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A survey of speech-language pathology treatment for non-progressive dysarthria in Australia

Published online by Cambridge University Press:  17 March 2020

Narissa Gracia ,
Anna F. Rumbach  and
Emma Finch
Narissa Gracia
Affiliation:
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Anna F. Rumbach
Affiliation:
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Emma Finch*
Affiliation:
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia Speech Pathology Department, Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland Government, Brisbane, Australia Centre for Functioning and Health Research, Metro South Hospital and Health Service, Queensland Government, Brisbane, Australia
*
*Corresponding author. Email: e.finch@uq.edu.au
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Abstract

Aim:

To identify management practices of Australian speech-language pathologists (SLPs) in the treatment of non-progressive dysarthria using a subsystem approach, and to explore SLPs’ consideration and implementation of the theoretical underpinnings of non-progressive dysarthria management.

Method:

A 39-item online survey was distributed to Australian SLPs, with 80 responses suitable for data analysis.

Results:

Practices of SLPs were variable for the management of the speech subsystems. The Lee Silverman Voice Treatment (LSVT®) was the most commonly used manualised treatment program, and was employed by 63.77% of respondents. Almost all SLPs (>88%) provided strategies to improve functional communication. There was no clear preference for low tech alternative and augmentative communication (AAC) devices. Speech generating devices were the most commonly employed high tech device. Almost two-thirds of respondents used non-speech oral motor exercises (NSOMEs) in treatment. SLPs had varied frequencies and models of service delivery for intervention. SLPs valued interventions targeting the activity and participation domains of the ICF, however this was restricted by the treatment context and resources available. The majority of SLPs (92.06%) were aware of the principles of motor learning, however many were unsure regarding the specifics of implementation.

Conclusion:

There is a clear need for further research into the efficacy of treatment techniques to guide decision-making.

Keywords

Speech-language pathologynon-progressive dysarthriatreatmentmanagementsurvey
Type
Articles
Information
Brain Impairment , Volume 21 , Issue 2 , September 2020 , pp. 173 - 190
Copyright
© Australasian Society for the Study of Brain Impairment 2020

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References

Bislick, L. P., Weir, P. C., Spencer, K., Kendall, D., & Yorkston, K. M. (2012). Do principles of motor learning enhance retention and transfer of speech skills? A systematic review. Aphasiology, 26(5), 709–728. doi: 10.1080/02687038.2012.676888.CrossRefGoogle Scholar
Blanchet, P. G., & Snyder, G. J. (2010). Speech rate treatments for individuals with dysarthria: A tutorial. Perceptual and Motor Skills, 110(3), 965–982. doi: 10.2466/pms.110.3.965-982.CrossRefGoogle ScholarPubMed
Block, S., Onslow, M., Packman, A., Gray, B., & Dacakis, G. (2005). Treatment of chronic stuttering outcomes from a student training clinic. International Journal of Language & Communication Disorders, 40(4), 455–466. doi: 10.1080/03093640500088161.CrossRefGoogle ScholarPubMed
Brady, M. C., Clark, A. M., Dickson, S., Paten, G., & Barbour, R. S. (2011). The impact of stroke-related dysarthria on social participation and implications for rehabilitation. Disability and Rehabilitation, 33(3), 178–186.10.3109/09638288.2010.517897CrossRefGoogle ScholarPubMed
Cheung, G., Trembath, D., Arciuli, J., & Togher, L. (2013). The impact of workplace factors on evidence-based speech-language pathology practice for children with autism spectrum disorders. International Journal of Speech-Language Pathology, 15(4), 396–406.10.3109/17549507.2012.714797CrossRefGoogle ScholarPubMed
Collis, J., & Bloch, S. (2012). Survey of UK speech and language therapists’ assessment and treatment practices for people with progressive dysarthria. International Journal of Language & Communication Disorders, 47(6), 725–737. doi: 10.1111/j.1460-6984.2012.00183.x.CrossRefGoogle ScholarPubMed
Conway, A., & Walshe, M. (2015). Management of non-progressive dysarthria: Practice patterns of speech and language therapists in the Republic of Ireland. International Journal of Language & Communication Disorders, 50(3), 374–388. doi: 10.1111/1460-6984.12143.CrossRefGoogle ScholarPubMed
Dickson, S., Barbour, R. S., Brady, M., Clark, A. M., & Paton, G. (2008). Patients’ experiences of disruptions associated with post-stroke dysarthria. International Journal of Language and Communication Disorders, 43(2), 135–153.CrossRefGoogle ScholarPubMed
Duffy, J. R. (2013). Motor speech disorders: Substrates, differential diagnosis, and management. Retrieved from https://ebookcentral.proquest.com/auth/lib/fjpw/login.action?returnURL=https%3A%2F%2Febookcentral.proquest.com%2Flib%2Ffjpw%2Fhome.action.Google Scholar
Finch, E., Cornwell, P., Ward, E. C., & McPhail, S. M. (2013). Factors influencing research engagement: Research interest, confidence and experience in an Australian speech-language pathology workforce. BMC Health Services Research, 13(1), 144.CrossRefGoogle Scholar
Finch, E., Rumbach, A. F., & Park, S. (2018). Speech pathology management of non-progressive dysarthria: A systematic review of the literature. Disability and Rehabilitation, 1–11. doi: 10.1080/09638288.2018.1497714.Google ScholarPubMed
Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105–112.CrossRefGoogle ScholarPubMed
Graneheim, U. H., Lindgren, B.-M., & Lundman, B. (2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today, 56, 29–34. doi: 10.1016/j.nedt.2017.06.002.CrossRefGoogle ScholarPubMed
Haak, P., Lenski, M., Hidecker, M. J. C., Li, M., & Paneth, N. (2009). Cerebral palsy and aging. Developmental Medicine & Child Neurology, 51(4), 16–23. doi: 10.1111/j.1469-8749.2009.03428.x.CrossRefGoogle ScholarPubMed
Health Workforce Australia. (2014). Australia’s health workforce series - speech pathologists in focus. Canberra (ACT): Department of Health.Google Scholar
Hoffman, T., Bennett, S., & Del Mar, C. (2013). Introduction to evidence-based practice. In McIntyre, T. (Ed.), Evidence-based practice across the health professions (2nd ed., pp. 1–15). Chatswood (NSW): Elsevier.Google Scholar
Lawrence, S. E., Coshall, G. C., Dundas, D. A. R., Stewart, D. A. J., Rudd, D. A. A., Howard, D. A. R., & Wolfe, D. A. C. (2001). Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke: Journal of the American Heart Association, 32(6), 1279–1284. doi: 10.1161/01.STR.32.6.1279.CrossRefGoogle Scholar
Ludlow, C. L., Hoit, J., Kent, R., Ramig, L. O., Shrivastav, R., Strand, E., … Sapienza, C. M. (2008). Translating principles of neural plasticity into research on speech motor control recovery and rehabilitation. Journal of Speech, Language, and Hearing Research, 51(1), S240–S258. doi: 10.1044/1092-4388(2008/019).CrossRefGoogle ScholarPubMed
Maas, E., Robin, D., Hula, S., Freedman, S., Wulf, G., Ballard, K., & Schmidt, R. (2008). Principles of motor learning in treatment of motor speech disorders. American Journal of Speech-Language Pathology, 17(3), 277–298. doi: 10.1044/1058-0360(2008/025).CrossRefGoogle ScholarPubMed
Mackenzie, C. (2011). Dysarthria in stroke: A narrative review of its description and the outcome of intervention. International Journal of Speech-Language Pathology, 13(2), 125–136. doi: 10.3109/17549507.2011.524940.CrossRefGoogle ScholarPubMed
Mackenzie, C., Muir, M., & Allen, C. (2010). Non-speech oro-motor exercise use in acquired dysarthria management: Regimes and rationales. International Journal of Language & Communication Disorders, 45(6), 617–629. doi: 10.3109/13682820903470577.CrossRefGoogle ScholarPubMed
Mackenzie, C., Muir, M., Allen, C., & Jensen, A. (2014). Non-speech oro-motor exercises in post-stroke dysarthria intervention: A randomized feasibility trial. International Journal of Language & Communication Disorders, 49(5), 602–617. doi: 10.1111/1460-6984.12096.CrossRefGoogle ScholarPubMed
Mackenzie, C., Paton, G., Kelly, S., Brady, M., & Muir, M. (2012). The “living with dysarthria” group: Implementation and feasibility of a group intervention for people with dysarthria following stroke and family members. International Journal of Language & Communication Disorders, 47(6), 709–724. doi: 10.1111/j.1460-6984.2012.00180.x.CrossRefGoogle ScholarPubMed
Miller, N., & Bloch, S. (2017). A survey of speech-language therapy provision for people with post-stroke dysarthria in the UK. International Journal of Language & Communication Disorders, 52(6), 800–815. doi: 10.1111/1460-6984.12316.CrossRefGoogle ScholarPubMed
Mitchell, C., Bowen, A., Tyson, S., Butterfint, Z., & Conroy, P. (2017). Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury. Cochrane Database of Systematic Reviews, (1). doi: 10.1002/14651858.CD002088.pub3.CrossRefGoogle ScholarPubMed
Park, S., Theodoros, D., Finch, E., & Cardell, E. (2016). Be clear: A new intensive speech treatment for adults with nonprogressive dysarthria. American Journal of Speech-Language Pathology, 25(1), 97–110. doi: 10.1044/2015_AJSLP-14-0113.CrossRefGoogle ScholarPubMed
Rumbach, A. F., Finch, E., & Stevenson, G. (2019). What are the usual assessment practices in adult non-progressive dysarthria rehabilitation? A survey of Australian dysarthria practice patterns. Journal of Communication Disorders, 79, 46–57.CrossRefGoogle ScholarPubMed
Rumbach, A., Rose, T., & Cheah, M. (2018). Exploring Australian speech-language pathologists’ use and perceptions of non-speech oral motor exercises. Disability and Rehabilitation, 1–10. doi: 10.1080/09638288.2018.1431694.Google Scholar
Schölderle, T., Staiger, A., Lampe, R., Strecker, K., & Ziegler, W. (2016). Dysarthria in adults with cerebral palsy: Clinical presentation and impacts on communication. Journal of Speech, Language, and Hearing Research, 59(2), 216–229. doi: 10.1044/2015_JSLHR-S-15-0086.CrossRefGoogle ScholarPubMed
Sellars, C., Hughes, T., & Langhorne, P. (2002). Speech and language therapy for dysarthria due to nonprogressive brain damage: A systematic Cochrane review. Clinical Rehabilitation, 16(1), 61–68. doi: 10.1191/0269215502cr468oa.CrossRefGoogle ScholarPubMed
Sharma, D. A., Chevidikunnan, M. F., Khan, F. R., & Gaowgzeh, R. A. (2016). Effectiveness of knowledge of result and knowledge of performance in the learning of a skilled motor activity by healthy young adults. Journal of Physical Therapy Science, 28(5), 1482–1486.CrossRefGoogle ScholarPubMed
Shrubsole, K., Worrall, L., Power, E., & O’Connor, D. A. (2017). Recommendations for post-stroke aphasia rehabilitation: An updated systematic review and evaluation of clinicalpractice guidelines. Aphasiology, 31(1), 1–24.CrossRefGoogle Scholar
Shrubsole, K., Worrall, L., Power, E., & O’Connor, D. A. (2018). The Acute Aphasia IMplementation Study (AAIMS): A pilot cluster randomized controlled trial. International Journal of Language & Communication Disorders, 53(5), 1021–1056.CrossRefGoogle ScholarPubMed
Shrubsole, K., Worrall, L., Power, E., & O’Connor, D. A. (2019). Barriers and facilitators to meeting aphasia guideline recommendations: What factors influence speech pathologists’ practice? Disability and Rehabilitation, 41(13), 1596–1607.CrossRefGoogle ScholarPubMed
Stroke Foundation. (2017). (Australian) Clinical Guidelines for Stroke Management 2017. Retrieved from https://app.magicapp.org/app#/guideline/2282.Google Scholar
Togher, L., Yiannoukas, C., Lincoln, M., Power, E., Munro, N., McCabe, P., … Douglas, J. (2011). Evidence-based practice in speech-language pathology curricula: A scoping study. International Journal of Speech-Language Pathology, 13(6), 459–468. doi: 10.3109/17549507.2011.595825.CrossRefGoogle ScholarPubMed
van Teijlingen, E., & Hundley, V. (2001). The importance of pilot studies. Social Research Update, 35(3), 289–295.Google Scholar
Walshe, M., & Miller, N. (2011). Living with acquired dysarthria: The speaker’s perspective. Disability and Rehabilitation, 33(3), 195–203.CrossRefGoogle ScholarPubMed
Wenke, R. J., Cornwell, P., & Theodoros, D. G. (2010). Changes to articulation following LSVT and traditional dysarthria therapy in non-progressive dysarthria. International Journal of Speech-Language Pathology, 12(3), 203–220. doi: 10.3109/17549500903568468.CrossRefGoogle ScholarPubMed
Wenke, R. J., Theodoros, D., & Cornwell, P. (2008). The short- and long-term effectiveness of the LSVT for dysarthria following TBI and stroke. Brain Injury, 22(4), 339–352. doi: 10.1080/02699050801960987.CrossRefGoogle Scholar
World Health Organisation. (2001). International classification of functioning, disability and health (ICF). Geneva: World Health Organisation.Google Scholar
Yorkston, K. (2010). Management of motor speech disorders in children and adults (3rd ed.). Austin, Texas: Pro-Ed.Google Scholar
Yorkston, K., & Baylor, C. (2009). The lack of RCTs on dysarthria intervention does not necessarily indicate there is no evidence to guide practice. Evidence-Based Communication Assessment and Intervention, 3(2), 79–82. doi: 10.1080/17489530902955814.CrossRefGoogle Scholar
Yorkston, K., Honsinger, M., Mitsuda, P., & Hammen, V. (1989). The relationship between speech and swallowing disorders in head-injured patients. Journal of Head Trauma Rehabilitation, 4(4), 1–16. doi: 10.1097/00001199-198912000-00005.CrossRefGoogle Scholar
Zipoli, R. P. Jr., & Kennedy, M. (2005). Evidence-based practice among speech-language pathologists. American Journal of Speech-Language Pathology, 14(3), 208–220. doi: 10.1044/1058-0360(2005/021.CrossRefGoogle ScholarPubMed
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