Advances in Communication and Swallowing - Volume 24, issue 2

Authors: Regan, Julie | Walsh, Irene P.

Article Type: Other

DOI: 10.3233/ACS-229001

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 73-73, 2021

Authors: Duchan, Judith Felson | Felsenfeld, Susan

Article Type: Review Article

Abstract: BACKGROUND: Cluttering has been described in the literature on speech disorders for over 300 years. Despite this, it remains a poorly understood condition whose history has not been analyzed as a whole to identify common themes and underlying frameworks. OBJECTIVE: The purpose of this review is to identify thematic questions and frameworks contained within the literature on cluttering since the earliest found reference in 1717. METHODS: Information from influential historical and contemporary documents were analyzed. Particular attention was paid to the types of questions, both implicit and explicit, that were posed in these materials. This information …was ultimately organized into five thematic strands, presented here in the form of key questions. RESULTS: Five questions were derived from our historical analysis: (1) What should the problem be called? (2) What kind of problem is it? (3) What are its defining features? (4) What are its causes? and (5) How should it be treated? The first four questions are discussed in this review. The fifth question will be addressed in a companion paper (see this issue). CONCLUSIONS: Consensus has been achieved on what to call the disorder (cluttering) and in what domain it should be placed (fluency). Less agreement exists regarding its defining features, causes, and treatment. We propose that alternative conceptual frameworks may be useful in breaking new ground in our understanding and management of this complex condition. Show more

Keywords: Cluttering, history, review, frameworks, medical model

DOI: 10.3233/ACS-210029

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 75-85, 2021

Authors: Duchan, Judith Felson

Article Type: Review Article

Abstract: BACKGROUND: This integrative review is of two literatures on cluttering treatments. It integrates into those two reviews a third literature to show an alternative way for cluttering to be treated in the future. OBJECTIVE: The aim is to encourage professionals involved in treating those who clutter to reflect on how conceptual frameworks can affect their treatment choices. METHODS: Works from three literatures on interventions are examined. Literatures covering two historic periods of cluttering treatments are compared to one another and to a third literature that offers an alternative framework for working with those who clutter. …RESULTS: Treatment approaches to cluttering have almost universally focused on remediating impairments associated with the disorder. This impairment focus flows from a medical model –a model that views cluttering as a disease, located in the person, in need of remediation. An alternative framework, called the social model, one that focuses on the social conditions surrounding cluttering, is reviewed for its applicability to cluttering therapy. CONCLUSIONS: The medical model, used by authors since cluttering first appeared in the literature, carries within it assumptions about the selection and sequencing of clinical goals aimed at reducing cluttering symptoms. The social model alternative would likely shift the focus to working on ways for promoting the life participation of those who clutter. The applicability of social model practices to the treatment of cluttering is explored and encouraged. Show more

Keywords: Cluttering, treatment, frameworks, medical model, social model

DOI: 10.3233/ACS-210033

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 87-97, 2021

Authors: Sullivan, Rebecca | Skinner, Ian | Harding, Katherine | Hemsley, Bronwyn

Article Type: Review Article

Abstract: BACKGROUND: Falls are a significant patient safety concern in hospital. Adult patients with stroke, and those with communication disability, are at an increased risk of falls during their hospital admission compared to patients without stroke or communication disability. OBJECTIVE: The aim of this review is to determine the circumstances and outcomes of falls in hospitalised patients with communication disability following stroke. METHOD: A qualitative synthesis of 16 papers according to the Generic Reference Model of patient safety. This is a secondary analysis of studies in a systematic review of the association between communication disability after stroke …and falls in hospitalised patients. RESULTS: In studies including participants with communication disability, falls commonly occurred at the patient bedside, during the day, and in transfers. However, no studies provided individual or group data specifically detailing the circumstances and outcomes of falls of the included participants with communication disability. CONCLUSION: Research to date provides scant evidence on the circumstances and outcomes of falls in hospital patients with communication disability after stroke. This review performs a useful function in highlighting a glaring gap in the literature and the urgent need to enrich hospital falls prevention research that includes patients with communication disability following stroke. Findings of this review are discussed in relation to providing a framework for analysis of for future research. Show more

Keywords: Patient safety, falls, inpatient, stroke, communication disability, falls research

DOI: 10.3233/ACS-210028

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 99-110, 2021

Authors: Smith-Tamaray, Michelle | Verdon, Sarah | Hoffman, Laura

Article Type: Research Article

Abstract: BACKGROUND: Recruitment and retention of skilled health workers into rural areas is a major challenge to achieving equity in health between rural and urban populations. OBJECTIVE: This study explored the impact of rurally-based tertiary education in promoting the recruitment and retention of speech and language therapists (SLTs) in non-metropolitan areas and intention to remain in the profession. METHODS: Participants in this cohort study were 133 graduates from a rurally-based speech and language therapy course in Australia who completed the course between 1998 and 2018. Data were collected via an online survey. Data were analysed using inferential …statistics, ArcGIS mapping software and content analysis in NVivo12. RESULTS: 65.0% of the graduates practiced in rural or remote areas with just 21.1% practicing in major cities. Most participants’ ideal work location was in a rural area. Benefits of rural practice included seeing a mixed caseload, living near family, work/life balance and loving their location. Challenges of rural practice included limited opportunities for specialist caseloads and career progression. In total, 93.2% of the rural graduates intended to remain in the speech and language therapy profession for the next 5 years. CONCLUSIONS: This study indicates that SLTs who are trained in rural areas with a focus on servicing rural populations are highly likely to enter and remain in rural practice, consistent with the rural pipeline model. Show more

Keywords: Retention, rural health, speech and language therapy, recruitment, higher education

DOI: 10.3233/ACS-210032

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 111-124, 2021

Authors: Gilheaney, Órla | Quigley, Duana

Article Type: Review Article

Abstract: BACKGROUND: The ability to reflect on one’s own performance, attitudes, and knowledge is an essential attribute of a competent allied health professional (AHP). Traditionally, reflective practice skills have been fostered during clinical placements via dyadic or narrative means (e.g. face-to-face supervision, journal writing, and observational assessment). However, with the onset of the COVID-19 pandemic, students face reduced opportunities for traditional clinical learning experiences, and embraced telepractice, simulation-based learning and other technology-based learning opportunities. OBJECTIVE: Research is limited regarding the use of digital technologies to facilitate the development of students’ reflective practice skills, therefore the best ways to facilitate …this novel learning are not fully known and students may be disadvantaged as a result. As such, a scoping review was conducted to identify studies addressing the enablers and barriers to facilitating reflective practice skills of third level healthcare students, including speech and language therapy students, through technological means. METHODS: Five electronic databases were searched for studies published between 2016 to 2020. Identified records were imported into Covidence and titles and abstracts were screened by two independent reviewers. Data charting and critical analysis was completed by both authors independently. RESULTS: Six studies were ultimately included in data charting. These were of heterogeneous design and mixed quality. Four themes and a range of subthemes were identified regarding enablers and barriers to the facilitation of reflective practice via technological means. CONCLUSIONS: This research has provided critical information which may support the future use of technology in facilitating reflective practice among students. Competency in reflective practice is crucial to the professional development of students, yet COVID-19 and resultant restrictions present challenges to implementing the processes traditionally involved in developing such skills. This research highlights potential avenues for future developments in higher education which may overcome these barriers and augment the professional development of students. Show more

Keywords: Education, practice education, clinical experience, reflective practice, reflection, online

DOI: 10.3233/ACS-210024

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 125-145, 2021

Authors: Gregory, Emma | Clegg, Judy | Cameron, Helen

Article Type: Article Commentary

Abstract: The COVID-19 pandemic has impacted significantly on the provision of speech and language therapy education. In this commentary, we consider the impact of unprecedented uncertainty and disruption on the student experience. Changes made within both university and practice-based learning environments have resulted in the continuation of high-quality learning experiences enabling students to continue or complete their programmes. However, studying in uncertain times has been destabilising for students having the potential to impact on the more nuanced aspects of clinical and professional development (e.g., self-efficacy, confidence, and professional identity formation). We reflect on collaborative efforts to support students with navigating uncertainty …and change and to facilitate their ongoing personal, professional and clinical development in a holistic way. There is a need for empirical research into the experiences of student speech and language therapists who have studied or are continuing to study in the context of COVID-19. Such research will help inform university and practice-based educators as well as speech and language therapy managers about the ongoing needs of this population. Dealing with uncertainty should be considered within university-based curriculum development as well as induction and supervisory systems within the workplace. Show more

Keywords: Speech and language therapy, education, uncertainty, professional identity, COVID-19

DOI: 10.3233/ACS-210030

Citation: Advances in Communication and Swallowing, vol. 24, no. 2, pp. 147-155, 2021