective and efficient.
Keywords: Parents, parental guidance
W7
SOUND LEVEL CALIBRATION OF AUDIO RECORDING SYSTEMS FOR
CLINICAL VOICE AND SPEECH ANALYSIS
Background: Sound level/intensity is a crucial acoustic aspect of the voice/speech signal. However, it is important that sound intensity measures of clinical audio recording and analysis systems are calibrated based on the output of a sound level meter, for them to be considered valid
and reliable. The current study was designed to evaluate the accuracy, validity and feasibility of
calibration methods including audiometric speech noise signals and human voice signals under
typical speech conditions. This workshop covers the outcomes of this study and demonstrates
the calibration methods.
Method: Calibration consisted of comparisons between the data from measurement microphoneand-computer and the data from sound level meter across twenty-nine recording systems using
signal-specific comparison with natural voice at three levels. Intensity measures from the recording systems were then linearly converted into calibrated data based on these comparisons, and
validity and accuracy of the calibrated sound intensity were investigated. How to calibrate according to this method will be shown during the practical part of the workshop.
Results: Between the calibrated data and the sonometer data across recording systems, very
strong correlations and quasi-similarity were found. Participants to the workshop will be able to
interpret the outcomes of the calibration method.
Conclusions: Calibration of clinical sound intensity measures according to the method presented
in this workshop is feasible, valid and accurate.
106
W8
THE ACQUISITION OF ADDITION ELEMENTS IN TYPICAL
DEVELOPMENT AND AS PART OF ARITHMETIC DIFFICULTIES
Anne-Françoise de Chambrier - Unité d’Enseignement et de Recherche en Pédagogie Spécialisée (UER PS), Haute Ecole
Pédagogique (HEP) du Canton de Vaud, Lausanne, Suisse
Pascal Zesiger - Logopédie, Faculté de Psychologie et des Sciences de l’Education (FPSE), Université de Genève (UNIGE),
Genève, Suisse
Objective: Difficulties in memorizing and recovering arithmetic skills are considered as one of
the most reliable signs of dyscalculia (Geary, 1993). Nevertheless, many studies on the acquisition of arithmetic in typically developing child (TD) show that the results of simple additions are
rarely fully recovered, or are only for some kinds of calculations (those ones having a sum under
10, Barrouillet & Lépine, 2005; the doubles, Groen & Parkman, 1972), or just in relatively older
children (10-11 years, Barrouillet & Fayol, 1998). Moreover, studies on this issue use very different methods, both for the arithmetic tasks and for the scores used, which makes the setting of
benchmarks for TD children very difficult. At the same time, it is remarkable that there is relatively
poor information available on arithmetic evidence used in the logic-mathematical assessments,
despite the role played by arithmetic disorders (AD) in the literature on dyscalculia. It seems therefore important to set clearer benchmarks on typical arithmetic learning and on those aspects that
differentiate AD children from their TD peers.
Methods: To this purpose a longitudinal study was conducted, comparing 53 TD children and 24
AD children in second grade (CE1).
Results: The results show that for simple additions, the TD students still frequently use calculating
strategies with digital support, while AD children show a very significant delay in adopting different strategies.
Conclusions: We will discuss the different results of this study that will enable clinicians to complete their logic-mathematical assessments through quantitative and qualitative observations on
arithmetics.
Keywords: Dyscalculia, arithmetic skills, typical and atypical learning
W9
ASSESSMENT OF DYSARTHRIA
Simone Knuijt - Radboud University Medical Centre, Nijmegen, Netherlands
Hanneke Kalf - Radboud University Medical Centre, Nijmegen, Netherlands
Objective: Speech-language therapists (SLTs) need to recognize and interpret the speech characteristics of dysarthric patients correctly to diagnose the type and severity of dysarthria, resulting in
the right choice of treatment. However, the clinical judgment of dysarthric speech is highly subjective and the reliability of perceptual judgments is typically low. In the Netherlands, we recently
developed, validated and published the Dutch Dysarthria Assessment (DDA), based on internationally agreed speech tasks, in order to standardize and improve the assessment of dysarthrias.
In addition to the instrument, videos and consensus-based descriptions of the type and severity
of 40 dysarthric patients are made available as a training tool for SLTs and students. Repeated
experiments showed that training with these videos is indeed necessary to improve perceptual
judgments of SLTs.
Methods: A consensus-based and evidence-based workshop on dysarthria assessment for SLTs
with some or advanced experience with dysarthric (adult) patients.
Results: This workshop will contain a demonstration of the DDA, its score form and the
107
presentation of several videos of dysarthric patients based on the assessment’s protocol. The aim
is to discuss the speech characteristics and dysarthria type and severity of patients with different
dysarthrias and also different languages, to generate an international training in the assessment of
dysarthric speech.
Conclusions: Perceptual dysarthria assessment is difficult, but by watching, listening and discussing many different types of dysarthria, SLTs can improve their diagnostic skill.
Keywords: Dysarthria, assessment, perceptual judgement
W10
CLINICAL SUPERVISION VS MENTORING: SUPPORTING SLP
UNDERGRADUATE, GRADUATE STUDENTS AND CLINICAL FELLOWS
Maria Christopoulou - European University of Cyprus, Nicosia, Cyprus
Learning Objectives: Upon completion of this course, participants will be able to: (1) Differentiate between feedback and evaluation; (2) Identify their primary role in the supervisory process; (3)
Employ various forms of feedback in their supervisory and/or mentor roles; (4) Supervisors and
mentors will self-evaluate their own supervision.
Methods: (1) Overview of the continuum of supervision; (2) Roles of clinical supervisors and mentors; (3) Use of feedback and evaluation; (4) Use of questions to guide student learning; (5) Generational considerations; (6) Roles and responsibilities of university faculty; (7) Supervision selfevaluation tool; (8) Questions and discussion.
Results: Clinical education and supervision of undergraduate and graduate students in the field of
speech-language pathology is an integral part of every university speech and language program.
Supervisors from the community offer guidance and support in helping graduate students to
become competent professionals. Clinical Fellow Mentors help new SLPs transition from being an
undergraduate/graduate student to an independent professional. However, most clinical supervisors and CF mentors have had little or no education in the area of clinical supervision. Supervision
is recognized as a distinct area of professional practice with its own set of knowledge and skills
(by ASHA).
Conclusions: This workshop will provide support and information for SLPs in the community who
are currently supervising students or who are considering supervising students. It will give SLPs
an overview of the important tools needed to undertake this professional responsibility.
Keywords: Supervision, adult focus, pediatric focus, mentoring, feedback, evaluation, self- evaluation, continuum of supervision, supervisory process
W11
HIERARCHICAL COGNITIVE-LINGUISTIC TRAINING IN ACQUIRED
NEUROLOGICAL CONDITIONS: THE CATEGORIZATION PROGRAM
Fofi Constantinidou - Center for Applied Neuroscience & Department of Psychology, University of Cyprus, Nicosia, Cyprus
Objective: Semantic organization and categorization is a basic cognitive skill present in all activities of daily living. It is essential for language, memory and learning, problem solving, and
decision-making. In this workshop we will present the theoretical framework that supports the use
of categorization training as part of a systematic cognitive-linguistic treatment program designed
to improve semantic organization in patients with acquired neurological disorders. We will present research from two different types of groups of patients: young adults with acquired brain
108
injury and older adults with mild cognitive impairment. Our clinical trials in TBI demonstrated that
categorization training is an effective tool to remediate cognitive-linguistic deficits in residential
rehabilitation (Constantinidou, Thomas, Best, et al., 2005; Constantinidou, Thomas, & Robinson,
2008). However, categorization training has not been implemented with adults with cognitivelinguistic deficits resulting from mild cognitive impairment (MCI) or early stages of dementia. The
purpose of our most recent study was to test the hypothesis that a systematic cognitive training
with the Categorization Program (CP) will improve neuropsychological performance in adults with
MCI.
Methods: The CP is a systematic hierarchical training program starting from concrete tasks and
progressing to more abstract skills. It addresses the two areas of categorization: recognition and
categorization of everyday objects; and new category learning and decision making. Outcome
measures include three categorization tests (CP Test 1, 2 & 3) and 4 probe tasks (to check generalization of skills) along with extensive neuropsychological battery. In our most recent study,
fifteen participants with MCI and fifteen healthy older adults completed the program to date
(average age = 71.70, SD = 4.47; average education = 9.20 years, SD = 4.47, range = 5 - 19)
completed the CP. All participants received 3-4 hours of cognitive treatment per week for 10-12
weeks.
Results: MANOVA analyses resulted in significant gains on the CP Tests, demonstrating improvement in the ability to describe objects (F = 21.90, p = .002) and to identify common traits between
objects and extract organization rules (F = 6.56, p = .031). Participants also demonstrated significant gains in generalizing abilities to new tasks across time (F = 10.95, p = .005), which followed a
linear trend (F = 30.70, p = .000).
Conclusions: The preliminary findings suggest that systematic cognitive training implementing
the CP protocol could be a useful and feasible tool for the training of categorization skills in older
adults with MCI in community settings. The present findings add to the growing line of research
supporting the use of categorization training in cognitive-linguistic treatment across the lifespan.
The workshop will conclude with implications for rehabilitation services provided by SLT.
Keywords: Rehabilitation, cognitive-linguistic training, brain injury, dementia, aging
W12
CPC&C (CREATIVE PC AND COMMUNICATION): A CREATIVE WAY OF
USING PC AND OTHER SIMILAR TOOLS WITH CHILDREN WITH ASD
Luciano Destefanis - S.C. NPI, C.A.S.A., ASL CN1, Regina Montis Regalis Hospital, Mondovi’, Italy
Elena Danna - S.C. NPI, C.A.S.A., ASL CN1, Regina Montis Regalis Hospital, Mondovi’, Italy
Objective: Among the criteria that define autism spectrum disorders is the qualitative impairment
in the area of communication. The most important of the need for parents of an autistic child is to
became able to communicate with him/her.
As one of the aspects of our practice is to help the development of communication skills and language in children with autistic spectrum disorder, the approach CPC&C consists of building small
software games - thanks to the use of authoring programs, often in real time with the child - and
share them with him. CPC&C also integrates the use of other software and tools already available
and coming with features that allow the modulation interaction, stimulate development, and lead
to the creation of an optimal situation for learning, giving the chance to develop and share systems of meanings and of signals.
Some of the properties that characterize CPC&C are: possibility of individualization, of help tuning, of software applications being created directly by operators, family members, and teachers in
cooperation with the child himself.
Methods: The CPC&C (Creative PC and Communication) has been growing, as a component of
the speech and language therapist’s work within a therapeutic model that combines a
109
cognitive-behavioral approach with a developmental, relationship-based one, in a multi-professional team context and in cooperation with the family and the school.
Results: So far the results of CPC&C, that look interesting from a qualitative point of view, have
been measured in the assessment of the skill evolution, related also to the application of other
tools and ways of treatment at the same time. A project to measure the outcomes which correlate
with CPC&C is being put to work.
Conclusions: CPC&C allows the creation of a ‘deeply adaptable’ environment in relation to the
autistic person, his characteristics of knowing the world, and his cognitive and representative style.
Keywords: Autistic spectrum disorders (ASD)
110
ROUND TABLE
DISCUSSION
111
EDUCATION ISSUES IN EUROPE:
CPLOL’S ROLE IN THE FORMATION OF GUIDELINES
Moderator: Maria Vlassopoulos, Greece
Discussant: Arlene Pietranton, United States of America
One of CPLOL’s main aims has been to monitor the development of educational programmes
throughout Europe, to record the wide range of educational practices in Europe and to promote
a common forum for discussion on qualifications across the continent. The Education Commission’s mission is to bear the standard for some of these challenges: to promote and maintain
quality standards in education of the profession, to create guidelines which may be utilized to
increase SLT educational standards and to disseminate information on best practice in the education of the profession.
In a widely diverse Europe with the coexistence of many countries with very different cultures,
languages and backgrounds in education and health, a constant vigil is needed in order to update
available information. Diversity has been the outstanding characteristic in the educational programmes: nevertheless, this diversity also has the benefit that it may yield innovation in the field
of education. The Education Commission through its Working Groups has taken up this challenge
by working on a wide range of significant issues, for instance, Minimum Standards in Education,
Forms of Clinical Practice, Specialization in SLT. Furthermore statistical surveying registers and
monitors changes within the various European educational establishments. The NetQues project,
which has recently been completed, has contributed towards the fine tuning of educational programmes throughout Europe.
The present Round Table aims to present some of the work in progress in the Education Commission: to address the methodology, to elicit a constructive critique, to present the challenges and
to envisage solutions, through which CPLOL can support and at the same time voice European
SLTs’ demand for high quality curricula in all educational establishments throughout Europe
RT1
DEVELOPING CLINICAL COMPETENCIES WITH MULTILINGUAL
POPULATIONS: FOCUS ON INITIAL SLT EDUCATION PROGRAMS
Mary Overton - CPLOL, Paris, France
Thora Masdottir - CPLOL, Paris, France
Anne-Lise Rygvold - CPLOL, Paris, France
Wiebke Scharff Rethfeldt - CPLOL, Paris, France
Irene Vernero - CPLOL, Paris, France
The goal of this Working Group is to set up an enquiry into how universities/higher education institutions’ SLT courses prepare students for future practice of multilingual SLT clients and their families. Information will be obtained by addressing representatives of initial education programmes of
all the member states to enquire how universities/higher education institutions (HEI) SLT courses
prepare students for future practice with language and communication disorders in multilingual
populations.
A questionnaire has been created which will be piloted in November 2014. The finalized questionnaire will be sent to selected HEI’s throughout Europe by January 2015. The responses from these
universities /HEIs will be analysed and a detailed index of course content and teaching methods
will be compiled.
Using the notion of EBP, following up on the NetQues enquiry, our practical goal is to conceptualize a work package containing useful resources, both academic and clinical, to help students
learn to become effective clinicians in providing clinical services for multilingual populations.
112
RT2
DIVERSITY IN TERMINOLOGY: IN QUEST OF A COMMON DENOMINATOR
Katarina Pavicic Dokoza - CPLOL, Paris, France
Katja Bucik - CPLOL, Paris, France
Marie-Claire Coets - CPLOL, Paris, France
Marleen D’hondt - CPLOL, Paris, France
Jean-Laurent Astier - CPLOL, Paris, France
Sarmite Tubele - CPLOL, Paris, France
Olga Havelkova - CPLOL, Paris, France
Dana Buntova - CPLOL, Paris, France
Daiva Kairiene - CPLOL, Paris, France
Carolina Bodea Hategan - CPLOL, Paris, France
Bence Kas - CPLOL, Paris, France
Terminologies in the SLT area (terms and definitions for particular conditions) have been extensively debated over the years. The paradigm of training in each country is an important element in
the approach to the terminologies that are adopted, and has been a major contributing factor to
variability in terminology. In many countries, terminology used is also influenced by the sector in
which SLTs work (e.g. health sector or education sector). So, the observed diversity in terminology
can cause misunderstanding within and between countries and between professionals within and
outside country borders. A Working Group commenced studying the diversity in terminologies
throughout Europe in order to make recommendations, which could be used by all professionals
across borders.
The WG started by studying the CPLOL website’s information under http://www.cplol.eu/profession/general-info.html. This information was found to be outdated and in need of revision. Progress in SLT science and practice has led to the expansion of SLTs’ areas of practice, as well as
changes in SLTs’ nomenclatures. Upon discussion it was decided that the WG’s goals would be
to contribute to the discussion on how to resolve the “problem” of terminology throughout Europe, to set up a questionnaire about the scope of practice and used terminology and to complete
the work with a recommendation for a new framework for the CPLOL website. The questionnaire
concerning the scope of practice of SLTs and terminology has been set up and sent to delegates
(Questionnaire relative to Terminology in Speech and Language Pathology within the European
Union). Through an analysis of the data from the questionnaires, the working group will provide
recommendations for a new framework for the CPLOL website.
RT3
INTERPROFESSIONAL EDUCATION PRACTICES IN SLT TRAINING
PROGRAMMES: WORKING IN PROFESSIONAL TEAMS TO MAXIMIZE
CLIENT PROGRESS
Fofi Constantinidou - CPLOL, Paris, France
Catherine Emmenegger - CPLOL, Paris, France
Alison Fuller - CPLOL, Paris, France
Nina Jordanova - CPLOL, Paris, France
Anneli Ojaste - CPLOL, Paris, France
Aim: To determine Interprofessional Education (IE) practices in SLT training programs. To identify
institutions offering IE in SLT education (graduate or post graduate) during academic and/or
113
clinical training and to make specific recommendations to improve IE training in SLT education.
Methods: The group has reviewed several European and North American resources available with
a focus on IE in SLT and in health allied professions. A survey was constructed to obtain information regarding IE from academic programs. The survey includes information about:
1. Terminology used to define IE
2. The course work that incorporates IE
3. Clinical training that facilitates IE
4. Recommendations for improving IE
Target population: The survey will be disseminated electronically to program directors around EU
nations.
Results and Conclusions: Survey analysis will include quantitative and qualitative methods. The
final product will include a report on the number of institutions in Europe that provide IE and the
type of IE opportunities (coursework and/or clinical training). It will conclude with practice recommendations to SLT programs in order to facilitate IE training and maximize communication among
team members to facilitate patient/client outcomes.
114
POSTER
PRESENTATIONS
115
P1.01
AUDITORY PROCESSING IN CHILDREN WITH LANGUAGE IMPAIRMENT
Helena Obucina - Private speech and language pathology practice ‘Blaži’, Zagreb, Croatia
Draženka Blaži - Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia
Marijana Balažinec - Private speech and language pathology practice ‘Blaži’, Zagreb, Croatia
Objective: Our goal is to determine whether there any differences in auditory processing ability
among children with language impairment, considering different subtypes of language impairments, and to confirm whether there any differences in auditory processing ability considering the
age of the examinees. We expect that the group of children with language impairment will have
significantly more difficulties in auditory processing ability, with respect to the control group, and
that auditory processing ability increases with the increase of chronological age.
Methods: In the analysis of the results basic statistical parameters were calculated and statistically significant differences were determined by t-test. The sample consists of 60 examinees divided
into experimental and control group. Experimental group consists of 30 examinees with the diagnosis of language difficulties, aged from 5;06 to 7;06. This sample is divided into three subgroups
– according to the chronological age and the type of language difficulties. Control group consists
of 30 children with normal language development matched with the experimental group according
to their age and gender. Control group sample was also divided into three subgroups – according to their chronological age. All children included in the research have normal intellectual status
without any confirmed additional difficulties.
Results: Results show that auditory processing ability is weaker among children with language
impairment. Also differences were shown with respect to gender and type of language impairment, but not considering the age of the examinees.
Conclusions: Analyzing the results we assume that there is a cause and effect relationship between the immaturity of the neurological system, lower auditory processing ability and the cause
of language impairment. The most discriminative were the subtests of dichotic listening which can
assess the neurological functions of the auditory system. Despite the probable connection between language impairment and auditory processing disorder, auditory deficit is not the only and
sufficient cause of language impairment.
Keywords: Auditory processing, language impairment
P1.02
PROVIDING ASSESSMENT TO MULTILINGUAL CHILDREN – COMMON
PRACTICES USED BY SPEECH-LANGUAGE THERAPISTS IN AUSTRIA
Michaela Brunner - FH JOANNEUM, Graz, Austria
Wiebke Scharff Rethfeldt - Logocom, Bremen, Germany
Objective: Research in literature shows that providing clinical assessment to multilingual children
with suspected primary LI is steadily increasing as are the caseloads of SLTs in Austria, which is
geographically situated in the center of Europe. Due to globalization and migration the percentage of patients who are multilingual and multicultural is constantly growing with nearly 20% of
the country’s population demonstrating a migration background. The increasing number of multilingual children has resulted in significant challenges to the provision of assessment services to
multilingual children who are at risk for primary LI. The lack of standardized assessment tools and
the variety of languages make it difficult for SLTs to conduct a proper assessment.
Methods: The current survey study sought to identify variables that influence SLTs’ use of evidence-based methods and their confidence in culture and assessment in order to identify
116
multilingual children with primary LI. The researchers created an online survey which was distributed to SLTs across Austria (n=81). Assessment strategies will be described and discussed in
consideration of the current state of the art.
Results: Regression analysis revealed a severe lack of knowledge and clinical practice with regards to assessment of multilingual children in SLT, that may result in allocation of misdiagnoses.
From the literature we know that several clinical markers that are appropriate to identify LI in
monolingual children are unsuitable for multilingual children. However, 74% of the participating
SLTs indicated a small lexicon in the child’s second language as an important clinical marker to
identify primary LI in multilingual children, next to other assumptions that may lead to misdiagnosis. One of the key features of this proposal are specialized tools and methods focusing on a
multilingual case history which, though available, still seems to be very little known. The main key
feature of this study is the focus on distinct clinical markers for identification of primary LI in multilingual children.
Conclusions: The results of the survey underline the demand for a profound and/or a revision of
initial SLT training including assessment instruments that are linguistically, culturally, and developmentally appropriate. This also accounts for CPD of SLTS. Finally, further research is needed in
order to assure an evidence-based practice.
Keywords: Assessment, clinical markers, multilingualism, primary language impairment
P1.03
LANGUAGE ABILITIES OF CHILDREN WITH DEVELOPMENTAL
STUTTERING
Ayse Aydin - Anadolu University, Faculty of Health Sciences, Speech and Language Therapy Department, Eskişehir, Turkey
Ramazan Sertan Özdemir - Anadolu University, Faculty of Health Sciences, Speech and Language Therapy Department,
Eskişehir, Turkey
The aim of this study was to compare differences among children with developmental stuttering,
children who recovered stuttering spontaneously and their age and gender matched peers with
typical development on standardized tests of expressive / receptive language in Turkish. Participants were 60 children between 3 -7 years old with developmental stuttering, 20 children who
recovered stuttering spontaneously between the ages of 5 and 7 and 60 age and gender matched
peers with typical development. In Study 1, language abilities of children with developmental
stuttering and their age and gender matched peers with typical development were compared.
In Study 2, language abilities of 20 children who recovered stuttering spontaneously and their
age and gender matched peers, who are still stuttering are compared. The differences between
groups are analysed with t-tests.
Keywords: Stuttering, language, spontaneous recovery
117
P1.04
NEUROSCIENCE AND THE PICTURE EXCHANGE COMMUNICATION
SYSTEM. LATEST STUDIES AND RESULTS OF WELL RESEARCHED
METHODS
Mario Montero Camacho - Pyramid Educational Consultants-Spain, UdG, Girona, Spain
Sonia Vilaltella Verdes - Pyramid Educational Consultants-Spain, UAB, Barcelona, Spain
Objective: To show that current neuroscience papers are showing the efficacy of the Picture Exchange Communication System (PECS) . To demonstrate that PECS has research-based benefits
on acquisition of speech, increasing social approach during play and reducing behaviour management target rates.
Methods: To share the findings of well-designed research comparing PECS and Pivotal Response
Training (PRT), School Based Studies (Pat Howlin), Paediatrics Summary review, evidence-based
practice (Odom & colleagues) and brain-based theories/models that suggest why PECS is effective.
Results: Latest papers on neuroscience are showing that PECS will help children to develop
speech, as well as other systematic approaches. For those children that will not develop speech,
PECS will already facilitate communication and hence the learning of new skills along with socializing and becoming independent, increasing, this way, social approaches during play and reducing behaviour management target rates. In sum, research also suggests stronger links between
speech development and PECS training versus other interventions
Conclusions: PECS has been presented as a treatment choice in neurorehabilitation for people
with autism, because it addresses the learner’s needs that fit with brain-based learner characteristics.
Keywords: Autism, early intervention, speech therapy, language disorders, communication disorders, applied behavior analysis, psychology, neuroscience, evidence-based studies
P1.05
THE ACQUISITION OF STOP AND TRILL CLUSTERS IN HUNGARIAN
Éva Tar - Department of Phonetics and Speech and Language Therapy, Eötvös Lorand University, Budapest, Hungary
B. May Bernhardt - School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
Joseph P. Stemberger - Department of Linguistics, University of British Columbia, Vancouver, Canada
Objective: The study sets out to compare the acquisition of word-initial /r/-clusters with singleton
trills in the speech of typically developing (TD) children and those with protracted phonological
development (PPD) in Hungarian.
Methods: Participants were 191 monolingual TD children between 3 and 6 years of age and 15
children with PPD (mean age 6;7) from two different areas of Hungary. A native speaker used a
picture-naming task to elicit speech samples with 11 /r/ targets (audio-recorded and transcribed
without diacritics). Data were analysed according to nonlinear phonological frameworks, in terms
of type and prevalence of mismatch patterns and match with adult targets (accuracy), both full
consonant match and timing unit match (presence of two consonants).
Results: For TD children, full match occurred for singleton /r/ at 5;0-5;5, and for clusters at 5;65;11. Mismatches for /r/ were mostly segmental errors, with variability noted in the younger
children. For the group with PPD, neither singleton /r/ nor the timing units for clusters matched.
Cluster mismatches entailed mostly deletion of /r/. The majority of children showed variability in
singleton /r/ production with some atypical segmental errors.
Conclusions: The study revealed various developmental phases related to constraints at various levels of the hierarchy of phonological knowledge. Development in children with PPD differed
118
from that of their same-age TD peers in both the level of mastery reached and, at least in part, in
mismatch patterns observed.
Keywords: Phonological development, nonlinear phonology
P1.06
USING AN ICF BASED CHECKLIST FOR SSD: APPLICATION TO A
CASE STUDY
Marisa Lousada - School of Health Sciences/ Center for Health Technology and Services Research (CINTESIS), University of
Aveiro, Aveiro, Portugal
Ana Margarida Ramalho - CLUL/CEL-UE, University of Lisbon/ University of Évora, Lisbon/ Évora, Portugal
Objective: Clinicians have limited time to analyse data and include ICF in their clinical practice.
Our proposal is to apply a new ICF based Checklist for SSD in a child with phonological disorder
using ICF codes related to language (codes that are not commonly used in phonologically based SSD).
Methods: After a literature review, the authors included several codes (body functions and structures, activity and participation, environmental factors) in the Checklist, to be used throughout the
clinical process i.e. from clinical history to intervention with SSD children.
Results: In some SSD sub-groups, where linguistic competence is affected (e.g. phonology), the
use of language related ICF codes is not common in assessment/analysis and intervention. However, once phonology is affected, the ICF descriptor mental functions of language (b167) should
also be used to classify some SSD sub-groups. In the case study presented we will show that the
code that better characterises phonological disorder is mental functions of language.
Conclusions: The use of ICF descriptors related to language when phonology is affected could facilitate the description of the underlying problem in some SSD sub-groups, promote an adequate
intervention using more appropriate approaches, and also have a better efficacy and efficiency for
treatment.
Keywords: Phonological disorders, ICF
P1.07
SPECIFIC LANGUAGE PROFILE FOR CHILDREN WITH AUTISM
SPECTRUM DISORDERS
Eveline Vogels - Arteveldehogeschool, Gent, Belgium
Ruth Vanderswalmen - Arteveldehogeschool, Gent, Belgium
Marleen D’hondt - Arteveldehogeschool, Gent, Belgium
Sabien Van Dycke - Arteveldehogeschool, Gent, Belgium
Objective: How specific are the language problems of children with an autism spectrum disorder
(ASD)?
Methods: Several studies have demonstrated poor language abilities in children with ASD. However the nature of these problems remains unclear. This study investigates the specific language
components in high functioning children with ASD. The participants (N= 77) were children aged 5
to 18 years with a clinical diagnosis of ASD without comorbid disorders. All children were tested
with the Clinical Evaluation of Language Fundamentals-4-dutch version (CELF-4NL), a test with
good psychometric value to assess language (Kort, Schittekatte & Compaan, 2003). The results
for receptive and expressive language as well as for content and structure of the language were
compared.
119
Results: Our data revealed that all children with ASD had an average (between -1SD and the
mean score) Receptive and Expressive Language index. The same was found for the Language
Content and Structure index. However, in line with previous studies, they all scored below the
thresholds (nearly -2SD) on the subtest Concepts and Following Directions.
Conclusions: This study revealed that children with ASD have severe problems following more
complex instructions (in long sentences), without having a more general language impairment.
The implications will be discussed.
Keywords: Autism spectrum disorders, language profile, CELF-4NL
P1.08
DEVELOPMENT OF EVALUATIVE COMMENTS OF NARRATIVES IN
FINNISH CHILDREN WITH SLI: AN INTERVENTION STUDY
Anne Suvanto - Faculty of Humanities, Logopedics, Child Language Research Center, University of Oulu, Oulu, Finland
Anneli Yliherva - Faculty of Humanities, Logopedics, Child Language Research Center, University of Oulu, Oulu, Finland
Matti Lehtihalmes - Faculty of Humanities, Logopedics, Child Language Research Center, University of Oulu, Oulu, Finland
Objective: Children with language impairment express less evaluative information in their stories
than typically developing peers. The purpose of the present study was to find out the effect of
nine months’ intervention on the expression of evaluative language in storytelling of children with
SLI aged 4–6 years.
Methods: The development of evaluative comments was assessed in three peer groups: SLI
children who got an intensive treatment, G1 (n=10) and control group with SLI children who got
traditional SLT once a week or less, G2 (n=8) and a group of typically developing comparison
group G3 (n=10). G1 children participated altogether in 40 speech therapy sessions (45 min each)
during 20 weeks. The goal of therapy was to improve a child´s vocabulary through the semantic
approach and to teach simple story structure through visual symbols. In addition, parents were
trained to use dialogic prompts while reading picture books to their children. Children´s storytelling with a wordless picture book was assessed five times during the study. All utterances were
transcribed and evaluative information was coded into six categories.
Results: Results showed that G1 children expressed more evaluative comments than G2 children
after intervention. The amount of evaluative comments increased 38 percent in G1 children after
intervention. The most common categories of evaluative comments were onomatopoeias, evaluative adverbs, references to emotional states or emotion verbs and character speech.
Conclusion: Intervention used in the present study seemed to have a positive effect on SLIchildren´s evaluative language during storytelling with a picture book.
Keywords: Specific language impairment, evaluative language, narration, intervention
120
P1.09
SYLLABLE SHAPES IN SLOVENIAN PRESCHOOL CHILDREN, AGED
FROM 2 TO 7 YEARS
Martina Ozbic - Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
Damjana Kogovšek - Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
Mojca Muznik - Osnovna Škola Kozara, Nova Gorica, Slovenia
Alja Marin - Zdravstveni Dom Maribor, Maribor, Slovenia
May Barbara Bernhardt - School of Audiology & Speech Sciences, University of British Columbia, Vancouver, Canada
Joseph Paul Stemberger - Department for Linguistics, University of British Columbia, Vancouver, Canada
Jerneja Novšak Brce - Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
Objective: The Slovenian language has several syllable shapes, from less complex as CV to more
complex as CCCV, both in initial, medial or final position, with consonants and consonant clusters
in onset and coda. The objective of the study is to describe and analyze the development of syllable shapes in Slovenian preschool speakers, based on a picture naming test.
Methods: 80 children, aged from 2 to 7 years, were asked to name a hundred pictures. Pictures
represented words with 1, 2, 3 and 4 syllables, with different syllable shapes, different syllable
stress patterns, with the whole set of Slovenian phonemes. Children were recorded, speech was
analyzed and transcribed with IPA symbols, and for further analysis Phon and Excel for windows
were used.
Results: The syllable shapes varied across age groups: as cluster reduction (-1 or -2 C) or syllable addition/cluster splitting because of epenthesis (+1 syllable or +1 V: i.e. ccv  cvcv). A more
detailed analysis will be shown for 1, 2, 3 and 4 syllable words.
Conclusions: Consonant clusters are a challenge for young children. Several phonological processes occur, among these cluster reduction and epenthesis. These phonological processes lead
to simplification of target words in two ways: a) by shortening words with the same number of
syllables or b) by lengthening words with simpler syllables shapes, including target C with epenthesis.
Keywords: Phonological development, protracted phonological development, phonological disorders, syllable shape
P1.10
AN INTERDISCIPLINARY PROJECT: PREVENTION FOR CHILDREN
WITH TRISOMY 21
Susanne Stoerch Mehring - University of Applied Sciences of Special Needs Education, Zurich, Switzerland
Christina Arn - University of Applied Sciences of Special Needs Education, Zurich, Switzerland
Objective: An interdisciplinary project: prevention for children with Trisomy 21. The aim of this
project was to offer children with Trisomy 21 an advancement in language and movement, based
on the theories of different authors in speech and psychomotor therapy.
Methods: Pilot Project – in context of prevention for a risk group, teaching students in a practical
situation and interdisciplinary cooperation (language and speech therapy & psychomotor therapy).
The method of ‘Movement fields’ focus: experimental confrontation with environment and selfactive experience in the context of movement and communication.
Results: The children with T21 show an observable progress in language and motor skills. The
family and the professionals of the children are more aware about language and motor skills, as
it is achieved by prevention. The benefits for the students are direct contacts and cooperation
121
between the students of SLT and PMT: to plan and to perform the therapy together. To learn about
the other theory concept and the different ways of working with children with T21.
Because of the fact that this is a pilot project, and we have no scientific support, our ‘results’ are
just observable. But the positive aspect of working directly together - as psychomotor and language and speech therapists - leads us to look forward to similar scientifically based projects.
Conclusions: Looking forward for more interdisciplinary and scientific supervised projects.
Keywords: Trisomy 21, prevention, interdisciplinary (language and speech therapy & psychomotor
therapy), practical project
P1.11
KIDS SOUND LAB: APP USED TO PROMOTE LITERACY SKILLS IN
AT-RISK CHILDREN
Bryndis Gudmundsdottir - Raddlist ehf. and Educational Office of Reykjanesbaer, Reykjanesbaer, Iceland
Children attending elementary school (School 1) at a reorganized former US Naval Air Station in
Iceland, have shown poor literacy preparatory skills and many speech errors, when starting 1st
grade. A special program with emphasis on articulation and phonological awareness was set up in
2012 to change the situation.
A special weekly program was implemented in the classrooms using the methodology of Kids
Sound Lab (KSL), including a new interactive approach with the App: Kids Sound Lab.
The teachers followed the “KSL approach” that is based on children’s developmental order of
speech sound acquisition. The program also includes all necessary preparatory phonological skills
for reading with special emphasis on phoneme awareness and correct articulation. A standardized
Icelandic pre- and post test (The Route to Literacy) revealed a significant difference in progress
over the 6 month intervention time. A correlational study was made and results compared with 3
other schools in the area to see if the progress made, was from the KSL program and not other
factors.
Results from pre- and post test scores from the 3 other local schools undergoing other conventional reading instruction, revealed that undergoing the Kids Sound Lab program, “children atrisk” in School 1 showed significantly greater progress than children in the other 3 schools using
other methods to teach reading.
The Methodology of Kids Sound Lab (Learning and Playing with Sounds) does promote literacy
skills in “at-risk children” in Iceland and is in correlation with other data that infer that children can
be taught very effectively if given the right stimulation and tutoring.
Keywords: Phonological disorders, dyslexia and specific developmental learning disorders,
screening, prevention
P1.12
DOMAIN OF MINIMUM CONTRASTS IN BRAZILIAN SIGN LANGUAGE
Diéssica Vargas - Universidade Federal de Santa Maria, Santa Maria, Brazil
Carolina Lisbôa Mezzomo - Universidade Federal de Santa Maria, Santa Maria, Brazil
Language, whether oral or gestural, is fundamental to the constitution of the subject and to the
communication of this with the people he socializes with. Thus, it emphasizes the importance of
investigating and analyzing the acquisition of Brazilian Sign Language (LIBRAS).
Purpose: To develop and implement an instrument of perception of minimal phonological
122
contrasts in LIBRAS, and investigate how the perceptual domain of minimal contrasts occurs.
Methods: We conducted a survey of the signs that varied on only one parameter, the criteria
for considering the child’s familiarity with the vocabulary and gestures were easy representations through drawings. The figures were arranged in cards, which were represented graphically.
Sample subjects are hearing children of deaf parents daughters therefore bilingual, aged 1-9 years
with an estimated total of at least 10 subjects. After every two months another sample was taken;
these children were followed for a period of one year.
Results: This work is an outline of a study that is still ongoing. To date, the instrument design was
already done. After the survey, the couple were sent to the judges with expertise in the area, who
analyzed if the minimal pairs were adequate. Then adjustments were made and the instrument
was administered. The age of onset and stabilization of perception of these minimum contrasts of
LIBRAS is still being checked.
Conclusion: It was found that the minimum contrasts in sign language, as well as oral language,
are of fundamental importance for the perception of that language. Furthermore, there seems to
be a difference in perception according to the parameter which is being investigated.
Keywords: Hearing impairment; developmental language disorders
P1.13
THE RELATION BETWEEN PLAY, PSYCHOMOTOR AND LANGUAGE
DEVELOPMENT IN PSYCHOLOGICAL RISK CHILDREN
Ana Paula Ramos de Souza - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Josiane Fernanda Vendruscolo - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Dani Laura Peruzzolo - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia, Universidade
Federal de Santa Maria, Santa Maria, Brazil
Francine Manara Bortagarai - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Objective: This work aims to analyze the play, psychomotor and language development of 16
infants with psychological risk, aged between 21 and 26 months.
Methods: Sixteen infants, detected as babies with psychological risk, were accompanied from 1
to 18 months with a developmental risk indices inventory. Between 21 and 26 months, they were
filmed in playful interaction with their mothers for 20 minutes through the provision of age appropriate toys. The recordings were analyzed through the behavioral observation protocol (PROC) for
cognitive categories, the inventory for object relations dimension (Graña, 2008), and by psychomotor development observation. The analysis included clinical observation, descriptive statistics
and comparison of the standard deviation to the reference values of the PROC test.
Results: We observed 14 subjects with transitional object relationships and two subjects with
fetish object relationships. Four of the sixteen subjects had language disorders, and these included the two subjects with fetish type impaired object relations. Also, this group of four subjects
showed the worst results in the cognitive dimension of play and the most significant psychomotor delay.
Conclusion: There was a significant relationship between the transitions of play in the cognitive
and psycho-affective dimensions and the presence of language disorder and psychomotor limitations.
GRAÑA CG. A aquisição da linguagem nas crianças surdas e suas peculiaridades no uso do objeto transicional: um estudo de caso. Contemporânea: psicanálise e transdisciplinaridade. Porto
Alegre, 2008, 5(1):143-153.
HAGE SRV, PEREIRA TC, ZORZI JL Protocolo de observação comportamental (PROC): valores de
referência para uma análise quantitativa. Rev CEFAC, São Paulo, 2012, 14(4):677-690.
123
P1.14
A MODEL FOR SPECIFIC DEVELOPMENTAL LEARNING DISORDERS
EVALUATION: A SINGLE CENTER EXPERIENCE
Elena Corbetta - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Pina Grossoni - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Laura Budelli - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Annalisa Maruca - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Andrea Calcaterra - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Cristina Del Pio - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Loredana Mecca - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Maria Rosa Ferrario - U.O.C. Neuropsichiatria Infantile, A.O. S.Antonio Abate, Gallarate, Italy
Objective: Specific developmental learning disorders (SDLD) are a class of disorders concerning
instrumental skills in learning, without affecting general intellectual functioning. SDLD incidence
ranges between 3 and 4% due to patient age and criteria applied by the examiner. Diagnostic
techniques improvements and research progress help to guarantee early diagnosis, however there
is no uniformity about diagnostic methods applied.
We describe a diagnostic method based on a preliminary speech language therapist (SLT) screening.
Methods: We studied 40 children (13 males, 27 females), attending primary or secondary school
with generic learning disabilities. Children had been preliminary tested by an SLT with a reading
text, a dictated track, and reading comprehension. Children who failed these tests underwent additional testing: an SLT investigated language development and reading and writing abilities with
words and non-words lists, while the psychologist evaluated IQ. Diagnosis of SDLD was based
on team discussion (neuropsychiatrist, psychologist, SLT) considering the results of the previous
tests.
Results: The mean age of the population examined was 8.4 ± 1.8 yrs. After the SLT screening
only 55% of the patients (n=22) needed additional testing. Among the children who underwent
in-depth analysis, the 54% (n=12) were classified as SDLD, while 23% (n=5) were diagnosed as
exhibiting intellectual disabilities or other developmental disorders. The other 23% (n=5) exhibited
non-specific learning disabilities, with an average IQ.
P1.15
PRELIMINARY OBSERVATIONAL STUDY OF COMMUNICATIVE
SKILLS IN CLEFT LIP AND PALATE INTERNATIONAL ADOPTED
CHILDREN
Elisa Monti - Regional Center for Cleft Lip and Palate - Smile House, A.O. San Paolo, Milan, Italy
Objective: At the Regional Centre for cleft children (Smile House, AO S. Paolo, Milan) since 2008
a substantial increase in arrivals of adopted children, mainly from China, has taken place. Due
to the authorization given by the Chinese government, from 2008 on, international adoptions are
possible with simplified procedures for the adopted special needs children. The 111 children,
whose first visit was between 2007 and 2014, show a very different linguistic and surgical history
from that of their Italian peers followed at the Smile House. Given the important relation already
studied in the literature between speech and language development in UCLP (Unilateral Cleft Lip
and Palate) and BCLP (Bilateral Cleft Lip and Palate) children, it was considered interesting to
investigate the history of the first communicative acts and speech skills in this population.
The aim of this study was to organize and describe the population of adopted children accessed
124
from 2007 to 2014 at the Smile House center of Milan, analyse the speech and language outcome
and find any statistical correlations between personal history, surgical approach and first communicative and speech abilities. Furthermore, a logopedic protocol for monitoring speech and
language in the adopted children with cleft lip and palate was established.
Methods: We selected 111 international adopted children with cleft palate with or without cleft
lip, aged between 24 months and 11 years and accessed at the Smile House Center at the San
Paolo’s Hospital between 2007 and 2014.
Results: Data from the medical records and surgical treatments were analyzed. To collect more
information about surgery, first communication abilities and their social and school skills, the
questionnaire “Questionnaire for parents of adopted children with cleft lip and palate” was implemented. To assess the first phonoarticulatory skills, a sample of 52 subjects suitable for age and
communication skills were evaluated with the GOS.SP.ASS. ’98 protocol. Statistical analysis was
performed using the nonparametric Spearman test in order to detect correlations between surgical time, adoption history, first communication abilities and phonoarticulatory skills.
Conclusions: This prospective observational study allowed us to describe the characteristics of
the adopted children. The age of adoption and surgical timing turned out to be important predictors for communication skills. Interpretation of the data allowed us to define a protocol useful for
collecting data on adopted children and monitor their communication skills from the moment of
their arrival in Italy.
This allowed a counselling training for parents and a more detailed follow-up over the first communicative skills that would be assessed between the age of 6 and 36 months through the “First
Vocabulary of the Child”. To assess the phonoarticulatory abilities at 36 months, it is necessary
to wait at least 6-8 months from their arrival in Italy in order to let the child achieve a good knowledge and comprehension of the Italian language. These data are collected using a sample of
spontaneous language during play and the GOS.SP.ASS. protocol.
Keywords: Cleft lip and palate children, international adopted children, speech abilities, first communication skills, cleft surgery, adoption age
P1.16
PREVENTIVE SPEECH-LANGUAGE ASSESSMENT FOR FIVE-YEAR-OLD
CHILDREN (PLP-5)
Mateja Gacnik - Centre for the Correction of Hearing and Speech Portorož, Faculty of Education, University of Primorska,
Portoroz, Slovenia
Nives Skamlic - CSGM, Maribor, Slovenia
Uršula Dular Kolar - ZGNL, Ljubljana, Slovenia
Mirjam Štok - CKSG Portorož, Portoroz, Slovenia
Lilijana Oberžan - CSGM, Maribor, Slovenia
Uršula Pintar - ZD Ljubljana, Ljubljana, Slovenia
Martina Ozbic - Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
Damjana Kogovšek - Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
Objective: In Slovenia, preventive assessment of speech, language and communication skills of
five-year-old children performed by a speech and language therapist (SLT) is regulated by law,
and represents an integral part of preventive healthcare. Early identification of speech, language
and/or communication delay or disorder at that age is important for the child’s overall development. Assessment requires a reliable, rapid and valid screening tool. In order to unify the assessment process, the screening tool, Preventive Speech-language Assessment for five-year-old
children (PLP-5), was developed and started to be implemented in 2014.
Methods: The authors of PLP-5 are SLTs, therefore, the screening was not developed only on
theoretical knowledge and past research, but is significantly based on clinical experience. During
the development and trial of a single task, each candidate item was evaluated and modified
125
several times. PLP-5 is individually administered and designed to enable SLTs to assess the
child’s comprehension, elicit a good speech sample in order to assess several speech and language modalities, socio-pragmatic skills and other language skills, for example verbal repetition
and syllable blending. The tool has not been standardized yet, however, evaluation criteria were
set on the basis of an extensive pilot study (N=191, age 4;10-5;07).
Results: Pilot data indicate that PLP-5 is a rapid, valid and reliable screening instrument. Cronbach coefficient (0.72) provides evidence for adequate reliability. Test administration takes 15-20
minutes; therefore screening is rapid and meets requirements for quick screening of a number of
children in a short period.
Conclusions: In September 2014 PLP-5 was put in use in clinical practice. Based on the results of
the pilot study and initial practical experiences with test administration, PLP-5 has been shown to
be a promising tool to identify children with an increased risk of a communication and/or speech
and language disorder and who therefore need further speech and language diagnostic
assessment.
Keywords: Screening, speech and language therapist, speech, language, communication,
five-year-old children
P1.17
THERAPEUTIC STRATEGIES FOR PATIENTS WITH LANGUAGE
DISORDERS BASED ON THE THEORY OF MULTIPLE INTELLIGENCES
Renata Gomes Camargo - Universidade Federal de Santa Maria, Santa Maria, Brazil
Introduction: Speech is an area of knowledge that brings many demands on the individual’s
performance by the complexity inherent in communication and by establishing an interface with
other areas of knowledge. Therefore, the need arises to approximate the studies conducted in this
field to others, in order to qualify to work with patients, among these being the Theory of Multiple
Intelligences.
Objective: To analyze the therapeutic strategies used in a Supervised Internship in Oral and
Written Language, held in a Serviço de Atendimento Fonoaudiológico (SAF), linked to a Federal
University in Brazil, focusing on the Theory of Multiple Intelligences.
Method: In the year 2013, therapeutic strategies and progress registered in 41 records of children
with language disorders treated at SAF were analyzed. We used a quantitative approach to research, from the statistical analysis of the 900 identifications of multiple intelligences in 562 therapeutic strategies, both for data description, as the realization of the Chi-square test and analysis
of residues of the same.
Results: The chance that their development is fully contemplated when the linguistic intelligence,
which is the verbal language, is crafted in therapy alone, without the association of other intelligences, is diminished. Still, intrapersonal intelligence, in relation to other intelligences, is the one
that provides increased opportunities to fully contemplate the development of linguistic intelligence when present in therapeutic strategies.
Conclusion: It is beneficial for the effectiveness of language therapy, to work with different therapeutic strategies that can mobilize other skills through multiple intelligences, beyond speaking,
reading and writing (linguistic intelligence).
Keywords: Language therapy, developmental language disorders, intelligence, speech, language
and hearing sciences
126
P1.18
THE INFLUENCE OF LEXICAL STRESS ON CHILDREN’S ACCURACY IN
NON-WORD REPETITION
Susan Richards - Centre for Neuroscience in Education, University of Cambridge, Cambridge, United Kingdom
Usha Goswami - Centre for Neuroscience in Education, University of Cambridge, Cambridge, United Kingdom
Objective: Non-word repetition is frequently used as a tool for assessing children’s language
competence and has been specified as a diagnostic clinical marker for identifying children with
specific language impairment (SLI). Our study set out to investigate the influence of the lexical
stress pattern of a given non-word on the accuracy of children’s repetitions.
Methods: 13 children with SLI and 24 age-matched typically developing (TD) children repeated an
experimental corpus of 72 non-words which varied systematically in number of syllables per word
and in the location of the stressed syllable. Children’s responses were transcribed and measured
for accuracy at word and syllable level.
Results: Children with SLI performed more poorly than controls at all word lengths. For three syllable words, the location of the stressed syllable affected word accuracy for children with SLI but
not TD controls, whereas for four syllable words, stress location had a significant effect for both
groups. There was no effect of stress location for either group for five syllable words. At syllablelevel, the relative position of each syllable within the word had a significant effect on syllable-level
accuracy for four and five syllable words, but not three. The stress status (stressed or unstressed)
of each syllable significantly affected syllable accuracy for three and four syllable words, but not
five.
Conclusions: Accuracy in non-word repetition for children with SLI and TD controls is affected
by a complex interplay of word-length, stressed syllable position and stress status for word and
syllable level measures. These factors affect children with SLI and TD controls differently across
wordlengths.
Keywords: Non-word repetition, specific language impairment, stress, prosody
P1.19
ASSERTIVE AND RESPONSIVE CONVERSATIONAL SKILLS OF
ITALIAN-SPEAKING LATE TALKING TODDLERS
Serena Bonifacio - Studio “Trieste”, Trieste, Italy
Luigi Girolametto - Department Speech-Language Pathology, Faculty of Medicine, University of Toronto, Canada
Elena Flaugnacco - Center for the Child Health - Onlus, Trieste, Italy
Objective: The aim of this study was to compare the assertiveness and responsiveness skills of
Italian-speaking late talkers with normative data from Le Abilità Socio-Conversazionali del Bambino (ASCB: Bonifacio, Girolametto, Montico, 2013), that is, the standardized Italian version of The
Social–Conversational Skills Rating Scale (Girolametto, 1997).
Methods: 83 monolingual Italian late-talking toddlers (51 M. and 32 F.) ranging in age from 24 to
36 months were identified as having fewer than 50 words on the basis of the PVB (Caselli et al.
2007). All children were within normal limits on non-verbal cognition and receptive language. The
ASCB includes 15 items that assess the child’s assertiveness and 10 items that assess the child’s
responsiveness.
Results: First, there was a significant difference between the late talkers and their typical peers in
terms of assertiveness skills. Overall, 79.5% of the late talkers displayed low ratings in the use of
this skill in interactions with parents. Second, there was a significant difference between the two
127
groups for responsiveness skills. In this case, 46.9% of the late talkers displayed low ratings in
their responsiveness within conversational interactions. Finally, none of the demographic measures (e.g., maternal education) were correlated with assertiveness or responsiveness measures.
Conclusion: The results of this study suggest that screening late talkers for pragmatic skills may
reveal important weaknesses in their social uses of language, which may require further assessment.
P1.20
ANIMAL-ASSISTED THERAPY: A PROPOSAL FOR LANGUAGE
INTERVENTION
Carolina Lisboa Mezzomo - Universidade Federal de Santa Maria, Serviço de Atendimento Fonoaudiológico, Santa Maria, Brazil
Diéssica Zacarias Vargas - Universidade Federal de Santa Maria, Serviço de Atendimento Fonoaudiológico, Santa Maria, Brazil
Paola Leonardi - Universidade Federal de Santa Maria, Serviço de Atendimento Fonoaudiológico, Santa Maria, Brazil
Purposes: To study Animal-Assisted Therapy (AAT) in the development of oral language by children with language disorder/delay, by investigating which linguistic components evaluated by the
Behavioral Observation Protocol obtained the best performances through this therapeutic procedure.
Method: Seven subjects, male and female, with ages from 6 to 10 years old, received at the
language sector in the clinic school, bound to a University were analyzed. They participated in a
group of Animal-Assisted Therapy in 2013/2014. To perform this study, the evaluation protocol
from the subjects’ records was used (PROC, Zorzi e Hage, 2004), with the purpose of collecting
data during therapy and verifying and comparing the linguistic progress during the period without
AAT (March 2012/March 2013) and with AAT (March 2013/March 2014). The statistical analysis
used the Wilcoxon’s Test, because the protocol scale is, mostly, ordinal.
Results: Concerning the comparison of the results which were obtained by the test in the 1st and
2nd evaluations (without AAT), it is observed that there is no significant difference between both
evaluations (p-valor>5%). In the comparison of the results obtained between the 2nd and 3rd
evaluations (with AAT), there was an observed significant difference for item 3.b (p-valor<5%). It
was also observed that almost all averages of the 3rd evaluation are higher than the average of
the 2nd evaluation. In the comparison between the 1st and 2nd evaluation and 2nd and 3rd evaluation, better performance in most items was observed, which was mainly in items 5, 12, 3, 6, 7,
which correspond to the communicative skills, means of communication, verbal means and levels
of language contextualization.
Conclusion: These results demonstrated that the AAT may help in the development and acquisition of several linguistic aspects. However, it is still necessary to perform more specific studies to
investigate these aspects in depth.
Keywords: Animal-Assisted Therapy, language therapy, language disorders, speech, language
and hearing sciences, child
128
P1.21
CROSSLINGUISTIC CHILD PHONOLOGY PROJECT - EUROPEAN
PORTUGUESE (CLCP-EP): ADAPTATION AND VALIDATION
PROCEDURES
Ana Margarida Ramalho - CLUL / CEL-UE, Universidade de Lisboa/ Universidade de Évora, Lisboa/ Évora, Portugal
Maria João Freitas - CLUL, Universidade de Lisboa, Lisboa, Portugal
Letícia Almeida - Université François-Rabelais, Tours, France
May Bernhardt - University of British Columbia, Vancouver, Canada
Joseph Stemberger - University of British Columbia, Vancouver, Canada
Objective: The goal of the poster is to describe the adaptation/validation procedures of a phonological assessment tool for European Portuguese (EP) as part of the Crosslinguistic Child Phonology Project (CLCP-EP).
Method: The tool is designed for children from age 3 to 7/8 yr. It includes 157 words (80% in an
EP children’s lexicon under age 3;0). A nonlinear phonological framework underlies the word selection, including variables: segmental inventory; syllable and word shape; word stress and length.
The validation study was a naming task (digitally presented and recorded) in a storytelling format
to check the adequacy of the pictures and the lexical items (28 children aged 3;3-6;1).
Results and current research: The storytelling format was effective. 120 words were named
spontaneously (75%). Changes were then made to some pictures and elicitation phrases, in order
to increase spontaneous naming to over 75%. Phonological data are now being collected from
100 children, 90 typically developing (30 each at ages 3, 4, 5) and 10 with protracted phonological
development.
Conclusions: It is the first EP NL based assessment instrument, rigorously controlled in a phonological way. Data collected since this pilot study (n=90) is being analysed in Phon. The final version (pictures, final word list, tests by age, manual) will be free and available by 2015.
Keywords: Screening, phonological disorders
P1.22
COGNITIVE LINGUISTIC AND SPEECH PRODUCTION MEASURES IN
SPEECH SOUNDS DISORDER
Haydée Fiszbein Wertzner - University of São Paulo, Department of Physiotherapy, Communication Science & Disorders,
Occupational Therapy. Faculty of Medicine, São Paulo, Brazil
Luciana de Oliveira Pagan-Neves - University of São Paulo, Department of Physiotherapy, Communication Science &
Disorders, Occupational Therapy. Faculty of Medicine, São Paulo, Brazil
Tatiane Faria Barrozo - University of São Paulo, Department of Physiotherapy, Communication Science & Disorders,
Occupational Therapy. Faculty of Medicine, São Paulo, Brazil
Objective: To verify the more appropriate cognitive linguistic and speech production measures to
identify children with speech sound disorder.
Methods: Participants were 40 children with speech sound disorders (Research Group-RG)
and 30 children with no speech and language impairment (Control Group-CG) aged from 5:1 to
7:11years. Cognitive linguistic measures analyzed were: PCC, PCC-R, number of phonological processes and the speech inconsistency classification (consistent X inconsistent children).
Speech production variables were: articulation rate (measured in phones per second in both short
and long sentences) and the number of absent sounds from the phonetic inventory.
Results: The logistic regression technique indicated that PCC was the cognitive linguistic measure that was mostly associated with the identification of the groups (p=0.012). The most powerful
129
speech production measure, indicated by the statistical test, was the number of absent sounds,
with 72.5% sensibility and 100% specificity. Spearman correlation test between the two measures
(PCC and number of absent sounds) was significant only for the RG (p<0.001).
Conclusions: The study indicated the Percentage of Consonants Correct (PCC) and the number
of absent sounds, as the most important measures to identify children with SSD. Results also
indicated that the PCC is directly associated to the number of absent sounds.
Keywords: Speech sound disorders, children
P1.23
PHONOLOGICAL AWARENESS: ON THE EMERGENCE OF
CONSTITUENTS IN EUROPEAN PORTUGUESE
Catarina Afonso - CLUL/FLUL, University of Lisbon, Lisbon, Portugal
Maria João Freitas - CLUL/FLUL, University of Lisbon, Lisbon, Portugal
Objective: Our goal is to identify the order of emergence associated with the awareness of phonological constituents (word, syllable, syllabic constituents, segments) in European Portuguese.
The subject is under debate since the 70’s and controversial data have been reported so far.
Methods: A segmentation task was used to test the awareness of the different constituents: 34
SVO sentences were segmented into words; 54 words were segmented into syllables; 35 disyllabic words were segmented into segments; 5 monosyllabic words were segmented into syllabic
constituents. The sample includes 48 monolingual Portuguese children: 21 1st graders (age average: 6;2); 27 3rd graders (age average: 8;4). The data analysis was performed through SPSS 19.0
(descriptive and inferential statistics).
Results: The following order of constituents was identified: syllable (1st graders: 80.4%; 3rd graders: 98.6%) > word (1st graders: 62.8%; 3rd graders: 94.8%) > syllabic constituents (1st graders:
1%; 3rd graders: 60%) > segment (1st graders: 0.12%; 3rd graders: 20.5%).
Conclusions: The results challenge the early awareness of words and stress the need to implement the stimulation of phonological awareness in preschoolers, in order to prevent reading/writing disorders. The study provides relevant guidelines for the construction of assessment tools and
intervention programs designed for children with phonological awareness disorders.
Keywords: Competency-based learning; quality of education
P1.24
COMPARISON OF THREE THERAPEUTIC APPROACHES
FOR PHONOLOGICAL DISORDERS
Roberta Freitas Dias - Universidade Federal de Santa Maria, Santa Maria, Brazil
Maria João Freitas - Universidade de Lisboa, Lisboa, Portugal
Objective: To test the efficiency of three therapeutic approaches designed for children with phonological disorders.
Methods: Seven subjects with phonological disorders, monolingual Brazilian Portuguese speakers (average age of 5:7) participated in this study: two preschoolers and five first graders of Elementary School. The data were obtained through the application of AFC – Avaliação Fonológica
da Criança (Yavas, Hernandorena & Lamprecht, 2001) and CONFIAS – Consciência fonológica:
Instrumento de avaliação sequencial (Moojen et al., 2003). Through AFC it was possible
130
to assess the children’s phonological system and to perform a contrastive analysis. Through
CONFIAS, nine tasks of syllabic awareness and seven tasks of phonemic awareness were performed by the children. The subjects were randomly divided in three groups, according to the
therapeutic approach: 1) pure phonological approach (Bagetti, Mota & Keske-Soares, 2005); 2)
therapy based on stimulation of phonological awareness skills; 3) phonological therapy associated
with stimulation of phonological awareness skills. Each subject had no more than 25 therapy sessions. The phonological system, the phonetic inventory, the PCC-R (Shriberg, et al. 1997) and the
performance of phonological awareness tasks were analyzed pre- and post-therapy.
Results: With the exception of one of the subjects, who received phonological therapy associated
with phonological awareness skills stimulation, all the other subjects acquired, on average, two
phones in their phonological system, two phones in their phonetic inventory, thus increasing, on
average, 9.7% the PCC-R. As for phonological awareness, all subjects improved their score (17%
on average), mainly the group with phonological therapy associated with phonological awareness
skills stimulation.
Conclusions: The three studied therapeutic approaches were equally effective for the treated
subjects. Considering the heterogeneity of the cases, such as the phonological disorder level, and
the size of the sample, further research is required in order to test the adequacy of the different
approaches tested.
Keywords: Developmental language disorders, phonological disorders
P1.25
EARLY LITERACY ABILITIES OF BILINGUAL CHILDREN WITH CLEFT
LIP AND PALATE
Dawn Patricia Chuan Yu Young - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Michelle Heng Yue Cheong - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Selena Ee-Li Young - Cleft & Craniofacial Centree, KK Women’s and Children’s Hospital, Singapore, Singapore
Liow Susan Jane Rickard - Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Mary Lay Choo Lee - Department of Psychology, National University of Singapore, Singapore, Singapore
Objective: To investigate the factors underlying early reading and spelling abilities of bilingual
children with nonsyndromic cleft lip and/or palate (CLP). This population is thought to be at-risk
of under-achievement in academic settings, so the results will support timely screening and the
design of intervention programmes for written communication difficulties.
Method: Thirty-five English-Mandarin bilingual children with CLP (aged 4 to 7 years) were
matched pairwise on language dominance, age, socioeconomic status, and nonverbal reasoning, with typically-developing (TD) bilingual children. Participants were assessed on single-word
reading and spelling abilities in English using the Wide Range Achievement Test 4th edition. Key
cognitive-linguistic factors known to be related to reading and spelling development were also
examined: Receptive and expressive vocabulary in English, rapid automatised naming (RAN),
phonological awareness (phoneme isolation and deletion), and auditory memory (forward and
backward digit span).
Results: Reading and spelling abilities were equivalent for the English-dominant CLP and TD
groups, but the Mandarin-dominant children with CLP showed poorer spelling, and phonological
awareness compared to their TD peers, suggesting second language learners with CLP may be
at greater risk. In addition, regardless of language dominance, faster RAN correlated with better
reading and spelling ability in the CLP but not the TD groups, while receptive vocabulary correlated with reading and spelling ability in the TD but not the CLP group.
Conclusions: These findings suggest that different factors underlie literacy development in bilingual children with CLP, and that early screening and intervention for literacy difficulties should be
tailored accordingly.
Keywords: Multilingualism, developmental language disorders, screening, prevention, speech
disorders
131
P1.26
NARRATIVE PRODUCTION SKILLS OF RUSSIAN-ESTONIAN
BILINGUAL CHILDREN
Merit Hallap - University of Tartu, Tartu, Estonia
Signe Raudik - University of Tartu, Tartu, Estonia
Marina Kuuseoja - Foundation Innove, Tallinn, Estonia
Objective: The study aimed to describe the production and assessment of narratives in Estonian
by simultaneous and sequential Russian-Estonian bilingual children.
Methods: The participants were 25 simultaneous and 25 sequential Russian-Estonian bilingual
children with normal language development, aged between 5 years, 6 months and 6 years, 5
months. The control groups included monolingual Estonian children with normal language development (NLD), and monolingual Estonian children with primary language impairment (PLI). To elicit
narratives, story generation based on two picture series was used. The narratives were recorded,
transcribed and analysed using the adapted Narrative Scoring Scheme (NSS).
Results: The results revealed that the narrative skills of simultaneous bilinguals were different from
those of sequential bilinguals. Significant differences appeared in the use of microstructure categories (reference and grammar). The analysis also showed significant differences between the
narratives by sequential bilinguals and monolingual children with PLI, both in macrostructure and
microstructure categories. The results of simultaneous bilinguals and monolingual children with
NLD were similar.
Conclusions: The data suggest that narration can be an ecologically valid method for
studying bilingual children`s communicative competence. The study confirmed that micro-level
factors differentiate between groups better than macro-level factors. The results are useful in interpreting the performance of Russian-Estonian bilingual children during the preschool period.
Keywords: Narratives, Russian-Estonian bilingualism
P1.27
SYSTEMATIC REVIEW OF EPIDEMIOLOGICAL STUDIES ONTHE
FREQUENCY OF DYSLEXIA IN DIFFERENT ORTHOGRAPHIC SYSTEMS
Valentina Tammaro - Rehabilitation Team for Developmental Age, Center of Audiophonologopedy, Rome, Italy
Eleonora Lacorte - National Center of Epidemiology, National Institute of Health, Rome, Italy
Nicola Vanacore - National Center of Epidemiology, National Institute of Health, Rome, Italy
Objective: The incidence of dyslexia varies widely across different countries. The incidence rate in
Italy varies from 19.6% in primary school children, to 24.9% in high school children (Report ISTAT
2013). This systematic review aims at comparing the prevalence of dyslexia in different orthographic systems based on rigorous and well-defined diagnostic criteria, defining if the incidence
of dyslexia is associated with the type of language, and to verify if prevalence and/or incidence
rates vary according to the transparence of the various languages.
Methods: The review was performed following the methodology stated in the Cochrane handbook
for systematic reviews published by the Cochrane Collaboration Group and reported basing on
the PRISMA statement for reporting systematic reviews and meta-analyses. All relevant literature published up to July 2014, in any language, was retrieved through structured bibliographic
searches on PubMed and The Cochrane Library databases. Studies were selected on the basis
of their relevance and pertinence with the topic of the review. All studies including children aged
6 to 14 years and reporting a diagnosis of dyslexia were included. Studies not reporting usable
132
data on the prevalence or incidence of dyslexia were excluded. Systematic and semi-systematic
reviews were also taken into consideration to check references and consistency of results. The full
texts of all included studies were qualitatively assessed using a revised version of the ADI 2009
tool, and data were extracted through a standardized table. Further potentially relevant articles
were also selected reviewing the references of included studies.
Results: The bibliographic searches yielded 1668 studies. Relevant studies were selected and the
predefined inclusion and exclusion criteria were applied. Eight studies were included and qualitatively assessed. Included studies reported data on the incidence of dyslexia in English, French,
Indian, German, Italian, Chinese, and Japanese children. The Indian study reports data on the
Kannada language, while the Japanese study reports data on both the Hiragana and Kanji writing systems. Orthographies were analyzed, and languages were classified as opaque (English,
French, Persian), semi-syllabic (Kannada, Hiragana), transparent (Italian, German), and logographic (Chinese, Kanji). Then, they were further categorized according to the gradient of transparence.
Results showed that the transparence of the language is inversely proportional to the prevalence
of dyslexia. Therefore, languages with an opaque orthography, thus a low gradient of transparency (English, French), are associated with a higher incidence of dyslexia. The linear model resulted
in an r value of -0.625, with a p value close to statistical significance (p=0.098).
Conclusions: Currently available studies carried out by single countries are providing evidence
that less opaque orthographies are a real advantage to both normal readers and dyslexic children
in acquiring reading skills. Readers of some orthographies interestingly form larger sublexical
reading units to resolve inconsistencies in grapheme to phoneme mapping. Treatments aimed at
favoring the automatic recognition of sublexical units (syllables) usually allow children to obtain
a normalization of the accuracy, and the highest results in terms of increase in reading speed.
Further studies are needed, with higher statistical power, to expand educational policies, plan targeted educational strategies, and inform educators (family and school) on how to support dyslexic
children.
Keywords: Incidence, dyslexia, specific learning disorders
P1.28
AURAL PERCEPTION OF PRE-SCHOOL CHILDREN – DIAGNOSIS
AND STIMULATING DEVELOPMENT
Irena Polewczyk - Instytut Pedagogiki, Uniwersytet Slaski, Katowice, Poland
Objective: This project features diagnostic research on aural perception’s levels and range among
pre-school children. It also shows the results of experimental research on stimulating aural perception according to authorial program.
Methods: Basic methods of research are authorial aural perception tests and experiments, using
authorial program, which stimulates aural perception.
Statistical methods: Chi-squared test to examine significant relationships between variables,
Cramer’s V to examine the strength of the relationship between elements of aural perception,
Kruskal-Wallis one-way analysis of variance, student’s t-test and Kendall tau distance to examine
the relationship between the two variables.
Results: Results of the research show a range of aural perception, which of them are the most
and the least mastered by 4, 5 and 6-year-old children. Outcomes show concurrent relationships
between particular aural ranges.
Conclusions: There are several research hypotheses in this project. Statistical calculations allowed the verification and rejection of a few of them. Hypotheses mainly concerned the examination of the relationships between particular aural perception ranges.
Keywords: Child language disorders, hearing impairment, screening, prevention
133
P1.29
ACQUISITION OF GRAMMAR IN GERMAN-SPEAKING CHILDREN
BETWEEN 4 AND 9 YEARS
Tanja Ulrich - Department of Rehabilitation and Special Education, University of Cologne, Cologne, Germany
Objective: Normative data concerning the acquisition of grammatical rules in German was delivered by Clahsen (1982). His observation of three children led to a phase model which assumes
that children have acquired the main grammatical structures of German by the age of four years.
More recent empirical findings indicate that this assumption might no longer be tenable, as several aspects of German grammar seem to cause difficulties even to school-aged children (Motsch
2010). However, the phase model of Clahsen has remained state-of-the-art and is still referred
to in current textbooks (Szagun 2007). This is due to a lack of data concerning the acquisition of
more complex and lately-acquired grammatical structures (e.g. passive constructions, case marking of dative). The aim of this study therefore is to deliver reliable and representative data on the
acquisition of grammar in monolingual German-speaking children between 4 and 9 years.
Methods: Data was collected in a multicentre study between 2013 and 2014. The acquisition of
grammatical structures was assessed by ESGRAF 4-9 (Motsch 2015). Normative data for N=910
monolingual, German-speaking children is available at the moment and will be analysed during
the next months.
Results: First results confirm that the assessment tool ESGRAF 4-9 is an objective, reliable and
valid instrument (Rietz & Motsch 2014). First analyses of data focus on the acquisition of case
marking in German. They give support to the presumption that the acquisition of case marking
(especially for the dative) is not completed by the age of four years, but creates difficulties even
for nine year old children.
Conclusions: The study delivers normative data about the acquisition of grammar in German. This
is the basis for the evaluation of normal and disturbed grammatical development.
P1.30
SPECIFIC LANGUAGE IMPAIRMENT: HOW SPECIFIC IS IT?
Silvana Bilonic Miloševic - SUVAG polyclinic, Zagabria, Croazia
Maja Kelic - SUVAG polyclinic, Zagabria, Croazia
Draženka Blaži - Faculty of Education and Rehabilitation Sciences, Universita Zagabria, Croazia
Objective: Specific language impairment is a developmental disorder affecting 3-7% of the
population (Tomblin et al., 1997), defined as primarily a linguistic deficit, not directly connected
to sensory deficits or structural neurological changes diagnosed using traditional excluding and
including criteria (Leonard, 1998). However, SLI is often connected to deficits in other cognitive
functions considered to be the possible origin of the language impairment, such as deficits in
verbal working memory, auditory perception or limited speed of processing. Approaching SLI from
a neuropsychological perspective suggests that the disorder might be related to more general
cognitive systems. Although SLI excludes brain lesions or defined neurological conditions, newer
neuroimaging studies show significantly lower activation suggesting functional abnormalities in
language processing. The comparison of individuals with language impairment related to brain
structure deviations and individuals diagnosed with SLI, widens our knowledge about the neurological basis of language processing in general and enlightens limitations in neurological plasticity.
Methods: This study included three groups of primary school children (aged from 7;03 to 9;10)
matched by age and gender: children with specific language impairment, children with language
134
impairment with neurological origin and a control group. The aim of this study was to explore the
similarities and differences in different language domains (phonology, morphology, semantics,
syntax) between the two groups of participants with language difficulties.
Results: Behavioural data showed no statistical differences between the two groups with language difficulties.
Conclusions: These findings lead to several possible explanations, which will be discussed.
Keywords: Language development, specific language impairment, neurological origin of Language difficulties
P1.31
PROMOTING LANGUAGE SKILLS IN KINDERGARTENS
AND NURSERY SCHOOLS
Angelika Rother - FH JOANNEUM, University of Applied Sciences, Graz, Austria
Nina Fuisz-Szammer - FH JOANNEUM, University of Applied Sciences, Graz, Austria
Christina Leitinger - FH JOANNEUM, University of Applied Sciences, Graz, Austria
Lisa Maria Zauchner - FH JOANNEUM, University of Applied Sciences, Graz, Austria
Background: Acquiring language skills forms the basis for all processes and aspects of education. Therefore, strengthening the basic competences in the area of language is the focus of the
first years in education. As an important person of reference, kindergarten teachers contribute to
a great extent to language acquisition in children. On the one hand this requires profound knowledge of children’s language acquisition and, on the other hand, applying an attitude that promotes
language in everyday situations. The attitude, knowledge and skills of teachers are crucial in defining to which extent children can develop their language potentials.
Methods: The main aim of this bachelor thesis is to depict the current knowledge of kindergarten
teachers of children’s language development and to show the quantity and quality of applying an
attitude geared towards language promotion in everyday life. Data acquisition for this study comprised two parts. An interview was conducted and also teachers were observed in their everyday
routine. Guidelines were used as a basis. Overall 40 kindergarten teachers participated, 34 who
work in kindergartens and 6 in nursery schools.
Results: Results show that the majority of kindergarten teachers have only a little expert knowledge concerning language development in children. Only a few possess good knowledge. Concerning language promotion in the kindergarten and in nursery school, most of them apply an attitude that promotes language development. Specific language promotion concepts are not being
applied in kindergartens.
Conclusion: It is of utmost importance to have expert competences in the area of language development as a kindergarten teacher, to be able to recognize abnormalities in time, and also to be
able to promote affected children and to suggest appropriate forms of treatment.
Keywords: Quality of education
135
P1.32
IT TAKES TWO AND A ROBOT TO TALK
Meia Meulensteen - Department of Speech and Language Therapy, Fontys University of Applied Sciences, Eindhoven, Netherlands
Lieke Elzenaar - Department of Speech and Language Therapy, Fontys University of Applied Sciences, Eindhoven, Netherlands
Tinne Boons - Department of Speech and Language Therapy, Fontys University of Applied Sciences, Eindhoven, Netherlands
Manon Peeters - Department of Speech and Language Therapy, Fontys University of Applied Sciences, Eindhoven, Netherlands
Sandra Tops - Department of Speech and Language Therapy, Fontys University of Applied Sciences, Eindhoven, Netherlands
Joost van Hoof - Department of Speech and Language Therapy, Fontys University of Applied Sciences, Eindhoven, Netherlands
Objective: Over the last decade, the role of robotics in health care has increased rapidly. For example, robots are currently used to prevent loneliness in older adults or to stimulate social behaviour in children with autism spectrum disorders. Research has shown that a robot as a therapist
assistant can evoke social interactions between child and therapist. Based on this finding, it is
plausible that a robot assistant can facilitate the interaction between a child with a language disorder and a speech language therapist (SLT).
Methods: In this explorative multiple case study, the effect of robot Reeti on the expressive language of three children with language impairment was observed. Reeti is a human-like robot that
can talk and produce numerous facial expressions, as almost all parts of his face can move and
his cheeks are able to change colour. The robot is controlled through an iPad application. The
participants (aged 6;4, 7;3, and 7;4) were diagnosed with a language production disorder. In their
therapy sessions, Reeti was activated during certain time blocks. The robot assisted the SLT by
explaining a task to the child or by providing positive feedback. The utterances of the children
were video-recorded and analysed using The Observer XT 11 software (Noldus, 2012). The mean
length of the utterances (MLU) and the grammatical accuracy were scored and a comparison between therapy blocks with and without Reeti was made.
Results: Results showed that during the therapy blocks in which Reeti was active, the children
produced consistently (1) more and (2) longer utterances and (3) the number of grammatically accurate utterances was higher than in therapy blocks without Reeti. Additionally, the SLT and the
children themselves were very pleased about their experience with the robot. The SLT noticed that
the children demonstrated more communicative confidence in therapy blocks with Reeti then in
therapy blocks without.
Conclusions: In the current study, children with a language impairment demonstrated higher
levels of language production in therapy sessions in which the robot Reeti was activated. Based
on the promising results of this explorative study, it is recommended that the effect of human-like
robots in language therapy is studied more extensively. Possibly, these robots can improve the
quality and efficiency of future therapy programs for children with language disorders by facilitating the interactions between child and SLT.
Keywords: Robotics, language disorder
P1.33
SOCIAL AND COMMUNICATIVE SKILLS RESEARCH ON A GROUP
WHICH INCLUDED CHILDREN WITH SPECIAL NEEDS
Christiana Vougiouka - Pammakaristos Foundation, Ioannina Greece, Athens, Greece
Ellianna Mantaka Brinkmann - Pammakaristos Foundation, Cerrara Italy, Athens, Greece
Objective: According to contemporary literature an important part of child development is their
social interaction and socialization. The aim of our research was to investigate how this can be
done within a group containing children with special needs.
136
Methods: Initially, we established the group for our study, which were the children from the kindergarten of the children’s institution “I Pammakaristos”. We then set the duration of the study at 19
weeks, and also the weekly program and goals. We created tables that helped us to quantitatively
analyze the data. Moreover, there was a calendar record that helped us in the qualitative analysis.
Results: Our main objectives which were the cooperation and understanding of the concept of
membership in a group, were achieved by all the children despite their difficulties. Psycho-emotional changes affected their participation, sometimes positively and sometimes negatively. We
found that the majority of children’s development was positive.
Conclusions: Data shows that irrespective of the fact whether the child has difficulties or not, in
order to participate in a group the child will have to go through certain stages. According to these
initial steps the child should handle himself, then he can coexist with other team members and at
the end can work and help the team.
Keywords: Social and communicative skills, children with special needs, working in a group
P1.34
CLASSIFICATION OF GREEK PRESCHOOL CHILDREN
WITH SPECIFIC LANGUAGE IMPAIRMENT
Maria Vlassopoulos - Community Mental Health Centre of Byron-Kaisariani, 1st Department of Psychiatry, University of Athens,
School of Medicine, Athens, Greece
Eirini Petraki - Community Mental Health Centre of Byron-Kaisariani, 1st Department of Psychiatry, University of Athens, School of
Medicine, Athens, Greece
Dimitris Anagnostopoulos - Community Mental Health Centre of Byron-Kaisariani, 1st Department of Psychiatry, University
of Athens, School of Medicine, Athens, Greece
Eleni Lazaratou - Community Mental Health Centre of Byron-Kaisariani, 1st Department of Psychiatry, University of Athens,
School of Medicine, Athens, Greece
Objective: Children with specific language impairment have been found to exhibit deficits in
their expressive vocabulary, grammar and phonology and have been classified according to their
deficits. The purpose of the present study was to investigate these linguistic components in Greek
preschool children with specific language impairment and to classify them.
Methods: The profiles of a group of 22 children with specific language impairment aged 4;0-6;0
years were examined using tests standardized to the Greek population regarding expressive vocabulary, grammar and phonology.
Results: All children performed poorly on the phonological test, lagging significantly behind their
chronological age. The majority of younger children (4;0-5;0 years old) faced concomitant vocabulary and/or grammatical difficulties in addition to their phonological deficits. No significant differences were found regarding gender.
Conclusions: Phonological difficulties prevail in Greek preschool children with specific language
impairment. However, concomitant linguistic difficulties allow their categorization into subgroups.
Keywords: Specific language impairment, vocabulary, grammar, phonology
137
P1.35
LEXICAL PROFILING IN LATE TALKERS
Kakia Petinou - Cyprus University of Technology, Limassol, Cyprus
Loukia Taxitari - Cyprus University of Technology, Limassol, Cyprus
Despo Minaidou - Cyprus University of Technology, Limassol, Cyprus
Objectives: Late onset of expressive language is typically identified on the bases of total number
of words produced by children. The current investigation focused on lexical diversity and lexical
profiling skills in late talkers (LTs) and typically developing children (TDs) through an analysis of the
different semantic/grammatical categories that comprise early word production.
Methods: Forty-eight children participated in the study, from 24 to 28 months. Expressive vocabulary was measured via the CYLEX, a parentally reported vocabulary checklist, which consists
of 22 semantic categories. Five grammatical categories were used in the analysis: verbs, nouns,
adjectives, adverbs and function words. The proportion of the total words produced was calculated for each of the five categories. One-way ANOVAs were run comparing the percentages of
words between LTs and TDs in these five categories, as well as Pearson r correlations between
total vocabulary and percentages of those categories in the two groups.
Results: Differences between the two groups were found only for one grammatical category,
namely adjectives, F (1.46) = 13,07, p < .01, with TDs producing a higher proportion of adjectives
than LTs. No other differences were found. The correlations between percentage of words in each
category and total vocabulary revealed an interesting pattern: For TDs, the higher the percentage
of verbs and function words was, the higher the total vocabulary, and inversely the higher the total
vocabulary was, the lower the percentage of nouns (ps < .05). LTs showed no such pattern.
Conclusion: A careful profiling of TDs and LTs’ early vocabulary production reveals differences in
performance, which could be indicative of early language difficulties and suggestive for intervention.
Keywords: Late talkers, expressive vocabulary, lexical profiling
P1.36
QUALITATIVE ANALYSIS OF THE DIBELS NEXT TEST FROM THE
PERSPECTIVE OF SPEECH AND LANGUAGE THERAPIST’S PRACTICE
Objective: The DIBELS NEXT test (Dynamic Indicators of Basic Early Literacy Skills) is considered
a quick and efficient universal screening, a progress monitoring instrument to identify students
in need of intervention support and to evaluate the effectiveness of interventions. The aim of the
presentation is to give a qualitative analysis of the use of the DIBELS NEXT test in the practice of
SLT and state its positive aspects and challenges.
Methods: Qualitative analysis of the use of the test.
Results: The content of the research deals with essential concepts and the procedure of the
DIBELS NEXT test; experience using the DIBELS NEXT test in speech and language therapist
practice is shared and its possibilities shown. Some analysis of dyslexia symptoms is done and its
correlation with test outcomes is stated.
Conclusions: There are positive aspects of DIBELS NEXT test use in SLT practice. It is good instrument to show parents and teachers valid comparative results of early literacy skills of a child.
It is a standardized tool for SLT to state the necessity of support measures for a child and to
observe the dynamics of early literacy skills. Nevertheless there are also challenges, because the
interpretation of the results do not state exact intervention tasks and additional evaluation of the
child is needed.
Keywords: DIBELS NEXT test, qualitative analysis, SLT practice
138
P1.37
STORY RETELLING SKILLS IN BILINGUAL IMMIGRANT
AND MONOLINGUAL ITALIAN CHILDREN AGED 4-6 YEARS
Elisa Monti - A.O. Luigi Sacco, A.O. Luigi Sacco, Milano, Italy
Antonio Schindler - A.O. Luigi Sacco, A.O. Luigi Sacco, Milano, Italy
Objective: The aim of this study is to observe the story-retelling skills in migrant bilingual children
at a pre-literacy age compared with monolingual Italian children. We also aim to establish a correlation between story-retelling skills and lexicon, phonology and non verbal reasoning skills.
Methods: 47 bilingual and 47 monolingual typically developing children were assessed in the
school environment with parental consent. Children were assessed through the Bus Story test,
Peabody test, Raven’s coloured matrices, and a nonword repetition test. Migrant children’s parents were given a questionnaire to collect information on the child’s language development. The
Bus Story test scores were compared between the two groups, using the Mann-Whitney nonparametric test and were correlated with other tests scores using the Spearman index.
Results: Input lexicon scores of bilingual children were significantly lower than those of monolingual children. Also the informativeness scores in the Bus story test were lower in the bilingual
group than in the monolingual group; Raven’s matrices and nonword repetition test scores were
comparable in both groups. The statistical analysis found differences in mean length of utterance
(MLU) between the experimental and control groups. A significant correlation was found between
the Bus Story test parameter of informativeness and MLU and all test scores in the monolingual
group (r > 0,4), but only between the Raven test scores and informativeness (r = 0,7) in the bilingual group.
Conclusions: The bilinguals’ skill of story-retelling proved to be lower than that of monolingual
children. Future studies will analyze variables that have an impact on this skill in migrant children.
Keywords: Multilingualism, children
P1.38
“LEXICON PIRATE” - AN EVIDENCE-BASED THERAPY APPROACH
FOR LEXICAL DISORDERS IN CHILDHOOD
Dana-Kristin Marks - Department of Rehabilitation and Special Education Speech and Language Rehabilitation, University of
Cologne, Cologne, Germany
Tanja Ulrich - Department of Rehabilitation and Special Education Speech and Language Rehabilitation, University of Cologne, Cologne, Germany
Hans-Joachim Motsch - Department of Rehabilitation and Special Education Speech and Language Rehabilitation,
University of Cologne, Cologne, Germany
Objective: Difficulties in the acquisition of vocabulary are common symptoms of (S)LI and are of
high relevance for further development (McGregor et al., 2013). To prevent the risk of continually
lagging behind normally developing peers on measures of vocabulary, an effective therapy for
children with lexical disorders must achieve transfer to untrained words (Motsch & Bruell, 2009).
Due to missing generalisation effects in traditional therapy approaches, the aim of the present
research project is to evaluate the effectiveness of a newly developed therapy approach called
“Lexicon Pirate”. The therapy focuses on individual lexical learning strategies - a proceeding that
is attracting interest increasingly in the scientific literature (e.g. German, 1992).
Methods: To investigate the effectiveness of the “Lexicon Pirate” strategy therapy on high evidence level, two randomised controlled trials (RCT) were conducted: one for pre-school children
(N= 82, Motsch & Ulrich, 2012) and another RCT for school age children (N= 157, Motsch &
139
Marks, 2015). Based on a pre-post-test design, the impact of the strategy therapy was compared
to another treatment group and/or a waiting control group (CG). Long-term effects were analysed
with follow-up test(s). Therapeutic success is interpreted by a generalisation effect demonstrated
as a significantly higher improved performance in standardised tests.
Results: Children of the strategy therapy group show stable long-term generalisation effects and,
in most assessment tests, a significantly higher increase in lexical performance than the waiting
controls or the other treatment group. Furthermore, analyses confirm the advantage of this approach for several sub groups as well (e.g. children with mild learning disabilities, children treated
in a small group setting, bilingual children). Moreover, the results show first transfer effects on
sentence comprehension and - for bilingual children - on vocabulary skills in the non-treated first
language Turkish.
Conclusions: The new therapy format “Lexicon Pirate” appears to be a convincing programme for
treating lexical disorders in pre-school and school aged children.
Keywords: Lexical deficit, childhood, strategy therapy, randomised controlled trial
P1.39
SOCIO-CONVERSATIONAL SKILLS IN ITALIAN-SPEAKING INFANTS
AND TODDLERS WITH DOWN SYNDROME
Antonella Olivo - Fondazione Istituto Antoniano, Ercolano (Na), Italy
Objective: The aim of the study is to describe assertive and responsive skills in Italian-speaking
toddlers with Down Syndrome (DS) by comparing data with normatives from Le Abilità SocioConversazionali del Bambino (ASCB, Bonifacio et al, 2013), id est standardized Italian version of
The Social–Conversational Skills Rating Scale (Girolametto, 1997).
Methods: ASCB, GMDS-R and PVB (Caselli et al, 2007) were administered to 76 toddlers with
DS, aged 12 to 36 months. Z-Scores for assertiveness and responsiveness scales and subscales
were computed by both sorting and matching data by chronological, developmental and lexical age.
Results: Only 14% of the subjects reached full development of assertiveness skills by 36 months
and 14% of responsiveness skills; 9% got a full score on both the scales. An “emergent level” of
assertive or responsive skills could be observed considerably (90% of the sample) starting from
29 months. Compared with peers, 60.5% of the toddlers displayed low ratings (<1,5ds) in one
or both the scales. Matching data by developmental or lexical age produces 44% and 29% low
scores respectively and reduces or quite nullifies the mean gap, even though there is large interindividual variability. “Putting a question” and “Answering a question” were the most critical areas.
Conclusions: DS toddlers show a wide variability in early pragmatic skills, which results in a relatively weak point in individual profiles. Screening for assertive and responsive skills may provide
useful data to better define goals for speech-language therapy.
140
P1.40
“FATIGABILITY” ON ORAL READING TASKS IN ITALIAN CHILDREN
ATTENDING PRIMARY SCHOOL
Antonella Olivo - Fondazione Istituto Antoniano, Ercolano (Na), Italy
Goffredo Scuccimarra - Fondazione Istituto Antoniano, Ercolano (Na), Italy
Marianna Padovano - Fondazione Istituto Antoniano, Ercolano (Na), Italy
Annunziata Di Rosa - Fondazione Istituto Antoniano, Ercolano (Na), Italy
Mariateresa Miranda - Fondazione Istituto Antoniano, Ercolano (Na), Italy
Objective: The aim of the study is to investigate oral reading fatigability, id est the on-going decreasing of speed and accuracy in a text reading performance.
Methods: 92 children attending primary school (grades IV and V) were tested on oral reading
speed and accuracy, both using the most frequently employed standardized measure for diagnosis and outcome evaluation in dyslexia (MT-2 Reading Test by Cornoldi and Colpo, 2011) and an
ad-hoc made test, the length of which was closer to school reading tasks. For the ad-hoc made
test (named “fatigability test” -FT) children were asked to read aloud a longer text than MT-2 (MT
syllabes number x 2), having the same Gulpease Readability Index (Lucisano, Piemontese,1988),
Basic Lexicon percentage (De Mauro, 1980) and visual appearance (typeface, font-size, spacing
and text arrangement in the page) as MT. Performance by typical readers (TR), dyslexic children
(DYS) and dyslexic children who had reached a functional compensation (COM) as an outcome of
a rehabilitative treatment were compared.
Results: Only COM-group children showed a significative variation (p<0.05) of speed and accuracy at the “fatigability test”.
Conclusions: A measure of oral reading on more ecological tasks could contribute to the rehabilitative outcome evaluation. Further investigations are needed; relations between fatigability and
reading comprehension need to be tested.
Keywords: Dyslexia, specific developmental learning disorders
P1.41
DEVELOPMENTAL PROFILING OF EXPRESSIVE LANGUAGE
IN TYPICALLY DEVELOPING CHILDREN
Loukia Taxitari - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Kakia Petinou - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Despo Minaidou - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Artemis Michael - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Vasia Christofidou - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Maria Alexandrou - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Maria Veresie - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Objective: Investigations of language development usually focus on total vocabulary scores of
children at different ages. The current investigation focused on lexical diversity and lexical profiling skills in typically developing children (TDs) developmentally through an analysis of the different
semantic/grammatical categories that comprise early word production.
Methods: Eighty-eight children participated in the study, divided in four age groups (24, 28, 32
and 36 months). Expressive vocabulary was measured via the CYLEX, a parentally reported vocabulary checklist, which consists of 22 semantic categories. Five grammatical categories were
used in the analysis: verbs, nouns, adjectives, adverbs and function words. The proportion of
141
words as a function of the total words produced was calculated for each of the five categories.
One-way ANOVAs were run comparing the proportion of words across the four age groups, separately for each grammatical category. Post-hoc comparisons tested which age groups behaved
differently for each category.
Results: Differences between the four groups were found for three grammatical categories:
nouns, F(3,84)= 4,8, p < .01, verbs, F(3,84)= 2,84, p < .05, and function words, F(3,84)= 11,25,
p < .01. Post-hoc comparisons showed significant differences in performance between 24- and
32-month-olds in the three categories, and also differences between 24- and 36-month-olds for
nouns and function words. Different patterns were found for each of those categories with the
proportion of nouns falling and the proportion of function words increasing across ages.
Conclusions: A detailed profiling of TDs’ early vocabulary production reveals interesting patterns
in the types of grammatical categories learned developmentally and is informative for both theory
and intervention.
Keywords: Expressive vocabulary, lexical profiling
P1.42
SCREENING AND FOLLOW-UP QUESTIONNAIRE FOR SLD
IN CHILDREN ENTERING PRIMARY SCHOOL
Marianna Barbetta - 1”Imparola” Center, Matera, Italy
Mariangela Bruno - 1”Imparola” Center, Matera, Italy
Objective: The present work proposes a screening and follow-up protocol for systematic and collective evaluation of written language prerequisite skills in children transitioning from preschool to
primary school.
Methods: The above-mentioned protocol comprises a questionnaire for parents and an observation grid for teachers that can together identify individuals with “weak” abilities or with predicting
signs of SLD (specific learning disability), in order to address them at a “second level” systematic
evaluation.
Results: Results confirm the efficacy of the protocol in screening and follow-up of learning disabilities.
Conclusions: The aim of the early recognition of this situation is the immediate enforcement of
empowering strategies that can positively influence development and school learning, especially
in children with SLD.
Keywords: Specific learning disabilities, SLD, early identification, screening, follow-up, preschool, primary school
142
P1.43
GREEK PRESCHOOL TEACHERS’ PERCEPTIONS ON
THE SIGNIFICANCE OF LANGUAGE FACTORS IN SCHOOL READINESS
Evdokia Lagakou - Community Mental Health Centre Vyrona - Kessariani, 1st Department of Psychiatry, Medical School,
National and Kapodistrian University of Athens, Athens, Greece
Katerina Sakellariou - Community Mental Health Centre Vyrona - Kessariani, 1st Department of Psychiatry, Medical School,
Ioanna Tsipra - Community Mental Health Centre Vyrona - Kessariani, 1st Department of Psychiatry, Medical School, National and
Kapodistrian University of Athens, Athens, Greece
Maria Vlassopoulos - Community Mental Health Centre Vyrona - Kessariani, 1st Department of Psychiatry, Medical School,
Zacharias Kalogerakis Community Mental Health Centre Vyrona - Kessariani, 1st Department of Psychiatry, Medical School,
Objective: School readiness is a concept used to describe the child’s capability to follow the
school curriculum. In recent years, there has been a shift in the notion of school readiness and
the concept has been enhanced regarding the dimensions and topics it should incorporate. As a
result, it may refer to a variety of individual factors, such as physical health and motor development, general knowledge and cognitive ability, approach to learning, social and emotional development, interpersonal relationships and self-regulation skills as well as language development.
Furthermore, it encompasses a variety of settings, such as the family, the school, the provided
services and the community. This paper reports on an interdisciplinary community programme to
raise awareness of teaching staff in the area’s kindergartens on issues regarding school readiness.
The goal of the programme is to sensitize the staff to children’s individual needs, to train the staff
so that they are in a position to detect “high risk” children, and to give specific techniques on a
range of issues.
Methods: Outcomes of the programme are measured through a questionnaire before and after
completion of the programme. The questionnaire consists of 60 likert-type questions which cover
all the possible areas related to school readiness: language, cognitive, visual-motor, social, emotional, concentration and behavior; the family’s attitudes; factors related to the school.
Results: The content of the programme, the methodology and initial findings with emphasis on
the Greek preschool teachers’ perceptions about the significance of language factors in school
readiness will be reported.
Conclusions: Initial findings show that preschool teachers cannot clearly differentiate between
factors related to the concept of school readiness, but after the training programme, they are better able to reflect on their relative importance.
Keywords: School readiness, speech, language, interdisciplinary community programme, kindergarten
P1.44
EFFECTIVENESS OF GRAMMAR INTERVENTION IN CHILDREN OF 4
AND 5 YEARS WITH SPECIFIC LANGUAGE IMPAIRMENT
Gerda Bruinsma - Faculty of Healthcare, Utrecht University of Applied Sciences, Utrecht, Netherlands
Ellen Gerrits - Faculty of Healthcare, Utrecht University of Applied Sciences, Utrecht, Netherlands
Frank Wijnen - Institute of Linguistics - OTS, Utrecht University, Utrecht, Netherlands
Paul Leseman - Department of Pedagogical and Educational Sciences, Utrecht University, Utrecht, Netherlands
Objective: Children with specific (or primary) language impairment (SLI) usually have difficulties in
grammatical development. They often produce short simple sentences with grammatical
143
errors. Especially problematic are argument structure and the use of grammatical morphemes that
mark verb tense and agreement (e.g. De Jong, 1999). The weaknesses in verb morphology are
conspicuous and persistent and can be considered as clinical markers of SLI (Verhoeven et al,
2011, Leonard, 2007). Timely and effective intervention to improve grammar is important. While
symptoms and explanations of grammatical problems in SLI are frequently described, studies that
address effectiveness of intervention are rare.
Methods: We conducted a literature review to work out what is known about the effectiveness of
intervention for grammar in 4 and 5 year old children with SLI. In the Dutch educational system
this age group is important, because children start primary education at that age. Databases were
systematically searched for studies published since 2004. Assessment of eligibility of studies was
done by two researchers independently. Subsequently the studies were rated according to the
Oxford Centre for Evidence-based Medicine Levels of Evidence (2001) and assessed for risk of
bias using the Cochrane Collaboration’s tool.
Results: We found 23 publications that met our inclusion criteria. The studies show a large variety in selection criteria of participants, interventions used and outcome measures. The studies
prove that grammar intervention in 4 and 5 year old children with SLI is effective. There is strong
evidence for children with expressive language disorders and moderate evidence for children with
combined receptive and expressive language disorders. Some authors supplement their results
by demonstrating that the progress made by children in the intervention group is clinically meaningful.
Conclusions: Over the last ten years there has been an increasing number of studies concerning intervention in children with grammatical problems. There is abundant evidence that grammar
intervention is effective in children with SLI aged 4 and 5. In the poster presentation we will focus
on the translation of results of the review to the actual practice of speech and language therapists.
Keywords: Grammar, intervention, specific language impairment, review
P1.45
METHODS OF IDENTIFICATION OF SPECIFIC LANGUAGE
IMPAIRMENT AND INTERVENTION STRATEGIES IN MULTILINGUAL
CHILDREN POPULATION
Vilma Makauskiene - A. Stulginskis University, Intercultural Communication and Educational Centre, Kaunas, Lithuania
Sigitas Daukilas - A. Stulginskis University, Intercultural Communication and Educational Centre, Kaunas, Lithuania
Objective: To disclose assessment and intervention methods in multilingual children with specific
language impairment and speech disorders.
Methods: Research is based on semi structured interviews with parents of multilingual children
with speech and language disorders. Information obtained from these interviews was analyzed by
content analysis.
Results: The analysis of research data shows the phenomenon of multilingual versatility and its
positive influence on children’s language development; more often parents are informed about
typical and atypical development of multilingual child language development; language assessment and therapy methods the more actively they participate in the educational process and
help to prevent language and / or learning problems in later age. The characteristics of speech
disorders in bilingual and multilingual children do not differ from speech disorders occurring in
monolingual children. However, the language of multilingual children may be more complex than
those of monolingual children, therefore the treatment of disorders in multilingual children is more
difficult, complex and time-consuming than the therapy of monolingual children. It is important
to identify children with language - speech disorders as early as possible and to examine the
kind of disorders they have as precisely as possible. Based on partially structured interviews with
their parents, the language and speech development of eight multilingual children with speech
144
disorders is described and analyzed in relation to the child‘s family, cultural and socio-economic
background. The results underline the necessity for close cooperation between parents, SLTs and
teachers to improve the child’s language and speech development. The earlier a speech disorder
is identified and treated, the better are the prospects of an effective and successful treatment.
Conclusions: Authors will present SLI identification and intervention strategies for multilingual
children in Lithuania.
Keywords: Multilingual children, specific language impairment
P1.46
ANALYSIS OF THE INTERACTIONS BETWEEN PARENTS AND THEIR
INFANT WITH CLEFT LIP AND PALATE
Willem Dhaese - Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium
Inge Zink - Department of Neurosciences, Exp ORL, KU Leuven, Leuven, Belgium
Maurice Mommaerts - Maxillofacial Surgery, University Hospital Brussels/Vrije Universiteit Brussel, Brussels, Belgium
Objective: Speech-and language development is a product of the early social interactions between children and their favorite adults. A healthy child is able to elicit responsive and sensitive
behaviour in the caregiver, even at the beginning of its life. Children born with cleft lip and/or
palate (CLP) have an established risk for communication problems, and seem to be less able to
do this. Therefore we developed a preventive approach: the ‘Parent Focused Approach’ (PFA). In
order to examine the effectiveness of this approach we developed a system based on 5 determinants in speech and language: 1. parent-child relationship, 2. expressing motor skills, 3. social
play, 4. body contact and 5. imitation.
The aim of our study was to develop and evaluate a system for analysis of videotapes made during interactions between parents and their infants.
Methods: To study the effectiveness of the ‘Parent Focused Approach’, the parents were asked to
play with their child as they do at home. We videotaped the interactions at the ages of 6, 12, 18,
24 and 30 months. The interactions between the children and their parents were analysed, based
on the 5 determinants in speech and language. The tapes were blindly analysed by two trained
evaluators. The quality of the system and the effectiveness of the approach were calculated.
Results: The preliminary results of the system to evaluate the interactions between parent and
child seem to be good. The video-analysis shows that parents who use an obvious facial expression evoke more intense viewing and listening behavior in their child and more distinct sounds.
Conclusions: The parents’ faces attract the child’s attention like a magnet, which is beneficial to
the speech development of children with CLP.
Keywords: Prevention, phonological disorder, developmental language disorder, cleft, early intervention, Parent Focused Approach
145
P1.47
ASSESSMENT OF SEMANTIC DEVELOPMENT
IN EUROPEAN-PORTUGUESE CHILDREN
Inês Cadório - Institute of Electronics and Telematics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
Marisa Lousada - School of Health Sciences, University of Aveiro, Aveiro, Portugal
Objective: Studies conducted in less-studied languages such as European Portuguese (EP)
contribute to advances in knowledge of the possible influence of different linguistic patterns in
children’s performance on developmental age. This study was designed to assess the impact of
extralinguistic variables (e.g., gender, age, socioeconomic status (SES) and ecological setting) on
children’s performance in semantic tasks, as well as to verify whether that performance depends
on the children’s mother tongue.
Methods: A valid and standardized instrument for EP children – Language Test: Pre-school Language Assessment (TL-ALPE) – was used to measure semantic skills of eighty EP-speaking children aged between 6;00 and 6;11 years. Statistical tests were performed in order to compare the
scores obtained from semantic tasks between groups: males and females; younger and older children; children living in rural, semi-urban and urban areas; children from high, middle and low SES.
Results: Children’s performance accuracy in semantic tasks transverses approximately the same
course in different languages. Significant differences were found only as a function of gender.
Females revealed better results than males in the total score of the semantic domain and in two
tasks: object function naming and antonym naming. A main effect for the variables age, SES and
place of residence was not observed. Thus, we assume that accuracy in semantic measures is
influenced by gender.
Conclusions: These outcomes contribute to the knowledge of late developmental processes in
the semantic domain in EP children, presenting well established performance standards.
Keywords: Semantic development, gender, age, SES, ecological setting
P1.48
THE ROLE OF HEREDITARY PREDISPOSITION IN STUTTERING
Stelios Andreou - The School of Humanities and Social Sciences, European University Cyprus, Nicosia, Cyprus
Costas Constantopoulos - The School of Humanities and Social Sciences, European University Cyprus, Nicosia, Cyprus
Objective: The etiology of stuttering has been a subject of study for many years. Nowadays, many
researchers accept the notion that stuttering is a multifactorial disorder, thus making it necessary
to continue the examination of all the factors which are responsible for its development. Furthermore, in the last twenty years most of the research shows that heredity clearly plays an essential role in many cases of stuttering. It is generally acceptable that the role of heredity is quite
complex, although how exactly the genetic factors might act in this speech disorder and in what
degree is still not known today. The aim of the present study is the exploration of the influence of
heredity in the etiology of stuttering in Cyprus.
Methods: In order for the causes of this disorder to be explored, twenty five children from Cyprus (17 boys and 8 girls) between the ages of 7 – 16 who were stutterers were examined during
a period of 4 years (2008 – 2012). The following steps were taken in order to record, analyse and
evaluate the findings: Documentation of the patient’s clinical record, interviews taken from the
patient’s parents and their school teachers, a general speech and language evaluation, an assessment involving the use of a stuttering examination test for recording, analysing and evaluating
samples of the children’s speech (Andreou, 2004) and finally genealogical (family) trees.
Results: The results gathered from this research are the following. The possible causes
146
of stuttering of the 25 children who took part in this research: (1) Hereditary predisposition: 10
(40%); (2) Speech delay: 6 (24%); (3) Unknown factors: 5 (20%); (4) Serious fear: 2 (8%); (5) Family
problems: 1 (4%); (6) Severe illness and traumatisms: 1 (4%).
Conclusions: The percentage of 40% represents the heredity trait on stuttering in children who
participated in this research. This percentage is quite remarkable, as it shows once more that
heredity is one of the most significant factors causing this speech disorder in school age children.
Further research is needed in this scientific field as this type of work could continuously be the
basis for other researchers aiming to gather more information concerning the genes responsible
for this disorder.
Keywords: Stuttering, causes of stuttering, hereditary predisposition, genealogical (family) trees
P1.49
CASE OF LOGOPAEDIC TREATMENT WITH IMPLEMENTATION OF
SENSORY INTEGRATION OF A CHILD WITH BRAIN STROKE
Svetlana Kartunova - Early Prevention and Therapy Consulting Office for Kids with Developmental Problems, Sofia, Bulgaria
A.I. is a normally born 2-year old boy, with after cardiac condition malformation operation and
thromboembolic cerebral stroke in both cerebellar hemispheres and bilaterally in both thalami.
He is in cerebral-palsy (CP) like state. Total lack of movement abilities, neither verbal or nonverbal
contact means he only reacts to pain and discomfort. The parents’ requirement is to help them
establish any possible contact with their child.
Objective: Based on the medical history and current state, the following goals were defined:
diagnostics of the current state of communication skills for the age up to 36 months; state of the
intact communicative and motor resources; reconstruction of body scheme perception; environmental and space relation development; awareness of self-emotional end arousal state; adaptive
communication response organisation;
Methods: The professional methods used are Communicative Strategies in Speech Therapy, Sensory Stimulation through Sensory Therapy, Stimulus to provoke an adaptive response and positive
emotions of their own performance.
Results: In the 2-year therapy the following have been achieved: successful communication interactions; building an emotional bond with the mother / parents; establishing self-initiated vocal,
verbal and motor reactions. The therapy continues.
Conclusions: In the present case the brain injuries at an early age have affected motor and communication skills and have been expressed by the presence of severe pathology.
Application of sensory stimulation therapy in this case during communicative treatment is particularly appropriate and useful. The compilation of both methods facilitates self-awareness and
fastens the formation of an expected adaptive response of the given stimuli. The present implementation improves the initiation and resumption of communication. This refers to the interaction
between the mother and the child, given the one with the therapist by default.
Keywords: Brain stroke, neurological damages, early intervention, sensory therapy, adaptive response, communication development, interactions, space and environment awareness
147
P1.50
THE BOEHM TEST OF BASIC CONCEPTS: TRANSLATION,
ADAPTATION AND PILOT STUDY IN TWO KINDERGARTEN STUDENTS
Evangelia Tsiapali - Speech Language Therapy, T.E.I., Ioannina, Greece
Stavroula Polykreti - Speech Language Therapy, T.E.I., Ioannina, Greece
The Boehm Test of Basic Concepts, Third Edition (Boehm–3) is a group administered assessment
for students in kindergarten through second grade. Boehm–3 was designed to evaluate young
students’ understanding of 50 important basic relational concepts integral for success in school
and to identify students who many not have had the learning experiences necessary to develop
an understanding of key concepts. The basic relational concepts as defined by Boehm–3 include
size, direction, and position in space, time, quantity, classification, and in general. Boehm – 3
provides professionals involved in early elementary assessment and education with a reliable and
efficient tool to evaluate basic relational concept acquisition in young students. The Boehm assessments continue to be renowned for demonstrating reliable and accurate results.
The materials that are used in the Boehm Test of Basic Concepts are: (1) 15 units where the major
purpose of each unit is to identify gaps in learning to guide instructing and intervention during
a child’s schooling towards success, (2) concept cards for every unit, (3) worksheets, (4) game
cards and (5) a separate book The Pairs.
The main purpose of the Boehm – 3 is to identify any difficulty that may exist in learning these
concepts so as to offer help to classroom teachers, speech-language pathologists, school psychologists, and other special education professionals in every possible way in order to help the
child acquire the basic relational concepts that fit their age.
After having translated and adapted the Boehm – 3 and having made the necessary alterations of
the materials according to Greek data, the test was granted to a small number of young students
in the kindergarten.
In conclusion, the results that came after granting the test were very encouraging, since none of
the students that were tested had any difficulties.
P1.51
CLUSTERING AND SWITCHING IN THE GREEK SPEAKING CYPRIOT
CHILDREN: NORMATIVE DATA
Dimitra Afxentiou - European University Cyprus, Nicosia, Cyprus
Maria Rayes - European University Cyprus, Nicosia, Cyprus
Stelios Andreou - European University Cyprus, Nicosia, Cyprus
Kostas Konstantopoulos - European University Cyprus, Nicosia, Cyprus
Objective: Verbal fluency (VF) is a well-known neuropsychological test which measures a number
of abilities including coordination of lexicosemantic knowledge, shifting from word to word, working memory and searching strategy/inhibition of irrelevant words. Clustering (production of words
within semantic or phonemic subcategories) and switching (the ability to shift efficiently to a new
subcategory) are two important components of the VF test. Even though, clustering and switching are widely used in adult populations diagnosed with a number of neurological and psychiatric
diseases, no information exists in the child population. The aim of the current study is to provide
normative data on clustering and switching in the Greek speaking Cypriot child population.
Methods: A total of 750 native Greek speaking Cypriot children divided in 10 age groups (7-16
years old) in yearly intervals took part in the study. Exclusion criteria involved the existence of
148
neurological and psychiatric diseases, mother history of alcoholism and drug abuse during pregnancy, birth prematurity, hearing loss and visual problems. Descriptive analysis involved means
and standard deviations of semantic/phonemic clustering and switching components of the VF
test. The SPSS 20.0 statistical software was used for the analysis of data.
Results: The size of semantic clusters remained the same across ages from 7 years old
(mean=1.88, SD=0.72) to 16 years old (mean=1.88, SD=0.41), while the number of semantic
switches increased from 16.55 words (SD=5.12) in 7 year old children to 29.07 words (SD=7.49) in
16 year old children. Similarly, the size of the phonemic switches remained the same across ages
from 7 year olds (mean=0.84, SD=1.08) to 16 year olds (mean=1.91, SD=1.28), while the number
of average phonemic switches was increased from 11.45 words (SD=5.02) in 7 year old children
to 25.24 words (SD=8.09) in 16 year old children.
Conclusions: The results show that in children’s development, the ability to shift to a new subcategory of words during the VF test (switching) is an important factor to qualitatively analyse the VF
test. A new study is needed to compare semantic and phonemic switching in clinical populations,
such as frontal lobe impairment, cerebellar tumor, attention-deficit hyperactivity disorder (ADHD)
and dyslexia.
Keywords: Verbal fluency, clustering, switching, normative data, Greek speaking children
P1.52
COMMUNICATION ATTITUDE OF SLOVENIAN STUTTERING AND
NONSTUTTERING PRESCHOOL CHILDREN
Jerneja Novšak Brce - Faculty of Education Ljubljana, University of Ljubljana, Ljubljana, Slovenia
Martine Vanryckeghem - University of Central Florida, Florida, United States
Stanislav Košir - Faculty of Education Ljubljana, University of Ljubljana, Ljubljana, Slovenia
Janez Jerman - Faculty of Education Ljubljana, University of Ljubljana, Ljubljana, Slovenia
Objective: Research studies have shown that children as young as three show an awareness of
dysfluency (Ambrose & Yairi, 1994; Ezrati, Platzky & Yairi, 2001) and report a negative speechassociated attitude (Clark et al. 2012; Vanryckeghem & Brutten, 2007; Vanryckeghem, Brutten
& Hernandez, 2005). The purpose of this study was to provide normative data for the Slovenian
version of the KiddyCAT© - Communication Attitude Test for Preschool and Kindergarten Children
Who Stutter (Vanryckeghem & Brutten, 2012).
Methods: In order to determine if a difference in speech-associated attitudes exists between Slovenian preschool children who stutter and those who do not, 49 preschoolers who stutter and 75
preschoolers who do not stutter, between the ages of 3 and 6, were administered the KiddyCAT.
Results: The data showed that preschool children who stutter scored statistically significantly
higher than the children who do not stutter on the KiddyCAT. The mean KiddyCAT score of younger (age 3 - 4,5) and older (age 4,5 - 6) preschool children who stutter differed to a statistically
significant extent. More specifically, the negative attitude toward their speech increased with age.
The KiddyCAT scores of the older non-stuttering children were descriptively, though not significantly, lower than those of the younger ones. Gender did not differentially affect the results. Also
the test’s internal reliability was shown to be high.
Conclusions: The Slovenian version of the KiddyCAT is a useful tool, provides a base for building
a more positive belief system, and helps guide treatment.
Keywords: Stuttering, communication attitude, KiddyCAT, preschool children
149
P1.53
PROMOTION OF ACTIVE ATTITUDES IN COMMUNICATION AMONG
CHILDREN WITH CLEFT
Objectives: The main goal is to present the aid strategies connected with speech therapy, which
build up active attitudes in communication and countervail any emergence of passive attitudes in
the case of children with cleft lip or cleft palate.
Method: Several strategies for helping these subjects are the effect of the analysis of the research
results into the style of communication presented by children with cleft. In the analysis of the
given results, the author uses the strategies of thinking which are of an explicit nature and she
also uses knowledge of the biological and cultural mechanisms involved in communication and its
development.
Results: The consequence of the analysis is a set of different strategies, which benefit active
attitudes in communication and counteract any emergence of passive attitudes. The strategies
which we have distinguished may be classified according to various criteria: the age of the child,
the subject of activity, the sort of developed competence and skill, the most significant areas
where help might be provided. For example, there are the typologies in which the age of the child
is taken into consideration and they are the strategies used during the prenatal period, during the
first year of life, at the age of 2-3, during the pre-school years and during the period when the
child starts school.
Conclusions: The results of the available research may become the methodological basis for the
elaboration of programs for helping people suffering from speech disorders. The strategies resulting from it are used by specialists. To sum up, the author presents the analysis carried out with 2
children with cleft whose speech development was different in each of the two cases by virtue of
the applied means of helping them in the early period of their lives.
Keywords: Speech disorders, prevention
P1.54
A CUED AND SPONTANEOUS DIALOGUE PRODUCED BY CHILDREN
WITH LIP CLEFT AND PALATE CLEFT
Objectives: The author presents the results of the research in the area of communicative style in
children with cleft and the strategies for helping them. The aim of the strategies is to counteract
the emergence of any passivity in communication and to promote an active attitude towards this
sphere of life. The research was based on the cued dialogue and the uncued one produced by the
subjects at the ages of 6 – 10 years (39 of them had cleft palate and cleft lip and 41 did not suffer
from this disorder).
Methods: In the assessment of the skills connected with carrying out a dialogue, two categories
of tasks were used; namely, I decided to take advantage of the child’s participation in the cued
dialogue and in spontaneous dialogue.
Results: The analysis of the results with the statistical calculation allowed us to state that the children with cleft undertook the initiative both in spontaneous dialogue and in cued dialogue significantly more rarely; they also asked less questions and had a visible problem with formulating any
questions, as well as taking advantage of formal phrases much less often. The interpretation of
the results was also supported by M. E. Fey’s model, which allowed to establish that the children
150
with cleft are passive speakers (they seldom start conversations, but react to the inducement).
Conclusions: The conclusion from the research is connected with the necessity to promote (from
the moment of birth or even earlier) their active attitude when they are communicating and the
development of competence and the skill connected with language and communication. The
author shows the strategies for helping the child with cleft. They may be divided according to the
different criteria: the age of the subject, the subject of the action, the sort of competence and skill
which is developed, the most important areas for help.
Keywords: Speech disorders, prevention
P1.55
THE ASSESSMENT OF EARLY STUTTERING
Jürgen Kohler - Departement für Pädagogisch-therapeutische Berufe, Hochschule für Heilpädagogik, Zürich, Switzerland
The Redeflusskompass © (Speech Flow Compass ©) has been designed for stutter detection
at the onset phase. The poster deals with the validation of the Redeflusskompass by testing its
quality criteria. The interdisciplinary decision for further action in case of non-fluent speech is
discussed.
The methods are re-test (N=81 cases), analysis of film sequences of case studies (with N=211 individuals) and a questionnaire on the problems arising in the application of the Redeflusskompass
(N=25 interviews and 8 group discussions).
Interrater reliability is established as critical and specificity as unsatisfactory. Sensitivity and validity prove to be satisfactory. The qualitative reasearch shows that non-proficient persons are not
capable of distinguishing between normal dysfluency and stuttering with the Redeflusskompass.
These results point out the need for the Redeflusskompass to be developed further in order to
be able to serve the needs of non-speech therapists who work on everyday intuition and for the
needs of language therapists with a basic knowledge on stuttering.
Keywords: Early childhood stuttering, prevention, diagnosis
P1.56
YOUNG CHILDREN AND IPADS: A DEVELOPMENTAL PERSPECTIVE
Veronica Montanaro - Association of Speech and Language Pathologists (Malta), University of Malta, Tal-Qroqq, Malta
Hilary Gardner - Department of Human Communication Sciences, University of Sheffield, Sheffield, United Kingdom
Objective: The objective of the study was to explore the way young children between the ages of
6 months and 36 months use an iPad and to outline the stages of development.
Methods: An empirical cross-sectional study was carried out in two phases. Five children, under
the age of three, were observed using the iPad. These observations formed a basis to create a
close-ended questionnaire for the second phase, which was responded by 153 participants. Participants were parents of children between the ages of 6 months and 36 months and had access
to tablet technology. Skills used by children of the said age were analysed and categorised according to the questionnaire responses.
Results: Findings revealed the ages at which iPad-specific behaviour emerges. The behaviours
included: attention skills, behaviour, cognitive skills, language and communication skills, exploration of the iPad, posture and iPad handling and motor skills. There was no statistically significant
difference between genders.
Conclusions: This study has provided insight into the way children under the age of three use an
151
iPad. It may also be beneficial to target specific skills that may be lacking in children who need to
use the iPad functionally.
Keywords: Apple iPad, children, stages of development, typical development, application recommendations, touchscreen technology, iOS, developmental milestones, core developmental skills,
attention skills, behaviour, cognitive skills, language and communication skills, exploration of the
iPad, posture and iPad handling and motor skills
P1.57
VOICELESS SONORANTS IN ICELANDIC: DATA FROM
A CROSSLINGUISTIC STUDY ON PROTRACTED PHONOLOGICAL
DEVELOPMENT
Thóra Másdóttir - National Hearing and Speech Institute of Iceland, University of Iceland, Reykjavík, Iceland
B. May Bernhardt - University of British Columbia, Vancouver, Canada
Joseph Stemberger - University of British Columbia, Vancouver, Canada
Objective: Icelandic has both voiceless and voiced sonorants, a rare occurrence crosslinguistically: word initially, both voiceless and voiced /l/, /r/ and /n/; word medially, voiceless sonorants
in clusters; word finally, /l/ and /r/ primarily voiceless and /n/, voiced. The current study compares
sonorant acquisition by children with protracted versus typical development (PPD, TD).
Methods: Data from fourteen 3-year-olds and thirteen 4-year-olds with PPD were compared with
data from age-matched TD peers. Twelve words were extracted from a test list of 110 words: (a)
word initially, 3 with voiced sonorants and 3 with voiceless ones; (b) word medially, 3 with voiceless sonorants; and (c) word finally, 3 with voiced /voiceless sonorants. Icelandic speakers transcribed the samples.
Results: The children with PPD had lower match (accuracy) scores for all /l/s and /r/s, the voiceless sonorants showing lower match scores. Voiced /n/ had a higher match level than /l/ and /r/
(PPD data). Word-initial voiceless /n/ had the lowest match level overall, across (both groups).
Conclusions: Word-initial voiceless sonorants are acquired later than voiced sonorants. Differences across sonorants reflect the sound classes and frequency. Rhotics and laterals are especially
challenging for children with PPD. These factors are key considerations for intervention planning.
Keywords: Protracted phonological development, phonological disorders, typical phonological
development, voiceless sonorants, Icelandic
P1.58
NON-VERBAL CHILDREN WITH ASD: LINGUISTIC COMPREHENSION
Dunia Garrido del Águila - University of Granada, Granada, Spain
Imedio Rocío García-Retamero - University of Granada, Granada, Spain
Gloria Carballo García - University of Granada, Granada, Spain
The language skills of children with ASD vary considerably due to the broadness of the spectrum.
However, evidence suggests that these children understand language (verbal and non-verbal)
worse than their peers with typical development (TD), showing a delay of acquisition in receptive
vocabulary.
Objective: To understand how comprehension skills in nonverbal children with ASD are affected
or disordered, and what type of sentences are more difficult.
Methods: A battery of direct (TTFC-2 and CEG) and indirect (GARS and SCQ) measures are used
152
to analyze language comprehension in 26 non-verbal children with ASD (: 9.8 years and SD: 3.1)
and 26 children with TD (: 3.9 years and SD: 1.1) matched for vocabulary age according to PPVT-III.
Results: The vocabulary and comprehension of orders in children with ASD are found to be well
below than those of their chronological-age peers. Moreover, significant differences in understanding grammatical structures (blocks p=0.001 and items p=0.001) are manifest between nonverbal children with ASD and children with TD. The children with ASD found the structure SVO
easier, and those sentences which do not follow the canonical order more difficult. Furthermore,
remarkable differences in social competence and communication observed indirectly through the
parents were found.
Conclusions: There is a significant grammatical and lexical disorder in all children with ASD considered in this study. Thus, this is an especially vulnerable area, which agrees with other studies
that found deficits in formal language aspects in these children. Our scores in GARS and SCQ
confirm ASD diagnosis and, as well, show that the alteration in communication is one of the traits
that typically describes the disorder, and one of the criteria that characterizes it, with a general
clinical and research consensus.
Keywords: Autistic spectrum disorders, language comprehension, non-verbal children
P1.59
A CASE STUDY APPROACH IN TWO CASES WITH CHILDHOOD
APRAXIA OF SPEECH
Christina Nikitopoulou - Community Mental Health Centre, 1st Department of Psychiatry, University of Athens, Athens, Greece
Objective: Childhood apraxia of speech (CAS) is a childhood neurological speech sound disorder
in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g. abnormal reflexes, abnormal tone). The core impairment in
planning and/or programming the spatio-temporal parameters of movement sequences results in
errors in speech sound production and prosody (ASHA 2007). Relatively few treatment studies of
CAS have been published, although there has been a recent increase in studies which meet EBP
criteria. The purpose of this study is to present systematic practice-based reports of two cases
with CAS.
Methods: The subjects consisted of two children diagnosed with CAS and control difficulties of
the articulators, aged 5;10 and 5;5 years respectively. The diagnostic criteria were inconsistent
errors on consonants and vowels in repeated productions of syllables or words, lengthened and
disrupted co-articulatory transitions between sounds and syllables, inappropriate prosody, especially in lexical or phrasal stress and oromotor difficulties. Intervention consisted of twice weekly
sessions for a total of 6 months. The therapy programme for each child was individualized and
consisted of oral motor exercises for muscle tone strengthening, non word repetition for diadochokinesis, production of target speech sounds using cued articulation and auditory discrimination, enhancement of phonological awareness and enhancement of prosody. Measurements were
taken before and after intervention.
Results: Measurements showed improvements in both children after intervention. The participants
had improved articulatory movement and accuracy, as well as verbal communication in general.
Also there were changes in their phonological awareness and writing skills, as well as the loudness and pitch of their voice.
Conclusions: An eclectic and individualized approach in CAS intervention appears to have significant results. The ages of the children, motivation, and number of sessions may also be contributing factors to therapy outcome.
Keywords: Childhood apraxia of speech, motor speech disorders, case study, intervention
153
P1.60
PROFILING SUBJECTS THAT STUTTER: A COMPARISON BETWEEN
ADOLESCENTS AND CHILDREN
Emilia Capparelli - C.R.C. Balbuzie Srl, Rome, Italy
Francesca Del Gado - C.R.C. Balbuzie Srl, Rome, Italy
Donatella Tomaiuoli - C.R.C. Balbuzie Srl, Sapienza University of Rome, Rome, Italy
Maria Grazia Spinetti - C.R.C. Balbuzie Srl, Sapienza University of Rome, Rome, Italy
Paola Falcone - C.R.C. Balbuzie Srl, Rome, Italy
Biancamaria Venuti - C.R.C. Balbuzie Srl, Rome, Italy
Objective: Stuttering is a complex multifactorial and multidimensional disorder, in which a number of heterogeneous elements interact in an unpredictable way. This complex interaction among
different factors necessarily produces manifest and /or hidden outcomes, with the result that the
disorder can take on different forms in different subjects that are affected. This brings about the
necessity to subject the patient to a multidimensional assessment and to differentiate the treatment from patient to patient. There are many types of treatment available at an international
level with multidimensional characteristics- that therefore do not limit themselves to treating just
the symptom- and which are differentiated per subject (see among these the MIDA-SDP). Their
efficacy requires an assessment which in itself is necessarily conducted on a multidimensional
basis. The multidimensional assessment of a stuttering patient brings about a result that can be
usefully inserted within the profiling system of the patients themselves. Even though each patient
is unique, it is still important to base the therapy on subject profiles. The remainder of the therapy
can then be developed to include a necessary residual personalization.
Methods: Moreover, the classification facilitates a synthesis of the results of the assessment and
provides the patient with a direction for choosing the most effective therapy. Profiling is based
on a number of pre-chosen parameters; on the basis of the possible range of values within the
parameter (if single), or by possible combinations of the different ranges of values within parameters (if more than one), it consequently becomes possible to identify subgroups of subjects that
present homogeneous characteristics among themselves (characterized, that is, by a low internal
variance).
The profiling proposed bases itself on two fundamental variables of the manifest aspects (symptomological) and the hidden aspects (syndromic) of the disorder present in the subject and on
his assessment. Four different profiles emerge, with specific characteristics and needs regarding
treatment. In this study, the sample, organized in clusters, was composed of 100 children aged
6 to 12 years and 100 adolescents aged 13 to 18 years. All the subjects were subjected to a
multifunctional structural assessment, which allowed the level of severity of manifest and hidden
aspects to be measured, allowing therefore the subjects to be profiled.
Results: The results of the study highlighted a significant difference between the distribution of
the profiles in the two age groups of adolescents and children and the distribution of the profiles
into two subgroups of males and females.
Conclusions: Through an analysis of the sample and the considered parameters the study has
allowed us to observe some useful elements, which can help us to better understand the distribution of different profiles in the population being evaluated among the different age groups, and to
facilitate the application of the proposed profiling system.
Keywords: Stuttering, MIDA-SP, profiling system, assessment
154
P1.61
PROCESSUS DE SOCIALISATION ET TROUBLES DU SPECTRE
AUTISTIQUE DANS UN CONTEXTE MULTILINGUE
Letizia Volpin - Université de Neuchâtel - Institut de lettres et communication - Logopédie, Université de Neuchâtel, Neuchâtel, Switzerland
Objectif: L’interaction entre adulte et enfant constitue une base indispensable pour l’acquisition
du langage. Mais, les pratiques langagières auxquelles l’enfant participe peuvent varier selon son
développement (typique ou atypique) et selon aussi sa culture d’appartenance.
Notre contribution présente une étude exploratoire de type ethnographique concernant le rôle
de l’environnement langagier dans le développement des liens sociaux chez deux enfants multilingues de neuf ans présentant des troubles du spectre autistique.
Méthodes: A cette fin, la méthode de la triangulation de points de vue a été choisie. Ainsi, les
processus de socialisation des sujets ont été explorés en croisant différentes perspectives en examinant les conduites verbales et non verbales des deux enfants dans différentes sphères touchant leur vie quotidienne. Nous avons recueilli nos données avec un enregistrement audio lors
d’interactions en classe et un focal sampling (Altmann, 1974) en cour de récréation (avec un suivi
sur 4 mois) ainsi qu’un entretien clinique et un entretien individuel avec un parent.
Résultats: L’ensemble de nos corpus a permis d’esquisser l’environnement langagier de l’enfant
et d’en apprécier la complexité. Nos résultats soulignent l’importance du langage dans le processus de socialisation. En particulier, ils suggèrent que les enfants ayant une construction langagière
plus avancée ont des réseaux sociaux plus larges que d’autres enfants dont le développement est
moins avancé.
Conclusions: A partir des résultats obtenus, nous proposons des perspectives de travail centrées
sur l’éveil aux langues chez une population souffrant de troubles du spectre de l’autisme.
Mots-clés: Autisme, multilinguisme, interaction, socialisation
P1.62
THE USE OF ASSISTIVE TECHNOLOGY TOOLS AND STRATEGIES
FOR CHILDREN WITH AUTISTIC SPECTRUM DISORDER (ASD)
Christian Leorin - Department of Neurosciences, University of Padova, Padova, Italy
Objective: The objectives of this poster are:
1. To present the design methodology and outcomes of a specific software that would support
speech and language therapy in children with autistic spectrum disorder (ASD) that have not developed verbal language.
2. To promote the use of an SLP software to stimulate and consolidate the execution of each
sound of the Italian language, simply providing a visual-spatial feedback as a consequence of
each child’s correct production.
3. To describe good practice in inter-professional collaboration with the engineer of an external
software company.
Methods: The software consists of 12 levels differentiated and defined by 4 articulatory and vocal
parameters. The frames are divided into two categories: the first one has the goal to make the
child aware that his verbal production, even if a-specific, could determine a modification in the
ambient. The second one aims to evocate and to consolidate each sound of the Italian language.
Depending on the selection of these parameters, every level includes specific phones that the
child has to perform and each correct execution will be systematically followed by its own visual
feedback. The software was tested with a sample group of pre-school children with ASD that
155
have not developed verbal language. The experimental phase included an initial assessment, a
questionnaire for the SLPs, followed by a treatment period and a post-treatment evaluation.
Results: The software increased the motivation and attention of ASD children during SLP therapy.
We have considered their interest in new technologies, as well as the fact that they mainly use a
visual-spatial system to elaborate information. The interprofessional collaboration played a significant role in the step-by-step development of the SLP software.
Conclusions: The use of a specific software may significantly improve the effectiveness of SLP
treatments provided that: 1) Children show a major interest for the five frames which are associated with vowels, because of the presence of both visual and auditory feedback; 2) The software
is used to achieve the rehabilitation outcomes identified by the SLP. In other words, rehabilitation
objectives should drive the use of technology and not the other way around; 3) The interprofessional collaboration provides a higher level of customization and specificity.
Keywords: Autistic spectrum disorder, assistive technology, SLP software, interprofessional collaboration, interdisciplinary learning.
P1.63
DESIGNING INTERVENTION FOR SCHOOL AGE CHILDREN WHO
STUTTER BASED ON A CHILD CENTERED EDUCATION PARADIGM
Vilma Makauskiene - Intercultural Communication and Educational Centre, A. Stulginskis University, Kaunas, Lithuania
- Faculty of Social Welfare and Disability Studies, Siauliai University, Siauliai, Lithuania
Regina Ivoskuviene - Faculty of Social Welfare and Disability Studies, Siauliai University, Siauliai, Lithuania
Objective: To investigate methods of assessment and therapy for pupils who stutter in Lithuania.
Methods: This research is based on a questionnaire and semi-structured interviews with parents
of school age children who stutter.
Results: The data shows the need to combine various methods of stuttering intervention, considering individual features of the pupils who stutter and their families in order to develop individual
educational therapy plans. Data reveal that methods of fluency shaping are dominant in Lithuania, however fluency skills are difficult to transfer in everyday life situations. Technical devices
and stuttering modification methods help to form positive self-esteem and overcome the fear of
stuttering and communication and are the least commonly used stuttering intervention methods in
Lithuania. Limited knowledge and experience of SLTs about the comprehensive stuttering intervention strategies, methods and their integration determine the tendency to use fluency shaping methods with insufficient consideration paid to the cognitive, emotional and social aspects
of stuttering. Based on the systemic approach and family–child centered paradigm reveals the
importance of active participation of parents and teachers in the stuttering therapy process. Most
parents and teachers are interested in the problem of stuttering and strive to gain new knowledge
about their possibilities, responsibilities in stuttering intervention, therefore their active involvement in the stuttering therapy process would be meaningful, while transferring gained fluency
shaping and / or stuttering modification skills to new communicational situations.
Conclusions: Authors will present stuttering assessment and therapy methods for school age
children who stutter in Lithuania.
Keywords: Stuttering, fluency shaping, stuttering modification methods
156
P1.64
MODIFY THE MOTHERESE TO LATE-TALKING TODDLERS: IS IT
POSSIBLE?
Bernadette Piérart - Faculté de Psychologie et des Sciences de l’Education, Université catholique de Louvain,
Kathy Huet - Faculté de Psychologie et des Sciences de l’Education, Université de Mons, Mons, Belgium
Hélène Dujardin - Faculté de Psychologie et des Sciences de l’Education, Université catholique de Louvain, Louvain-la-Neuve, Belgium
Marion Godtbil - Faculté de Psychologie et des Sciences de l’Education, Université catholique de Louvain, Louvain-la-Neuve, Belgium
Motherese, when a child presents a delay in speech and language development, is very specific
on acoustical special features: it is too fast, shows few melodic variations, too short, too rare and
has badly placed breaks. On the syntactic level also, the sentences are too long and too complex.
If these special features, described in French by Pierart and Harmegnies
(1993) and Pierart, Huet, and Harmegnies (2003), are not the actual cause of the delay in the
child’s language development, they contribute to it nevertheless.
The purpose of this research is to guide mothers of 5-year-old children, benefiting from therapy
for speech and language delay, in certain modifications which can be made to their language
when they address their child. The research concerned 6 mothers of late-talking toddlers. After this pretest contrasting the special features of the mothers’ speech and language when they
speak to their child versus when they speak to an adult, the mothers were the object of individual
counselling for 7 weeks, at the rate of a session a week. They were guided in self-observation of
their speech and language addressed to their child. They then were trained to vary their intonation watching that stress accents fall on the words with content, to slow down their fluency and to
have more breaks, to simplify their sentences. A first post-test took place at the end of the period
of training followed by a second post-test one month after the end of the counselling. The results
confirm that maternal guidance infers vocal and interactive changes of the mothers’ behavior, in
the short term, which remains in most of them in the long term as well.
P1.65
L-C.O.S.E.: EVALUATION INSTRUMENT OF SKILLS
AND MATURATIONAL BUCCO-FACIAL LEVELS IN THE PRETERM
INFANT AND IN THE NEWBORN
Monica Panella - ASLBI-Biella, Ospedale degli infermi, Biella, Italy
Marta Majoli - Genoa, Italy
Preterm infants are often not able to be fed per os. This is due to the immaturity of the respiratory,
neurological and gastroenterological systems. The newborn with very complex pre-, peri- and
post-natal iter may face different kinds of difficulties in feeding, which require short-term help in
activation, re-activation and/or rehabilitation. According to the “care” philosophy (a mix of strategies focused to minimize the stress in preterm babies during their stay in N.I.C.U.), which continues in the natural environment of the baby’s home, the role of the SLP, thanks to his/her knowhow
about swallowing skills, is aimed to observe and evaluate mouth functions in a specific way.
L.-C.O.S.E. (Little – Child Oral Stimulation and Evaluation) is the result that comes from the previous neuro-motor balance of the mouth (M.G. Buratti). It gives a detailed evaluation of the skills
and maturation levels of oral competences and, together with the cervical auscultation technique
with and without food (detection of breathing sounds, breathing – swallowing coordination, suck157
ling/sucking–breathing–swallowing coordination), it allows one to participate in evaluating the
possibility of feeding through os, to identify possible oral and/or swallowing difficulties in the
child who is already fed orally, to define specific buccal stimulation aimed to oral feeding in the
child that has not been fed yet, and to monitor the evolution and development of skills in the child
involved in the swallowing rehabilitation path.
Keywords: Preterm infant, newborn, dysphagia, evaluation
P1.66
NEW EVIDENCE FOR SLTs ON OTITIS MEDIA WITH EFFUSION
Ana Catarina Baptista - School of Health, University of Algarve, Faro, Portugal
Maria João Freitas - Faculty of Letters, University of Lisbon, Lisbon, Portugal
Óscar Dias - Faculty of Medicine, Hospital of Santa Maria / University of Lisbon, Lisbon, Portugal
Objective: The goals of this study are: (i) to investigate the impact of age of emergence of OME in
linguistic development, with reference to phonology; (ii) to determine the linguistic (and the phonological) profile of children with OME one month before the myringotomy with ventilation tube
placement and 12 months after this surgery.
Methods: To assess language development, a standardized test for European Portuguese was
used (TICL). Phonological development was evaluated with a picture-naming test designed for the
study (control of phonological variables: segmental inventory, syllable constituency, word length,
position within the word, word stress). A sample of 9 children aged 4;7 to 6;4 was gathered: a
control group (n=3); two experimental groups with OME (Group 1: OME during the first year of life
(n=3); Group 2: OME after 3;0 (n=3)). None of the children was submitted to speech and language
therapy; a mild and intermittent hearing loss was identified.
Results: An effect of age of emergence of OME was attested: before surgery, Group 1 shows a
deficit in linguistic development (morphological rules, auditory memory, metalinguistic skills) and
in phonological development (repair strategies for problematic segments under complex prosodic
structures). Group 2 matches the control group (mastery of all structures tested). 12 months after
the surgery, Group 1 still shows a deficit in linguistic and phonological development.
Conclusions: Early OME episodes thus have a negative effect on linguistic development, although
lexical knowledge seems to be unaffected. The voicing contrast within fricatives may be a phonological marker for children with early OME. SLTs have a crucial role in improving language competence and academic achievement in these children. The age effect must be further tested and
exported into the medical and scientific communities.
Keywords: Developmental language disorders, phonological disorders, hearing impairment
158
P1.67
LANGUAGE DEVELOPMENT IN CHILDREN WITH CLEFT LIP
AND PALATE: EVALUATION OF PREDICTIVE FACTORS
Cecilia Zannoni - Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
Anna Barbot - Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
Angela Rezzonico - Azienda Ospedaliera San Paolo, Milano, Italy
Ilaria Fontana - Azienda Ospedaliera San Paolo, Milano, Italy
Fulvia Aceti - Azienda Ospedaliera San Paolo, Milano, Italy
Objective: To investigate predictive factors of language development in children with cleft lip and
palate (CLP) in preverbal and first language age.
Methods: A sample of children with CLP was selected and followed up as regarding speech and
language skills at the Hospital of Parma and the Smile House Center of Milan at the San Paolo’s
Hospital. To assess the communication skills, the same protocol in both centers was used:
(1) a questionnaire “The MacArthur Communicative Development Inventory” (CDI), made up of
two parts “Words and gestures” and “Words and sentences”, filled out by the parents;
(2) a formal test “TVL–Test of Language Evaluation”, administered by the speech and language
pathologist.
Results: The CDI was found to be a successful instrument to individuate risk factors of first language delay. A score less than 10° percentile at CDI was found to be a predictor of a probable
developmental delay of both active and passive vocabulary.
Conclusions: The CDI was suitable to assess the development of communicative skills and particularly of receptive language and use of gestures in children with cleft lip and palate. The persistence of a score lower than 10° percentile in these two skills was found to be the most important
predictor of language developmental delay.
Keywords: Cleft lip and palate, MacArthur Communicative Development Inventory, language development and predictive factors
P1.68
A NEW SCREENING TEST FOR SCHOOL READINESS IN THE GREEK
SPEAKING CYPRIOT CHILDREN
Maria Christopoulou - European University Cyprus, University, Nicosia, Cyprus
Elena Petsa - European University Cyprus, University, Nicosia, Cyprus
Kostas Konstantopoulos - European University Cyprus, University, Nicosia, Cyprus
Objective: ‘School readiness’ refers to the physical well-being, motor development, socio-emotional development, approaches toward learning, language (listening, speaking, vocabulary, and
literacy), general knowledge and cognition (sound-letter association, spatial relations and number
concepts) as identified by the National Education Goals Panel (NEGP) Resource and Technical
Planning Groups (Kagan et al., 1995). However, no screening test for school readiness exists in
the Greek language. The aim of the present study is, thus, to provide preliminary data of a screening test in Greek speaking Cypriot kindergarten children.
Methods: A total of 30 healthy children aged 5.0-5.6 years took part in the study. Exclusion criteria involved the existence of neurological and psychiatric diseases, mother history of alcoholism
and drug abuse during pregnancy, birth prematurity, hearing loss and visual problems. Descriptive
analysis involved means and standard deviations of subtests (general knowledge, auditory memory, mathematical calculations, judgment, language, and sentence completion). The SPSS 20.0
159
statistical software was used for the analysis of the data.
Results: The total score of the group in the test was 30.6/60 (SD=8.3). The mean of the group
for general knowledge was 3.6/6 (SD=1.38), the mean for auditory memory was 3.53/6 (SD=.90),
the mean for mathematical calculations was 5.17/8 (SD=1.74), the mean for judgment was 3.6/5
(SD=1.10), the mean for language was 10.5/15 (SD=.99) and the mean for sentence completion
was 4.2/6 (SD=1.20).
Conclusions: The results showed that the test may underestimate the abilities of the healthy
children for school readiness. A new study is needed to compare healthy children’s performances
with children exhibiting various disorders in order to show the sensitivity of the test in different
pathologies.
Keywords: School readiness, general knowledge, auditory memory, language, judgment, normative data, Greek speaking children
P1.69
A PROPOSAL FOR A MULTIMODAL EXTENSION
(MSCE: MULTIMODAL SIGNAL CATHEGORIES EXTENSION) OF PVB
(PRIMO VOCABOLARIO DEL BAMBINO; ITALIAN VERSION OF CDIS),
ALSO EXPORTABLE TO CDIS IN OTHER LANGUAGES
Luciano Destefanis - S.C.NPI, C.A.S.A., ASL CN1, Regina Montis Regalis Hospital, Mondovi’, Italy
Caterina Grillo - Riabilitation Center, Onlus, La Spezia, Italy
Debora Bonelli - S.C.NPI, C.A.S.A., ASL CN1, Regina Montis Regalis Hospital, Mondovi’, Italy
Pasqualina Pace - Fondazione Marino Per L’autismo, Onlus, Reggio Calabria, Italy
Elena Danna - S.C.NPI, C.A.S.A., ASL CN1, Regina Montis Regalis Hospital, Mondovi’, Italy
Objective: The use of the adaptation of the Italian CDIs (MacArthur-Bates Communicative Development Inventories), PVB (Primo Vocabolario del Bambino, Caselli et al., 1995; 2007), allows us
to obtain important information about the communicative and linguistic development of children
with severe communication difficulties up to the age of 3 and in particular, for children with autism
spectrum disorder (ASD). In fact, the inventory tool allows to obtain information from parents or
other caregivers who know the child well. At a certain point, we felt the need to broaden the collection of the child’s skills data to some nonverbal signal categories too.
Methods: We took inspiration from a categorization of signal types proposed by Linda Watson.
Some categories have been added to the original ones of PVB to include other kinds of signals
(for sentences and vocabulary, in comprehension and production) like hand over hand movements, objects, gestures, pictures along with the verbal. The revised form (extended) of the questionnaire was modulated so as not to be too difficult for the compiler. An Excel module has also
been made, that allows one to process the raw data by calculating statistics and building summary tables and graphs.
Results: The data collected with the extended form allows on the one hand a broader assessment
of some nonverbal aspects of signaling. On the other hand, some kind of stereogram among other
graphics (lexical landscapes) allows caregivers to get a clear and evocative image of the situation
of the child’s semantic-lexical knowledge.
Conclusions: The proposed extension, made possible by the use of tools such as the Excel
spreadsheet, adds a greater oppportunity to get information from the questionnaire PVB and use
it, particularly in the case of individuals with autism spectrum disorders. This extension can also
be adapted to versions of CDIs in other languages, because it is independent of the specific language.
Keywords: Autism spectrum disorder (ASD)
160
P1.70
ACOUSTIC ANALYSIS AND CLINICAL IMPLICATIONS: EVIDENCE
FROM THE LATERAL /L/
Susana Rodrigues - School of Health (ESS), University of Algarve, Faro, Portugal
Fernando Martins - Faculty of Letters and Centre of Linguistics (CLUL), University of Lisbon, Lisboa, Portugal
M. T. Jesus Luis - School of Health Sciences (ESSUA, Institute of Electronics and Telematics Engineering of Aveiro, University of
Aveiro, Aveiro, Portugal
Objective: Liquid consonants are the last to be acquired in the process of speech and language
acquisition and they are also a problematic sound class for children with speech sound disorders.
The purpose of this study is to investigate the acoustic characteristics of /l/ in different phonetic
and prosodic contexts and to determine which acoustic properties are more salient to help SLT in
a more effective intervention.
Methods: Data were collected from 10 adults (5 female and 5 male speakers).They were all monolingual speakers of European Portuguese and none had a history of speech and/or language disorders. A set of real words was recorded based on the following principles: trissyllabic word; with
paroxytone stress pattern; onset, complex onset and coda positions and the nuclear vowel varied
between seven oral vowels. The acoustic signal was recorded at 16 bits and a sampling frequency
of 44100 Hz.
Results: F2 frequency values indicate a velarized /l/ in all syllabic positions, despite a tendency to
higher frequency values of F2 in front vowel context. F1 frequency values are significantly higher
in coda than in onset position, which reflects a strong pharyngeal component in coda. Slope of
the F2 transition is higher in front vowel contexts. Results are interpreted in relation to the acoustic characteristics in adult production and discussed in terms of their clinical implications, because
the speech of adults works as a model with which the child compares his/her own production.
Conclusions: Results demonstrate that vowel context and syllable position play an important role
in the /l/ production and must be considered as routine in clinical practice.
Keywords: Acoustic analysis, /l/, clinical implications, speech sound disorders
P1.71
TEO FA LE SMORFIE- PRIMI PASSI VERSO IL LINGUAGGIO
Valentina Minelli - Centro Percorsi, Centro di Riabilitazione, S.Severo, Italy
Grazia Lombardi - Centro Percorsi, Centro di Riabilitazione, S.Severo, Italy
Objective: This is an illustrated book for the rehabilitation of oral, communication and pre-linguistic functions in children under the age of 3, as well as children with attention and cognitive
difficulties of varying degrees. The book engages the young readers in a pleasant myofunctional
and phono-articulatory rehabilitation therapy program appropriate to their age. The program is
delivered through play, as “non-formal learning”, avoiding in this way the risk of presenting the
exercises as a “task”. Instead the story offers a meaningful context, through the use of simple
stimuli, clear and engaging images, topics pertaining to the children’s’ everyday life experience,
and a book size perfect to be handled by the young readers’ “little hands”!
Methods: The choice of oral-motor exercises follows the advice given by various authors (Fournier, del Grande, Vernero, Maurino, Fanzago) within their swallowing and speech impairment (articulation) rehabilitation program. The methodological structure is inserted inside a short illustrated
story of the young protagonist eating ice cream, celebrating his birthday, playing and so on.
Below each image the adult will find some useful suggestions to support the child in imitating the
actions of TEO.
161
Building time-trial: 5 years. Target audience: Children from 2 to 8 years of age with language, cognitive, attention and motor difficulties, autism, typical development children.
Results: Highly motivating for all children, develops imitation and oro-motor skills, promotes
listening and attention skills, includes captivating images, stimulates narrative skills by offering
a model to the child first and encouraging the child to retell the story on his own later. For the
speech therapist: opportunity to assess informally through play the young and/or cognitively impaired child’s oro-motor abilities, as well as their imitation abilities and sound stimulability.
Conclusions: “Teo fa le smorfie” has proved a useful tool for the assessment and rehabilitation of
children with language, communication and development impairments. Easy to use, it can be recommended not only to speech and language therapists, but also to parents and teachers with the
purpose of pleasantly stimulating the production and/or the imitation of oral praxis and onomatopoeia. Furthermore, it can be used as a pre-reading activity by encouraging the child to listen to a
simple illustrated story.
Keywords: Oral-motor, pre-verbal
P1.72
INTERVENTION AREAS IN SPEECH AND LANGUAGE THERAPY WITH
THE FRAGILE X SYNDROME POPULATION: A SYSTEMATIC REVIEW
Ana Paris Leal - PIN - Progresso Infantil, PIN - Progresso Infantil, Lisbon, Portugal
Ana Beirao - PIN - Progresso Infantil, PIN - Progresso Infantil, Lisbon, Portugal
Objective: A systematic review was conducted to summarize and evaluate the literature on the
topics that may be of interest to speech language therapists regarding intervention of the Fragile X
syndrome population.
Methods: Databases searched included the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, EBSCO and PubMed. A systematic literature search
was conducted from January 2004 through December 2014. A total of x articles were independently screened. A broad set of key words related to Fragile X syndrome, communication, language, speech, breathing, suction, swallowing, mastication, was generated by the author. These
key words were then mapped to the medical subject headings from the National Library of Medicine or to the controlled vocabulary specific to each of the searched databases. Truncated search
terms were used to capture spelling or suffix variations. To identify as many relevant citations as
possible, the systematic search combined a pearl growing strategy and plain text searching.
Results: Research is still ongoing.
Conclusions: Research is still ongoing
Keywords: Fragile X syndrome, speech and language therapy, intervention, systematic review
162
P1.73
CAREGIVER AND CHILD PERSPECTIVES ON QUALITY OF LIFE IN
CHILDREN EXPERIENCING CEREBRAL PALSY
Shyamani Hettiarachchi - Department of Disability Studies, Faculty of Medicine, University of Kelaniya & Curtin University,
Colombo, Sri Lanka
Objective: To document the key concerns regarding QOL between caregivers and children with
cerebral palsy.
Methods: Translations of the CPQOL in Sinhala and Sri Lankan Tamil were completed by 30
primary caregivers with children with cerebral palsy (15 Sinhala-speaking; 15 Sri Lankan-Tamil
speaking) together with open-ended interviews with key informants. Perceptions of QOL were
gathered from 15 children with cerebral palsy via narratives of their artwork.
Results: The primary caregivers associated the severity of motor difficulties with limited physical
well-being and autonomy and shared concerns about pain. The interviews uncovered a preoccupation with the uncertainty of the future for children with cerebral palsy and concerns associated
with feeding their child. The child participants shared their feelings about friendships and opportunities for play.
Conclusions: The questionnaire instrument was not able to fully reflect the socio-cultural realities
of the caregivers. It strongly suggests the need for culture-specific measures of QOL.
Keywords: QOL, culture, questionnaire, interview, artwork, caregivers, child, cerebral palsy
P1.74
OUTCOME MEASUREMENTS IN CHILDHOOD STUTTERING TREATMENT
Miglena Simonska - South-West University ‘Neofit Rilski’, SWU, Blagoevgrad, Bulgaria
Objective: The main aim of this study is to explore types of outcome measurement in the process
of childhood stuttering treatment.
Methods: Three types of outcome measurement were included in the study: (1) percent syllables
stuttered, (2) stuttered syllables per minute, (3) mean length of the three longest dysfluencies.
They were implemented once per week after the therapy sessions. Measurement procedures were
based on audiotapes of the children’s speech. The minimum length of speech samples was 200
syllables. To prove the treatment’s progress, a nonparametric method of analysis was use.
Results: Results show that all types of measurement show treatment progress and can be used to
prove progress. In the frame of the outcome measurement process it was found that the easiest
way for recording weekly therapy progress is percentile syllables stuttered, but for the effectiveness measurement it is advisable, at the end of the monthly visits, to measure stuttered syllables
per minute and mean length of the three longest dysfluencies, because they take a longer time.
At the same time it was found that in the beginning of treatment children decreased their speech
rate. At the end of treatment, some of them increased speech rate, but children with more severe
stuttering kept the slower speech rate.
Conclusions: As we mentioned above, we implemented three types for outcome measurement in
order to check which of them is better for use during treatment. All of them show treatment progress. The speech therapist is free to choose which method they can use depending of the stuttering behavior demonstrated by each child.
Keywords: Outcome measurement, childhood stuttering, stuttering treatment
163
P2.01
INTERDISCIPLINARY COOPERATION AT THE STROKE UNIT OF THE
HOSPITAL OF THE REGION SALZKAMMERGUT IN VÖCKLABRUCK
Angelika Rother - University of Applied Sciences, FH JOANNEUM, Graz, Austria
Eva Ebner - University of Applied Sciences, FH JOANNEUM, Graz, Austria
Insult is one of the third most common reasons for death besides coronary heart disease and cancer. By establishing so called “Stroke Units”, which are special units for treating acute strokes, the
mortality rate could be decreased by 10 percent.
To ensure the best possible care, a close cooperation of the interdisciplinary team is imperative.
This team comprises medical doctors, care staff with a specific training, as well as speech and
language, physical and occupational therapists.
The aim of this paper is to describe the interdisciplinary cooperation at a Stroke Unit in practice,
to explain the therapeutic concepts which are applied and to highlight the role speech and language therapy assumes. Therefore, a qualitative interview was conducted with the members of
the interdisciplinary team of the Stroke Unit at the Salzkammergut-Klinikum Vöcklabruck (hospital
of the region Salzkammergut in Vöcklabruck), comprising the chief resident of the Stroke Unit,
four speech and language therapists and one team member of the care staff, one physical and
one occupational therapist.
At the Stroke Unit of the hospital of the region Salzkammergut in Vöcklabruck there are a lot of
overlapping areas of work that are covered by care staff, physical, occupational and speech and
language therapists. Consequently, interdisciplinary cooperation is of utmost importance, which
is guaranteed by conducting team meetings, constantly consulting medical doctors and care staff
and using interdisciplinary therapies. There is no consistent therapy concept that is applied at
the Stroke Unit of the hospital of the region Salzkammergut in Vöcklabruck. The main concepts
employed, however, are Bobath and PNF. The speech and language therapy at the Stroke Unit
commands a central role, when it comes to diagnosing and treating neurogenic dysphagia and
communication disorders.
Keywords: Stroke Unit
P2.02
PRIMARY PROGRESSIVE APHASIA
Angelika Rother - University of Applied Sciences, FH JOANNEUM, Graz, Austria
Johanna Mitterhuber - University of Applied Sciences, FH JOANNEUM, Graz, Austria
Primary Progressive Aphasia (PPA) is a relatively rare neurodegenerative condition, which commences with an isolated language impairment that prevails all through the course of the disease.
Additionally, more symptoms can develop within the first two years of onset, which mainly affect
cognition and/or motor functions, respectively. Due to the primary and prevailing language disorder speech and language therapists are mainly responsible for treating this condition. However,
the standard of knowledge about PPA is not very high among speech and language therapists.
The aim of this paper is after reviewing literature for symptoms, diagnostics and treatment of PPA,
to present latest findings, achieved by interviewing experts such as two neurologists, a neuropsychologist and three speech and language therapists.
Hence the paper presents possible symptoms related to PPA, aspects of diagnostics (including
potential differential diagnoses) as well as treatment options and suggestions from the perspective of the three named occupational groups. Results show that the disorder PPA is complex,
comprises various characteristics, progresses differently and shows similarities to dementia.
164
Consequently, also material for diagnosing and treating patients with dementia can be applied for
diagnosing and treating PPA, as well as material for diagnosing and treating aphasia with vascular cause. In general, the main focus in therapy comprises the following aspects: compensation,
maintaining function and status and aligning therapy with everyday life of patients. Nevertheless,
there is a considerable need for research concerning treatment of patients with PPA. Additionally,
due to the fact that this disorder is not well known, sensitizing and raising awareness about this
disorder would help to recognize and diagnose this disease at an earlier stage.
Keywords: Primary Progressive Aphasia, PPA
P2.03
INITIAL SPEECH ASSESSMENT IN THE ACUTE STAGE OF STROKE
Aaro Nursi - Neurology Clinic, Tartu University Hospital, University of Tartu, Tartu, Estonia
Maarja Pähkel - Clinic of Medical Rehabilitation, East Tallinn Central Hospital, Tallinn, Estonia
Liis Virkunen - Speech Therapy Unit, Haapsalu Neurological Rehabilitation Centre, Haapsalu, Estonia
Pille Taba - Neurology Clinic, Tartu University Hospital, University of Tartu, Tartu, Estonia
Objective: The aim of the present study was to adapt and validate the Mississippi Aphasia
Screening Test (MAST; Nakase-Thompson, 2004) to assess the speech of Estonian speaking
patients in the acute stage of stroke. The second aim was to elaborate the eighth subtest’s (verbal
fluency) diagnostic value as one part of MAST.
Methods: The sample consisted of 60 stroke patients and 35 healthy volunteers. The cognition of
all subjects was briefly assessed before speech assessment with MAST. The adapted and complemented MAST was used to evaluate 30 left hemisphere stroke patients, 30 right hemisphere
stroke patients and 35 healthy volunteers. Evaluation of inpatients were within 4 days of onset of a
unilateral stroke.
Results: The results of the study showed that it is possible to differentiate left hemisphere stroke
patients from healthy volunteers and right hemisphere patients on the basis of MAST scores. It
was found that the eighth subtest’s score was strongly correlated with the total index. It demonstrates the necessity of the subtest as part of the full aphasia screening test. The study also
indicates that it is possible to give a first estimation of a person’s speech abilities from the brief
cognition assessment. The results suggested a high internal consistency and good content validity for MAST.
Conclusions: It was found that MAST could be used with patients in the acute stage of stroke.
Speech therapists may use MAST to get a primary objective impression of a patients’ speech abilities. The test is also feasible for patients with severe health conditions. The given study presents
the most appropriate tasks and stimulus material for the Estonian version of MAST (MASTest). A
subsequent study is being carried out with a greater sample than in the previous research, using
MASTest on new stroke patients and healthy volunteers.
Keywords: Acute stage of stroke, speech assessment, test adaption, aphasia screening tests
P2.04
COMMUNICATION ABILITIES IN TRAUMATIC BRAIN INJURIES
Sanja Habus - Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia
Objective: The aim of this paper was to estimate the communication abilities of persons with traumatic brain injuries in the verbal, gesticular and graphic modalities. We had a set of 4 hypotheses,
165
and in order to verify them, we used the Porch Index of Communicative Ability, (PICA, B:E:Porch,
1981) as a measuring instrument. We conducted the survey on 14 persons of both genders from
21 to 62 of age through 3 periods with 3 months in between in order to follow the progress of the
examinees through follow up examinations.
Methods: The data that were gathered were processed by univariate and multivariate analysis.
Friedman nonparametric test is used to test significance of differences between arithmetic means
of small dependent samples. We used the program called PROM (Nikolić, 1997) to analyse variable system of quantitative and qualitative changes of one sample at two points in time. The
results obtained are shown in frequencies, percentages and mean values.
Results: All applied methods of data processing contributed to the evaluation of the hypotheses
which are partially accepted based on the results.
Conclusions: Communication abilities in persons with traumatic brain injuries are different with
regards to diffuse lesions, different kinds of blows and hits and the severity of the traumatic brain
injury. The results that were obtained point to the smallest degree of rehabilitation in the verbal
modality. Gesticular modality is significantly damaged in the initial examinations, but under the
influence of therapy, it is recovers more quickly. Graphic modalities show the worst results due to
pareses and plegias of the extremities. The results point to the importance of early participation of
certain modality in communication difficulties after brain injuries.
Keywords: Traumatic brain injury, communication difficulties
P2.05
ICF IMPLEMENTATION IN DAY-TO-DAY PRACTICE IN
NEUROREHABILITATION INSTITUTIONS IN AUSTRIA
Angelika Rother - FH JOANNEUM Graz, Graz, Austria
Michaela Brunner - FH JOANNEUM Graz, Graz, Austria
Andrea Haid - Schweizer Hochschule für Logopädie Rorschach, Rorschach, Switzerland
Jürgen Steiner - Interkantonale Hochschule für Heilpädagogik, Zürich, Switzerland
Objective: The International Classification of Functioning Disability and Health (ICF) places the
focus on the context of disability. Therefore SLT assessments, goals, treatment and evaluation
need to focus on participation. The idea of ICF is well known throughout all professions concerned. However, there is only a small amount of specific instruments and methods to conduct
assessment as well as therapy outcome evaluation. Focusing on participation demands more
emphasis on the individuals’ needs and resources.
Methods: This study aimed to identify the degree of implementation of ICF standards in day-today practice of SLPs in neurorehabilitation institutions in Austria. There were 3 main questions to
be answered:
(1) What is the institution’s commitment to ICF?
(2) Are there certain SLT tasks implementing the ideas of ICF?
(3) Is the cooperation between in-patient and out-patient therapy settings satisfying?
In autumn 2013 an online survey consisting of 21 questions (open and closed questions) was addressed to the heads of SLT departments of 19 participating institutions. Quantities were calculated, qualities (open questions) were analyzed on content.
Results: Results show that in Austria only half of the institutions work within the idea of ICF. This
is due to a lack of time and knowledge. When asking the participants what they focus on most in
intervention, goals concerning individual participation of patients in activities of daily living were
mentioned only once. Therapy outcomes are evaluated through tests, observation and interviews.
The lack of out-patient therapy options makes it difficult for patients to continue working on their
impairments and focusing on encouraging their resources.
Conclusions: The study highlights the need for further education to be able to work with ICF
166
and special coordinated timeframes to support further implementation. ICF compatible assessment tools would help to perform better concerning the implementation of ICF standards and to
achieve the goal of optimal participation of patients.
Keywords: ICF, neurorehabilitation, aphasia
P2.06
INTENSIVE ANOMIA THERAPY (IAT)
Izabella Szöllosi - Eötvös Lorand University, National Institute of Medical Rehabilitation, Budapest, Hungary
Éva Mészáros - Eötvös Lorand University, National Institute of Medical Rehabilitation, Budapest, Hungary
Objective: Recently reported intensive therapies significantly improve language abilities of aphasic patients. We developed a new intensive anomia therapy (IAT) inspired by certain aspects of
linguistic-based treatments and cognitive aphasia therapies aiming for the improvement of executive functions. The therapy comprises of systematic exercises, utilising all language modalities.
Our goal is to improve language abilities in aphasic patients and provide new insights of intensive
methods.
Methods: IAT takes 3-4 weeks with 2-2.5 hours of personal practice per day. The sessions are
organized thematically, practicing different semantic categories each day. 5 nouns and 5 verbs
in the same category return about 50 times in the tasks. Exercises vary in: (i) nouns and verbs
as target words, (ii) visual and auditory tasks; and concern all linguistic levels and modalities. In
addition, they rely on those executive functions which might contribute to language processes.
Three aphasics (two long-term and one short-term) were involved who had naming difficulties with
different types of aphasia.
Results: Naming was generally improved in all subjects. In certain tasks we observed increased
performance in linguistic components, such as repetition and updating. Generalization effect was
observed in improved naming abilities in unpracticed words. Long-term aphasic patients revealed
greater improvement in naming than short-term aphasics.
Conclusions: IAT proved to be effective in improving naming abilities; however, the therapy might
affect other processes of the language system, such as repetition or updating linguistic information. Moreover, our results indicate that the treatment is most effective for long-term aphasics.
Keywords: Aphasia
P2.07
GROUP TREATMENT IN TRAUMATIC BRAIN INJURY
REHABILITATION – THE SPEECH AND LANGUAGE PERSPECTIVE
Maja Ogrin - University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia
Objective: Patients after traumatic brain injury (TBI) experience various difficulties in their cognitive abilities and communication. With regards to communication, these patients mostly have
problems recalling the words they need to express ideas or to explain their thoughts through
speech and/or writing. They can have problems with understanding written, as well as spoken,
messages.
Methods: Group therapy for patients after TBI has been implemented at the University Rehabilitation Institute since 2010. Patients included in the group most frequently have aphasia and problems with attention, memory, judging and solving problems, as well as problems with executive
abilities. The group is open, the number of group members changes weekly. It is organized once
167
a week with a maximum duration of 90 minutes. It is moderated by a psychologist and a speechlanguage therapist. We are using two questionnaires for monitoring patient progress, one used by
the patients and the other by the therapists.
Results: Based on an analysis of the questionnaires we found that participants gain better insight into their abilities and problems, learn to change and adapt their behaviour according to the
reactions of other participants in the group and develop more acceptable social behaviour. They
learn that they are able to communicate despite their limitations; also the recognition of words
and speech fluency was improved. Furthermore, they began to socialize with other patients in
between therapy sessions.
Conclusions: Our experiences confirm the findings of other experts, that this form of therapy can
significantly motivate and prolong the effects of individual treatment in TBI patients.
Keywords: Head injury, group, rehabilitation
P2.08
THE ROLE OF LESION LOCATION AND VOLUME OF STROKE IN
APHASIA
Hedda Døli - Institute of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Karsten Specht - Institute of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Wenche Andersen Helland - Institute of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Objective: Lesion location and volume in stroke is a debated subject within aphasia research.
Clinical research using brain imaging techniques can provide new insights to this multifaceted
field of research. The aim of the present study is to investigate the relationship between lesion
location, lesion volume and aphasia in patients with left hemispheric stroke.
Methods: All patients underwent diffusion-weighted MRI (DWI-MRI) within 24 hours post onset
symptoms. The results from DWI-MRI have been analyzed using the Alberta Stroke Programme
for Early CT score (ASPECTS). These results give a rough picture of stroke site and size. Language function was assessed using the Norwegian Basic Test of Aphasia (Reinvang & Engvik,
1980) within one week post-stroke. Furthermore we plan to use voxel-based lesion-symptom
mapping (VBLSM) to get more accurate results of lesion location and volume.
Results: Fifty-eight patients with aphasia were included in the study (mean age 66.5, SD: 14.6).
The patients exhibit different aphasia types and different degrees of aphasia (mean score on the
aphasia test 151.6, SD: 69.8, range: 0-217). The preliminary results using the ASPECTS shows
that infarctions within or near the insula, the left frontal lobe and the temporal lobe will most likely
cause aphasia post stroke. Furthermore, the larger the lesion sites, the more severe is the aphasia.
Conclusions: Preliminary findings show that infarctions within the insula, the frontal lobe and
temporal lobe are predictors of aphasia post stroke. Further analysis will be conducted to achieve
more accurate and precise analysis of lesion location and lesion volume.
Keywords: Aphasia, acute stroke
168
P2.09
CONVERSATION STUDY FINDINGS FOR THE UNDERSTANDING OF
VERBAL COMMUNICATION DIFFICULTIES DUE TO
THE ALZHEIMER’S DISEASE
Tran Thi Mai - Département d’Orthophonie - Faculté de Médecine, Université de Lille, Lille, France
Boye Maïté - Département d’Orthophonie - Faculté de Médecine, Université de Lille, Lille, France
Natalia Grabar - UMR 8163 STL, Université de Lille, Villeneuve d’Acsq, France
Objective: The objective is to study verbal communication of Alzheimer’s Disease (AD) patients
in conversation situations. This study continues reflection on diagnosis and therapy based on
language tests. We propose to detect criteria specific to the language of AD people and to study
relations between deficient and preserved elements in natural conversation for better treatment.
Methods: We performed a comparative analysis of spoken corpora collected from five AD (initial/
moderate stage) and five control persons, aged over 80 (average=90 years). Participants conversed with a known interlocutor for 20 minutes. Automatic analysis (eg, TreeTagger, Flemm, Dérif)
of corpora addressed two aspects: (1) verbal interaction (turns and time of speech, overlappings);
(2) conversation content through spoken (primes, pauses, repetitions, self-corrections, interruptions, verbal output), lexical (number of words, lexical diversity, informativity, Yes/No utterances,
lexical errors) and syntactic (average length of utterances, syntactic diversity, interpolated clauses
and reported speech) phenomena.
Results: Our study indicates that, despite some similarities, verbal production of AD persons is
different quantitatively and qualitatively from control people: AD persons speak less, produce
shorter and poorer sentences, are inclined to use frequent words, show poorer lexicon, participate
passively in conversations, remain centered on their own opinions. This can explain why their discourse contains less dysfluencies, non-empty pauses, interpolated clauses and reported speech,
and more Yes/No utterances.
Conclusions: Our work offers new perspectives. Lexical and semantic difficulties of AD persons
are usually tackled through surface manifestations (paraphasia, pauses, self-corrections, repetitions and interruptions), while our study demonstrates that their absence does not imply absence
of difficulties, but indicates that they may be presented differently: with shorter and poorer sentences and poor participation in conversation, even if such people can still maintain verbal interaction. Our study offers new clues for a better diagnosis and therapy. The automatic method is
reproducible and can be applied to a larger number of participants.
Keywords: Communication handicap, Alzheimer’s disease, conversation, Automatic Linguistic
Analysis
P2.10
CORPOREALITY, USABILITY AND LIVABLE SPACE: NEW
PARAMETERS FOR THE ANTHROPOLOGICAL-PHENOMENOLOGICAL
ASSESSMENT OF APHASIA AND A NEW REHABILITATIVE
APPROACH
Lidia Gomato - S.G.Battista S.M.O.M Hospital, Roma, Italy
Objective: The phenomenological method has the assignment of showing the correlations and the
co-production between the subjective and objective dimension of an individual. Neurophenomenology aims to study the human experience systematically [2]. The neurophenomenologist
169
Professor Longhi (1909-1997) has suggested a systematic classification of the aphasic experience. Through his studies of aphasia, Longhi tries to prove that an alteration of the finalized
gesture, oriented in time and space, is at the basis of aphasic disorder and that the use of verbal
gesture is more compromised in those patients who have difficulties in structuring praxic gesture
and iconic gesture [3].
Methods: The study of Longhi and al. [4], performed with the neurophenomenological approach,
has been conducted on 40 aphasic patients at the neurorehabilitation center of S.G. Battista
S.M.O.M Hospital in Rome. The aim of this study was to analyze, by using the functional evaluation protocol “Aphasic profile”, the aphasic disorder according to three new parameters: the
corporeality, the usability and the livable space in order to identify: (1) the substructure most
compromised, (2) the substructure less compromised, (3) the substructure which should be taken
into greater consideration, (4) the substructure which may represent a possible way of facilitating
functional recovery.
Results: The results of this study, obtained from probabilistic analysis, showed two different
behaviors of the aphasic patients: a first group of 27 patients, who did not have prominent difficulties in the tests of praxic gesture and of iconic gesture, expressed, even if at a reduced level, a
causal management of the verbal gesture during a theme realization. In these patients the lesion
was not so severe as to completely damage the remaining brain tissue, thus the semantic level
of the verbal gesture was still possible. On the other hand, a second group of 13 patients, showing marked difficulties in the tests of praxic gesture and of iconic gesture, expressed as random
management of the verbal gesture, which never reached the level of a theme communication, but
instead stopped at a pre-semantic level.
Conclusions: The protocol “Aphasic profile” has proven to be a useful tool [1]: (1) to predict the
possibility of recovery; (2) to define the therapeutic target; (3) to choose the most appropriate
rehabilitation strategy to achieve the objective.
References
1. Gomato L., Afasia come alterazione del gesto verbale: valutazione e riabilitazione. Approccio
antropologico-fenomenologico. Rivista di Neuroscienze, Psicologia e Scienze Cognitive,
(speciale afasia) novembre 2013
2. Cappuccio M., Neurofenomenologia,– Bruno Mondadori 2009
3. Longhi L., Afasia. In: Trattato di Neurologia Riabilitativa Marrapese 1985
4. Longhi L.,L. Gomato et al., La parola come gesto; la sua spazialità. In: Neuroriabilitazione
dell’Emiplegico. Ermes Medica 1981
Keywords: Aphasic profile, neurophenomenological approach, language, corporeality, livable
space, sub-stuctures, verbal gesture, iconic gesture, praxic gesture
P2.11
COMMUNICATION NEEDS OF PEOPLE WITH APHASIA. LET’S ASK THEM!
Livia Bratus - University of Turin, Turin, Italy
Marta Barbaro - CROS’NT, Verona, Italy
Patrizia Steni - ASL TO1, Rehabilitation Department, Turin, Italy
Objective: Communication problems due to aphasia often cause social limitations and restrictions
in every-day life activities. Communication needs arise predominantly when individuals with aphasia return home and face real-life situations. During this phase of the therapeutic treatment, rehabilitation activities should be aimed to give patients the best possibility to live successfully with
aphasia, primarily addressing their main needs. The aim of our study is to give voice to people
with aphasia, investigating their communication needs starting from their own point of view.
Methods: 22 individuals with non-fluent aphasia, without prevailing comprehension or cognitive
impairment, were interviewed for our study; all had their acute event at least 6 months before
170
recruitment and were living at home when recruited. Our interview followed a semi-structured format in order to explore a common ground of communication needs and maybe encourage some
spontaneous items. In order to facilitate the interaction with the interviewees, Supported Conversation techniques were used and a PowerPoint presentation was created to support the interview
with pictures and a standardized set of written questions and answers.
Results: Data analysis is still ongoing, but preliminary remarks show that participants were really
motivated by the possibility to be useful to other people with aphasia and to direct the rehabilitation’s course. An initial survey on the results shows that their major needs include the possibility
to use the telephone, to tell one’s own life, to find the right words or alternative communication
strategies and to train their partners on communicating with them.
Conclusions: Further observations concerning the development of data analysis will be discussed
together with the conclusions during the presentation.
Keywords: Aphasia
P2.12
PROMOTING PARTICIPATION IN PERSONS WITH APHASIA:
A MULTIPROFESSIONAL SOCIAL APPROACH
Rossella Muò - ASL TO1, Rehabilitation Department, Torino, Italy
Marcella Di Pietro - Fondazione Carlo Molo onlus, Centro Afasia CIRP, Torino, Italy
Maristella Crielesi - Fondazione Carlo Molo onlus, Centro Afasia CIRP, Torino, Italy
Alessia Congia - Fondazione Carlo Molo onlus, Centro Afasia CIRP, Torino, Italy
Lorena La Rocca - Fondazione Carlo Molo onlus, Centro Afasia CIRP, Torino, Italy
Stefano Monte - Fondazione Carlo Molo onlus, Centro Afasia CIRP, Torino, Italy
Introduction: Language and communication changes associated with aphasia can have a broadranging impact on daily life, affecting everyday interactions and resulting in changed relationships,
poor vocational outcomes and decreased quality-of-life and psychological well-being; an impact
on family members is also highlighted. Living with Aphasia Framework for Outcome Measurement
(A-FROM) is a conceptual framework that includes four domains (impairment, participation in life
situations, communication and language environment, and personal factors) and their interactions, in relation to aphasia-related Quality of Life. Following the A-FROM framework, the “Aphasia Center CIRP” offers integrated multiprofessional treatments and support activities to persons
with aphasia throughout the entire course of the disease.
Aims. Main goals of interventions are 1) to help individuals with aphasia cope with the fact that
they have been left with a chronic disability, 2) to help individuals with aphasia start living successfully with aphasia, 3) to raise public awareness on aphasia and individuals with aphasia.
Methods. CIRP’s activities include psychological support for both patients and caregivers, social
worker counseling, legal counseling, two social theater co-conducted groups to stimulate nonverbal communication abilities and SLP consultant in agreement with the ASL TO1 Rehabilitation
Department; “Conversazioni Narrative” co-conducted group also aimed to increase communication abilities in more ecological situations. The aim of the presentation is to give a description
of CIRP’s activities in order to share the social approach and information on useful activities for
people with aphasia.
171
P2.13
POSITIVE EFFECTS OF SPEECH AND LANGUAGE THERAPY WITH DOG
ON ADULTS WITH NEUROLOGICAL DISORDERS
Mateja Omahna - The University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
Objective: Speech-language therapy with dog is an approach, with which we may enrich the
usual therapy for adults with neurological disorders. We introduce speech therapy aided by a dog,
while animal-assisted therapy has a positive impact on communication.
Methods: Once a week we provided speech-language therapy with dog for adults in the neurological rehabilitation department, who are already having usual speech-language therapy. The
team includes a speech-language therapist, a client, a dog and its owner. The speech-language
therapist sets the goals and makes an evaluation after every session. The speech-language therapist evaluates the client’s non-verbal communication, speech, language, attention, motivation and
emotional well-being due to usual speech-language therapy.
Results: Speech-language therapy with dog was very well received by the clients. They were
more positive and happy and did not have a feeling they were in therapy. Instead of displaying
their problems, the relationship with the dog became the center of attention. They were also additionally motivated and tried to do their best at their tasks; also their attention was better. Clients asked more questions about the dog and were more talkative. Those with dysarthria tried to
speak more loudly and clearly.
Conclusion: Speech-language therapy with dog proved to be an efficient supplement to usual
therapy. The positive experiences and results are an additional motivation for further work and
research.
Keywords: Speech-language therapy with dog, adults, communication, neurological disorder
P2.14
VALS: TEST FOR THE EVALUATION OF COGNITIVE AND LINGUISTIC
SKILLS IN ADULTS – A NORMATIVE SAMPLE
Kinga Gaspary - Asl Roma D, Università degli Studi di Roma Tor Vergata, Roma, Italy
Anna Giulia De Cagno - Asl Roma D, Università degli Studi di Roma Tor Vergata, Roma, Italy
Solene Mantione - Asl Roma D, Università degli Studi di Roma Tor Vergata, Roma, Italy
Learning disability (LD) is a chronic disorder, whose expression is modified in relation to age and
environmental requirements. Its prevalence is higher in primary and secondary levels, but tends
to persist throughout life to be a potential factor of vulnerability. The approval of the law 170/2010
“New rules on specific learning disorder in schools” responds to these social needs for people
with LD, which require a certificate drawn up in accordance with the regulations.
By reason of a lack of standardized procedures and instruments that can be used over 18 years,
we have found it useful to fulfil a series of tests, aimed to the evaluation of cognitive and linguistic
skills, in adulthood. The assessment battery used in this study, has been adapted from a French
test (Evalad 2001), and the purpose of this study was to determine the normative data relating to
cognitive and linguistic skills in an adult population with different age, sex, and educational level.
The population of this study consists of 132 people, including 51 males and 81 females, aged
between 18 and 65 years old and native Italian, with different degree.
Method: to reveal the data about the normative sample inferential statistics was used.
From this study it seems that the battery may be useful for the evaluation of cognitive and linguistic skills in adulthood, so it was submitted to 12 adult dyslexics, then we compared the results.
172
However, we should increase the sample of dyslexics to have statistically significant data and it
will be the subject of future studies.
P2.15
LITERACY IN THE BRAZILIAN UNIVERSITY:
STUDENTS WITH LANGUAGE DIFFICULTIES
Ana Paula Santana - Universidade Federal de Santa Catarina, Florianópolis, Brazil
Introduction: In Brazil, 38% of university students show some kind of difficulty in reading interpretation and written production. Considering that this reflects the profile of typical students, what
can one say about those who may have learning difficulties as a consequence of many possible
kinds of disorders: hearing or visual impairment, global development disorders, dyslexia, language
impairment and so on? In this sense, learning difficulties may influence the student´s performance
in reading interpretation and written production affecting significantly their permanency in the
universities. However, what exactly are these difficulties and what are these students’ literacy
practices?
Objective: The aim of this work is to analyze the literacy practices of the university students with
interpretation and written production problems and the difficulties related to such practices.
Methods: This is a qualitative research based on semi-structured interviews with students who
had reported difficulties in their academic activities. To emphasize our holistic and historic-cultural
approach, family members were interviewed as well. Five students from a public university in
Brazil took part in this research. All the interviews was taken individually, recorded, transcribed
and analyzed.
Results: The results show that students with brain paralysis, dyslexia, or deafness have low
practices of literacy and present difficulties in production and interpretation in secondary genders,
usually required in the academic environment.
Conclusion: This result points to the importance of an interdisciplinary discussion and actions to
promote more oriented learning for these students. In this sense, speech therapy could contribute
actively to the university educational program and lead to better quality of life for these students in
the university.
P2.16
SMAAV: A NEUROPSYCHOLOGICAL BATTERY FOR ASSESSING
SEMANTIC MEMORY IMPAIRMENT ON ACTION VERBS
Gloria Gagliardi - CIRI Scienze Della Vita e Tecnologie Della Salute, Università di Bologna, Bologna, Italy
Objective: The poster will present the structure and the norms of the SMAAV neuropsychological
test (“Semantic Memory Assessment on Action Verbs”) for cognitively intact adults. The battery
was designed to be used to assess the lexical retrieval skills and conceptual knowledge deterioration exploiting the semantic properties of action verbs.
Methods: The test was made from a selection of data belonging to the IMAGACT interlinguistic
ontology of action [Moneglia et al., 2014]. The items were derived from a subset of verbs (the Italian lemma “girare”, its hyponyms and semantic relatives), by applying pragmatic variations to the
action types. SMAAV has been structured with two subtests, to point out lexical erosion patterns:
a visual confrontation naming test (25 stimuli) and a comprehension-lexicalization multiple choice
test (11 stimuli). Stimuli consist of short video clips (3–5 s) depicting movements and actions. The
173
standard setting (still ongoing) has currently involved 45 persons, according to a cross-sectional
study design.
Results: Cut-off score has been determined, and furthermore some statistically significant trends
and correlations have been found (e.g. score/age, score/education).
Conclusions: SMAAV may be used for the early diagnosis of mild cognitive impairment and the
neuropsychological evaluation of acute stroke and traumatic brain injury patients.
Keywords: Cognitive impairment, psychiatric disorders
P2.17
AUDITORY LEXICAL – SEMANTIC PROCESSING IN APHASIA DURING
SEMANTIC CATEGORIZATION TASK: ERP STUDY
Karolina Lice - Polyclinic SUVAG, Polyclinic SUVAG, ZAGREB, Croatia
Marina Paprika - Polyclinic SUVAG, Polyclinic SUVAG, ZAGREB, Croatia
Martina Vukovic Ogrizek - Polyclinic SUVAG, Polyclinic SUVAG, ZAGREB, Croatia
Marijan Palmovic - Edukacijsko-rehabilitacijski fakultet, Edukacijsko-rehabilitacijski fakultet, Zagreb, Croatia
Objective: N400 has proved to be a robust ERP component and has been regarded as an electrophysiological correlate of various aspects of language processing: semantic integration, facilitated
lexical access, semantic memory search, etc. According to previous neuropsychological, neuroimaging and some electrophysiological studies on semantic categorization in healthy volunteers,
animate and inanimate categories differentially modulate N400 at fronto-central sites. Although
there are controversies about these differences, some electrophysiological studies on healthy individuals have shown that N400 effect begins earlier and have smaller amplitude for animate than
inanimate words due to their easier processing (Proverbio et al., 2007; Kiefer, 2001; Bermeitinger,
2010; Costanzo et al., 2013). As supported by available literature, animate stimuli are easier for
categorization than inanimate ones, because they represent a more homogenous category sharing more perceptual and semantic features. Some behavioral studies on brain damaged patients
have shown that they selectively lost semantic knowledge on animate categories, while retaining
knowledge on inanimate ones, although the opposite pattern has also been observed. However,
there are no ERP studies on aphasia using semantic categorization tasks. The aim of this study is
to investigate semantic processing in patients with aphasia with different levels of auditory comprehension disorder using a semantic categorization task.
Methods: We will utilize event related brain potentials (ERP) to characterize subjects’ responses
as they made superordinate categorical decisions (animate vs. inanimate) for about 200 auditory
presented disyllabic words. Three groups of participants will be included in the research: 5 aphasics with predominant language comprehension disorder, 5 aphasics with predominant language
expression disorder and 10 controls.
Results: We will observe N400 differences between groups depending on stimulus types (animate
vs. inanimate) and prototypicality of category examples.
Keywords: Aphasia, comprehension disabilities, lexical-semantic processing, superordinate categorization, ERP, N400
174
P2.18
STROKE REHABILITATION TEAM AND THE SLP’S ROLE:
THE PERCEPTIONS OF HEALTH CARE TEAM PROFESSIONALS AND
STUDENTS IN TURKEY
Aylin Müge Tunçer- DILKOM, Anadolu University, Eskisehir, Turkey
Ilknur Mavis - DILKOM, Anadolu University, Eskisehir, Turkey
Objective: In a stroke rehabilitation team, neurologists, physiotherapists (PT), nurses, psychiatrists, psychologists (PSY) and speech and language therapists (SLP) should work together to
achieve greater recovery. A high-functioning team affects stroke outcome positively. The advantages of working as a team can be realized when team members have knowledge of each member’s professional role. The purpose of this study is to determine the perceptions and knowledge
of health care team professionals and students about the type of “disciplinary team working” they
want to participate in.
Methods: The participants are professionals and candidates of SLPs, PTs, PSYs, and nurses in
Turkey (total n=170). A survey developed by Felsher & Ross (1994) was translated into Turkish.
The survey consisted of four sections: (a) participants’ biographical information; (b) and (c) participants’ knowledge of rehabilitation and their perception about advantages and disadvantages of
teamwork; (d) stroke team leader; and (e) the role of the speech and language therapists.
Results: The preliminary results showed that 70% of all participants had worked with stroke patients; all SLPs and PTs have had stroke rehabilitation experience. The PSYs have the least experience with stroke (40%). The most existing teamwork approach is multidisciplinary; however, the
preferred teamwork approach is transdisciplinary. Almost all the participants agreed that teamwork is a holistic approach and provides an opportunity to exchange ideas from different frames
of reference. There is more disagreement on the disadvantages than the advantages of teamwork,
but they think teamwork is beneficial and they generally understand the primary responsibilities of
SLP.
Conclusions: There is significant evidence that organized stroke units are effective in improving
outcome. Communication within the team should be coordinated both by meetings and by sharing a dedicated geographic space. According to the results we can identify existing and preferred
teamwork approaches and opinions about teamwork of health professionals and candidates.
Keywords: Teamwork, stroke team, SLP’s role
P2.19
USE OF AN ICF ORIENTED TOOL TO DESCRIBE DISABILITY IN
APHASIC PATIENT
Letizia Montano - Department of Medical Science and Neuroscience, University of Siena, Siena, Italy
Santi Centorrino - Rehabilitation Usl 7 Siena, Usl 7 Siena, Campostaggia, Italy
Objective: The classic assessment of the aphasic patient is often focused on his malfunction,
without considering the individual level of social participation. The literature emphasizes the
necessity of considering the patient in a holistic way instead, aiming to promote a better level of
participation rather than focusing exclusively on linguistic skills. We developed a tool for an ICF
oriented assessment, which ensued from the specific communication indicators of the Core Set
for ictus, aimed at pointing out the level of functioning and participation in order to treat the aphasic patient in his entirety.
Methods: Review of different assessment tools and instruments developed according to ICF
175
indicators; the Core Set ICF analysis with the screening of chapters and descriptors useful to describe the individual’s functioning.
Results: We obtained an ICF oriented observation tool that proved its usefulness in indicating the
competence and performance of the patients and a useful questionnaire for the analysis of the
patient’s communicative context. They were tested on twelve aphasic patients: the ICF oriented
tool confirmed that performance is often higher than the ability; caregivers’ implication allowed us
to identify different contextual factors that often invalidate the patient’s communication.
Conclusions: It is important to promote an ICF oriented tool that would support the individual’s
level of contextual participation, independently from the results of a treatment focused on specific
linguistic deficits.
Keyword: Aphasia
P2.20
THE EFFECTS OF A SEMANTICALLY AND PHONOLOGICALLY BASED
THERAPY IN HUNGARIAN SPEAKING INDIVIDUALS WITH APHASIA
Lilla Zakariás - Potsdam Graduate School, University of Potsdam, Potsdam, Germany
Zita Orley - Rehabilitation Department of Hemiplegics, National Institute of Medical Rehabilitation, Budapest, Hungary
Tünde Buják - Neurology and Rehabilitation Centre, Flór Ferenc Hospital, Kistarcsa, Hungary
Objective: ‘Topics in everyday conversation’ is a recently published workbook in Hungarian for individuals with aphasia (IWA). It is thematically organised and multimodal; the 14 tasks practised at
each session target phonology, semantics, and functional communication. The aims of the study
were to investigate the effectiveness of this novel therapy method and to compare how IWA with
semantic vs phonological impairment benefit from the treatment.
Methods: We designed a combined multiple case study using a pre/post treatment design. So far,
two participants with transcortical motor and anomic aphasia (M.J. and K.L., respectively) participated. M.J. had a primary semantic impairment and difficulty accessing the phonological output
lexicon, whereas K.L. had difficulties in phonological assembly. The treatment consisted of 3
sessions of 60 mins per week over 4 weeks. The primary outcome measure was a picture naming
task with items treated (ITs), and items not treated but semantically related to ITs. Secondary outcome measures were spoken scene description, auditory comprehension, and aphasia severity.
Results: Both participants improved on picture naming of ITs, and importantly, this led to improvement on untreated items as well. Results of secondary outcome measures suggest that the level
of impairment affects treatment related development.
Conclusions: ‘Topics in everyday conversation’ is adequate to evoke improvement on word retrieval and to evoke generalisation effects. Participants with semantic or phonological impairment
can benefit from this therapy method.
Keywords: Aphasia, semantic therapy, treatment effectiveness, generalisation
176
P2.21
THE ACOUSTIC CHANGES OF VOICE AFTER THYROID SURGERY IN
PATIENTS WITHOUT LARYNGEAL RECURRENT NERVE LESION.
PRELIMINARY DATA
Baiba Trinite - Speech and Voice Research Laboratory, Liepaja University, Liepaja, Latvia
- Liepaja Regional Hospital, Liepaja, Latvia
Diana Aigare - Liepaja Regional Hospital, Liepaja, Latvia
Objective: The purpose of the study was to determine changes in voice acoustic parameters after
thyroid surgery in patients without recurrent laryngeal nerve lesion.
Methods: Total or hemi-thyroidectomy under general anaesthesia was performed on 13 female
patients. Acoustic voice assessment (MDVP, VRP) and calculation of Dysphonia Severity Index
(DSI) were conducted at two time points – directly before surgery and 1-2 weeks after surgery.
Nonparametric statistic methods were used for data analysis.
Results: The mean age of the respondents was 55.5 (9.7) years; 3 smokers; 2 voice professionals. 10 patients had a total thyroidectomy, mean duration of surgery was 150.77 (28.86) minutes,
mean pressure of balloon cuff during surgery 22.83 (4.26) mm/Hg, mean size of thyroid 98.09
(99.14) cm3. Although all acoustic parameters and duration of maximal phonation time changed
from the first to the second assessment, statistically significant differences were only found for
maximal frequency (p<0.01), frequency range (p<0.01), and maximal intensity (p<0.05). Statistically significant differences between pre-operative and post-operative measurements of DSI were
not found. A strong negative correlation was found between the post-operative DSI and mean
pressure of a balloon cuff of endotracheal tube during surgery (r=-0.8, p<0.01).
Conclusions: The fact that maximal frequencies and frequency range respectively decrease in
post-operative measurements implies that: (1) the lesion of an external branch of superior laryngeal nerve impacts on performance of high pitch sounds; (2) discomfort and slight pain in the region
of the neck do not allow the production of sounds of higher intensity and in a higher tone. The
study should continue by increasing the group of patients and conducting a third measurement at
least three month after surgery.
Keywords: Voice acoustic analysis, thyroid surgery
P2.22
IMPLEMENTATION OF TOR-BSST©, A DYSPHAGIA TOOL FOR
STROKE PATIENTS: USING WEB-MEDIA TO MAINTAIN SWALLOWING
SCREENING SKILLS
Marina Di Ponio - Swallowing Lab, University of Toronto - Faculty of Medicine/University of Health Network, Toronto, CanadaRosemary Martino - Swallowing Lab, University of Toronto - Faculty of Medicine/University of Health Network, Toronto, Canada
Objective: Dysphagia is common following stroke and is associated with increased morbidity and
mortality. This innovation presents an interdisciplinary swallowing team trained to provide dysphagia screening of all stroke survivors using the TOR-BSST© and its Bi-Annual online Assessment;
thereby, serving to maximize screeners’ skills and to facilitate speech language pathologist (SLP)
follow up training.
Methods: The TOR-BSST© is a tool by which health care professionals can screen stroke patients for early diagnosis of dysphagia. Based on the Canadian Stroke Guidelines for dysphagia,
all stroke patients will have access to rapid and timely screening to minimize the development of
complications. Stroke patients who fail screening will receive a dysphagia assessment by an SLP
177
within 24 hours. Across Canada, screening occurs by any SLP trained interdisciplinary swallowing
team member. A web-media tool, the TOR-BSST© Bi-Annual Assessment, designed for TORBSST© screeners previously certificated by an SLP, will maintain their skills and facilitated SLP
follow up.
Results: SLPs specialized in swallowing disorders assess and treat dysphagia. Due to limited resources within worldwide hospitals, timely dysphagia assessment is challenging. The importance
of a reliable and accurate screening tool for dysphagia and its Bi-Annual follow up will serve to
identify patients with dysphagia and then direct them for assessment by an SLP. The TOR-BSST©
is such a tool (Schepp et al., Stroke 2012). The TOR-BSST© can be done by any trained multidisciplinary team member available as soon as the patient is in hospital: thereby, identifying dysphagia earlier and preventing risks of complications. The web-media TOR-BSST© Bi-Annual Assessment determines screeners continued competency or need for refresher training by the SLP. This
innovative program serves to sustain an efficient and effective Swallowing team.
Conclusions: The implementation of this TOR-BSST© web-media protocol in clinical practice will
allow success in early diagnosis of dysphagia and maximize clinical practice worldwide.
Keywords: Dysphagia, TOR-BSST©, web-media
P2.23
FACTORS AFFECTING RESEARCH PARTICIPATION BY ADULTS WHO
STUTTER
Jan McAllister - University of East Anglia, Norwich, United Kingdom
Objective: Commissioning of speech and language therapy services is driven in part by research
evidence, for example from randomised controlled trials (RCTs). The success of RCTs is often
compromised by difficulties with participant recruitment. The aim of this study was to identify factors that may influence research participation among adults with developmental stuttering.
Methods: An online questionnaire was carried out with the help of the British Stammering Association. It asked about self-rated stuttering severity and measured social anxiety using the Social
Phobia Inventory (SPIN). Other questions focused on prior research participation, likelihood of
participation in studies of various kinds, and logistic factors that might influence participation.
Results: Three hundred and thirty two people provided useable information. Two hundred and
twenty five (67.8%) scored at or above the social phobia threshold on the SPIN. SPIN score did
not appear to be related to stuttering severity. Fewer anxious than non-anxious respondents had
been or were currently participating in research studies. Around 75% of respondents indicated
that they were likely or very likely to take part in research, regardless of whether the study was a
clinical trial or other kind of study (suggesting that people are not put off specifically by the research being a clinical trial). Telephone was the least favoured option for interacting with researchers, especially among those who were highly anxious. Altruism was a major factor determining
decisions to take part. Respondents reported that they were relatively unlikely to be influenced by
others (SLTs, doctors, friends, family). They were not particularly concerned about randomisation
in RCTs.
Conclusions: The online questionnaire provided information that will be useful in designing future
studies, specifically those involving adults who stutter but also potentially those with other communication disorders.
Keywords: Stuttering, social anxiety, research participation
178
P2.24
DETERMINING OF PROXY AND SELF-REPORT AGREEMENT ON THE
TURKISH VERSION OF STROKE AND APHASIA QUALITY OF LIFE
SCALE-39 (SAQOL-39-TR)
Bulent Togram - Center for Speech and Language Disorders, Anadolu University, Eskisehir, Turkey
Eda Iyigun-Bulbul - Center for Speech and Language Disorders, Anadolu University, Eskisehir, Turkey
Objective: Health related quality of life (HRQL) measures are increasingly used to evaluate after
stroke conditions. However, after stroke people with severe aphasia are not be able to self-report
on such scales and their proxies report on their behalf. This research aims to determine the level
of agreement between people with aphasia and their proxies on the Turkish Stroke and Aphasia
Quality of Life Scale-39 and whether this agreement is influenced by demographic variables and
proxy levels of depression
Methods: People with chronic aphasia (4 months post stroke) were recruited through the UK
national charity for PWA. They were interviewed on the Turkish version of SAQOL‐39 and their
proxies were interviewed on the Turkish version of SAQOL‐39, the Turkish version of Caregiver
Well-Being Scale. Proxy respondents had to be 18 years of age, see the person with aphasia at
least twice a week and have no known severe mental health problems or cognitive decline.
Results: 32 eligible pairs took part in the study. Results showed that proxies and PWA on the
Turkish version of SAQOL-39 for the total of the scale is perfect; for the physical, communication,
psycho-social and energy subtests a good degree of agreement is observed (The overall Turkish
version of SAQOL‐39 (intra‐class correlation coefficient ICC 0.8), the physical domain, the psychosocial, the energy domain and communication domains (0.6-0.7)). There were no significant
differences: Proxies rated PWA and PWA rated themselves. The SDs of the difference scores were
large, but the difference was not significant for all SAQOL‐39 domains and the overall mean. Demographic variables did not affect the level of agreement.
Conclusions: For group comparisons, proxy respondents who are in frequent contact with people
with chronic aphasia can reliably report on their health related quality of life, using the Turkish version of SAQOL‐39. There are no significant differences between PWA and proxy responses.
Keywords: Aphasia, proxy, life quality, health, stroke
P2.25
PREVALENCE AND SIGNIFICANCE OF DYSPHAGIA
AND PRESBYPHAGIA IN ACUTE-GERIATRIC PATIENTS
Angelika Rother - FH JOANNEUM, University of Applied Sciences, Graz, Austria
Eva Resinger - FH JOANNEUM, University of Applied Sciences, Graz, Austria
Background: Everybody knows the feeling when you swallow something up or when food gets
stuck in your throat. For many, especially for older people, this is common while they are eating. In geriatrics 40 – 60% of swallowing disorders are not diagnosed as such, because clinical
symptoms while swallowing are not recognized and therefore are not examined or treated in the
course of dysphagia management. When being asked whether they think that they have a swallowing disorder, most adults respond with a no. They have got used to coughing and clearing their
throat and accept it as something normal. When applying a dysphagia diagnosis it can be shown,
however, that there is already a swallowing disorder or beginning swallowing disorder signs are
present.
Methods: A pilot study dealing with this topic was conducted at the Albert Schweitzer Clinic
179
(ASC) in Graz. In the course of this study patients of the emergency unit and the day care clinic of
the ASC should be identified, who already show beginning signs of swallowing disorder, but have
not been examined or treated for dysphagia. Overall 37 patients were questioned and examined
using two tools that had been specifically designed for this study: A newly developed questionnaire “beginning of swallowing disorders” and an adapted diagnostic form “swallowing disorders
in geriatrics”, which includes the Danieltest (water swallowing test). A main aim of the study was
to identify the prevalence of beginning swallowing disorders in study participants.
Results: The questionnaire was evaluated considering quantitative, as well as qualitative, aspects
and shows a high sensitivity regarding the question about beginning swallowing disorder signs in
geriatric patients in acute care. A significant correlation between evident test results and the Danieltest and the questionnaire could not be shown.
Conclusion: The results of the study clearly indicate the need for sensitive swallowing diagnostics, especially for geriatric patients, so that swallowing disorder signs can be recognized and
treated at an early stage.
Keywords: Dysphagia, presbyphagia, geriatric, swallowing
P2.26
VOICE THERAPY IN PATIENTS WITH REINKE’S EDEMA ON VOCAL
FOLDS
Nataša Prebil - Clinic of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center, Ljubljana, Slovenia
Objective: Voice therapy is a type of speech-language therapy provided by a speech-language
therapist. The main goals of voice therapy are the reduction or elimination of voice disorders, prevention of recurrence of voice disorders and improvement of vocal function.
Methods: In the treatment of Reinke’s edema, a close cooperation between an otolaryngologistphoniatrician, a speech-language therapist, and in some cases a psychologist is important. In
our practice, surgical treatment and voice therapy are often combined. A majority of patients with
Reinke’s edema come to voice therapy in the preoperative period for preoperative consultation.
A phoniatrician decides which patients need further voice therapy after microlaryngoscopy. The
reasons for patients’ referral for speech therapy treatment in the postoperative period are: vocal
misuse or voice abuse as a cause of the Reinke’s edema, difficulty getting used to the new form
of vocal cords and the development of “false voice technique” because of Reinke’s edema.
Results: The success of therapy depends on the patient’s willingness to participate in it. They
must often give up some harmful habits and change their vocal technique.
Conclusions: The patient must be motivated to carry out voice therapy, the phoniatrician must
determine which patients need further voice therapy and the speech therapist must be properly
trained professionally. When all these conditions are provided, the patient, with the acquisition of
the proper vocal technique and voice habits, can obtain a higher quality voice.
Keywords: Voice therapy, vocal hygiene, vocal technique
180
P2.27
DYSPHAGIA MANAGEMENT: THE IMPORTANCE OF NMES
AND TRADITIONAL APPROACH
Elena De Bonis - Fondazione Centri di Riabilitazione Padre Pio - Onlus, San Giovanni Rotondo, Italy
Maria Antonietta Ritrovato - Fondazione Centri di Riabilitazione Padre Pio - Onlus, San Giovanni Rotondo, Italy
Laura Bonghi - Fondazione Centri di Riabilitazione Padre Pio - Onlus, San Giovanni Rotondo, Italy
Objective: A 55 year old woman, in June 2014, had surgery to remove a right cerebellopontine
angle meningioma with secondary damages to the peripheral facial, right hypoglossal and auditory nerves which caused dysphagia to solids and liquids, hoarseness, diplopia and impaired
balance. Objective was the recovery of sensation, mobility and strength of the bucco-lingual-facial
and pharyngeal-laryngeal structures; recovery of the swallowing function; reduction of feeding
time via PEG and progressive restoration of the normal autonomous supply per os.
Methods: The traditional speech therapy approach was integrated with NMES stimulator for 10
weeks, 6 days a week, 30 minutes 2 times a day, in order to increase the quality of contraction,
swallowing muscle strength and larynx elevation. Thanks to NMES, it is possible to bypass damaged central circuits by activating the neural tissue and contracting the deficient muscles. The
patient was assessed by FEES: moderate phenomena of penetration / aspiration of the liquid and
dense bolus. With Doss O’Neill protocol: level 1, severe dysphagia. With AAO-HNS facial nerves
House Brackman scale: grade VI.
Results: At the end of the 8th week, Doss-O’Neill protocol: level 6. AAO-HNS facial nerves House
Brackman scale: grade IV. In October 2014, PEG was removed whereby restoring self-feeding via os.
Conclusions: Integration between classic approach and NMES has shown efficacy for the rehabilitation of peripheral paralysis of the facial nerve and swallowing. Therefore, it deserves further
study.
Keywords: Dysphagia
P2.28
IS SALIVA REDUCTION IN ALS PATIENTS WITH DROOLING
AND SEVERE DYSPHAGIA STILL BENEFICIAL?
Hanneke Kalf - Department of Rehabilitation/ Speech-Language Pathology, Radboud University Medical Centre,
Radboud Institute for Health Sciences, Nijmegen, Netherlands
Janneke Weikamp - Department of Rehabilitation/ Speech-Language Pathology, Radboud University Medical Centre,
Bert de Swart - Department of Rehabilitation/ Speech-Language Pathology, Radboud University Medical Centre,
Objective: Drooling is a physically and socially distressful symptom that occurs in about 50% of
the patients with amyotrophic lateral sclerosis (ALS). Radiotherapy (RT) and injections with botulinum neurotoxin (BoNT) are effective to reduce saliva production, but which is better in cases of
severe drooling caused by severe dysphagia?
Methods: ALS patients with severe drooling were randomized to treatment with BoNT-A or RT.
Drooling status (Drool Rating Scale; DRS) global rate of change of drooling and satisfaction with
treatment, were assessed at baseline, 4, and 12 weeks after treatment to evaluate subjective
treatment effect. Treatment outcomes were correlated with dysphagia severity measured with the
ALS severity scale swallowing score (ALS-SSS).
Results: Twenty patients with ALS (13 women) and drooling were randomized to treatment with
BoNT-A (n=10) or RT (n=10), in the course of 5 years. All outcomes were similar between
181
treatments after 4 and 12 weeks. However, more severe dysphagia (12/20 patients had a gastrostomy tube) was strongly correlated with a lower global rate of change of drooling (r = 0.73; p
= 0.00) and a lower satisfaction with treatment (r = 0.65; p = 0.01) at 4 weeks and a lower global
rate of change of drooling (r = 0.68; p = 0.01) at 12 weeks after treatment, independently of treatment.
Conclusions: RT and BoNT have similar effects on drooling severity, but ALS patients with severe
dysphagia seem to have less benefit from either treatment. Consequently, saliva reduction in ALS
patients with drooling and severe dysphagia might not be beneficial.
Keywords: Amyotrophic lateral sclerosis, dysphagia, radiotherapy, botulinum toxin
P2.29
DIFFERENCES IN AUDITORY PROCESSING OF WORDS
AND PSEUDOWORDS IN APHASIC PATIENTS: ERP STUDY
Martina Vukovic Ogrizek - Polyclinic SUVAG, Polyclinic SUVAG, Zagreb, Croatia
Marina Paprika - Polyclinic SUVAG, Polyclinic SUVAG, Zagreb, Croatia
Karolina Lice - Polyclinic SUVAG, Polyclinic SUVAG, Zagreb, Croatia
Marijan Palmovic - Polyclinic SUVAG, Polyclinic SUVAG, Zagreb, Croatia
Objective: Lexicality effect in N400 has been confirmed in numerous ERP studies suggesting
differential processing of words (W) compared to pseudowords (PW). Some electrophysiological
studies in healthy individuals found long latency of peak activation and larger N400 amplitude for
pseudowords as opposed to words. This may indicate prolonged search in the mental lexicon
and more effortful processing of pseudowords than real words (Cheng et al., 2014, Curran, 1999).
This effect is found to be more pronounced in aphasic patients (for both words and pseudowords)
suggesting a prolonged memory search and increase of nervous activity in the cells surrounding damaged area (Kitade, 1999.) During the years, two most prominent types of aphasia have
been recognized: (i) patients with dominant difficulties in expressive language and (ii) patients
with dominant difficulties in comprehension. In most aphasias, patients have difficulties in finding
words. Therefore, it is reasonable to expect that patients with aphasia will have difficulties in differentiating words and pseudowords.
Methods: The aim of this paper is to compare the N400 effect during an auditory lexical decision task between 5 patients with dominant difficulties in expressive language and 5 patients with
dominant difficulties in comprehension. A group of healthy subjects matched for age, gender,
handedness and education level will serve as a control group. All patients are included in language therapy at the Polyclinic SUVAG, Zagreb. The stimuli in this research will be 120 disyllabic
Croatian words and pseudowords (60 of each) specially chosen regarding the imageability and
frequency of the word. Pseudowords are constructed from words using programme Wuggy-0.1.9.
The subject is required to decide whether the auditory presented stimuli is a real word or a pseudoword.
Results: We will observe N400 effect differences during the auditory lexical decision task between
aphasic and control groups and differences between two types of aphasic patients.
Conclusions:
Keywords: Aphasia, N400, word, pseudoword, lexical decision task
182
P2.30
SELECTED PRIMARY COMPENSATORY STRATEGIES
AND NON-NORMATIVE PHONETIC FEATURES IN ADULT SPEECH
Barbara Sambor - Acting Department, National Academy of Theatre Arts, Cracow, Poland
Objective: The study’s objective was to determine the relationship between the type of swallowing
or tongue rest position, as well as the method of consonant and vowel phonemes implementation.
Methods: The study included 280 adults. In the assessment of biological functions palpation and
visual inspection methods were used. Evaluation of the phonemes realisation was based on the
analytical phonetic method, using sight, hearing, touch or specific experimental tests, eg. Czermak or Gutzmann trials.
Results: The authors compared the frequency of the most common non-normative phonetic
features to the models of swallowing and tongue rest position. Using statistical method of analysis the authors conclude that the incorrect pattern of swallowing and tongue rest position corresponds to the articulatory conformation of phones, eg. dorsal realisations of phonemes co-occur
with dorsal laying of the tongue during swallowing and tongue rest position while breathing,
interdental or asymmetric realisation of phonemes occurs with addental/asymmetric swallowing
pattern, etc.
Conclusions: In the case of pathological factors occurrence in the orofacial area, primary compensatory strategies are used (eg. non-standard ways of swallowing and tongue resting position).
It is connected with using the analogous patterns of tongue movements during the implementation of phonemes. The types of swallowing and tongue resting positions mentioned are rarely
described in the literature, although they may have a major impact on speech disorders.
Keywords: Speech disorders
P2.31
DYSPHAGIA AND TRACHEOSTOMY IN PATIENTS WITH SEVERE
ACQUIRED BRAIN INJURY
Cristina Reverberi - AUSL Reggio Emilia, Staff Formazione Corsi di Laurea, Reggio Emilia, Italy
Serena Ricchi - AUSL Modena, NPIA, Modena, Italy
Emanuela Borghi - AUSL Reggio Emilia, Ospedale di Correggio, Reggio Emilia, Italy
Objective: The aim is to highlight the main outcomes in patients with GCLA in terms of dysphagia,
weaning from principals and autonomy in feeding.
Method: Retrospective cohort study. Inclusion criteria were: patients with severe acquired brain
injury, age greater than 16 years, admitted to an intensive rehabilitation department, dysphagia
and tracheostomy tube. 389 patients were included, 146 excluded. 28% female, 72% male; average age of 49.56 years (SD 15.37). Etiology: 38% hemorrhagic, 36% traumatic, 12% ischemic,
6% anoxic, 8% infectious.
Results: First outcomes (dysphagia): there was a significant relationship between age and the
presence of dysphagia at discharge (p <0.01), between the type of dysphagia at the entrance and
at discharge (p <0.01) and between the presence of cough voluntary entrance and dysphagia at
discharge. According outcome (tracheotomy): a correlation was found between weaning of the
tracheostomy tube and the patient’s age (p <0.01), between the type of dysphagia at the entrance
and the weaning of the tracheostomy tube (p <0.01) and between the presence of cough reflex
and voluntary and the weaning of the tracheostomy tube. Third outcomes (nutrition):
183
the relationship between the presence of voluntary cough at the entrance and the resumption of
oral discharge was found.
Conclusion: From the analysis of the sample positive prognostic factors compared to dysphagia
age, the type of dysphagia at the entrance and the presence of voluntary cough were found. Regarding weaning from the tracheostomy tube, the positive prognostic factors identified were age
and the presence of cough.
Keywords: Dysphagia, weaning, tracheostomy tube, cough, nutrition
P2.32
USE OF THE ICF-MODEL IN THE MANAGEMENT OF HUNTINGTON’S
DISEASE DYSPHAGIA
Angela Nuzzi - Centro Rham, Rehabilitation Centre, Matera, Italy
Angela Tedesco - Centro Rham, Rehabilitation Centre, Matera, Italy
Antonella Parente - Istituto S. Agostino, Rehabilitation Centre, Noicattaro, Bari, Italy
Marilina Notarnicola - Centro Giovanni Paolo II, Rehabilitation Centre, Putignano, Bari, Italy
Valentina Lavermicocca - B.R.A.I.N. Centre for Neuroscience (TS) - Centro Giovanni Paolo II, Rehabilitation centre,
Putignano, Bari, Italy
Anna Rita Dellomonaco - Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, University of Bari, Bari, Italy
Objective: Huntington’s disease (HD) is a rare and fatal autosomal dominant neurodegenerative
disorder characterized by progressive motor dysfunction, cognitive decline, and psychiatric disturbance. As a result of the combination of these signs,
it is known that many patients with HD suffer from dysphagia leading to death in the later stages
of the disease. Due to the complexity and the progressive nature of the disease, the management
of oral feeding difficulties is a challenge and the implementation of a holistic program of intervention is recommended by European HD guidelines in order to improve swallow safety and efficiency. The purpose of this study is to describe the application of the World Health Organization’s
International Classification of Functioning, Disability and Health (ICF) to dysphagia assessment
and goal setting for patients with HD.
Methods: We examined swallowing function in an individual with HD using clinical and instrumental evaluations, self-reported questionnaires in combination with standardised outcome measures
based on the ICF framework. Analysis of assessment and intervention information was completed
with a modified version of the Rehabilitation Problem Solving Form (RPS-Form). Finally, a set of
ICF codes relevant to the impact of dysphagia was identified and an ICF-based documentation
tool was developed.
Results: The distribution of these codes across the ICF framework showed that the components
of Body Functions, Activities and Participation, and Environmental Factors were almost equally
represented. However the analysis revealed that environmental factors, such as caregiver support,
were both key barriers and facilitators to achieve successful outcomes in HD dysphagia care.
Conclusions: This case illustrates the potential of using the ICF to conceptualize the complexity
and multifaceted impact of dysphagia in HD. Further investigation of its application is suggested.
Keywords: Dysphagia, neurodegenerative disorders
184
P2.33
A CASE OF FOREIGN ACCENT SYNDROME: SPEECH THERAPY
TRAINING AND TEST OF ACCENT PERCEPTION
Angela Tedesco - Centro Rham Rehabilitation centre, Matera, Italy
Angela Nuzzi - Centro Rham Rehabilitation centre, Matera, Italy
Valentina Lavermicocca - Centro Giovanni Paolo II, Putignano (BA), Italy
Antonella Parente - Centro S. Agostino, Noicattaro (BA), Italy
Marilina Notarnicola - Centro Giovanni Paolo II, Putignano (BA), Italy
Anna Rita Dellomonaco - Az. Ospedaliera Universitaria Consorziale Policlinico di Bari, Bari, Italy
Foreign accent syndrome (FAS) is a rare neurological speech disorder characterized by an unlearned foreign accent following brain injury or stroke. The perception of foreignness is due to
modifications in segmental and prosodic features of speech. This research presents a case study
of a 70 year old Italian patient speaking with a foreign accent after a right hemisphere stroke. He
had segmental deficits, abnormal production of linguistic prosody, slow and monotonous speech.
The patient was evaluated with the “Robertson dysarthria profile”, “BLED SantaLucia”, “Questionario di autovalutazione della disartria”. Voice recordings were taken and analysed with Praat
software. After 6 months of intensive speech therapy training, including singing exercises, the
results are: changed prosodic (speech rate, pitch) and segmental features (speech accuracy) and
better self-evaluation of impairments. In the second part of the research an empirical test of accent attribution is presented, to investigate the perception of foreign accent, in comparison to the
patient’s pre-stroke accent. A sample group of 21 listeners was employed to judge patient preand post-stroke voice, on two different days. The pre-stroke voice was perceived as Italian by all
the listeners, the post-stroke voice as foreign by 67% of them. They perceived the voice as being
from different countries. The results of this accent attribution experiment reveal that FAS accent
is perceived as a generic foreign one. This is the first study that describes speech evaluation and
rehabilitation of an Italian case of FAS. FAS is a rare and heterogeneous disorder, so that group
studies are difficult to implement, but we hope, through the growth of works about rehabilitation,
to quantify the efficacy of treatment.
Keyword: Speech disorders
P2.34
PARKINSON’S DISEASE: IMPACT OF DYSEXECUTIVE SYNDROME
ON LANGUAGE PRODUCTION PROCESS
Marilina Notarnicola - Centro Giovanni Paolo II, Putignano (BA), Italy
Valentina Lavermicocca - Centro Giovanni Paolo II, Putignano, BRAIN Centre, Trieste, Italy
Antonella Parente - Istituto S. Agostino, Noicattaro (Bari), Italy
Angela Nuzzi - Centro Rham Rehabilitation Centre, Matera, Italy
Angela Tedesco - Centro Rham Rehabilitation Centre, Matera, Italy
Anna Rita Dellomonaco - Azienda Ospedaliera Policlinico di Bari, Università Degli Studi Aldo Moro, Bari, Italy
Objective: In the last few years, a growing focus has been addressed to non-motor symptoms in
Parkinson’s disease (PD). Particularly, current studies on cognitive dysfunction in PD contribute to
identify a large proportion of patients with cognitive decline, involving single domain or meeting
criteria for dementia. Some researchers, investigating the presence of a mild cognitive impairment
(MCI) in PD, found that executive functions represent the dominant neuropsychological finding.
Several studies converge on the strong impact of dysexecutive syndrome on cognitive abilities,
185
including the language production process. The purpose of this study is to define how executive
deficits can affect language output in individuals with PD.
Methods: Within the body of recent literature, we examined studies that describe impairments of
complex language production in PD and the impact of differences in cognitive abilities on language production.
Results: Studies on complex language production in PD are somewhat limited and differ in the
methods used. There is general agreement that fluency difficulties, reduced information content
and simplification of syntax, typically observed in patients with PD, are significantly related to
working memory and executive functioning; however, cognitive abilities did not fully account for
the differences in language performances. It also appears that language production in individuals
with PD is particularly vulnerable to differences in the complexity of the eliciting task.
Conclusions: It is necessary for a more precise delineation of the language impairments in PD
that can then be developed into therapeutic strategies which may be integrated in the speech
language treatment of patients with PD.
Keywords: Neurodegenerative disorders, cognitive impairment
P2.35
PROPOSAL FOR THE USE OF VIDEO-ASSISTED TREATMENT
FOLLOWING SMILE SURGERY
Chiara Bertolini - Azienda Ospedaliero-Universitaria di Parma, Azienda Ospedaliera, Parma, Italia
Objective: To improve the treatment plan for facial motion recovery following smile surgery.
Methods: A new training method was proposed to patients with both congenital and acquired
paralysis of the cranial nerve VII after they received smile surgery at the Department of Maxillofacial Surgery at the Parma University Hospital (Azienda Ospedaliero – Universitaria di Parma).
The training program was entirely designed with specific video exercises. All patients were asked
to video record themselves when they were following the audio instructions and simultaneously
performing the exercises on the videos.
Results: The study is still in progress. Preliminary results show good patient compliance in frequency and quality in performing the training. The video tracks of the patients are used to monitor
their improvement over time.
Conclusions: Patients – both adults and adolescents – seemed to enjoy this training approach
and reported feeling more confident when performing the video-assisted exercises, rather than
when performing the traditional exercises in the mirror.
Keywords: Professional Practice, E-learning, orofacial myofunctional therapy, paralysis cranial
nerve VII, smile surgery, video exercises
P2.36
LOWER AND UPPER FACE APRAXIA IN ABI PATIENT: COMPARISON
BETWEEN TWO TESTS
Chiara Tomasello - Università degli Studi di Torino, Università degli Studi di Torino, Torino, Italy
Objective: First, we aimed to check the overlapping of two oral apraxia assessment protocols for
a functional diagnosis. The second aim was to assess the entire face praxis in order to determine
the number of patients with both lower and upper face apraxia. Finally, in order to investigate
performance of familiar and unknown gestures imitation tasks separately, we applied the praxic
186
system theory to the evaluation of bucco-facial apraxia.
Methods: We administered two different oral apraxia assessment protocols to 49 adult patients:
the one suggested by Denes G. and Pizzamiglio L. - commonly used in SLP practice - and the
Bizzozero et al. experimental one (tests A1 and A2), assessing upper and lower face praxis. The
tests were administered upon imitation.
Results: We observed a very good correlation between the two tests, showing a diagnostic agreement of approximately 86%. Moreover, 14% of the patients were pathologic for A1 Bizzozero et
al.’s test but not for the Denes and Pizzamiglio one. Overall, 71% of the sample showed upper
face apraxia, 96% of which also showed lower face one. We found an indication of a better performance for familiar items than for unknown ones, and for items that have a sound component
than for items that do not (p=0.07 e p=0.18).
Conclusions: Item list composition influences patients’ performance, with poorer results in the
case of mixed lists of familiar and unfamiliar items. For this reason, in clinical practice and rehabilitation, it is important to assess the various categories separately.
Keywords: Traumatic head injury, acute stroke, cognitive impairment, speech disorders
P2.37
THE EFFECTIVENESS OF COGNITIVE REHABILITATION
IN PARKINSON’S DISEASE
Valentina Lavermicocca - Giovanni Paolo II Centre, University of Trieste, Bari, Italy
Marilina Notarnicola - Giovanni Paolo II Centre, University of Bari, Bari, Italy
Antonia Parente - Sant’Agostino Institute, University of Bari, Bari, Italy
Angela Nuzzi - Rham Rehabilitation Centre, Universiy of Bari, Bari, Italy
Valentina Fumarola - Giovanni Paolo II Centre, University of Bari, Bari, Italy
Angela Tedesco - Rham Rehabilitation Centre, Universiy of Bari, Bari, Italy
Anna Rita Dellomonaco - Policlinico of Bari, University of Bari, Bari, Italy
Objective: Parkinson’s disease is a neurodegenerative disorder characterized by dopamine depletion in the striatum. Clinical studies show that the main function of basal ganglia is related to
motor behavior. However, PD is characterized by a series of non-motor symptoms. Basal ganglia
establish anatomical connections with prefrontal areas through dorsolateral, orbitofrontal and
anterior cingulated circuits, respectively involved in executive functions, regulation of social behaviour and motivation. Although cognitive decline insidiously occurs, PD patients show executive
dysfunction in the early stages; this condition can evolve into mild cognitive impairment initially
and subcortical dementia later.
Motor symptoms have a good response to drug therapy, but not cognitive symptoms.
The study aims to investigate the effectiveness of cognitive rehabilitation on patients with PD.
Methods: 6 patients affected by idiopathic PD were recruited, staged according to the H&Y scale
and previously evaluated cognitively. Inclusion criteria: age from 45 to 85, intact or correct auditory and visual functions, phase on of dopaminergic therapy. Patients with previous cerebrovascular insults and patients taking ChIs drug were excluded. The sample was submitted to cognitive
training consisting in 3 weekly sessions of 45 minutes each for 2 months.
Results: At the end of treatment, cognitive re-evaluation showed a significant increase in scores.
In particular, an improvement in the performance of attention-related tasks was observed. However, the follow-up controls show a decrease in scores to baseline levels.
Conclusions: Cognitive rehabilitation appears to be a valid support for PD treatment. However,
our experience so far shows that patients periodically need reminder therapy, otherwise recurrence of cognitive dysfunction is observed.
Keywords: Neurodegenerative disorders, cognitive impairment
187
P2.38
VOICE DYSFUNCTIONS IN EDUCATORS AND STUDENTS
OF EDUCATION - THE (PRE) PROFESSIONAL IMPACT
Katerina Vitásková - Institute of Special Education Studies, Faculty of Education, Palacký University, Olomouc, Czech Republic
Katerina Jehlicková - Institute of Special Education Studies, Faculty of Education, Palacký University, Olomouc, Czech Republic
Lucie Šebková - Institute of Special Education Studies, Faculty of Education, Palacký University, Olomouc, Czech Republic
Tereza Keprdová - Institute of Special Education Studies, Faculty of Education, Palacký University, Olomouc, Czech Republic
Objectives: The aim of the research was to analyse the particular problems with voice in specific
groups of teachers and university students (including logopedists) with emphasis on the need for
prevention of voice disorders in education studies students and that way avoiding secondary consequences negatively influencing the quality of the education process and their competitiveness
in the labour market.
Methods: We used the Voice Handicap Index (VHI). The subgroups of teachers were compared
with other voice professionals. Then, a group of students, including those focused on educational
or other vocally demanding professions, was more specifically investigated and analysed,.
Results: We recorded moderate voice disorders within all groups which reported severe difficulties – especially in professional coaches, high school teachers and actors, which reflects the
same distribution as within the group of mild problems. Appropriate knowledge of so-called vocal
hygiene rules is unfortunately minimal. Specific findings also present the results of the comparison
group of university students of the Faculty of Education.
Conclusion: The need for lifelong education and acquisition of special voice pedagogy techniques
seems to be more than a possibility for teachers during their professional career.
Keywords: Voice disorders, vocal hygiene, university students, education, educator, special needs
education
P2.39
PHONETIC TRANSCRIPTION AS A BASIC SKILL FOR SLT’S AT THE
FACULTY OF EDUCATION IN THE UNIVERSITY OF LJUBLJANA
Jerneja Novšak Brce - Faculty of Education Ljubljana, University of Ljubljana, Ljubljana, Slovenia
Martina Ozbic - Faculty of Education Ljubljana, University of Ljubljana, Ljubljana, Slovenia
Damjana Kogovšek - Faculty of Education Ljubljana, University of Ljubljana, Ljubljana, Slovenia
May Barbara Bernhardt - University of British Columbia, University of British Columbia, Vancouver, Canada
Joseph Paul Stemberger - University of British Columbia, University of British Columbia, Vancouver, Canada
Objective: Phonetic transcription with symbols and diacritics from IPA and extIPA chart (2005) is
a basic skill for researchers who study, analyze, and describe speech. Transcription allows rereading, comparative analysis of speech sounds and cluster realization in different words, it allows
phonetic and phonological analysis, analysis of phonological processes, of phonetic and phonological development, deviations in speech sounds in speakers. Software such as Praat, Speech
Analyzer, Phonology Assistant and Phon, allows the researcher to transcribe speech, to do acoustic, phonetic and phonological analysis on the surface levels of sounds, and on deep levels of
syllabic structures, and distinctive features.
Methods: The paper describes a sixty hour module for teaching phonetic transcription with the
aim to share experience, discuss and to promote transcription among speech and language
therapists and teachers for the deaf/hard of hearing.
Results: At the end we present the results of the survey about module Phonetic transcription.
188
42% of the 16 SLT students chose this optional module because they consider that transcription
is a skill required for their profession (SLT), 21% chose the module because they wanted to learn
how to transcribe speech and 28% chose it because they thought that transcription is interesting. For more than half of the students the module seems to be very useful and topical, 75% of
students believe that it should become a compulsory module, 87% of students believe that the
module should have 30-45 hours or more.
Conclusions: By attending this course, students acquired the skills of transcription with IPA symbols and diacritics, and they improved listening. What they found important was the use of computer programs. In future they would like to have a greater number of exercises, more work with
computer programs and more transcription of speech sound disorders.
Keywords: Phonetic transcription, SLT students, teaching, module
P2.40
CELEBRATING 6TH MARCH ALL AROUND THE EU
Veronika Raudsalu - The North Estonia Medical Centre, Tallinn, Estonia
Maria Kyriacou Solomonidou - Private Practice, Larnaca, Cyprus
Objective: CPLOL celebrates EU day on 6th March every year, on the anniversary of the signing
of the constitutional charter in 1998. The objective is for all the SLT professional associations to
focus on raising awareness of communication and swallowing disorders on the same date across
the EU. These campaigns highlight key information about the impact of communication difficulties
on the quality of life for individuals and their families and also help to promote awareness of the
professional role of the speech and language therapist (SLT).
Methods: The annual topics focus on a specified communication disorder and campaign slogan,
for all associations to implement in the own country. In 2015 the topic is acquired neurological
communication disorders. “Communication is everything: Speech and Language Therapy is the
key”; Les troubles du langage d’origine neurologiques. “La communication est tout. L’orthophonie
en est la clé”.
Results: There is an annual report of activities from each country to share examples of successful initiatives. The poster will show a wide range of creative activities and materials recently used
across CPLOL member countries.
Conclusions: Continuing to celebrate EU day will support SLTs across Europe to have high quality resources and messages to promote awareness of our role and to influence the general public,
multi-professional colleagues, politicians and the media.
Keywords: Professional practice, public awareness
189
P2.41
RELATING THE NETQUES BENCHMARKS TO EQF LEVELS
Rossella Muo - Rehabilitation Department, Servizio di Logopedia, Torino, Italy
Elina Niemitalo-Haapola - Faculty of Humanities, The Child Language Research Center, University of Oulu, Oulu, Finland
Karin Pfaller - Logopädieaustria – Austrian Assoziation of Speech and Language Therapists, Vienna, Austria
Objective: In order to facilitate increased transnational mobility of the workforce, the European
parliament recommended the establishment of the European Qualifications Framework for lifelong
learning (EQF). Through a set of eight reference levels different countries’ national qualifications
systems can be related to this common European reference framework. CPLOL initiated and led
the NetQues project with the aim to contribute to the harmonization of speech-language therapy
(SLT) education in Europe. Data from the 31 participating countries showed that SLT programs in
Europe are offered at different educational levels. A list of benchmarks was agreed upon, defining the threshold for entry into the profession in terms of competences required. A proposed EQF
level assignment to each of the competences in the project report is preliminary and needs further
consideration. The aim of this CPLOL work group is to revise and elaborate this proposal.
Methods: Important aspects of this work will be to define what distinguishes EQF levels 6 and 7,
identified as the most relevant for being able to practice as an SLT, and to interpret and specify
the benchmarks in order to motivate level assignment.
Results: EQF levels will be described and related to pedagogical models like Bloom’s Taxonomy
of Educational Objectives (Bloom, 1973) and the SOLO (Structure of the Observed Learning Outcome) taxonomy (Biggs & Collis, 1982) and to the NetQues project outcome benchmarks. Examples of what needs to be taken into consideration will be given.
Conclusions: Reflections and discussions on levels of competence will contribute to enhanced
understanding and awareness, and shared views on how to design SLT programs that support
the students to reach the necessary competences agreed upon in the NetQues benchmark document.
Keywords: EQF, NetQues benchmarks, SLT competences
P2.42
COMPETENCE CULTURELLE ET COMMUNICATION AU SEIN DE LA
FORMATION INITIALE EN ORTHOPHONIE / LOGOPEDIE
Sylvia Topouzkhanian - Centre Hospitalier le Vinatier, ISTR - Lyon 1, Lyon, France
Objectif: En Europe, le contexte interculturel induit fréquemment des situations de malentendus,
des incompréhensions culturelles et des zones de chocs culturels. Ce contexte nécessite de la
part des orthophonistes / logopèdes européens la capacité d’interpréter les actes de communication intentionnels et inconscients et les coutumes de leurs patients issus d’autres sociétés.
Méthodes: Le problème n’est pas tant de n’avoir pas connaissance des pratiques culturelles de
l’Autre, que de considérer un modèle (celui de sa propre culture) comme universel et allant de soi.
C’est ainsi que la décentration puis la connaissance du cadre de références de l’Autre sont des
éléments indispensables aux étudiants en orthophonie/logopédie, professionnels en devenir et
futurs thérapeutes de la communication.
Résultats: Au travers de la dispensation de cours spécifiques sur les expériences translinguistiques et transculturelles en dernière année de cursus d’orthophonie, les étudiants d’un centre
français de formation sont ainsi immergés dans une position de découverte et de relativité de la
connaissance. De par des apports théoriques, cliniques, vidéos et partages d’expériences de
190
stage en France et à l’étranger, ils s’exercent ainsi entre pairs à donner un sens global aux indices de communication verbale et non verbale observés chez les patients, à adopter une posture
réflexive et à développer une compétence culturelle.
Conclusions: En formation initiale, un enseignement autour de la communication en lien avec la
compétence culturelle est indispensable afin de mieux former les futurs professionnels et ainsi d’
“ouvrir les portes à la communication”.
Mots-clé: Formation initiale en orthophonie, communication, compétence culturelle, éducation
interculturelle, anthropologie
P2.43
THE PROGRESS TEST IN SLT INITIAL EDUCATION IN ITALY
Carla Budriesi - Università di Modena e Reggio Emilia, Modena, Italy
Giovanna Lovato - AUSL Camposanpiero (PD), Padova, Italy
Objective: To identify a valid and reliable tool to assess the progress and the eventual loss of academic knowledge of students in SLT initial education in Italy.
Methods: The Progress Test was chosen. It is a longitudinal, feedback oriented tool evaluating
development and sustainability of cognitive knowledge during a learning process. It consists of
a written exam administered to all students at the same time once a year. The test samples the
complete knowledge domain expected of new graduates upon completion of their courses, regardless of the year level of the student. 200 multiple choice questions were formulated based on
the Italian SLT core competence and core curriculum and assembled in 9 thematic areas. All the
joining universities followed the same procedures to administer the test, gather the data and communicate the results to students, the local teaching board and to the national coordinating team.
Consistently with the Progress Test philosophy, each course became acquainted only with its own
and the national results.
Results: The Progress Test has been administered since 2009-10. The number of participating
universities and students has gradually grown; in the year 2013-14 nine universities participated,
with a total of 762 students. The feedback questionnaire has shown its popularity and effectiveness.
Conclusions: The Progress Test can be used as a self-assessment tool, both at the level of the individual student and to improve SLT course standards through feedback of actual achievements.
Keywords: Initial education, quality of education, Progress Test, knowledge assessment core
competence, core curriculum
P2.44
THE COMPETENCE OF PARENTS’ COUNSELLING IN SPEECH
AND LANGUAGE THERAPY SERVICES FOR CHILDREN
Daiva Kairiene - Lithuanian Logopedist Association, CPLOL member, Siauliai University, Siauliai, Lithuania
Simona Raibuzyte - LLA, CPLOL, Centre of Speech and Language Support, Telsiai affiliate, Telsiai, Lithuania
Objective: To disclose the structure of parents’ counselling competence and presumptions for its
development, when providing SLT services for pre-school age children.
Methods: Semi-structured interview of SLTs (N=14), working in different workplaces (early intervention centre, comprehensive and specialised pre-school, centre of special education, pedagogical psychological centre, private practice).
Results: On the basis of inductive analysis of SLTs’ experiences, the structure of parents’ counselling
191
competence was identified: (1) abilities to make assessment of child communication competence,
recognise the disorder and share the relevant knowledge with parents; (2) abilities to choose relevant form of parents’ counselling depending on the goals of consultation; (3) abilities of interpersonal communication, which would lead to the equal relationship between SLT and parents. The
main barriers of successful parents’ counselling are defined as lack of parents’ awareness of the
active role during the process of counselling. The other one is related with organisational issues,
such lack of time, type of activity in the institution, etc.
Conclusions: SLTs’ experiences show that the competence of parents’ counselling often is developed in further rather than in initial education. Research findings invite the review of the SLT training programmes, where more attention should be paid to parents’ counselling competence development. Research data provide presumptions for this competence development, which mostly is
related with attitudes of situated and collaboration-based learning in the workplace.
Keywords: Parents’ counselling competence, speech and language therapy for pre-school age
children, situated and collaboration-based learning
P2.45
INFORMATION TECHNOLOGIES IN SPEECH AND LANGUAGE THERAPY
Raluca Soare (Trifu) - I Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- CPLOL Professional Practice Commision
- CPLOL Professional Practice Commision
Objective: In SLT, IT technologies have been used for quite a long time. The working group “IT in
SLT” was created as part of the PP Commission. The aim of this working group was to get data
from all over Europe concerning the usage of ITs during SLT sessions. An overview of all IT resources is desirable. We aim to investigate which IT sources are used by SLTs, how much experience SLTs have in using IT sources and in which clinical pictures IT sources are used by SLTs.
Methods: In order to get data about the use of IT in SLT, we developed an online survey. The
survey was translated into 5 languages. We sent the survey to the CPLOL delegates. We asked
the delegate to distribute the link to all members of the SLT’s association from their country. Data
were exported in Excel and processed with the Analysis Tool Pack. We used graphs and tables to
represent data.
Results: The survey was filled in by 384 participants from 21 counties. There were 350 complete
answers. The most answers came from Austria and Switzerland with a total of 78 answers. Romania had 44 and Portugal 37. Most of the respondents were young, 93% were female and 7%
male. N 250 use IT in SLT, 71 persons gave a No answer. N 195 think IT in SLT is important. Apps
(229), software (223) and web pages (213) are preferred. Schools (166), kindergartens and nurseries (216) are the most frequent settings for IT in SLT.
Conclusions: IT is used in different settings during SLT sessions, for Therapy/Treatment, to acquire and improve skills in different Disorders, Anamneses, Diagnostics, Evaluations, Organization
PP. Cost and adaptation to new ways of therapy contribute to the rejection of IT in SLT. But it is
definitely clear that SLT could benefit from IT in order to increase communication and time management. The huge IT industry impacts SLT. But further analyses and a larger sample are needed.
Keywords: IT in SLT, SLT techniques
192
P2.46
IMPLEMENTATION OF INTERPROFESSIONAL LEARNING IN THE
STUDY PROGRAMME IN SPEECH AND LANGUAGE PATHOLOGY
AT THE KAROLINSKA INSTITUTE
Ellika Schalling - Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology,
Karolinska Institutet, Stockholm, Sweden
Anita McAllister - Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
Objective: In order to prepare speech and language pathology (SLP) students to provide effective
and safe care in a range of health care settings in their future careers, a line of recurring interprofessional learning-activities throughout the eight semesters of the study programme in SLP at the
Karolinska Institute were developed and evaluated. The aim was to create learning opportunities
that aid students individual development of specific and generic skills as a base for effective collaboration with other professions.
Methods: The project was initiated by curriculum mapping where all course syllabi were reviewed
and learning outcomes and learning activities related to interprofessional learning, (IPL) were
identified. In addition, new IPL outcomes and activities were developed and implemented during a 2-year period. Workshops about IPL for SLPs with assignments as supervisors for students
during clinical practicum placements were given. One national objective for the professional
degree in speech and language pathology is to be able to work in interprofessional teams and
in collaboration with representatives from other professionals. Students perceptions of how well
they achieved this goal were evaluated in the final programme evaluation two years in a row. In
addition outcomes were assessed in course evaluations directly after each course including IPLactivities.
Results: Through the curriculum mapping seven IPL-activities were identified and further developed for courses related to clinical practicum and in addition 4 new IPL activities were developed for theoretical SLP-courses, resulting in implementation of a recurring line of IPL-activities
throughout the SLP-programme. Activities were performed in collaboration with students in the
study programmes in audiology, occupational therapy and nursing. Examples of learning objectives and activities will be presented.
Ninety six percent of the students rated that they achieved the goal related to team-work and
interprofessional collaboration to a rather high, high or very high degree during the second year of
implementation of the IPL-activities. Goal achievement to a rather high, high or very high degree
was rated to be 85% following the first year of implementation of the new IPL-activities. Feedback
was positive in course evaluations directly following the IPL-activities.
Conclusions: Curriculum mapping leads to the identification and development of a line of IPLlearning outcomes- and activities in the study programme in SLP. Following the implementation of
these activites, 96% of students rated rather high, high or very high goal achievement related to
team-work and collaboration with other professionals.
Keywords: Interprofessional education, study programme in speech and language pathology
193
P2.47
IMPROVING QUALITY OF CARE USING A PATIENT SATISFACTION
QUESTIONNAIRE (PSQ): A PILOT STUDY
Sandrine De Coster -Faculty of Education, Health & Social Work, University College Ghent, Ghent, Belgium
Objective: If we want to ensure the quality of care in SLT services, it is important to measure
the outcomes. Measuring patient satisfaction could help today’s more educated, informed and
demanding consumers to make well-informed choices about their care. This is part of a patientcentered approach. In Flanders (Belgium) there is no standardized procedure to collect and use
patient data to improve the services of self-employed SLTs.
Method: A 31-item patient satisfaction questionnaire (PSQ) was developed based on a review of
the literature and an additional group interview with self-employed SLTs.
The PSQ measures attitudes toward the more salient characteristics of SLTs and SLT services
(provided general and technical information, perceived treatment quality, relationship with SLT,
treatment adherence, etc.). In a pilot study the PSQ was presented to a randomly chosen group
of patients (n=10) to evaluate the usability of the instrument, as well as the understanding of the
items.
Results: Preliminary results show that the PSQ should be shortened so that the patient would
complete the questionnaire. A paper and pencil administration is not a very efficient method. In a
next phase, we will explore the possibilities of an online survey-method to collect and analyze the
data.
Conclusion: Analyzing patient information is a first step in conducting research on quality of care.
The use of a PSQ helps identify deficiencies in the provided care and setting future goals for improvement. SLTs should be encouraged to systematically use a PSQ.
Keywords: Professional issues, professional practice
P2.48
INITIAL SPEECH-LANGUAGE THERAPY TRAINING IN EUROPE
Ana Isabel Rodrigues Tavares - CPLOL, Paris, France
Norma Camilleri - CPLOL, Paris, France
Maria Ronlev - CPLOL, Paris, France
Objective: The Biennial Statistics working group is one of several working groups within the Education Commission of CPLOL. The aim of this group is to check the development of speech language therapy training programmes in all CPLOL countries, as well as to ascertain the standards
of initial SLT training and other post-qualification studies.
Methods: A questionnaire is sent out to the Education Commission delegates of all CPLOL member countries via Survey Monkey. The survey consists of 32 questions pertaining to the type of
programmes offered in all countries in initial SLT training, employment of new graduates and
further post-graduate training for SLPs.
Results: The results will be analysed using Survey Monkey. No results are yet available at the time
of writing. The data is still being collected.
Conclusions: The information gathered from this biennial questionnaire helps CPLOL achieve one
of its objectives, that is to promote the harmonisation of standards and quality of initial training
and continuing education. Educational programmes register considerable changes from one twoyear period to the next. It is important to monitor these changes as they reflect the policies in our
field throughout Europe.
Keywords: Initial SLT education, CPLOL, biennial statistics
194
P2.49
INCLUSION IN THE UNDERGRADUATE: RESEARCH REPORT FROM
THE VISION OF COORDINATORS
Paola Baron - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Florianópolis, Brazil
Ana Paula Oliveira Santana - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Florianópolis, Brazil
Silva Suelen Machado - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Florianópolis, Brazil
Objective: To identify the position of the coordinators of undergraduate programs of a State University in reference to the audience of special education students.
Methods: We used a questionnaire containing seven questions sent by email to 73 of the coordinators of undergraduate programs. The coordinators were asked about their position in relation to
inclusive education and if they are ready to accommodate these students.
Results: We analyzed through discursive research. The number of coordinators that responded
was only 14, where 50% of them stated that they have an inclusive education system in their
program, 29% had no records, and 21% did not have inclusive education. Extra services and
help is not provided in most of the cases. In analyzing the results it was observed that 93% of the
coordinators did not feel prepared to support these students educationally. They pointed out the
following problems: the lack of preparedness by the university teachers to deal with these students and the need for preparatory courses and professionals with expertise in the area that may
accompany the students with difficulties. We can also infer that there is ignorance and insecurity
on the part of the coordinators on the subject, since only 19% of them responded.
Conclusions: The university is not prepared to admit such students. In order to deepen the analysis of the reality of inclusion in higher education and to be able to contribute to political, social
and educational change, there is an increasing need to conduct earnest studies in the field of
inclusive education.
Keywords: Quality of education, problem-based learning
P2.50
THE IMPORTANCE OF OBSERVATION OF EXPRESSION
IN DIFFERENT LANGUAGES OF HIGH SKILLS / GIFTEDNESS
Renata Gomes Camargo - Universidade Federal de Santa Maria, Santa Maria, Brazil
Introduction: Students with high skills / giftedness are part of the target audience of special
education that should provide different forms of care for these people, and one of these is the
extracurricular enrichment. In this type and other assistance, the expression of high skills / giftedness, can be understood as the manifestation in different languages of multiple intelligences, for
example, the making of a sculpture is a demonstration of kinesthetic-body intelligence.
Objective: To investigate the importance of recognizing and stimulating the potential of manifestation in different languages in students with high skills / giftedness.
Method: There was a semi-structured interview with 24 students with high skills / giftedness,
participants in three extracurricular enrichment programs, in three different states of Brazil. We
performed content analysis of the data following categories: educational strategies and developed
languages and multiple intelligences activities.
Results: The analysis of categories and subcategories allowed us to understand that students
with high skills / giftedness share through a directed gaze and are influenced by the settings (s),
language (s), intelligence (s) which (is) their behavior high skills / giftedness are related to. Therefore, it is extremely important to recognize and encourage the different languages in which the
195
high skills / giftedness can manifest itself, and this is done in the extracurricular enrichment programs in the activities they offer.
Conclusions: The educational opportunities, especially for school, must reflect the diversity of
students with high skills / giftedness, through the recognition and encouragement of different
languages in which their high potential can be manifested. The actions taken in extracurricular
enrichment programs can be accessed and/or reworked to check their implementation feasibility
within schools, so as to provide adequate opportunities for expression in this space.
Keywords: Quality of education, high skills / giftedness students, languages
P2.51
PRATIQUE DE L’ÉDUCATION THÉRAPEUTIQUE AUPRÈS DES
APHASIQUES POST AVC ET RÉÉDUCATION:
ÉTUDE DES RÉPRESENTATIONS DES PROFESSIONNELS
Nathaly Joyeux - UNADREO, Lurco Eru40, Avignon, France
Objectif: L’éducation thérapeutique du patient (ETP) telle que développée en France depuis la loi
HPST de 2009 a pour objectif l’autonomie du patient dans la gestion de sa vie avec une maladie
chronique (OMS, 1998). A la suite des recommandations élaborées par la Sofmer (2011), des programmes d’ETP commencent à être proposés au malade aphasique et à son entourage. Il s’agit
dans ces programmes de diminuer le handicap de communication, d’améliorer la communication
entre l’aphasique et l’aidant et d’améliorer leur qualité de vie. Par ses buts, visant à l’autonomie
et la gestion de la maladie, l’ETP se distingue de la rééducation orthophonique individuelle ou
en groupe ou de la pratique des groupes de parole. Cependant qu’en est il sur le terrain pour les
professionnnels de la rééducation ? Quelles sont leurs représentations mentales sur l’éducation
thérapeutique et sur sa pratique par rapport à la rééducation.
Méthodes: Une première observation sous forme d’entretien dirrigés a été faite auprès de professionnels de la rééducation. Les verbatim ont été analysé et ont permis de construire un questionnaire destiné à les enquêter sur une plus grande population.
Une analyse quantitative et qualitative permettra ensuite de mettre en évidence :
- Le profil des personnels concernés en terme de formation initiale et continue, le métier exercé.
- Une catégoristion des représentations sur l’éducation thérapeutique par rapport à la rééducation.
Résultats: Les premiers résultats de l’analyse seront discutés.
Conclusions: Les premiers résultats issus des verbatim de l’observation initiale montrent une difficulté importante des professionnels de la rééducation à envisager l’éducation thérapeutique selon
les recommandations de l’OMS.
Mots-clé: AVC, rééducation, éducation thérapeutique
196
P2.52
COLLABORATIVE WORKING IN SPEECH-LANGUAGE PATHOLOGY:
A EUROPEAN SURVEY
Sonia Azzopardi Axiak- CPLOL, Professional Practice Commission
Susanne Westerbring- CPLOL, Professional Practice Commission
Veronika Raudsalu- CPLOL, Professional Practice Commission
Hazel Roddam- CPLOL, Professional Practice Commission
Sini Smolander- CPLOL, Professional Practice Commission
Randi Fosser- CPLOL, Professional Practice Commission
Maria Peeva- CPLOL, Professional Practice Commission
Irena Sachova- CPLOL, Professional Practice Commission
Daria Hercigonja Salamoni- CPLOL, Professional Practice Commission
Fiona Hill- CPLOL, Professional Practice Commission
Objective: The present study aims to explore if and how speech-language pathologists (SLPs) in
Europe work collaboratively with other professions and to identify which professions and practice
areas are involved, as well as benefits and challenges associated with collaborative working.
Methods: A web-based survey was designed and disseminated to SLP CPLOL representatives of
all CPLOL member countries to explore collaborative working practices.
Results: A total of 27 European countries responded to the survey. This study revealed that SLPs
all over Europe are working collaboratively as part of multidisciplinary teams, in both health and
education sectors. Overlapping roles and competencies exist between SLPs and a broad range of
other professions in a variety of different practice areas. A number of key advantages and challenges of collaborative working were identified.
Conclusions: Findings suggest that SLPs work collaboratively in multidisciplinary contexts with
a range of other professions, which brings both benefits and challenges. Regulations and guidelines need to be developed to address overlapping roles and competencies between professions.
Keywords: Collaborative working, multidisciplinary working
P2.53
EDUCATION DEVELOPMENT IN LATIN AMERICA THROUGH
ASHA/WHO COLLABORATION
Silvia Martinez - ASHA, USA
Lily Schuermann Waterston - ASHA, USA
Objective: In 2013, the first UN High-Level Meeting on Disabilities and Development agreed to
include people with disabilities in the post-2015 development agenda. Accordingly, the ASHA
developed a series of priorities. Among them were to (1) exchange information with international
groups that focus on health, communication, and education, (2) ensure ASHA representation
global health, communication, and education project, and (3) collaborate with the World Health
Organization (WHO).
Methods: ASHA/WHO through the Pan American Health Organization selected three of the most
impoverished countries in Latin American that self-identified needs regarding communication
disorders in their countries: El Salvador, Guyana, and Honduras. The process has included onsite needs assessments that identified the most urgent needs in each country, prioritizing needs,
recommending support activities/materials, and identifying experts. The countries’ main needs
focused on education. Honduras identified a need to establish their first phonoaudiology program
197
in the country. El Salvador has identified their need for continuing training of non-professionals,
professionals, and audiologists in specialized equipment. Guyana has also identified the need for
in-service for their personnel as well as the need to develop their first phonoaudiology program.
In support, ASHA established three ad hoc committees composed of ASHA members with expertise in specific areas to address the strategic plans of each country and support their implementation.
Results: Different goals have been achieved for each country. Honduras completed their program proposal and is waiting for final approval, with aims to start in 2015. For El Salvador, training plans are being developed for specific audiology equipment, and speech pathology in-service
training for three levels of professionals. Guyana developed a curriculum for a new program,
while identified in-service training needs.
Conclusions: Through this poster, attendees will explain how organizations can work together to
address the needs of impoverished countries, and how educational/training programs are developed for specific country needs.
Keywords: Initial education
P2.54
L’ORTHOPHONIE EN AFRIQUE FRANCOPHONE SUB-SAHARIENNE:
ÉMERGENCE, DÉFIS ET ENJEUX
Sylvia Topouzkhanian - Centre Hospitalier le Vinatier, ISTR - Lyon 1, Lyon, France
Agnès Gascoin - Orthophonistes du Monde, CHU Grenoble, Grenoble, France
Karilowô Ate - Ministère de la Santé, CHU Campus de Lomé, Lomé, Togo
Objectif: Ce poster présente les étapes clés ayant permis l’émergence de l’orthophonie en Afrique
francophone subsaharienne, les difficultés rencontrées par les jeunes orthophonistes africains et
les défis qui les attendent.
Méthodes: Nous exposerons le cursus ayant permis la création de la première école de formation
initiale diplômante en orthophonie en Afrique de l’Ouest et du Centre, au sein de l’Ecole Nationale des Auxiliaires Médicaux (ENAM) de Lomé (Togo) en 2003. Elle est le fruit d’un partenariat
entre des associations européennes (Orthophonistes du Monde et Handicap International) et les
Ministères togolais.
Nous exposerons la façon dont l’orthophonie africaine se façonne et se structure, afin de se faire
connaître et reconnaître, dans un contexte de soins et de plurilinguisme bien spécifique.
Résultats: Depuis 2006, soixante six professionnels africains ont été formés au Togo et exercent
actuellement dans neuf pays. Certains d’entre eux sont devenus formateurs et gèrent de façon
autonome la formation à l’ENAM.
Des associations nationales de professionnels ont été créées et un projet de création d’une
fédération africaine d’orthophonie est en cours. Les défis à relever sont nombreux et concernent
notamment la création et l’adaptation de matériel adapté et le développement de la recherche.
Conclusions: L’orthophonie est actuellement en plein essor sur le continent africain. De nombreux
projets sont en cours, pour développer et promouvoir la profession.
Mots-clé: Orthophonie, Afrique, profession, développement, formation , adaptation, plurilinguisme
198
P2.55
INTERACTIONS LOGOPÉDISTES-ADOLESCENTS:
QUESTION/ REPRISE: PHÉNOMÈNES INTERACTIONNELS
CONSTITUTIFS DU RÉCIT
Audrey Sublon - Chaire de logopédie (Speech Therapy), Neuchâtel, Neuchâtel, Switzerland
Geneviève De Weck - Chaire de logopédie (Speech Therapy), Neuchâtel, Neuchâtel, Switzerland
Morgane Gallet - Chaire de logopédie (Speech Therapy), Neuchâtel, Neuchâtel, Switzerland
Objectif: L’étude proposée cherche à mettre en évidence, d’un point de vue socio-interactionniste, le travail par rapport aux compétences discursives qui se fait dans les traitements logopédiques impliquant des adolescents avec troubles du langage oral. Il s’agit d’expliciter certains
des mécanismes d’interaction lors d’activités de coproduction de récit d’expériences personnelles (REP) qui favorisent le développement des compétences de communication.
Méthodes: Les interactions verbales de 3 dyades adolescent-logopédiste (19 séances), avec des
jeunes âgés de 12 à 16 ans, sont divisées en séquences discursives, dont celle de REP au sein
de laquelle les énoncés consistant en une question ou en une reprise (répétition et reformulation)
sont relevés. Trois aspects sont analysés : leurs fonctions selon l’interlocuteur qui les utilise, la
nature des demandes ou les caractéristiques des reprises et l’impact de ces formes sur la progression du récit.
Résultats: Parmi les interventions du logopédiste, 1/3 sont des reprises, 1/3 des questions. Il
utilise aussi souvent des formes mixtes qui consistent en des demandes de confirmation, de clarification ou d’information visant l’intercompréhension, la correction formelle, l’établissement de la
référence ou la structuration temporelle. L’adolescent produit ¼ de reprises, 5 % de questions.
L’hétéro-reprise lui permet de produire ses réponses. L’auto-reprise permet au locuteur d’élaborer
son discours. La question permet aux participants de coproduire le récit: initiation, ouverture et
développement thématique.
Conclusions: Questions et reprises, ressources importantes en séance, permettent l’intervention
tout comme la sollicitation des participants.Considérant le récit comme un outil à disposition des
participants, l’intérêt portéà ses phénomènes interactionnels permet de rendre efficace le travail
des cliniciens sur la production du récit.
Mots-clé: Developmental language disorders, speech therapy, reiteration processes, questions,
interaction, adolescence, personal storytelling
P2.56
THE USE OF EVIDENCE-BASED PRACTICE BY SPEECH
AND LANGUAGE THERAPISTS IN THEIR CLINICAL WORK IN PORTUGAL
Ana Beirao - PIN - Progresso Infantil, Escola Superior de Saúde do Alcoitão, Estoril, Lisboa, Portugal
Objective: To describe the beliefs, attitudes, knowledge, and behaviors of speech and language
therapists working in Portugal in relation to evidence-based practice, as well as the use and the
barriers in the different practice settings.
Methods: A questionnaire designed to determine beliefs, attitudes, knowledge, and behaviors of
speech and language therapists regarding EBP was translated, adapted and validated. 76 valid
answers were obtained. Responses were summarized for each item (attitudes and beliefs about
EBP; education, knowledge, and skills related to obtaining and evaluating evidence; attention to
the literature relevant to practice; access to and availability of information; and finally, perceptions of the barriers to EBP). We proceeded to the statistical analysis of answers to determine
199
demographic and professional information and logistic regression analyses were made to examine
relationships among variables.
Results: Study is still ongoing (results’ analysis and final conclusions).
Keywords: Evidence-base practice, speech and language therapists, speech and language
therapy, barriers, practice settings
P2.68
PRODUCTION AND PERCEPTION OF VOICELESS AND VOICED
STOPS IN PHONOLOGICAL DISORDER
Helena Bolli Mota - Federal University of Santa Maria, Santa Maria, Brazil
Roberta Melo- Federal University of Santa Maria, Santa Maria, Brazil
Objective: The voicing contrast of stops represents a complex gestural coordination, frequently
impaired in cases of phonological disorders (PD). There are many gaps related to the factors that
influence the stabilization of that contrast. The purpose of this research was to correlate the production data and the performance in a discrimination test of the feature [+voice] in children with PD.
Methods: Five boys who presented PD, difficulties in the production of voiced stops and other
difficulties, were evaluated. We observed the occurrence of the production of negative VOT during the voiced stops and the duration pattern of the vowels adjacent to the voiced and voiceless
stops. The authors elaborated a Stop Voicing Discrimination Test (SVDT) to evaluate the performance of the individuals regarding discrimination. The test consists of 12 pairs of words, which
were only different in the contrast [+voice] and were represented by pictures.
Results: Through a descriptive analysis, no direct relation between difficulties in the production of
voicing contrast of stops and auditory discrimination of these sounds was verified, both in the observation of prevoicing production, regarding the pattern production observation of the length of
the vowel. For the prevoicing production of voiced stops, only one child in the sample presented a
negative VOT. On the other hand, there was a greater use of the other acoustic indication, length
of the vowel. Regarding the performance in the SVDT, the percentage of correct answers on the
test ranged from 33.33% to 91.67%.
Conclusions: It is important to carry out some assessments of discrimination and inclusion of
strategies that enable children with PD, establishing the connection between discrimination and
the phonemic aspects of speech production. Once, from the perception of the distance between
their productions to adult productions, the child starts to abandon the stable pattern in his/her
speech to venture into new attempts. Therefore, this is a facilitator period, permitting the speech
therapist to provide the ways and appropriate means to promote an approach to the standard
language (Freitas, 2012).
P2.69
COMPARISON BETWEEN QUANTITATIVE AND QUALITATIVE
CLASSIFICATION OF SEVERITY OF PHONOLOGICAL DISORDER
Vanessa Giachinni - Federal University of Santa Maria, Santa Maria, Brazil
Introduction: Some children do not follow the expected developmental sequence and their phonological system is organized differently. Thus, it results in a system that differs from the target
language and that is phonologically inappropriate to their surrounding language. Such cases are
200
known as phonological disorders (PD). For rating the severity of PD, both quantitative analyses
and qualitative assessments can be used. The most common quantitative analysis is the Percent
Consonants Correct (PCC). A recent qualitative hypothesis ranks PD using the distinctive feature
as a basic unit of analysis. The four constituent categories of phonological systems act as the
parameter for this hypothesis . This study aimed to check if there are any differences between the
severity ratings obtained using the PCC and the qualitative assessment based on features.
Method: Pre-therapy speech data was selected concerning 38 subjects, 25 male children and 13
female children, with ages ranging from 4:4 to 7:1. The quantitative assessment of the disorders
was carried out based on the PCC. The data was ranked as: mild deviation; mild-moderate deviation; moderate-severe deviation; severe deviation. The qualitative assessment was carried out
based on the hypothesis of distinctive features, ranked according to the deviation severity: mild
deviation; moderate deviation; moderate-severe deviation; severe deviation. The data were analyzed using frequency charts and the statistical test Chi-squared (p<0.05).
Results: Results have shown a low concordance between the qualitative and the quantitative
assessments of PD. The hypotheses only matched on the rating of 34.79% of the assessments.
When each of the severity levels was analyzed separately, it was concluded that the most extreme
levels - the milder and the most severe - had almost the same rating with both of the hypotheses.
Conclusion: This study supports the importance of joint assessments, in which both qualitative and quantitative measures are used, mainly for the differentiation and characterization of the
middle levels of severity of the phonological disorder.
P2.70
THE USE OF CONJUNCTIONS IN CHILDREN WITH TYPICAL
LANGUAGE DEVELOPMENT
Fernanda Wiethan - Federal University of Santa Maria, Santa Maria, Brazil
Letícia Nóro - Federal University of Santa Maria, Santa Maria, Brazil
Yasmim Glória - Federal University of Santa Maria, Santa Maria, Brazil
Letícia Hanauer - Federal University of Santa Maria, Santa Maria, Brazil
Objective: To investigate the use of conjunctions in the spontaneous speech of three year old
children with typical language development, who live in Santa Maria – RS.
Methods: 45 children, aged 3:0 – 3:11; 29 from the database of the Center for the Study of Language and Speech (CELF) of the Federal University of Santa Maria (UFSM) participated in this
study. The spontaneous speech of each child was transcribed. Afterwards an analysis of the
samples identifying the types of conjunctions for each age group was made. The samples were
analyzed statistically using the R software, that allowed the evaluation of the number and type of
conjunctions used in each age group by comparing them with each other.
Results: The data indicated that the greater the age of the child, the greater the number of types
of conjunctions used by them. The comparison between age groups showed significant differences when comparing the average number of conjunctions per age group, as well as for additive
conjunctions and subordinating conjunctions.
Conclusion: From the age of three the children begin to develop the grammatical use of conjunctions, additive, adversative and explanatory coordinating conjunctions appearing early, and from
3:6 the most complex conjunctions, such as subordinating conjunctions, appeared.
Keywords: Speech therapy, child language development, linguistics, vocabulary.
201
P2.71
INITIAL LEXICAL ACQUISITION AND NOUN BIAS HYPOTHESIS
VERIFICATION
Letícia Nóro - Federal University of Santa Maria, Santa Maria, Brazil
Débora Durigon da Silva - Federal University of Santa Maria, Santa Maria, Brazil
Objective: To verify how the initial lexical acquisition occurs in children with typical development,
regarding to types and tokens of the lexical items. Furthermore, the study wants to verify if the
noun bias hypothesis occurs, and in what version, strong or weak, in both sexes and according to
age.
Methods: The sample consisted of 20 children, male and female, with typical language development. This research covered ages from 1:0 to 1:11 (years: months) divided into three age groups.
Audio data from spontaneous speech were collected, and afterwards, lexical and statistical analysis was performed.
Results: No statistical significance was found in the variables regarding gender. However, statistical difference was found between age group 1 in relation to 2 and 3 for the majority of the
variables. Furthermore, the prevalence of content words in age groups 2 and 3 was verified. The
prevalence of nouns over verbs in all age groups was observed.
Conclusion: The initial lexical acquisition in children with typical development occurs gradually
according to increase in age. In this period the gender variable does not influence linguistic performance. Furthermore, the noun bias hypothesis was confirmed in its weak version, confirming
the thesis that inspired this research.
P2.72
THE APPLICABILITY OF VOCAL TECHNIQUES AND DYSPHAGIA
MANEUVERS IN PATIENTS WITH BURNS OF THE FACE AND NECK
Diana Lança - Arte & Fala, Lda, Clinic, Oeiras, Portugal
Introduction: This paper focuses on theoretical and clinical issues involving burn face and neck
patients, particularly with regard to the possibility of applying certain vocal techniques and dysphagia maneuvers in these individuals.
Objective: To investigate the possibility of application of vocal techniques and dysphagia maneuvers in patients with burns of the face and neck.
Method: An exploratory and descriptive cross-sectional study was conducted from a database
of the literature related to vocal techniques and dysphagia maneuvers and the whole process of
rehabilitation of patients with burns of the face and neck. The research consisted of the search for
reference books and scientific articles from the past 20 years indexed in the electronic databases
Medline, PubMed and SciELO. Furthermore, the observational aspect comes from visits to the
Burns Unit of Iamspe of São Paulo - Brazil.
Results: It was found that not all vocal techniques and dysphagia maneuvers have applicability in
patients with burns of the face and neck. The outcomes of the burn in the epithelial tissue, reducing skin extensibility and the mobility of supra-hyoid muscles and larynx muscles are the main
objections for its effectiveness.
Conclusion: It was concluded that from a total of 30 vocal techniques considered, only 9 have
applicability in patients with burns of the face and neck. Concerning the dysphagia maneuvers, it
was found that only 5 of these 11 are useful with this type of patients. Early speech therapy intervention and an appropriate application of vocal techniques and dysphagia maneuvers prevents
and restores the balance of the functions of the stomatognathic system.
202
AUTHORS’ INDEX
RÉPERTOIRE
DES AUTEURS
203
A
Abbiati Vera 04.4
Accornero Anna 04.2
Aceti Fulvia P1.67
Afonso Catarina P1.23
Afxentiou Dimitra P1.51
Aigare Diana P2.21
Albera Roberto 20.3
Alexandrou Maria P1.41
Almeida Letícia P1.21
Amir Ofer 04.5
Amundsen Line W5.2
Anagnostopoulos Dimitris P1.34
Andreou Stelios P1.48, P1.51
Antenucci Roberto 08.5, 10.5, 12.5
Arkkila Eva 02.3
Armon-Lotem Sharon 02.2, 02.6
Asbjørnsen Arve 21.3
Assi Cristiana 15.3
Astier Jean-Laurent RT2
Ate Karilowô P2.54
Awad Rehab 04.1
Aydin Ayse 05.5, P1.03
Azzopardi Axiak Sonia P2.52
B
Bakota Koraljka 13.5
Balažinec Marijana P1.01
Baptista Ana Catarina P1.66
Barbaro Marta P2.11
Barbetta Marianna P1.42
Barbot Anna P1.67
Bargagna Stefania 18.5
Baron Paola P2.49
Barrozo Tatiane Faria P1.22
Barsties Ben 04.3
Beirao Ana P1.72, P2.56
Bellini Giulia 08.5
Benazzo Marco 04.4
Benvenuti Michela 08.5
Bergamasco Laura 12.1
Bernhardt B. May W3, P1.05, P1.09, P1.21, P1.57, P2.39
Berns Philine 07.1
Bertino Giulia 04.4
Bertolin Andy 17.3
Bertolini Chiara P2.35
Bérubé Daniel W3
Bianchi Federica 10.3
Bilonic Miloševic Silvana P1.30
Binelli Carlotta 10.5, 12.5
Bishop Dorothy HS
Bittner Dagmar 06.5
Blaži Draženka P1.01, P1.30
Blondet Lucille 09.3
Blumenthal Mirjam 02.4
Bodea Hategan Carolina 14.6, RT2
Boér Eniko-Zsuzsánna 18.6
Boey Ronny W6
Bolli Mota Helena P2.68, P2.69, P2.70, P2.71
Bonelli Debora P1.69
Bonelli Jessica 12.3
Bonetti Silvia 19.4
Bonghi Laura P2.27
Bonifacio Serena P1.19
Boons Tinne P1.32
Borghi Emanuela P2.31
Bortagarai Francine Manara P1.13
Bosco Ersilia W1, W2
Bovoli Anna 14.1
Boyanova Violeta 18.2
Bozzini Emilia 10.5, 12.5
Bramucci Savina 08.1
Bratus Livia P2.11
Brizzolara Daniela 19.4
Brogi Andrea 19.2
Bron Annelies 09.2
Brondino Natascia 04.4
Brouwer Catherine E. 11.3
Brozovic Blazenka 05.3, 22.2
Bruinsma Gerda P1.44
Brunner Michaela P1.02, P2.05
Bruno Mariangela P1.42
Bucik Katja RT2
Budelli Laura P1.14
Budriesi Carla P2.43
Buettner Julia 21.2
Buják Tünde P2.20
Buntova Dana RT2
C
Cadório Inês P1.47
Calcaterra Andrea P1.14
Camilleri Norma P2.48
Cancialosi Patrizia 10.6
Cantor Cutiva Lady Catherine 04.2
Capecci Marianna 08.1
Capparelli Emilia 14.5, 19.6, P1.60
Carballo García Gloria P1.58
Cardinali Cecilia 08.5, 10.5, 12.5
Cardoso Rita 10.2
Carlucci Giovanna 12.3
Carmona Jaqueline 14.4
Caverzasi Edgardo 04.4
Centorrino Santi 10.4, 12.3, P2.19
Ceravolo Maria Gabriella 08.1
Cerchiari Antonella 15.2
Cerri Barbara 03.5
Chelas Evripidis Nikolaos 22.5
Cheong Michelle Heng Yue P1.25
Chialva Chiara 04.4
Chilosi Anna 03.5,19.4
Christofidou Vasia P1.41
Christopoulou Maria W10, P1.68
Christou Kristia 22.5
Ciappolino Valentina 04.4
Cipriani Paola 03.5
Citro Raffaella 20.4, W1
Cittadoni Lorena 03.5
Clegg Judy 02.5
Cobben-Crefcoeur Claudy 20.6
Coccia Michela 08.1
Cocquyt Mie 03.4, P1.46
Coelho Orquídea 19.3
Coets Marie-Claire RT2
Cohen Tervaert Floor 09.1
Colman Katrien 12.4
Congia Alessia P2.12
Constantinidou Fofi RT3, W11
Constantopoulos Costas P1.48, P1.51, P1.68
Coopmans Jeanine 16.2
Corbetta Elena P1.14
Courelas Carla 16.3
Cozman Doiana 14.6
Crestani Anelise Henrich 11.6
Crielesi Maristella P2.12
Cristofani Paola 19.4
Croce Alessandro 21.4
Crosetti Erika 17.3
D
Danna Elena W12, P1.69
Daukilas Sigitas P1.45
Davies Karen 11.1
De Beer Joost 16.2, 19.5
De Bonis Elena P2.27
De Cagno Anna Giulia 05.2, P2.14
De Chambrier Anne-Françoise W8
De Coster Sandrine P2.47
De Swart Bert P2.28
De Weck Genevieve 11.5, 18.4, P2.55
De Wit Ellen 13.1
Dekker-Van Doorn Connie 07.2
204
Del Gado Francesca 14.5, P1.60
Del Pio Cristina P1.14
Del Vecchio Lucia 08.2
Dellomonaco Anna Rita P2.32, P2.33, P2.34, P2.37
Demanez Laurent 13.6
Dessyla Vasiliki 16.5
Destefanis Luciano W12, P1.69
Dhaese Willem P1.46
D’hondt Marleen RT2, P1.07
Di Martino Maria Valeria 08.2
Di Pietro Marcella P2.12
Di Ponio Marina P2.22
Di Rosa Annunziata P1.40
Dias Óscar P1.66
Dieleman E.P. 15.5
DiLieto Maria Chiara 19.4
Døli Hedda P2.08
Dufournier Pascaline 16.6
Dujardin Helene P1.64
Dular Kolar Uršula P1.16
Dulcic Adinda 13.5
Durignon de Silva Debora P2.71
E
Ebner Eva P2.01
Ege Pinar 20.4
Eikeland Ole-Johan 21.3
Elzenaar Lieke P1.32
Emmenegger Catherine RT3
Esbensen Annette 13.2
F
Falcone Paola 14.5, P1.60
Fantini Marco 17.3
Fantozzi Carlo 09.6
Feroldi Sarah 10.1, 10.3
Ferrario Maria Rosa P1.14
Ferreira Joaquim J. 10.2
Ferretti Fabio 12.3
Fiori Simona 03.5
Fisketjøn Synnøve T W5.4
Flaugnacco Elena P1.19
Fontana Ilaria P1.67
Fosser Randi P2.52
Fox Gwendoline 11.5
Freitas Dias Roberta P1.24
Freitas Maria João P1.21, P1.23, P1.24, P1.66
Frouin Camille 21.5
Fuisz-Szammer Nina P1.31
Fuller Alison RT3
Fumarola Valentina P2.37
Fuschetto Laura 10.4
G
Gacnik Mateja 20.4, P1.16
Gagliardi Gloria P2.16
Gallet Morgane P2.55
Galli Federica Lucia 08.1
García-Retamero Imedio Rocío P1.58
Gardner Hilary P1.56
Garrido del Águila Dunia P1.58
Garsol Lea W5.3
Gascoin Agnès P2.54
Gaspary Kinga P2.14
Gasperini Filippo 19.4
Gayraud Frédérique 21.5
Génot Harmonie 21.6
Georgaki Alexandra 22.6
Gerrits Ellen 05.1, 09.1, 12.2, P1.44
Ghayoumi Zahra 21.1
Giachinni Vanessa P2.69
Ginocchio Daniela 10.1, 10.3
Giovanardi Giulia 08.5
Girolametto Luigi P1.19
Gloria Yasmim P2.70
Godtbil Marion P1.64
Gomato Lidia P2.10
Gomes Camargo Renata P1.17, P2.50
Goswami Usha P1.18
Grabar Natalia P2.09
Grech Helen 02.4
Grignard Christine 20.4
Grillo Caterina P1.69
Grohmann Kleanthes 01.1
Grossoni Pina P1.14
Gruppi Maria Paola 10.5, 12.5
Guaran Francesca 19.4
Gudmundsdottir Bryndis P1.11
Guerzoni Letizia 13.4, W2
Guglielmino Paola 20.3
Guimaraes Isabel 10.2, 17.4
Guiraud Claire 09.3
Guthrie Susan 07.4
Güven Orhan Selçuk 01.3
H
Habus Sanja P2.04
Haid Andrea P2.05
Hallap Merit P1.26
Hanauer Leticia P2.70
Hansen Dorthe 11.3
Hansson Kristina 01.2, P2.41
Haupt Christina 02.5
Havelkova Olga RT2
Helland Turid W5.1, W5.2, W5.3, W5.4, W5.5
Helland Wendhe A. W5.2, W5.3, W5.4, P2.08
Hercigonja Salamoni Daria P2.52
Hettiarachchi Shyamani 01.4, P1.73
Hilaire-Debove Géraldine 06.6
Hill Fiona P2.52
Huaut Camille 21.6
Huet Kathy P1.64
I
Iché Aurélie 12.6
Ird Kadi 03.3
Ivoskuviene Regina P1.63
Iyigun-Bulbul Eda P2.24
J
Jaeger-Begheijn Uta 16.2
Jagomägi Triin 03.3
Jehlicková Katerina P2.38
Jerman Janez P1.52
Jesus Luis M.T. P1.70
Joffe Victoria 07.5
Jones Lise W5.2, W5.3, W5.4
Jordanova Nina RT3
Jordens Peter 06.5
Joyeux Nathaly P2.51
K
Kacar-Kutukcu Dilber 05.5
Kairiene Daiva RT2, P2.44
Kalf Hanneke W9, P2.28
Kalogerakis Zacharias P1.43
Kambanaros Maria 01.1
Kartunova Svetlana P1.49
Kas Bence 06.4, RT2
Kazanoglu Deniz 05.5
Kelic Maja P1.30
Keprdová Tereza P2.38
Kern Sophie 06.6
Kleczek-Marek Michalina 07.3
Knuijt Simone W9
Kogovšek Damjana P1.09, P1.16, P2.39
Kohler Jürgen P1.55
Kohlleppel Susanne 20.1
Košir Stanislav P1.52
Kruythoff Astrid 09.1
Kunnari Sari 02.3
Kuuseoja Marina P1.26
Kyriacou Solomonidou Maria P2.40
205
L
Laasonen Marja 02.3
La Rocca Lorena 20.3, P2.12
Lacorte Eleonora P1.27
Lagakou Evdokia 11.2, 11.4, P1.43
Lanca Diana P2.72
Lancaster John 07.4
Lavermicocca Valentina P2.32, P2.33, P2.34, P2.37
Lavesson Ann 01.2
Lazaratou Helen 11.2, P1.34
Lecocq Elsa 13.6
Lee Mary Lay Choo P1.25
Lehes Lagle 03.3
Lehtihalmes Matti P1.08
Leitinger Christina P1.31
Leonardi Paola P1.20
Leorin Cristian 09.6, P1.62
Leseman Paul P1.44
Levi Omer 04.5
Lice Karolina P2.17, P2.29
Lima Sónia 04.6
Lisboa Mezzomo Carolina P1.12, P1.17, P1.20, P1.24
Logullo Francesco 08.1
Lombardi Grazia P1.71
Lopes Ana Cláudia 16.3
Lopez Patrizia 08.6
Lorenzini Irene 03.5
Loureiro Rui 19.3
Lousada Marisa P1.06, P1.47
Lovato Giovanna P2.43
Lövdén Martin 01.2
Lowit Anja 16.1
Luinge Margreet R. 05.1, 15.5
Lukács Ágnes 06.4
Lurato Enrico 22.1
Lundeborghammarström Inger W3
Lunetta Christian 10.1
M
Machado Silva Suelen P2.49
Mahmoodi Bakhtiari Behrooz 21.1
Maïté Boye P2.09
Majoli Marta 15.3, 15.4, P1.65
Makauskiene Vilma P1.45, P1.63
Makri Eleni 16.5
Malandrini Alessandro 19.2
Maneta Athanasia 16.5
Manger Terje 21.3
Mantaka-Brinkmann Ellianna 16.5, 20.4, P1.33
Mantione Solene P2.14
Marin Alja P1.09
Marini Andrea 22.4
Markova Raina 18.2
Marks Dana-Kristin P1.38
Marque Cécile 13.6
Marselos Rea 16.5
Martin Frederic 08.4
Martinez Silvia P2.53
Martino Rosemary P2.22
Martinot-Randoux Gisèle 15.6
Martins Fernando P1.70
Maruca Annalisa P1.14
Maryn Youri 04.3, 17.1, W7
Masciarelli Giovanni 22.1
Masdottir Thora RT1, P1.57
Massari Ermelinda 12.1
Mavis Ilknur 05.4, P2.18
Mazzotti Sara 19.4
McAllister Anita P2.46
McAllister Jan P2.23
McLeod Sharynne 03.1
McNeilly Lemmietta 20.2
Mecca Loredana P1.14
Meir Natalia 02.2
Melo Roberta P2.68
Meravoglou Paraskevi 11.4
Mészáros Éva P2.06
Meulensteen Meia P1.32
Michael Artemis P1.41
Mick Liron 04.5
Migliazzi Silvia 04.4
Minaidou Despo P1.35, P1.41
Minelli Valentina P1.71
Miranda Mariateresa P1.40
Mitterhuber Johanna P2.02
Mommaerts Maurice 03.4, P1.46
Montanaro Veronica P1.56
Montano Letizia P2.19
Monte Stefano 20.3, P2.12
Montero Camacho Mario P1.04
Monti Elisa P1.15, P1.37
Mora Gabriele 10.3
Moraes Anaelena Bragança 11.6, P1.13
Morken Frøydis W5.1, W5.2
Morra Federica 20.3
Motsch Hans-Joachim P1.38
Mozzanica Francesco 18.5
Münch Heike 15.1, P2.45
Muò Rossella 12.1, 20.3, 21.4, P2.11, P2.12, P2.41
Muznik Mojca P1.09
N
Nasser Nadimi 03.4
Neijenhuis Karin 07.2
Nespoulous Jean Luc KS2
Nicastri Maria W1, W2
Nicolotti Domenico 08.5, 10.5, 12.5
Niemitalo-Haapola Elina P2.41
Nikitopoulou Christina P1.59
Nilsen Steffen W5.3
Noro Leticia P2.70, P2.71
Notarnicola Marilina P2.32, P2.33, P2.34, P2.37
Novšak Brce Jerneja P1.09, P1.52, P2.39
Nursi Aaro P2.03
Nuzzi Angela P2.32, P2.33, P2.34, P2.37
O
Oberžan Lilijana P1.16
Obucina Helena P1.01
Ogrin Maja P2.07
Ojaste Anneli RT3
Okalidou Areti 13.3
Olim Catarina 04.6, 17.2, 17.6
Oliveira Santana Ana Paula P2.49
Olivo Antonella P1.39, P1.40
Olizzi Barbara 08.5, 10.5, 12.5
Ölmez Selen 05.4
Omahna Mateja P2.13
Oonk Leonoor 14.3
Orgassa Antje 16.2
Orley Zita P2.20
Orsi Monica 10.5, 12.5
Ottow-Henning Esther 09.1
Overton Mary RT1
Oz Hadar 02.6
Ozbic Martina W3, P1.09, P1.16, P2.39
Ozdemir Ramazan Sertan P1.03
P
Pace Pasqualina P1.69
Padovano Marianna P1.40
Padrik Marika 03.3
Pagani Roberto 04.4
Pagan-Neves Luciana de Oliveira P1.22
Page Judith L. IS1
Pagnamenta Emma 07.5
Pähkel Maarja P2.03
Palmovic Marijan P2.17, P2.29
Panella Monica 15.3, 15.4, P1.65
Panigati Rosa 04.4
Panizzolo Sara W1
Papadopoulou Elisavet 17.5
206
Papadopoulou Soultana, L 08.3
Paparizos Konstantinos 22.5
Paprika Marina P2.17, P2.29
Parente Antonella P2.32, P2.33, P2.34, P2.37
Paris Leal Ana P1.72
Pasqua Eleonora 19.6
Patelli Ilaria W2
Paterniti Maria Rosa 22.1
Patroni Paola 10.5, 12.5
Patterson Aileen 16.1
Pavicic Dokoza Katarina 13.5, RT2
Pecini Chiara 19.4
Pedersen Nina Helen W5.5
Peeters Manon P1.32
Peeva Maria P2.52
Pertijs Mark 14.2, 14.3
Peruzzolo Dani Laura P1.13
Petinou Kakia P1.35, P1.41
Petraki Eirini P1.34
Petsa Elena P1.68
Pevere Francesca 22.4
Pfaller Karin P2.41
Pfanner Lucia 03.5
Piazzalunga Silvia 01.5
Picciolini Odoardo 15.3
Piérart Bernadette 13.6, P1.64
Pierro Anna 06.3
Pietranton Arlene A. IS1, RT
Pintar Uršula P1.16
Pinto Diogo 17.2, 17.6
Pinto Serge 10.2
Pizzorni Nicole 17.3
Pluta- Wojciechowska Danuta 07.3, P1.53, P1.54, P2.30
Polato Federica 21.4
Polewczyk Irena P1.28
Pollini Maria Teresa 10.5
Polykreti Stavroula P1.50
Pommersheim Angela 20.4
Porazzi Valentina 15.3, 15.4, P1.65
Posilovic Monika 06.1
Prebil Nataša P2.26
Previtali Lisa 01.5
Primov-Fever Adi 04.5
Protti Daria 10.6
Provinciali Leandro 08.1
R
Rabino Giulia 12.1
Raggi Rossella 08.5, 10.5, 12.5
Raibuzyte Simona P2.44
Ramalho Ana Margarida P1.06, P1.21
Rapti Maria 16.5
Raudik Signe P1.26
Raudsalu Veronika P2.40, P2.52
Raven-Takken Evelijn 12.2
Rayes Maria P1.51
Rea Monica W1
Reginelli Alfonso 08.2
Reijneveld Sijmen A. 05.1
Resinger Eva P2.25
Reverberi Cristina P2.31
Rezzonico Angela P1.67
Ricchi Serena P2.31
Richards Susan P1.18
Rickard Liow Susan Jane P1.25
Rigato Valentina 09.6
Rinaldi Sara 05.2
Rinaudo Marta 12.1
Ritrovato Maria Antonietta P2.27
Rives Christophe 12.6
Rizzotto Giuseppe 17.3
Robinson Jr. Tommie 20.2
Robotti Carlo 04.4
Rocca Christine W2
Roddam Hazel W4, P2.40, P2.52
Rodrigues Susana P1.70
Rodrigues Tavares Ana Isabel P2.48
Rodríguez-García Lidia 16.4, 20.5
Ronlev Maria P2.48
Rossetto Tiziana 20.4
Røssland Marte W5.2
Rother Angelika P1.31, P2.01, P2.02, P2.05, P2.25
Rousseau Thierry 21.6
Rygvold Anne-Lise 19.1, RT1
S
Sachova Irena P2.52
Sakellariou Katerina P1.43
Salameh Eva-Kristina 02.4
Saltarelli Simonetta 06.3
Salvadorini Renata 03.5, 18.5, 19.4
Sambor Barbara P2.30
Sansone Valeria 10.1
Santana Ana Paula P2.15
Schalling Ellika P2.46
Scharff Rethfeldt Wiebke 02.4, RT1, P1.02
Scheper Annette 09.2, 09.5
Schindler Antonio 01.5, 10.1, 15.3, 15.4, 17.3, P1.37
Schuermann Waterston Lily P2.53
Scuccimarra Goffredo P1.40
Selås Magnhild 22.3, W5.5
Sforza Elisabetta 15.2
Siddi Roberta 19.6
Sierens Sarah 03.4, P1.46
Simonska Miglena P1.74
Sivertsen Åse W5.5
Skamlic Nives P1.16
Smolander Sini 02.3, P2.52
Soare (Trifu) Raluca 14.6, P2.45
Soares Célia 04.6
Somayeh Rahmati 18.4
Souza Ana Paula Ramos 11.6, P1.13
Specht Karsten P2.08
Spinetti Maria Grazia P1.60
Spoglianti Silvia 19.4
St Louis Kenneth O. 14.5
Staal I.I. 15.5
Stackhouse Joy 02.5
Stankova Margarita 18.2
Stansfield Jois KS3, 07.4
Steiner Jürgen P2.05
Stemberger Joseph Paul W3, P1.05, P1.09, P1.21, P1.57, P2.39
Steni Patrizia 12.1, 21.4, P2.11
Stoerch Mehring Susanne P1.10
Sublon Audrey 11.5, P2.55
Succo Giovanni 17.3
Susigan Manuela 09.6
Sutherland Helen 22.6
Suvanto Anne P1.08
Suvi Tiina 03.3
Szentkuti-Kiss Katalin 06.4
Szöllosi Izabella P2.06
Šebková Lucie P2.38
Štok Mirjam P1.16
T
Taba Pille P2.03
Tamborrino Giovanna 04.2
Tammaro Valentina P1.27
Tar Éva P1.05
Taxitari Loukia P1.35, P1.41
Tedesco Angela P2.32, P2.33, P2.34, P2.37
Terband Hayo, H.R. 03.2
Theodorou Eleni 01.1
Thi Mai Tran P2.09
Thomsen Mette 20.4, W4
Thomsen Pia 13.2
Thordardottir Elin 02.1, 06.2
Togram Bulent P2.24
Tomaiuoli Donatella 14.5, 19.6, P1.60
Tomasello Chiara P2.36
Topbas Seyhun 05.5
207
Topouzkhanian Sylvia P2.42, P2.54
Tops Sandra P1.32
Traisci Gabriella W1, W2
Trinite Baiba 07.6, 16.1, P2.21
Tsiapali Evangelia P1.50
Tsipra Ioanna 11.2, P1.43
Tubele Sarmite 07.6, RT2, P1.36
Tunçer Aylin Müge P2.18
U
Uilenburg Noelle 09.4
Ulrich Tanja P1.29, P1.38
V
Valassis Kalliopi 13.6
Van der Schaaf Aafke 20.1
Van der Schans Cees P. 05.1
Van der Zee Rosanne B. 09.4
Van Doornik-van der Zee Anniek, J.C. 03.2
Van Dycke Sabien 05.6, 18.1, P1.07
Van Ewijk Lizet 12.2
Van Hoof Joost P1.32
Van Tilburg Francis 09.5
Vanacore Nicola P1.27
Vanderswalmen Ruth 18.1, P1.07
Vanryckeghem Martine P1.52
Vasileva Veneta 18.2
Vasshaug Kjersti B W5.4
Vedrodyova Miriam 10.3
Velho Júlio 16.3
Vendruscolo Josiane Fernanda P1.13
Venuti Biancamaria 19.6, P1.60
Verdolini Abbott Katherine IS2
Veresie Maria P1.41
Verhoef Joan 07.2
Vermeij Bernadette A.M. 09.4
Vernero Irene RT1
Versteegde Lotte 12.2
Vescovi Diego 09.6
Vilaltella Verdes Sonia P1.04
Vio Claudio 19.4
Virkunen Liis P2.03
Visser-Bochane Margot I. 05.1
Vitásková Katerina P2.38
Vlassopoulos Maria 01.6, 11.2, 11.4, RT, P1.34, P1.43
Vogels Eveline 18.1, P1.07
Vogindroukas Ioannis 22.5
Volpin Letizia P1.61
Voltan Elisabetta 06.3
Volterra Virginia KS1
Voor in t holt Willy 20.1
Vougiouka Christiana P1.33
Vukovic Ogrizek Martina P2.17, P2.29
W
Weikamp Janneke P2.28
Wertzner Haydée Fiszbein P1.22
Westerbring Susanne P2.52
Wiefferink Karin 09.1, 09.4
Wiethan Fernanda P2.70
Wijnen Frank P1.44
Witkamp Erica 07.2
Witko Agnes 09.3
Wolf Michael 04.5
Wozniak Tomasz 18.3
Y
Yadegari Fariba 21.1
Yliherva Anneli P1.08
Young Dawn Patricia Chuan Yu P1.25
Young Selena Ee-Li P1.25
Zannoni Cecilia P1.67
Zarokanellou Vasiliki 01.6
Zauchner Lisa Maria P1.31
Zesiger Pascal W8
Zink Inge 03.4, P1.46
Zuccotti Gian Vincenzo 15.4
HS Honorary speech / Conférence honorifique
KS Keynote speech / Conférences principales
IS Invited session / Conférenciers invités
RT Round table / Table ronde
W Workshop / des ateliers
P Poster presentation / des présentations poster
Z
Zacarias Vargas Diéssica P1.12, P1.20
Zakariás Lilla P2.20
Zampino Giuseppe 15.2
208
ACTES
DE CONGRÈS
9 CONGRÈS
DU CPLOL
ème
Ouvrir les portes à la communication
8 & 9 Mai 2015
Florence, Italie
Actes de Congrès
9ème Congrès du CPLOL
Mai 8 & 9, 2015, Florence, Italie
CPLOL, 2015
Éditeur
Baiba Trinite
Éditeurs (langues)
Maria Vlassopoulos
Traduction
Maria Rosaria Broggi
Conception graphique
Uvetamex
© CPLOL, 2015
Comité Permanent de Liaison des Orthophonistes-Logopèdes de l’Union Européenne
145 Bd Magenta, F-75010 Paris
www.cplol.eu
ISBN
978-2-9552505-0-1
EAN9782955250501
ACTES
DE CONGRÈS
9 CONGRÈS
DU CPLOL
ème
Ouvrir les portes à la communication
8 & 9 Mai 2015
Florence, Italie
COMITÉ EXÉCUTIF CPLOL 2013-2016 Présidente: Michèle Kaufmann-Meyer
Secrétaire Générale: Ulrika Guldstrand
Vice Présidente, Formation: Maria Vlassopoulos
Vice Présidente, Pratique Professionnelle: Catarina Olim
Vice Présidente, Congrès: Baiba Trinite
Vice Présidente, Reconnaissance: Raffaella Citro
Trésorière: Frédérique Schneider
PRÉSIDENTE DU CONGRÈS
Michèle Kaufmann-Meyer (Suisse)
PRÉSIDENTE DU PAYS D’ACCUEIL
Tiziana Rossetto (Italie)
COMITÉ SCIENTIFIQUE
Présidente: Baiba Trinite (Lettonie)
Enfants-troubles du langage
Kristina Hansson (Suède)
Rositsa Iossifova (Bulgarie)
Maria Vlassopoulos (Grèce)
Enfants-troubles non langagiers
Vilma Makauskiene (Lituanie)
Thora Masdottir (Islande)
Heike Münch (Autriche)
Adultes-personnes âgées troubles du langage
Jean-Laurent Astier (France)
Fofi Constantinidou (Chypre)
Mary Overton Venet (Suisse)
Adultes-personnes âgées troubles non linguistiques
Raffaella Citro (Italie)
Hanneke Kalf (Pays Bas)
Youri Maryn (Belgique)
Formation initiale
Bauke Leijenaar (Pays Bas)
Anne-Lise Rygvold (Norvège)
Irene Vernero (Italie)
COMITÉ D’ORGANISATION
Raffaella Citro (Italie)
Anna Giulia De Cagno (Italie)
Gianfranca Errica (Italie)
Ulrika Guldstrand (Suède)
Catarina Olim (Portugal)
Sara Panizzolo (Italie)
Frédérique Schneider (France)
Baiba Trinite (Lettonie)
Maria Vlassopoulos (Grèce)
SECRÉTARIAT DU CONGRÈS
Italy Destination Labs
An Uvet American Express division
Via La Marmora 36
50121 Florence - Italy
SOMMAIRE
Message de bienvenue
5
Conférenciers invités
7
Conférences principales
7
Séances invitées
Présentations orales
11
13
Ateliers
110
Table ronde
123
4
Présidente du CPLOL
Présidente du Congrès
Logopédiste
Chers amis et collègues,
En tant que Présidente du Comité Permanent de Liaison des Orthophonistes Logopèdes
de l’Union Européenne (CPLOL), j’ai le privilège et le grand plaisir de vous inviter et de
vous souhaiter la bienvenue au 9ème congrès Européen d’orthophonie/logopédie qui se
tiendra à Florence en Italie du 7 au 9 mai 2015, au Palazzo dei Congressi et au Palazzo degli Affari.
Le CPLOL représente 33 associations nationales d’orthophonistes/logopèdes et ainsi plus de 80.000 professionnels de 30
pays Européens. Notre but principal est de représenter tous les spécialistes à travers l’Europe et de promouvoir l’orthophonie/logopédie sur les scènes scientifiques, académiques et cliniques.
Le congrès Européen du CPLOL est un événement important pour la collectivité logopédique. Il attire une grande communauté de cliniciens, chercheurs, académiciens et de professionnels des domaines en lien avec la communication et la
réadaptation, d’Europe et du monde entier.
Florence est le chef-lieu de la région Toscane et la ville la plus peuplée de cette région. En raison de son héritage artistique
et architectural, elle a été nommée une des plus belles villes du monde et déclarée patrimoine mondial par l’UNESCO en
1982. Elle est considérée comme le berceau de la Renaissance et offre une multitude d’attractions historiques et culturelles. Que ce soit pour la mode, les délices culinaires ou les vins de Toscane, son caractère typique saura sans aucun
doute enthousiasmer ses visiteurs.
Le comité d’organisation en collaboration avec Uvet American Express et le comité scientifique, fait un travail fabuleux
et sera en mesure de présenter un programme scientifique stimulant. Les conférenciers pivots, la grande diversité de
sessions parallèles, les ateliers et les présentations de posters plairont certainement au public éclectique, multilingue,
multiculturel et diversifié de notre congrès.
De plus, le congrès donne toujours aux participants l’occasion de tisser des liens sociaux et d’avoir de nombreux
échanges professionnels, culturels et pourquoi pas culinaires.
Je me réjouis de cet événement et d’avoir l’occasion de partager l’aventure avec des amis et des collègues de notre merveilleuse communauté d’orthophonistes/logopèdes au-delà des frontières.
Allons ensemble “OUVRIR LES PORTES À LA COMMUNICATION“ et partager notre passion!
Tiziana Rossetto
Présidente de FLI
Coprésidente du Congrès
Logopédiste
Chers collègues et amis,
la Fédération des Logopédistes Italiens est heureuse et fière d’accueillir le 9ème congrès
CPLOL en Italie.
Au rendez-vous 2015, la Communauté Européenne des logopèdes/orthophonistes
affirmera encore une fois les hautes compétences e le rôle professionnel d’un logopédiste
face aux nouveaux défis posés par les systèmes sanitaires européens en cette période
complexe.
La communauté des logopèdes/orthophonistes recherche et développe depuis de
nombreuses années des méthodes et des solutions basées sur des preuves scientifiques
afin de promouvoir la qualité de leurs interventions.
Comme exemple que l’Europe n’est pas simplement celle d’un concept financier, la Fédération des Logopédistes Italiens (FLI) vous donne rendez-vous en 2015 en Italie, dans la ville qu évoque le mieux la culture, l’histoire, l’excellence et
l’innovation: Florence.
Le 9ème congrès du CPLOL aura donc son édition en Italie, nation protagoniste d’un autre événement international:
l’Expo 2015 “nourrir la planète, énergie pour la vie”. Cette exposition universelle se tiendra à Milan et sera un souvenir
indélébile, une expérience unique pour ceux qui auront l’occasion de la visiter.
La Fédération des Logopédistes Italiens contribuera également au congrès européen en tenant sa conférence nationale
“nourrir l’esprit, qualité pour la vie” au cours de la même semaine et au siège-même du congrès de façon à réinterpréter
le thème de l’Expo tout en partageant les meilleures pratiques de la logopédie.
Dans cette perspective de grandes opportunités culturelles et scientifiques, l’Italie vous attend!
À bientôt à Florence.
5
Baiba Trinite
Responsable du comité scientifique
Vice-présidente du CPLOL
Orthophoniste/logopède
Chers collègues,
Le congrès scientifique est une référence pour tout chercheur et orthophoniste/logopède
en général.
J’ai le privilège de présenter dans cet ouvrage plus de 300 résumés de 39 pays différents
du monde entier qui ont été soumis à notre congrès.
Durant ce processus, j’ai tenté de trouver une réponse à la question:
« Qui est l’orthophoniste/logopède européen en 2015 ? » Ma réponse est définitive,
convaincue et claire. L’orthophoniste/logopède européen d’aujourd’hui est
éclectique – il touche à une multitude de différents domaines de l’orthophonie/logopédie
Il est réfléchi – se penche en profondeur sur les troubles, cherchant à trouver des explications au sujet des causes, des
symptômes, des techniques thérapeutiques. Il est international – prouvant que la science n’a pas de frontières et que
des réseaux scientifiques peuvent être créés non seulement en Europe, mais par la communication transcontinentale. Et
finalement il est jeune – un grand nombre de jeunes chercheurs font leur premiers pas sur la vieille scène orthophonique/
logopédique européenne et se souviendront du Congrès à Florence comme leur plate-forme d’initiation.
Je souhaite que le 9ème Congrès scientifique du CPLOL soit un tremplin pour tous les jeunes et talentueux professionnels
désireux de se consacrer à l’orthophonie/logopédie, un lieu où ils peuvent trouver des idées pour des études futures et
pour les cliniciens et les chercheurs expérimentés, que le Congrès leur offre une plate-forme permettant à la théorie de
venir à la rencontre de la pratique pour faire jaillir de nouvelles idées. Ainsi, l’esprit orthophonique/logopédique sera une
inspiration pour tous.
Je voudrais remercier ici toutes les personnes impliquées dans les préparatifs du Congrès, membres du comité d’organisation, FLI, Uvetamx. Ensemble nous avons formé une équipe parfaite!
Nous avons ouvert les portes à la communication et la communication ouvrira les portes à la science, à l’expérience et à la
collaboration!
6
CONFÉRENCIERS INVITÉS
Dorothy Bishop
Royaume-Uni
Dorothy Bishop est Professeure de Neuropsychologie Développementale à l’Université
d’Oxford. Elle travaille grâce au financement du “Wellcome Trust” dans le cadre d’un
Projet interne de collaboration scientifique et dirige le programme de recherche des
troubles de la communication chez les enfants.
L’intérêt de Dorothy pour les troubles cognitifs a été éveillé pendant ses études en
psychologie expérimentale à l’Université d’Oxford au début des années 70 ; elle a
ensuite poursuivi sa formation en tant que psychologue clinicienne à l’Institut de
Psychiatrie à Londres.
Elle a eu la chance de recevoir un financement de recherche à long terme d’abord du Conseil de Recherche Médicale
puis du « Wellcome Trust », ce qui lui a permis d’avoir une approche étonnement large de l’étude des troubles du langage
des enfants. Dorothy est l’auteure de deux livres, en a édité quatre autres et a publié plus de 200 articles dans des revues
scientifiques. Elle a développé des outils d’évaluation du langage des enfants utilisés à grande échelle dont fait partie le
“Test for Reception of Grammar“ et le “Children’s Communication Checklist”.
Dorothy est collaboratrice scientifique de la “Royal Society”, de l’Académie des Sciences Médicales et de la “British Academy”. Elle a obtenu un Doctorat honorifique des Universités de Newcastle upon Tyne, de Western Australia et de Lund,
en Suède. Elle est collaboratrice scientifique surnuméraire du Collège St John’s à Oxford.
Conférence principale
Pourquoi certains enfants ont-ils tant de difficultés à apprendre le langage?
Les comptes rendus théoriques au sujet des troubles du langage chez les enfants ont souvent polarisé les positions entre
ceux qui les associent aux déficits des traitements auditifs et les autres aux déficits des faibles compétences grammaticales. J’aborderai les preuves apportées par une étude utilisant un entrainement sur ordinateur afin d’étudier l’apprentissage chez les enfants ayant des difficultés de langage inexpliquées. Nous avons comparé l’apprentissage de nouveau
vocabulaire avec l’apprentissage à répondre à de simples phrases réversibles contenant une préposition spatiale (p.ex.
« le canard est au-dessus de la balle »). Nos résultats ont montré que les problèmes de compréhension de ces enfants
ne s’expliquaient pas en termes de problèmes de traitements auditifs. Ces enfants n’avaient pas non plus de lacunes au
niveau de leurs connaissances grammaticales ; leurs problèmes dans l’épreuve des prépositions, reflétaient plutôt des
limites au niveau de la performance et non des compétences. Le profil général des résultats permettait de confirmer l’hypothèse qu’il existe un problème d’apprentissage procédural chez les enfants ayant un trouble spécifique du langage. Une
compréhension limitée des phrases apparait lorsque l’enfant doit garder en mémoire un certain matériel tout en traduisant
une séquence de mots en sens. L’apprentissage déclaratif – impliqué dans l’association de sons et de sens – est rarement
épargné. Nous discuterons les incidences de ces conclusions pour la thérapie.
7
Virginia Volterra
Italie
Virginia Volterra, auparavant Directrice de l’Institut de Science Cognitive et de Technologies
du CNR (1998-2001), auquel elle est associée actuellement. Elle a étudié le développement
précoce du langage auprès d’enfants ayant un développement typique et atypique et a
permis de fournir des explications concernant le rôle du geste. Elle a été une des pionnières
de la recherche sur le langage des signes en Italie. Auteure de plus de 200 publications
d’éditeurs nationaux et internationaux, elle a été nommée Collaboratrice Scientifique
honorifique de l’«University College London».
De l’action au langage: perspectives théoriques récentes et épreuves empiriques
Cette présentation est centrée sur les premières phases du développement et explore les émergences du langage d’action
chez l’enfant ainsi que son évolution vers le système adulte.
À la fin des années 70, quand ont commencé les études systématiques sur l’acquisition du langage, les découvertes
concernant le rôle de l’action et du geste dans l’acquisition et le développement du langage n’ont pas suscité d’intérêt
particulier parmi le grand public. Plus récemment, un nouveau cadre théorétique dérivant de différentes disciplines et perspectives (évolutionniste, neuro-psychologique, linguistique) a rendu l’approche de l’ontogénèse du langage très pertinente.
Des découvertes récentes sur le lien étroit entre actions, gestes et paroles chez les petits enfants sont en accord avec les
hypothèses avancées par ces nouvelles perspectives théorétiques.
8
Jean-Luc Nespoulous
France
Jean-Luc NESPOULOUS, Professeur Emérite Parcours universitaire résumé. A partir
d’une formation initiale « double » en (a) anglais et (b) en Linguistique Générale, Jean-Luc
Nespoulous s’est spécialisé, dès la fin des années 60, en Pathologie du Langage, et plus
particulièrement, dans l’approche linguistique et psycholinguistique des troubles du langage
consécutifs à des lésions cérébrales focales (= « aphasies »).
Après avoir été Maître-Assistant à l’Université de Toulouse-Le Mirail, il est, en 1980, parti
fonder, avec André-Roch Lecours (neurologue), le laboratoire de neuropsycholinguistique
« Théophile Alajouanine » à l’Université de Montréal où il est rapidement devenu Professeur
Titulaire.
De retour à Toulouse, en 1988, et après avoir dirigé l’équipe de neuropsychologie de l’Unité
INSERM 230 (CHU de Purpan, Toulouse), il a fondé, en juillet 1990, le Laboratoire
de Neuropsycholinguistique Jacques-Lordat (E.A 1941) au sein du Département des Sciences du Langage de l’Université
de Toulouse Le Mirail.
Il a fait partie du comité toulousain de lancement du Réseau Toulousain en Sciences Cognitives PRESCOT, en 1990, dans
le cadre du « Programme Interdisciplinaire de Recherche COGNISCIENCES » du CNRS.
En 2000, il a fondé l’ « Institut des Sciences du Cerveau de Toulouse » (IFR 96) dont il a été Directeur depuis sa création
jusqu’à janvier 2007.
Il a également fondé, en 2007, l’Unité de Recherche Interdisciplinaire OCTOGONE (E.A 4156), laquelle, pour la première
fois à Toulouse, a rendu possible le regroupement d’enseignants-chercheurs (n= 41) en Sciences du Langage et en Psychologie (Psychologie du développement, de la santé et psychopathologie).
Médaille d’Argent du CNRS (2005) au titre de l’interdisciplinarité et des Sciences Cognitives, il a terminé sa carrière universitaire en 2010, alors membre senior de l’Institut Universitaire de France (Chaire de Neuropsycholinguistique cognitive).
Communiquer en dépit de l’aphasie…
Et si les aphasiques communiquaient mieux qu’ils ne parlent!
Si la compétence linguistique requiert bien la maîtrise des unités phonologiques et lexicales de même que les règles
morphosyntaxiques caractéristiques de la structure d’une langue naturelle, la compétence communicative « in situ »
(Cherry, 1957, Hymes, 1966) nécessite, de son côté, la mobilisation de diverses stratégies adaptatives flexibles afin que
soit garantie, le transfert adéquat d’une information d’un locuteur à son interlocuteur.
Si de tels propos s’appliquent universellement à tout acte de parole (Austin, 1962 ; Searle, 1969…) entre sujets normaux, ils sont encore plus vrais quand on en vient à considérer la communication impliquant quelqu’un qui se trouve
atteint d’un trouble du langage (ici l’aphasie) et qui tente de le contourner autant que faire se peut.
Dans le contexte de notre présentation, nous nous concentrerons plutôt sur la seconde perspective et nous tenterons
ainsi de rendre compte des stratégies adaptatives (palliatives) développées tout à la fois par le patient lui-même et par
l’environnement humain dans lequel il évolue dans sa vie sémiotique quotidienne (Nespoulous, 1973, 2014). A ces stratégies intrinsèques, essentiellement spontanées, peuvent/doivent bien entendu être ajoutées les stratégies extrinsèques
induites par l’orthophoniste, lequel utilisera parfois les outils technologiques modernes de la « communication augmentée » (Nespoulous & Virbel, 2007).
La notion de « handicap partagé » sera développée et l’accent sera mis sur la nécessité, pour les orthophonistes, de
recourir à une approche neuropsycholinguistique fonctionnelle – pragmatiquement « située » -- de l’aphasie acquise.
Références bibliographiques:
Austin, J. How to do things with words, Oxford, Oxford University Press, 1962.
Cherry, C. On human communication, Cambridge (Mass.), The M.I.T Press, 1957.
Hymes, D.H. « Two types of linguistic relativity », in W. Bright (Ed.) Sociolinguistics, The Hague, Mouton, 114-158, 1966.
Nespoulous, J-L., Etude linguistique de divers phénomènes d’agrammatisme, Thèse pour le Doctorat de 3ème cycle,
Université de Toulouse-Le Mirail, 1973.
Nespoulous, J-L., « L’aphasie : du déficit à la mise en place de stratégies palliatives », in J-M. Mazaux., X. de Boissezon., P. Pradat-Diehl. & V. Brun (Eds.)., Communiquer malgré l’aphasie, Montpellier, Sauramps Médical, 11-19, 2014.
Nespoulous, J-L., « Intérêt de la recherche pour la clinique et vice versa. Clinique è Recherche èClinique è Recherche.
Symptômes è Modélisations è Symptômes è modélisations », Rééducation Orthophonique, N°257, 21-34, 2014
Nespoulous, J-L. & Virbel, J. « From the study of language dysfunction and handicap^to a better understanding of
linguistic processing in normality », in M. J. Ball & J.S. Damico (Eds.)., Clinical aphasiology. Future directions, Hove,
Psychology Press, 107-124, 2007.
Searle, J. Speech Acts, Cambridge, Cambridge University Press, 1969.
9
Jois Stansfield
Royaume-Un
JJois Stansfield est une orthophoniste/logopède engagée dans les domaines académiques
et cliniques en Angleterre, au Canada et en Écosse travaillant avec un large groupe de
patients présentant en majorité des troubles intellectuels et des troubles de la fluence.
Elle détient le poste de professeur en orthophonie/logopédie à l’Université Manchester
Metropolitan depuis 2003. Elle y donne des cours sur les troubles cliniques, l’éthique et
les troubles de la fluence et supervise les projets d’étudiants du premier cycle en
psychologie et pathologie du langage ainsi qu’en pathologie et thérapie du langage.
Elle contribue également au développement de la pratique basée sur les preuves ainsi
que des unités de niveau Master. Actuellement elle dirige le développement d’un degré Master “en ligne“ en recherche
dans le domaine de la santé et des soins sociaux.
Ses intérêts dans la recherche comprennent le domaine de l’éthique aussi bien en recherche que dans la clinique,
la communication dans le handicap intellectuel, le bégaiement, la formation des étudiants, les évaluations de services orthophoniques/logopédiques et l’histoire de la logopédie. Ses doctorants étudient l’autisme, la dysphagie, les
troubles auditifs, le handicap intellectuel, les troubles du langage chez des enfants âgés, les réponses psychologiques
à la maladie et les prises de décisions cliniques en logopédie. Elle a fait partie du groupe directeur dans le projet de
l’UE NetQues regroupant une multitude de partenaires qui a développé un répertoire des compétences spécifiques
des logopédistes/orthophonistes à travers l’Europe. Une autre recherche récente met l’accent sur l’identification des
compétences requises pour le gestion de la dysphagie pour les “nouveaux orthophonistes/logopédistes, l’expérience
de parents présentant des déficits intellectuels et l’aide qui peut leur être apportée dans leur communication avec des
figures d’autorité. Elle a finalement terminé un projet mandaté par l’association professionnelle britannique sur l’histoire
du corps professionnel (RCSLT).
Éducation, pratique effective et éthique dans la thérapie du langage et de la parole
Cet article décrit les approches de la thérapie du langage et de la parole au XXème siècle et s’inspire de la recherche
sur la formation des orthophonistes/logopèdes au Royaume Uni dans les années 90. Il met en lien ces aspects avec les
conclusions du projet européen NetQues, complété en 2014, afin d’identifier les domaines considérés dans la pratique
de la profession, comme étant essentiels pour que tout nouvel orthophoniste/logopède soit considéré comme “compétent”.
Les étudiants en orthophonie/logopédie détiennent dès le début des habilités cognitives linguistiques et interpersonnelles et une haute motivation personnelle à suivre le programme d’études. Pendant celles-ci et à travers les différentes
possibilités de formation, ils développent un ensemble de connaissances professionnelles spécifiques, de compétences
cliniques ainsi qu’une base de valeurs. Cela leur permet de réussir dans les domaines choisis et d’entrer dans la communauté thérapeutique orthophonique.
Beaucoup de modèles de compétence pratique en orthophonie/logopédie sont présentés et liés à des approches courantes de la formation initiale pour la pratique.
On estime que les caractéristiques et les valeurs personnelles renforcent la mise en œuvre des connaissances et des
compétences cliniques, que les valeurs peuvent être enseignées et qu’elles sont au cœur d’une pratique effective et
compétente.
Cependant, il y a un lien complexe et toujours changeant entre ces différents aspects de compétence directement
influencés par le contexte d’exercice professionnel du thérapeute.
Des études de cas sont utilisées comme exemples de décisions cliniques dans la pratique de l’orthophoniste/logopède.
On attend de tout orthophoniste/logopède, une pratique éthique et cet article va aborder également les bases du
raisonnement éthique dans la thérapie orthophonique/logopédique, les moyens de soutenir ce raisonnement et les
moyens d’action lorsque la pratique éthique ou les compétences professionnelles sont mises en cause.
L’article conclut en considérant les changements de coutumes sociales au cours du temps et combien la diversité
culturelle au sein de l’Europe peut défier les valeurs de l’orthophoniste/logopède. Il fait référence aux résultats du projet
NetQues et aux implications de la devise officielle de l’Union Européenne “Unis dans la diversité” pour l’éducation et
pour la pratique orthophonique/logopédique.
10
Katherine Verdolini Abbott
États-Unis d’Amérique
Katherine VERDOLINI ABBOTT, Docteure et détentrice d’une certification en compétences
d’ASHA (CCC-SLP), M.Div.
Dr. Verdolini Abbott est Professeure en Science et Troubles de la Communication à
l’Université de Pittsburgh, En Pennsylvanie (USA). Elle est également membre de la faculté
de l’Institut de Médecine Régénérative McGowann de l’Université de Pittsburgh et au Centre
pour la Base Neuronale de la Cognition à l’Université de Carnegie-Mellon et à l’Université
de Pittsburgh. Depuis 1997, elle est au bénéfice d’un fond pour ses recherches sur la voix
et les troubles de la voix de l’Institut National de la Santé (USA). Elle a porté son intérêt
principalement sur les effets de l’hydratation et de la déshydratation de la voix, sur les modèles biomécaniques des
productions vocales, sur les modèles d’apprentissage perceptuo-moteurs appliqués à la voix, sur les voies de connection entre l’esprit et le corps dans la voix, sur les interactions entre la respiration et la fonction laryngale et la physiologie
de l’exercice. Elle est collaboratrice scientifique de l’Association professionnelle américaine (American Speech-Language-Hearing Association-ASHA), de laquelle elle a reçu les Honneurs en 2009. Elle est l’ancienne éditrice du “Journal
of Speech, Language, and Hearing Research” et conférencière G. Paul Moore au Symposium de fondation pour la voix
2011 à Philadelphie. Elle a récemment terminé un “Master of Divinity” au séminaire théologique de Pittsburgh et est très
intéressée par la spiritualité et la santé.
Séances invitée
Modèles émergents de thérapies pédiatriques de la voix : adieu au repos vocal !
La voix des enfants peut être affectée par des troubles divers. Toutefois, les causes de loin les plus communes sont celles
attribuées à des modèles d’utilisation de la voix, comme les nodules. Ces troubles phono-traumatiques sont abordés le
plus souvent en premier lieu par une approche de traitement comportementale. Les modèles comportementaux traditionnels d’intervention mettent l’accent sur la conservation de la voix. La logique suivie est que s’il y a un problème causé par
l’utilisation de la voix, une réduction de l’utilisation devrait aider à éliminer le problème. En surface, cette logique parait
raisonnable. Toutefois, en y regardant de plus près, elle a des points faibles pour deux raisons principales. D’abord, nous
sommes des spécialistes de la communication. Il est donc paradoxal pour nous d’adresser les troubles de la communication en demandant de communiquer moins. Cela met nos patients dans une situation de handicap soit à cause de leur
trouble, soit à cause de leur traitement. D’autre part, de nouvelles données en biologie à propos des lésions laryngées
et de la guérison des plaies, suggèrent que certaines formes de mobilisation des tissus pourraient être réparatrices pour
les formes aigues et peut-être même pour les formes chroniques des lésions des cordes vocales. Cela concernerait par
exemple les modèles de voix sonore.
Cette présentation passera en revue les données biologiques et les appliquera aux nouveaux modèles de thérapies de
la voix enfantine. Elle accordera une attention particulière également aux facteurs théoriques de l’apprentissage perceptuo-moteur des enfants qui devraient influencer nos thérapies. Elle apportera des exemples de la manière dont on peut
intégrer les variables biomécaniques et d’apprentissage dans un nouveau modèle de thérapie pédiatrique de la voix.
Adventures in Voice.
11
Arlene A. Pietranton
Arlene A. Pietranton, Docteure, CAE est Présidente-Directrice générale de ASHA
l’association professionnelle scientifique et d’attestation professionnelle pour plus de
173’000 membres : des audiologistes, des orthophonistes/logopèdes, des chercheurs
dans le domaine du langage, de la parole et de l’audition ainsi que des étudiants et des
adhérents internationaux et du personnel de soutien. Le personnel d’ASHA, composé
de 260 personnes est basé à Rockville, MD, dans les locaux de l’association certifiée au
niveau national de Gold LEED.
Avant de travailler pour l’ASHA, Arlene travaillait au Centre Médical Universitaire Georges
Washington à Washington DC où elle a occupé divers postes en tant qu’orthophoniste/logopède et membre de l’administration médicale du centre. Elle est collaboratrice scientifique et ancienne présidente de l’association professionnelle
du district de Columbia.
Arlene est active au sein de la société américaine des dirigeants d’associations (American Society of Association Executives - ASAE) et a travaillé activement avec des responsables d’associations à travers l’Amérique du Nord, d’Europe,
d’Australie et d’Asie dans les domaines du management et de la direction. Elle est collaboratrice scientifique de l’ASAE
et ancienne présidente du comité directeur de l’ASAE.
Arlene a effectué un « Bachelor of Arts » en biologie puis un « Master of Arts in speech-language pathology », et un
doctorat en psychologie à l’université George Washington. Elle habite Washington, DC avec son mari et ses 2 filles
adultes. Dans ses loisirs, elle s’intéresse entre autre à l’histoire et à la culture internationale, à la lecture, au théâtre, aux
voyages, au ski et aux moments passés en famille et avec des amis.
Judith L. Page
Judith L. Page, Docteure et détentrice d’une certification en compétences d’ASHA
(CCC-SLP), Professeure de la Section des sciences et troubles de la communication à
l’université du Kentucky, a été la directrice du programme pendant 17 ans et cheffe du
département des sciences de la rééducation pendant 10 ans. Ses domaines cliniques,
de formation et de recherche concernent les méthodes de recherche, la communication
alternative et augmentative, l’offre au sein de l’école publique et les stratégies d’intervention
langagière pour les personnes ayant des besoins complexes de communication.
Judy est membre honorifique d’ASHA et actuellement Présidente de l’Association ASHA (American Speech-LanguageHearing Association). Dans ce rôle elle siège au sein du Comité Directeur, du comité de planification financière et au
conseil d’administration de la fondation américaine de la parole, du langage et de l’audition. Dans ses activités précédentes au sein de l’ASHA, on compte la présidence du conseil d’accréditation académique en audiologie et pathologie
du langage et du conseil de certification en audiologie et pathologie du langage, son engagement en tant que visiteur des
lieux d’accréditation et plusieurs autres comités au sein de l’ASHA. Judy est l’ancienne présidente de l’association parole,
langage, audition du Kentucky, ancienne présidente du comité des troubles de la parole, du langage et de l’audition et
ancienne secrétaire du conseil des présidents d’associations des États d’Amérique.
Judi possède trois degrés en pathologie de la parole et du langage: un Bachelor de l’Université de Minnesota, un Master
de l’Université d’Illinois et un Doctorat de l’Université de Perdue. Elle réside à Lexington, KY avec son partenaire et plusieurs enfants à quatre pattes. Ses intérêts personnels se trouvent dans la musique de chorale, la lecture, les voyages, le
théâtre, le design moderne du mid-century et les moments passés entre amis.
Séances invitée
Pathologie de la parole et du langage aux états unis et pour asha: son histoire et son futur
Arlene A. Pietranton, Judith L. Page
Les associations jouent un rôle essentiel dans le succès de chaque profession. À travers les standards professionnels
développés, les ressources et le matériel de sensibilisation du public distribués et le différentes formations permanentes
offertes, les associations contribuent vraiment à rendre le monde meilleur, plus sure et plus malin. Cette session présente un court historique de la profession d’orthophoniste/logopède aux États Unis ainsi que de l’association professionnelle et scientifique « ASHA » (American Speech-Langage-Hearing Association). Les priorités de l’organisation et
de la recherche actuelles de l’association ASHA ainsi que ses collaborations externes y seront présentées: Aussi seront
abordées les découvertes récentes qui caractérisent la haute performance des comités d’associations
12
PRÉSENTATIONS
ORALES
13
01.1
LA RÉPETITION DES ÉNONCÉS COMME OUTIL DE DÉPISTAGE DE
TSL: LE CAS DU GREC CYPRIOTE
Eleni Theodorou - Cyprus Acquisition Team, University of Cyprus, Nicosia, Cyprus
Maria Kambanaros - Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
Kleanthes Grohmann - Cyprus Acquisition Team, University of Cyprus, Nicosia, Cyprus
Objectif: Les chercheurs ont reconnu l’utilité de la tâche de répétition d’énoncés dans l’évaluation
de compétences langagières des enfants et, pour cela, des tests diagnostiques et de dépistage
l’ont incorporée comme un subtest. Les objectifs de cette étude sont:
1. évaluer la performance des enfants grecs cypriotes atteints de Trouble Spécifique du Langage
(TSL) dans une tâche de répétition d’énoncés ;
2. évaluer la précision diagnostique, en particulier les degrés de spécificité et sensibilité des
tâches;
3. déterminer si les performances des enfants pendant la tâche de répétition sont corrélées aux
performances dans les tests du langage utilisés par les orthophonistes/logopèdes de Chypre.
Méthodes: 38 enfants grecs cypriotes âgés de 5 à 9 ans ont participé à cette étude. Les enfants
ont été divisés en deux groupes: un groupe d’enfants avec TSL (n=16) et un groupe de contrôle
basé sur l’âge chronologique (n=22).
La tâche de répétition a exploré le rappel des énoncés comprenant sujet, objet, proposition
relative, proposition introduite par “que”, proposition causale, phrases négatives et propositions
subjonctives.
Résultats: L’analyse des données a montré que la tâche de répétition induit des différences
importantes dans les performances des enfants avec TSL et les enfants à développement typique (EDT). Les enfants avec TSL ont obtenu des résultats beaucoup moins bons que le groupe
contrôle.
L’analyse de la précision diagnostique a montré de bons niveaux de spécificité et de sensibilité
(80%). En plus, la tâche a été reconnue comme liée aux valeurs inclues dans la batterie des tests
diagnostiques (p.ex. test de diagnostic du QI verbal: morphosyntaxe, test d’aptitudes générales :
propositions subordonnées).
Conclusions: Aussi bien le degré de précision de la tâche que sa corrélation avec les évaluations
de différentes composantes du langage, ont indiqué que la tâche de répétition peut être utilisée
pour la précision diagnostique dans le contexte des TSL.
Mots-clés: TSL, répétition des énoncés, Grec cypriote, précision du dépistage
01.2
UN TEST SUÉDOIS POUR LE DÉPISTAGE DES TROUBLES
DU LANGAGE A 4 ANS
Ann Lavesson - Department of speech- and language pathology, Skåne University Hospital, Lund, Sweden
Martin Lövdén - Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Objectif: En Suède le test de dépistage des troubles du langage le plus complet est mené à l’âge
de 4 ans par des infirmiers. Les protocoles adoptés se focalisent surtout sur la phonologie et
échouent souvent à dépister les enfants atteints de graves troubles du langage. Le but de notre
étude est de mettre en place un test standardisé de dépistage des troubles du langage sur la
base des recherches et à partir des signes cliniques pour distinguer les enfants nécessitant une
14
intervention orthophonique.
Méthodes: Un test comportant différentes tâches a été mis en place. Des infirmiers de différents
centres pédiatriques ont utilisé le test pour le dépistage des troubles du langage sur 342 enfants
de 4 ans. Aucun tri particulier n’a été fait pour le groupe et 24% des enfants étaient multilingues,
ce qui est représentatif de la démographie suédoise. Un premier échantillon a été sélectionné en
vue d’une consultation auprès d’un orthophoniste/logopède.
Résultats: Il a été recommandé à 42 enfants de consulter un orthophoniste qui les a évalués dans
les domaine de la phonologie expressive, la grammaire et la compréhension lexicale. Dans 31
cas, la recommandation a été jugée appropriée. Sur la base des informations données, la sensibilité du test est de ,94 et la spécificité de ,96. Le multilinguisme n’avait pas de rapport avec le
score total et la corrélation avec le sexe était très faible. Pour identifier des éventuels faux négatifs, un questionnaire de suivi adressé aux parents des enfants de 5½-6 ans sera finalisé pour le
mois d’avril 2015.
Conclusions: Le test semble posséder des propriétés satisfaisantes pour dépister les enfants
devant être traité par un orthophoniste à 4 ans et il est adéquat autant pour les enfants monolingues que multilingues.
Mots-clés: Troubles du langage, dépistage des troubles du langage, sensibilité, spécificité
01.3
LA PRÉCISION DIAGNOSTIQUE DE DEUX TESTS
DE DÉVELOPPEMENT DU LANGAGE EN TURQUE
Orhan Selçuk Güven - Research, Education and Training Center for Speech and Language Therapy, Anadolu University,
Eskisehir, Turkey
Objective: L’objectif de cette étude est double: (a) définir score seuil sur la base des données
pour identifier les troubles du langage chez les enfants et (b) enquêter sur la précision diagnostique des deux tests (TEDiL et TODiL) à partir du score-seuil.
Méthodes: Le Turkish Early Language Development Test (TEDİL; Topbaş & Güven, 2011) est une
adaptation du Test of Early Language Development-3, et le Turkish School Age Language Development Test (TODİL; Topbaş & Güven, à paraitre) est une adaptation du Test of Language Development-Primary:4. Dans cette étude, pour le TEDİL (N=1431) et le TODİL (N=1231), une base de
données de 2662 enfants a été utilisée. L’échantillon est très représentatif et différents aspects
démographiques (comme le gendre, l’âge et l’ethnie) ont été pris en compte. Les résultats a permis de définir un score-seuil sur la base des données de -1.00 sd - ou quotient 85 - pour les deux
tests. Dans cette étude, en plus d’un degré minimum de sensibilité et de spécificité, des ratios
positifs et négatifs minimums de probabilité ont également servi de critères.
Résultats: Les résultats obtenus ont montré qu’aussi bien le TEDİL que le TODİL, ont des degrés
convenables d’identification des enfants monolingues avec ou sans troubles du langage primaires
ou secondaires. D’autre part, l’efficacité des deux tests a été jugée comme insuffisante pour
l’identification du développement typique (DT) des enfants bilingues.
Conclusions: Malgré leur grande exactitude pour identifier les enfants monolingues présentant
un développement typique ou atypique, ces tests doivent être utilisés attentivement dans le cas
d’enfants bilingues.
Mots-clés: Tests de développement du langage, troubles du langage, précision diagnostique,
sensibilité, spécificité
15
01.4
VALIDATION D’UN BILAN PHONOLOGIQUE ET DOCUMENTATION
DES PROCESSUS PHONOLOGIQUES CHEZ DES ENFANTS DE
LANGUE CINGALAISE AGÉS DE 2 A 6 ANS AU SRI LANKA
Shyamani Hettiarachchi
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya & Curtin University, Colombo, Sri Lanka
Objectif: 1) Développer et valider des tests pour une évaluation phonologique du cingalais chez
des enfants âgés de deux à six ans, 2) documenter l’acquisition des phonèmes typiques et les
processus phonologiques chez des enfants de langue cingalaise âgés de 2 à 6 ans.
Méthodes: L’ «Évaluation des troubles du langage et de la parole pour la langue cingalaise» a été
mise au point par les chercheurs en se basant principalement sur “L’évaluation diagnostique de
l’articulation et de la phonologie » (Dodd et al., 2002) et a été appliquée à 250 enfants de langue
cingalaise, âgés de 3 à 5 ans (50 enfants par catégorie d’âge de 3 ans à 3,5, de 3,6 à 3,11, de 4 à
4,5, de 4,6 à 4,11, de 5,0 à 5,5 et de 5,6 à 6,0). L’usage des éléments de tests a été déterminé par
des mesures de la validité du contenu, par la fiabilité test-retest et par le coefficient d’objectivité.
Les données phonologiques ont été transcrites phonétiquement et des analyses quantitatives
et qualitatives ont été effectuées afin de déterminer tant l’acquisition phonologique que phonémique. En prenant pour guide l’Évaluation phonologique du langage de l’enfant (PACS, Grunwell,
1985), des inventaires phonétiques et phonémiques individuels ont été extraits pour chaque
participant. Les sons des consonnes ont été analysés selon deux caractères phonétiques : place
et mode d’articulation. Le critère choisi pour la maîtrise du son (voyelles ou consonnes) a été
celui de la production de ce dernier au cours de l’évaluation soit spontanément, soit en imitation
dans au moins deux positions dans le mot (Dodd et al., 2002). Bien que la plupart des études en
anglais aient analysé les phonèmes en position initiale ou finale du mot (ex. Dodd et al., 2002;
Smit et al., 1990), dans le cas des données pour le cingalais, on a estimé admissible de considérer la maîtrise du son tant en début, qu’au milieu ou en fin de mot, étant donné que la présence
de consonnes en fin de mot est rare dans la langue cingalaise (Disanayaka, 1991). Les mesures
quantitatives comprennent le Pourcentage Correct de Consonnes (PCC), le Pourcentage Correct
de Voyelles (PCV) et le Pourcentage Correct de Phonèmes (PCP) ainsi que des analyses statistiques utilisant des test de Student (test t) et des analyses de la variance (ANOVA) unidirectionnelles. Des analyses qualitatives seront effectuées par le biais d’une comparaison des données
avec les normes utilisées actuellement dans la pratique clinique pour l’anglais2.
Résultats: Une influence significative de l’âge sur l’acquisition des phonèmes et sur les processus
phonologiques à été mise en évidence. Il y avait des caractères « universels » et « propres à la
langue » à la fois pour le taux et l’ordre d’acquisition des phonèmes, ainsi que pour les modèles
de processus phonologiques en cingalais en comparaison avec les normes de l’anglais. Des
modèles phonologiques comparables typiques de l’anglais comprenaient la palatalisation harmonique des consonnes, les pauses et la rééducation des groupes de sons, bien que les sons
vocaux substitués diffèrent entre les deux langues. Par contre, les processus phonologiques
propre à la langue comprenaient la latéralisation et la dénasalisation des pauses prénasalisées.
Conclusions: Les éléments du test ont été à même d’identifier des phonèmes et des processus
phonologiques cibles chez des participants âgés de 2,0 à 6,0 ans. Les résultats ont indiqués des
modèles d’acquisitions langagières universelles et propres à la langue, en mettant en lumière la
nécessité de normes et d’évaluations phonémiques propres à chaque langue. Ceci a des implications cliniques importantes pour les clients/enfants en Europe et dans le monde entier, notamment pour les enfants des communautés ethniques minoritaires.
Mots-clés: phonème, processus phonologique, normes, cingalais, anglais, évaluation
16
01.5
TEST DE RÉPÉTITION DES NON-MOTS BISYLLABIQUES ET
TRISYLLABIQUES : CORRÉLATION ENTRE PERCEPTION AUDITIVE,
COMPÉTENCES LINGUISTIQUES ET MOTRICES ET MÉMOIRE
PHONOLOGIQUE
Silvia Piazzalunga - Università degli Studi di Milano, Milano, Italy
Lisa Previtali - Università degli Studi di Milano, Milano, Italy
Antonio Schindler - Università degli Studi di Milano, Milano, Italy
Objectif: Le test de répétition des non-mots NonWord Repetition Test (NWR) indiqué fournit un
index relativement clair de la mémoire phonétique à court-terme, que ce soit chez les enfants à
Développement Typique (DT), ou chez les enfants atteints de Troubles Spécifiques du Langage
(TSL). L’importance des compétences motrices et de perception auditives ayant souvent été
négligée, notre recherche vise à quantifier le rôle plausible de ces compétences dans la répétition
des non-mots (NWR).
Méthodes: Un échantillon d’enfants de langue maternelle italienne de Développement Typique
(DT) (âgés de 26 à 28 mois) a été évalué à l’aide d’une batterie de tests standardisés (taches de
perception auditive, motricité orale, et mémoire phonologique) ainsi que par un nouveau test de
répétition de non-mots (NWR) qui a été spécifiquement validé pour les enfants italiens quant à la
complexité articulatoire,. La formation des parents a également été prise en compte en tant que
variable d’explication possible. Des comparaisons directes (utilisation du coefficient de Spearman) ont été faites pour établir le lien entre le test de répétition des non-mots (NWR) et d’autres
variables.
375 enfants ont participé à cette étude. L’analyse à montré une corrélation positive entre le test
de répétition des non-mots (NWR) et les taches de perception auditive, motricité orale et mémoire
phonologique (0,31<r<0,61, ρ=0,0001).
La formation des parents n’indiquait pas de corrélation linéaire significative.
Conclusions: Les résultats ont montrés que le test de répétition des non-mots (NWR) est une
tache complexe, liée non seulement à la mémoire phonologique, mais aussi aux compétences
de perception auditive, de motricité orale, tout en restant apparemment indépendant du degré de
formation des parents. Ces conclusions ont apporté d’importantes contributions théoriques aux
thèses sur le développement du langage et pourraient modifier les comportements lors des bilans
cliniques, en facilitant le dépistage des divers profils étiologiques.
01.6
ÉTUDE PILOTE SUR LA VALIDITÉ DE DEUX TESTS
DE VOCABULAIRE EN LANGUE GRECQUE
Vasiliki Zarokanellou - Department of Speech-therapy, TEI of Western Greece, Patra, Greece
Maria Vlassopoulos - Medical School of Athens, University of Athens, Athens, Greece
Objectif: Le test révisé “Echelle de vocabulaire en images Peabody“ (EVIP-R) et l’échelle de Vocabulaire Peabody III (EVP-III) sont deux tests anglais et américains connus et utilisés. Le but de
cette étude est d’examiner la validité des deux tests en langue Grecque.
Méthode: La forme A du EVP-III a été traduite et retraduite par deux orthophonistes bilingues,
alors que le EVIP-R a été traduit, retraduit et adapté à la langue grecque. Les participants à
l’étude étaient tous des enfants monolingues avec un DT (développement typique) et vivant à
Athènes.
17
26 enfants de 8,6 à 9,11 ans ont été soumis au test EVP-IIIA. D’abord le test EVIP-R a été administré à deux groups de 26 élèves de 7,0-8,5 à 8,6-9,11 ans, puis à un groupe de 25 enfants de
7,0 à 9,11 ans. Le dernier groupe a aussi été évalué par le TEST ATHINA, une échelle standard
pour la langue grecque, qui prévoit la définition de 20 mots en grecque. Tous les dépistages ont
été menés par un orthophoniste expérimenté.
Pour participer à l’étude, l’autorisation écrite des parents était nécessaire.
Résultats: Les valeurs moyennes et la variation standard de l’âge chronologique équivalant et
de l’âge lexical ont été calculées dans chaque groupe. Pour la comparaison entre l’âge chronologique et l’âge lexical, on a utilisé dans chaque groupe le « test-t pour données appariées »
(p=0,01). Les résultats montrent que le EVP-III ne peut pas être utilisé pour la langue grecque à
moins d’en faire une adaptation importante, alors que l’adaptation et traduction du test EVIP-R
semblent être un outil valable pour la langue grecque.
Conclusions: L’importance de la spécificité culturelle dans le développement du vocabulaire a été
réaffirmée dans cette étude pilote. D’importantes modifications sont nécessaires pour ces tests,
qui sont traduits, adaptés et utilisés d’une langue à l’autre.
Mots-clés: dépistage, développement lexical
02.1
LE VOCABULAIRE CHEZ LES ENFANTS BILINGUES SÉQUENTIELS
EN PREMIERE ANNÉE D’ÉCOLE PRIMAIRE
Objectif: Une recherche précédente a confirmé que les enfants bilingues séquentiels d’âge préscolaire doivent avoir au minimum 50% d’exposition à une des langues pour obtenir un score dans
les limites normales (SLN) comparé aux monolingues. Le début de la scolarité apporte d’importants changements dans l’entourage linguistique. Cette étude en cours examine la relation entre
l’exposition et la performance chez les enfants bilingues au cours de la deuxième année d’école
primaire.
Méthodes: 38 enfants de première année à l’école francophone de Montréal, Québec, ont participé à l’étude: 18 bilingues simultanés, 8 bilingues séquentielles et 12 francophones monolingues.
L’anglais était la deuxième langue pour la majorité des enfants. Les groupes ne différaient pas par
rapport à l’âge (moyenne 82,8 mois (SD 5,5) ou au niveau de l’éducation maternelle (18,2 ans (SD
2,06), mais ils différaient par rapport au pourcentage de temps passé dès la naissance avec des
sujets francophones (évalué par des questionnaires très détaillés aux parents (sim: 66,5% (SD 21),
seq: 21,2 % (SD 14), monol: 99,8% (SD 0,2). Selon les parents, tous les enfants ont eu un développement normal et présentent aussi un développement cognitif normal (score moyen de Leiter:
111,4 (SD 21). Les enfants ont été testés individuellement pour le vocabulaire français réceptif
(EVIP = échelle de vocabulaire en image) et expressif (CELF-4 = évaluation clinique des notions
langagières fondamentales).
Résultats: Dans l’ensemble, le pourcentage global d’exposition à la langue française était fortement corrélé avec la performance (EVIP: r=.610, p<0,000; CELF expr: r=.0,366, p=0,025). ANOVAs montrait des différences significatives des groups tant pour le vocabulaire réceptif (p=0,001)
qu’expressif (p=0,029) avec des tests post-hoc qui ont révélé des score plus bas dans les deux
groups bilingues que dans celui des monolingues, mais pas de différences très significatives entre
eux.
Conclusions: le dégrée d’exposition linguistique demeure un facteur qui influence de manière
significative les apprentissages chez les enfants bilingues en première année d’école primaire: les
bilingues séquentiels ne diffèrent pas des bilingues simultanés en dépit d’une exposition générale
nettement inferieure.
Mots-clés: multilinguisme, évaluation et prévention
18
02.2
TACHES DE RÉPÉTITION COMME MARQUEURS CLINIQUES
POTENTIELS D’UN TSL CHEZ LES ENFANTS MONOLINGUES
ET BILINGUES
Natalia Meir - Department of English Literature and Linguistics, Bar-Ilan University, Ramat-Gan, Israel
Sharon Armon-Lotem - Department of English Literature and Linguistics, Bar-Ilan University, Ramat-Gan, Israel
Objectifs: La mémoire de travail verbale (MtV) est connue pour être faible chez l’enfant présentant
un trouble spécifique du langage (TSL) (Montgomery, 2002). Cette étude analyse la mémoire de
travail verbale (MTV) chez des enfants bilingues avec et sans TSL, et évalue la validité prédictive
de la tâche de répétition pour diagnostiquer un TSL chez l’enfant bilingue.
Méthodes: Quatre groupes d’enfants âgés de 5,6 à 7,1 ans ont participé: 45 enfants bilingues
russe-hébreu (dont 15 avec TSL) et 32 monolingues hébreu (dont 12 avec TSL). Tous les sujets
réunissaient les critères d’exclusion pour le TSL (Leonard, 2000). Les quatre groupes sont appariés selon l’âge, les conditions socio-économiques et le QI non verbal; les enfants bilingues sont
appariés selon la durée d’exposition à la L2/l’hébreu. On retrouve dans l’anamnèse des enfants
présentant un TSL des indicateurs de TSL et des performances langagières inférieures à la norme
(pour les enfants bilingues dans les 2 langues).Trois tâches de répétition ont été utilisées en hébreu: (1) Empan à l’endroit (Emp-E); (2) Répétition de non-mots (RNM) et (3) répétition de phrases
(RP).
Résultats: Les effets du bilinguisme et d’un TSL ont été explorés à l’aide d’une analyse de variance (ANOVA). Un effet de TSL est manifeste pour les 3 tâches (p<.001), un effet du bilinguisme
dans les tâches requérant un traitement langagier important : RNM (p<.05) et RP (p<.05); aucune
interaction entre les deux variables. Les enfants monolingues et bilingues obtiennent des scores
comparables pour les 3 mesures. La précision prédictive est de 71% pour la RNM, de 73% pour
l’Emp_E, et de 87% pour la RP.
Conclusions: Les résultats soutiennent l’hypothèse que les enfants avec TSL présentent un
déficit en MTV comme les enfants bilingues avec TSL. Nos observations indiquent que le fait de
parler deux langues n’a pas d’effet aggravant pour les enfants bilingues avec TSL. Les 2 tâches
de répétition (RNM et RP) sont des marqueurs diagnostiques de valeur pour identifier un TSL chez
les enfants monolingues comme chez les bilingues.
Mots-clés: Multilinguisme, Troubles Spécifiques du Langage
02.3
LES PROFILS LINGUISTIQUES DE L’APPRENTISSAGE DE LA
PREMIÈRE ET DEUXIÈME LANGUE: DÉVELOPPEMENT TYPIQUE
ET ALTÉRÉ
Sini Smolander - Child Language Research Center, University of Oulu, Oulu, Finland
- Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
Marja Laasonen - Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
Eva Arkkila - Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
Sari Kunnari - Child Language Research Center, University of Oulu, Oulu, Finland
Objectif: L’étude présente fait partie de l‘étude longitudinale d’Helsinki sur les TSL (HelTSL), dans
laquelle 150 enfants bilingues séquentiels âgés de 3 à 6 ans, 250 enfants monolingues atteints de
troubles du langage (Bi-TL et Mono-TL), ainsi que 160 enfants ayant un développement normal du
19
langage/développement typique DT (Bi-DT et Mono-DT), ont été évalués de manière transversale
et longitudinale. Leurs profils linguistiques seront ici examinés pour mettre en lumière les caractéristiques langagières de la L2 des sujets issus de l’immigration qui reflètent le trouble du langage.
Méthodes: Les données actuelles sont un sous-échantillon transversal des données de l’étude
du HelTSL qui comprend 65 enfants Mono-TL et 65 Bi-TL. Ils seront comparés à un groupe de
80 enfants Mono-DT et Bi-DT. Les enfants bilingues participant à cette étude sont des enfants
qui parlent une langue chez eux (leur langue maternelle) et qui parlent le finlandais (comme L2) à
l’école maternelle, de préférence au moins pendant deux ans. Une large batterie d’évaluation sera
utilisée pour déterminer le profil de compétences des enfants dans la L2.
Résultats: Évaluation des conséquences de ces résultats sur les profils linguistiques et leur pertinence pour identifier les troubles du langage chez les sujets apprenants une L2. Sur la base des
résultats provisoires et de la littérature, nous émettons l’hypothèse que les enfants Bi-DT, surtout
ceux de très jeune âge, manifesteront des caractéristiques similaires à celles des enfants de L1
pour le développement du langage.
Conclusions: Pour développer l’identification de la L1, les données normatives concernant le
développement de la L2 sont nécessaires pour ouvrir la voie et éviter des erreurs de diagnostic.
Cette étude soulignera les outils d’évaluation les plus fiables, et évoquera le besoin des nouveaux. Etant donné que, d’après nous, les modèles développementaux ne divergeront que plus
tard, l’approche longitudinale d’un projet de plus grande envergure définira la différence entre le
développement typique et le développement altéré du langage.
Mots-clés: Multilinguisme, troubles développementaux linguistiques, troubles spécifiques du
langage
02.4
LES TROUBLES PRIMAIRES DU LANGAGE CHEZ LES ENFANTS
MULTILINGUES: IDENTIFIER LE MANQUE DE CONNAISSANCES
Wiebke Scharff Rethfeldt - LOGOCOM Institute, Bremen, Germany
Helen Grech - Department of Communication Therapy, University of Malta, Msida, Malta
Eva-Kristina Salameh - Logopedmottagningen Sprakens Hus, Skanes Universitetssjukhus, Malmö, Sweden
Mirjam Blumenthal - Kentalis Academie, Koninklijke Kentalis, Sint-Michielsgestel, Netherlands
Objectif: Présenter les défis que représentent la prise en charge d’enfants atteints de Trouble Primaire du Langage exposés à plus d’une langue pour les professionnels concernés en Europe.
L’équipe multidisciplinaire pour la prise en charge de ces enfants est composée tout d’abord
d’orthophonistes/logopèdes, mais aussi d’éducateurs spécialisés, de psychologues et des responsables pour les mineurs (tuteur/curateur). L’étude est axée sur les connaissances de pointe en
matière de terminologie et de diagnostic des TPL chez les enfants multilingues dans le contexte
européen.
Méthodes: Étant donnée la composition multiculturelle de l’UE, le projet MULTI-TSL financé par
l’UE a réuni orthophonistes/logopèdes, psychologues, éducateurs spécialisés autres membres
d’équipes pluridisciplinaires de sept pays de l’UE, face à des défis similaires, en particulier en ce
qui concerne la diversité linguistique en Europe. Le projet de l’UE (2013-2015) a été mis en place
pour faciliter les échanges entre professionnels et leurs institutions et informer les acteurs de la
recherche appliquée des principaux défis posés aux à toutes les personnes impliquées autour
des enfants cherchant à trouver des solutions et les meilleurs façons de faire pour combler les
lacunes entre la théorie et la pratique clinique.
Résultats: Des lacunes dans le domaine de la recherche et des défis auxquels ont été confrontés les praticiens ont pu être identifiés, reliées en particulier à la diversité linguistique existant en
Europe. L’étude présente les différences et similarités dans l’usage de la terminologie du diagnostic ainsi que les critères utilisés dans les écoles et institutions fréquentés par ces enfants et où ils
20
suivent un traitement orthophonique.
Nous allons démontrer que le terme TSL est largement utilisé, bien qu’il soit interprété de façons
différentes dans les pays d’Europe.
Conclusions: En conclusion, les critères « exclusifs et/ou inclusifs », tout comme le terme « spécifique » dans la description des Troubles Spécifiques du Langage (TSL) chez les enfants multilingues, doivent être revu car ils pourraient ne pas être applicables chez les enfants monolingues.
Ceci est important pour les experts devant définir des lignes directrices pour des interventions
appropriées au niveau clinique et culturel auprès d’enfants multilingues.
Mots-clés: Troubles spécifiques du langage, multilinguisme, Europe
02.5
ENFANTS ISSUS DE LA COMMUNAUTÉ ROM ET SCOLARITÉ DE
NIVEAU PRIMAIRE: IMPLICATIONS POUR LES SERVICES PUBLICS
D’ORTHOPHONIE
Christina Haupt - University of Applied Sciences, Hochschule Osnabrueck, Osnabrueck, Germany
Judy Clegg - The University of Sheffield, Sheffield, United Kingdom
Joy Stackhouse - The University of Sheffield, Sheffield, United Kingdom
Objectifs: Au Royaume Uni, les enfants issus de la communauté rom (RP) ont des difficultés à
accéder à l’école et leurs performances scolaires sont en-dessous des attentes nationales. La
nature des obstacles limitant ces aspects est peu connue. Nous rapportons ici les résultats d’une
étude récente qui concerne les défis pour ces enfants (RP) dans le système scolaire primaire de
Grande Bretagne, la relation entre leurs compétences linguistiques en anglais (EL), leurs performances scolaires et les implications pour les services d’orthophonie.
Méthodes: L’étude a été faite en deux phases: (1) 17 enseignants primaires (TS) dans 3 écoles en
milieu urbain ont rempli un questionnaire. 11 ont ensuite participé à des entretiens semi-structurés concernant leurs expériences en tant qu’enseignants avec les élèves roms (RP). (2) 18 enfants
issus de Slovaquie (5-11 ans) ont été interviewés, leur niveau linguistique en anglais évalué et
leurs notes scolaires examinées.
Résultats: Les enseignants (TS) identifient les défis selon quatre catégories limitant l’accès pour
les élèves roms aux apprentissages: des aspects de communication, socio-culturels, organisationnels, ainsi que des barrières institutionnelles. Les écoliers roms (RP) expriment un intérêt élevé
pour les apprentissages et l’anglais. Leur niveau d’anglais et leurs performances scolaires varient
mais ils se situeraient dans l’ensemble en dessous du niveau attendu pour leur âge. Pour les
élèves plus âgés, ce fossé est d’autant plus important.
Conclusions: Les résultats montrent le besoin d’impliquer les orthophonistes avec la population
croissante d’enfants roms (RP), non seulement pour identifier les besoins de ces enfants dans le
domaine du langage et de la parole, mais par le soutien et la formation que les orthophonistes
peuvent dispenser aux enseignants afin que ceux-ci soient à même de différencier entre un
trouble du langage et une « différence ». De plus, il est souhaitable d’impliquer les orthophonistes
du service public (SLS) dans la conceptualisation et la mise en oeuvre de programmes spécifiques au sein des classes, dans l’objectif de soutenir les élèves roms et leurs familles.
Mots-clés: élèves roms, scolarité primaire, compétences linguistiques, performances scolaires
21
02.6
LE QUESTIONNAIRE POUR PARENTS BILINGUES
BILINGUAL PARENTS’ QUESTIONNAIRE (BIPAQ) DANS
UN CONTEXT CLINIQUE: DIAGNOSTIQUE ET TRAITEMENT
Hadar Oz - Bar Ilan University, Ramat Gan, Israel
Sharon Armon-Lotem - Bar Ilan University, Ramat Gan, Israel
Objectifs: Les orthophonistes /logopèdes rencontrent beaucoup de difficultés diagnostiques chez
les enfants bilingues séquentiels qui présentent un retard pour leur deuxième langue (L2). Ces
difficultés entrainent un sur- ou sous-diagnostic de trouble du langage. Un questionnaire pour les
parents bilingues (BIPAQ) [1] a été utilisé avec des enfants ayant été signalés en clinique afin de
différencier les bilingues séquentiels avec ou sans troubles spécifique du langage et de fournir un
traitement efficace adapté à leurs besoins.
Méthodes: 120 enfants bilingues séquentiels (entre 3 et 7 ans) ont participé: 60 enfants ayant déjà
consulté pour des difficultés langagières et 60 enfants n’ayant jamais consulté un orthophoniste/
logopède. Un questionnaire pour les parents bilingue (BIPAQ) a été distribué aux parents et des
évaluations post-thérapeutiques ont été recueillies par les orthophonistes/logopèdes. Seuls 20
enfants ayants un passé clinique ont été diagnostiqués après la thérapie pour des troubles du
langage. En utilisant une analyse ROC (fonction d’efficacité du récepteur), un score seuil a été
identifié parmi les enfants ayants un passé clinique (EPC). En utilisant ce score seuil, 8 enfants sur
les 60 sans passé clinique (non-EPC) présentaient des troubles du langage (TL): 6 des ces enfants
ont présenté des scores très bas dans les deux langues.
Résultats: Une étude de suivi post-thérapeutique a exposé les enfants avec un passé clinque
sans trouble du langage à la L2 (hébreux) de manière soutenue dans des petits groups. 12
séances ont montré une amélioration significative dans le vocabulaire, la compréhension des
récits et des situations, l’empathie des émotions et des désirs des personnages de récits ainsi
que dans la longueur et complexité des phrases, les amenant à un niveau normal de la L2.
Conclusions: Pour conclure, plus de 50% des enfants n’ayant pas eu de suivi thérapeutique
préalable n’ont pas été diagnostiqués comme ayant des troubles du langage selon le questionnaire BIPAQ bien qu’ils présentaient des difficultés en L2. Un traitement de group basé sur une
approche développementale naturelle a pu les aider à combler leurs lacunes.
Mots-clés: Bilan des enfants bilingues, questionnaire pour les parents, thérapie orthophonique de
groupe
03.1
ÉCHELLES D’INTELLIGIBILITÉ EN CONTEXTE: UN OUTIL DE
DÉPISTAGE CHEZ LES ENFANTS MULTILINGUES EN 60 LANGUES
Sharynne McLeod - Research Institute for Professional Practice, Learning and Education, Charles Sturt University, Bathurst, Australia
Objectif: L’échelle d’intelligibilité en Contexte (The Intelligibility in Context Scale = ICS) est un outil
de dépistage gratuit pour les parents, traduit en plus de 60 langues. L’échelle de 7 paramètres a
été introduite par le ICF-CY (WHO, 2007)
Méthodes: L’échelle ICS a été appliquée à 804 enfants australiens et validée par 120 enfants
anglophones en Australie et 74 enfants de langue chinoise cantonaise à Hong Kong.
Résultats: D’importantes différences ont été mises en évidence par rapport au sexe, à l’âge et
inquiétudes concernant les troubles du langage. Aucune différence importante n’a été identifiée
par rapport au nombre de langues parlées. L’échelle ICS possède une très grande cohérence, une
22
bonne fiabilité de test re-test, et de validité des critères.
Conclusions: Une validation supplémentaire, la mise en place de normes et des études cliniques
ont été menées en Croatie, aux îles Fidji, en Islande, Jamaïque, Allemagne, Slovénie, Afrique du
Sud, Suède et d’autres études sont en cours. L’échelle ICS est un outil de dépistage prometteur
pour l’intelligibilité fonctionnelle.
Mots-clés: intelligibilité, langue, évaluation, multilinguisme, enfants
03.2
LA CONTRIBUTION DU QUESTIONNAIRE DES POURCENTAGES DE
CONSONNES CORRECTES (PCC) ET DE L’INTELLIGIBILITÉ À LA
SÉVÉRITÉ DES TROUBLES DU DÉVELOPPEMENT DU LANGAGE
(TDL)
Anniek J.C. van Doornik-van der Zee - Opleiding voor Logopedie, Utrecht University of Applied Sciences, Utrecht, Netherlands
Hayo H.R. Terband - Utrecht Institute of Linguistics-OTS, Utrecht University, Utrecht, Netherlands
Objectif: La sévérité des troubles développementaux du langage résulte d’une combinaison entre
les caractéristiques segmentales du langage et l’intelligibilité. A la lumière du cadre conceptuel
CIF, cette étude a comparé différentes mesures d’intelligibilité sur le plan du handicap et de la
participation à une évaluation générale d’intelligibilité accomplie par des auditeurs non connus
des enfants. La mesure générale d’intelligibilité a été utilisée comme référence de sévérité des
TDL.
Méthodes: 37 enfants (d’âge de 48 à 103 mois, 20 garçons et 17 filles) avec troubles développementaux du langage et du son (TDL, n=13) et à développement typique (DT, n=24) ont participé
à l’étude. Les données du langage ont été recueillies sur des tâches langagières diverses et sur
le discours spontané. Le Pourcentage de Phonème Corrects (PPC) a été calculé. L’intelligibilité
comme mesure de participation a été évaluée par les parents en utilisant la version hollandaise
de la Intelligibility in Context Scale (ICS-NL; McLeod, Harrison, & McCormack, 2012). Les évaluations sur l’intelligibilité effectuées sur un panel de 22 auditeurs ont été inclues comme mesures de
résultats dans une étude corrélée.
Résultats: Une analyse régressive multiple de tous les enfants (DT et TDL) a indiqué que pour
61% (n = 35, R2 = .606, p < 0,0001) la variabilité dans l’intelligibilité générale pourrait être expliquée par une combinaison entre PCCN (PCC scores sur les tâches non verbales) et ICS-NL. Le
pourcentage de la variance totale s’élevait à 69% (n = 22, R2 = 0,69, p < 0,0001) dans le groupe
DT, et à 76% (n = 11, R2 = 0,762, p < 0,004) dans le groupe TDL.
Conclusions: Cette étude est une première étape prometteuse vers une mesure de sévérité des
troubles du langage et du son qui peut être utilisée dans la pratique quotidienne. Par conséquent,
PCCN + ICS-NL sont proposées comme une mesure exprimant la sévérité des TDLS développementaux.
Mots-clés: troubles développementaux du langage et du son, PCC, intelligibilité, mesures de la
sévérité
23
03.3
ÉVALUATION PERCEPTIVE DE LA PAROLE D’ENFANTS PORTEURS
DE FENTES LABIALES ET/OU PALATINES (FLP)
Kadi Ird - Tartu University, Tartu, Estonia
Tiina Suvi - Tartu University, Tartu, Estonia
Triin Jagomägi - Tartu University Hospital, Tartu, Estonia
Lagle Lehes - Tartu University Hospital, Tartu, Estonia
Marika Padrik - Tartu University, Tartu, Estonia
Objectif: Les enfants présentant des anomalies cranio-faciales sont à plus haut risque de développer des troubles de la parole. Afin d’améliorer la qualité de l’analyse de leur parole, il est urgent
de créer un protocole standardisé spécifique à la langue estonienne. L’objectif de cette étude préliminaire est de développer une méthodologie pour l’analyse perceptive de la parole des patients
porteurs de FLP.
Méthode: Les premiers outils de recherche et de documentation pour les enfants estoniens
porteurs de FLP ont été développés en 2013 suivant les protocoles d’évaluation « Scandcleft»
et « Americleft ». Le matériel linguistique prend en compte les spécificités phonétiques de la
langue estonienne en tant que langue finno-ougrienne. De plus, nous avons demandé aux parents
d’enfants FLP de compléter un questionnaire sur le développement de leur enfant, la disponibilité
et l’efficacité du traitement et l’impact de la FLP sur leur vie de famille. Nous avons étudié treize
enfants, âgés de 6 à 12 ans divisés en deux groupes d’âge.
Résultats: Nous avons décrit le type d’erreurs de parole et de résonnance chez les enfants FLP
estoniens. L’analyse du langage conversationnel et de phrases spécifiques sont nécessaires pour
l’analyse précise des troubles de la parole liés à la FLP. Nous avons constaté que le contraste
dans les paires minimales et les mots isolés révèlent une plus grande sensibilité pour les troubles
de la parole liés à la FLP. Nous avons développé une première version d’un protocole FLP estonien.
Conclusion: Notre échantillon était réduit et une étude sur un groupe de patients plus étendu est
nécessaire afin d’améliorer et d’ajuster le protocole. A partir de janvier 2015, nous aurons la possibilité de comparer et de valider la fiabilité des résultats obtenus avec le protocole perceptif par
rapport aux études instrumentales.
Mots-clés: enfants avec FLP, analyse perceptive de la parole, protocole standardisé
03.4
INTERVENTION PRÉCOCE CHEZ DES NOURRISSONS AVEC FENTE
LABIO PALATINE (FLP) PAR LE BIAIS DE L’ “APPROCHE CENTRÉE
SUR LES PARENTS”
Inge Zink - UZ Leuven, MUCLA
Nadjmi Nasser - Antwerp University, University Hospital Antwerp, Craniofacial Association, Antwerp
Maurice Mommaerts - University Hospital Brussels,Vrije Universiteit Brussel
Objectif: Près d’un enfant sur 700 nait avec une fente labiale et/ou palatine (FLP). La malformation
est souvent découverte pendant la grossesse, ce qui signifie que les parents sont mieux préparés
lorsqu’ils voient le visage inhabituel de leur bébé à sa naissance. Ils ont toutefois besoin d’un soutien émotionnel et d’une information correcte sur le traitement, qui se concentre de préférence sur
une croissance optimale de la partie médiale de la face et un développement normal du langage
24
et de la parole. La fente labiopalatine représente un risque avéré de troubles de la communication.
Une fois qu’un retard est apparu, toutes les phases successives vont être retardées. Par conséquent, une approche préventive au traitement est proposée. Le but de notre étude est d’améliorer
l’intervention orthophonique pour ce groupe cible.
Méthodes: Nous avons mis au point un programme personnalisé de l’”Approche Centrée sur les
Parents” (ACP) pour la prévention et le dépistage précoce des problèmes de communication chez
des enfants porteur de fentes labiopalatines. Dans cette approche les parents apprennent à offrir
une « stimulation renforcée » par des interactions au cours de leurs activités quotidiennes avec
leurs enfants.
L’ACP est basée sur les principes du Centre Hanen de Toronto, s’inspirant à leur tour des principes de Ward, Girolametto, Montfort, Golding-Kushner, Jansonius, Tan et Njiokiktjien. Elle se
fonde sur 3 piliers du comportement communicatif : 1. L’nteraction parent-enfant, 2. La précocité des habiletés sociales et communicatives, 3. Les habiletés de langage réceptif et expressif.
L’impact de l’ACP a été examiné au moyen d’un plan randomisé de contrôle et d’intervention
chez des enfants de 6 à 30 mois. Nous avons suivi les enfants jusqu’à ce que tous les problèmes
du langage et de la parole ait été résolu, afin d’en savoir davantage sur les résultats à long terme.
Résultats: Aucun des enfants n’a présenté d’articulation compensatoire grave et aucun d’eux n’a
eu besoin d’une pharyngoplastie. La stimulation d’un comportement d’attention et d’écoute intensifs semble être déterminante.
Conclusions: L’ACP s’est révélée être une intervention précieuse afin de prévenir ou limiter les
problèmes communs de langage et de parole dans ce groupe cible.
Mots-clés: prévention, trouble phonologique, trouble du développement langagier, fente, intervention précoce, Approche centrée sur les parents
03.5
CARACTÉRISTIQUES LANGAGIÈRES ET NEURORADIOLOGIQUES
D’ENFANTS ITALIENS ATTEINTS D’APRAXIE DE LA PAROLE
IDIOPATHIQUE
Anna Chilosi - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Simona Fiori - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Irene Lorenzini - Scuola Normale Superiore, Laboratorio di Linguistica, Pisa, Italy
Barbara Cerri - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Renata Salvadorini - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Lorena Cittadoni - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Lucia Pfanner - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Paola Cipriani - IRCCS Stella Maris, Dipartimento di Neuroscienze Dell’eta Evolutiva, Pisa, Italy
Objectifs: Le but de cette étude est d’enqueter sur les caractéristiques cliniques et neuroradiologiques de 32 enfants italiens atteints de apraxie de la parole idiopathique pour recueillir des
informations sur les marqueurs comportamentaux et neuro-anatomiques possibles des troubles.
Méthodes: Chaque participant a été soumis a un bilan complet : neurologique, oro-moteur et de
la parole et du langage. Le protocole comprenait l’évaluation du développement de la motricité
globale et fine, des capacités orales et motrices, de la précision et de la cohérence du langage,
de la diadococinésie ainsi que de l’organisation lexicale et grammaticale. Les données de l’IRM
ont été recueillies grace à un scanner IRM 1.5 T. (GE, Signa Horizon 1.5, Milwaukee, WI, USA).
Résultats: Les profils langagiers sont caractérisés par un répertoire phonétique très limité, un
pourcentage élevé de productions imprécises et inchoérentes et d’une diadococinésie déficitaire dans la performance des taches de répétition Ces symptomes sont associés chez 83% des
patients à des signes d’apraxie orale non verbale. La majorité des enfants présente un retard
sévère du langage ainsi que des difficultés lexicales et grammaticales persistantes.
L’IRM structurale et spectroscopique ne révèle aucune anomalie cérébrale majeure. Ces résultats
suggèrent que l’apraxie de la parole chez l’enfant est un dysfonctionnement à plusieurs niveaux
qui atteint les aptitudes de programmation du langage et les compétences oro-motrices. Son
étiologie est probablement due à des anomalies neuro-anatomiques fines, qui ne sont pas dépistées par les méthodes standards de l’IRM clinique séquentielle.
Mots-clés: Apraxie de la parole chez l’enfant, imagerie par résonance magnétique
25
04.1
EST-CE QUE LE FAIT D’AUGMENTER LA CONSCIENCE DU PATIENT
A PROPOS DE SA VOIX CHANGE SA PERCEPTION DU PROBLÈME?
Rehab Awad - Lewisham and Greenwich NHS Trust, University Hospital Lewisham, London, United Kingdom
Objectif: Cette étude porte sur la question d’examiner si le fait d’augmenter la conscience du
patient relatif à l’utilisation de sa voix et à son hygiène vocale, change sa perception du trouble de
la voix and influencerait ainsi le dernier score au questionnaire VHI (Voice Handicap Index.)
Méthodes: 212 patients ayant complété un traitement orthophonique pour un trouble dysphonique ont rempli un questionnaire VHI, selon de ce qu’ils pensaient ressentir avant le début du
traitement.
Ces scores sont appelés VHI-estimés (VHI-est) et ont été comparés aux scores VHI obtenus avant
le début du traitement- VHI initiaux (VHI-int).
Résultats: En comparant les scores VHI-est et les scores VHI-int respectifs (pour l’ensemble des
patients traités N=212), ils se sont avérés statistiquement différents. Un modèle de régression
linéaire a été établi avec une corrélation de coefficient (R=0,94 à 99% de confiance). Ce modèle
prouve une relation entre les variables et peut servir pour calculer une variable à partir de la valeur
de l’autre variable
Conclusions: Il existe une différence significative chez les patients souffrant d’une dysphonie
entre leur perception initiale et finale du trouble, due à une conscience accrue, aux conseils fournis et à la thérapie vocale. Ceci est démontré dans la différence entre les scores VHI initiaux et
estimés.
Mots-clés: Troubles, de la voix, questionnaire d’auto-évaluation, VHI, évaluation pré- post- traitement d’une dysphonie
04.2
CONSENSUS ENTRE LES SYMPTOMES D’AUTO-PERCEPTION DE
LA VOIX ET L’ANALYSE OBJECTIVE DE LA VOIX PARMI LES FUTURS
ENSEIGNANTS
Giovanna Tamborrino - Università degli Studi di Torino, Dipartimento di Scienze Chirurgiche, Torino, Italy
Lady Catherine Cantor Cutiva - Erasmus Medical Center, Erasmus Medical Center, Rotterdam, Netherlands
Anna Accornero - Università degli Studi di Torino, Dipartimento di Scienze Chirurgiche, Torino, Italy
Objectif: Établir un consensus sur les symptômes d’auto-perception de la voix et l’analyse objective de la voix; déterminer les facteurs associés aux plaintes de la voix auto-rapportées parmi les
futurs enseignants.
Méthode: Nous avons mené une étude transversale parmi 106 futurs enseignants sur deux sites
d’une université publique de Turin, Italie. Les participants ont rempli un questionnaire sur les
plaintes de la voix et leurs facteurs associés. Puis les futurs enseignants ont enregistré un échantillon vocal qui a été analysé par le biais du logiciel PRAAT (application d’analyse phonétique).
Nous avons déterminé un consensus entre les plaintes de la voix auto-reportées et quatre paramètres objectifs de la voix (fréquence de base, jitter (stabilité en fréquence du signal acoustique),
shimmer (stabilité de l’intensité du signal acoustique) et temps maximum de phonation) en utilisant la courbe ROC (fonction d’efficacité du récepteur – Receiver Operatin Characteristics). Une
analyse de type régression logistique multiple a été utilisée pour identifier les variables associées
aux plaintes de la voix auto-reportées.
Résultats: Les quatre paramètres objectifs de la voix ont montré une légère distinction entre les
26
futurs enseignants présentant ou non un enrouement. Le temps maximum de phonation a montré
une certaine distinction entre ceux ayant une plainte au niveau de leur voix et ceux sans plainte.
Parler à haute voix était un facteur important associé à l’enrouement parmi les futurs enseignants.
Conclusions: les plaintes de la voix auto-rapportées et l’analyse objective de la voix ont montré
des différences importantes et peuvent fournir des informations complémentaires sur la qualité et
la fonction de la voix parmi les futurs enseignants.
Mots-clés: Troubles de la voix
04.3
L’IAQV À REPRÉSENTATIVITÉ ÉLARGIE: VALIDITÉ EXTERNE
ET PRÉCISION DIAGNOSTIQUE AVEC 1058 ÉCHANTILLONS DE VOIX
Ben Barsties - Deutsche Stimmklinik, Hamburg, Germany
Youri Maryn - Department of Otorhinolaryngology and Head & Neck Surgery, Sint Augustinus, Antwerp, Belgium
Objectif: L’Index Acoustique de Qualité de la Voix (IAQV) est un modèle acoustique composé de
six facteurs et basé sur l’analyse régressive linéaire. Elle mesure objectivement la qualité générale
de la voix dans un discours continu et dans des segments de phonation soutenus. Il a été déterminé que le nouveau modèle de l’IAVQ est plus représentatif et écologiquement mieux adapté, car
un équilibre interne de l’index se retrouve en proportions égales dans les deux activités de discours. Cette étude vise à explorer sa validation externe et sa précision diagnostique sur une base
de données très large.
Méthodes: Une équipe composée de 12 orthophonistes expérimentés (possédant une expérience de 5 à 40 ans dans l’évaluation perceptive des troubles de la voix) ont évalué la qualité
générale de la voix des 1058 échantillons vocaux recueillis (34 syllabes de discours continu et
3 secondes avec maintien de la voyelle a [a:]) variant de la normo-phonie à la dysphonie aiguë
d’étiologies diverses, organiques et non organiques.
Le coefficient de l’ordre de corrélation Spearman (rs) et le coefficient de détermination (r2s) ont
été utilisés pour mesurer la validité concomitante. La précision diagnostique du test IAVQ a été
évaluée par le récepteur en tenant compte de plusieurs estimations selon ses différentes caractéristiques de performance (ROC= Receiver Operating Characteristic).
Résultats: Enfin, 8 experts sur 12 ont été choisis à cause de leur fiabilité acceptable (kappa >
0.41). La valeur « G » des 8 examinateurs (moyenne-G) a alors été prise comme facteur de réception du niveau de sévérité de dysphonie pour chaque échantillon de voix. Une forte corrélation
entre le résultat du test AVQI et la moyenne-G a été identifiée (rs = 0.815, p= 0.000). Il indiquait
que le 66,4 % de la variation de moyenne-G était expliqués par le AVQI (i.e. r2s = 0.664). En plus,
les résultats COR ROC ont encore une fois montré de meilleurs résultats diagnostics à un seuil
limite de AVQI=2.43 (i.e. sensibilité= 0.785, spécificité= 0.932).
Conclusions: Cette étude souligne la validation externe et la précision diagnostique de la version
étendue du test AVQI comme une échelle de mesure valable et écologique pour exprimer la qualité générale de la voix.
Mots-clés: Qualité de la voix, évaluation de la voix, échelle de qualité de la voix
27
04.4
CORRÉLATIONS PSYCHOPATHOLOGIQUES DE LA DYSPHONIE
DYSFONCTIONNELLE: NOUVEAU DIAGNOSTIC ET PERSPECTIVES
DE RÉÉDUCATION
Carlo Robotti - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Giulia Bertino - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Chiara Chialva - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Silvia Migliazzi - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Vera Abbiati - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Valentina Ciappolino - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Roberto Pagani - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Rosa Panigati - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Natascia Brondino - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Edgardo Caverzasi - Department of Brain and Behavioural Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Marco Benazzo - IRCCS Policlinico San Matteo Foundation, Department of Otolaryngology, University of Pavia, Pavia, Italy
Objectif: Plusieurs mécanismes psychopathologiques et traits de personnalités, dont l’implication
est suspectée dans l’étiologie des dysphonies dysfonctionnelles (DD) ont été étudiés. A ce jour,
cependant, leur rôle dans les mécanismes de la dysphonie reste à comprendre. C’est pourquoi
le but de cette étude est d’évaluer l’influence de ces facteurs sur les dysphonies hypokinétiques
et hyperkinétiques, par rapport à un groupe contrôle, et d’étudier l’implication que cela peut avoir
dans le diagnostic et la rééducation.
Méthode(s): Nous avons recruté cent six patients souffrant de DD (84 hyperkinétiques et 22 hypokinétiques) suivis dans notre centre entre juin 2011 et décembre 2012 et cinquante-trois patients
contrôle. Tous les sujets ont subi un examen ORL et un bilan orthophonique, suivis par une vidéolaryngo-stroboscopie et un examen acoustique et aérodynamique de la phonation. De plus, les
patients et les sujets sains ont remplis un questionnaire d’auto-évaluation développé pour dépister les traits de personnalité psychopathologiques.
Résultat(s): Un nombre plus important de symptômes dépressifs ont été retrouvés chez les
patients DD hypokinétiques que chez les patients DD hyperkinétiques et les patients sains, il n’y a
cependant pas de différences significatives concernant les traits anxieux. Le score de recherche
de nouveauté (RN) corrélé au taux dopaminergiques est plus élevé chez les patients DD hyperfonctionnels et pourrait être un potentiel indicateur objectif et subjectif de sévérité de la DD.
Conclusion: Nos résultats confirment l’importance des facteurs psychologiques dans le développement des DD et soulignent le besoin d’en tenir compte dans l’approche des patients dysphoniques dysfonctionnels.
Mots-clés: Troubles de la voix, dysphonies
28
04.5
ÉVALUER LA DYSPHONIE CHEZ LES ENFANTS:
EXISTE-T-IL DES DIFFÉRENCES ENTRE PÈRES ET MÈRES?
Ofer Amir - Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel
Michael Wolf - Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
Liron Mick - Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel
Omer Levi - Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel
Adi Primov-Fever - Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
Contexte: l’auto-évaluation subjective est un facteur essentiel du bilan pluridimensionnel de la
voix. Des outils divers sont disponibles pour quantifier l’auto-évaluation de la voix chez l’adulte.
Pourtant, l’utilisation d’outils standardisés pour évaluer les troubles de la voix chez l’enfant est
nécessaire.
Objectif: Cette étude vise en premier lieu à valider la version hébraïque de l’Index des Troubles de
la Voix Pédiatriques Pediatric Voice Handicap Index (pVHI).
Ensuite, notre étude examine pour la première fois, les différences entre l’évaluation de la dysphonie des enfants par leurs pères ou leurs mères.
Méthodes: Le pVHI a été traduit et adapté à la langue hébraïque. La version traduite a été soumise à un groupe de 141 parents (58 parents d’enfants dysphoniques, 83 parents d’enfants
non-dysphoniques). La validité et la fiabilité du questionnaire, tout comme les différences entre
les groupes ont été testées. Consécutivement, un sous-échantillon de participants a été examiné
pour évaluer les différences de réponse des mères (n=46) et pères (n=46) d’un même enfant.
Résultats: Les analyses statistiques ont dévoilé une fiabilité très haute du questionnaire en langue
hébraïque (alpha de Cronbach = 0,97). De manière générale, les parents d’enfants dysphoniques
ont évalué leur enfant avec un résultat considérablement plus élevé (plus grave) que les parents
des enfants non-dysphoniques (p<0.001). Les mères des enfants dysphoniques évaluaient leurs
enfants avec un résultat plus élevé que les pères dans toutes les sous-échelles (0.001p<0.047).
En revanche, aucune différence significative n’a été relevée entre mères et pères d’enfants nondysphoniques (p>0.05).
Conclusions: La version hébraïque du questionnaire pVHI est un outil fiable pour quantifier la
perception des parents face aux handicaps de la voix de leur enfant. De plus, cette étude prouve
que les mères d’enfants dysphoniques évaluent le handicap vocal de leur enfant plus sévèrement
que les pères ; alors que les deux parents d’enfants non-dysphoniques expriment leur évaluation
de façon similaire.
Mots-clés: Voix, dysphonie, enfants, auto-évaluation, pVHI, parents
04.6
LA VOIX CHEZ LES OPÉRATEURS DES CENTRES D’APPEL
Sónia Lima - Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
Célia Soares - Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
Objectif: Cette recherche se propose de contribuer au diagnostic des facteurs affectant la qualité
de la voix et le degré de handicap vocal (IHV) chez les opérateurs des centres d’appel (OCA) de
25 organisations portugaises.
Méthodes: Il s’agit d’une étude préliminaire menée sur un échantillon de 100 OCA avant une action de formation vocale préventive. Nous avons utilisé un questionnaire de caractéristiques démographiques pour l’identification des facteurs de risque et du VH19 pour l’Index de Handicap Vocal.
29
Résultats: Près de 52% des OCA présentaient un handicap vocal et on a trouvé une relation plus
forte entre la dimension physique et la dimension d’autoperception liée à des facteurs de risque
tels que le genre (les femmes=0,063t), l’âge plus avancé (0,05U), davantage d’heures de travail
(0,047U), le tabac, l’alcool et le café (0,000t).
Conclusions: Des indicateurs répondant aux besoins de formation dans le domaine de la santé et
de la technique vocale, tels que les conditions biologiques et les styles de vie professionnels.ont
été identifiés. La pertinence de ces actions contribue à la certification des professionnels de la voix.
Mots-clés: Index de Handicap Vocal, VHI9, Operateurs de Centres de Contact, facteurs de risque
de la voix
05.1
RECHERCHE DE CONSENSUS SUR LES SIGNES D’APPEL ET LA
TERMINOLOGIE DANS LE DÉVELOPPEMENT ATYPIQUE
DU LANGAGE ET DE LA PAROLE
Margot I. Visser-Bochane - Research and Innovation Group in Health Care and Nursing / Research and Innovation Group
Child, Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
Ellen Gerrits - Research Group Speech and Language Therapy, HU University of Applied Sciences, Utrecht, Netherlands
Sijmen A. Reijneveld - Department of Health Sciences, University Hospital Groningen, Groningen, Netherlands
Cees P. van der Schans - Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences,
Margreet R. Luinge - Research Group Speech and Language Therapy, HU University of Applied Sciences, Utrecht, Netherlands
Objectif: Le développement atypique du langage et de la parole est l’un des troubles développementaux les plus courants chez le jeune enfant. Cependant, un consensus n’a pas été atteint
sur les signes cliniques et sur la terminologie du diagnostique. L’objectif de notre étude est d’atteindre un consensus sur les signes cliniques qui définissent un trouble du langage et de la parole
chez l’enfant de un à six ans, et sur la terminologie relative aux troubles persistants du langage et
de la parole.
Méthodes: Nous avons conduit une étude en trois étapes suivant la méthode Delphi aux PaysBas avec un panel national (n=24) d’orthophonistes/logopèdes et de linguistes. Les membres du
panel ont répondu à des questionnaires interactifs englobant les signes cliniques et la terminologie. Le consensus a été défini à >70% des experts s’accordant sur un point. Entre les phases
deux et trois, nous avons effectué une enquête extensive sur la terminologie avec des experts
(n=247) recrutés via les réseaux sociaux.
Résultats: La première phase a permis d’établir une liste de 161 signes cliniques et 16 termes
(préfixes, adjectifs et noms) en vue d’étiqueter les troubles persistants du langage et de la parole.
Dans la seconde phase, nous avons atteint un consensus sur 34 signaux d’alarme et sur l’adjectif
« développemental » (70%), l’adjectif « langagier » (100%) et le nom « trouble » (74%). L’enquête
plus large a révélé une préférence pour l’adjectif « primaire » (65%) comparé à « spécifique ». La
troisième phase a finalement révélé un consensus sur l’adjectif « primaire ».
Conclusion: L’étude par la méthode “Delphi” a résulté en un consensus sur signaux d’alarme sur
l’ensemble du champ linguistique et un consensus sur la formule « trouble primaire du développement langagier » en référence aux troubles persistants du langage et de la parole.
Mots-clés: Troubles du développement langagier, dépistage, prévention
30
05.2
CORRÉLATION ENTRE LES TROUBLES SPÉCIFIQUES DU LANGAGE
ET DES APPRENTISSAGES: UNE REVUE MÉTHODIQUE
DE LA LITTERATURE
Sara Rinaldi - A.U.L.S.S. 15 ‘Alta Padovana’, Padova, Italy
Anna Giulia De Cagno - A.S.L. Roma D, Roma, Italy
Objectif: Le but de cette étude est de comprendre les corrélations existant entre les compétences
des enfants à un âge préscolaire atteint de troubles spécifiques (TSL) et les capacités des enfants
à un âge préscolaire atteints de troubles spécifiques des apprentissages (TSA).
Méthodes: Nous avons effectué une revue méthodique de la littérature en consultant PubMed,
PsychInfo et la bibliothèque Cochrane. Basé sur les demandes cliniques, nous avons défini quatre
volets de recherche, établi les critères d’admissibilité pour les études et fourni une grille d’examen
pour l’analyse des données des études incluses.
Résultats: Aucune des études n’a répondu à tous les critères d’admissibilité. Cependant neuf
études intéressantes ont été identifiées et analysées : elles ont non seulement confirmé l’association entre les troubles mais ont également aidé à valider l’hypothèse du rôle central du traitement
phonologique dans la relation entre TSL et TSA, indiquant, en outre, que le traitement phonologique n’avait pas un rôle exclusif et que d’autres compétences linguistiques comme la sémantique, la syntaxe et les compétences narratives peuvent également influencer la corrélation entre
le TSL et TSA.
Conclusions: La recherche scientifique actuelle ne nous permet pas de définir les facteurs pronostiques du développement de la TSA chez les enfants avec TSL ni l’importance du TSL comme
facteur de risque pour les enfants atteints de TSA. Il est important de tenir compte du profil du
fonctionnement spécifique des troubles et de leurs sous-types et de mener des recherches visant
à définir l’importance de la compétence impliquée dans la corrélation entre le TSL et TSA.
Mots-clés: trouble spécifique du langage, trouble spécifique des apprentissages, corrélations,
facteurs de risque, pronostic
05.3
LES LÉSIONS PÉRINATALES DE LA SUBSTANCE BLANCHE
CÉRÉBRALE QUI INFLUENCENT LA COMMUNICATION PRÉCOCE
ET LE DEVELOPPEMENT DU LANGAGE
Objectif: Les lésions de la substance blanche cérébrale, les ischémies péri-ventriculaires (IP) et
les lésions hémorragiques (LH) sont les lésions cérébrales périnatales les plus fréquentes. De
manière générale, les phénomènes du développement plastique cérébral périnatal ne devraient
pas influencer de manière trop forte le développement en lui-même. Le but de cette étude est
d’explorer l’effet des lésions péri-ventriculaires de la substance blanche sur la communication
précoce et le développement du langage.
Méthodes: 30 enfants de 2 à 3 ans ayant souffert de lésions périnatales cérébrales et un groupe
de contrôle de 30 enfants en bonne santé, regroupés par âge et par sexe ont participé à l’étude.
Des aspects différents de la communication précoce et du développement du langage ont étés
évalués: l’acquisition des différentes fonctions et façons de communiquer et le développement
gestuel et verbal. L’évaluation de la communication précoce incluait l’évaluation de la
31
compréhension linguistique et d’autres aspects du langage expressif et des compétences linguistiques (articulation, expression verbale, ampleur et composition du vocabulaire expressif)
Résultats: Malgré un développement général normal, 50% des sujets ayant souffert de lésions
cérébrales présentaient un retard de communication et/ou linguistique et 30% des sujets montraient des formes de troubles d’articulation. Cependant, dans le groupe contrôle, aucun troubles
de la communication ou du langage n’ont été dépistés et 17% des sujets présentaient uniquement des troubles d’articulation.
Conclusions: Les sujets atteints de lésions cérébrales périnatales de la substance blanche sont
fortement sujets à développer des troubles de la communication et du langage. Si elles ne sont
pas diagnostiquées et traitées précocement, les conséquences à long terme des lésions cérébrales périnatales sur la communication et sur le langage peuvent avoir une influence négative sur
le développement général de l’enfant.
Mots-clés: Troubles de développement du langage
05.4
APPRENTISSAGE DU VOCABULAIRE ET DE LA GRAMMAIRE EN
TURC AU MOYEN DU CDI-TR: LA COMPARAISON ENTRE LES
ENFANTS A DÉVELOPPEMENT TYPIQUE (DT) ET LES ENFANTS
AVEC UN RETARD DE LANGAGE (RL)
Ilknur Mavis - Department of Speech and Language Therapy, Faculty of Health Sciences, Anadolu University, Eskisehir, Turkey
Selen Ölmez - Metin Uğur Sarıkaya Özel Eğitim ve Rehabilitasyon Merkezi, Mersin, Turkey
Le MB-CDI (The Mac Arthur-Bates Communicative Development Inventory) est une échelle visant
à évaluer le développement du langage des enfants entre 8 et 30 mois grâce aux rapports des
personnes s’occupant d’eux (Fenson et al., 2000). C’est un outil qui a été récemment standardisé
en Turquie sous deux formes TIGE-1 & TIGE-2 (Acarlar et al., 2012). Dans ce cadre, notre objectif
a été d’évaluer 60 enfants à développement typique (DT) entre 24 et 36 mois et 35 enfants avec
retard de langage (RL), entre 30 et 48 mois, concernant l’apprentissage du vocabulaire et de la
grammaire, selon les rapports TIGE des parents. Le langage réceptif et expressif des enfants a
d’abord été évalué par un test standardisé en Turc: TEDİL (Topbaş and Güven, 2012). Les résultats ont montré que les enfants DT ont utilisé 63,5% de la production totale des mots, alors que
le groupe RL a utilisé 15,4%, les enfants TD ont utilisé 65% de la production totale des verbes,
alors que le groupe RL a utilisé 13%. Les enfants TD ont produit 59% de la production totale des
noms, alors que le groupe RL a utilisé 17,2%. Les résultats de la LME = 5,24, en général, prévoient 35-36 mois, qui est l’âge équivalent pour les enfants à DT, mais la LME= 2,99 prévoit seulement 25-26 mois pour le groupe RL, bien qu’ils aient approximativement 48 mois. Les énoncés
des enfants avec RL semblaient être simples, puisque la plupart des structures ont commencé à
émerger entre 42 et 48 mois. Il est reconnu que le retard du langage peut être un indicateur de
divers problèmes neuro-développementaux, il faudrait donc en tenir compte très sérieusement et
d’autre dépistages diagnostiques sont recommandés (Buschmann et al., 2009). Les enfants qui
ont un retard de langage à l’école maternelle ont tendance à développer des compétences langagières plus faibles à leur entrée à l’école. Les rapports des parents ne sont représentatifs de la
conduite réelle du langage de l’enfant, que s’ils sont des observateurs sensibles et précis.
32
05.5
DÉVELOPPEMENT D’OUTILS DE DÉPISTAGE DES TROUBLES DU
LANGAGE CHEZ LES ENFANTS MONOLINGUES ET PLURILINGUE
Seyhun Topbas - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Ayse Aydin - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Deniz Kazanoglu - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Dilber Kacar-Kutukcu - Department of Speech and Language Therapy, Anadolu University, Eskisehir, Turkey
Contexte: Les profils linguistiques des enfants turques bilingues ou monolingues souffrant de
troubles du langage ont été peu étudiés et ce pour plusieurs raisons: le manque de tests standardisés, les erreurs de diagnostics, le manque de personnel et de connaissance des troubles spécifiques du langage. C’est à la lumière cette constatation qu’un projet national a été conduit afin
d’examiner des échantillons de langage spontanés d’enfant TSL et des données issues de tests
psychométriques quantitativement et qualitativement. En parallèle, plusieurs autres missions ont
été élaborées dans le cadre du projet COST IS 0804. Le but de cette présentation est d’exposer
le travail de développement de deux tests, le LITMUS- test de répétition de phrases turques et le
Test turque révisé de répétition de non-mots et les résultats obtenus.
Méthode(s): Quarante-trois enfants ont participé à cette étude (15 turques monolingues, 15
turques présentant des troubles du langage et 13 turques bilingues). La première langue du
groupe bilingue était le turque et leur langue seconde était l’allemand. Tous les enfants bilingues
ont été exposés à l’allemand à 3 ans. Des analyses statistiques comparatives et corrélative entre
des tests standardisés et adaptés au turque (TELD-3 et TOLDP-4) et les tests nouvellement
développés (LITMUS – test de répétition de phrases - et le Test turque révisé de répétition de non
mots) seront présentées. Leur sensibilité, spécificité et prédictibilité ont été calculées.
Résultats: En définitive, chacun des deux tests (LITMUS – test de répétition de phrases- et le
Test turque révisé de répétition de non mots) ont distingué le groupe d’enfants présentant des
troubles du langage par rapport au deux groupes contrôle monolingues et bilingues. Les scores
de sensibilité (89%) et de spécificité (86,5%) obtenus par les tests sont très élevés et le score de
prédictibilité est de 90% pour les enfants présentant des troubles du langage.
Conclusions: Bien que les résultats obtenus soient ceux d’un sous-groupe réduit, ils suggèrent
que les deux tests sont des outils valables et fiables pour évaluer les capacités de répétition des
enfants turcophones. Ils peuvent être utilisés cliniquement afin de compléter d’autres tests standardisés.
Mots clés: troubles du langage, TSL, Turc, dépistage
Ce projet turque a été permis grâce à TÜBITAK, no109K001 2009-2013 en collaboration avec le
projet COST IS0804: troubles du langage dans une société multilingue: les modèles linguistiques
et la route vers le dépistage.
33
05.6
PEUT-ON PRÉVOIR LE NIVEAU DES COMPETENCES EN LECTURE
ET EN ORTHOGRAPHE À PARTIR DE LA CONSCIENCE
PHONOLOGIQUE ACQUISE À LA MATERNELLE?
Sabien Van Dycke - Arteveldehogeschool Department Audiology and Speech Therapy, University Ghent, Ghent, Belgium
Objectif: Dans cette étude, nous voulons examiner la relation entre la conscience phonologique
en maternelle et l’orthographe et la lecture en 4°année.
Contexte et méthodologie: Plusieurs études démontrent l’importance des compétences phonologiques dans le processus précoce de lecture et d’écriture, même si la prédiction pour des
compétences plus avancées est moins claire. En conséquence, 176 enfants de maternelle ont été
testés avec des sous-tests de conscience phonologique du CELF-4NL. (Kort & al., 2008), du DAS(
De Backer & al, 1991) et du PFB (Elen, 2006). Tous les enfants ont suvi un enseignement ordinaire et étaient âgés entre 4,10 ans et 5,11 ans. Nous les avons suivis jusqu’ à la 4° année pour le
langage, la lecture, l’écriture et les compétences mathématiques en utilisant des tests standards
(LVS, EMT, AVI, VST).
Résultats: Pour l’orthographe, nos données ont révélés qu’une corrélation importante a été trouvée entre la conscience phonologique et le LVS(r=.35, p<001), aussi bien qu’entre la conscience
phonologique(CELF-4-NL) et l’orthographe de certains mots existants(VST) (r=.18, p<.05) en 4°année. Pour la lecture, il y avait une corrélation importante entre la conscience phonologique(CELF4-NL) et la lecture de certains mots existants (EMT; r= .214, p<.05) et entre la conscience phonologique et la compétence de la lecture de textes(AVI; r=.197, p<.05).
Conclusion: Comme dans certaines études précédentes (Elbro & Scarborough, 2003), nous avons
confirmé l’importance de la conscience phonologique pour la précision dans la lecture et nous
avons ajouté une prédiction pour les compétences de lecture en 3° année. Les implications pour
l’évaluation et les interventions seront discutées.
Mots-clés: Conscience phonologique, orthographe, lecture
06.1
LIEN ENTRE TROUBLES PHONOLOGIQUES ET PROCESSUS
PHONOLOGIQUES
Monika Posilovic - The SUVAG Polyclinic, Zagreb, Croatia
Objectif: L’un des objectifs de notre étude est de détecter quelles sont les erreurs phonologiques
les plus fréquentes chez les enfants présentant des troubles phonologiques en langue croate
et de voir s’il y a une constance dans ces erreurs. Un autre objectif est aussi de comparer ces
résultats avec les études menées dans des pays anglophones. Deux hypothèses ont été posées:
la première est que la substitution et la réduction des groupes consonantiques sont les erreurs
les plus communes, la seconde postule qu’il y a une cohérence dans les erreurs phonologiques
commises par les enfants porteurs de troubles phonologiques en langue croate.
Méthode(s): L’étude inclut quatorze enfants ayant des troubles du langage oral : huit garçons et
six filles d’âges chronologiques allant de 5 ans 5 mois à 6 ans 11 mois. Les enfants inclus dans
l’étude présentent tous des troubles phonologiques inclus dans leur trouble du langage oral mais
ne présentent pas de troubles sensoriels ou organiques pouvant influencer l’articulation ainsi que
des capacités cognitives normales. Les enfants ont passé trois tests différents : le Test d’articulation (Vuletic, 1990), Répétition de mots et Pseudo-mots (Vuletic, 1990) et un court échantillon de
langage spontané. L’examinateur a interrogé les enfants sur leur journée durant 5 minutes pour
34
que le sujet de la conversation soit compatible.
Résultat(s): Les données obtenues grâce aux tests ont été traitées séparément et analysées
statistiquement. Les résultats obtenus montrent que dans la plupart des cas, la substitution et la
réduction des groupes consonantique sont utilisés alors que la fusion et l’assimilation ne le sont
pas. Ces résultats permettent de valider la première hypothèse formulée sur le type d’erreurs
commises par les enfants présentant des troubles phonologiques. De même, les résultats ont
permis d’observer une cohérence dans les troubles phonologiques en langue croate. L’apparition
systématique des mêmes erreurs phonologiques et leur combinaison dans les mots et pseudomots dans les tests présentés aux enfants ont pu être observés. De ce fait, la seconde hypothèse
sur la systématisation des erreurs phonologiques chez les enfants présentant des troubles phonologiques est également confirmée.
Conclusion: Les résultats montrent que l’erreur phonologique la plus courante chez les enfants
présentant des troubles phonologiques en langue croate est la substitution et qu’il y a régularité dans la survenue de ces erreurs. La comparaison des résultats obtenus dans cette étude et
ceux des études menées dans les pays anglophones montre des différences entre les traitements
phonologiques de ces enfants. Dans les pays anglophones, l’erreur phonologique la plus courante est la réduction des groupes consonantiques alors qu’elle est la seconde plus fréquente en
langue croate. Du fait de la taille réduite de l’échantillon, les résultats obtenus dans cette étude ne
peuvent pas être généralisés. Un échantillon plus grand et plus représentatif sera nécessaire afin
d’avoir une analyse plus précise et claire sur les processus phonologiques en langue croate.
Mots-clés: troubles phonologiques, erreurs phonologique, substitution, réduction des groupes
consonantiques
06.2
LA MORPHOLOGIE EST-ELLE UN DES SIGNES CLINIQUES DES
TROUBLES SPÉCIFIQUES DU LANGAGE (TSL) CHEZ LES
ISLANDAIS?
Contexte: La précision morphologique est un signe clinique de Troubles Spécifiques du Langage
(TSL) chez les enfants anglophones, particulièrement autour de 5 ans. Dans les langues plus
flexionnelles, les enfants ayants un TSL obtiennent de moins bons résultats en morphologie comparé aux enfants de même âge ayants un Développement Typique (DT); cependant, la précision
générale est souvent très haute, tandis que la précision diagnostique reste incertaine. Cette étude
examine la précision diagnostique de l’exactitude morphologique chez les enfants de 4 à 14 ans
qui parlent Islandais, une langue très flexionnelle.
Méthodes: L’étude comprenait 29 enfants ayants un TSL (de 48 à 173 mois) et 27 enfants ayant
un DT (de 48 à 169 mois). Les corpus de conversations ont été analysés au point de vue de
l’exactitude dans l’utilisation par les sujets, du temps des verbes, des modes et cas, des genres
et nombres des noms, des adjectifs et des pronoms. Des erreurs ont pu être relevées sur le choix
erroné des mots, l’ordre des mots et leurs omissions.
Résultats: La comparaison des groupes TSL et DT a montré au moyen de diagrammes de dispersion et d’estimations de courbes, que la longueur moyenne des énoncés (LME) augmentait de
façon linéaire par rapport à l’âge dans les deux groupes. Dans les deux groupes, l’exactitude morphologique, en particulier dans l’indication des personnes, augmentait en fonction du LME et de
l’âge et était en général très haute (85 - 100%). Les enfants ayants un TSL obtenaient en général
de moins bons résultats, mais les écarts diminuaient en fonction de l’âge dans les deux groups
qui obtenaient un résultat final de 98 à 100%. En divisant les enfants en trois groupes selon les
âges (4-5 ans, 9-10 ans, 12-14 ans), les tests diagnostiques ont montré des différences significatives entre les TSL et les TD pour différentes mesures et selon l’âge. Pour certaines mesures un
35
critère de basse performance peut être proposé qui suggère la présence d’un TSL; cependant,
les scores élevés n’excluent pas un TSL;
Conclusions: la mesure de l’exactitude morphologique chez les sujets Islandais est une procédure très longue qui n’est pas particulièrement utile dans la diagnostique des TSL.
06.3
LES FONCTIONS EXÉCUTIVES ET LE RENFORCEMENT DES
FONCTIONS NARRATIVES CHEZ LES ENFANTS D’ÂGE
PRÉSCOLAIRE
Anna Pierro - Faculty of Medicine and Dentistry, University “La Sapienza” of Rome,(RM), Seat of Ariccia (RM), Italy
Simonetta Saltarelli - Neuropsychiatry Service, ASL Roma H, Velletri (RM), Italy
Elisabetta Voltan - Private practice, Genzano di Roma (RM), Italy
Contexte: Les fonctions exécutives, la compréhension de textes et les compétences narratives
sont des processus cognitifs simultanés dans l’élaboration du récit et les fonctions exécutives
sont au cœur de ce processus, particulièrement à l’oral. Le renforcement des fonctions exécutives
améliore également d’autres processus cognitifs comme les compétences linguistiques (lexical,
syntaxique et sémantique), l’aptitude scolaire et les capacités inférentielles.
Méthodes: La narration a été choisie comme instrument de renforcement des fonctions exécutives par la création d’un entrainement narratif spécifique pour les enfants d’âge préscolaire au
cours de quinze séances de groupe. Le choix s’est porté sur des histoires simples, illustrées par
des dessins clairs : les histoires de Julio Lapin. A partir de ces histoires, des cartes de renforcement ont été présentées et utilisées dans la narration et les exercices spécifiques des fonctions
exécutives. Le travail s’est divisé en différentes phases: -une phase pilote avec 18 enfants ayant
déjà bénéficiés d’une rééducation orthophonique pour des troubles développementaux de différents types. -une phase, actuellement toujours en cours, avec 20 enfants suivis dans le service de
neuropsychiatrie. -une phase, prévue en janvier 2015, avec 20 enfants de classe maternelle.
Résultats: Les résultats de la phase pilote sont très positifs pour les textes et la compréhension
morphosyntaxique et lexicale. Alors que 18% des enfants présentaient un signal d’alerte (SA) et
20% le besoin d’une intervention immédiate (II), l’entrainement narratif a permis de faire réduire
les taux de SA à 3% et de II à 5%.
Conclusion: L’entrainement narratif est un outil efficace, facile à mettre en œuvre et peu coûteux,
donc présentant un fort intérêt dans la rééducation du langage.
Mots-clés: Troubles spécifiques du langage, troubles développementaux, prévention
06.4
COMPRÉHENSION ORALE DES PHRASES TRANSITIVES EN
HONGROIS PAR LES ENFANTS AVEC ET SANS TROUBLES DU
LANGAGE
Bence Kas - Research Institute for Linguistics, Hungarian Academy of Sciences, Budapest, Hungary
Ágnes Lukács - Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
Katalin Szentkuti-Kiss - Research Institute for Linguistics, Hungarian Academy of Sciences, Budapest, Hungary
Contexte: Les difficultés d’acquisition de la grammaire sont connues chez l’enfant souffrant de
troubles du langage ; ces difficultés sont largement influencées par la langue. Nos principaux
36
objectifs sont de (I) trouver les symptômes morphosyntaxiques des troubles du langage en hongrois, (II) identifier les différences qualitatives par rapport au développement typique du langage,
(III) de trouver les liens entre les troubles morphosyntaxiques et d’autres facteurs et (IV) évaluer
les théories des troubles du langage. Méthodes: L’épreuve consiste en une tâche de désignation
d’image sur consigne orale. Vingt-neuf enfants entre 5 ans 1 mois et 12 ans 5 mois porteurs de
troubles du langage y ont participés ainsi que 29 enfants contrôle entre 3 ans 3 mois et 9 ans
10 mois appariés individuellement selon leur score en vocabulaire passif. Résultats: Les résultats montrent que l’ordre des mots influence fortement la compréhension des phrases transitives
simples dans les deux groupes et les phrases de type SVC (sujet-verbe-complément) et SCV
(Sujet-complément-verbe) étant les 2 plus utilisées par tous les enfants. Les enfants souffrant de
troubles du langage avaient des difficultés plus importantes en compréhension des phrases transitives simples. Si leurs performances sont généralement similaires à celles du groupe contrôle,
les phrases où le COD précède le sujet leur posent particulièrement problème. Conclusion: Les
troubles de la compréhension chez les enfants ayant un trouble du langage sont fortement corrélés aux effets de fréquence des structures syntaxiques dans les phrases mais également à
une faiblesse de la mémoire de travail. Cette étude soutient la théorie des troubles de traitement
d’entrée dans les troubles du langage (Leonard, 2007). Les difficultés de compréhension des
phrases transitives et de l’ordre S-C pourrait être un marqueur clinique intéressant des troubles
du langage en Hongrois. Mots-clés: troubles spécifiques du langage, morphosyntaxe, hongrois
06.5
STAGNATION SYNTAXIQUE DANS LES TSL : LE DISCOURS COMME
MAILLON MANQUANT DE LA CHAINE
Dagmar Bittner - Centre for General Linguistics, ZAS, Berlin, Germany
Peter Jordens - MPI for Psycholinguistics, MPI, Nijmegen, Netherlands
Objectif: Les études sur le développement des compétences narratives chez les enfants avec
TSL ont montré que la prise en charge des macrostructures narratives, par exemple la production
d’un but, d’une tentative, d’un résultat… ont amélioré les traits micro structurels des récits (Ringmann 2014). De manière similaire, des améliorations de la structuration globale ont donné lieu à
l’application de la connaissance linguistique sur la cohérence du discours qui était présente préalablement. Si c’était vrai, cela changerait la perspective dominante sur les problèmes des enfants
dans la production de textes cohérents.
Méthodes: Pour enquêter sur cet argument plus en détail, nous avons effectué des analyses de
la communication verbale spontanée des enfants de langue maternelle allemande ayant des TSL,
d’âge compris entre 3,6 et 5,5 ans. Les analyses se sont concentrées sur la composante initiale
des propositions principales et sur la position V2 du verbe conjugué. En allemand, la position
initiale de la proposition principale fait le lien structural d’information au sujet du contexte linguistique préalable. Elle peut comprendre exactement une phrases syntaxiques mais de type différent.
Les analyses ont concerné :
a) l’émergence du V2
b) la typologie des composantes syntaxiques produites par l’enfant
c) la typologie des composantes en position initiale
d) la manière dont les énoncés ayant des composantes « non-sujet » en position initiale sont liées
au contexte linguistique précédent.
Les analyses c) + d) incluent des analyses parallèles d’enfants DT d’âge compris entre 2,6 et 3,0
ans.
Résultats: L’analyse a) a montré l’émergence du V2 chez les enfants atteints de TSL d’âge compris entre 3,6 et 3,10 ans. Pour cela, toutes les autres analyses de données liées à ces enfants
ont démarré à 4,0 ans. Les analyses b-d) ont fait émerger le tableau suivant: tous les types de
37
composantes sont présents dans la production des enfants atteints de TSL à partir de 4,5 ans. En
position initiale, il y a une proportion inférieure de sujets pronominalisés et d’adverbes déictiques
et une proportion inférieure de propositions objectives et de pronoms interrogatifs que chez les
enfants atteints de DT. Cependant, la majorité des phrases OVS (Objet/Verbe/Sujet) et des questions interrogatives sont corrélées au contexte linguistique précédent dans les deux échantillons,
TSL et DT.
Conclusions: D’après nous, les derniers résultats ont montré que les enfants atteints de TSL ont
acquis les connaissances de base linguistiques en ce qui concerne la cohérence discursive. Nous
discuterons du fait que le plateau-SVO typique des enfants allemands ayant des TSL après l’apprentissage de la position V2 des verbes conjugués n’est pas causé par un manque de connaissance grammaticale, par exemple la position CP (Hamann et al. 2001), mais par les limitations
corrélées au temps sur le traitement et l’intégration d’informations linguistiques complexes (Kolk
1998).
Mots-clés: TSL
06.6
ACQUISITION ET ÉVALUATION ORTHOPHONIQUE DES PROCESSUS
RÉFÉRENTIELS AU COURS D’UN RÉCIT
Hilaire-Debove Kern - LURCO, UNADREO, Paris, France
Géraldine Debove - LURCO/UNADREO, Université Claude Bernard Lyon 1 (ISTR), Paris, France
Sophie Kern - Laboratoire DDL UMR5596, Université Lumière Lyon 2 et CNRS, Lyon, France
Objectif: La construction du récit est une tâche langagière complexe (Kern, 1997 ; 2002) qui
implique notamment la référence tout au long du récit à des participants aux statuts différents par
le biais de moyens linguistiques spécifiques (Clark & Havinland, 1977) difficilement maitrisés par
l’enfant TSL notamment (Bigouret, 2004 ; Hilaire-Debove et Roch., 2010 ; 2012 ; Liles, 1996 ; Van
der Lely, 1997).
Notre étude porte sur le développement des outils linguistiques utilisés pour introduire, maintenir
et réintroduire des personnages dans une narration par des enfants. L’exposé présente la trajectoire développementale de ces enfants et l’étalonnage construit à partir des données recueillies,
utilisable lors d’un bilan orthophonique.
Méthodes: Les récits ont été élicités à partir d’une histoire en images : Frog, Where are You ?
(Mayer, 1969) auprès de 350 enfants francophones âgés de 4 à 11 ans.
Résultats Pour l’introduction du référent, dès 4 ans, les formes nominales sont privilégiées. A
partir de 7 ans, l’introduction se fait par le biais d’un syntagme nominal avec déterminant indéfini
contrairement aux enfants plus jeunes. Certains enfants utilisent des dislocations à gauche (le
chien il) qui disparaissent à 7 ans au profit de subordonnées relatives. Pour le maintien du référent, l’utilisation des pronoms personnels est privilégiée très tôt et augmente significativement
avec l’âge. De plus, les pronoms personnels objets augmentent significativement en fonction de
l’âge alors que les dislocations à gauche décroissent. Les ellipses apparaissent tardivement à 8
ans. Enfin pour la réintroduction, les formes nominales simples ou disloquées sont privilégiées
à tous les âges. Par ailleurs, les erreurs sur l’utilisation des pronoms personnels sujets et objets
sont relativement rares et décroissent significativement entre 5 et 8 ans.
Conclusions: Ces résultats montrent que les enfants apprennent progressivement à s’adapter au
niveau de connaissance de leur interlocuteur et à utiliser les moyens linguistiques adéquats. Faire
produire une narration basée sur ce même matériel à des enfants en difficulté langagière permet
de mieux situer le niveau et la nature de leurs difficultés. Deux études de cas sur un enfant TSL et
un enfant TED serviront d’illustration.
Mots-clés: Troubles spécifiques du langage, troubles développementaux du langage
38
7.1
DÉVELOPPEMENT ET MISE EN PLACE D’UN “PROFIL DE TÂCHES
ET DE COMPÉTENCES” POUR LES ÉTUDIANTS EN ORTHOPHONIE/
LOGOPÉDIE
Philine Berns - College for Speech and Language Therapy, University for Applied Sciences, Rotterdam, Netherlands
Objectif: Le développement d’un “profil de tâches et de compétences” pour les étudiants en
orthophonie/logopédie et sa mise en place dans le cadre d’un programme de Bachelor.
Méthodes: Depuis 2004, toutes les universités pour la logopédie aux Pays-Bas utilisent un profil
de niveau de compétences des étudiants (Compass; NVLF, 2005) reconnu au niveau national. Le
modèle décrit 9 compétences, liées aux tâches et aux situations professionnelles. Chaque compétence repose sur 5 niveaux. Le cinquième niveau correspond au niveau d’un professionnel
débutant.
Un nouveau programme d’étude a été mis en place à l’Université des Sciences Appliquées de
Rotterdam. Un des objectifs était de développer un profil de compétences dans le cadre du
CanMEDS (Frank, 2005) programme basé sur les compétences Des consultations avec des
conférenciers en TLP et des professionnels des TLP ont permis de développer le COLORRS: un
programme au sein duquel 5 missions sont décrites. Nous avons réorganisé les compétences de
notre modèle national pour l’adapter à la structure des missions et nous l’avons réordonné sur 3
niveaux.
En 2013, nous avons lancé un nouveau programme d’étude incluant le COLORRS, au cours de la
première année. En 2014, nous l’avons inséré en deuxième et troisième année.
Résultats: COLORRS est une structure importante pour le programme d’études. Les avantages et
désavantages du travail en terme de tâches sont devenus plus clairs au cours des deux dernières
années d’utilisation de la structure. La mise en place se poursuit: nous continuons à analyser ce
qui convient ou non. Le résultat de ces recherches peut favoriser la réécriture de certaines compétences ou tâches ou même aider à réorganiser les niveaux décrits.
Conclusions: Il est possible de modifier un profil de compétences étudiant reconnu nationalement
vers une structure utilisée dans un programme particulier de TLP. Il semble qu’une structure décrivant les tâches plutôt que les compétences comme point de départ soit plus compréhensible
pour les étudiants.
Mots-clés: Qualité de l’éducation
07.2
MESURER LES COMPÉTENCES DE LA PRATIQUE BASÉE SUR LES
PREUVES (EBP) DES ÉTUDIANTS EN ORTHOPHONIE/LOGOPÉDIE.
OÙ SONT LES LACUNES ?
Karin Neijenhuis - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Joan Verhoef - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Erica Witkamp - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Connie Dekker-Van Doorn - Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
Objectif: La formation en pratique basée sur les preuves (EBP) est devenu part intégrante des
programmes d’étude en orthophonie/logopédie, l’évolution allant dans le sens d’une intégration
de ces approches dans le cursus afin de développer une attitude « basée sur les preuves » dans
tous les programmes d’étude. Nous avons mesuré les résultats et les comportements liés à la
pratique EBP pour estimer le niveau actuel des connaissances des étudiants. Professeurs et
39
praticiens ont été évalués par les mêmes tests, pour identifier les écarts entre les groupes. Enfin,
les performances en EBO et les comportements des orthophonistes/logopèdes ont été comparés
avec celles d’autres professionnels de santé.
Méthodes: Le test hollandais Fresno modifié (The Dutch Modified Fresno test = DMF; Spek et
al., 2012; Ramos et al., 2003), mesurant les connaissances et les compétences en EBP a été
administré aux étudiants et aux praticiens. Des versions différentes ont été développées pour les
programmes d’étude des écoles d’infirmiers et d’autres professions de santé. Les sujets ont aussi
completé un questionnaire sur les inpressions personnelles au sujet de l’ EBP (Spek et al., 2013).
Résultats: Les scores du DMF de 44 étudiants, 13 professeurs et 18 praticiens seront comparés
dans la présentation. Les premiers résultats montrent que les scores des étudiants sont très différents de ceux des professeurs. En outre, la corrélation entre performance (DMF) et comportement
(questionnaire) a été examinée.
Conclusions: On note des écarts entre les compétences en EBP des étudiants, des professeurs
et des praticiens. Aujourd’hui la formation en EBP est complètement intégrée et acceptée dans
les programmes d’étude en orthophonie/logopédie. Il est temps d’accorder plus d’attention à
combler les lacunes des praticiens par rapport aux professeurs. Sans formation permanente, ces
compétences risquent de diminuer.
Mots-clés: Pratique basée sur les preuves, éducation
07.3
LE CURSUS EN GÉRONTOLOGIE DANS LES ÉTUDES D’ORTHOPHONIE
Michalina Kleczek-Marek - Institute of Polish Language, University of Silesia, Katowice, Poland
Objectif: L’objectif de cette étude est de développer le cursus en gérontologie pour les études
enorthophonie. Les auteurs ont analysé les prédictions liées à l’évolution de la société. Dans
quelques décennies, on prévoit, un nombre grandissant de sujets de plus de 65 ans, y compris
des sujets ayant des troubles du langage liés aux pathologies du vieillissement. Ce seront de nouveaux défis et pas seulement pour l’orthophonie/logopédie.
Méthodes: Les auteurs proposent une orthophonie/logopédie en gérontologie comme nouvelle
méthode pour l’évaluation des troubles du langage et pour la formation des orthophonistes/logopédistes. La base de cette distinction d’orthophonie/logopédie en gérontologie est associée aux
pratiques spécifiques de la prise en charge des sujets âgés. L’expression “Orthophonie/Logopédie en Gérontologie” vient des termes: gérontologie et orthophonie/logopédie.
Résultats: L’Orthophonie/Logopédie en gérontologie est une branche du traitement ou une méthode analytique d’un domaine de connaissances et de pratique liée aux procédures spécifiques
pour les sujets âgés ayant des troubles du langage ou risquant de les développer. Elle est basée
sur des facteurs pathologiques de nature neurologique, psychiatrique, oncologique, périphérique
ou socio-psychologique.
Parmi les troubles du langage qui peuvent faire partie du domaine de l’orthophonie/logopédie
en gérontologie, on peut compter: l’aphasie, la prosopagnosie, les troubles du langage dans les
maladies neuro-dégénératives, et les troubles du langage dus à des lésions des organes périphériques de la phonation, des maladies comme le cancer du larynx ou de la langue. D’autres
troubles du langage peuvent être dépistés chez les sujets âgés, comme le bégayement et le bredouillement ou peuvent être liés à une perte auditive ou à une hypoacousie.
Conclusions: Les auteurs ont montré les problèmes les plus importants lies à un domaine à part
du programme d’étude d’orthophonie/logopédie. Le programme des orthophonistes/logopèdes
est ici présenté. Le concept du programme d’étude ici décrit est composé par trois partes principales: médicale, sociale et orthophonique.
Mots-clés: Troubles neuro-dégénératifs, troubles du langage, vieillissement, gérontologie
40
07.4
UN MODÈLE POUR LE DÉVELOPPEMENT DES COMPÉTENCES
DANS LE DOMAINE DE LA DYSPHAGIE
John Lancaster - Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
Susan Guthrie - Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
Jois Stansfield - Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
Objectif: Développer un modèle consensuel pour le développement des compétences dans le
domaine de la dysphagie chez les orthophonistes/logopèdes nouvellement diplômés (Newly Qualified = NQ) en Angleterre du Nord-Ouest.
Méthodes: L’étude est divisée en trois étapes. Une étude de la littérature et des entretiens avec
des experts du Royaume-Uni ont été menés pour identifier les meilleures pratiques et méthodes
pour le développement des compétences dans le domaine de la dysphagie. Des orthophonistes/
logopèdes travaillant dans le Nord-ouest de l’Angleterre et des étudiants en orthophonie/logopédie ont été interrogés pour évaluer les approches courantes pour le développement des compétences. Une consultation des parties prenantes ainsi que des cliniciens par la méthode Delphi
a permis d’explorer les différents modèles permettant aux logopédistes nouvellement diplômés
d’acquérir des compétences.
L’échantillonnage était représentatif d’une large gamme de contextes cliniques et d‘expérience
des orthophonistes/logopèdes.
Résultats: Un modèle de consensus a été développé à l’aide de différents procédés pour parvenir aux compétences dans le domaine de la dysphagie recherchées. Les étudiants en orthophonie/logopédie ont acquis des connaissances théoriques et ont obtenu des compétences pratiques post-diplôme.
Des discussions sur la manière de franchir les barrières géographiques de cette étude ont permis
d’élaborer des recommandations pour des modèles de supervision et pour établir des cadres
appropriés permettant de développer les compétences des étudiants et des orthophonistes/logopèdes diplômés dans différents contextes de pratique.
Conclusions: Les modèles mis en place pour atteindre ces compétences peuvent varier selon les
différents contextes de pratique mais un consensus visant à la mise en œuvre d’un protocole de
supervision, d’évaluation et de développement des compétences pour le domaine de la dysphagie a été défini avec des alternatives qu’il faut prendre en compte selon les différents contextes.
On a établi un lien avec la nouvelle orientation de l’association professionnelle des orthophonistes/logopèdes (RCSLT) sur le développement des compétences dans le domaine de la dysphagie dès la période de formation initiale en orthophonie/logopédie
Mots-clés: Education initiale, apprentissage basé sur les compétences, qualité de l’éducation,
dysphagie
07.5
RÉDUIRE L’ECART ENTRE RECHERCHE ET PRATIQUE CLINIQUE
DE L’ÉVIDENCE BASED PRACTICE (PRATIQUE BASÉE SUR LES
PREUVES): D’ÉTUDIANT A EXPERT CLINICIEN
Victoria Joffe - City University London, London, United Kingdom
Emma Pagnamenta - Royal College of Speech and Language Therapists, London, United Kingdom
Contexte: L’évaluation critique des travaux de recherche, leur application à la pratique clinique et
la possibilité de recueillir des données pour évaluer sa pratique, sont des exigences
41
essentielles à l’exercice de l’orthophonie, comme souligné par le Conseil des Professions de
Santé aux Royaume-Uni. L’entrainement et la sensibilisation à ces capacités commence lors de la
formation initiale des orthophonistes mais continue tout au long de leur carrière professionnelle.
L’objectif de cette présentation et de proposer un point de vue britannique sur l’évolution de la
réflexion critique et des capacités en matière de recherche au travers de profils d’orthophonistes
passant d’étudiants à expert-cliniciens.
Méthodes: Cette présentation va montrer l’importance croissante que prennent la recherche et la
pratique clinique en orthophonie comme le souligne l’association professionnelle britanique, le «
Royal College of Speech and Language Therapists », incluant une évaluation d’initiatives récentes
comme par exemple la recherche d’un responsable à la recherche et de chercheurs-champions.
Le feed-back sur ces changements sera étudié grâce à des questionnaires, des groupes de
discussion et des entretiens. Une analyse du programme de formation à la pratique basée sur les
preuves au cours des études d’orthophonie/logopédie au Royaume-Uni sera également faite au
travers de questionnaires.
Résultats: Nous identifierons les domaines de la pratique basée sur les preuves qui restent à
approfondir chez les étudiants et les orthophonistes/logopédistes.
Conclusions: La recherche et la pratique clinique en orthophonie sont de plus en plus reconnues
au Royaume-Uni. L’impact positif de la compréhension et de l’utilisation de la recherche clinique
dans la rééducation orthophonique au service des utilisateurs sera démontré dans cette présentation.
Mots-clés: Éducation, formation continue, recherche, pratique basée sur les preuves
07.6
RÉFLEXIONS AU SUJET DE L’ACQUISITION DE COMPÉTENCES
PROFESSIONNELLES LIÉE AUX THÈMES DE RECHERCHE
EN ORTHOPHONIE/LOGOPÉDIE
Baiba Trinite - Faculty of Education and Social Work, University of Liepaja, Liepaja, Latvia
Objectif: Le but de cette présentation est d’analyser la corrélation entre les compétences principales des orthophonistes/logopèdes présentées dans le projet NetQues et les thèmes de
recherche en orthophonie/logopédie des étudiants de trois institutions de formation supérieure
en Lettonie (University of Latvia, University of Liepāja et Riga Teacher Training and Management
Academy).
Méthodes: Analyse quantitative et qualitative des thèmes de recherche
Résultats: Cette présentation rapporte huit ans d’expérience de consultation, supervision et de
revue des thèmes de recherche des orthophonistes pendant leur formation initiale et certaines
conséquences pour la formation au niveau Master. Certaines analyses des résultats du projet
Netques pour les compétences des orthophonistes nouvellement diplômés a été menées et comparées aux thèmes de recherche.
Conclusions: Les conclusions montrent qu’il existe une corrélation entre les compétences des
orthophonistes nouvellement diplômés définis dans le projet NetQues et le choix des thèmes de
recherche. L’intérêt principal des étudiants des programmes de formation initiale des orthophonistes en Lettonie est lié à l’approche pédagogique en orthophonie/logopédie, bien que certains
thèmes de recherches cliniques des étudiants sont également choisis dans le domaine de la
santé. Ces choix sont liés aux compétences et au lieu de travail du directeur de recherche.
Mots-clés: Compétences professionnelles des orthophonistes7logopèdes, thèmes de recherche
des diplômés en orthophonie/logopédie
42
08.1
LA DYSPHAGIE DANS LE CADRE DES MALADIES
NEUROMUSCULAIRES: VERS UN OUTIL DE DÉPISTAGE COMMUN
Federica Lucia Galli - Neurorehabilitation Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Michela Coccia - Neurorehabilitation Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Francesco Logullo - Neurologic Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Savina Bramucci - Neurorehabilitation Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Leandro Provinciali - Neurologic Clinic, Ospedali Riuniti Di Ancona, Ancona, Italy
Marianna Capecci - Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
Maria Gabriella Ceravolo - Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
Objectif: La dysphagie est fréquemment observée dans les maladies neuromusculaires (MN) et
influence notamment les performances des patients. Malgré son appartenance clinique, il existe
peu de descriptions et de propositions concernant son bilan de dépistage. L’étude présente vise
à décrire les caractéristiques de la dysphagie chez les MN et à identifier les tests cliniques efficaces.
Méthodes: Sujets: 144 sujets consécutifs MN divisés en deux groupes (maladies de motoneurone
et myopathies). Bilan: évaluation clinique fonctionnelle des étapes de la déglutition orale et pharyngée, test 3OZ Water Swallow Test (WST) et échelle de sévérité de la dysphagie = Dysphagia
Outcome Severity Scale (DOSS), menés par des orthophonistes.
Résultats: La dysphagie survient chez 68% des patients MN (80% pour les maladies du motoneurone (MMN) et 61% pour les myopathies).
En comparant les signes cliniques de la dysphagie entre les maladies du motoneurone et les
myopathies, nous avons découvert que les MMN sont beaucoup plus associées à une apparition
aiguë de dysarthrie, perte de force au niveau des lèvres, fasciculation de la langue et atrophie.
Le risque d’avoir un test 3OZ positif est 5,7 fois plus élevé et le score du test DOSS empire de
manière significative.
A l’intérieur du groupe des myopathies, les sujets souffrant de dystrophie myotonique de type 1
(DM1) ont une apparition de dysphonie, de déficit de la motilité mandibulaire, de clairance orale
et formation de bols alimentaire anormales. Le risque d’avoir un test 3OZ positif est 3,5 fois plus
élevé et le score du test DOSS empire de manière significative.
Conclusions: La dysphagie atteint particulièrement les patients avec MN. Sa fréquence et son
cadre clinique dépendent de la maladie sous-jacente. Les données recueillies fournissent la base
d’un outil d’évaluation de MN qui peut favoriser un dépistage précoce et efficace de la dysphagie.
Mots-clés: Dysphagie, troubles neuro-dégénératifs
08.2
RÔLE DE L’ORTHOPHONISTE/LOGOPÈDE DANS LE DIAGNOSTIC
RADIOLOGIQUE DE LA DYSPHAGIE. SON UTILITÉ DANS LA
PRATIQUE CLINIQUE
Lucia Del Vecchio - Department of Sciences Anesthetic, Surgical and Emergency, Second University of Naples, Naples, Italy
Alfonso Reginelli - Department of Internal and Experimental Medicine, Second University of Naples, Naples, Italy
Maria Valeria Di Martino - Rehabilitation Professional Service, Azienda Ospedaliera Dei Colli - Monaldi Hospital, Naples, Italy
Objectif: Notre but est de présenter le rôle de l’orthophoniste/logopède dans le diagnostic radiologique de la dysphagie.
Méthodes: Un total de 321 patients avec une dysphagie oro-pharyngée ont été soumis à un
43
examen vidéofluoromanométrique (VFM) par une équipe multidisciplinaire comprenant un radiologue, un chirurgien gastro-entérologue et un orthophoniste/logopède.
Le rôle de l’orthophoniste /logopède dans l’établissement du diagnostic est réparti sur trois
phases:
1) analyse de l’anamnèse et de l’historique de la déglutition ;
2) recherche d’éléments pouvant guider des interventions diététiques et une rééducation
orthophonique pendant le VFM ;
3) instruction concernant le type et la consistance des aliments afin que le patient puisse manger
en toute sécurité et, si nécessaire, indications concernant la posture et les mécanismes de
compensation.
Résultats: chez 76/321 patients (23,7%) le VFM a révélé une aspiration. La solution de la dysphagie a été obtenue chez: N 17 patients avec aspiration avant la déglutition (100%) ; N 24 patients
avec aspiration pendant la déglutition (75%) ; N 20 cases avec aspiration après la déglutition
(95%) ; Dans 6/70 cas (7,9%) il y avait une aspiration multiple et des postures compensatoires
non recherchées par ces patients.N 5 patients présentant un trouble de transit du bol alimentaire
(100%)
Conclusions: Un diagnostic précoce et précis de la dysphagie oro-pharyngée permet d’intervenir
efficacement avec des techniques orthophoniques, d’améliorer la qualité de vie du patient et de
réduire au minimum les complications. Les résultats de notre étude montrent l’importance de la
présence d’un orthophoniste/logopède au cours de l’examen radiologique afin de compléter le
rapport instrumental avec des informations sur les types d’aliments permis et ceux à éviter, sur les
postures de compensation possibles et/ou sur les techniques d’orthophonie/logopédie à adopter
dans le programme de rééducation.
Mots-clés: dysphagie, examen radiologique, orthophoniste/logopède
08.3
LE ROLE DES EXERCICES CERVICAUX ISOMÈTRIQUES DANS
L’ALIGNEMENT DES VERTEBRES CERVICALES CHEZ LES PATIENTS
DYSPHAGIQUES ADULTES ATTEINTS DE PARALYSIE CÉRÉBRALE.
UNE ÉTUDE DE CONTRÔLE RANDOMISÉE
Soultana L. Papadopoulou - Physical Medicine and Rehabilitation Clinic, Medical School, Ioannina Greece, Greece
Objectif: La paralysie cérébrale peut causer une scoliose cervicale, une cyphose et une hyperlordose. Cette étude vise à évaluer l’utilisation des exercices hypsométriques chez les patients
adultes dysphagiques atteints de troubles de l’alignement des vertèbres cervicales causés par
paralysie cérébrale.
Méthodes: Il s’agit d’une étude randomisée des patients adultes dysphagiques atteints de paralyse cérébrale aiguë. Les patients étaient exclus s’ils avaient eu un suivi de chirurgie spinale, un
passé clinique de difformité spinale ou connu de dysphagie. A l’approche thérapeutique régulière,
des exercices cervico-hypsométriques dans les 4 directions ont été menés 10 minutes par jour
par un groupe de patients pris au hasard. Les patients ont été soumis à la VFSS (vidéofluoroscopie de la déglutition) pour évaluer la déglutition (0=normal, 1=pénétration, 2=aspiration) et à
l’imagerie radiologique cervicale-spinale en position verticale (en position debout ou assise) pour
mesurer l’angle de Cobb C2-C7 des courbures de la scoliose et de la lordose à deux moments
différents. Des changements d’index radiographiques tout comme la VFSS, ont été calculés et
mis en relation.
Résultats: Soixante-dix patients consécutifs, atteints de paralysie d’origine cérébrale (41 par AVC,
19 par traumatisme crânien et 10 via d’autres étiologies) et une moyenne (SD) d’âge de 52±15
ans ont été inclus dans l’étude. Cinquante-sept d’entre eux ont pratiqué des exercices cervicaux
s’ajoutant au programme thérapeutique. Le temps moyen entre la première et la deuxième
44
évaluation était de. 227±183 jours. A l’évaluation initiale, la courbe scoliotique >10° de la colonne
cervicale convexe sur le coté hémiplégique a été indiquée chez 18 patients (19%), alors que 18
autres patients (19%) ont présenté une difformité cervicale (inversion de la lordose normale). Une
hyperlordose a été trouvée chez 10 patients (11%). Au dernier contrôle, les patients ont vu leur
alignement cervical s’améliorer (p<0,001), autant sur le plan coronal que sagittal et dans la déglutition. Les patients qui ont effectué les exercices cervicaux avaient une correction plus prononcée
(p<0.05) de l’alignement cervical sur les deux plans et dans la déglutition.
Conclusions: Les patients dysphagiques adultes avec paralysie cérébrale en phase de rééducation qui ont pratiqué des exercices isométriques ont présenté une correction importante de
l’alignement cervical sur le plan coronal et sagittal et des améliorations plus prononcées de la
déglutition, comparés aux patients n’ayant pas pratiqué des exercices isométriques cervicaux.
Mots-clés: exercices cervical-hypsométriques, cyphose, lordose, troubles de la déglutition
08.4
ORTHOPHONIE/LOGOPÉDIE APRÈS UNE CHIRURGIE
RECONSTRUCTIVE DU VISAGE. NOUVELLE APPROCHE
A LA RÉADAPTATION FACIALE
Martin Frederic
- Cabinet D’Orthophonie Philippe Auguste, Hopital Europeen Georges Pompidou - Paris, Paris, France
La chirurgie plastique et reconstructive est souvent associée à une rééducation fonctionnelle
adaptée. Les progrès de la chirurgie, les modèles pré-opérationnels et les progrès de la neurologie devraient amener les orthophonistes/logopèdes à faire évoluer leurs techniques afin de
répondre aux nouveaux besoins chirurgicaux. Nous avons l’intention de développer notre exposé
en trois phases:
- Histoire de la chirurgie reconstructive du visage, depuis les « gueules cassées » de la première
guerre mondiale jusqu’aux transplantations faciales;
- Rééducation : évaluation, restauration du langage, expressions faciales, mastication, déglutition,
renforcement du contrôle sensori-moteur et cortical, toucher thérapeutique, aspects psycholo
giques et éthiques, réinsertion ;
- Résultats de deux études originales : (1) Validation du protocole de rééducation par
« effet- miroir» chez 26 patients avec paralysie faciale qui ont subi une myoplastie
d’allongement du muscle temporal(LTM) ; (2) Résultat pour la fonctionnalité et la qualité de vie
dans 6 cas de transplantation faciale. Quelles leçons peut-on tirer de la rééducation faciale
neuromusculaire.
45
08.5
L’IMPORTANCE DE LA FORMATION INTERDISCIPLINAIRE POUR LA
FORMATION A L’ÉVALUATION ET AU TRAITEMENT ADÉQUATS DE
LA DYSPHAGIE: L’EXPÉRIENCE DE L’ÉQUIPE DE DYSPHAGIE DE
PIACENZA, ITALIE
Roberto Antenucci - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Rossella Raggi - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Cecilia Cardinali - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Barbara Olizzi - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Michela Benvenuti - Otorinolaringoiatria, AUSL Piacenza, Piacenza, Italy
Giulia Bellini - Cure Primarie, AUSL Piacenza, Piacenza, Italy
Giulia Giovanardi - IRCCS Fondazione Maugeri, Fondazione Maugeri, Montescano (PV), Italy
Domenico Nicolotti - Unita’ Spinale, AUSL Piacenza - Ospedali Borgonova V.T.e Villanova Sull’arda (PC), Piacenza, Italy
Objectif: La dysphagie est encore mal connue, malgré les risques graves auxquels sont confrontés les patients concernés. Une équipe interdisciplinaire a organisé une formation à l’hôpital
publique de Piacenza. Les objectifs étaient de comprendre les dimensions du problème et de
savoir comment évaluer les signes et symptômes de la dysphagie.
Méthode: La formation s’adressait à la majorité du personnel de l’hôpital. Les formateurs étaient
des spécialistes en médecine physique, des phoniatres, des médecins ORL, des nutritionnistes,
des gérontologues, des neuropsychologues, orthophonistes/logopèdes, des kinésithérapeutes,
des infirmiers. La formation comprenait des cours en classe et des stages pratiques. Pour évaluer
les compétences préexistantes et l’efficacité de cette formation, un questionnaire anonyme identique au test d’évaluation final a été mené préalablement.
Résultats: 516 participants ont pris part à la formation répartis sur 15 éditions du cours. Le taux
moyen de réponses correctes données au pré-questionnaire était de 41,3±5%. Un taux faible de
bonnes réponses au sujet du diagnostic instrumental, du B.M.I., de la mise en place de sonde à
ballonnet, de l’administration des médicaments et de la posture a été souligné. Dans l’évaluation
finale, la moyenne de réponses correctes était de 85.4±4%. L’efficacité d’apprentissage était statistiquement significative.
Conclusion: Les connaissances des participants sur l’évaluation et la prise en charge de la dysphagie se sont améliorées. Les participants ont jugé la formation très efficace pour leur formation
continue. L’explication du faible taux de réponses correctes n’est pas claire (peut être à cause
d’un manque de formation ou de suivi). Le taux d’acceptation confirme la nécessité de formation
interdisciplinaire, théorétique et pratique pour tous les professionnels de la santé en lien avec la
dysphagie.
Mots-clés: dysphagie, traitement pluridisciplinaire, formation du personnel hospitalier
08.6
CINQ ANNEES D’ACTIVITÉ D’UNE EQUIPE PLURIDISCIPLINAIRE
POUR LES TROUBLES DE LA DÉGLUTITION A SENIGALLIA, ITALIE
CENTRALE
Patrizia Lopez - Azienda Sanitaria Area Vasta 2 Marche,Senigallia (AN), Italy
Objectif: Rendre compte des cinq années d’activités de l’équipes pluridisciplinaire pour les
troubles de la déglutition à Senigallia en Italie centrale.
46
Méthodes: Ce projet est une analyse rétrospective. 1613 sujets souffrant de dysphagie ont été
mis sous observation entre janvier 2009 et décembre 2013 dans une clinique spécialisée (Outpatient Dysphagia Clinic)
Le dépistage de la dysphagie a été effectué sur demande du médecin généraliste (patients en
consultation externe) ou des médecins cliniciens (patients hospitalisés) en utilisant les tests
suivants: dépistage des troubles de la déglutition (Bedside Swallowing Evaluation, BSE), Auscultation Cervicale (Cervical Auscultation, CA), échelle de sévérité de la dysphagie (Dysphagia
Outcome Severity Scale (DOSS), et outil universel de dépistage de la malnutrition (Malnutrition
Universal Screening Tool, MUST). L’équipe de cliniciens de dysphagie a également procuré des
conseils nutritionnels et un suivi thérapeutique. Dans la mesure du possible, des autorisations
anticipées de sortie validées par le médecin ont été mise en place par l’équipe multidisciplinaire
(médecin généraliste, médecin spécialiste, orthophoniste, diététicien, responsable des soins infirmiers)
Résultats: Dans la période considérée, 1613 patients ont été observés (787 hommes et 826
femmes) d’un âge moyen de 83,2 ans (entre 8 et 102 ans). L’étiologie principale de la dysphagie
étant: la démence (55%), les accidents vasculaires cérébraux (14%), la presbyphagie (13%), le
reflux gastro-oesophagiens (10%), le néoplasme (5%), d’autres pathologies (3%). Depuis 2009, le
nombre de patients bénéficiant d’autorisations de sortie anticipée du programme a progressivement augmenté.
Conclusion: L’approche multidisciplinaire de la dysphagie offre une prise en charge plus adaptée
et plus efficace du patient atteint de troubles de la déglutition. Une telle approche devrait réduire
le nombre de ré-hospitalisations dues à la déshydratation, la malnutrition ou la bronchopneumonie. Cette stratégie est abordable d’un point de vue économique et pourrait être reprise dans des
contextes similaires.
Mots-clés: dysphagie, dépistage des troubles de la déglutition, modifications alimentaires, autorisation anticipée de sortie d’hôpital.
09.1
APPRENDRE DES MOTS: L’EFFICACITÉ DE L’ENTRAINEMENT
LEXICAL CHEZ LES ENFANTS DÂGE PRÉSCOLAIRE AYANT UN
TROUBLE SPÉCIFIQUE DU LANGAGE
Esther Ottow-Henning - Royal Auris, Research & Development, Gouda, Netherlands
Astrid Kruythoff - NSDSK, Research & Development, Amsterdam, Netherlands
Floor Cohen Tervaert - NSDSK, Research & Development, Amsterdam, Netherlands
Karin Wiefferink - NSDSK, Research & Development, Amsterdam, Netherlands
Ellen Gerrits - HU University of Applied Sciences, Faculty of Health Care, Utrecht, Netherlands
Contexte: L’objectif de cette étude est de déterminer les effets d’un protocole d’entrainement
lexical à l’oral sur l’enrichissement du vocabulaire des enfants d’âge préscolaire avec TSL. Le
protocole d’entrainement lexical est basé sur le principe de “stimulation focalisée” (Girolamette
et al., 1996) et comporte différentes stratégies comme la réitération, l’utilisation des mots dans
différents contextes, l’utilisation de geste et l’ébauche orale (Steele et Mills, 2001).
Méthodes: Nous avons testé l’effet d’un protocole expérimental d’entrainement lexical sur le
schéma pré-test/intervention/post-test par un essai randomisé et contrôlé en comparaison avec
les traitements conventionnels. Les deux rééducations ont été menées trois fois par semaine
pendant quatre semaines. Notre étude porte sur soixante-trois enfants avec TSL âgés de 2 à 4
ans répartis de manière aléatoirement entre le groupe expérimental (n=32) et le groupe contrôle
(n=31). Dans les deux cas, l’objectif est de faire apprendre aux enfants une liste de 25 mots
cibles. La reconnaissance des 25 mots cibles et des 25 mots contrôles a été évaluée grâce à une
épreuve de dénomination immédiate, en rappel différé juste après l’intervention et un mois plus tard.
47
Résultats: Les résultats préliminaires montrent que les enfants du groupe expérimental ont un
meilleur score sur les mots-cibles juste après l’intervention que les enfants du groupe contrôle (6
contre 3 dans le groupe contrôle; (F(1,61)=11,30, p=.001). Les scores des deux groupes étaient
équivalents pour la liste de mots contrôles, en moyenne deux nouveaux mots de cette liste ont
été appris.
Conclusion: Au vu des résultats de notre étude, il semblerait que l’entrainement lexical soit plus
efficace que les traitements conventionnels dans l’apprentissage de nouveaux mots chez l’enfant
avec TSL.
Mots-clés: Troubles spécifiques du langage, pratique basée sur les preuves, apprentissage de
mots, entrainement lexical
09.2
LES EFFETS DE LA PRISE EN CHARGE PHONOLOGIQUE DANS LES
TSL HOLLANDAIS
Annelies Bron - Royal Dutch Kentalis, Speech and Language Centre, Eindhoven, Netherlands
Annette Scheper - Royal Dutch Kentalis, Speech and Language Centre, Eindhoven, Netherlands
Objectif: Au Royal Dutch Kentalis (organisation de prise en charge des troubles de l’audition et du
langage) , des enfants présentant des troubles phonologiques sévères ont été diagnostiqués et
soumis à une prise en charge intensive dans le Centre.
Ces enfants avec TSL ont été adressés au centre Kentalis parce que leurs compétences langagières n’amélioraient pas de manière satisfaisante en dépit d’un traitement orthophonique régulier.
Notre recherche a analysé l’efficacité d’un traitement phonologique spécifique.
Methods: dans cette étude, 50 enfants ayant des troubles phonologiques ont été pris en charge.
Une méthode standardisée pour l’analyse phonologique a été utilisée pour évaluer le degré de
contraste dans le développement phonologique et la récurrence des processus de simplification
phonologique.
La mesure PCC (Percentage of Consonants Correct - Shriberg & Kwiatkowski, 1982) et LME
(Longueur moyenne des énoncés / Phonological mean length of utterance - Ingram, 2002) ont
été utilisés pour évaluer la sévérité du trouble et si le traitement phonologique spécifique a eu du
succès. L’habilité à produire des énoncés grammaticalement corrects et à raconter une histoire
cohérente a été analysé par une tâche d’élaboration de récit (Récit de la grenouille, Mayer, 1969).
Tous les enfants ont été testés au début du traitement et après 6 mois.
Résultats: Les résultats montrent que la majorité des enfants ont sensiblement améliorés leurs
compétences phonologiques. Des améliorations importantes ont été trouvées au niveau du
contraste, du processus de simplification phonologique et dans les tests PCC et LME.
On a aussi montré que l’amélioration au test PCC coïncide avec l’amélioration dans le LME. De
meilleures représentations phonologiques semblent favoriser l’usage de mots plus complexes.
Lorsque la phonologie d’un enfant s’améliore, l’enfant peut produire des énoncés plus longs et
introduire plus d’éléments dans son récit.
Conclusions: Pour les enfants présentant des troubles phonologiques sévères, un traitement phonologique spécifique permet d’améliorer l’intelligibilité du langage. Leur système langagier évolue
sur le plan du vocabulaire et de la syntaxe, créant de meilleures compétences langagières.
Mots-clés: Troubles spécifiques du langage, troubles phonologiques
48
09.3
UNE ÉTUDE PILOTE AUPRÈS DES JEUNES DÉLINQUANTS
FRANÇAIS. ÉVALUATION DES TROUBLES DE LA PAROLE LIÉS AU
PARCOURS EN SYSTEME CARCÉRAL
Witko Agnes - ISTR Institut des Sciences et Techniques de la Réadaptation - Département Orthophonie, Université Claude
Bernard, Lyon (69), France
Blondet Lucille - ISTR Institut des Sciences et Techniques de la Réadaptation - Département Orthophonie, Université Claude Bernard, Lyon (69), France
Guiraud Claire - ISTR Institut des Sciences et Techniques de la Réadaptation - Département Orthophonie, Université Claude
Bernard, Lyon (69), France
Objectif: De nombreuses études au Royaume-Uni (Bryan, 2004, 2007, 2011), aux Etats- Unis
(Sanger et al. (2001) et en Australie (Snow & Powell, 2004, 2008, 2011) ont montré que la fréquence des troubles du langage est beaucoup plus élevée parmi les jeunes délinquants que dans
la population générale. A notre connaissance, aucune étude similaire n’a encore été menée en
France. Le but de cette étude pilote était de recueillir des renseignements éminemment nécessaires sur les difficultés langagières d’un petit groupe de jeunes délinquants dans le système
carcéral français, pour susciter une prise de conscience concernant leurs difficultés de communication.
Méthodes: Un bilan fonctionnel et formel du langage oral a été établi auprès d’un petit échantillon
de 19 sujets. Des tâches de production et de réception ont été utilisées pour dépister les deux
facettes de la compétence langagière.
Six tâches centrales ont été utilisées comme marqueurs de troubles du langage.
Mesures de la production du langage: la morphologie et la syntaxe en utilisant la tâche de répétition d’un énoncé (L2MA-R, Chevrier-Muller & al., 2011), une tâche consistant à compléter un
énoncé et une tâche discursive utilisant le rappel d’un récit oral (Exalang 11-15, Lenfant & al.,
2009).
Mesures de la réception du langage: le vocabulaire réceptif (EVIP, Dunn & Theriault-Whalen, 1993)
a été mesuré en utilisant l’adaptation française du PPVT (Dunn & Dunn, 1981), un test de compréhension des instructions et un bref débat, tous deux basés sur des situations fonctionnelles
(Exalang 11-15, Lenfant et al, 2009).
Une analyse plus détaillée a été utilisée pour comparer les troubles du langage et le parcours en
système carcéral.
Résultats: Certains sujets n’ont pas complété le protocole. Cependant, les principaux résultats
sont les suivants :
(1) 15 sujets sur 19 ont obtenu des scores inférieurs à 1,65 SD ou en-dessous de C10 pour une
ou plusieurs des six tâches principales.
(2) Une comparaison effectuée entre les sous-groupes a montré que parmi les 19 sujets évalués,
ceux ayant des difficultés majeures dans les tâches du vocabulaire réceptif et dans les tâches
narratives sont ceux ayant effectué une peine plus longue en prison et ceux étant moins susceptibles de vivre dans une unité protégée.
Conclusion: Cette étude a confirmé qu’un degré élevé de troubles du langage était présent
parmi la population évaluée. Il a été également confirmé que ces difficultés peuvent influencer le
parcours des jeunes délinquants en système carcéral. Des problèmes quant au bilan de compétences langagières chez les adolescents et à la pertinence du protocole utilisé dans cette étude
seront discutés. Les limites de l’étude et les indications pour de futures recherches seront aussi
analysées afin d’envisager une prochaine étude sur un échantillon plus important.
Mots-clés: Étude pilote, centre de rééducation pour mineurs, jeunes délinquants, parole, troubles
du langage et de la parole
49
09.4
EFFICACITÉ DE LA PRISE EN CHARGE PRÉCOCE DES ENFANTS
AYANT UN TROUBLE SPÉCIFIQUE DU LANGAGE
Bernadette A.M. Vermeij - NSDSK, Research Department, Amsterdam, Netherlands
Karin Wiefferink - NSDSK, Research Department, Amsterdam, Netherlands
Rosanne B. van der Zee - NSDSK, Research Department, Amsterdam, Netherlands
Noelle Uilenburg - NSDSK, Research Department, Amsterdam, Netherlands
Objectif: Le but de cette étude est d’acquérir une connaissance sur l’efficacité de la prise en
charge précoce des enfants ayant un Trouble Spécifique du Langage (TSL) sur leur développement langagier.
Méthodes: 75 enfants souffrant de troubles du langage (âgés de 25 à 45 mois) ont participé à un
groupe de traitement du NSDSK à Amsterdam (fondation néerlandaise pour les sourds et malentendants). Le développement langagier de ces enfants a été testé au début et à la fin de la prise
en charge par des tests standardisés de langage. Approximativement, la moitié des parents a
aussi participé à un programme pour les parents au cours duquel ils ont acquis des compétences
pour améliorer la communication avec leurs enfants.
Résultats: Les résultats ont montré que le langage expressif et réceptif des enfants s’est significativement amélioré, aussi bien au niveau du mot que de la phrase. La participation des parents
aux programmes de langage a eu un effet positif sur l’expression langagière des enfants. La durée
du traitement en groupe a aussi eu une influence positive sur le langage expressif.
Conclusions: Le développement du langage des enfants qui ont participé au traitement de
groupe du NSDSK s’est significativement amélioré. Plus le traitement était long, meilleurs étaient
les résultats.
Mots-clés: TSL, prise en charge précoce, efficacité
09.5
«COMMUNICATIE VIA SCHERM» (CVS), UN PROGRAMME DIGITAL
POUR LES INTERVENTIONS SPÉCIFIQUES EN ORTHOPHONIE, QUI
DÉCRIT L’UTILISATION SYSTEMATIQUE DES «BARRIER GAMES»
POURLES THÉRAPIES DES ENFANTS PRÉSENTANT UN TROUBLE
SPÉCIFIQUE DU LANGAGE TSL
Francis van Tilburg - Centre for Speech and Language Disorders, Royal Dutch Kentalis, Utrecht, Netherlands
Annette Scheper - Centre for Speech and Language Disorders, Royal Dutch Kentalis, Utrecht, Netherlands
Objectif: Le Royal Dutch Kentalis, centre pour les troubles de la parole et du langage a développé
«Communicatie via Scherm» (CvS), un programme digital pour l’intervention spécifique du langage qui décrit une utilisation systématique des « barrier games » (jeux où deux joueurs ou plus
tentent d’atteindre le même but sans se voir) dans les thérapies avec les enfants atteint de TSL
(Van Tilburg&Scheper 2014). Les objectifs de cette présentation sont de développer les compétences métalinguistiques de l’enfant, accroitre l’utilisation de mots et de contenu et améliorer
leurs compétences communicatives. Le CvS utilise une barrière entre l’adulte et l’enfant. L’enfant
exerce en alternance son écoute et ses compétences verbales. Après chaque tour de jeu, l’enfant
reçoit des commentaires d’une manière métalinguistique de l’orthophoniste.
Méthodes: l’efficacité du CvS est examiné dans une étude sur l’efficacité précoce avec un groupe
de pré- et post-test (N=9) (Bekkenutte, 2013). Les participants ont un diagnostic de TSL.
50
Résultats: Dans les conditions du post-test, les enfants utilisent davantage d’autocorrections, ils
montrent un comportement de prise de parole plus indépendant et utilisent davantage de noms et
de verbes lexicaux pour enrichir le contenu de leur production langagières.
Conclusions: le CvS semble être efficace dans le traitement des enfants présentant un TSL. Les
conditions spécifiques d’interaction que la barrière apporte, semblent être une manière adéquate
pour les enfants de prendre conscience de leur comportement de communication et d’améliorer
leurs compétences communicatives et métalinguistiques. Pour étayer les effets du CvS, il est
nécessaire d’intensifier la recherche scientifique. Les conclusions de nouvelles recherches pourraient contribuer à développer le Cvs comme intervention basée sur les preuves qui est absolument nécessaire dans le domaine de la thérapie du langage pour les enfants avec TSL.
Mots-clés: «barrier games» ; compétences métalinguistiques; TSL
09.6
COOPEÉRATION INTERPROFESSIONNELLE ET UTILISATION DES
OUTILS DE TECHNOLOGIE ASSISTÉE EN
ORTHOPHONIE/LOGOPÉDIE POUR LES TROUBLES
DÉVELOPPEMENTAUX DU LANGAGE
Cristian Leorin - Department of Neurosciences, University of Padova, Padova, Italy
Manuela Susigan - U.O.C. - O.R.L., Hospital San Donà di Piave, Venezia, Italy
Carlo Fantozzi - Department of Information Engineering, University of Padova, Padova, Italy
Valentina Rigato - Department of Neurosciences, University of Padova, Padova, Italy
Diego Vescovi - Department of Information Engineering, University of Padova, Padova, Italy
Objectif: (1) Présenter un projet méthodologique et les résultats d’un outil professionnel visant à
améliorer l’efficacité générale des traitements des troubles du langage et de la parole et à stimuler
la participation de l’enfant par le biais d’applications mobiles personnalisées.(2) Favoriser l’usage
de tablettes et des applications orthophoniques. (3) Illustrer une bonne pratique de coopération
interprofessionnelle avec un corpus académique externe (Département d’Ingénierie Informatique,
Université de Padoue).
Méthodes: L’application mobile a été créée pour aider les jeunes patients dans la construction de
phrases. La rétroaction interactive et visuo-auditive de la construction vise à aider les enfants à
développer la complexité des phrases et de la morphologie.
L’application a été testée sur un échantillon d’enfants d’âge préscolaire ayant un TSL et des
troubles secondaires du langage. L’étape expérimentale incluait un bilan initial, un questionnaire
pour les orthophonistes, suivi d’une période de traitement et une évaluation finale.
Résultats: L’application mobile a augmenté l’attention des enfants au cours du traitement orthophonique. La précision des réponses a pu être améliorée. La coopération interprofessionnelle a
joué un rôle important dans le développement par étapes des outils orthophoniques.
Conclusions: L’utilisation des applications mobiles peut améliorer l’efficacité des traitements
orthophoniques de manière significative, à condition que 1) les orthophonistes mettent en place
pour chaque patient un plan de traitement résultant d’un bilan clinique; 2) l’application mobile soit
utilisée pour obtenir les résultats attendus de la rééducation. La coopération interprofessionnelle
fournit un niveau plus élevé de personnalisation et de spécificité.
Mots-clés: Troubles du langage, technologie assistée, applications mobiles, coopération interprofessionnelle, apprentissage multidisciplinaire
51
10.1
RELATION ENTRE DYSARTHRIE ET QUALITÉ DE VIE CHEZ
PATIENTTS SOUFFRANT DE SCLÉROSE LATERALE
AMYOTROPHIQUE (SLA)
Daniela Ginocchio - NEuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Christian Lunetta - NEuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Valeria Sansone - NEuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Antonio Schindler - Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
Objectif: Évaluer la dysarthrie et la qualité de vie liée à la dysarthrie chez les patients atteints de
sclérose latérale amyotrophique (SLA) et analyser la relation entre l’âge des patients, la durée de
la maladie, les fonctions motrices, la dépression et la qualité de vie en général.
Méthodes: N=43 patients SLA. Critères d’inclusion: bilan d’évaluation des fonctions cognitives
avec le MMSE = Mini Mental State Examination ≥24), sévérité et caractéristiques de la dysarthrie,
sévérité de la SLA, dépression, qualité de vie en général et liée à la dysarthrie ont été évalués par
la Therapy Outcome Measure (TOM), le Profil de Robertson, l’échelle de cotation fonctionnelle
SLA dans sa forme révisée (ALSFRS-R), l’inventaire pour la dépression de Beck, le protocole sur
la qualité de vie du patient SLA (QOL-DyS), le questionnaire d’évaluation de la SLA (ALSAQ-40) et
le Questionnaire court d’étude de la santé (SF-36).
Résultats: 31/43 patients présentaient une dysarthrie (13 légères, 18 sévères). Le Profil de Robertson et le QOL-DyS était beaucoup plus altéré chez les patients dysarthriques (p<0,001). Nous
avons trouvé d’importantes corrélations entre le QOL-DyS et toutes les sous-échelles du Profil
de Robertson (r=0,812) et de la TOM (r=0.705). Le QOL-DyS a montré une forte corrélation avec
les items de communication et de nutrition du ALSAQ-40 (r=0,857) avec des différences entre les
dysarthriques et les non-dysarthriques (p<0,001). Le QOL-DyS est aussi corrélé au sous-score
bulbaire (r=0,616) et respiratoire (r=0,421). Le QOL-DyS n’a pas montré de corrélations avec le
SF-36, l’âge du patient, la durée de la maladie, la santé mentale ou la dépression.
Conclusions: La dysarthrie sévère influence la qualité de vie selon les scores obtenus. Le test
QOL-DyS devrait être utilisé aussi dans la pratique clinique pour mieux investiguer la qualité de
vie liée à la dysarthrie chez les patient présentant un SLA.
Mots-clés: Dysarthrie, troubles neurodégénératifs
10.2
PERFORMANCE ORO-MOTRICE DANS LA MALADIE IDIOPATHIQUE
DE PARKINSON ET FACTEURS INFLUENTS
Isabel Guimaraes - School of Health Sciences at Alcoitão (ESSA), Alcoitao-Alcabideche, Portugal
Rita Cardoso - Campus Neurológico Sénior (CNS), Torres Vedras, Portugal
Serge Pinto - Laboratoire Parole et Langage, Aix-en-Provence, France
Joaquim J. Ferreira - Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon,
Portugal
Objectif: (1) Déterminer et identifier la nature et les schémas de mouvements oro-moteurs, en
particulier des réflexes, de la respiration, des lèvres, du palais, du larynx, de la langue ainsi que
l’intelligibilité chez les patients atteints de la maladie de Parkinson idiopathique (MPI) selon leur
genre. (2) Prédire quelles sont les variables - âge, durée de la maladie, vue, ouïe, dentition, humeur, posture et le feedback de la perception sensorielle orale – associées à la performance oro-motrice.
52
Méthodes: Les patients atteints de MPI ont été évalués en utilisant la version 2 du Frenchay
Dysarthria Assessment (FDA-2). Le score maximum total au FDA-2 est de 104 et correspond à la
plus mauvaise performance des patients. Pour l’analyse statistique, on a utilisé le test de Student
à des fins comparatives et celui de la régression linéaire multiple afin de trouver quelles sont les
combinaisons variables associées le plus souvent à la mesure dépendante clé (score FDA total).
Pour les deux tests, le niveau de signification critique était de 5%.
Résultats: 80 patients atteints de maladie de Parkinson idiopathique, 44 hommes (âge
moyen=66±1,5) et 36 femmes (âge moyen=67,6±1,9), atteints de MPI depuis (durée) 11,9±1,1 ans
et 9,9±1,2 ans, respectivement, ont été considérés. Le score total au FDA-2 selon le genre était
de 40,4±4,3 et de 46,8±4,1 pour les hommes respectivement les femmes. Bien que les femmes
aient présenté une moins bonne performance oro-motrice que les hommes, cette différence
n’était pas statistiquement significative. Les résultats de l’analyse de régression multiple indiquent
que le modèle général est un modèle prédictif hautement significatif (p<0,001) du score total
au FDA expliquant 44% de sa variance (R élevé au carré=0,441). De plus, les valeurs t et p du
modèle montrent que seules les variables de la durée de MPI et de l’humeur sont des indicateurs
indépendants significatifs. Les coefficients de poids beta montrent que le meilleur indicateur dans
ce modèle est la durée de la maladie (495) suivie par l’humeur (0,246), l’ouïe (0,133), l’âge (0,117),
la dentition (0,110), la posture (0,067), la rétroaction orale sensorielle (0,063) et la vue (-0,078).
Conclusions: Les résultats de cette étude n’ont pas pu indiquer une différence statistiquement significative entre les femmes et les hommes atteints de MPI. L’indicateur combinant 8 variables est
un modèle hautement significatif expliquant pour 44% des cas la nature et le modèle des mouvements oro-moteurs de la MPI. Les données recueillies fourniront une information de référence
importante pour les orthophonistes/ logopèdes lors du diagnostic des troubles oro-moteurs chez
les patients MP.
Mots-clés: Maladie de Parkinson, modèle oro-moteur, facteurs influents
10.3
DYSPHAGIE ET DYSARTHRIE DANS UN SYNDROME DE
NEURONOPATHIE MOTRICE SENSORIELLE A DEBUT FACIAL : PRÉSENTATION D’UN CAS
Federica Bianchi - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Daniela Ginocchio - NeuroMuscular Omnicentre, Niguarda Cà Granda Hospital, Milan, Italy
Gabriele Mora - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Miriam Vedrodyova - IRCCS Salvatore Maugeri Foundation, Milan, Italy
Objectif: Observer l’impact de la Gastrostomie Percutanée Endoscopique (GPE) sur la progression de la dysarthrie et de la dysphagie chez un patient mal nourri atteint du syndrome de neuronopathie motrice sensorielle à début facial.
Méthodes: Un home âgé de 53 ans a fait l’objet d’une évaluation de la parole et de la déglutition avant et après l’insertion d’une sonde GPE. Une évaluation endoscopique à fibres optiques
avec des liquides et des semi-solides a été effectuée. La gravité de la dysphagie a été évaluée au
moyen l’Échelle à 8 Points d’Aspiration (Penetration Aspiration Scale - PAS) et l’échelle de gravité
fonctionnelle de la dysphagie (échelle DOSS). La présence et la gravité de la dysarthrie ont été
étudiées à l’aide du Profil d’évaluation de la dysarthrie de Robertson. Des questionnaires d’autoévaluation de la dysphagie et de la dysarthrie en relation avec la qualité de vie (Swal-QOL et QOLDyS) ont été remplis.
Résultats: Un an après l’insertion du GPE, l’indice de masse corporelle du patient est passé de
19,7 à 20,7. La sécurité de déglutition pour les semi-solides et les liquides séquentiels est restée
la même, alors qu’elle a augmenté pour un bol liquide isolé (PAS de 8 à 1).
53
Le Profil de Robertson a montré une dysarthrie légère pour les deux examens. Le sous-test de
force musculaire et du taux de diadococinésie a donné des valeurs plus élevées au dernier examen. Les résultats du QOL-DyS ont été plus mauvais pour les caractéristiques du langage et de
la parole ainsi que pour la perception de la réaction des autres. Les résultats du Swal-QOL plus
mauvais pour l’activité sociale mais meilleurs pour les symptômes.
Conclusion: Le dépistage de la dysphagie et de la malnutrition et l’insertion précoce de GPE
avec le maintien d’une nutrition hédonique ont eu des effets positifs sur l’état nutritionnel, sur
les symptômes de dysphagie et de dysarthrie et sur la relative qualité de vie après un suivi d’un
an. C’est pourquoi un traitement précoce de la pathologie du langage et de la parole devrait être
envisagé dans la pratique clinique ave les patients ayant un syndrome de neuronopathie motrice
sensorielle à début facial. Des études ultérieures sont nécessaires.
Mots-clés: Dysphagie, dysarthrie, troubles neurodégénératifs
10.4
LE RÔLE DE L’ORTHOPHONISTE/LOGOPÈDE INSPIRÉ DU « MODÈLE
DE SOINS DE LONGUE DURÉE » (CCM) DANS LA GESTION DES
PATIENTS PARKINSONIENS
Laura Fuschetto - Department of Neuroscience, Università di Siena, Siena, Italy
Santi Centorrino - Rehabilition Unit, Campostaggia Hospital USL 7 Siena, Siena, Italy
Objectif: Le système de santé a besoin de trouver des stratégies de gestion des maladies chroniques. Une réponse possible est le “modèle de soins de longue durée” (Chronic care model
CCM) basé sur une interaction entre le patient informé et l’équipe de professionnels. Nous voulons vérifier le rôle possible de l’orthophoniste/logopède dans une perspective de CCM applicable
au traitement des patients avec maladie de Parkinson.
Méthodes: R.P., une femme âgée de 66 ans, souffrant de la maladie de Parkinson diagnostiquée
il y a 8 ans, a reçu un traitement phono-articulatoire une fois par semaine pendant cinq semaines.
L’évaluation portait sur trois volets : la voix, l’articulation, la qualité de vie. Tests utilisés: échelle
GIRBAS, analyse électro-acoustique du signal vocal à l’aide du logiciel Praat, Voice Handicap
Index. Profil d’évaluation de la dysarthrie, échelle d’évaluation unifiée pour la maladie de Parkinson (UPDRS), Questionnaire pour la maladie de Parkinson. Au cours de ces séances, la patiente a
reçu des instructions pour des exercices à exécuter chez elle et des instructions imprimées avec
des exercices de transcription. Au bout de cinq semaines, un suivi hebdomadaire par téléphone
et un contrôle mensuel ont été effectués.
Résultats: Les changements paramétriques observés au cours du mois qui a suivi le traitement
étaient positifs ( défaillances vocales de 19 à 0, tremblement de 1,508% à 0,65%, miroitement
de 14,89% à 13,4%, NHR de 0.46% à 0,17% dB, HNR de 4,350 à 9,923) mais n’ont pas eu de
répercussions dans les mois suivants. L’impact psychologique des améliorations perçues par la
patiente a eu des retombées positives sur sa qualité de vie.
Conclusions: L’expérience a mis en évidence l’importance d’une forte alliance thérapeutique
entre le patient chronique et l’orthophoniste/logopède en vue d’une prolongation de la durée de
la prise en charge. La réaction de la patiente était positive et a permis une relation basée sur la
“collaboration active” en réduisant le risqué d’accoutumance à la thérapie. Les orthophonistes/
logopèdes peuvent jouer un rôle spécifique dans le CCM. Il serait utile de contrôler son impact
sur la maladie et sur la qualité de vie d’un plus grand nombre de patients.
Mots-clés: Pratique professionnelle
54
10.5
ENTRAINEMENT COGNITIF CENTRÉ SUR LES TÂCHES MOTRICES
POUR DES PATIENTS AYANT UNE CONSCIENCE ALTÉRÉE ET DES
TROUBLES DES FONCTIONS EXÉCUTIVES
Rossella Raggi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Emilia Bozzini - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Roberto Antenucci - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda
Maria Paola Gruppi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda
Carlotta Binelli - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Maria Teresa Pollini - CDD Villa Igea, Lodi, Italy
Barbara Olizzi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Cecilia Cardinali - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Paola Patroni - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Monica Orsi - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda (PC),
Piacenza, Italy
Domenico Nicolotti - Unita’ Spinale-Medicina Riabilitativa Intensiva, AUSL Piacenza-Ospedali Borgonovo Villanova Sull’arda
Objectif: Cette étude décrit un protocole d’entraînement pour la rééducation des fonctions exécutives, fondée sur l’approche de la formation en langage intériorisé. Elle a été réalisée par toute
l’équipe interdisciplinaire de rééducation, sous la direction et supervision d’un neuropsychologue.
L’intervention compensatoire consistait en une procédure d’auto-instruction demandant de lire
et verbaliser un plan de comportement avant et pendant l’exécution de la tâche d’entraînement ;
après quoi, les instructions ont été graduellement intériorisées. Les troubles des fonctions exécutives représentent des obstacles significatifs à une rémission fonctionnelle, car la faiblesse
du contrôle de soi, les troubles de la conscience et de la capacité de programmer empêchent la
sélection et le filtrage des étapes qui sont nécessaires pour apprendre de nouvelles stratégies.
Méthodes: Deux patients présentant une ischémie cérébrale en phase sub-aiguë ont participé.
Le protocole était centre sur le rappel de transfert et sur la sécurité dans la marche. Des cartes
préparées spécialement ont facilité l’auto-verbalisation graduelle des stratégies. Afin d’améliorer
la prise de conscience et l’autocontrôle, des cartes figuratives ont été préparées pour permettre
l’auto-évaluation avant et après l’exécution de l’entrainement en incluant le feedback du physiothérapeute. Un graphique spécifique de tendance protocolaire a été réalisé pour l’autocontrôle.
L’entrainement a duré 3 semaines à raison de 5 séances par semaine.
Résultats: Le protocole d’entrainement, centré sur les tâches motrices, a amélioré la prise de
conscience intellectuelle émergente et a permis la rémission des habiletés fonctionnelles.
Conclusions: Ce protocole d’entrainement pour la remédiation des fonctions exécutive basée sur
un entrainement de langage intériorisé permet aux patients d’améliorer leur performances dans
des tâches spécifiques qui ont été sélectionnées au préalable par l’équipe entière de réhabilitation
et adaptées par l’utilisation de cartes appropriées.
Mots-clés: Fonctions exécutives, approche du langage intériorisé, traitement interdisciplinaire
55
10.6
L’ÉVALUATION DE LA DYSARTHRIE DEVRAIT ÊTRE RÉALISÉE
UNIQUEMENT A TRAVERS DES ACTIVITÉS LANGAGIÈRES
Daria Protti - Centro Traumatologico Ortopedico Torino (CTO), Citta’ della Salute e della Scienza di Torino, Turin, Italy
Patrizia Cancialosi - Centro Traumatologico Ortopedico Torino (CTO), Citta’ della Salute e della Scienza di Torino, Turin, Italy
Objectif: Etudier les effets des activités non langagières ou motrices dans l’évaluation clinique de
la dysarthrie.
Selon la théorie dépendante de l’activité, le cerveau a un système sensori-moteur distinct pour
la production du langage. Du point de vue clinique cela implique que les patients dysarthriques
pourraient montrer un niveau différent de troubles dans les activités langagières et non langagières. C’est pourquoi l’évaluation de la dysarthrie ne devrait pas comprendre d’activités non
langagières, telle que les praxies orales et la diadococinésie articulatoire. Un essai clinique a été
mis en place pour évaluer si ce qui est affirmé dans la théorie dépendante des activités peut être
démontré de manière concrète chez les patients italiens dysarthriques.
Méthodes: Un groupe de 28 patients dysarthriques a été sélectionné (le test est encore en cours
et le groupe sera bientôt élargi), chaque patient a été évalué par le biais de deux protocoles: le
premier se compose seulement d’activités langagières, et le second d’activités langagières et
non langagières. La relation entre les deux valeurs obtenues dans les activités langagières et non
langagières a été analysée.
Résultats: Une différence importante du point de vue statistique a été trouvée entre les capacités
des patients dysarthriques dans la performance des activités langagières et non langagières oromotrices.
Conclusions: Les résultats semblent confirmer la théorie dépendante des activités: il existe un
système neural spécifique pour le contrôle de la production du langage; l’évaluation du langage
chez les dysarthriques devrait donc être réalisée uniquement au moyen d’activités langagières.
Mots-clés: Troubles du langage, dysarthrie
11.1
L’ÉVOLUTION DANS LA CONCEPTION QUE LES PARENTS SE FONT
DE LEUR RÔLE DANS LE DÉVELOPPEMENT DU LANGAGE DE LEUR
ENFANT: IMPLICATIONS SUR LA PRATIQUE ORTHOPHONIQUE
Karen Davies - NHS England, Manchester Metropolitan University, Manchester, United Kingdom
Contexte: L’objectif de cette étude est de montrer le changement dans la conception qu’ont les
intervenants, parents et orthophonistes de leur rôle dans la prise en charge orthophonique(I) mais
également mettre en évidence l’évolution longitudinale de l’implication des parents dans la prise
en charge orthophonique(II).
Méthode: Une étude a été conduite en deux phases utilisant différentes méthodes : des entrevues
semi-dirigées et des questionnaires auprès de 65 familles d’enfants d’âge préscolaire suivis en
orthophonie et 72 orthophonistes. Au départ, 15 parents et 12 orthophonistes ont participé à des
entrevues semi-dirigées afin de créer un questionnaire transversal. Un sous-groupe de 10 parents
a participé à une étude longitudinale sur une période de neuf mois afin de repérer des changements concernant la manière dont ils concevaient leur rôle dans la prise en charge. Les données
qualitatives ont été analysées au moyen d’une analyse par réseaux thématiques afin d’identifier
un thème initial puis une analyse du cadre logique afin de voir l’évolution des thèmes dans le
temps. Une analyse descriptive et de corrélation a été appliquée aux données du questionnaire.
56
Résultats: Ces données suggèrent que, avant la prise en charge orthophonique, les parents
n’avaient pas une conception claire de leur rôle en tant qu’acteur du développement langagier de
leur enfant et n’anticipaient pas cette fonction. Durant la rééducation, certains parents décrivent
un changement dans la vision qu’ils ont de leur rôle et s’impliquent dans la prise en charge. De
plus, dans certains cas, ils décrivent des changements significatifs dans leur idée de la parentalité
et suggèrent des modifications dans leur approche de l’éducation. L’idée que se font les orthophonistes de leur rôle est clairement celui d’expert, intervenant et négociateur mais leur conception du rôle des parents comme partenaires de la rééducation varie clairement. Les orthophonistes voient leur tâche d’intervenant de deux façons : soit en tant que “planificateur et soignant”,
doit comme “conseiller et guide”. Les orthophonistes adoptant ce dernier point de vue expriment
leur volonté d’impliquer les parents dans le développement langagier de leur enfant et de leur
donner de l’assurance dans leur rôle. Bien que les orthophonistes n’expriment pas clairement leur
volonté d’être des “éducateurs de parents”, en pratique, ils aident les parents à envisager autrement leur rôle de parents, ce qui est accueilli de manière positive par ces derniers. Conclusion:
Notre étude démontre que, contrairement à ce qui était considéré jusqu’à maintenant, les parents
sont susceptibles d’évoluer dans leur implication au cours de la prise en charge orthophonique.
Cette implication est importante car elle encourage l’orthophoniste à adopter un rôle de guidance
et d’encouragement afin d’améliorer la compréhension qu’ont les parents de leur rôle dans le
développement langagier de leur enfant. Ceci devrait encourager les orthophonistes à considérer
les parents comme des partenaires dans la rééducation orthophonique et à les inclure dans les
conceptions thérapeutiques.
Mots-clés: Rôle des parents, guidance parentale
11.2
PERCEPTION DES PARENTS ET DES ENSEIGNANTS A PROPOS DES
DIFFICULTÉS DE COMPORTEMENT DES ENFANTS PRÉSENTANT
DES TROUBLES DU LANGAGE
Maria Vlassopoulos - 1st Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Evdokia Lagakou - 1st Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Ioanna Tsipra - 1st Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Helen Lazaratou - 1st Department of Psychiatry, University of Athens School of Medicine, Athens, Greece
Objectif: Une recherche récente a démontré que les trouble du langage chez les enfants font
partie d’un ensemble plus global de troubles du développement neurologique, ce qui peut expliquer en partie pourquoi il y a une cooccurrence de ces troubles chez un même individu. L’objectif
de cette étude est d’étudier la façon dont les enseignants et les parents considèrent le comportement des enfants chez qui on a diagnostiqué des troubles du langage et s’il y a un accord sur la
perception des difficultés de comportements des enfants de ces groupes.
Méthodes: Les participants à l’étude étaient des parents et les enseignants de 272 enfants d’âge
préscolaire (d’une moyenne d’âge de 4,2 ans, SD 0,9) diagnostiqués comme présentant de
troubles du langage. Les parents ont été priés de remplir la liste de contrôle du comportement
de l’enfant (Achenbach, 1991), alors que 40 enseignants ont rempli en parallèle le formulaire de
rapport (C-TRF) pour un même échantillon de ces enfants.
Résultats: Les parents ont relevé des problèmes d’intériorisation (par ex. des problèmes d’attention, d’anxiété et de dépression) pour environ 24% de l’échantillon d’enfants ; des problèmes
d’extériorisation (par exemple, la réactivité émotionnelle et l’agression) pour 13%, et des problèmes des deux types pour 17,5%. Au contraire, les enseignants ont constaté que 20% avaient
des problèmes d’intériorisation et 29% avaient des problèmes d’extériorisation, avec 15% présentant l’ensemble de ces problèmes. Lorsque les enseignants ont comparé leurs résultats avec
ceux des parents, il a été démontré que les enseignants ont constaté beaucoup plus de
57
problèmes d’attention (<0,001) et de comportements agressifs (<0,001) que les parents.
Conclusions: Dans cette étude, les parents rapportent une incidence plus élevée des difficultés
de comportement chez les enfants atteints de troubles du langage. Des écarts ont cependant été
constatés entre le compte-rendu des parents et des enseignants. Cette divergence d’avis peut
être justifiée par les différents milieux (foyer / école), où par des facteurs tels que la frustration de
l’enfant pour la communication et le besoin d’attention plus individuelle qui peuvent mener à un
comportement plus agressif ou augmenter les difficultés relatives aux tâches. L’importance des
sources multiples de collecte de données afin d’évaluer le fonctionnement de l’enfant dans des
contextes divers a été mis en évidence. En outre, cette étude souligne les pourcentages élevés de
problèmes de comportement concomitants (50%) déclarés aussi bien par les enseignants que par
les parents d’enfants atteints de troubles du langage, malgré le désaccord sur leur types.
Mots-clés: trouble du langage; enfants; difficultés de comportement; parents, rapports des enseignants
11.3
INDICATIONS SUR L’ADHÉRENCE PARENTALE AUX ACTIVITÉS
PROPOSÉES PAR LES ORTHOPHONISTES POUR LES EXERCICES A
DOMICILE
Dorthe Hansen - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Catherine E. Brouwer - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Objectif: Cette étude contribue mieux comprendre les méthodes d’explications utilisées par les
orthophonistes (SLT) et comment celles-ci fourniraient le moyen d’établir de façon interactive un
consensus avec les parents d‘enfants présentant des Troubles du Développement du Langage
(TDL), pour l’élaboration du plans de traitement.
Méthodes: La recherche comporte des enregistrements vidéo de 5 rencontres, durant lesquels les
parents recevaient des instructions des orthophonistes pour des activités langagières à effectuer
à domicile avec leur enfant.
Utilisant une méthodologie ethno-méthodologique d’analyse conversationnelle, les intéraction ont
été transcrites et analysées en détail.
Résultats: L’analyse démontre que des indications d’adhérence parentale sont repérables dans
les entretiens eux-mêmes. La méthode d’instruction elle-même va influencer dans quelle mesure
ces indices sont explicites ou implicites: dans les cas où les parents reçoivent une série de directives, celles-ci n’a pas d’influence de façon séquentielle sur le traitement effectif. Ici, les indications de convergence sont implicites, faibles ou absentes. Au contraire, lorsque les parents sont
invités à réagir au cours de la séquence d’instruction, une occasion séquentielle leur est explicitement fournie, leur permettant de consentir explicitement, et démontrant ainsi une meilleure
acceptation du plan thérapeutique.
Conclusions: Lorsqu’ils sont invités à réagir et à contribuer aux propositions des orthophonistes
pour des activités langagières à effectuer à domicile, les parents d’enfants avec TDL fournissent
des indices à propos leur future adhérence. Ces informations constituent une base pour évaluer le
besoin de réajustement du plan de traitement.
Mots-clés: Troubles du développement du langage, adhérence, analyse conversationnelle
58
11.4
LE PROGRAMME PSYCHO-ÉDUCATIF PARENTAL POUR LE DÉVELOPPEMENT DE LA COMMUNICATION DES ENFANTS
PRÉSCOLARISÉS ATTEINTS DE TROUBLES DU LANGAGE
Paraskevi Meravoglou - Psychiatric clinic, Medical school, National and Kapodistrian University of Athens, Athens, Greece
Evdokia Lagakou - Psychiatric clinic, Medical school, National and Kapodistrian University of Athens, Athens, Greece
Maria Vlassopoulos - Psychiatric clinic, Medical school, National and Kapodistrian University of Athens, Athens, Greece
Un programme psycho-éducatif structuré, adressé aux parents d’enfants d’âge préscolaire, de 2
à 4 ans et atteints de retard ou de troubles du langage, est présenté. Il s’agit d’un programme pilote mené par la première Unité Psychiatrique de l’Université d’Athènes en Grèce. Le programme
est basé sur les principes du Parent Hanen Program “deux personnes sont nécessaires à une
conversation”. Cependant, certaines modifications étaient essentielles pour adapter les besoins
des parents dans la communauté grecque.
Objectif: Le programme spécifique est basé sur le postulat qu’il est recommandé de fournir
des services indirects aux enfants d’âge préscolaire atteints de troubles du langage, mobilisant
l’engagement des parents dans un groupe psycho-éducatif. Dans un cadre préventif et centré sur
l’enfant, les buts principaux du programme sont d’éduquer les parents à mieux comprendre le
développement du langage et les facteurs l’influençant, de les encourager à appliquer des stratégies pour aider leurs enfants à développer les compétences communicatives dans les situations
de la vie quotidienne et de soutenir les parents en leur donnant la chance de partager leurs idées
et leurs préoccupations avec d’autres parents dans la même situation.
Méthodes: Le programme est mené conjointement par un psychologue de l’école et un orthophoniste/logopède. Les critères de sélection, le processus d’évaluation, les contenus des séances et
les données d’évaluation qualitatives du programme d’évaluation sont présentés. Des adaptations
spécifiques culturelles au Program Hanen seront aussi exposées.
Résultats: Les compte rendus parentaux soulignent l’amélioration des leurs compétences à se
rapporter à leurs enfants d’âge préscolaireet à communiquer avec eux, menant à des résultats
positifs en ce qui concerne l’expression verbale et l’intention communicative des enfants. De
plus, des résultats positifs sur la routine familiale ont aussi été constatés.
Conclusions: Une évaluation qualitative préliminaire de ce programme était cohérente avec la
recherche internationale dans le domaine de la prise en charge indirecte. Nous avons noté que
les modifications apportées au program Hanen original étaient nécessaires pour son application
dans la communauté grecque.
Mots-clés: programme psycho-éducatif parental, troubles développementaux du langage, enfants
préscolarisés, prévention
59
11.5
FONCTIONNEMENT DES PROCESSUS DE RÉITÉRATION DANS DES
INTERACTIONS ADOLESCENT-ORTHOPHONISTE/LOGOPÈDE
Gwendoline Fox - Institut des Sciences du Langage et de la Communication, Chaire de Logopédie, Université de Neuchâtel,
Audrey Sublon - Institut des Sciences du Langage et de la Communication, Chaire de Logopédie, Université de Neuchâtel,
Geneviève de Weck - Institut des Sciences du Langage et de la Communication, Chaire de Logopédie, Université de
Neuchâtel, Neuchâtel, Switzerland
Objectif: De nombreuses études ont montré le rôle important joué par la réitération (reformulation,
répétition...) dans l’acquisition du langage. Toutefois, la plupart d’entre elles se concentrent sur
l’acquisition chez les jeunes enfants et il existe peu de travaux sur la réitération chez les adolescents, notamment avec des troubles du langage. Aussi est-il difficile d’avoir une vue d’ensemble
de comment elle peut aider les jeunes locuteurs à devenir « pleinement experts ». La réitération
est aussi perçue comme un feedback de l’adulte pour aider les enfants ; les études portent donc
habituellement sur la répétition par l’adulte du langage de l’enfant et éventuellement aussi la réaction de l’enfant à cette répétition.
A l’aide d’un corpus de dyades adolescents et orthophonistes/logopèdes, nous proposons une
classification de tous les types de répétitions observables destinée à constituer une méthode qui
inclut les formes de répétition les plus variées applicables à des interactions avec des enfants ou
des adolescents et qui permet de mieux comprendre le fonctionnement et le rôle des processus
d’interaction qui sont en jeu durant les séances d’orthophonie/logopédie.
Méthodes: Nous étudions les répétitions trouvées dans 3 dyades en interaction (adolescents
âgés de 12 à 16 ans) au cours du traitement et nous les classons selon des critères tels que
l’auteur de la répétition, l’auto-réitération par rapport à l’hétéro-réitération, pendant et en dehors
de leur tour de parole, caractères formels.
Résultats: Les résultats montrent, entre autre, que les orthophonistes/logopèdes se servent
significativement plus de la réitération (38%), mais que celle-ci est également considérable dans
les données des adolescents (25%). De plus, on peut distinguer 2 principaux types de répétition
ayant des buts différents: 45% sont utilisées par le locuteur pour formuler son propre discours
dans son tour de parole et 55% apparaissent en dehors de leur tour de parole et servent à coconstruire le dialogue. Enfin, l’auto-réitération est très présente (66% en tout), même en dehors
des tours de parole(37%).
Conclusions: Ces résultats nous indiquent que la réitération présente de multiples facettes et
contribue à l’acquisition du langage du jeune locuteur par des autres voies que celle d’un simple
dispositif de soutien.
Mots-clés: Troubles du développement du langage, orthophonie/logopédie, adolescents, interaction, processus de réitération
60
11.6
LA PRODUCTION DE LA PAROLE CHEZ LES ENFANTS ENTRE 13 ET
22 MOIS ET SA RELATION AVEC LES VARIABLES
SOCIO-ECONOMIQUES, OBSTÉTRIQUES ET PSYCHOSOCIALES
Ana Paula Ramos Souza - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Anelise Henrich Crestani - Programas de Pós-Graduação em Distúrbios da Comunicação Humana e Psicologia,
Objectif: Analyser la relation entre le vocabulaire des enfants âgés de 13 à 22 mois et les variables socio-économiques, obstétriques et psychosociales.
Méthodes: L’échantillon était constitué de 46 dyades mère-enfant. Les données ont été recueillies
lors d’un entretien analysant les variables socio-économiques et obstétriques par le biais d’un
Inventaire d’Anxiété et de Dépression pour établir l’état moral de la mère. Le développement du
vocabulaire à travers les souvenirs spontanés des mères et par l’observation du comportement
de l’enfant a été évalué chez les enfants âgés de 13 à 16 mois.
Entre 17 et 22 mois, une liste de contrôle a été utilisée pour évaluer l’étendue du vocabulaire dans
diverses catégories.
Résultats: Le vocabulaire le plus important, présenté aussi bien dans le nombre total de mots que
dans l’acquisition du vocabulaire entre le premier et le deuxième groupe d’âge évalué, était lié
au fait que la mère avait une activité (p = 0.002) entre 17 et 22 mois, et était associé à un niveau
d’éducation maternelle supérieur entre 13 et 16 mois (p = 0.029).
Conclusions: Le niveau d’éducation de la mère et le fait que la mère de l’enfant ait une activité
peuvent être considérés comme des facteurs de protection et peuvent être favorables à l’acquisition du langage chez l’enfant
12.1
SÉRIE DE MESURES D’OBSERVATION POUR ÉVALUER LE SOUTIEN
ET LA PARTICIPATION A LA CONVERSATION : VALIDATION
ITALIENNE
Marta Rinaudo - Universita’ degli Studi di Torino, Turin, Italy
Giulia Rabino - Universita’ degli Studi di Torino, Turin, Italy
Ermelinda Massari - Universita’ degli Studi di Torino, Turin, Italy
Laura Bergamasco - Universita’ degli Studi di Torino, Turin, Italy
Patrizia Steni - Department of Rehabilitation, ASL TO 1 / Universita’ degli Studi di Torino, Turin, Italy
Rossella Muò - Department of Rehabilitation, ASL TO 1 / Universita’ degli Studi di Torino, Turin, Italy
Objectif: Lors d’une conversation avec des sujets aphasiques, les interlocuteurs jouent un rôle
essentiel et soutiennent la communication en offrant des “passerelles de communication”. Les
échelles de mesure MSC (Measure of supported Conversation for Adults with Aphasia) et MPC
(Measure of Participation in Conversation for Adults with Aphasia ont évalué les capacités de
communication de la dyade aphasique-interlocuteur. Les échelles MPC n’ont pas encore été
traduites et validées pour la langue italienne. Le but de cette étude est de valider une version Italienne des échelles MSC-MPC.
Méthodes: La traduction des échelles MSC-MPC a suivi le processus de retraduction. 16 patients
aphasiques non fluents ont été filmés lors d’une conversation avec des interlocuteurs formés et
61
non formés; un examinateur expérimenté et deux non expérimentés ont évalué séparément 32
vidéos. La fiabilité inter- et intra-examinateur a été calculée par le biais du test ICC (Coefficient de
corrélation interne) et de Spearman (coefficient de corrélation entre 2 variables). Des corrélations
avec le Protocol Pragmatique, I-ASHA-FACS (Functional Assessment Communication Skills), et
avec la gravité de l’aphasie ont aussi été calculées par le biais de tests de Spearman et de Pearson.
Résultats: Les corrélations de fiabilité inter-examinateur étaient élevées/très élevées (ICC>.66);
une différence entre les examinateur experts et non experts a été mise en évidence. La fiabilité
intra- examinateur était très élevée (ρs>.90). La version italienne de l’échelle MSC-MPC a montré
des corrélations très importantes avec la sévérité de l’aphasie (ρs>.65), la communication fonctionnelle (ρs>.75) et les compétences pragmatiques (ρp>.80); les corrélations avec les performances linguistiques étaient plus faibles (ρs>.30).
Conclusions: Les échelles MSC-MPC sont des outils valables et fiables. La sensibilité liée à
l’expérience de l’évaluateur peut être soulignée. L’utilisation des échelles MSC-MPC est recommandée pour tenir compte aussi des capacités des interlocuteurs à soutenir et faciliter la conversation avec un patient aphasique.
Mots-clés: aphasie
12.2
DÉVELOPPEMENT DE «L’ÉCHELLE POUR LA QUALITE DE VIE
APRÉS AVC ET APHASIE» HOLLANDAISE
Lizet van Ewijk - Department of Speech and Language Therapy, Utrecht University of Applied Sciences, Utrecht, Netherlands
Lotte Versteegde - Department of Speech and Language Therapy, Utrecht University of Applied Sciences, Utrecht, Netherlands
Evelijn Raven-Takken - Department of Speech and Language Therapy, Utrecht University of Applied Sciences, Utrecht, Netherlands
Ellen Gerrits - Centre for Innovation in Healthcare, Research group Speech and Language Therapy, Utrecht University of Applied
Sciences, Utrecht, Netherlands
Objectif: Développer une échelle valable et fiable d’évaluation de la qualité de vie en lien avec
la santé (HQOL = Health Related Quality of Life) pour les sujets aphasiques hollandais, l’échelle
SAQoL-39NL (Stroke and Aphasia Quality of Life Scale)
Méthodes: L’échelle anglaise SAQoL-39g (Hilari et al., 2009) a été traduite en hollandais selon les
lignes directrices du processus d’adaptation interculturel des mesures auto-reportées décrites par
Beaton et al. (2000). Les propriétés psychométriques (acceptabilité, cohérence interne, fiabilité de
test-retest, validité de la structure) ont été évaluées (n=50 sujets aphasiques chroniques).
Résultats: De manière générale, les résultats ont montré que l’échelle SAQoL-39NL est une
échelle acceptable, valable et fiable pour mesurer la qualité de vie en lien avec la santé (HRQL)
dans les aphasies chroniques. La cohérence interne (alpha de Cronbach = 0,89) et la validité
(corrélation moyenne entre les domaines) ont été considérés comme acceptables. La fiabilité de
test-retest était excellente (ICC=0,93). De plus, les résultats étaient très similaires à ceux obtenus
au test originel SAQoL-39g.
Conclusions: L’échelle hollandaise SAQoL-39NL s’est révélée être un outil fiable, valable et
acceptable pour mesurer la qualité de vie en lien avec la santé (HQOL) chez les sujets aphasiques
chroniques. Elle peut être utilisée aux Pays-Bas par des cliniciens et des chercheurs pour évaluer
la qualité de vie en lien avec la santé dans la prise en charge et l’évaluation des pratiques, le suivi
clinique et de priorisation du traitement des sujets aphasiques suite à un AVC. De plus, puisque
l’échelle SAQoL-39g a été utilisée pour la traduction, elle permet une comparaison internationale
des services et des patients.
Mots-clés: aphasie
62
12.3
UNE ÉTUDE DE STANDARDISATION DE LA VERSION ITALIENNE DU
FRENCHAY APHASIA SCREENING TEST (FAST) POUR DES PATIENTS
APHASIQUES ET DES SUJETS CONTRÔLE
Jessica Bonelli - Department of Neuroscience, University of Siena, Siena, Italy
Santi Centorrino - Rehabilitation Unit, Usl 7, Siena, Italy
Fabio Ferretti - University of Siena, A.O.U.S Le Scotte, Siena, Italy
Giovanna Carlucci - Stroke Unit, A.O.U Careggi, Firenze, Italy
Objectif: le FAST (Frenchay Aphasia Screening Test) semble être l’outil le plus largement utilisé
et soigneusement évalué de la littérature de recherche sur les AVC. Le but de cette étude est de
développer une version italienne (I-FAST) du Frenchay Aphasia Screening Test et de tester sa
fiabilité et sa validité.
Méthodes: le “River Scene” du panel de stimuli dans la version originale du FAST a été adapté
pour le I-FAST. La structure du test et des domaines du langage (la compréhension, l’expression,
la lecture et l’écriture) est restée inchangé. Nous avons standardisé I-FAST pour 186 adultes
italiens normaux non-aphasiques (MA 52.37, SD 19.877) et 102 patients aphasiques italiens (MA
70.10, SD 13.105). LE diagnostic d’aphasie a été posé suite à des examens cliniques standards
orthophonique et neurologique. Nous avons analysé la cohérence interne de I-FAST, la fiabilité
intra/inter évaluatrice et la validité de I-FAST. Les valeurs seuils de I-FAST ont été établies avec la
courbe Roc (receiver operating characteristics).
Résultats: Dans le modèle de Rasch, le MEAN INFIT (MNSQ) était de 1,00/(ZSTD) 0,1 pour la validité des sujets testés (normaux et aphasiques) ; pour la validité de I-FAST, le MEAN INFIT (MNSQ)
était de 0.96/(ZSTD) -0,3. La fiabilité des sujets de 0,84; la fiabilité d’I-FAST était de 0,98. Le α de
Cronbach 0,931. Les coupures de I-FAST établis avec la courbe de Roc sont de 24 points pour la
version complète et 16 points pour la version réduite (I-FAST-R).
Conclusions: L’analyse suggère l’utilité de I-FAST comme un outil de dépistage fiable et valide
pour la détection de l’aphasie et le suivi de ses progrès des sujets italiens.
Mots-clefs: Aphasie
12.4
LA PERCEPTION DES AVANTAGES ET DES OBSTACLES A LA
TECHNOLOGIE MOBILE DANS LA RÉÉDUCATION DES ADULTES
PRÉSENTANT UN TROUBLE DE LA COMMUNICATION NEUROGENE
ACQUIS: UNE ÉTUDE QUALITATIVE AUPRÈS DES
ORTHOPHONISTES FLAMANDS
Katrien Colman
- Department of Speech-Language Therapy & Audiology, Thomas More University College, Antwerp, Belgium
Objectifs: Les smartphones et les tablettes offrent une plateforme unique pour soutenir les sujets
souffrant de troubles de la communication neurogènes acquis. Cette étude explore les obstacles
rencontrés et les avantages liés à l’utilisation des technologies mobiles au sein d’un groupe d’orthophonistes flamands pour mieux comprendre les avancées nécessaires de ces technologies.
Résultats: Les résultats ont montré que les orthophonistes ont comparé la technologie mobile
aux dispositifs technologiques d’ancienne génération pour décrire les avantages de la première
catégorie: portabilité, stockage de stimulus compacts, matériel visuellement attrayant prêt à
l’usage et déclencheur de discours. Le groupe a décrit la technologie mobile comme un moyen
63
d’augmenter l’indépendance et la participation à la vie sociale. L’utilisation de la technologie
mobile dans le traitement peut être appliquée à la vie de tous les jours et peut aider le patient à
mener ses activités quotidiennes. Les troubles cognitifs et la peur d’utiliser la technologie sont
considérés comme les obstacles majeurs. Les participants ont souligné que la technologie mobile
ne pourra jamais remplacer l’orthophoniste en tant que personne.
Conclusions: La prochaine recherche devra confirmer ces résultats sur un échantillon plus important d’orthophonistes. Les patients devront aussi être inclus dans un groupe à part. La discussion
sera illustrée par des applications qui peuvent être utilisées pour l’entraînement clinique et comme
support à la communication dans la vie quotidienne des adultes souffrant de trouble de la communication neurogène acquis.
Mots-clés: technologie mobile, applications, obstacles, troubles du langage et de la parole
nèuogeniques acquis
12.5
ENTRAINEMENT A L’ORIENTATION VISUO-SPATIALE DANS LA
RÉÉDUCATION DE LA NÉGLIGENCE: COMPTE-RENDU DE CAS
Cecilia Cardinali - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Emilia Bozzini - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Barbara Olizzi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Monica Orsi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Paola Patroni - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Rossella Raggi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Maria Paola Gruppi - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Carlotta Binneli - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Roberto Antenucci - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Domenico Nicolotti - Unita’ Spinale , AUSL Piacenza - Ospedali Borgonovo V.T. e Villanova Sull’arda (PC), Piacenza, Italy
Objectif: La Négligence Spatiale Unilatérale (NSU) est définie comme l’incapacité à « détecter,
s’orienter vers, ou répondre à des stimuli porteurs de signification lorsqu’ils sont présentés dans
l’hémi-espace contra-lésionnel du cerveau”. C’est un fort signe annonciateur d’un mauvais rétablissement chez les patients ayant eu un AVC. L’entrainement à l’orientation visuo-spatiale est
une technique utilisée dans la rééducation de la NSU. Des chercheurs ont obtenu de bons résultats sur un certain nombre d’exercices, en variant les matériaux et les activités. Le but de cette
étude est d’analyser la généralisation réelle des effets de l’entrainement sur la reprise fonctionnelle du patient dans une série de cas simples de négligence.
Méthodes: La NSU a été évaluée auprès de 5 patients par les tests suivants: le barrage de lignes,
la tâche d’annulation de lettre-symboles, la copie de formes géométriques, les batteries progressives de Raven, test de l’horloge, et BREF (la batterie rapide d’efficience frontale). L’index Barthel
(mesure des performances d’activité quotidiennes), l’échelle d’activités de la vie quotidienne,
l’échelle d’activité instrumentale de la vie quotidienne, et l’échelle C. Bergego (évaluation fonctionnelle de l’héminégligence dans la vie quotidienne) ont été administrés pour évaluer les compétences dans la vie quotidienne. Le programme d’entrainement a duré 6 semaines à raison de
5 séances par semaine; l’approche descendante a été utilisée pour la rééducation. Les patients
ont été soumis au même bilan neuropsychologique six mois après la fin du traitement.
Résultats: Tous les patients ont montré une amélioration des performances dans les activités
d’orientation visuo-spatiale et dans des milieux écologiques. L’évaluation de suivi a montré que la
reprise restait constante.
Conclusions: L’entrainement à l’orientation visuo-spatiale est une méthode efficace pour le traitement de la négligence et des effets généralisés, et pour améliorer les compétences des patients
dans la vie quotidienne. La reprise fonctionnelle est restée stable après la fin du traitement.
Mots-clés: négligence, rééducation neuropsychologique, entrainement à l’orientation visuo-spatiale
64
12.6
LE PTECCA : UN BILAN D’ÉVALUATION ECOSYSTÉMIQUE DE
L’ APHASIE
Aurélie Iché - Cabinet d’orthophonie libéral 11 rue Eugène Lozes 31500, Paul Sabatier Toulouse III, Toulouse, France
Christophe Rives - Cabinet d’orthophonie libéral 11 rue Eugène Lozes 31500, Paul Sabatier Toulouse III, Toulouse, France
Les restrictions de communication générées par les déficits langagiers pénalisent la personne
aphasique au quotidien. La mouvance des approches fonctionnelles de l’aphasie et notamment
les approches écosystémiques, permettent d’appréhender le handicap partagé en associant
l’entourage à l’évaluation et à la prise en charge orthophoniques, pour former les partenaires de
communication à une communication efficace, adaptée aux déficits langagiers.
Le PTECCA a été élaboré pour s’inscrire dans cette approche écosystémique. Il permet en effet
de repérer simultanément les comportements des deux interlocuteurs pour leur proposer des
ajustements adaptés à leur profil de communication et aux symptômes aphasiques. Il se compose d’une grille d’observation globale et d’un ensemble d’épreuves écologiques créées pour
mettre les deux interlocuteurs en interaction. Des essais de thérapie écosystémiques, orientés par
les résultats obtenus au PTECCA ont aussi été menés.
L’élaboration du PTECCA s’est faite en plusieurs temps et avec différentes équipes. Des modifications basées sur les résultats des expérimentations ont concerné les épreuves, les méthodes
de cotation ainsi que la grille. De plus, des études parallèles ont permis de valider l’intérêt de cet
outil.
Au cours de la passation, l’orthophoniste n’est qu’observateur et remplit en temps réel la grille
d’analyse conversationnelle qualitative qui évalue simultanément les comportements de communication des deux partenaires. La passation est filmée. Les résultats sont visualisés sur un diagramme en étoile.
Le PTECCA s’inscrit dans une démarche « bilan » qui ne se réfère pas à une norme mais qui évalue qualitativement les aspects de la communication propres à chaque couple observé.
Les expérimentations menées nous montrent la pertinence de ce dispositif d’analyse et la possibilité de développer des thérapies écosystémiques à partir des profils qu’il permet d’obtenir et de
réduire ainsi l’impact du handicap partagé de communication entre la personne aphasique et son
entourage.
Mots-clés: Aphasie, approche écosystémique, evaluation fonctionnelle, handicap communicationnel, réadaptation
13.1
LES TROUBLES DU PROCESSUS AUDITIF (TPA): UN TROUBLE
CLINIQUE SPÉCIFIQUE OU NON?
Ellen de Wit
- Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences Groningen,
Objectif: Les enfants suspectés être atteints de troubles du processus auditif (TPA) peuvent rencontrer des difficultés auditives en présence de bruits de fond, malgré des seuil auditifs normaux.
Pour les chercheurs et les cliniciens, il n’est pas certain que les TPA puissent être considérés
comme des troubles uni- ou plurimodaux. L’objectif de cette étude est de mettre en évidence les
caractéristiques associées aux TPA et de déterminer si les TPA peuvent être considérés comme
des troubles cliniques.
Méthodes: Dans cet analyse systématique, six bases des données électroniques ont été analysées par des experts en utilisant les mots-clés processus auditif, troubles auditifs, perception
65
centrale et auditive. Deux examinateurs indépendants, ont évalué d’importantes études selon les
critères d’inclusion et ont évalué la qualité méthodologique de ces études en utilisant le canevas
d’évaluation du niveau de preuves de l’ASHA (« levels-of-evidence scheme »)
Résultats: Au total, 3078 énoncés ont été filtrées par titre et 502 études par extraits. 41 études
ont respecté le critère d’inclusion duquel trois étaient exclues à cause d’une faible validité interne.
Enfin, sur 38 études ont été inclues, et seulement une a été classifiée comme étude d’une grande
qualité méthodologique. Des différences entre les enfants avec TPA (suspectés) et les enfants à
développement typique (DT) ont été trouvées dans les fonctions cognitives, de communication,
du langage, de la lecture et des mesures auditives cérébrales, comme le potentiel auditif lié à un
évènement (Event-related-Potential) et les oto-émissions acoustiques.
Conclusions: Aucune preuve ne permettant de conclure que les TPA peuvent être considérés
comme un trouble clinique unique et identifiable n’ont été trouvés. Les caractéristiques des
enfants avec TPA (suspectés) ne sont pas propres à la modalité auditive. Les difficultés auditives
seraient la conséquence de troubles cognitifs, du langage ou de l’attention, plutôt que des problèmes auditifs de base.
Mots-clés: Troubles Spécifique du Langage, Troubles du langage développemental, troubles
cognitifs, troubles psychiatriques, troubles auditifs
13.2
MÉMOIRE DE TRAVAIL VERBALE ET COMPRÉHENSION DU
LANGAGE CHEZ LES ENFANTS SOURDS, AVEC TSL (TROUBLE
SPÉCIFIQUE DU LANGAGE) ET ENFANTS EDT (ENFANTS AVEC
DÉVELOPPEMENT TYPIQUE)
Annette Esbensen - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Pia Thomsen - Department of Language and Communication, University of Southern Denmark, Odense, Denmark
Objectif: Une recherche sur des enfants danois de 7 à 12 ans, avec perte auditive (PA) (20-70 dB
bilatéral neurosensorielle), enfants avec TSL et enfants tout venants (EDT) pour mieux comprendre
la relation entre la mémoire de travail verbale (MtV) et la compréhension du langage.
Méthodes: Expérimentale: 83 participants (19 enfants avec PA, 28 avec TSL et 36 EDT) ont participé à deux tâches de mémoire de travail verbale (un empan inverse, une version danoise du
CLPT - Competing Language Processing Task – tâche de rappel d’item en présence d’une tâche
langagière - , ainsi qu’une tâche de compréhension du langage (le Trog2).
Résultats: Les chiffres et les phrases pour l’empan inverse et le CLPT ont été préenregistrés en
cabine insonorisée, et présentés aux enfants, dans la situation de test, au moyen de MP3 avec
enceintes sonores. Les phrases du Trog2 n’avaient pas été préenregistrées. La tâche d’empan
inverse contient 8 blocks, cotés en termes de performance à l’empan et de temps de rappel. La
version Danoise du CLPT contient 6 blocks, au total 42 phrases. Les résultats ont été cotés en
termes d’empan, du temps de rappel, du nombre de bonnes réponses avec valeur sémantique et
du nombre de bonnes réponses de mémorisation (que les enfants aient ou non rappelé le dernier
mot de chacune des phrases).
Conclusions: Cette étude est la seule à notre connaissance effectuée au Danemark qui traite des
liens entre la cognition (capacités en MtV) et le langage (compréhension) chez des enfants sourds
et les enfants TSL. Cette étude apporte une contribution à notre objectif, qui est de créer de meilleures évaluations des domaines langagiers dans lesquels la cognition est largement impliquée,
ainsi que des interventions améliorées pour les enfants sourds danois avec TSL.
Mots-clés: atteinte auditive, compréhension du langage, mémoire de travail verbale, TSL, empan
en mémoire verbale, cognition
66
13.3
FAVORISER UNE APPROCHE AXÉE SUR L’ENFANT POUR LES
TRAITEMENTS LIÉS A L’ORTHOPHONIE/LOGOPÉDIE CHEZ LES
ENFANTS AVEC IMPLANTS COCHLÉAIRES
Areti Okalidou - University of Macedonia, Greece
Une fois implantés, les enfants porteurs d’implants cochléaires, parviennent à accéder aux interactions spécifiques du langage et à en apprendre le fonctionnement par le biais d’un apprentissage fortuit ou officiel. Les objectifs de la thérapie sont dynamiques et se focalisent sur le
développement de tous les facteurs du langage simultanément: phonologie, sémantique, morphosyntaxe et pragmatique, en les intégrant à l’intérieur d’un ensemble cohérent.
Cet article analyse les avantages d’une approche axée sur l’enfant pour les jeunes sujets d’âge
préscolaire, en utilisant un langage holistique et des techniques hybrides pour la stimulation du
langage dans des contextes naturalistes. Cela permet d’illustrer les étapes thérapeutiques de
l’approche axée sur l’enfant en orthophonie/logopédie, en montrant le fonctionnement des techniques permettant de fournir une stimulation holistique du langage et une stimulation indirecte par
des rôles de facilitation. Enfin cela permet de discuter des résultats par le biais d’une vidéo. De
plus, l’approche hybride a été mise en place par le biais de dialogues enfant-orthophoniste/logopède dans des contextes de jeux induits, utilisant des techniques comme la stimulation focalisée,
les trilles, les commandes auditives sont mélangées dans un jeu de rôle conversationnel pour
obtenir des objectifs thérapeutiques spécifiques. Les conclusions soulignent les avantages de
cette approche pour les enfants porteurs implants cochléaires.
13.4
DÉVELOPPEMENT DES HABILETÉS SOCIALES DE CONVERSATION
CHEZ DES ENFANTS IMPLANTÉS À UN ÂGE PRÉCOCE
Letizia Guerzoni - Department of Otolaryngology, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
A. Murri, D. Cuda - Department of Otolaryngology, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
Objectif: Le but de cette étude est: (1) d’étudier l’effet de l’âge d’activation d’un implant cochléaire (IC) sur le développement des habiletés sociales de conversation chez des enfants
implantés avant l’âge de deux ans. (2) d’examiner le rôle de l’âge auquel la surdité a été diagnostiquée et du niveau d’éducation maternel sur les habiletés sociales de conversation.
Méthodes: 22 enfants sourds ayant reçu un implant cochléaire avant l’âge de 24 mois (âge
moyen: 11,7 mois; SD +/-2,5) ont été inclus dans cette étude. La version italienne de l’échelle
d’évaluation des habiletés sociales de conversation a été utilisée. Le questionnaire a été rempli 12
mois après l’activation de l’implant. Les scores ont été calculés en corrélation avec l’âge d’activation de l’implant, l’âge auquel a été diagnostiquée la surdité et le niveau d’éducation de la mère.
Les données des enfants implantés ont été comparées aux données de la version italienne de
l’échelle d’évaluation des habiletés sociales de conversation (ASCB). Pour effectuer cette comparaison, les scores de chaque enfant ont été transformés en scores Z basés sur le score moyen et
sur la déviation standard des données normatives pour l’âge de l’enfant en nombre de mois.
Résultats: Les scores des habiletés sociales de conversation ont été corrélés avec l’âge chronologique au moment de l’activation de l’implant cochléaire et avec 12 mois d’utilisation de
l’implant. Le niveau d’éducation de la mère n’a pas montré ud’effet positif significatif sur le développement des habiletés sociales de conversation.
Conclusions: Effectuer des implants chez des enfants de moins de deux ans avec un déficit
67
auditif grave peut offrir une bonne possibilité de développer des habiletés pragmatiques semblables à celles de leurs pairs ayant une audition normale.
13.5
L’UTILISATION DE LA MÉTHODE VERBO-TONALE DANS
L’EXPRESSION CRÉATIVE AU COURS DU PROCESSUS DE
RÉÉDUCATION
Adinda Dulcic - SUVAG, Polyclinic, Zagreb, Croatia
Koraljka Bakota - SUVAG, Polyclinic, Zagreb, Croatia
Katarina Pavicic Dokoza - SUVAG, Polyclinic, Zagreb, Croatia
La méthode verbo-tonale intègre des éléments importants pour stimuler la créativité chez les enfants ayant un trouble auditifs et un trouble du langage. De cette manière, elle améliore en même
temps les compétences cognitives, psychologiques/émotionnelles, langagières, tactiles, visuelles
et sensorielles. Pour stimuler la créativité, il est particulièrement important que les enfants ayants
des difficultés développent une attitude positive envers eux mêmes; la difficulté n’est plus au
premier plan et l’enfant développe ses compétences créatives. Dans la Policlinique “SUVAG” à
Zagreb utilise la méthode verbo-tonale avec ses procédures, au cours du processus de rééducation des enfants présentant des troubles auditifs et langagiers, et encourage les enfants à utiliser
tout leur potentiel sensoriel pour construire la meilleure communication possible et à développer
tout leur potentiel créatif. Dans cet article les progrès réalisés par les enfants présentant des
troubles auditifs et/ou langagiers rééduqués par l’approche de la méthode verbo-tonale dans
leurs expressions créatives seront démontrés.
L’objectif de l’approche éducative et rééducative verbo-tonale est de stimuler la créativité chez les
enfants ayant des troubles et d’améliorer leurs compétences auditives, de mémoire, de la parole,
d’articulation et de communication. Le but de ce projet est de présenter une performance dans laquelle les étudiants montreraient les progrès liés à ce programme d’éducation et de rééducation.
Les procédures suivantes ont été utilisées: stimulation des mouvements corporels, stimulations
musicales, stimulation de la parole par la dramatisation et reconnaissance des étudiants dans des
domaines artistiques et visuels.
Les enfants retirent de ces activités:
- Une possibilité d’utiliser des talents spécifiques et d’apprécier le fait que chacun puisse apporter
quelque chose pour le bien commun;
- Un sens de l’accomplissement lorsque sa contribution est montrée sur vidéo;
- Une chance d’exprimer leurs pensées et leur créativité, y compris le besoin de peaufiner et de
clarifier leurs explications mutuelles (une meilleure expression verbale).
Les orthophonistes/logopèdes et les parents retirent de ces activités:
- La capacité d’identifier les qualités et les défauts académiques et sociaux chez les enfants;
- Une meilleure définition des stratégies de rééducation en général et souvent en particulier;
- Un bilan des habilités verbales et non verbales des enfants ;
- Le développement d’un support pratique pour les parents ayant pour but de les impliquer dans
cette partie du développement des enfants.
68
13.6
LE PROCESSUS AUDITIF CENTRAL CHEZ DES ENFANTS
FRANCOPHONES PRÉSENTANT DES TROUBLES SPÉCIFIQUES DU
LANGAGE (TSL)
Bernadette Piérart - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain,
Laurent Demanez - Service ORL du Centre Hospitalier Universitaire de l’Université de Liège, Université de Liège, Liège, Belgium
Elsa Lecocq - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
Cécile Marque - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
Kalliopi Valassis - Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
L’objectif de cette étude est d’examiner les compétences du processus auditif central de 41
enfants francophones souffrants de TSL (syndrome phonologique-syntaxique) âgés de 6,8 à
13,11 ans. Les enfants ont été évalués par les tests BAC (Batterie d’audition centrale, Demanez,
2003)- un outil pédiatrique français (5 tests) conçu pour évaluer les pertes du processus temporal- un test d’identification des bruits linguistiques familiers (Piérart, en parution) et un test de
gnosies linguistiques et de pratique articulatoire (Piérart, 2011). L’audition périphérique de l’enfant
a été vérifiée (audiométrie tonale et tympanométrie). Les enfants avec TSL ont eu des résultats
en dessous du niveau de 5 ans dans tous les tests en lien avec le processus auditif central et des
résultats correspondant à leur âge dans la reconnaissance des bruits non verbaux.
Leurs résultats dans les tests linguistiques étaient aussi en dessous du niveau attendu.
Les résultats seront évoqués en termes de maturation du processus auditif central.
La nature spécifiquement linguistique des troubles sera également discutée.
14.1
UNE RECHERCHE DES EFFETS DE LA PERCEPTION QUE LES
PÈRES ONT DE LA FLUENCE DE LEUR ENFANT BÈGUE ET SON
INFLUENCE SUR LE PROCESSUS THÉRAPEUTIQUE EN
ORTHOPHONIE
Anna Bovoli - Special Primary school, Primary Education, Katerini, Greece
Objectif: Un grand nombre d’orthophonistes expriment le besoin de mieux explorer l’influence
de la diversité dans la perception des parents d’enfants présentant un bégaiement. De plus, les
résultats de la recherche montrent qu’il existe des différences entre les pères et mères, et notamment que les pères ont tendance à surestimer la performance de leur enfant en lien avec les
résultats réels du traitement. L’objectif de cette étude est: a) d’investiguer la compréhension des
pères quant au niveau de communication et de fluence de leur enfant, et b) d’étudier comment
ceci influence le résultat de la prise en charge orthophonique.
Méthodes: Suite à un premier entretien parental, l’étude actuelle a investigué 26 pères d’enfants
bègues. Elle a été menée au moyen de questionnaires présentés dans les 4 mois après l’installation du trouble. Puis les pères ont rempli « l’échelle d’évaluation de la parole et du Langage »
(Speech and Language Assessment Scale - SLAS) (Hadley & Rice, 1993).
Résultats: L’étude montre que a) la majorité des pères n’est pas capables d’évaluer de manière
fiable les compétences communicatives de leur enfant, et par conséquent, imposent à leur enfant
des modèles et des attentes peu réalistes par rapport à la communication et à la fluence et b) les
attentes inappropriées des pères affectent le résultat du traitement orthophonique de leur enfant.
Conclusions: Même si les questionnaires mesurent les représentations mentales des pères et non
69
leurs comportements réels, cette étude sert de point de départ pour discuter du besoin d’explorer
d’avantage comment différentes variables, telle que le jugement du père, affectent ou non l’évolution du trouble en termes de rémission, d’exacerbation ou de maintien. En lien avec la pratique
professionnelle, elle nous permet et nous donne la motivation de voir l’adéquation de la perception des capacités de leur enfant lors de l’apparition du bégaiement et l’influence que cela a sur
les résultats de la thérapie.
14.2
RÉMISSION SPONTANÉE DU BÉGAYEMENT. QUAND DÉBUTER LE
TRAITEMENT ET COMMENT SURVEILLER LE DÉVELOPPEMENT DE
LA FLUIDITÉ CHEZ LES ENFANTS BÈGUES?
Mark Pertijs - Department Speech and Language Therapy, University of Applied Sciences Utrecht, Utrecht, Netherlands
Objectif: Formuler des recommandations et des lignes directrices basées sur une approche factuelle pour les orthophonistes/logopèdes afin de décider quand débuter le traitement des enfants,
des adolescents et des adultes qui bégaient.
Méthodes: Des lignes directrices cliniques basées sur une approche factuelle liées au bégayement ont été développées aux Pays-Bas par une équipe d’orthophonistes/logopèdes, de spécialistes de la fluidité verbale et de sujets qui bégaient. Ces lignes directrices ont été développées
sous l’autorité de l’Association professionnelle des Pays Bas (NVLF) et en coopération avec
l’Institut Hollandais pour la Promotion de la Santé (CBO). Pour l’élaboration des lignes directrices,
nous avons utilisé l’approche EBRO (Evidence-based Guideline Development Circle) et celle du
groupe de travail du GRADE (Grading of Recommendations Assessment, Development and Evaluation, Guyatt et al., 2010). Une des principales questions auxquelles le bureau chargé de l’élaboration des lignes directrices était tenu de répondre était : « quand débuter le traitement ? ».
Résultats: Huit recommandations sur le début du traitement et sur la manière de surveiller les
signes de rémission spontanée chez les enfants qui bégaient ont pu être formulées.
Conclusions: Les taux de rémission chez les enfants qui bégaient sont compris entre 50% et
94%. Selon l’expérience, le début du traitement devrait être un an après l’apparition des premiers
signes de bégayement. Les lignes directrices cliniques hollandaises basées sur l’approche factuelle (Dutch Evidence-based Clinical Guideline on Stuttering, Pertijs et al, 2014) décrivent une
approche systématique basée sur le processus décisionnel concernant le début du traitement et
sur la modalité de suivi des signes de rémission spontanée. Cette approche intègre les meilleures
preuves scientifiques disponibles, le raisonnement clinique et le processus décisionnel partagé
pour guider les parents des enfants qui bégaient et les orthophonistes/logopèdes à prendre des
décisions appropriées sur le début du traitement.
Mots-clés: lignes directrices, thérapie du bégayement
70
14.3
LES LIGNE DIRECTRICES HOLLANDAISE FONDÉE SUR LES
PREUVES POUR LA PRISE EN CHARGE ET LE TRAITEMENT DU
BEGAIEMENT
Leonoor Oonk - University of Applied Sciences Utrecht, Utrecht, Netherlands
Mark Pertijs - University of Applied Sciences Utrecht, Utrecht, Netherlands
Objectif: Mettre en place des lignes directrices fondées sur les preuves pour la prise en charge et
le traitement du bégaiement, à l’usage des orthophonistes/logopèdes des Pays Bas
Méthodes: L’Association Hollandaise des Orthophonistes/Logopèdes (NVLF) a créé un groupe de
travail pour mettre en place des lignes directrices fondées sur les preuves pour l’évaluation et le
traitement du bégaiement. Le groupe de travail est composé d’orthophonistes, spécialistes de la
fluidité verbale et du bégaiement.
Le groupe de travail a identifié sept problématiques majeures:
(1) Pour les petits enfants qui commencent à bégayer, à quel moment entreprendre une thérapie;
(2) Quelle est la validité et fiabilité des outils diagnostiques pour le bégaiement; Quel est l’effet du
traitement du bégayement chez (3) les enfants en âge pré-scolaire, (4) enfants en âge scolaire;
(5) adolescents/adultes; (6) Quand l’orthophoniste/logopède doit-il référer le patient à un autre
spécialiste; (7) Comment organiser le suivi du traitement;
Ces problématiques ont été abordées par le Groupe de Travail GRADE (Grading of Recommendations Assessment, Development and Evaluation) (Guyatt et al., 2010).
Résultats: Pour les questions données, 25 recommandations ont été formulées.
Les lignes directrices ont été validées en Octobre 2014 par l’Association Hollandaise des Orthophonistes/Logopèdes (NVLF) et par l’Association Hollandaise des Thérapeutes de la Fluidité
Verbale (NVST).
Conclusions: Ces nouvelles lignes directrices fondées sur les preuves pour l’évaluation et le
traitement du bégaiement seront un outil important pour améliorer la qualité des traitements des
sujets présentant un bégaiement. Puisque les preuves sont données par la littérature internationale, les lignes directrices hollandaises pourraient fournir un point de départ à d’autres pays pour
créer leurs propres lignes directrices sur le bégayement.
Mots-clés: lignes directrices; bégaiement
14.4
EXPERIENCE DE BÉGAIEMENT ET DE HANDICAP VOCAL CHEZ LES
ADULTES: DONNÉES PRÉLIMINAIRES POUR LE PORTUGAIS
EUROPÉEN
Jaqueline Carmona - Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
Objectif: Le but de cette recherche est: (a) d’obtenir des données préliminaires à l’aide de
l’ÉGELB – “Évaluation Globale de l’Expérience du Locuteur » et de l’Index de Handicap Vocal
(IHV) dans un groupe de locuteurs portugais porteurs de bégaiement, comparé à un groupe de
locuteurs sans bégaiement.
Méthodes: L’ÉGELB a été traduit en portugais européen (PE) selon les critères spécifiques
standardisés des instruments de mesure de la qualité de vie (HRQoL). La version en portugais
européen de l’IHV a été utilisée. 51 adultes ont été évalués avec les deux outils. Parmi eux, 22
présentaient un bégaiement à un âge moyen de 36,14±3,17 ans et 29 ne présentaient aucun
bégaiement à un âge moyen de 38,3± 2,56 ans. Les différences entre les deux groupes n’étaient
71
pas statistiquement significatives. Le test T de Student a été utilisé et le niveau critique de signifiance était de 5%.
Résultats: Les personnes bègues présentent une moyenne totale générale plus élevée pour
l’ÉGELB (217,64±46,73) et pour l’IHV (25,73±22,70) que les non-bègues, respectivement
(152,45±37,79) et (8,59±8,99). Les différences entre les groupes tant pour l’ÉGELB que pour IHV
étaient statistiquement significatives (p<0,05).
Conclusions: Les résultats préliminaires indiquent que les adultes bègues ont de plus mauvaises
expériences et plus de handicaps vocaux que les personnes qui ne bégaient pas. Cette étude
est une première tentative d’acquérir des connaissances sur l’expérience de bégaiement et sur le
handicap vocal chez les adultes portugais européens bègues.
Mots-clés: Instruments de mesure de la qualité de vie, bégaiement, adultes
14.5
STÉRÉOTYPES NÉGATIFS DU BÉGAYEMENT EN ITALIE:
LE POSHA-S COMME OUTIL DE DÉPISTAGE
Emilia Capparelli - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
Donatella Tomaiuoli - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
- Sapienza University of Rome, Rome, Italy
Francesca Del Gado - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
Paola Falcone - C.R.C. Balbuzie Srl, C.R.C. Balbuzie Srl, Rome, Italy
Kenneth O. St Louis - West Virginia University, West Virginia University, Morgantown, United States
Objectif: Cette étude présente les résultats d’une recherche menée auprès du public italien sur
le bégayement, et vise à décrire et analyser les opinions et les attitudes envers ce trouble, en
évaluant en particulier le degré d’influence que les variables démographiques, telles que le sexe,
l’âge, le niveau d’éducation opère sur l’impression générale que les sujets développent à propos
de ce trouble.
Méthodes: Cette étude a été menée par le biais de la version écrite du questionnaire POSHA-S
(Public Opinion Survey of Human Attributes- Stuttering / enquête sur sur un échantillon de 300
sujets non bègues provenant des régions du Nord, du Centre et du Sud de l’Italie, âgés de 18 à
60 ans ayant différents niveaux d’éducation. Les sujets interrogés n’avaient eu aucun contact
direct – familial et/ou professionnel – avec des bègues, afin que leurs opinions ne soient pas
influencées.
Résultats: Cette étude décrit les données sur les stéréotypes négatifs du bégayement, en soulignant les différences parmi les trois régions examinées et la corrélation entre le bas niveau d’information concernant le trouble et l’opinion négative qui en découle.
Conclusions: Cette étude a révélé une opinion publique en général peu ou pas informée sur
ce trouble, qui n’a pas d’idée claire concernant le trouble même et qui a des convictions plutôt
négatives sur le bégayement et sur les sujets qui en souffrent (stéréotypes négatifs). Il est donc
important d’informer et sensibiliser l’opinion publique pour combattre les stéréotypes négatifs, en
créant à la fois des conditions d’entourage plus favorables pour les bègues et qui contribueront à
améliorer leur qualité de vie.
Mots-clés: Bégayement, opinion publique, stéréotypes négatifs
72
14.6
LA FLUENCE VERBALE CHEZ LES ADULTES SOUFFRANT DE
DÉPRESSION
Raluca Soare (Trifu) - Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Carolina Bodea Hategan - Babes-Bolyai University, Cluj Napoca, Romania
Doiana Cozman - Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Objectif: La dépression est généralement associée à une défaillance des troubles cognitifs et exécutifs. La performance dans les activités de fluence verbale peut être particulièrement sensible à
la dépression à cause des déficits associés à la dépression même: attention, concentration, récupération, rapidité. La fluence verbale est l’habilité d’un sujet à produire une série d’énoncés dans
un segment temporal limité, sur la base de critères donnés. Le but de cette étude est d’évaluer la
fluence verbale sémantique et phonémique chez les patients souffrant de dépression, comparés
aux sujets non dépressifs.
Méthodes: Les déficits de la structure neurologique dans la dépression sont évalués par le biais
du Test oral d’association de mots (COWAT= Controlled Oral Word Association Test). La fluence
verbale phonémique est évaluée par trois tests son/phonème FAS (test de fluence verbale / CTL),
dans lesquels il est demandé aux participants de dire le plus de mots possible.
Pour chaque phonème le participant a 1 minute pour exprimer les mots. Aucune répétition ni
noms propres ne sont autorisés.
La fluence verbale phonémique est limitée par catégorie. Dans cette étude, nous avons utilisé les
fruits. Nous avons appliqué le COWAT pour les groupes déprimés et de contrôle (N=20).
Le deux groupes sont appariés selon des facteurs socio-économiques, de niveau d’éducation et
de sexe. Les patients dont la dépression est diagnostiquée (selon l’ICD-10) étaient des patients
hospitalisés dans les Unités Psychiatriques de Cluj, mais les deux groupes ont été préalablement
évalués avec la version roumaine de l’échelle de dépression et d’anxiété (DASS-21R) pour la précision des données et pour éviter les faux diagnostics.
Résultats: Les sujets dépressifs ont présentés des résultats moins bons que le groupe de
contrôle, autant dans les activités de fluence verbale phonémique que sémantique.
Les scores de fluence verbale sont plus bas. Les résultats dépendent de la période d’évaluation,
plus bas à leur admission, plus élevés à leur sortie.
Conclusions: Les activités liées à la fluence verbale sont un indicateur valable des disfonctionnements cognitifs et exécutifs chez les patients dépressifs. La production de mots dans la dépression est liée à la gravité de la dépression. Des études futures devraient évaluer les différences
entre les patients dépressifs et les autres groupes en termes de langage.
Recognitions: Cet article a été publié dans le projet no. POSDRU/159/1.5/S/138776.
Mots-clés: fluence verbale, dépression, fonctions cognitives et exécutives, fluence phonémique,
fluence sémantique
15.1
ÉVALUATION POTENTIELLE DES FONCTIONS ORO-FACIALES CHEZ
LES ENFANTS ET LES ADULTES SAINS ET AVEC TROUBLES DE LA
NUTRITION
Objectif: Pour le développement des fonctions oro-faciales – en plus des fonctions nutritives –
l’assomption et le choix de la nourriture jouent un rôle clé pendant la maturation. Pour les patients
73
étant diagnostiqués comme atteints d’anorexie mentale (AM), la consommation de nourriture est
une façon abusive de résoudre des problèmes qui autrement semblent insolubles. Dans certains cas d’observation orthophonique, les fonctions primaires et secondaires des patients avec
AM semble être très différentes des fonctions des sujets qui ne souffrent pas de troubles de la
nutrition. Le but de cette étude pilote est de recueillir les données corrélées aux symptômes des
disfonctionnements oro-faciaux.
Méthodes: Dans le cadre d’un examen potentiel des fonctions oro-faciales, des patients en cours
de traitement orthodontique, suspectés de disfonctionnements oro-faciaux (groupe 1), et des
patients porteurs de diagnostic AM (groupe 2) ont été évalués.
Dans le but de cette recherche, le matériel diagnostique OFD_01 a été mis au point par l’auteur.
Résultats: Les résultats de l’étude ont montré que, concernant les fonctions primaires et secondaires, certaines variables sont très différentes dans chaque groupe de patients. Des différences
importantes entre les deux groupes ont été retrouvées pour la voix (p=0,024), le goût du “sucré”
(p=0,049), les schémas de mastication “nourriture de texture moyenne” (p=0,036), “nourriture
molle” (p=0.023). L’intubation influence beaucoup la voix (p=0,04) et les paramètres vocaux
(p=0,004).
Conclusions: Les résultats indiquent que le test OFD_01 permet de montrer les différences entre
les deux groupes de patients.
Sur la base des résultats, on peut dire que les patients avec AM ne présentent pas tous les symptômes typiques liés aux disfonctionnements oro-faciaux.
Les fonctions acquises pendant le processus développemental ne changent pas suite à une
consommation très réduite de nourriture. Cependant, certaines fonctions oro-faciales peuvent
effectivement être endommagées. Pour évaluer si un traitement orthophonique spécifique pourrait
améliorer ces troubles fonctionnels, et s’il peut par conséquent avoir un effet positif sur la qualité
de vie des patients avec AM, une étude sur la prise en charge serait nécessaire.
15.2
DYSPHAGIE PÉDIATRIQUE ET SYNDROME CHARGE
Elisabetta Sforza - Università Cattolica del Sacro Cuore, Rome, Italy
Giuseppe Zampino - Università Cattolica del Sacro Cuore, Rome, Italy
Antonella Cerchiari - Ospedale Pediatrico Bambin Gesù,-Roma e Palidoro, Roma, Italy
la déglutition et de la nutrition pendant une période prolongée. Cette étude a pour but d’évaluer la
prévalence et la nature de ces difficultés sur une population de 15 enfants présentant le syndrome
CHARGE et d’analyser la corrélation entre les caractéristiques cliniques majeures et mineures du
syndrome et le degré de dysfonction des capacités de déglutition.
Méthodes: 15 enfants CHARGE ont été considérés tous hospitalisé au centre de référence pour
les maladies congénitales de l’hôpital universitaire A. Gemelli à Rome. La présence de caractéristiques majeures et mineures du symptôme a été enregistrée pour chaque enfant. Par la suite,
le pourcentage des particularités de notre échantillon et celui rapporté dans la littérature internationale a été rigoureusement vérifié. Chacun des enfants de notre étude est arrivé au service de
dysphagie de l’hôpital des enfants « Bambino Gesù à Plidoro en raison de la présence de troubles
de la déglutition ou de la nutrition.
Dans l’institution, nous avons évalué le degré de développement des capacités nutritionnelles en
considérant l’âge des enfants. Treize enfants ont été soumis à d’autres diagnostics pour l’étude
de l’aspiration (Vidéo-fluoroscopie, test de scintigraphie salivaire). Enfin nous avons analysé la
corrélation entre les particularités cliniques du syndrome et le degré de dysfonction des capacités
oro-faciale et de déglutition de notre échantillon sans distinction au niveau du diagnostic. (présence possible de délétion ou de mutation du gène CDH7 dans la région chromosomique 8q12).
Résultats: Le pourcentage des caractéristiques majeures de notre échantillon correspond au
74
pourcentage rapport dans la littérature international, alors qu’il ne correspond qu’en partie pour
les caractéristiques mineures.
Il est important de noter que le pourcentage des caractéristiques “retard de croissance” diverge
des standard en raison de leur relation probable à une diète précoce par des voies alternatives.
Nous avons pu montrer une corrélation entre la présence d’und dysphagie et les informations
contenue dans l’anamnèse et nous avons démontré que les enfants faisant partie de notre étude
et présentant une dysphagie avaient : 11/13 – une cardiopathie, 6/13 une canule trachéale sans
collerette, 12/13 des troubles de l’appareil de déglutition et respiratoire; 5/13 une fente de la
cavité orale, 10/13 un anomalie du nerf cranien. L’évaluation des capacités de déglutition et de
nutrition ont montré différents degrés diététiques. Les données collectées ont permis d’estimer
que les troubles de la déglutition et de la nutrition ont une prévalence de 100% dans le syndrome
CHARGE, alors que l’aspiration a une prévalence d’environ 80%.
Conclusion : L’évaluation Clinique et le raisonnement sur la réhabilitation des jeunes patients
CHARGE ne nécessite pas de protocole standardisé, mais il doit se baser sur des données
comme indiqué dans cette étude. La connaissance des conséquences des troubles de la déglutition et de la nutrition dans le syndrome CHARGE, comme pour d’autres maladies rares, est
capital pour faire une évaluation détaillée de l’enfant. C’est une source d’information en soi pour
le choix d’une méthode adaptée et efficace de réhabilitation.
Mots-clés: dysphagie pédiatrique, syndrome CHARGE, syndromes rares
15.3
PROTOCOLE L-C.O.S.E SUR LES COMPÉTENCES ORALES CHEZ
LES PRÉMATURÉS: ÉTUDE SUR LA FIABILITÉ INTER ET INTRA
ÉVALUATION
Marta Majoli1, Monica Panella2, Valentina Porazzi3, Antonio Schindler4, Odoardo Picciolini5,
Cristiana Assi5
1Genoa, Italy
2ASLBI-Biella, Ospedale degli infermi, Biella, Italy
3Novara, Italy
4Dipartimento di Scienze Biomediche e Cliniche, Ospedale Luigi Sacco, Milan, Italy
5Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Objectif: Introduire et vérifier la fiabilité d’un nouvel outil d’évaluation qui permette l’examen des
compétences orales chez les prématurés et l’identification de la présence de problèmes d’alimentation par voie orale et de déglutition.
Méthodes: En utilisant le nouveau protocole “Stimulation orale et évaluation de l’enfant”, les
compétences orales d’un échantillon de 50 nouveau-nées prématurés (d’un âge gestationnel de
30 semaines), hospitalisés dans une USIN (Unité de soins intensifs néonatals) ont été évaluées
et filmées. Cet outil propose l’utilisation de l’auscultation cervicale et l’exécution de l’évaluation
du trouble moteur et oro-facial par la stimulation et la détection de 11 réflexes oraux. L’analyse
statistique a permis de mesurer le degré de fiabilité de l’outil. La fiabilité intra-évaluatrice a été
évaluée en comparant deux fois les scores attribués aux 50 vidéos par le même évaluateur dans
un certain laps de temps, tandis que la fiabilité inter-évaluatrice a été évaluée en comparant les
scores de l’examinateur avec ceux qui ont été affectés par deux autres évaluateurs. Les données
ont été recueillies en évaluant les compétences des enfants et une analyse de corrélation statistique a permis d’identifier les principaux facteurs qui influencent les compétences orales des
nourrissons prématurés.
Résultats : La fiabilité du protocole L-C.O.S.E est excellente, avec un indice de corrélation de
Spearman entre 0,90 et 0,97 en fonction de l’examinateur. Les compétences orales semblent
surtout affectées par l’état comportemental, l’utilisation des moyens d’alimentation alternatifs et
75
le niveau de la croissance et de la maturité des bébés.
Conclusions: Le L-C.0.S.E est utile et fiable dans l’évaluation de l’enfant prématuré. Il permet une
évaluation systématique des compétences orales et d’alimentation, compte tenu de ses facteurs
ifluençants. Il permet également la planification de la réhabilitation pour des tâches spécifiques et
définit les résultats obtenus grâce à la comparaison quantitative des évaluations, même après une
courte période. Cependant, d’autres études sont nécessaires, à la fois pour valider l’outil et que
pour évaluer son application à un âge de gestation inférieur.
Mots-clés: dysphagie, nourrissons prématurés, évaluation de l’alimentation orale
15.4
CAPACITÉS ORO-MOTRICES DANS LES 48 PREMIÈRES HEURES
DE LA VIE: COMPARAISON ENTRE NOURRISSONS NÉS A TERME ET
NOURRISSONS PRÉMATURÉS
Monica Panella - ASLBI-Biella, Ospedale degli Infermi, Biella, Italy
Marta Majoli - Genova, Italy
Gian Vincenzo Zuccotti - Azienda Ospedaliera - Istituti Clinici di Perfezionamento, Ospedale dei Bambini Vittore Buzzi, Milano, Italy
Antonio Schindler - Dipartimento di Scienze Biomediche e Cliniche, Ospedale Luigi Sacco, Milano, Italy
Objectif: Comparer un groupe de nourrissons nés à terme avec un groupe de nourrissons prématurés pour les scores obtenus en appliquant le nouveau protocole d’évaluation des reflexes oraux
(L.-C.O.S.E.); comparer les scores obtenus à l’aide du protocole par des nourrissons nés à terme
ayant moins de 39 semaines de gestation et par ceux ayant plus de 39 semaines de gestation,
des nourrissons ayant moins d’un jour et ceux ayant plus d’un jour, dans des états comportementaux différents, nés d’un accouchement eutocique (naturel) ou dystocique (chirurgical), ayant un
poids réduit à la naissance (petit poids pour l’âge gestationnel ou PAG) ou un poids qui est considéré approprié pour l’âge gestationnel(AGA), garçons ou filles.
Méthodes: Après une période de formation spécifique sur l’usage du protocole L.-C.O.S.E,
auprès de la Structure simple de Néonatologie de l’hôpital Luigi Sacco de Milan, un groupe de
60 nourrissons nés à terme ont été sélectionnés à un âge gestationnel de plus de 37 semaines,
de sexe masculin et féminin, dans des conditions de physiologie évaluées selon le protocole L.C.O.S.E. Un échantillon de 50 nourrissons prématurés a également été sélectionné dans l’unité de
soins intensifs néonatals de l’Ospedale Maggiore Policlinico de Milan ; ces nourrissons admis au
service de néonatologie à un âge gestationnel de plus de 30 semaines, de sexe masculin et féminin, sans instabilité clinique, ni complications médicales telles qu’une dysgénésie chronique, des
troubles métaboliques, des syndromes de malformation, avec des systèmes cardiovasculaires et
respiratoires stables, autonomes du point de vue respiratoire, ont été également évalués selon le
protocole L.-C.O.S.E.
Résultats: Une différence statistique significative est apparue entre les scores du groupe de nourrissons nés à terme comparé aux nourrissons prématurés (p = 0,043). Une différence statistique
significative est apparue seulement entre les nourrissons PAG et AGA (p = 0,039).
Conclusions: Les nourrissons nés prématurés avaient des scores inférieurs aux scores des nourrissons nés à terme, de même que les nourrissons PAG par rapport aux AGA.
Mots-clés: Dysphagie, nourrissons nés à terme, nourrissons prématurés, L.-C.O.S.E, évaluation,
réflexes oraux
76
15.5
ÉVALUER UNE LIGNE DIRECTRICE POUR LES SOINS DE SANTÉ
PRIMAIRES ; DÉVELOPPEMENT ATYPIQUE DU LANGAGE ET DE LA
PAROLE CHEZ LES ENFANTS ÂGÉS DE DEUX ANS
E.P. Dieleman - Research Group Child, Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
I.I. Staal - GGD Zeeland, Primary Youth Healthcare, Goes, Netherlands
M.R. Luinge - Research Group Child, Language & Development, Hanze University of Applied Sciences, Groningen, Netherlands
Objectif: Un outil de dépistage et de suivi a été développé (en 2012) pour les soins de santé primaires (SP) dans le but d’identifier les troubles du développement du langage et de la parole chez
les petits enfants (âgés de 24 à 30 mois) en vue de leur prise en charge (soins et interventions).
Le but de cette étude est de transformer la méthode qui est basée sur la pratique en une ligne
directrice fondée sur des preuves. L’étude comprend plusieurs éléments : 1. Vérifier par le biais
des soins de santé primaires si le dépistage des troubles du langage et de la parole est exacte. 2.
quelles variables influencent le progrès du développement du langage et de la parole et 3. vérifier
si les enfants tirent profit du dépistage et du suivi.
Méthodes: Le projet est une étude de cohorte prospective. La SP a demandé aux parents de participer, 61 enfants ont échoué au test de dépistage et 61 enfants (même âge, sexe et provenance)
n’ont pas échoué. Les enfants (N=122) ont tous été soumis au test deux fois dans leur environnement familial: (T0) juste après avoir été en contact avec la SP et puis (T1) un an après. Les enfants
ont été examinés sur la base du développent du langage et de la parole, de l’interaction sociale et
de qualité de vie.
Résultats: Les résultats suivants sont relatifs au T0. L’hypothèse était de trouver des troubles du
langage dans 50% des sujets testés, toutefois, 57% des enfants ont présenté des difficultés langagières. Ces résultats sont répartis en trois catégories : l’acquisition du langage (52%), la compréhension du langage (38%) et les capacités d’interaction (38%).
Conclusions: Un certain nombre d’enfants de deux ans semble être plus à risque pour les
troubles du langage si on considère des variables spécifiques comme la prématurité, un faible
poids à la naissance, être un bébé silencieux et avoir des troubles auditifs. Nous serons en mesure de présenter plus de résultats au cours du congrès en mai.
15.6
L’APPROCHE POSTURO-MOTRICE DANS LA PRISE EN CHARGE DE
L’ARTICULATION ET DES TROUBLES DE LA MUSCULATURE
ORO-PHARYNGÉE
Gisèle Martinot-Randoux - Centre Psychologique et Logopédique de l’Universitete, CPLU, Université de Liège, Liège, Belgique
Objectif: Face aux troubles mécaniques, fonctionnels de la langue, du larynx, la rééducation
orthophonique ne doit pas se réduire à un simple reconditionnement lingual ou laryngé. L’objectif
est de rendre des crédits de mobilité aux tissus musculaires et de rendre des informations neuronales permettant une correction automatique des systèmes concernés
Méthode: Après une anamnèse fouillée du patron de croissance, nous réalisons un bilan des
remaniements fonction-structures qui s’opèrent au fil de l’évolution du patient puis nous utilisons des techniques issues de l’eutonie, des chaines musculaires, des techniques de thérapie
manuelle et de rééquilibration neurosensorielle. Nous utilisons une démarche directe, impliquant
une réévaluation de la gestion tonique posturale globale, linguale, mandibulaire et oro-pharyngée.
Celle-ci repose sur des modèles théoriques issus de J.Talmant (Modèle de la fonction
77
respiratoire), J.Delaire, (Modèle de l’organisation de l’architecture cranio-faciale) et transpose ces
modèles vers l’organisation corporelle posturale globale de l’individu.
Résultats: Ceci aboutit à une correction rapide, parfois instantanée dans la distribution du tonus
musculaire requis pour les fonctions respiratoires, vocales, articulatoires, ou encore la gestion
posturale. Cela modifie l’aspect des tissus mous oro-faciaux. Ces techniques activent aussi des
changements comportementaux dans la représentation de soi.
Mots-clés: langue -, musculature oro-pharyngée- réajustement posturo-moteur-
16.1
UNIS DANS LA DIVERSITÉ:
HARMONISER NETQUES - LA FORMATION EUROPÉENNE DES
ORTHOPHONISTES/LOGOPÉDISTES EST-T-ELLE HARMONIEUSE?
Aileen Patterson - CPLOL, France
Anja Lowit - Faculty of Humanities and Social Sciences / Reader, Speech and Language Therapy School of Psychological Sciences
and Health Strathclyde University, United Kingdom
Baiba Trinite - Voice and Speech Research Laboratory, Faculty of Education and Social Work, Liepaja University, Latvia
Objectif: Identifier les enjeux d’une formation des orthophonistes/logopèdes cohérente, “répondant à ses objectifs” dans toute l’Europe et les solutions possibles en explorant les résultats du
projet NetQuest.
Méthodes: 65 partenaires issus de toute l’Europe ont été recrutés dans un réseau académique et
professionnel multilatéral pour le projet d’harmonisation de la formation des orthophonistes/logopèdes européens (NetQues). Des équipes multinationales ont identifié les pratiques courantes,
les thèmes communs, les programmes et l’offre des programmes de formation initiale des orthophonistes/logopèdes. Chacune des lignes de la méthodologie du projet européen NetQues a été
prise en compte dans la conception du projet. Des méthodes ethnographiques et de recherche
par sondage ont été adoptées. Le réseau européen s’est accordé sur un ensemble global de
compétences des orthophonistes/logopèdes qui a été traduit dans les 24 langues de l’Union
européenne par les partenaires orthophonistes/logopèdes. Deux enquêtes ont été menées à
l’échelle européenne:
- A. Une enquête ministérielle sur un échantillon d’établissements de formation offrant des programmes d’orthophonie/logopédie dans chaque pays UE (enquête).
- B. Une enquête biennale sur les statistiques nationales des programmes de formation initiale
dans chaque pays.
Résultats: Les compétences reconnues (analyses comparatives), un glossaire terminologique,
des aperçus sur les profils des pays et des exemples de bonne pratique ont été identifiés afin de
soutenir la formation des orthophonistes/logopédistes en Europe en y associant les instituts de
formation, les responsables politiques d’accréditation et les principaux partenaires engagés à
garantir des standards de qualité dans la profession et dans la formation initiale.
Conclusions: Alors que les différences et la diversité peuvent poser des défis, tous les pays
aspirent à former des professionnels compétents et attentifs, capables de travailler de façon sûre
et efficace avec les connaissances mises à jour et les capacités requises en vue de l’admission
à une unique profession clairement identifiable. Un air chanté en harmonie vaut plus qu’un air
chanté en solo – et dans la formation des orthophonistes/logopédistes, nous avons une magnifique musique à chanter ensemble de vive voix.
Mots-clés: formation initiale; harmoniser; analyses comparatives; compétences; différence
Le projet NetQues a été entrepris avec l’aide de l’Union Européenne. Le projet a été cofinancé
dans le cadre du Programme ERASMUS pour l’éducation et la formation tout au long de la vie de
la Commission européenne, par l’intermédiaire de l’Agence exécutive « Éducation, audiovisuel et
culture ». Cette présentation ne reflète que les points de vue de l’auteur et la Commission ne peut
être tenue responsable de tout usage qui pourrait être fait de l’information qui y est contenue.
78
16.2
FAVORISER L’INTERNATIONALISATION DE L’ « EUREGIO »:
PREUVE D’UNE VARIANTE GERMANO-HOLLANDAISE DE LA
LICENCE A NIJMEGEN
Joost de Beer - HAN University of Applied Sciences and Tilburg University, Nijmegen and Tilburg, Netherlands
Antje Orgassa - School for Speech and Language Therapy, Hogeschool van Arnhem en Nijmegen, Nijmegen, Netherlands
Uta Jaeger-Begheijn - School for Speech and Language Therapy, Hogeschool van Arnhem en Nijmegen, Nijmegen, Netherlands
Jeanine Coopmans - School for Speech and Language Therapy, Hogeschool van Arnhem en Nijmegen, Nijmegen, Netherlands
Objectif: L’internationalisation de l’éducation supérieure est une des priorités du Ministère de
l’Education hollandais (Nuffic, 2014). Le département d’orthophonie de l’ Hogeschool van Arnhem de Nijmegen adjoint à cette priorité la mise en place d’une variante germano-hollandaise
du Bachelor eurégional. Nijmegen est situé aux confins des Pays-Bas et de l’Allemagne et a une
longue histoire d’accueil d’étudiants allemands, certains poursuivant leur vie professionnelle
d’orthophonistes aux Pays-Pas.
Inversément, il y a un nombre important d’orthophonistes et de familles hollandaises qui habitent
et travaillent en Allemagne. Ce mouvement bi-culturel continu a produit l’unique variante eurégionale de ce type en 2013, en préparant les étudiants aux deux systèmes de santé.
L’objectif de cet article est de débattre des défis qui découlent de ce programme et de sa mise en
place pour les pratiques courantes d’orthophonie/logopédie.
Défis: La connaissance des systèmes orthophoniques des pays d’accueil est essentielle au travail
d’un orthophoniste. Les étudiants doivent d’abord obtenir des compétences linguistiques de
niveau B2 autant en allemand qu’en hollandais. Pour établir des plans de politique institutionnelle,
différentes formes d’internationalisation, comme des cours en anglais, la participation à des projets européens et l’offre de compétences interculturelles sont également proposées.
Mise en oeuvre: En dépit de ces obstacles, la preuve a été faite (Gaalen et al., 2014) que la sensibilisation aux questions internationales peut produire des résultats standardisés d’apprentissage
en plus des résultats interculturels et multilinguistiques (Gaalen et al., 2014). Nous considérons
que cette approche peut être appliquée à notre variante germano-hollandaise. Nous croyons que
cette variante peut améliorer la conscience internationale et la conduite autoréflexive envers des
clients provenant de différents milieux culturels.
16.3
ORTHOPHONIE/LOGOPÉDIE AU MOZAMBIQUE: ESPÉRANCES ET
DEFIS DE LA CRÉATION D’UNE NOUVELLE PROFESSION
Júlio Velho - Instituto Superior de Ciências da Saúde, Maputo, Mozambique
Carla Courelas - Instituto Superior de Ciências da Saúde, Maputo, Mozambique
Ana Cláudia Lopes - Instituto Superior de Ciências da Saúde, Maputo, Mozambique
Méthodes: cette présentation rend compte des processus initiaux adoptés au Mozambique pour
développer la formation en orthophonie/logopédie. Les auteurs décrivent tout d’abord le processus de développement du programme du formation initiale. Ensuite, les auteurs illustrent les facteurs les plus importants pour l’adaptation de la profession au contexte du Mozambique à partir
de l’expérience tirée de l’enseignement aux étudiants. de première année. Les données recueillies
sont discutées en tenant compte de l’information déjà publiée sur d’autres réalités africaines.
Résultats: Les pathologies les plus fréquentes et les populations qui bénéficieraient le plus d’une
intervention d’orthophonie/logopédie ont été identifiées. Les auteurs ont également reconnu les
79
facteurs économiques, sociaux, culturels et linguistiques qui interfèrent avec la formation et la
pratique professionnelle.
Conclusions: Ce premier cours pour orthophonistes/logopèdes dans notre pays est le résultat de
la collaboration entre deux universités, l’une se trouvant au Portugal et l’autre au Mozambique.
Nous avons réfléchi aux problèmes propres à ce pays qui affectent la formation et le travail des
spécialistes dans des services d’orthophonie/logopédie au Mozambique. Les résultats obtenus
donnent une idée des changements futurs ainsi que des espérances et des perspectives liées à
ce processus.
Mots-clés: Problèmes professionnels, pratique professionnelle
16.4
ORTHOPHONIE/LOGOPÉDIE POUR LES
ORTHOPHONISTES/LOGOPÈDES: UN PARCOURS DE REFLEXION,
PRISE DE CONSCIENCE ET SECOURS MUTUEL
Lidia Rodríguez-García - Faculty of Occupational Therapy, Speech and Language Therapy and Nursing, University of
Castilla-La Mancha, Talavera-Toledo, Spain
Objectif: En tant qu’experts de la communication humaine, les étudiants en orthophonie/logopédie doivent être conscients de leurs propres capacités de communication, de la qualité de
leur voix, de leur élocution et de sa fluidité, de leurs compétences orales et écrites et de certains
troubles possibles. Parfois, une formation explicite est nécessaire, ainsi la faculté d’ergothérapie,
orthophonie/logopédie et soins infirmiers de Castille-La Manche, Espagne, a programmé un cours
pour aider les étudiants à jouer les deux rôles d’orthophoniste/logopède et de patient. Le présent
rapport met en évidence le développement et l’amélioration des capacités communicatives nécessaires pour devenir un expert et une référence en communication humaine dans les domaines
associés, capacités grâce auxquelles ils pourront aider leurs patients futurs.
Méthodes: Ce cours appelé Orthophonie/logopédie pour les orthophonistes/logopèdes offre une
occasion pour les étudiants de réfléchir sur leurs propres capacités, de sonder les principaux
domaines liés à la communication, à l’élocution, à la voix, à l’ouïe et à la déglutition et enfin, de
programmer une intervention, si nécessaire. Les étudiants travaillent sur leurs propres difficultés
individuellement, en couples et avec le secours de toute la classe (selon le processus d’apprentissage par problèmes - APP). Ils jouent à la fois les rôles d’étudiant, de patient et d’orthophoniste/
logopède, expérimentant ainsi les sentiments, les émotions, les progrès, l’étayage, l’adaptation et
les nouvelles exigences tout au long du processus, comme le feraient les futurs orthophonistes/
logopèdes et leurs patients. Des compétences spécifiques et générales (instrumentales, inter/
intrapersonnelles et systémiques) sont développées par ce processus.
Résultats: Pour les orthophonistes/logopèdes, la communication est un processus d’apprentissage continu tout le long de la vie, car ils devront toujours adapter leurs compétences aux nouveaux
patients, groupes, familles, autres professionnels, futurs étudiants, auditoires et ainsi de suite.
Conclusions: Les étudiants ont donné une évaluation tout à fait positive de cette expérience, en
soulignant l’importance du processus réflexion-action, de la prise de conscience émotionnelle au
cours de tout le processus et de ses avantages au plan personnel et professionnel.
Mots-clés: Apprentissage par problèmes, orthophonie/logopédie, évaluation, capacités de communication, éducation de la voix, compétences interpersonnelles/intrapersonnelles et émotionnelles
80
16.5
IMPORTANCE DE LA JOURNÉE EUROPÉENNE POUR L’ASSOCIATION
PANHELLÉNIQUE DES ORTHOPHONISTES/LOGOPÈDES EN GRÈCE
EN RELATION AVEC UNE PRATIQUE FUTURE BASÉE LES PREUVES
Maria Rapti - PAL (Panhellenic Association of Logopedists), Athens, Greece
Ellianna Mantaka-Brinkmann - PAL (Panhellenic Association of Logopedists), Athens, Greece
Rea Marselos - PAL (Panhellenic Association of Logopedists), Athens, Greece
Athanasia Maneta - PAL (Panhellenic Association of Logopedists), Athens, Greece
Vasiliki Dessyla - PAL (Panhellenic Association of Logopedists), Athens, Greece
Eleni Makri - PAL (Panhellenic Association of Logopedists), Athens, Greece
Objectif: En considérant le thème de la journée Européenne pour l’année prochaine – troubles
neurologiques acquis de la communication – il s’agit d’une occasion de promouvoir la recherche
et la pratique fondée sur des preuves, en ayant recours à des méthodes à la fois quantitatives
et qualitatives afin d’identifier les points forts et faibles de la profession dans le pays. Notre but
est également de rendre compte des problèmes plus importants rencontrés dans le secteur de la
santé publique en Grèce.
Méthode: Un questionnaire basé sur le « Questionnaire sur la qualité de vie » sera distribué aux
patients présentant des troubles de la communication neurologiques acquis ainsi qu’aux aidants
ou aux membres de leur famille.
Résultats: Les résultats obtenus à partir des données du questionnaire nous permettront de fournir certaines informations sur la qualité de vie des patients présentant des troubles neurologiques
acquis, sur leurs familles et sur le système de santé, ainsi que sur le travail des orthophonistes/
logopèdes.
Conclusion: En accord avec les directives du CPLOL pour la journée Européenne, outre la sensibilisation accrue du public à une vaste gamme de troubles de la communication et au rôle des
orthophonistes/logopèdes – leurs évaluations, leurs méthodes et leurs processus thérapeutiques
– un objectif commun sera fixé aux orthophonistes/logopèdes qui travailleront en commun pour
donner une impulsion dynamique à la promotion de la santé et de la qualité de vie des enfants
et/ou des adultes ayant des troubles de communication en Grèce et par conséquent en Europe.
Sur la base des principes énoncés ci-dessus, l’étude pilote fournira une information sur le travail
des orthophonistes/logopèdes, les points forts et faibles des services d’orthophonie/logopédie en
Grèce traitant les troubles neurologiques acquis, les effets positifs des efforts mutuels, ainsi que
l’importance de tenir toujours nos portes ouvertes à la communication avec les autres.
Mots-clés: Qualité de vie, questionnaire, troubles neurologiques acquis de la communication
16.6
ROAD: LA RÉÉDUCATION ORTHOPHONIQUE A DISTANCE, VIA UN
LMS, VERS UNE NOUVELLE APPROCHE DE L’ORTHOPHONIE
Pascaline Dufournier - Cabinet Libéral, Université de Lyon 2, Clermont Ferrand, France
Objectif: L’apport des TICE dans l’enseignement est maintenant avéré.
La conception d’un dispositif FOAD (Formation ouverte à distance) pour la Rééducation Orthophonique à Distance est-elle envisageable et permet-elle d’apporter une nouvelle démarche rééducative dans la prise en charge orthophonique des troubles de l’apprentissage?
La faisabilité d’un dispositif de rééducation en FOAD ne doit pas se concevoir comme une transposition d’une rééducation en présentiel sur un dispositif en ligne mais comme une nouvelle
81
pratique orthophonique adaptée et enrichie par le nouveau mode de médiatisation que représente la pratique en ligne.
Fort d’une première expérimentation en 2008-2009 dont les résultats ont prouvé l’efficacité de
l’orthophonie distance, une recherche-action est donc en cours depuis 4 ans et consiste à évaluer
la qualité clinique (mesures qualitatives) de la séance orthophonique via les outils à distance ainsi
que l’efficacité de la téléorthophonie. (mesures quantitatives)
La distance permet-elle de conserver les caractéristiques cliniques des soins orthophoniques et
garantit-elle une efficacité de soins ?
Méthode: Un partenariat entre université du Nord (Université Laval et de Sherbrook au Québec)
permet d’ancrer la ROAD dans la francophonie et d’assurer la localisation du dispositif dans des
régions francophones diversifiées culturellement afin d’en confirmer sa validité.
La construction, la passation et le dépouillement de questionnaires qualitatifs explorant les caractéristiques de la clinique thérapeutique orthophonique en présentiel et en rééducation à distance
visent à valider l’approche thérapeutique de la rééducation à distance.
L’étude vise à évaluer l’efficacité de la téléorthophonie par le biais de passation de tests insturmentaux orthophoniques propres à chaque pays, en début d’expérience et à 6 mois de rééducation.
Les résultats exprimés en percentiles permettent d’universaliser l’aspect quantitatif et de discuter de
l’efficacité de la rééducation quelque soit la culture, quelque soit le type de pathologies traitées.
Résultats: Les résultats obtenus prouvent une efficacité de la rééducation, d’un point de vue
académique. Cependant, la pratique de ce type de rééducation a soulevé des difficultés dont il
faudra tenir compte dans la conception d’un dispositif de rééducation par internet.
Les résultats permettent de supposer que la rééducation orthophonique est réalisable et efficace
à distance.
Le média internet n’appauvrit pas la relation duelle. Certes, il la modifie mais la différence n’est en
rien un frein aux bénéfices rééducatifs.
Cependant, un dispositif efficace de rééducation doit se concevoir au regard des difficultés technologiques et pédagogiques.
Rééduquer via internet ne peut être conçu comme une simple rééducation via skype. Bien que
bénéfique, elle ne peut être suffisante et n’exploite alors pas les multiples avantages éducatifs
que proposent les dispositifs à distance s’ils sont bien conçus.
Conclusions: ROAD est une ouverture nouvelle vers l’accès aux soins dont elle constitue un gage
de qualité , le dispositif respectant les principes de la triple concordance entre objectifs, choix des
méthodes et choix de l’évaluation. (Poumay, 2007)
A l’heure des TICE, l’orthophonie ne peut faire l’impasse de tels outils, les expérimentations
(2008-2015) montrent des perspectives concluantes sur le bénéfice d’une plate-forme de rééducation orthophonique à distance.
Mots-clés: FOAD, TICE, Orthophonie, ROAD, Téléorthophonie
17.1
UN APPAREIL VOCAL SEMI OCCLUSIF INFLUENCE-T-IL LE TEMPS
DE PHONATION MAXIMUM DES CLINICIENS NORMOPHONIQUES?
Objectif: Tout d’abord, la semi-occlusion de l’appareil vocal (SOAV) a montré des effets favorables
sur la physiologie des cordes vocales dans une série d’études. Par ailleurs, le temps de phonation
maximum (TPM) est une mesure plausible et très bien établie en tant que mesure des résultats de
la thérapie de la voix. Cependant, l’influence de la thérapie SOAV sur les données de TPM reste
floue, d’où cette étude analysant l’influence de divers exercices de SOAV sur le TPM des cliniciens normophoniques.
Méthodes: Vingt-deux orthophonistes spécialistes de la prise en charge des troubles de la voix
82
ont participé au test et devait maintenir les quatre types de phonation suivants le plus longtemps
possible: (1) la voyelle [a:], (2) la consonne nasale [m:], (4) la bilabiale fricative [β:], et (d) la phonation dans un tuyau de silicone ayant la partie distale 2 cm au-dessous d’un niveau de l’eau
(tuyau2cm). Les temps de phonation ont été mesurés avec un chronomètre. Les différences parmi
les types de phonation ont été examinées avec le test de Wilcoxon des rangs signés.
Résutlats: La moyenne du TPM des quatre types de phonation peut être ordonnée comme suit:
(du plus court au plus long): [m:], [a:], [β:] et tuyau2cm. À l’exception de la comparaison entre les
données de [a:] et [m:], toutes les comparaisons ont montré d’importantes différences au niveau
du TPM.
Conclusions: Cette étude fourni des preuves aux études préalables, soulignant l’influence positive de la semi-occlusion dans la physiologie des cordes vocales.
17.2
LA QUALITÉ DE LA VOIX POUR LE LEADERSHIP CHARISMATIQUE
Objectif: La présente étude a pour but de comprendre si l’amélioration de la qualité de la voix
accroit chez autrui la perception qu’un leader est charismatique. Par cette étude nous pouvons
nous référer à la qualité de la voix comme attribut pour analyser le caractère charismatique des
leaders.
Méthodes: Nous avons enregistré la performance vocale d’un manager avant et après un programme de formation en technique vocale. Les discours qui en en ont résulté ont été présentés à
deux groupes de participants qui en ont évalué l’impact sur l’affect – mesuré en utilisant l’Échelle
d’affects positifs et d’affects négatifs – et la perception du charisme – mesurée en utilisant un
élément de l’Échelle de Leadership charismatique de Conger-Kanungo.
Résultats: Les résultats ont montré qu’une amélioration de la qualité vocale aboutit à une perception plus élevée du charisme par autrui. La qualité de la voix contribue également à augmenter
l’affect positif des subalternes. Un affect positif entraîne à son tour des niveaux plus élevés de
charisme et l’inverse est également vrai.
Conclusions: Nous suggérons que cette recherche puisse servir de base au problème particulier
dans la formation des leaders qui néglige habituellement la qualité de la voix. L’amélioration de
celle-ci apparait comme un moyen d’accroitre chez autrui, la perception du charisme chez les
leaders.
Mots-clés: Voix, discours, leadership, charisme, communication
83
17.3
RESULTATS FONCTIONNELLES A LONG TERME APRÈS UNE
LARYNGECTOMIE PARTIELLE HORIZONTALE DE TYPES IIA ET IIIA:
UNE ÉTUDE COMPARATIVE
Nicole Pizzorni - Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
Marco Fantini - Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Turin, Italy
Erika Crosetti - Department of Otorhinolaryngology, Ospedale Martini, Turin, Italy
Andy Bertolin - Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
Giuseppe Rizzotto - Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
Giovanni Succo - Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Turin, Italy
Antonio Schindler - Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
Objectif: Les laryngectomies partielles horizontales sont d’anciennes techniques chirurgicales
conservatrices pour le traitement de carcinomes laryngés. Les différences entre les sous-types
de laryngectomies sont liées aux limites inférieures de l’excision. L’objectif de cette étude est de
comparer les résultats fonctionnels à long terme chez les patients suivis après une laryngectomie
partielle horizontale de type IIa ou IIIa, et de recueillir des données sur les répercussions de l’intervention chirurgicale sur la déglutition, la voix et la qualité de vie.
Méthodes: 23 patients ayant subi une laryngectomie partielle horizontale de type IIa et 18
patients avec un suivi de laryngectomie partielle horizontale IIIa ont été recrutés 6 mois après
l’intervention. Les deux groupes étaient comparables en âge, sexe, situation familiale, profession, niveau d’éducation, période entre l’intervention et la dissection du cou. Chaque patient a
été soumis à une évaluation de la déglutition par Endoscopie à fibres optiques (FEES Fiberoptic
Endoscopic Evaluation of Swallowing) avec 5 ml de liquides, des semi-solides et ½ biscuit. La
motilité et les vibrations de la néo-glotte ont été évaluées par endoscopie vidéo. Les évaluations
aérodynamiques, l’analyse spectrographique et l’évaluation perceptive de la voix ont été mises en
place. L’apparition de complications pulmonaires et la variation pondérale pré et post-intervention
ont été enregistrées. Les paramètres de qualité de vie (QOL = Quality of Life), de la voix et de la
déglutition ont été évalués. Les données ont été comparées statistiquement en utilisant le test
Mann-Whitney U ou le test exacte de Fisher, ceux-ci étant considérés comme les plus appropriés.
Résultats: Des différences importantes entre les deux groupes n’ont été mises en évidence que
pour le score « Pooling »( modèle endoscopique pour l’évaluation de la sévérité de la dysphagie)
avec un bol alimentaire solide et pour les paramètres de l’échelle INFVo. Les patients suite à une
laryngectomie partielle de type IIIa ont obtenu de moins bonnes performances que les patients
suite à une laryngectomie de type IIa. Aucune différence statistique importante n’a été mise en
évidence concernant les paramètres généraux de qualité de vie, de la voix et de la déglutition.
Conclusions: Les patients ayant subi une laryngectomie partielle horizontale de type IIa et IIIa
présentent des résultats fonctionnels comparables à long terme, ce qui indique que la différence
d’ampleur de la résection entre les deux techniques chirurgicales, n’a pas d’influence significative
sur la qualité de vie (QOL), de la voix ou de la déglutition.
Mots-clés: Oncologie Tête et Cou, dysphagie, troubles de la voix
84
17.4
VOIX-OFF A LA TÉLÉ. UNE PERSPECTIVE PORTUGAISE
EUROPÉENNE
Isabel Guimaraes - School of Health Sciences at Alcoitao, University, Alcoitao-Alcabideche, Portugal
Objectif: a) Quels sont les habitudes de vie saine des journalistes, les troubles de la voix et du
langage, les formations dans le domaine de la voix et les expériences au sein d’une chaine de
télévision au Portugal? Existe-t-il d’importantes différences entre les journalistes de télévision et
non professionnels qui utilisent leur voix dans leur métier?
Méthodes: Des journalistes de télévision portugais ont été évalués par le biais d’un entretien
semi-structuré pour déterminer les problèmes liés à leur santé, les troubles de la voix et du langage, la formation de leur voix, l’expérience de travail en tant que commentateur télé. Parmi eux,
22 femmes ont été sélectionnées et réparties en deux groupes, débutantes et expérimentées,
puis comparées à 11 sujets non professionnels. La lecture à voix haute d’un paragraphe standard
de “L’aventure d’Arthur le rat” a été utilisée pour mesurer les valeurs acoustiques et temporales à
l’aide du logiciel Praat.
Résultats: 59 journalistes âgés de 21 à 45 ans ont montré a) 66% de femmes; b) troubles de
santé les plus fréquents : RGO (reflux gastro oesophagien) , allergies et sinusites ; c) 30,5% de fumeurs; d) 11,9% de dysphonies, épisodes phono-traumatiques et 5,1% de troubles articulatoires;
e) 69,5% ont suivi une formation de la voix à court terme; f) 42.4% ont un an ou moins d’expérience en tant que présentateur télé. Au cours de la lecture à voix haute, les voix féminines n’ont
montré des différences statistiquement significatives (p≤0.05) que pour les mesures temporales
(rapidité de lecture, durée et nombre de pauses), selon l’expérience professionnelle de la voix.
Conclusions: les journalistes portugais de télévision montrent un taux très élevé de problèmes
liés à la santé, une formation de la voix spécifique très faible et des caractéristiques vocales temporales différentes lors de la lecture à voix haute.
Mots-clés: Voix-off; utilisateurs professionnels de la voix.
17.5
MODIFICATIONS ACOUSTIQUES PERCEPTUELLEs ET OBJECTIVEs
DE LA QUALITÉ DE LA VOIX CHEZ DES ADULTES APRÈS LA POSE
D’UN IMPLANT COCHLÉAIRE
Elisavet Papadopoulou - University College London, UCL EAR Institute, London, United Kingdom
Objectif: Les caractéristiques de la voix chez les adultes ayant une perte auditive neurosensorielle
sévère à profonde est sensiblement différente de celles des personnes entendantes. Souvent, les
professionnels décrivent leurs voix comme étant «aérée », « rauque », « craquante » et « rude ».
Suite à la pose d’un implant cochléaire, le contrôle auditif de la voix est possible et la qualité de
leur voix s’améliore. Cette étude tente d’identifier les modifications acoustiques perceptuelles et
objectives de la qualité de la voix des adultes ayant une perte auditive neurosensorielle sévère à
profonde quatre semaines après l’activation de l’implant cochléaire.
Méthodes: 5 adultes ayant une perte auditive neurosensorielle sévère à profonde âgés de 18 à
60 ans ont été examinés à deux différents moment (pré et post IC). Le matériel d’enregistrement:
pour l’analyse laryngographique et acoustique de l’échantillon de voix un électrolaryngographe et
un logiciel “studio speech software» (mesure objective) et pour l’analyse et l’évaluation perceptuelle de la qualité de la voix l’échelle GRBAS (mesure subjective)
Échantillons de voix: voyelles soutenues /i/, /a/, /o/, et un passage lu à haute voix (The Story of
85
Arthur the Rat) en discours continu.
Résultats: Les résultats de l’analyse statistique (logiciel SPPS) a montré que les modifications
acoustiques perceptuelle et objectives de la qualité de la voix n’étaient pas significatives pour
tous les paramètres mesurés 4 semaines après l’activation de l’implant cochléaire. Les corrélations des jugements de voix perceptuelle parmi les examinateurs n’étaient pas compatibles pour
toutes les échelles de GRBAS. Enfin, la relation entre les mesures objectives et subjectives de la
voix était faible.
Conclusions: Un plus grand échantillon de personnes et d’examen sur une période de 6 moins
après l’implantation cochléaire pourrait indiquer une amélioration significative de la qualité de la
voix. La faible corrélation entre les évaluations pourrait provenir des contextes linguistiques et
culturels différents pour chacun des examinateurs. Enfin, les analyses objectives et subjectives de
la voix n’indiquent pas les mêmes tendances puisque le matériel vocal utilisé pour les voyelles et
le discours continu pourraient avoir une influence sur la voix.
Mots-clés: troubles de la voix, troubles auditifs
17.6
HELP ME SING! (AIDEZ-MOI À CHANTER!) UN OUTIL DE
PERFECTIONNEMENT DU CHANTEUR
Les caractéristiques et les détails de l’outil “Help me sing” (Aidez-moi à chanter) seront présentés
dans cet atelier. L’objectif de cet outil est de mettre en valeur la performance vocale du chanteur
et de rééduquer la voix dans une situation pathologique, au moyen d’une intervention indirecte,
en encourageant le patient à poursuivre l’intervention à son domicile et en renforçant la technique
déjà apprise dans le contexte de la session de rééducation.
En tant qu’usagers professionnels de la voix, les chanteurs sont souvent affectés par des problèmes vocaux (Lopez & Bouzas, 2010). Les chanteurs nécessitent une considération particulière
lors du diagnostic et du traitement des problèmes vocaux, car ils doivent maintenir un niveau
plus élevé d’agilité phonatoire, de force et de puissance, afin d’exécuter de façon répétée des
manœuvres laryngées complexes (Zeitels, Hillman, Desloge, Mauri, & Doyle, 2002). C’est pourquoi, cet outil a aussi pour objectifs l’alignement postural, le ton, la respiration et son support,
les registres vocaux, la résonance, la projection vocale/l’intensité, toutes ces composantes étant
nécessaires pour une bonne performance vocale chez un chanteur. Bien que l’outil soit destiné
principalement aux chanteurs professionnels adultes, les chanteurs non-professionnels peuvent
aussi l’utiliser. Les pictogrammes illustrant les exercices vocaux contiennent des gammes musicales qu’un chanteur ayant une formation musicale pourra jouer sur un piano et un chanteur sans
formation musicale aura la possibilité de se servir d’un CD audio.
Les orthophonistes/logopèdes tout comme les professeurs de chant se servent de leur voix dans
leur profession, et elle constitue aussi un élément de leur travail, même si les objectifs et les voies
suivies sont différents (Ferreira, 1993). C’est pourquoi, il est important que les orthophonistes/
logopèdes spécialisés en chant collaborent avec les professeurs de chant pour la transmission de
leurs connaissances en anatomie et en physiologie vocale, car d’un côté le professeur de chant
ne prend pas en considération les aspects organiques et fonctionnels de la voix et, de l’autre
côté, l’orthophoniste/logopède met de côté les composantes artistiques de la voix.
L’utilisation de de pictogrammes ainsi que de dossiers audio assurera le maximum d’autonomie
au chanteur en rendant l’intervention thérapeutique plus efficace.
Mots-clés: Voix, chanteurs, adultes, éducation à la santé, orthophoniste/logopède
86
18.1
TROUBLES SPÉCIFIQUES DU LANGAGE, DYSPHASIE…
QUELLE EST LA VALEUR D’UN NOM?
Ruth Vanderswalmen - University College Arteveldehogeschool and Ghent University, speech language therapy, Ghent, Belgium
Eveline Vogels - University College Arteveldehogeschool and Ghent University, speech language therapy, Ghent, Belgium
Sabien Van Dycke - University College Arteveldehogeschool and Ghent University, speech language therapy, Ghent, Belgium
Objectif: il existent différentes expressions pour définir les troubles du langage et de la parole
chez l’enfant (TSL, dysphasie…) utilisés comme synonymes ; si on considère les définitions, critères, prévalence… Quelles sont les variables qui influencent ces expressions ?
Méthodes: Différentes expressions sont utilisées pour parler de troubles du langage chez l’enfant,
p.ex. dysphasie, TSL. Cette étude est une recherche de littérature. Un questionnaire en ligne a été
rempli par 111 orthophoniste/logopèdes flamands travaillant dans des domaines différents.
Résultats: Plusieurs analyses de variance (ANOVA) ont été menées. Le terme TSL est beaucoup
plus utilisées par les orthophonistes/logopèdes ayant suivi une formation Master (F (1,96) = 14,25,
p = 0,00). Aucune différence significative n’a été rapportée pour les autres expressions en lien
avec le niveau d’étude. Le terme “dysphasie” est utilisé considérablement plus dans les centres
de réhabilitation (F (2,98) = 9,27, p = 0,00), alors que “trouble développemental du langage et de
la parole” est utilisé plus dans l’éducation spécialisée (F (2,98) = 7,63, p = 0,00). Dans la pratique indépendante, l’expression “retard de langage” est utilisé considérablement plus (F (2,98) =
5,42, p = 0,01). Cette expression est moins utilisée par les orthophonistes/logopèdes qui traitent
souvent des enfants ayant des troubles du langage. L’utilisation des expressions « troubles du
langage et de la parole » et « dysphasie » était aussi déterminée par le lieu en Belgique. 89% des
orthophonistes demandent moins d’ambiguïté dans la nomenclature.
Conclusion: Dans la littérature, les termes « troubles du langage développementaux, TSL et dysphasie sont les plus communément utilisés. Certains auteurs les utilisent comme des synonymes,
du point de vue de la définition, des critères et de la prévalence, d’autres pas. Neuf orthophonistes sur 10 demandent plus clarté sur la nomenclature. Le niveau d’étude, le contexte, les
nombres des patients traités et la lieu de pratique sont des variables qui influence le choix de la
terminologie. Les implications seront discutées.
Mots-clés: Troubles spécifiques du langage
18.2
TROUBLES DU LANGAGE ET PROBLÈMES COMPORTAMENTAUX
CHEZ LES ENFANTS EN ÂGE PRÉSCOLAIRE
Margarita Stankova - New Bulgarian University, Sofia, Bulgaria
Violeta Boyanova - New Bulgarian University, Sofia, Bulgaria
Raina Markova - New Bulgarian University, Sofia, Bulgaria
Veneta Vasileva - New Bulgarian University, Sofia, Bulgaria
Objectif: Cet article comprend l’étude de deux groupes – des enfants présentant des troubles
spécifiques du langage et des enfants ayant un développement langagier typique. L’objectif de
cette étude est de trouver des relations entre les compétences langagières et les problèmes émotionnels et comportementaux.
Méthodes: Version bulgare du Child Behavior Check-List (CBCL), 1.5 - 5 ans (Achenbach, Rescorla), et Méthode pour le Diagnostic et la Prévention du Langage (Stoyanova, Yosifova, Poppandova, Netsova).
87
Résultats: Les résultats ont montré d’importantes différences entre les deux groupes en classe
maternelle pour les paramètres suivants: réactivité émotionnelle, anxiété, introversion, troubles de
l’attention et agressivité.
Conclusions: Les troubles du développement du langage influencent l’apparition et l’expression
de problèmes comportementaux et émotionnels chez les enfants en âge préscolaire.
Mots-clés: troubles spécifiques du langage, problèmes émotionnels et comportementaux
18.3
LES TROUBLES DU LANGAGE ET DE LA PAROLE DANS LA
SCHIZOPHRÉNIE A DÉBUT PRÉCOCE (CHEZ L’ENFANT)
Tomasz Wozniak - Institute of Logopedics and Applied Linguistics, University of Maria Curie-Sklodowska, Lublin, Poland
Récemment, la schizophrénie à début précoce a été prise en considération dans les cas de psychoses chez les sujets de moins de 13 ans (Remschmidt 2002).
La schizophrénie chez les enfants de moins de 13 ans est très rare, environ un cas sur 10’000.
Parmi les symptômes de psychose schizophrénique dans cette forme de la maladie, nous avons
aussi observé des troubles de la communication langagière. Cependant, ces troubles diffèrent de
la symptomatologie schizophrénique de l’adulte. (voir A. Sims, 1995).
Les études en psychiatrie montrent certains phénomènes particuliers dans les énoncés des
enfants schizophréniques comme les néologismes, l’écholalie, la phonographie, la persévération,
l’usage incorrect de pronoms, la dominance du monologue (Sulestrowska 1989).
Cet article présente les résultats des études linguistiques de la communication chez 20 patients
schizophrènes à débuts précoces. L’étude est basée sur les réactions dans le dialogue, aux compétences narratives, à la compréhension et à la mémorisation de texte.
Les résultats indiquent que la schizophrénie à début précoce (VEOS) est un trouble neuro-développemental qui retarde et altère l’acquisition typique du langage. Le dialogue est dominé par la
communication en blocs, la compréhension narrative et la capacité syntaxique se déroulent à un
niveau très bas et la mémorisation de texte est encore plus réduite. Les études n’ont pas confirmé la fréquence des troubles du langage décrits par les psychiatres.
Les résultats de ces tests révèlent que les orthophonistes devraient être impliqués dans la prise
en charge des enfants schizophrènes. Il est important qu’en parallèle de la pharmacothérapie et
de la psychothérapie, on puisse utiliser la stimulation professionnelle du développement du langage (Wozniak 2008).
Mots-clés: troubles du langage chez l’enfant, schyzophrénie, schyzophasie
18.4
L’IMPRESSION DES PARENTS D’UNE LOQUACITÉ EXCESSIVE ET
DE LA LONGUEUR DES ÉNONCÉS DANS L’INTERACTION AVEC LES
ENFANTS ATTEINTS DE TDAH
Rahmati Somayeh - University of Neuchâtel, Neuchâtel, Switzerland
Genevieve de Weck - University of Neuchâtel, Neuchâtel, Switzerland
Objectif: Certaines études font état de la présence de troubles pragmatiques du langage (TPL)
chez les enfants atteints de troubles/déficits de l’attention / hyperactivité (TDAH). Un des symptômes communs mentionné parmi d’autres pour les TDAH et pour le TPL est celui de la loquacité.
Cependant, de nombreux aspects du discours (longueur des énoncés, tours des rôles, gestion de
88
thèmes) peuvent donner l’impression d’une loquacité excessive (Bishop, 1994). Cette étude vise
à enquêter sur les similarités/spécificités du comportement pragmatique en se focalisant sur la
longueur des énoncés (par ex. mots, durée) dans les interactions entre enfants atteints de TDAH
et enfants à développement typique (DT).
Méthodes: Dans ce but, 14 enfants francophones (9;8-12;4) avec/sans diagnostic de TDAH
(associés par âge) ont été observés en interaction avec leurs camarades. Les sujets étaient
mélangés par présence/absence de TDAH et TPL par une check-list et une série de tests pour le
niveau du langage structural. Les interactions ont eu lieu dans le contexte de la préparation d’un
spectacle et pendant le goûter. Les données ont été transcrites en indiquant le commencement
et la fin de chaque conversation, à tour de rôle. Le nombre de mots et d’énoncés à tour de rôle
a été quantifié. L’impression des parents d’une loquacité excessive a été déduite par le biais de
deux check-lists pour le TPL et les TDAH.
Résultats: L’analyse des données qualitatives a montré des durées différentes de conversation en
relation à l’environnement et à la population. Bien que les enfants atteints de TDAH aient obtenu
les scores les plus élevés en loquacité dans les évaluations des parents, ils ne correspondaient
pas aux mesures quantitatives de la longueur de la conversation.
Conclusions: Les résultats suggèrent que malgré la longueur des énoncés, d’autres facteurs
peuvent contribuer à l’impression de loquacité excessive. Comme implication clinique, cette
étude peut donner un aperçu plus approfondi sur la “loquacité” des enfants atteints de TDAH et
apporter des preuves permettant de les considérer dans le bilan clinique et la prise en charge.
Mots-clés: loquacité excessive, interaction avec les pairs, TDAH
18.5
APPLICATION DE L’ÉCHELLE ITALIENNE D’ÉVALUATION DES
COMPÉTENCES CONVERSATIONNELLES (ASCB) CHEZ LES ENFANTS ATTEINTS DE TROUBLES DU LANGAGE
Renata Salvadorini - IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy
Francesco Mozzanica - Luigi Sacco Hospital, Department of Clinical Sciences, University of Medicine, Milano, Italy
Stefania Bargagna - IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy
Objectif: Le but de cette étude est d’évaluer les compétences conversationnelles sur un échantillon d’enfants âgés de 36 à 48 mois présentant des troubles du langage.
Méthodes: pour analyser les compétences conversationnelles des enfants âgés de 36 à 48 mois
présentant des troubles du langage, une cohorte de 18 patients, dont 15 garçons et 4 filles d’ âge
moyen de 45 mois, a été évaluée.
Leurs compétences conversationnelles ont été évaluées en utilisant l’échelle italienne d’évaluation
des compétences de conversation sociale Social-Conversational Skills Rating Scale -Italian version - ASCB). Il s’agit d’un questionnaire destiné aux parents, composé de 25 questions réparties
en deux échelles: affirmation et réceptivité. Sur la base des résultats du questionnaire, les patients
ont été divisés en 4 profils conversationnels. Le nombre des mots prononcés a été aussi mesuré.
Résultats: Les enfants atteints de troubles du langage ont obtenu des scores plus bas en affirmation et en réceptivité. Une différence importante dans la production de mots a été démontrée
parmi les 4 profils conversationnels. Une relation significative entre le type de profil conversationnel et le type de trouble du langage a aussi été soulignée.
Conclusions: Le développement des compétences de conversation sociale semble être corrélé au
type de trouble du langage et au développement du vocabulaire. L’échelle ASCB semble être utile
dans l’évaluation et la planification du traitement des patients atteints de troubles du langage.
Mots-clés: Compétences socio-conversationnelles, troubles du langage, services de conseil
89
18.6
LE RAPPORT ENTRE LES TROUBLES DU LANGAGE ET
L’APPRENTISSAGE DE LA LECTURE EN CIRCONSTANCES
MULTILINGUISTIQUES SOUSTRACTIF
Eniko-Zsuzsánna Boér - Lycée Français de Budapest, Budapest, Hongrie
Contexte: Au travers de 3 études de cas nous allons présenter l’évolution des démarches cognitivo-lingusitques au cours des 6 premiers mois de l’apprentissage de lecture chez 3 enfants multilingues (CP, 6 ans) présentant des troubles du langage dans leur langue maternelle (hongrois) et
des compétences francophones médiocres.
Méthode(s): Comme méthodes diagnostiques, enseignement et rééducative on utilise le protocole diagnostique orthophonique(H) et BSEDS 5-6 (F), les méthodes de lectures Murail- Bulle (F),
Meixner-Játékház (H)
Résultat(s): Les démarches d’acquisition des correspondances grapho-phonémiques (la généralisation, le développement des images mentales, correspondance entre une image mentale et sa
représentation graphique) seront présentées à l’occasion du congrès. En cours de recherche.
Conclusion / message à retenir: Les 3 enfants présentés ont de grosses difficultés en cours d’acquisition du langage écrit : malgré un ralentissement en correspondance grapho-phonémiques ils
favorisent la voie d’assemblage contre la voie d’adressage, dont l’installation est empêchée par
le manque du vocabulaire passif qui entraîne une mauvaise compréhension. Les circonstances
multilinguistiques transforment la nature d’intervention orthophonique, notamment la rééducation
du langage oral en langue maternelle et celui du langage écrit en français
Mots-clés: Multilinguisme, troubles spécifiques du langage, dyslexie et troubles spécifiques développementaux du apprentissage
19.1
SIMILAIRES OU DIFFÉRENTS? LA LANGUE ET LA COMPRÉHENSION
ECRITE CHEZ LES ENFANTS ADOPTÉS A L’INTERNATIONALE
Anne-Lise Rygvold - Department of Special Needs Education, University of Oslo, Oslo, Norway
Objectif: Le langage et le développement de la lecture chez les enfants adoptés à l’internationale
entre 4 et 13 ans comparés aux compétences des leurs camarades norvégiens non adoptés.
Méthodes: Le projet de cette étude est longitudinal et a démarré avec 40 enfants adoptés venant
d’Asie et d’Amérique du Sud dont l’âge d’adoption se situait entre 2 et 38 mois, et avec 79 enfants
contrôle norvégiens monolingues. À 4 ans le langage et les compétences cognitives des enfants ont
été évalués. Au cours de la deuxième année d’école primaire, les compétences langagières, la stratégie de lecture et la compréhension ont été mesurées. Actuellement, les participants sont en 8ème
année et le dernier suivi sur le langage et les compétences langagières est en cours.
Résultats: Les résultats des 4 ans d’évaluation ont montré peu de différences entre les enfants
adoptés et le groupe contrôle dans les compétences langagières. Seuls les résultats en compréhension ont présenté des différences importantes entre les deux groupes. En deuxième année,
les enfants adoptés avaient rattrapé leurs camarades dans les compétences de compréhension
orale, mais obtenaient des scores beaucoup plus bas dans la compréhension de la lecture.
La question de recherche pour l’évaluation en cours est de savoir si les enfants adoptés ont rattrapé ou non le groupe contrôle sur le plan de la compréhension à la lecture en 8ème année. Les
premiers résultats seront présentés.
Conclusions: La compréhension du langage semble être une compétence fragile chez les enfants
90
adoptés à l’internationale. Ils semblent être beaucoup plus à risque de développer des difficultés
langagières que leurs camarades non adoptés. Déterminer ce qui explique les résultats dans le
domaine de la compréhension orale chez les enfants adoptés Aest aléatoire, mais théoriquement
beaucoup de facteurs peuvent compliquer l’apprentissage d’une seconde langue maternelle, y
compris l’âge d’adoption, les conditions de pré-adoption et le changement soudain de langue et
de culture.
Mots-clés: Langage et compréhension à la lecture, enfants adoptés à l’internationale
19.2
FORMATION META-PHONOLOGIQUE DE GROUPE: UNE EXPÉRIENCE
D’ENRICHISSEMENT COMME CONDITION ESSENTIELLE POUR LA
LECTURE ET L’ÉCRITURE
Andrea Brogi - Neuroscience and surgical, medical science department, Siena University, Siena, Italy
Alessandro Malandrini - Neuroscience and surgical, medical science department, Siena University, Siena, Italy
Objectif: Il a été démontré que presque 30% des sujets atteints de troubles spécifiques du langage développent des difficultés particulières d’apprentissage. De récentes études ont souligné
que la méta-phonologie pouvait être un outil utile dans la prise en charge des patients souffrant
de troubles spécifiques du langage et, par conséquence, dans la prévention des difficultés particulières liées à l’apprentissage. Un concept nouveau de formation méta-phonologique a été
développé pour améliorer les compétences méta-phonologiques globales, comme base pour un
développement correct de l’apprentissage. Cette formation est composée de 80 jeux créés et
adaptés à cet objectif.
Méthodes: Un groupe de 10 patients avec troubles spécifiques du langage a participé à cette
étude; un des enfants fréquentait la deuxième année d’école primaire et les autres la dernière
année de maternelle. Les patients ont été évalués en premier lieu par le test CMF (test d’évaluation des compétences méta-phonologiques) puis ce même test a été appliqué pour réévaluer les
sujets après 4 mois et vérifier l’efficacité de la pratique.
Résultats: Le test CMF établit après la formation méta-phonologique a montré que 6 enfants sur
8 ont amélioré leurs capacités.
Conclusions: Les résultats obtenus ont montré qu’une formation méta-phonologique spécifique
au cours de la dernière année de maternelle améliore les tâches méta-phonologiques et, par
conséquent, réduit la probabilité de développer des troubles spécifiques d’apprentissages. Bien
que cette étude préliminaire souligne l’importance préventive de cette formation spécifique, elle
ne peut pas démontrer avec certitude absolue qu’elle pourrait prévenir un trouble spécifique
d’apprentissage, lequel demanderait un dépistage plus approfondi accompagné du suivi de plusieurs cas.
Mots-clés: Troubles spécifiques du langage, troubles phonologiques, dyslexie et troubles du
développement et de l’apprentissage
91
19.3
L’EFFICACITÉ DE L’ORTHOPHONIE/LOGOPÉDIE DANS LA RÉUSSITE
SCOLAIRE : ÉTUDE DE CAS DE SCOLARITÉ DANS UNE ZONE
D’INTERVENTION PRIORITAIRE
Rui Loureiro - Agrupamento de Escolas Professor Óscar Lopes, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
Orquídea Coelho - Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Faculdade de Psicologia e
de Ciências da Educação da Universidade do Porto, Porto, Portugal
Objectif: Depuis toujours, les problèmes sociaux ont influencé les dynamiques scolaires. Cependant, à l’heure actuelle, les membres des communautés délèguent de plus en plus un rôle décisionnel pour la résolution de problèmes à l’autorité scolaire. Les zones d’intervention prioritaires
- terme portugais se référant aux milieux scolaires avec un statut socio-économique défavorisé
- sont des exemples d’écoles situés dans ces contextes, où les étudiants atteignent des niveaux
de réussite particulièrement faibles, en particulier dans l’apprentissage de la langue portugaise et
des compétences langagières. Dans ce contexte, ces écoles peuvent avoir besoin de ressources
humaines accrues, composées d’orthophonistes/logopèdes, afin de combler les carences langagière et de communication des élèves qui sont à la base de leurs difficultés d’alphabétisation.
Les objectifs de cette étude étaient: d’évaluer la perception des enseignants d’école primaire sur
l’importance de l’intervention de l’orthophoniste/logopède dans ce contexte, d’évaluer leur opinion sur l’influence des troubles du langage et de la parole dans l’acquisition de la lecture et de
l’écriture et d’identifier leur perception à propos de l’association entre l’étiologie de ces troubles et
les caractéristiques du milieu scolaire. Un échantillon de 82 étudiants de l’école primaire a également été évalué par rapport au développement sémantique, morphologique, syntaxique et phonologique après l’intervention, tout comme l’existence de différences dans les résultats par année
scolaire et notes en langue portugaise.
Méthodes: Cette recherche est descriptive et exploratrice et se base sur une étude de cas en
milieu scolaire socio-économiquement faible. L’analyse des données recueillies repose sur une
approche combinée, en utilisant des méthodes qualitatives et quantitatives, comme des analyses
de contenu et des statistiques descriptives et déductives.
Résultats: Les résultats qualitatifs ont montré que les enseignants considèrent le rôle des orthophonistes/logopèdes dans les écoles comme important. Les résultats ont aussi montré que les
enseignants ont confirmé la relation entre la fréquence élevée des troubles du langage et de la
parole et les difficultés d’alphabétisation. Les résultats quantitatifs ont montré que plus de 70%
des étudiants ont amélioré leur pourcentage dans tous les domaines de la langue portugaise
après intervention et 57% ont amélioré leurs notes en Portugais au moins d’un point. Les tests
statistiques ont confirmé la relation entre les différences de développement et les variables «
année scolaire » et « notes en Portugais ».
Conclusions: Ces résultats montrent l’efficacité des interventions orthophoniques /logopédiques dans la réussite scolaire. Compte tenu de la fréquence élevée des problèmes langagiers
et connaissant leur influence sur la réussite académique, il est de la responsabilité des écoles de
créer un espace d’intégration comme levier de la réussite pour tous les étudiants.
Mots-clés: Orthophonie/logopédie; langue; intervention; efficacité
92
19.4
“RUN THE RAN!”: L’ENTRAINEMENT A LA DÉNOMINATION RAPIDE
AUTOMATISÉE (RAPID AUTOMATIZED NAMING – RAN) PEUT-IL
AMELIORER LE DÉCODAGE DE LA LECTURE? ÉTUDE PILOTE
Chiara Pecini - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Silvia Bonetti - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Silvia Spoglianti - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Maria Chiara DiLieto - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Francesca Guaran - UO NPI, ASL 10, San Doà di Piave, Italy
Filippo Gasperini - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Paola Cristofani - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Sara Mazzotti - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Renata Salvadorini - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Daniela Brizzolara - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Anna Chilosi - IRCCS Stella Maris, University of Pisa, Pisa, Italy
Claudio Vio - UO NPI, ASL 10, San Doà di Piave, Italy
Objectif: Il est bien connu que les déficits de dénomination rapide automatisée (rapid automatized
naming RAN) sont souvent associés aux déficits de rapidité de lecture et de sévérité du trouble
dans la dyslexie développementale (DD), à tous les âges, dans toutes les langues (Norton & Wolf,
2012; Landerl et al., 2013). Cependant, peu d’études ont entrepris d’améliorer la rapidité du RAN
pour améliorer les compétences à la lecture (Kyrby et al., 2012). De plus, les enfants atteints de
déficits isolés de RAN ne sont pas traités précocement parce que le déficit le plus évident, c’està-dire le déficit du processus phonologique, demande plus souvent une intervention et pourrait ne
pas être présent (Wolf & Bowers, 2000). De fait, surtout dans les langues à orthographes régulières, comme l’italien, des déficits isolés en RAN et de rapidité de lecture sont souvent observés
(Wimmer, 1993; Zoccolotti et al., 1999; Brizzolara et al., 2006; Chilosi et al., 2009).
Cette étude vise à augmenter les compétences de dénomination rapide automatisée chez les
enfants en âge préscolaire atteints de déficits RAN ou chez les enfants atteints de DD et d’un
déficit prévalent de la rapidité du décodage de la lecture.
Méthodes: La rapidité du RAN a été entrainée en utilisant le projet “Run the RAN” (Ridinet, Anastasis, Bologna, IT), un nouveau logiciel auto-adaptatif pour la rééducation à domicile. Il prévoit
dénomination d’images en noir et blanc présentées à vitesse croissante sur un écran d’ordinateur.
L’entrainement a duré 2 ou 3 mois, environ 10 minutes par jour. Alors que l’enfant atteignait la
rapidité demandée, la difficulté (rapidité, type et dimension des images) augmentait. Un psychologue expérimenté surveillait l’entrainement et rencontrait l’enfant une fois par semaine pour faire
accroître la compliance des participants et éventuellement changer les paramètres d’entrainement. Tous les enfants (n=15), âgés de 5 et 11 ans, ont été évalués avant et après le traitement
par le biais d’une batterie de tests neuro-psychologiques, évaluant la fluence lexicale, les habilités
métaphonologiques, l’attention visuelle, l’inhibition, la rapidité du décodage de la lecture et la
précision et compréhension de la lecture.
Résultats: Les résultats préliminaires sont encourageants et l’entrainement par le ‘’Run the RAN’’
a été associé aux améliorations liées à la rapidité de dénomination, à l’attention visuelle, à l’inhibition et, de manière plus importante, à la rapidité de lecture des textes et mots.
Une compliance et une motivation élevées ont été obtenues lorsqu’il a été demandé à des enfants
DD de faire progresser leur capacité à la lecture par le biais d’un jeu à l’ordinateur ne requérant
pas d’exercices de lecture.
Conclusions: ‘’Run the RAN’’, une procédure d’entrainement visant à améliorer les principaux
processus cognitifs sous-tendant à la lecture, peut représenter un nouvel outil dans la prise en
charge des enfants atteints, ou à risque, de déficits de rapidité de la lecture.
Mots-clés: RAN, dyslexie développementale, entrainement
93
19.5
APPROCHE AXÉE SUR LES CAPACITÉS APPLIQUÉE À LA DYSLEXIE
DÉVELOPPEMENTALE DANS LA VIE PROFESSIONNELLE
Joost de Beer - HAN University of Applied Sciences and Tilburg University, Hogeschool van Arnhem en Nijmegen and Tilburg
University, Nijmegen and Tilburg, Netherlands
Objectif: Décrire des expériences de travail chez des adultes ayant une dyslexie développementale (DD) dans le cadre de l’approche axée sur les capacités, en se servant du socle commun des
capacités professionnelles de Van der Klink et al. (2012).
Méthode: Nous nous sommes servis de l’approche axée sur les capacités (AC) (Sen, 1992)
comme cadre central de cette étude. Dans la littérature sur l’AC deux capacités ont été décrites
comme étant fondamentales: la capacité d’être en bonne santé (Venkatapuram, 2011) et la
capacité de recevoir une éducation appropriée (Terzi, 2005). Ces deux capacités ont une grande
importance pour la participation à la vie professionnelle des personnes avec DD. Dans le domaine
du travail, Van der Klink et al. (2012) ont identifié un socle commun de sept capacités professionnelles rendu opérationnel par le biais d’un questionnaire. Un exemple de capacité est de
construire des relations professionnelles significatives avec les autres. Ce socle commun a été utilisé comme cadre pour 30 entretiens approfondis avec 30 personnes ayant un diagnostic de DD
et travaillant au moins 12 heures par semaine. Dans le guide d’entretien les questions portant sur
les capacités avaient une structure similaire à celle du questionnaire : quelle importance a pour
vous cette capacité, votre travail vous offre-t-il les opportunités pour l’appliquer, l’appliquez-vous
réellement et quel est le rôle de la DD dans ce processus ? Les entretiens ont été analysés à l’aide
de Atlas-ti 6.
Résultats: Des analyses préliminaires nous indiquent que les sept capacités sont également
importantes pour tous les participants. Il existe toutefois des différences considérables entre
les possibilités de mettre en œuvre ces capacités dans le travail courant. Les différences sont
associées à des facteurs personnels tels que l’âge, l’expérience, les stratégies d’adaptation et de
compensation, la motivation et la persévérance, mais aussi à des facteurs environnementaux tels
que le soutien social et la compréhension de la DD et de son impact sur les employeurs.
Conclusion: Le socle commun des compétences professionnelles permet de décrire l’impact de
la DD sur la participation à la vie professionnelle. Il donne également des indications pour une
intervention ciblée tant au niveau personnel que contextuel.
Mots-clés: Dyslexie développementale, travail/emploi, participation, approche axée sur la capacité
19.6
BÉGAYEMENT ET TROUBLES SPÉCIFIQUES DE LA LECTURE:
ANALYSE D’UNE POPULATION CLINIQUE D’AÂGE SCOLAIRE
Eleonora Pasqua - Clinical Center, CRC Balbuzie, Rome, Italy
Emilia Capparelli - Clinical Center, CRC Balbuzie, Rome, Italy
Roberta Siddi - Clinical Center, CRC Balbuzie, Rome, Italy
Biancamaria Venuti - Clinical Center, CRC Balbuzie, Rome, Italy
Donatella Tomaiuoli - Clinical Center, CRC Balbuzie, Rome, Italy
Objectif: Les enfants bègues peuvent avoir tendance à lire plus lentement que des enfants provenant d’un échantillon normal, à cause du retard/atypie découlant des troubles de la fluidité verbale.
Pour ces raisons, en général, les caractéristiques de lecture chez les enfants bègues ne sont pas
94
considérées comme des indicateurs fiables de troubles spécifiques de l’apprentissage au cours
du bilan d’évaluation, en dépit du fait qu’un taux élevé de comorbidité entre les deux troubles soit
rapporté (environ 10-15%).
Le but de cette étude est :
a) d’enquêter sur la qualité de la lecture chez les sujets bègues et chez les sujets ayant une
comorbidité de bégayement et de dyslexie, en portant une attention particulière aux modifications
possibles des troubles de la fluidité verbale au cours de lecture
b) d’analyser les différences qualitatives et quantitatives possibles des troubles de la fluidité verbale au cours de la lecture entre les deux groupes et comprendre comment ces variantes dans les
troubles de la fluidité verbale peuvent être corrélées aux troubles de la lecture.
Méthodes: Cette étude a analysé la qualité de la lecture sur un échantillon d’enfants d’âge scolaire étant suivi pour le bégayement au « Centro CRC de Rome » pendant une période de 4 ans
de 2011 à 2014.
Tous les enfants ont participé à un bilan d’évaluation pluridisciplinaire concernant le degré général
du développement, les compétences neuropsychologiques et d’apprentissage et un bilan multidimensionnel du bégayement.
Il a donc été possible de comparer les sous-groupes d’enfants, les uns présentant seulement de
bégayement, les autres ayant une comorbidité de bégayement et de troubles de la lecture.
En particulier, une analyse des troubles de la fluidité verbale concernant les deux sous-groupes a
été menée au cours de la lecture de textes et a été comparée aux troubles de la fluidité produits
pendant le discours spontané.
Résultats: Une analyse des résultats obtenus nous a permis de:
- confirmer la présence d’une comorbidité élevée et souvent non- identifiés entre les deux
troubles;
- mettre en évidence chez les enfants bègues et dyslexique les traits spécifiques des troubles de l
a fluidité verbale produits au cours de la lecture et des troubles produits lors du discours spon
tané; cette preuve nous a permis de définir de nouveaux indicateurs d’évaluation capables de
prévoir les difficultés d’apprentissage chez les enfants bègues.
Conclusions: Le bégayement peut “masquer” les troubles de la lecture qui peuvent sérieusement
compromettre la performance scolaire. Cette étude souligne donc l’importance de toujours mener
des bilans précis d’évaluation de la lecture chez les enfants bègues, afin de planifier une prise en
charge qui tienne compte de la comorbidité.
Mots-clés: Bégayement, dyslexie, comorbidité, compétences de lecture
20.1
DÉVELOPPER DES OUTILS POUR LES MAITRES DE STAGES EN
ORTHOPHONIE/LOGOPÉDIE
Willy Voor in t holt - Hanze University of Applied Sciences, Hanze University of Applied Sciences, Groningen, Netherlands
Aafke van der Schaaf - Hanze University of Applied Sciences, Hanze University of Applied Sciences, Groningen, Netherlands
Susanne Kohlleppel - Hanze University of Applied Sciences, Hanze University of Applied Sciences, Groningen, Netherlands
Objectif: Préparer les étudiants en orthophonie/logopédie aux stages pratiques cliniques est une
activité difficile pour les enseignants. A l’Université de Sciences Appliquées de Hanze, Pays Bas,
les étudiants doivent suivre un programme de formation et un stage lors de la deuxième et troisième année d’études dans les « leerwerkplaats » (places virtuelles d’apprentissage). Ils constituent un petit cabinet, d’environ 12 étudiants, où ils apprennent à évaluer les patients, les compétences de la pratique clinique ainsi qu’à développer des attitudes professionnelles et réfléchies.
Les enseignants ont développé ensemble une boite à outils contenant des exemples importants,
utilisables et efficaces pour soutenir la progression de leurs étudiants. Ce programme a aussi
contribué au développement professionnel des enseignants et à développer leurs connaissances
95
afin de mettre en place de nouvelles ressources pour eux-mêmes.
Méthodes: Par le biais d’un processus itératif d’analyse, de prototypes, d’expérimentations,
d’observations, de réflexions et d’évaluations formatives, des outils éducatifs ont été développés.
En ce qui concerne le programme de formation des orthophonistes/logopèdes, les étudiants, les
enseignants et les chercheurs ont tous participé à l’amélioration des stratégies et des méthodes
d’enseignement pour la mise en place des stages internes dans les « leerwerkplaats ».
Résultats: Les compétences intégratives, cognitives et métacognitives, qui sont considérées
comme des facteurs importants du raisonnement clinique, n’ont pas été activées facilement
dans les « leerwerkplaats », selon les dires des étudiants et des enseignants. Le développement,
l’expérimentation et la réflexion sur les outils éducatifs ont permis aux étudiants d’améliorer leur
expérience cognitive et métacognitive.
En même temps, il a fourni aux enseignants des idées sur la didactique des programmes d’apprentissage interne et des outils efficaces et utilisables.
Conclusions: Le projet collaboratif et le développent clinique d’outils éducatifs dans le contexte
des ‘ leerwerkplaats’ s’est révélé efficace. Il a amélioré la conscience des étudiants par rapport
aux apprentissages cognitif et métacognitif, ainsi que la conscience des enseignants au sujet des
possibilités didactiques. Ces outils constituent le point de départ d’une boîte à outils contenant
des éléments flexibles que les enseignants peuvent utiliser dans les stages avec leurs étudiants et
les préparer ainsi aux stages cliniques effectifs.
La devise de cette présentation sera donc:
“Soyez courageux. Prenez des risques. Rien ne peut remplacer l’expérience” Paolo Coelho
Mots-clés: Internat, apprentissage métacognitif, enseignants de Orthophonie/Logopédie, outils
éducatifs
20.2
SERVICES CONTINUS DES PRESTATIONS EN ORTHOPHONIE/LOGOPÉDIE
Lemmietta McNeilly - American Speech-Language-Hearing Association, N/A, Rockville, United States
Tommie Robinson Jr. - Children’s National Health System
Objectif: Décrire l’importance des prestations en orthophonie/logopédie et les résultats en terme
de communication fonctionnelle ; revoir les éléments de pratique collaborative et décrire l’utilisation efficace du personnel de soutien.
Méthodes: Se concentrer sur la prestation de service permet au patient/enfant/client de mieux
fonctionner dans différents contextes comme la maison, l’école, le bureau et la communauté.
Trouver les ressources pour former les autres orthophonistes/logopèdes, les professionnels de la
santé, les individus et leurs familles sur l’importance des prestations en orthophonie/logopédie
et du rapport des résultats, y compris de la satisfaction du patient. Recueillir des données sur les
prestations de télé-thérapie en orthophonie/logopédie et sur le personnel de soutien pour évaluer
leur impact sur les patients.
Résultats: Les orthophonistes/logopèdes travaillent avec du personnel de soutien et coopèrent
avec des professionnels d’autres domaines pour satisfaire les besoins de communication de leur
patients/clients. Le nombre d’orthophonistes/logopède qui travaillent en télé-thérapie est en a
Conclusions: Exercer la profession “au plus près de leur enseignement” est un concept qui guide
les orthophonistes/logopèdes à s’engager dans une pratique clinique qui demande des connaissances et des compétences professionnelles et à déléguer des tâches pouvant être exécutées
par ex. par le personnel de soutien ayant un degré de formation inférieur ou des compétences
différentes. Les orthophonistes/logopèdes qui travaillent au plus près de leur enseignement,
consultent d’autres professionnels, évaluent les sujets, planifient des traitements qui satisfont aux
besoins fonctionnels des clients/patients. Ils forment et supervisent également d’autres professionnels ainsi que le personnel de soutien dans la pratique des compétences de communication.
Les orthophonistes/logopèdes communiquent la valeur des services d’orthophonie/logopédie aux
autres.
Mots-clés: Personnel de soutien, pratique à distance, pratique collaborative
96
20.3
UN PROJET SOCIAL DE THÉÂTRE AVEC DES SUJETS APHASIQUES
ET DES ÉTUDIANTS EN ORTHOPHONIE/LOGOPÉDIE:
IMPLICATIONS ÉDUCATIONNELLES
Federica Morra - University of Turin, Turin, Italy
Lorena La Rocca - Carlo Molo Onlus Foundation, Center for Aphasia CIRP, Turin, Italy
Stefano Monte - Carlo Molo Onlus Foundation, Center for Aphasia CIRP, Turin, Italy
Roberto Albera - University of Turin, Turin, Italy
Paola Guglielmino - University of Turin, Turin, Italy
Objectif: Les lignes directrices des association nationales et nternationales des orthophonistes/
logopèdes et les documents et projets sur la formation en orthophonique soulignent l’importance
de l’acquisition des compétences génériques ou spécifiques pour les étudiants en orthophonie/
logopédie. En particulier, les compétences de communication intra-personnelles et interpersonnelles ont été récemment reconnues comme essentielles pour les nouveaux orthophonistes/logopèdes.
L’Université de Turin a soutenu le Projet du Centre d‘Aphasie pour les étudiants en orthophonie
“Théâtre et aphasie: des bonnes pratiques pour la prise en charge “. Le but de ce projet était de
vérifier l’accroissement des compétences des étudiants en orthophonie pour la communication
verbale et non verbale, l’empathie et les compétences relationnelles avec les sujets aphasiques
dans le cadre d’un projet social de théâtre. (Teatro Babel).
Méthodes: Cinq étudiants en orthophonie et le groupe du « Teatro Babel » ont participé à l’étude
qualitative et rétrospective. Deux grilles ont été utilisées pour observer les changements et les
progrès.
Résultats: Nos données qualitatives ont montré une progression des compétences de communication non verbale, tout comme les aptitudes émotionnelles et relationnelles; tous les étudiants
ayant participé à l’étude ont rempli un questionnaire qui a montré de bonnes compétences au
niveau de la relation, de l’autocontrôle émotionnel et d’aptitudes de communication à prendre en
charge des sujets aphasiques, comparé aux étudiants n’ayant pas participé, appariés par année
académique.
Conclusions: Nos résultats ont suggéré que le projet peut être considéré comme un outil valable
pour développer les compétences communicatives, comportementales et relationnelles, qui sont
essentielles pour des professionnels qualifiés et très recommandés par les associations d’orthophonistes/lAAogopèdes.
97
20.4
INTERVENTION DE L’ORTHOPHONISTE/LOGOPÈDE DANS LE
CONTEXTE ÉCONOMIQUE DES PAYS EUROPÉENS: DIFFICULTÉS ET
STRATÉGIES. UNE ÉTUDE PILOTE PAR LE CPLOL
Ellianna Mantaka-Brinkmann - CPLOL, Professional Practice Commission, Paris, France
Mette Thomsen - CPLOL, Professional Practice Commission, Paris, France
Christine Grignard - CPLOL, Professional Practice Commission, Paris, France
Tiziana Rossetto - CPLOL, Professional Practice Commission, Paris, France
Angela Pommersheim - CPLOL, Professional Practice Commission, Paris, France
Mateja Cacnik - CPLOL, Professional Practice Commission, Paris, France
Raffaella Citro - CPLOL, Professional Practice Commission, Paris, France
Pinar Ege - CPLOL, Professional Practice Commission, Paris, France
Objectif: Le groupe de travail sur la situation économique a été constituée en mai 2012 au sein de
la Commission Pratique Professionnelle. Le but du travail était de recueillir les données sur la pratique des orthophonistes/logopèdes en relation avec la situation économique des pays membres.
L’étude se proposait de contacter les orthophonistes/logopèdes de chaque pays, d’étudier leur
situation financière, le soutien financier dont ils disposent et voir comment ils peuvent assurer la
pratique la plus efficace dans les limites de leurs moyens. Cette étude pilote a été menée par les
délégués de la Commission Pratique Professionnelle.
Méthodes: Un questionnaire a été préparé par le groupe de travail visant à étudier des sujets tels
que la position des orthophonistes/logopèdes dans le cadre du système, le système de référence dans leur pays, la couverture d’assurance privée et/ou publique disponible, les possibilités
d’emploi pour les orthophonistes/logopèdes, ce que les orthophonistes/logopèdes pensent au
sujet de certains de ces problèmes, etc. Alors que certaines questions étaient à choix multiple,
d’autres étaient ouvertes et nécessitaient des réponses détaillées de la part des orthophonistes/
logopèdes. Le questionnaire a été envoyé aux membres de la Commission Pratique Professionnelle. Leurs réponses ont été analysées et font l’objet d’un rapport dans cette étude. Plus tard, le
questionnaire sera proposé à tous les orthophonistes/logopèdes dans tous les pays membres.
Résultats: Cette étude éclairera la situation économique relative à la pratique des orthophonistes/
logopèdes dans chaque pays membre. Les résultats donneront une information sur les similitudes
et les différences entre les pays quant aux outils économiques et aux possibilités offertes aux professionnels, indiqueront comment la situation dans chaque pays peut être modifiée afin d’améliorer l’efficacité au plan économique ainsi qu’à celui de l’évaluation et du traitement et comment les
orthophonistes/logopèdes jugent la situation dans laquelle ils se trouvent.
Conclusions: Le partage des résultats entre toutes les parties concernées dans chaque pays
pourrait améliorer la collaboration entre les institutions publiques et privées et les orthophonistes/
logopèdes au profit de tous les citoyens européens.
Mots-clés: Pratique professionnelle, efficacité, situation économique
98
20.5
LOGOPEDIA PROLINGUA : PROJET INTERDISCIPLINAIRE POUR LA
PROMOTION, L’INNOVATION ET L’INTERNATIONALISATION
DE L’ORTHOPHONIE/LOGOPÉDIE EN ESPAGNE
Lidia Rodríguez - Faculty of Speech and Language Therapy, University of Castilla-La Mancha, Talavera-Toledo, Spain
Objectif: Logopedia Prolingua est un projet d’innovation qui vise à promouvoir l’internationalisation de l’orthophonie en Espagne. C’est un projet multidisciplinaire et interuniversitaire coordonné
par l’Université de Valladolid et l’Université de Castilla-La Mancha. Quelques-uns de ses objectifs sont: de favoriser les dimensions internationales et multilingues dans la formation initiale de
l’enseignement supérieur espagnol en orthophonie/logopédie.
Méthodes: Le projet est structuré en trois phases et cinq unités de travail (UT) selon le Projet
Netques, auquel nous avons participé. UTP1: Coordination. UTP2: Langues Prolingua. UTP3:
Mobilité Prolingua. UTP4: Prolingua Institutionnelle. UTP5. Exploitation. Le projet a bénéficié du
financement partiel soutenu par: Proyectos de Innovación Docente, 2013-15, Vicerrectorado de
Innovación. Universidad de Valladolid, Espagne.
Résultats: Pendant deux ans, différentes actions ont été menées. Dans un premier temps, la
participation active de deux universités espagnoles au Projet Netques (coordonné par le CPLOL).
Des congrès d’orthophonie/logopédie ont été organisés à l’Université de Valladolid et à l’Université de Castilla-La Mancha. De plus, deux thèmes ont été enseignés en langue anglaise: (1) anglais
pour les orthophonistes/Logopèdes, VU, et (2) Designing materials for Speech and Language
Therapy, UCLM. Plusieurs actions en collaboration avec les professionnels et des instituts scientifiques ont été développées. En ce qui concerne le travail obligatoire que les étudiants doivent présenter pour obtenir leur diplôme en orthophonie/logopédie, des aspects bilingues ont été introduits pour les projets finaux en orthophonie, et l’intégration des étudiants étrangers a également
été facilitée. Pour finir, une dimension supplémentaire d’internationalisation a été crée au sein de
l’Association Espagnole des orthophonistes par la vice-présidence des Relations Internationales.
Conclusions: Au cours de l’année académique 2013-14, l’utilisation de la terminologie professionnelle orthophonie/logopédie a été encouragée par les étudiants. Pour favoriser la dimension
internationale des universités participant au projet, un soutien institutionnel majeur est requis.
Mots-clés: projet d’innovation, formation supérieure en orthophonie, congrès d’orthophonie/logopédie, relations internationales.
20.6
LA FORMATION INTERPROFESSIONNELLE AUJOURD’HUI POUR LES
PROFESSIONNELS DE LA SANTÉ DE DEMAIN
Claudy Cobben-Crefcoeur - ZUYD, University of Applied Sciences, Heerlen, Netherlands
Objectif: Une équipe de la Faculté des Sciences de la Santé de l’Université en Sciences Appliquées
de Zuyd (Pays Bas) a mis en place de façon systématique un cadre de compétences pour la formation interprofessionnelle (FIP) qui servira de base dans tous les programmes de formation dans le
domaine de la santé (soins infirmiers, orthophonie/logopédie, ergothérapie, physiothérapie, technologies médicales, thérapie par l’art et obstétrique). En 2015 ces compétences interprofessionnelles
seront progressivement mises en place dans tous les programmes de formation en santé.
Méthodes: L’équipe FPI a effectué un travail préparatoire pendant deux ans. En conformité avec
le Model of Implementation (R.Grol & M. Wensing, 2006), un plan de mise en œuvre ascendante a
été développé. Celui-ci guide l’équipe et le personnel de façon considérable. Toutes les étapes du
99
projet seront expliquées et illustrées.
Résultats: Un cadre de compétences de FPI est composé de ce que l’on appelle “Eléments de
Zuyd” (Zuyd Building Blocks).
Ces éléments représentent toutes les compétences (aptitudes, connaissances et savoir-faire)
qu’on peut attendre d’un professionnel de la santé (par exemple d’un orthophoniste/logopède) de
demain. Ils seront mis en œuvre dans plusieurs programmes de formation en santé de l’Université
de Zuyd pour équiper les futurs professionnels de façon appropriée. Le programme d’orthophonie
permet la mise en œuvre d’ des premières adaptations de ces compétences.
Conclusions: Les organisations de santé du monde entier ont besoin de professionnels de la
santé qui ont des connaissances, des compétences et des aptitudes interprofessionnelles. Les
bonnes pratiques offrent des modèles à suivre. Cependant, la mise en place de ces compétences
de façon satisfaisante dans différents programmes de santé de l’Université des Sciences Appliquées de Zuyd n’est pas aisée. Elle nécessite une approche durable, un travail d’équipe dans la
joie et la bonne humeur et la de persévérance. Mais cela en vaut la peine !
Mots-clés: Formation interprofessionnelle (FPI); professionnels de la santé; futurs professionnels
21.1
LES TROUBLES DE LA COMMUNICATION DANS LE TRAUMATISME
CRANIO-CÉRÉBRAL
Zahra Ghayoumi - University of Social Welfare and Rehabilitation, Tehran, Iran
Fariba Yadegari - University of Social Welfare and Rehabilitation, Tehran, Iran
Behrooz Mahmoodi-Bakhtiari - University of Tehran, Tehran, Iran
Objectifs: La production du discours étant est une tâche cognitive et linguistique de haut niveau,
on s’attend en général à ce que les individus traumatisés crâniens (TCC) démontrent des difficultés dans cet aspect de la communication Ainsi, l’évaluation clinique du discours est devenu un
outil intéressant pour apprécier les compétences de communication après TCC. Il existe plusieurs
types différents de discours. Parmi eux, le discours de persuasion est considéré comme un des
plus exigeants sur le plan cognitif. Toutefois, peu de travaux portent sur la question du discours
de persuasion chez les adultes avec TCC.
L’objectif de l’étude est donc d’évaluer la performance d’adultes traumatisés crâniens sur une
tâche de discours de persuasion en production orale afin de déterminer des indices de troubles
langagiers.
Méthodes: 13 adultes TCC non aphasiques, locuteurs en Farsi (Iran), âgés entre 19 et 40 ans (âge
moyen: 25,54; mois post TCC: 25,75; nombre de jours de coma: en moyenne 56,15; score moyen
à l’échelle de Glasgow : 8,23; test de Folstein (ou MMSE - test d’évaluation des fonctions cognitives) – en moyenne 26,77) et 20 adultes appariés pour les besoins de cette étude ont été inclus
dans cette étude. Aucun des participants n’avaient d’éléments anamnestiques de type psychiatrique ou neurologique, mis à part leur TCC. La tâche de discours de persuasion a été présentée
en demandant à tous les participants d’exprimer leur point de vue sur un thème. En analysant
les productions discursives, les 2 groupes ont été comparés sur certaines dimensions micro- et
macro-linguistiques.
Résultats: Le groupe TCC a produit des discours significativement différents en terme d’indices
retenus, tant au niveau micro- que macro-linguistique comparé au groupe contrôle.
Conclusions: Il nous paraît important d’évaluer les troubles du discours chez les sujets TCC en
plus de leurs autres troubles cliniques, compte tenu du fait que le discours de persuasion est
crucial dans les milieux sociaux et académiques. Ce type de discours pourrait fournir un outil utile
pour les orthophonistes souhaitant évaluer les troubles de la communication chez les patients
cérébro lésés.
Mots clés: traumatisme cranio-cérébral, troubles acquis de la communication
100
21.2
DÉPISTAGE DES TROUBLES DU LANGAGE COGNITIFS CHEZ LES
PATIENTS AYANT UN DISFONCTIONNEMENT EXÉCUTIF
Julia Buettner - Department
of Speech and Language Therapy & Faculty of Linguistics, Hospital for Neurology and Rehabilitation
Schoen Klinik Bad Aibling & Ludwig Maximilians University of Munich, Munich, Germany
Objectif: Les troubles cognitifs de la communication sont caractérisés par une conduite discursive et de cohérence du texte non concluante. Les handicaps sont liés aux disfonctionnements
des habilités exécutives et peuvent influencer la vie quotidienne.
Le but de cette étude est a) de corréler l’interaction des fonctions exécutives et les résultats d’un
nouvel outil de dépistage (MAKRO), b) de comparer les scores des patients MAKRO aux groupes
de contrôle sains, c) d’évaluer l’approche thérapeutique sur la base des résultats du dépistage
individuel.
Méthodes: Dans une étude de cohorte potentielle (n=41), les scores des patients MAKRO ont été
comparés aux scores des groupes de contrôle sains, et corrélés aux compétences du système
exécutif, tout comme la planification (Tower of London, ToL), la mémoire de travail et la fluence
verbale. Les patients avaient subi soit un traumatisme cranio-cérébral soit un accident vasculaire
cérébral (AVC), avec lésions des lobes (pré)frontaux. De plus, un sous-groupe (n=8) a suivi un
entrainement pendant 3 semaines visant à améliorer les habilités macrostructurales de planification et de contrôle.
Résultats: Les patients pathologiques ont obtenu de moins bons résultats que le groupe contrôle
dans les tests de dépistage (z= -5,33, p< 0,001). Ceux ayant préservé des habilités exécutives ont
montré moins de handicap sur le plan du discours. Le ToL a eu la répercussion la plus forte sur les
activités de production. Après le traitement, les patients ont progressé de manière significative,
autant en termes d’habilités de planification qu’en termes de résultats MAKRO (z= -2,37; p< 0,05).
Conclusions: Le test MAKRO favorise non seulement le dépistage distinctif des habilités langagières plus élevées, mais il fourni aussi des approches thérapeutiques efficaces chez les patients
présentant des déficiences exécutives.
Mots-clés: Traumatisme cranio-cérébral, trouble cognitif
21.3
LA COMPETENCE EN LECTURE DES ADULTES INCARCÉRÉS:
LE QUESTIONNAIRE POUR LA LECTURE DES ADULTES(QLA) POUR
LE DÉPISTAGE DES BESOINS ÉDUCATIFS SPÉCIFIQUES
Arve Asbjørnsen - Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Terje Manger - Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
Ole-Johan Eikeland - Eikeland Education and Research, NA, Bergen, Norway
Objectifs: Le nombre de défis liés à l’apprentissage est en augmentation parmi les personnes
adultes incarcérées. Des procédures d’évaluation fiables sont donc essentielles pour déceler les
besoins éducatifs spécifiques et pour planifier les programmes de soins et les prises en charge.
Le Questionnaire pour la Lecture chez l’Adulte (QLA) a été développé pour évaluer les compétences en lecture et en orthographe chez les adultes susceptibles d’être atteints de dyslexie, en
se concentrant sur quatre facteurs : la lecture, la recherche de mots, l’attention et l’hyperactivité.
L’objectif principal de cette étude est de déterminer si le questionnaire (QLA) est valable comme
outil de dépistage des compétences en lecture et en orthographe chez les adultes incarcérés et
d’évaluer s’il peut dépister avec fiabilité les adultes dyslexiques.
101
Méthodes: 1541 adultes incarcérés (5,4% de femmes) ont effectué une traduction en norvégien
du QLA dans le cadre de l’enquête d’évaluation des compétences de base, des besoins éducatifs et des motivations liées à l’éducation. Chez 29% des participants une dyslexie a été diagnostiquée.
Résultats: Les résultats du Questionnaire pour la Lecture chez l’Adulte (QLA) sont les suivants : un
coefficient α de Cronbach de 0,88, qui montre que cette échelle peut comprendre plus d’un facteur.
Le modèle à quatre facteurs a produit un coefficient de détermination acceptable, mais un modèle
simplifié a produit un coefficient de détermination bien meilleur, en différenciant de manière fiable le
diagnostic des participants avec - ou sans - dyslexie (spécificité = .80; sensibilité =.65).
Conclusions: Le Questionnaire QLA semble être une procédure valable et fiable pour le dépistage des compétences de lecture chez l’adulte, mais des essais de validation spécifiques seront
nécessaires. Les premières expériences réalisées à partir des sections en Norvégien sont encourageantes. Puisque le Questionnaire QLA a produit des résultats similaires sur un échantillon au
Royaume-Uni, l’échelle semble être une variable indépendante de la langue.
Mots-clés: Dyslexie, éducation de l’adulte, dépistage des besoins éducatifs spécifiques, éducation des sujets incarcérés
21.4
LES TECHNOLOGIES D’ASSISTANCE DANS LA PRISE EN CHARGE
ORTHOPHONIQUE DES PATIENTS ATTEINTS DE DÉMENCE
Alessandro Croce - Università degli Studi di Torino, Torino, Italy
Federica Polato - Università degli Studi di Torino, Torino, Italy
Rossella Muò - ASL TO1, Dipartimento di Riabilitazione, Servizio di Logopedia, Torino, Italy
Patrizia Steni - ASL TO1, Dipartimento di Riabilitazione, Servizio di Logopedia, Torino, Italy
Objectif: Evaluer l’efficacité des Technologies d’Assistance (TA) dans la prise en charge des
patients atteints de troubles cognitifs chroniques progressifs. (TCCP)
Méthodes: Etude des cas en série sur 12 patients. Critères d’inclusion: diagnostic médical de
TCCP ou de troubles cognitifs légers, âge <90 ans et assistés par des aidants coopérants.
Critères d’exclusion: comorbidité avec troubles psychiatriques, non réactifs aux TCCP.
S’assurer de l’adéquation du procédé d’association entre patient et TA , tout comme des services
de suivi du traitement (entrainement et suivi), respect des recommandations d‘évaluation par la
technologie d’assistance (Scherer, 1998). Des instruments standardisés ont été utilisés pour évaluer les besoins des patients, leur prédisposition à l’utilisation des TA et les résultats du traitement
(en terme d’amélioration de la qualité de vie).
Résultats: Les domaines d’intervention principaux concernaient les supports de mémorisation,
les compétences de communication et de loisir à travers l’utilisation d’outils informatiques comme
les ordinateurs portables, les tablettes et les smartphones. Le protocole adopté s’est avéré
être utile et applicable et les outils d’évaluation des résultats ont montré de très hauts niveaux
de satisfaction avec l’assistance proposée. Cependant, l’amélioration de la qualité de vie était
minime. La période très brève mise à disposition pour l’entrainement et le suivi et le manque de
compliance de certains des aidants au projet ont eu une influence négative sur les résultats.
Conclusions: L’étude a confirmé l’efficacité des TA sur l’amélioration de la qualité de vie chez les
patients et a démontré l’importance d’utiliser des outils standardisés et validés pour le soutien
aux cliniciens dans toutes les étapes de la prise en charge pour atteindre un haut niveau de qualité d’intervention.
Mots-clés: Troubles neurodégénératifs, troubles cognitifs, troubles psychiatriques
102
21.5
MÉMOIRE DE TRAVAIL ET CAPACITÉ SYNTAXIQUE CHEZ LES
PATIENTS ATTEINTS DE LA MALADIE D’ALZHEIMER
Frédérique Gayraud - Laboratoire Dynamique du Langage, CNRS & Université de Lyon, Lyon, France
Camille Frouin - Laboratoire Dynamique du Langage, CNRS & Université de Lyon, Lyon, France
Objectif: L’objectif de cette étude est de comprendre la relation entre la mémoire de travail et la
capacité à répéter des énoncés de complexité variable chez les malades atteints d’Alzheimer.
Malgré une capacité syntaxique relativement bien préservée, (Kempler, Jackson, 1987), la production des énoncés est simplifiée due à une réduction des capacité de la mémoire de travail (Kemper et al,1993).
Les phrases contenant des propositions relatives, notamment celles situées au centre des
phrases sont assez complexes (i) car elles éloignent le sujet de la proposition principale et de ses
verbes, et (ii) interrompent l’ordre normal de la phrase.
Méthodes: L’étude a comparé 30 sujets francophones atteints de la maladie d’Alzheimer et un
groupe de contrôle associé selon l’âge, le sexe et le niveau d’éducation. Les résultats sur la mémoire à court-terme et ceux sur la mémoire de travail ont été recueillis. Les participants devaient
répéter 24 phrases de complexité variable (une ou deux proposition(s), ordre des mots, type de
ramification), et dont la longueur, la fréquence et l’ AoA étaient strictement contrôlés.
Résultats: Le pourcentage de phrases correctement répétées était considérablement inférieur
chez les patients atteints de la maladie d’Alzheimer à celui du groupe contrôle. De plus, les résultats relatifs à la mémoire de travail correspondaient fortement aux résultats de la répétition des
énoncés, mais seulement pour les phrases contenant des propositions relatives situées au milieu
et pour celles ne présentant pas un ordre normal des mots.
Aucune correspondance significative n’a été relevée concernant les phrases simples. Enfin, qualitativement les processus de simplification mis en place par les patients ont eux aussi été analysés.
Conclusions: En conclusion, nous discutons des différentes méthodes utilisées pour évaluer la
mémoire de travail ainsi que des tâches de répétition des énoncés pour évaluer les capacités
syntaxiques chez les patients souffrant de la maladie d’Alzheimer.
Mots-clés: Mémoire de travail, syntaxe, maladie d’Alzheimer, production orale, répétition d’énoncés
21.6
MALADIE D’ALZHEIMER: THÉRAPIE ÉCOSYSTEMIQUE DES
TROUBLES DE LA COMMUNICATION, TROUBLES DU
COMPORTEMENT ET PRESCRIPTION DE NEUROLEPTIQUES
Thierry Rousseau - Laboratoire Unadréo de Recherche Clinique en Orthophonie (LURCO), Université d’Angers,
Sablé sur Sarthe, France
Harmonie Génot - DUEFO et Laboratoire Unadréo de Recherche Clinique en Orthophonie (LURCO), Université Paris VI Pierre et
Camille Huaut - DUEFO et Laboratoire Unadréo de Recherche Clinique en Orthophonie (LURCO), Université Paris VI Pierre et
Contexte: Les troubles du comportement des patients atteints de maladie d’Alzheimer sont
souvent très perturbateurs étant parfois à l’origine d’un isolement du malade et d’une prescription médicamenteuse susceptible d’avoir des effets indésirables. Ces troubles comportementaux
peuvent relever de facteurs propres à la maladie ou somatiques, mais également de facteurs
environnementaux. Quels peuvent être alors les effets d’une thérapie écosystémique de la communication sur les troubles du comportement et la prescription de neuroleptiques de
103
patients-Alzheimer institutionnalisés?
Méthode: 36 malades institutionnalisés en établissement d’hébergement pour personnes
âgées dépendantes (EHPAD) ont été répartis aléatoirement dans deux groupes égaux équivalents en termes de niveau d’atteinte. Chaque groupe comprenait 1 malade d’atteinte légère
(20<MMSE<25), 3 d’atteinte modérée (10<MMSE<20) et 14 d’atteinte profonde (MMSE<10). Les
patients d’un des groupes ainsi que leurs aidants ont été pris en charge en orthophonie, dans le
cadre d’une thérapie écosystémique des troubles de la communication, pendant 5 mois à raison
d’une séance hebdomadaire afin de faciliter et permettre l’émission des actes de langage encore
à la compétence du malade et d’optimiser son environnement de communication en adaptant les
situations de communication, les thèmes de discussion et le comportement des interlocuteurs.
Résultats: Contrairement aux patients témoins, ceux ayant bénéficié d’une prise en charge
orthophonique ont vu leurs capacités de communication, évaluées avec la Grille d’Evaluation des
Capacités de Communication (GECCO), s’améliorer quantitativement et qualitativement, bien que
la taille de l’échantillon et la durée de l’étude n’aient pas permis d’objectiver statistiquement le
rôle tenu par la thérapie écosystémique sur les troubles du comportement (mesurés par le NPI), ni
sur la prescription de neuroleptiques.
Conclusion: Cette étude a montré l’intérêt d’une intervention orthophonique quant à la stimulation
cognitive, au soutien moral, au bien être, au plaisir et aux capacités de communiquer des patients
atteints de maladie d’Alzheimer ainsi que l’intérêt pour l’entourage familial et soignant.
Afin de valider statistiquement les résultats sur l’effet au niveau du comportement et de la prescription de neuroleptiques, il conviendrait de mettre en œuvre une prise en charge sur une population plus importante et sur une durée plus longue (12 à 18 mois) à raison de 2 séances hebdomadaires afin d’optimiser le potentiel de la thérapie systémique sur la base d’ une étude contrôlée
randomisée.
Mots clés: Maladie neurodégénérative, maladie d’Alzheimer, thérapie Écosystémique, neuroleptiques, troubles du comportement, communication
22.1
MODÈLES COMPORTEMENTAUX ET COGNITIFS DES TROUBLES
PRAGMATIQUES DE LA COMMUNICATION
Giovanni Masciarelli - LOGOGEN, Center for SLT and Neuropsychological Rehabilitation, Rome, Italy
Enrico Lurato - LOGOGEN, Center for SLT and Neuropsychological Rehabilitation, Rome, Italy
Maria Rosa Paterniti - Corso di Laurea in Logopedia, Università degli Studi di Palermo, Palermo, Italy
Objectif: Les troubles sociaux (pragmatiques) de la communication font l’objet d’un nouveau
diagnostic dans le DSM V, caractérisé par d’importants problèmes liés à l’utilisation de la communication verbale et non verbale dans des buts sociaux. Cette étude vise à enquêter sur les
points communs et les différences existants entre les traits comportementaux et cognitifs chez les
individus atteints de troubles identiques.
Méthodes: Neuf cas ont été étudiés: trois enfants d’âge pré-solaire, trois enfants d’âge scolaire
et trois adolescents. Chaque patient a été évalué avec une batterie de tests standards de QI et de
compréhension ainsi qu’avec la Checklist de Communication des Enfants – deuxième édition =
Children’s Communication Checklist – second édition (CCC-2).
Résultats: Pour tous les sujets, on a observé une différence importante entre le QI verbal et les
performances de QI, avec toutefois des déficits spécifiques dans les compétences verbales,
associés à des troubles pragmatiques. Tous les sujets ont présenté des difficultés dans les tâches
de compréhension syntaxique et d’inférences dans les discours oraux. Cependant les résultats
des tests sur la maîtrise de la dénomination et sur la fluidité verbale étaient dans la normale. La
moitié des sujets a montré des difficultés de mémoire de travail verbal, mais tous les sujets ont
obtenus des résultats dans la normale dans les compétences visuelles et spatiales.
104
Du point de vue scolaire, nos sujets ont montré un déficit dans la compréhension de la lecture,
même si la moitié des sujets ont présenté des valeurs normales dans la précision et fluidité de
la lecture. Des fautes d’orthographe ont été dépistées chez trois sujets sur six, mais tous présentaient des difficultés dans les tâches mathématiques et la rapidité d’effectuer des calculs,
bien que certain sujets seulement présentaient des signes de déficits procéduraux dans le calcul
mental et écrit.
Conclusions: Les résultats démontrent que le déficit principal de la communication sociale pragmatique se trouve dans l’usage social de la langue, bien que différents profils pathologiques
puissent être établis. Les implications pratiques de ces résultats ont été évoquées dans une perspective de rééducation.
Mots-clés: Troubles Pragmatiques du Langage, compréhension orale, fonctions exécutives,
troubles de l’apprentissage
22.2
COMMUNICATION PRÉCOCE CHEZ DES ENFANTS AYANT DES
TROUBLES DU SPECTRE AUTISTIQUE ET DES ENFANTS AYANT UN
DÉVELOPPEMENT TYPIQUE
Objectif: Explorer les similitudes et les différences des caractéristiques complexes du comportement communicatif précoce des enfants ayant des troubles du spectre autistique (TSA) et
des enfants ayant un développement typique. La diversité et la complexité des fonctions et des
formes de communication ont fait l’objet de cette étude.
Méthodes: 20 sujets, âgés entre 1,5 et 4 ans, dont 10 avec TSA et 10 avec un développement
typique, ont été filmés pendant une interaction non-structurée de jeu avec un parent. Les groupes
étaient assortis selon le genre et la dimension du lexique expressif, estimés à l’aide des Inventaires Mac Arthur-Bates du développement de la communication. Le corpus d’énoncés spontanés
et d’actes de communication ainsi obtenu a été transcrit et analysé en ce qui concerne le type et
la fréquence des différentes fonctions de communication avec un parent pendant 15 minutes de
jeu. De plus, la diversité et le nombre de fonctions et de formes communicatives, exprimées lors
de la communication quotidienne ont été évalués par un questionnaire structuré présenté sous
forme d’entretien avec le parent.
Résultats: Les résultats nous montrent beaucoup de différences quantitatives et qualitative quant
à l’initiation de la communication, au nombre et au type de fonctions et moyens de communication produits par ces deux groupes de sujets. Le modèle des actes de communication fonctions/
langage dans le groupe d’enfants autistiques diffère de celui des enfants au développement
typique plus jeunes d’un niveau de langage expressif semblable.
Conclusions: L’analyse de l’usage fonctionnel du langage dès les phases précoces de l’acquisition de la langue peut contribuer de façon significative à une identification précoce des troubles
du spectre autistique.
Mots-clés: Troubles du spectre autistique
105
22.3
LES HABILITÉS PRAGMATIQUES CHEZ LES ENFANTS
ET ADOLESCENTS PORTEURS DU SYNDROME DE NOONAN,
MESURÉES PAR LA GRILLE CCC-2
Le syndrome de Noonan est un syndrome relativement rare causé par une mutation de voie de signalisation intracellulaire RAS/MAPK, entrainant donc un large spectre de symptômes physiques
et psychologiques dont l’obstination, l’irritabilité et des troubles de la communication font partie
(Pierpont, Tworog‐Dube, & Roberts, 2013). Cet article, appartenant à une étude plus large, s’est
intéressé aux différents aspects des capacités linguistiques de quinze enfants âgés de 6 à 15 ans
porteurs du syndrome de Noonan (SN). Dans cette présentation, nous traiterons uniquement de
l’aspect des habiletés pragmatiques. Les parents des participants ont rempli la Children’s Communication Checklist, deuxième version (CCC-2) (Bishop, 2003). La CCC-2 calcule dix scores et
deux scores composites: un score composite des marqueurs de déviance (SCMD) et un score
composite de la communication (SCC). Les résultats de ces deux scores montrent qu’il n’y a
pas de profils linguistiques type chez les enfants avec SN. En étudiant de façon isolée les scores
linguistiques, afin de créer un score de pragmatique composite, on constate que tous les enfants
sauf un, présentent des capacités pragmatiques en dessous de la moyenne. Ces éléments nous
indiquent qu’il n’y a pas de profil linguistique type chez les patients mais qu’ils présentent souvent des capacités pragmatiques déficientes. Bishop, D. V. (2003). The Children’s Communication
Checklist: Harcourt Assessment London.
Pierpont, E. I., Tworog‐Dube, E., & Roberts, A. E. (2013). Learning and memory in children with
Noonan syndrome. American Journal of Medical Genetics Part A, 161(9), 2250-2257.
22.4
DÉVELOPPEMENT DU LANGAGE CHEZ LES ENFANTS DE 7 À 11
ANS ATTEINTS DE TROUBLES DU SPECTRE AUTISTIQUE: UNE
ÉTUDE TRANSVERSALE
Francesca Pevere - Associazione “La Nostra Famiglia”, Pasian di Prato, Udine, Italy
Andrea Marini - Università degli Studi di Udine, Udine, Italy
Objectif: Décrire les compétences du langage structural sur la production et la compréhension
des enfants âgés de 7 à 11 ans, atteints de troubles du spectre autistique (TSA) et ayant un QI de
performance supérieur à 85.
Enfin, cette étude transversale vise à soutenir l’hypothèse d’une superposition entre étiologie des
troubles du langage et de la parole (TLP) et les TSA.
Méthodes: Des enfants âgés de 7 à 11 ans, atteints de troubles du spectre autistique avec un QI
de performance supérieure à 85 (TSA groupe = 35) ont été comparés à des enfants de même âge
à développement typique (DT) (groupe C, n=70). La production et la compréhension du langage
des enfants sur le plan lexical, grammatical et pragmatique-narratif a été évaluée en utilisant la
batterie d’évaluation du langage évolutif (Batteria di Valutazione del Linguaggio in età evolutiva
BVL 4-12, Marini et al., dans la presse). Les sous-tests de répétition non-verbale (RNV) et la longueur moyenne des énoncés (LME) ont été considérés comme des indicateurs de la maturation
du langage.
Résultats: Les deux indicateurs de la maturation linguistique (RNV et LME) révèlent un trouble
important du langage chez les enfants TSA comparé au groupe C. Les trois niveaux du langage
106
(lexical, grammatical et pragmatique-narratif) et les deux modalités (production et compréhension)
sont plus compromis chez les enfants TSA que chez les enfants à développement typique.
Conclusions: Cette recherche souligne une correspondance fidèle entre les indicateurs de la
maturation linguistique et les performances obtenues dans les tests linguistiques chez les enfants
avec un phénotype TSL. Le groupe TSA a obtenu des résultats significativement inférieurs au
groupe C dans les deux tâches RNV et LME. En cohérence avec ces résultats, les performances
du groupe TSA ont montré des déficits sur le plan lexical, grammatical et pragmatique-narratif,
dans la production et dans la compréhension.
Mots-clés: troubles du spectre autistique, trouble spécifique du langage
22.5
L’INTERVENTION COMPORTEMENTALE INTENSIVE EN ORTHOPHONIE
Ioannis Vogindroukas - Medicopedagogical Center, Psychiatric Hospital Thessaloniki, Thessaloniki, Greece
Nikolaos Chelas Evripidis - REIST, Ioannina, Greece
Konstantinos Paparizos - REIST, Kastoria, Greece
Kristia Christou - Orizontas, Limasol, Cyprus
Contexte: L’intervention comportementale intensive (ICI) a été développée par Dave Hewett
et Mélanie Nind, enseignants à l’école spécialisée de Harperbury, pour les enfants ayant des
troubles spécifiques des apprentissages et des troubles des interactions sociales (Nind et Hewett
1994). L’intervention comportementale intensive a été développée simultanément à la notion de
“maternage intensif” élaborée par le psychologue Dr Gary Ephraim à l’hopital de Levensden dans
les années 80 (Ephraim 1982). L’institut britanique des troubles d’apprentissage a décrit l’intervention comportementale intensive comme une approche ludique et attractive. Les partenaires de
communication sont informés sur la façon dont la communication se développe habituellement
chez l’enfant, ils appliquent alors ces connaissances de façon sensible et respectueuse au patient
quel que soit son âge. (www.bild.org.uk)
Méthodes: Les fondements de cette approche ainsi que les résultats quantitatifs et qualitatifs
obtenus auprès de trois enfants autistes ayant bénéficié de l’ICI en Grèce seront exposés lors de
cette présentation. Des vidéos seront présentées et analysées et un débat sur la fréquence des
séances et l’implication des parents aura lieu.
Résultats: L’ICI est largement utilisée auprès des enfants se trouvant dans le spectre autistique
et des études ont montré l’impact positif de cette approche (Watson et Knight, 1991; Nind, 1996;
Lovell et al. 1998; Kellett, 2000; Cameron et Bell, 2001; Kellett, 2003; Kellett, 2004, Kellett, 2005;
Leaning et Watson, 2006; Barber, 2008; Samuel et al, 2008; Zeedyk et al, 2009; Zeedik et al,2009;
Argyropoulou et Papoudi, 2012). Nos résultats montrent une augmentation de la collaboration,
des interactions sociales, du contact visuel et des prises de parole.
Conclusion: L’ICI est une méthode valable de prise en charge des enfants souffrant de troubles
du spectre autistique.
Mots-clés: Intervention comportementale intensive, Autisme, Orthophonie
107
22.6
ORTHOPHONIE ET MUSICOTHÉRAPIE : UTILISATION D’UNE
APPROCHE COMMUNE POUR DÉVELOPPER L’ATTENTION ET LA COMMUNICATION DES JEUNES AVEC TROUBLES DU SPECTRE
AUTISTIQUE ET TROUBLES DES APPRENTISSAGES
Helen Sutherland - East London Foundation NHS Trust, Child Health HQ, Edgware Community Hospital, London, United Kingdom
Alexandra Georgaki - Mapledown School, Claremont Rd, Cricklewood, Mapledown School, London, United Kingdom
Objectif: Explorer la façon dont la collaboration entre l’orthophonie et la musicothérapie peut
favoriser les compétences de l’attention et de la communication chez les jeunes présentan un
trouble du spectre autistique (TSA) et de graves difficultés d’apprentissage.
Méthodes: Un projet pilote informel a été achevé en juillet 2014, expérimentant l’utilisation d’une
approche de collaboration entre l’orthophonie et la musicothérapie, en utilisant des pratiques thérapeutiques spécifiques des deux domaines. Ces techniques comportent l’écoute rythmique, le
chant (de matériel pré-composé et improvisé) et la récit. Des observations informelles ont montré
des avantages particuliers pour les participants, ce qui a justifié une recherche plus approfondie
qui est actuellement en cours.
La méthode thérapeutique est reproduite avec la collecte de données au début et dans les
phases post-thérapeuthiques. L’échelle de communication pré-verbale (ECPV) a été utilisée pour
mesurer les compétences de communication. L’enregistrement vidéo est utilisé pendant chaque
séance de thérapie pour permettre une analyse descriptive et qualitative plus approfondie. La
période de thérapie est de 10 semaines et s’est achevé en décembre 2014. Les participants sont
un petit groupe d’élèves de 7 ans (N=4) avec une TSA et de graves troubles de l’apprentissage.
Résultats: Les données du projet pilote ont montré des améliorations dans les domaines suivants:
1. La conscience du langage, qui comprend:
a. la conscience des sons vocaux;
b. La conscience que ces sons vocaux véhiculent du sens; et
c. La réception et la réponse lorsque des sons vocaux prévus sont absents.
2. l’attention;
3. l’anticipation;
4. une vocalisation accrue.
Cette étude a permis de rassembler des données plus précises permettant de mesurer les changements dans ces aspects et dans les autres domaines du développement.
Actuellement, les travaux sur ce projet indiquent que le personnel enseignant qui soutient les étudiants au cours des séances de thérapie ont insté sur l’importance de poursuivre ce travail dans
la salle de classe, en utilisant une structure spécifique d’activités de formation et les conseils de
thérapeutes.
Conclusions: Les conclusions préliminaires découlant des données du projet pilote et des travaux
menés sur ce projet sont actuellement les suivants:
1. L’utilisation combinée de l’orthophonie et des pratiques de musicothérapie sont efficaces
pour améliorer les compétences de communication chez les élèves atteints de TSA et de graves
difficultés d’apprentissage. La mise en commun de services pour ce groupe de patients doit être
considéré lors de la planification des services.
2. Les pratiques thérapeutiques particulières sont bien adaptées à la collaboration entre l’orthophonie et la musicothérapie. Ces pratiques ont des similitudes fondamentales, dont des exemples
comprennent:
a. L’utilisation des programmes rythmiques
b. L’utilisation de la voix pour la communication ou comme outil sensoriel, voire les deux. Cela est
visible dans l’utilisation de la prosodie en orthophonie au cours de la récit et de l’utilisation de la
mélodie, de la hauteur, du timbre, du volume, etc en musicothérapie.
c. Les principes de mise en miroir et d’inclusion, dans lequel les thérapeutes reconnaissent et
108
comprennent les actions verbales et non verbales des élèves, permettent de les intégrer dans
l’activité du groupe (par exemple lors de l’improvisation musicale et pendant le récit).
3. L’ analyse des similitudes fondamentales entre l’orthophonie et les pratiques de musicothérapie
utilisés pendant les sessions suivant les axes de progrès observés peuvent donner des informations sur les mécanismes sous-jacents du changement et sur la pratique clinique dans ces deux
domaines.
4. Ces activités thérapeutiques peuvent être présentées comme une structure spécifique des activités à réaliser en classe à un personnel enseignant formé et expérimenté de manière adéquate.
De plus, soutenir la généralisation des compétences pour les étudiants en post-thérapie a des
implications qui acroissent les avantages de cette approche à un groupe plus large d’étudiants,
par exemple ceux qui figurent sur une liste d’attente pour une thérapie. Des recherches ultérieures
explorant les résultats à plus long terme pour les étudiants ayant eu ce soutien post thérapeutique
sont indiquées.
Mots-clés: orthophonie, musicothérapie, travail collaboratif, trouble du spectre autistique, communication, attention
109
ATELIERS
110
W1
EFFICACITÉ DE LA FORMATION DES PARENTS: UNE ÉTUDE
CONTRÔLÉE SUR LES FAMILLES D’ENFANTS AVEC IMPLANTS
COCHLÉAIRE
Gabriella Traisci - Department of Sense Organs, Università “La Sapienza”, Roma, Italy
Ersilia Bosco - Department of Sense Organs, Università “La Sapienza”, Roma, Italy
Raffaella Citro - Private Practice, Salerno, Italy
Maria Nicastri - Department of Sense Organs, Università “La Sapienza”, Roma, Italy
Sara Panizzolo - Azienda Ospedaliera dei Colli, Ospedale Monaldi, Napoli, Italy
Monica Rea - Department of Clinical Psychology, Università “La Sapienza”, Roma, Italy
Objectif: Évaluer l’efficacité d’un cours de formation visant à améliorer les capacités de communication de parents normalement entendants avec leurs enfants sourds
Méthodes: 5 familles de 5 enfants sourds implantés ont été évalués à l’aide de l’Indice de stress
parental (ISP) et du Test de préférence parentale (TPP) avant et après avoir fréquenté un cours de
formation pour les parents. La compréhension et la production langagières orales des enfants ont
été évaluées à l’aide des Inventaires MacArthur-Bates du développement de la communication.
Le cours avait suivi le modèle “It takes two to talk” (il faut être à deux pour parler). Les familles ont
participé à 12 sessions, centrées sur la stimulation de la réactivité des parents tout en réduisant
les directives inappropriées et en contrôlant les interactions. Cinq familles de 5 enfants sourds
implantés, assortis par sexe, âge chronologique, âge auditif et compétences langagières aux
enfants du groupe expérimental, formaient un groupe contrôle n’ayant pas reçu de formation.
Résultats: Une réduction des deux dimensions qui expriment une difficulté relationnelle avec
leur propre enfant a été trouvée au moyen de l’ISP chez les mères ayant suivi la formation, alors
qu’elles ont augmenté chez les mères du groupe contrôle. Un niveau plus élevé de flexibilité chez
les pères et de contingence chez les mères a été enregistré à l’aide du TPP dans le groupe ayant
suivi la formation. Le langage s’est accru davantage chez les enfants des familles ayant suivi la
formation que chez les enfants du groupe contrôle.
Conclusions: Même en tenant compte des limites dues à l’exiguïté de l’échantillon, il semble que
les parents aient tiré profit d’une formation bien conçue, au cours de laquelle ils ont pu apprendre
des stratégies couronnées de succès pour stimuler leurs capacités et promouvoir la communication. Ceci correspond aux évidences internationales sur la formation des parents. La recherche de
modalités plus efficaces de participation active des parents au processus de rééducation de leurs
enfants sourds doit faire l’objet d’un effort commun de tous les cliniciens afin de permettre à tout
enfant de parvenir au meilleur résultat possible.
Mots-clés: Trouble de l’audition
111
W2
“CHE BELLA GIORNATA”: UN NOUVEL OUTIL DE RÉHABILITATION
POUR LES NOURRISSONS ET LES JEUNES ENFANTS PRÉSENTANT
UNE PERTE AUDITIVE
Ersilia Bosco - Department of Sense Organs, University ‘Sapienza’, Rome, Italy
Letizia Guerzoni - ENT Department, “G da Saliceto” Hospital, Piacenza, Italy
Maria Nicastri - Department of Sense Organs, University ‘Sapienza’, Rome, Italy
Ilaria Patelli - ENT Department, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
Christine Rocca - Mary Hare School, Mary Hare School, London, United Kingdom
Gabriella Traisci - Department of Sense Organs, University ‘Sapienza’, Rome, Italy
Objectif: Montrer la mise en œuvre d’un outil de réhabilitation « Che bella giornata ! » qui tire parti
des aspects ludiques de la musique et des chansons, pour aider les professionnels et les parents
à développer des compétences d’écoute et de communication avec les nourrissons et les petits
enfants porteurs d’appareils auditifs ou d’implants cochléaires au cours de leurs interactions et de
leur routine quotidienne, et pour évaluer l’impact préliminaire du nouvel outil sur les parents et les
enfants.
Méthodes: Quatre centres ont coopéré pour mettre en œuvre « Che bella giornata » L’outil destiné
aux enfants âgés de 3 à 36 mois est structuré en trois parties :
1) un livre illustré qui raconte le quotidien d’un enfant avec des chansons pour chaque routine
fondamentale ;
2) des activités et de simples jeux suggérés pour chaque moment choisi pour les tout-petits
(enfants de 3 à 18 mois) et les plus grands (19 à 36 mois), pour guider les parents et les professionnels à communiquer efficacement avec leurs enfants pendant la journée ;
3) une section contenant des descriptions simples et claires des étapes normales que chaque
enfant suit au cours de sa croissance et des listes pour surveiller les progrès de l’enfant et en
discuter avec les professionnels.
Un questionnaire rempli après l’utilisation de l’outil par les parents de 20 enfants a été mis en
place pour mesurer la facilité, les avantages perçus, l’acceptation et la satisfaction de l’outil.
Résultats: Tous les parents ont exprimé de hauts niveaux de satisfaction dans l’utilisation de
l’outil et dans l’augmentation progressive de l’engagement des enfants dans les interactions quotidiennes au cours des mois.
Conclusions: “Che bella giornata” est bien accepté. Les parents expriment l’utilité de l’outil lors
de l’examen de l’usage naturel de la musique et des chansons pendant les interactions avec leurs
enfants, en améliorant leur mode de communication avec les enfants pendant la journée. Le fait
d’avoir une idée claire et une certitude sur ce qu’ils font et quelle sera la prochaine étape de développement normal, apaise leur anxiété et leurs questions à propos de l’enfant.
Mots-clés: surdité, nourrisson, enfant, routine quotidienne, musique
112
W3
ÉTUDE INTER-LINGUISTIQUE DU DÉVELOPPEMENT PHONOLOGIQUE:
RÉSULTATS DE LA RECHERCHE ET OUTILS POUR L’ORTHOPHONIE
May B. Bernhardt - School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
Daniel Bérubé - Faculty of Education, Université de St.-Boniface, Winnipeg, Canada
Inger Lundeborghammarström - KE/Dpt of Neuroscience/ Division of Logopedics, Linköping University, Linköping, Sweden
Martina Ozbic - Pedagoška fakulteta, University of Ljubljana, Lljubljana, Slovenia
Joseph Stemberger - Department of Linguistics, University of British Columbia, Vancouver, Canada
Objectif: Une étude internationale inter-linguistique sur le développement phonologique a deux
objectifs: (1) documenter l’apprentissage phonologique des structures des mots, consonnes et
voyelles, chez les enfants à développement typique (DT) comparé à un retard de développement
et (2) élaborer des outils d’évaluation dans plusieurs langues pour susciter et analyser des échantillons de langage en vue de planifier la prise en charge.
Méthodes: Un cadre phonologique non linéaire permet de concentrer l’attention sur les points
forts et les besoins de l’enfant dans la hiérarchie phonologique, de la phrase aux particularités.
Les équipes de recherche: ont (1) développé des outils stimulants de 100 mots par langue; (2)
recueilli et transcrit les données enregistrées des enfants d’âge préscolaire (DT, DPP) et (3) utilisé
le logiciel Phon pour analyser les données.
Résultats: Les résultats montrent que les enfants sont sujets à des restrictions similaires à travers les langues. Cependant, les inventaires du langage (longueur des mots, accent, structure
des syllabes, consonnes et voyelles) et leur prévalence structurale et phonémique donnent lieu à
différents modèles d’erreur.
Conclusions: Deux auteurs présenteront les résultats de la recherche; deux autres expliqueront
le fonctionnement des outils d’évaluation et présenteront un séminaire en ligne sur l’analyse
d’échantillon langagiers et la création d’activités de traitement phonologique. La distribution des
outils du projet et les résultats seront discutés.
Mots-clés: développement phonologique, phonologie non linéaire
W4
DÉVELOPPER DES RÉSEAUX DE RECHERCHE EN ORTHOPHONIE EN
EUROPE DANS DES PROGRAMME DE MENTORAT: UNE NOUVELLE
APPROCHE STRATÉGIQUE
Mette Thomsen - University College Capital, University, Copenhagen, Denmark
Objectif: Les programmes fondés sur les preuves lancent d’importants défis aux orthophonistes
dans la pratique clinique. En plus des compétences de compréhension et de mise en pratique
des projets de recherche, les orthophonistes/logopèdes doivent aussi envisager les nombreuses
lacunes existant dans les expériences cliniques ; comme par exemple les données normatives
établies pour l’acquisition du langage dans différentes langues et les études d’intervention validées pour les populations locales. En parallèle, les orthophonistes européens ont développé des
méthodes de travail efficaces et adaptées à leur environnement qui méritera

9th CPLOL CONGRESS BOOK OF ABSTRACTS

Transcription

Documents pareils

Dix choses que je peux faire chez moi en utilisant les

WHAT WE OFFER CHILDREN

Voici un petit tutorial pour ceux qui souhaite ajouter des voix

10 Marks - LangJobs

Dépliant pREMIERS pas cHAMPLAIN

brands, shops, posters, catalogues et cartoons - sciences

List of Participants

Conference Poster - Winthrop-King Institute for Contemporary

Back Pack: Expression écrite: généralités

2015.09 - FLyer IbrunCh.indd