Browsing by Subject "Logopedi"

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  • Kanerva, Henna (Helsingfors universitet, 2017)
    Objective. The previous studies have focused mainly on deviant linguistic processing regarding dyslexia, while people's experiences and contextual factors have received less attention. This study gives voice to the dyslexic students who can tell about their own experiences about dyslexia. Additionally, the objective of this study is to examine what kind of difficulties the students face while studying and which strengths they have. This study can bring a new perspective and decrease prejudices towards dyslexia. Method. Focused interview was used as a method of this study. The interviews consisted of questions inspired by the previous literature. Eight students were interviewed, six of them were studying at the university and two of them were studying at the university of applied sciences. The interviews were recorded and transcribed. The transcriptions were analysed with qualitative content analysis. Results and conclusion. On the basis of the analysis the interviews included several positive aspects. Many of the participants told they were quite open about their own dyslexia. They were also used to observe their learning and they had found several useful ways to learn. Many of them used deep learning as their learning method. They had also coped several difficulties and they believed in themselves. Especially organizing big amount of information, learning foreign languages and organizing different studying was challenging for them. Several participants reported that their learning was quite slow. In this study dyslexia was a phenomenon, not only a limitation. All the students have their strengths and limitations, regardless if they have a dyslexia or not.
  • Rohiola, Assi (Helsingfors universitet, 2015)
    Aim: People with severe and profound intellectual disabilities communicate with early communication skills through their life. It is difficult for them to interact with other people in their daily life and that is why they usually end up on the edge of interaction. Usually people with severe and profound intellectual disabilities communicate mainly with staff members. Staff members' abilities and time determine how the interaction will work between the communication partners. The purpose of this study was to find out how the HYP model, developed for supporting interaction, works. The aim was also to find out which are the benefits of the use of HYP model and opportunities for the staff members to support the interactions between them and persons with intellectual disabilities by using the HYP model. The aim of this study is also to produce information that people with intellectual disabilities would get more opportunities for interaction. Methods: This research data were collected in the Communication and Technology Center of the Finnish Association on Intellectual and Developmental Disabilities (Tikoteekki). The data were collected during autumn 2013 and spring 2014 in three different Finnish units where the first trials of the HYP model were accomplished. Participants of this study were staff members and clients. Staff members were altogether 48, 2 to 7 per client. They were, for example, teachers and school assistants. The clients were people with intellectual disabilities and people with autism. The data consisted of different HYP forms, which the staff members had filled in during the HYP periods. These data were analyzed using the Grounded Theory methodology. Results and conclusions: The core category from the data forms through Grounded Theory methodology to be reciprocal interaction. The main categories were cooperation, presence, contact and initiative. The core category collected the whole data and all the different categories together. It was, for example something what the staff members tried to reach during the HYP interaction or it was a wish to achieve with their clients. By using the HYP model the staff members got to know their clients' different interaction styles better. Because of these elements reciprocal interaction was easier to be accomplished during the HYP moments.
  • Väänänen, Pauliina (Helsingfors universitet, 2016)
    Aim: People with speaking disabilities have equal rights to functional interaction and communication as people without disabilities. These rights actualize only through the actions and skills of more able communicators. Guiding staff and family members is an important part of every speech and language pathologist's (SLP) job, especially if the client has severe learning disability. However, many SLPs experience guiding difficult and the results of staff communication training have been unsatisfactory. There are different models that can be used to help the process of indirect speech and language therapy. One of them is called Intensive interaction (II). Its role in enhancing interaction skills of more able communicators has only been studied a little. The purpose of this study is to find out if II is a meaningful approach to carry out indirect speech and language therapy. The aim was to find out if and how the interaction skills of a staff member change during an II process. The aim was also to figure out how she saw the significance of II. Methods: This research data were collected in the Communication and Technology Centre Tikoteekki of the Finnish Association on Intellectual and Developmental Disabilities. The data were collected during an II process that took place in 2014 and 2015 in a residential unit for people with learning disabilities. This study had two participants, one of whom was a resident with multiple learning and speaking disabilities, and the other one a staff member. The video material was composed of 14 interaction videos between the resident and the staff member, and one video of guidance discussion between the staff member and the mentoring SLP in the end of the process. The data were analysed according to the themes arising from the data, by mostly qualitative means. The changes in interaction skills were described with different tables and transcriptions. The guidance discussion was transcribed and analysed according to inductive analysis. Results and conclusions: The interaction style of the staff member became more sensitive and present. That change manifested through improvements in four elements of interaction: distance from the interaction partner, touching, quality and quantity of vocalization and tasklessness of interaction. The staff member saw II as a meaningful approach, especially for herself as an employee, but also for her interaction partner with multiple disabilities and more generally. These results suggest that II is a meaningful and effective means of mentoring significant others to become more sensitive, skillful and able interaction partners for persons with severe speaking disabilities. Additionally this study gives premises for further research on II and indirect speech and language therapy. In light of this research II is also important on societal level.
  • Salonen, Jonna-Maria (Helsingfors universitet, 2015)
    Objectives. Online discussion forums are part of extensive interactive network environments known as social media. Large part of the public debate today takes place on its fields. Any search for information on the internet may easily lead to online discussion forums. Speech therapy and issues related to it are also discussed on many discussion forums. The aim of this study was to identify the main themes being discussed about speech therapy and to analyse the forum users' perceptions of speech therapy. The theoretical framework of the study relies on social constructionism and socio-cultural learning theory. Perceptions are constructed by language in social interaction, and are based on one's own and others' experiences. Sharing experiences, peer support and information online are part the cultural change taking place in society. The change affects the ways of learning and retrieving information. Connectivism is a digital age learning theory that is based on the learning online via networks. Methods. The survey was conducted by analysing 88 online discussion chains from a popular Finnish online forum. The discussions had taken place 2005-2014. The data analysis was carried out using content analysis by means of themes and phenomenographic research approach, which focused on the interpretation of the perceptions from the online discussions. The network of perceptions was contemplated by interpreting the expressed cause-and-effect relationships between the themes. Results and discussion. Based on analysis there were a total of 11 themes in discussions. Three main themes were speech therapy resources, differences of municipal and private speech therapy, and speech therapists' role and job description. All the other themes were related to the three main themes. The cause-and-effect relationships between the themes were a basis for a interpreted network of speech therapy perceptions. Online discussions can be considered to partly reflect the situation in society, as well as to follow other media. Lack of resources in speech therapy and many other social and health services has become reality in Finland in recent years. Health care services transfer to the private sector has been a topic of discussion also in traditional media. Information provided by analysing attitudes, opinions and perceptions of speech therapy could help to address the customers' needs and direct the guidance, advice and support in the best possible manner.
  • Söderholm, Tiina (Helsingfors universitet, 2015)
    Aphasia is often a chronic impairment. Regaining the premorbid language function is rare. Anomia is the most common residual disorder once the aphasia has stabilized. Earlier studies indicate that transcranial magnetic stimulation (rTMS, repetitive Transcranial Magnetic Stimulation) together with intensive speech therapy improves the outcome of the language rehabilitation. The aim of the current study was to find out what kinds of quantitative and qualitative changes occur in the participants' ability to name noun and verb pictures that were shown during the rTMS/sham-rTMS protocol. All of the participants received two weeks of either rTMS or sham-rTMS treatment and after a one-week break another two weeks of either rTMS or sham- rTMS treatment together with intensive group speech therapy (ILAT, Intensive Language Action Therapy). This is a multiple case study with six participants that have chronic expressive aphasia. The first two groups of a larger study were selected into this study. Group 1 (n=3) received 1Hz- rTMS therapy and group 2 (n=3) received sham-rTMS. rTMS was given to the right hemisphere on the pars triangularis area. Every participant named the same amount of action and object pictures during the rTMS/sham-rTMS treatment. Namings were analysed with a rating system derived for the current study. Each participant received intensive group speech therapy in the latter two-week part of the intervention. Language testing was conducted before, during and three months after the intervention. The naming abilities in all participants seemed to improve in both noun and verb series during the rTMS/sham-rTMS treatment and language tests. Results of the follow-up testing suggest that the positive results are long lasting. The results of this study are promising, even though the amount of participants is too small to draw further conclusions. This study brings positive evidence and reason for further research on the effectiveness of aphasia therapy.
  • Suni, Mari (Helsingfors universitet, 2016)
    Background and aims: Aphasia is commonly associated with deficits in all linguistic modalities.In mild, chronic aphasia syndromes difficulties in reading can interfere with tasks of everyday life. The rehabilitation of reading difficulties caused by a general linguistic deficit is closely related to the rehabilitation of spoken language, especially in the early stages. Partly due to the limited resources granted to speech therapy, rehabilitation seldom proceeds to reading in its own right. Research has shown that rehabilitation of reading as such can however be beneficial to more general linguistic abilities. In this study, the quality and responsiveness to treatment of a sublexical reading deficit related to mild, chronic conduction aphasia were examined. The aim was to investigate, whether a sublexical therapy method and in particular text-level reading practice were effective in enhancing the fluency of reading or more general linguistic abilities. Methods: A 37-year-old man with mild, chronic conduction aphasia and resulting phonological alexia participated in the study. The intervention consisted of 17 training sessions (total of40 hours) of speech therapy, during which independent practice of repetitive reading that lasted for 11 weeks was started. Therapy consisted of phonological and word-level repetition and naming tasks combining the auditive and written modalities. Data consisted of linguistic tasks collected before, during and after the practice period. The effects of the intervention were evaluated by examining oral reading speed and accuracy of connected text and nonwords. More general phonological and linguistic abilities were examined through auditive repetition and auditive memory tasks. Results and discussion: The reading deficit reflected a more general linguistic difficulty that seemed to originate in auditive processing. Difficulties in reading seemed to arise from weakened phonological activation of word forms. No clinically significant changes were observed after the rehabilitation period. Still, positive changes were noted that imply the rehabilitation can be efficient when carried out through a longer period. Reading speed increased in nonword reading task, but speed of reading connected text increased steadily through the whole study period. A positive change in oral reading speed was observed in first readings of practice texts that might imply a more consistent enhancement during a longer training interval. No rehabilitative effect was apparent in auditive repetition or auditive memory, even though individual tasks improved. The results of this case study imply that repetitive reading ought to be further investigated as a reading rehabilitation method for persons with mild phonological reading deficits. Considering more general phonological rehabilitation, systematic methods could enhance the effectiveness of practice.
  • Ahola, Minna (Helsingfors universitet, 2016)
    Goals. Event schema, also known as a script, contains information about a structure of a particular event; about the sequences of events and their temporal order. With the information the scripts contain, one can anticipate and plan for future events and actions. People with traumatic brain injury (TBI) can have difficulties in the verbal planning of actions. Previous international research has shown that the scripts produced by people with TBI contain fewer actions central to the schema, than scripts produced by healthy control subjects. The aim of this study is to examine what kind of scripts Finnish speaking subjects with TBI and their healthy control subject counterparts generate in a script generation task consisting of eight scripts. This study also examines whether the script type has influence on the features of the generated scripts. Methods. Fifteen subjects with TBI and fifteen healthy control subjects participated in the study. The researcher collected the research material during the spring and summer 2015. The research material consisted of the scripts generated by the subjects and control subjects, as well as the results of the control tasks (Boston Naming Test, Rapid Automatized Naming Test, semantic and phonemic fluencies). The subjects were asked to generate event schemas for eight everyday tasks belonging to four schema categories. The categories were 'open high frequency' (go shopping, go for a walk), 'open low frequency' (apply for a job, go on a vacation), 'closed high frequency' (make coffee, brush teeth), and 'closed low frequency' (go to a doctor, go to a restaurant). Closed scripts are related to events where the actions involved in their execution are well established and tightly related to each other. Open scripts are less structured and have loose connections between the actions involved. High and low frequency scripts differ on how frequent the event is. Time given for generating each script was 60 seconds. The scripts were scored for the total number of events produced, the number of event repetitions, the informativeness of the script, and the meaningfulness and the centrality of the events. The results of the qualitative analysis were displayed in a statistical form and analyzed with the non-parametrical Mann-Whitney U -test. Results and conclusions. The results showed that the scripts produced by the subjects with TBI were less informative and contained less actions than the scripts produced by the healthy control subjects, regardless of the script type. Closed scripts were found to be more informative than open scripts, and the subjects produced more actions to the closed than to the open scripts. When the high and low frequency scripts generated by the subjects with TBI were examined, no significant difference was found between the two script types. The results of this study can be explained by the disturbances in executive functions, and disturbances in the working memory as well as the episodic memory, all of which can affect the subject's ability to produce a coherent story and recall actions belonging to a certain event.
  • Kangas-Lumme, Jertta (Helsingin yliopisto, 2014)
    There is very little research on the effects of memory illnesses such as Alzheimer's disease (AD) on the linguistic performance of congenitally deaf sign language users. With spoken language users the effects of AD are often first found in semantics and pragmatics. Deteriorated naming skills are often an early symptom of AD. As the disease progresses the linguistic skills are widely affected and communicating becomes difficult. When studying sign language users results have shown that people with AD have corresponding difficulties of comprehending and producing signed language as spoken language users with Dementia have with spoken language. The aim of this research was to study how two Finnish Sign Language (FSL) users with AD perform in object and action naming tests. The participants were evaluated with the Boston Naming Test (BNT) and the Action Naming Test (ANT) in two consecutive years. Of each performance, the researcher recorded the total score, the number of immediate answers, the time the participant spent on the task and how the answers were given. An analysis of naming errors was made. As a result it was noted that both object and action naming skills of the participants deteriorated as Dementia progressed. Action naming skill were less affected than object naming skill. The participants made more errors and gave less immediate responses in the BNT than in the ANT. Both the signed responses and the method of answering varied with the FSL users with a memory illness: the answers were given either in varying signs, by speaking only or by both speaking and signing simultaneously, or with signs created spontaneously in test situation. Most of the errors were Other errors, especially "I don't know" –answers in both tests. As a result of this study it is clear that there is a need for assessment tests which have been translated into sign language, since the existing naming tests are not necessarily suitable for testing signed language users without a culturally-sensitive translation. This study is the first longitudinal study in Finland focusing on evaluating Finnish Sign Language users with Dementia and the changes in their linguistic skills. It is also one of the first studies internationally on the linguistic changes of sign language users with a memory illness.
  • Järvinen, Heli (Helsingfors universitet, 2017)
    Autism spectrum disorder (ASD) is a condition that affects social interaction, communication and behavior. Since effective communication and interaction is a prerequisite for learning, the use of augmentative and alternative communication (AAC) methods has been considered necessary in study environments. The education professionals' perspectives and attitudes towards the use of AAC methods have been linked to the extent to which they support the development of communication skills of their pupils using communication aids. The purpose of this study is to describe the experiences of autism classroom teachers and classroom assistants in the use of AAC methods. This topic is examined based on the benefits and challenges that autism education professionals associate with the use of communication aids, the number of factors contributing to the successful use of the AAC methods as well as the development of the students' communication skills. In this study nine education professionals who worked in autism education classrooms and school's afternoon activities in Helsinki were interviewed. The interviews were conducted as semi-structured individual interviews, which discussed the use of AAC methods for students with ASD. The interviews were recorded, transcribed and analyzed by using inductive thematic analysis approach. Finally, the themes of each research question were compared with each other. Based on the results of this study, AAC methods are particularly useful not only for communication between students and education professionals, but also for the students' ability to express themselves, to develop better social skills and to become more independent in their everyday lives. The challenges of using AAC methods related to usability factors, students' developmental abnormalities, education professionals' practices and various resource issues. Professional co-operation, motivation, favorable usability factors of the AAC methods, and factors related to the activities and roles of education professionals were seen to influence the successful use of the AAC methods and to improve the students' communication skills. In addition, the interviewees strongly emphasized the importance of students' spontaneous communication and speech development in the motivation and work satisfaction of education professionals. The autism classroom teachers' and classroom assistants' experiences in the use of AAC methods emphasize the importance of training and multiprofessional co-operation in support of the use of communication aids and development of students' communication skills. Based on the results of this study, the speech therapists' counseling activities can be regarded as significant for the development and maintenance of the education professionals' AAC skills and for constituting positive attitudes related to the use of AAC methods. This study highlights the importance of further research focusing particularly on more specific identification of challenges related to the use of AAC methods in autism classroom education.
  • Partanen, Elina (Helsingfors universitet, 2015)
    Aims: Embodied practices among people with aphasia remain relatively little known until now. The aim of this study was to describe free conversation interaction between a seriously aphasic speaker and his wife. This study aims to explore what kinds of nonverbal elements appear during the conversation of the aphasic person, and how the nonverbal elements arise in different conversational turns. The main focus of this study is on the substitutive and the complementary gestures of the speech. Earlier studies on aphasia interaction suggest that gestures are an important resource to construct meanings in turns of an aphasic speaker. Data and methods: This is a qualitative study where conversational analysis is used as a research method. Data consists of two videotaped recordings of the couples' free conversation at home settings. Results and conclusions: Several nonverbal elements, which had a significant influence for the conversation interaction of this couple, appeared in the data of this study. The wife interpreted aphasic person's nonverbal elements in the conversation as meaningful elements. The wife gave time and space for the aphasic person to participate in conversation. The aphasic speaker took advantage of the gestures in order to compensate speech loss. In fact, he almost completely relied on the substitutive and complementary gestures in conversation. He used the gestures in many ways and combined gestures skillfully to his limited verbal elements. A significant result in the study was that the aphasic speaker hardly showed any signs for verbal word search before expressing nonverbal elements. He started gesturing often seamlessly just before of his typical turn initiator verbal expressions yeah yes and yeah but or simultaneously with them. Aphasic person's expression were built fast and effortlessly despite the loss of speech. It can be said that aphasic person had adapted to his handicap caused by aphasia by taking advantage from gesturing.
  • Nylander, Niina (Helsingfors universitet, 2014)
    Aims. Improved quality of life is considered to be the overarching goal of aphasia rehabilitation based on the social model. Around the world research has been done on the factors that affect the quality of life with people with aphasia. Different kinds of structured quality of life measurements have been developed that aim to enable people with aphasia to self-report quality of life. In Finland research on the subject has been scarce. The aim of this study was to explore the views of Finnish speech and language therapists (SLT) on the quality of life in aphasia rehabilitation and the prevailing clinical practices as well as to investigate how they compare internationally. Methods. For the purposes of this study a questionnaire composed by the Aphasia Committee of the International Association of Logopedics and Phoniatrics (IALP) was translated into the Finnish language. 64 questionnaires were filled out. The Finnish data was analysed by using descriptive statistics and content analysis. The data collected in this survey formed Finland's part of an international survey conducted by IALP, which allowed the comparison between the Finnish and international results. The international survey contained 581 respondents from 16 countries including Finland. The Finnish and international data were compared by cross tabulation and Chi Squared -test. Results and conclusions. According to Finnish SLTs it is important to incorporate into practice with aphasia several quality of life domains, such as communication, affect, in/dependence, social activities, personal outlook and in addition to consider life satisfaction, social support and environment. Almost all of the Finnish SLTs used interviewing as their primary method for assessing the quality of life, only four used structured quality of life measures. Internationally there were mentioned many different structured quality of life assessments. This study indicates explicitly that there is a demand for structured quality of life assessments in Finland. The results can be applied in developing education, research and clinical practice.
  • Oker-Blom, Daniela (Helsingfors universitet, 2016)
    Goal. The purpose of this study was to investigate school teachers' experience of stuttering and students who stutter. The goal was to identify school teachers' knowledge about stuttering and the characteristics of stuttering. The purpose was also to investigate what kind of knowledge school teachers feel they need about stuttering. School teachers' awareness of stuttering has only received little attention in the field of logopedics. Researchers have emphasized the teacher's important role in school children who stutter, but previous research findings have shown that teachers have a defective knowledge about stuttering. School teachers' experience of stuttering and students who stutter has not, as been claimed, been investigated in Finland before. The goal of this study is to identify school teachers' experience of stuttering and students who stutter. Method. This was a quantitative survey. All principals in the Swedish speaking primary schools in Helsinki and Espoo were contacted and asked to forward an email with a link to a questionnaire to primary school teachers in the schools. E-questionnaire reached an estimated 400 primary school teachers. A total of 40 primary school teachers participated in the survey. Responses were analyzed by suitable quantitative analytical methods. The open questions were analyzed by using appropriate qualitative methods. Results and reflection. Over half of the teachers indicated that they had no knowledge of stuttering from the past. Half of the teachers assessed their knowledge of stuttering to be poor. Majority of the respondents reported that their current knowledge of the underlying cause was poor and consequently stuttering characteristics seemed to be unfamiliar to many. Only a fraction knew the different strategies they could use in the classroom with a student who stuttered. There seems to be a need to inform and educate primary school teachers on stuttering, to improve school teachers' knowledge about stuttering and inform them about how best to respond, assist and support students who stutter in the classroom setting.
  • Huotari, Salla-Maaria (Helsingfors universitet, 2015)
    Aims. The purpose of this single-case study was to investigate the effects of intensive tablet-based treatment in overall language performance level and in reading and writing processes in mild aphasia. The communicative effectiveness and task performances on the tablet software were also studied. The tablet software included tasks where semantic, syntactic and phonological processing were required; written naming, sentence writing and reading comprehension. Previous studies have indicated improvements in language skills after computer-based treatment (Katz & Wertz, 1997; Wade, Mortley & Enderby, 2003). Especially reading and writing skills can be treated by the computer-based softwares (Katz, 2008). Methods & Procedures. In this single subject research the ABA design was used. The participant in this study was a 47 year old man who had a stroke 2.5 years earlier. He had a mild chronic aphasia with difficulties in writing, reading and naming. The data of this study was formed by linguistic tests and by a self-assessment method as the participant evaluated his communicative effectiveness (CETI). The methods used in the analysis of written and read narratives included assessing rate, authenticity and the types of errors. The analysis of written narratives also included assessing word classes and type-token –ratio. Based on the data by the tablet-based software the rate and the share of errors of task performances were assessed. Results & Conclusions. Based on the Western Aphasia Battery (WAB) results, the severity of the aphasia decreased but the change was not clinically significant. Naming improved but the change wasn't stable until the follow-up. The participant showed positive development in his written and reading production; he made less spelling and reading errors after the treatment. At the same time reading and writing processes became slower. The share of lexical verbs, adjectives, pronouns and numerals increased in written narratives. The communicative effectiveness improved. The task performance on the tablet software was faster during the fourth week compared to the first week. Also the amount of incorrect performances decreased or remained the same. Based on the results, an intensive self-monitored tablet-based language treatment was effective to the subject.
  • Heino, Wilma (Helsingfors universitet, 2017)
    Objective. Preterm birth can cause challenges for early interaction between parent and infant. Early interaction is the basis for language and cognitive development, so parents play an essential part in supporting the development of their preterm child. Very little research of early interaction has been made from the fathers' point of view. The aim of this study was to depict fathers' experiences of early interaction with their prematurely born infants and examine the effect premature birth has on fatherhood. Participants and methods. The participants were four fathers of prematurely born infants and eight fathers of full-term infants. The prematurely born children were born between 30+4–33+6 weeks of gestation and weighed between 1 400–2 900 grams at birth. At the time of the study the premature infants were between 2–7 months of corrected age. The full-term children were between 1–6 months of age at the time of the study. The method of this study was semi-structured interview. The themes were composed for this study, based on previous research on premature birth, parenthood and early interaction. A pilot interview was carried out prior to the research interviews. The research interviews were conducted in autumn 2016. A theory-based content analysis and theme identification was carried out. Results and conclusions. The fathers described feelings of stress and anxiety, but felt that most of the support available for parents of premature children was focused on the mothers. The fathers' experiences differed most with the time spent in the hospital, the perceived fragility and passivity of the child, the concern over the well-being of the mother and the strain of childcare. Similar types of play were used in both groups. The premature infants had more variation in sleep and eye-contact. The results indicate there should be more support available for the fathers of prematurely born children.
  • Rantanen, Eveliina (Helsingfors universitet, 2017)
    Objectives. Assessment of language development and differential diagnosis between typical bilingual language development and developmental language disorders in bilingual children is difficult due to lack of appropriate diagnostic tools and norms. Dynamic assessment has been proposed as a complementary method in which learning potential is assessed instead of current language skills. Graduated prompting as dynamic assessment method involves helping children with the tasks by presenting graduated prompts. The aim of the study was to add information about the dynamic assessment of language skills in preschool-age children acquiring Finnish as their second language and its applicability in the differential diagnosis. Methods. A dynamic assessment method was translated and adapted into Finnish and piloted with eight bilingual children aged between 4 to 6 years whose home language was not Finnish, Swedish or Sami language. Half of the children were typically developing bilinguals and half were bilinguals with diagnosed or suspected developmental language impairment. Children's language skills and learning of receptive and expressive vocabulary as well as sentence production were assessed. Test scores were analyzed quantitatively and compared between groups and matched pairs. The usefulness of the prompts was analyzed qualitatively. In addition, the usability and the suitability of the method for the assessment of bilingual children were examined. Results and conclusions. The typically developing children scored slightly higher in the dynamic measures of vocabulary. In the static pre- or post measures of vocabulary or in the measures of sentence production no such difference was found. The results of the vocabulary assessment were in line with previous studies stating dynamic assessment having potential as a differential diagnostic tool. Score differences were minor and the sample was small, thus the results cannot be generalized. The assessment method is short enough to be carried out in single assessment session but complicated to use and rate. The used tasks need be improved further. However, new dynamic assessment methods in Finnish can be developed based on the information gathered in the study.
  • Martio, Lotta (Helsingfors universitet, 2015)
    Aims: Speech and language development is delayed or proceeds atypically with children with intellectual disabilities. Speech expression is limited and a person communicates mainly by early means such as gestures and vocalizations. Interaction is heavily dependent on communication partners. Logopedic interaction studies aim to find out how interaction works when some of the participants have communication problems. Earlier study has brought much information on the communication features of people with aphasia. Communication of people with intellectual disabilities has been studied less. This study provides information on communication features of an adolescent with severe intellectual disability. Methods: The study examined the conversation between Sari and a logopedics student during speech therapy sessions. Conversation analysis (CA) was applied. CA is a qualitative method used to search regularities in naturally occurring conversations. Sari is a 14-year-old girl with Cornelia de Lange Syndrome. She has been diagnosed with severe intellectual disability with autistic features. Her communication is mainly non-verbal. The data consisted of six videotaped speech therapy sessions. The study focused on task phases of the sessions when the participants conducted a speech therapy exercise with four different tasks. For analysis, the videotaped data was transcribed in detail. Sari's communication features and the sequential construction of conversation were described. Things that made interaction fluent or nonfluent were analysed. Results and conclusions: Repetitive structures of interaction were discovered applying CA. Therapy task sequences consisted of three-part structures, where the student first assigned a task, Sari responded and the student commented Sari's response. Negotiation sequence was often built between the first and the second turn. Interaction was fluent when Sari's response to the student's turn was preferred and nonfluent when Sari's response was not preferred. Sari communicated mostly with pointing gestures and bodily activity. Success of Sari's communication was largely determined of how well the student was able to interpret her communication.
  • Kytöharju, Satu (Helsingin yliopisto, 2015)
    Aim. In conversation mutual understanding is achieved through co-operation of each participant. Mutual understanding might be more at risk in conversation where one or more participants use augmentative and alternative communication (AAC). To be able to support people who use AAC and guide their communication partners, interventionists should understand how communication problems and challenges are being resolved in a natural conversation. The aim of this study is to describe how participants orient to problems in AAC conversation. Conversation partners' other-initiations of repair and the problems these initiations indicate are being studied. Method. The database consists of two videotaped conversations where one aided speaker, a 15-year-old boy with cerebral palsy, talks with a speech-language pathology student (conv 1) and with his speech-language pathologist (conv 2). The data was originally videotaped for speech therapy follow-up. Problems and how they were managed were studied using conversation analysis (CA) and one of its basic organizations, repair organization. CA enables detailed examination of natural interaction. Results and conclusions. Almost every other-initiation of repair fell upon the problems in aided speaker's turn and were initiated by conversation partners. These problems related broadly to speech understanding, more precisely to understandability of utterances. No problems of hearing were raised. Reasons underlying the trouble sources were most often conversation partner's difficulty in understanding the meaning of aided speaker's whole turn or part of a turn, extra words or other mistakes in selecting symbols, or vague reference. From all the conversation partners' other-initiations of repair interpretative means, candidate understandings, were used most often and the initiations of repair were at the same time pointing a problem and trying to resolve it. Interpretation seemed to be explicitly on display in both conversations. It was used to show understanding of AAC turn and to initiate repair. In order to be able to understand how to support AAC users' human agency and active participation in conversation, more research needs to be done on different conversations.
  • Rantakangas, Tuula (Helsingin yliopisto, 2017)
    Aims. Verbal apraxia might occur with aphasia. Apraxia may impact on person`s ability to be in talk-in-interaction with. Little is known about how apraxia of speech might influence talk-in-interaction and a person`s use of gestures. Even the less is known how these communication strategies will change by time. In addition, a person with apraxia must find new communication strategies. To help a person with apraxia of speech to communicate better with their significant others there is a need for information: how one can support a person with verbal apraxia the most effective way. The aim of this study is to explore how the sequential organization of conversation is constructed with a person with apraxia of speech and non-fluent aphasia and a speech therapist and how gestures are used by person with verbal apraxia for one year. Methods. The participant was a 78-year-old woman who had a verbal apraxia and aphasia. The qualitive data consisted of 3 videotaped conversations with person with apraxia and non-fluent aphasia and a speech therapist (58 minutes, 50 seconds of raw data). The data was collected for one year. Focus of the analysis was on changes in the conversation organization and the use of semiotic resources in conversation for one year. The method of conversation analysis is utilized in this study. Results and conclusions. The qualitive analysis in this study showed that conversation between the speakers were typically consisted of `hint and guess` sequences. The first data (videotaped 3 weeks after the stroke) revealed that the participant was almost speechless and her use of gestures was fussy. The lack of speech and fussy gesturing made her utterances difficult to understand and conversation consisted of long negotiation turns. After six months, the participant`s utterances and the use of gestures were more detailed and she showed more active role in interaction. After one year, the participant`s utterances and gestures were even more detailed. According to these improvements, the length of negotiation turns decreased and conversation started to go along more fluent. The way how the participant used iconic gestures and pantomime were different when comparing to other studies. One potential hypothesis is that the apraxia might influence negatively one's ability to use gestures for compensatory strategies. According to these results, it is important to research more about apraxia and talk-in-interaction.
  • Tillander, Saara (Helsingfors universitet, 2016)
    Objectives. Specific language impairment (SLI) is a heterogeneous disorder and its symptoms change with development. For most people it has a profound effect on functional ability, participation, and learning. The symptoms are persistent especially among those with difficulties in speech-reception. Simultaneous learning of multiple languages increases the individual variation in linguistic difficulties. Language functioning of Finnish monolingual and multilingual children at age over 10 years has not been thoroughly investigated. The objective of this study was to describe how SLI manifests itself in 11–12-years-old monolingual and multilingual children. The study focused on language ability and health-related quality of life. The acquired information may help in improving supporting practices. Methods. Four male participants at age of 11–12 years living in the Capital Region of Finland, and with SLI diagnosis (F80.2) were recruited from Helsinki University Central Hospital Audiophoniatric ward 22 for the study. Two participants were monolingual and two were multilingual learning Finnish as their second language. The gathered data consisted of language tests and questionnaires intended for parents, teachers, and the participants. Testing was videotaped and the acquired narratives were transcribed. Results were compared against age norms as well as previous literature. Furthermore, the questionnaire data were grouped based on the content, and the results were analyzed qualitatively. In addition, the test results and questionnaire data were compared to each other. Finally, the differences in language abilities were examined in relation to medical reports written before school age. Results and conclusions. All participants had deficiencies in language abilities, but language symptoms, social ability, academic achievement, and quality of life varied individually. Results were in line with previous studies. Difficulties were observed especially in grammatical and reading abilities, short-term memory and word naming. Moreover, according to parents and teachers, the participants had problems in speech reception, narration, pragmatics, and some of them also in social interactions. Finnish vocabulary among the multilingual participants was smaller than that of their monolingual counterparts. However, differences in other areas were larger at single-level than at group-level. Three of the participants still received substantial support in school. Support of the fourth participant had been discontinued due to favorable progress. Majority of the participants perceived their health-related quality of life slightly weaker than that of controls. Based on the results, it is important to support pragmatic skills at school age since previous studies have shown an association of these to social integration. A Study with a larger sample size and longitudinal setting is needed in the future.
  • Leppänen, Saara (Helsingfors universitet, 2011)
    Goals. Specific language impairment (SLI) has a negative impact on child's speech and language development and interaction. Disorder may be associated with a wide range of comorbid problems. In clinical speech therapy it is important to see the child as a whole so that the rehabilitation can be targeted properly. The aim of this study was to describe the linguistic-cognitive and comorbid symptoms of children with SLI at the age of five, as well as to provide an overview of the developmental disorders in the families. The study is part of a larger research project, which will examine paths of development and quality of life of children with SLI as young adults. Methods. The data consisted of patient documents of 100 5-year old children, who were examined in Lastenlinna mainly at 1998. Majority of the subjects were boys, and children's primary diagnosis was either F80.1 or F80.2, which was most common, or both. The diagnosis and the information about the linguistic-cognitive status and comorbid symptoms were collected from reports of medical doctors and experts of other fields, as well as mentions related to familiality. Linguistic-cognitive symptoms were divided into subclasses of speech motor functions, prosessing of language, comprehension of language and use of language. Comorbid symptoms were divided into subclasses of interaction, activity and attention, emotional and behavior problems and neurologic problems. Statistical analyses were based mainly on Pearson's Chi Square test. Results and conclusions. Problems in language processing and speech motor functions were most common of the linguistic-cognitive symptoms. Most of the children had symptoms from two or three symptom classes, and it seemed that girls had more symptoms than boys. Usually children did not have any comorbid symptoms, or had them from one or three symptom classes. Of the comorbid symptoms the most prevalent ones were problems in activity and attention and neurological symptoms, which consisted mostly of motoric and visuomotoric symptoms. The most common of the comorbid diagnoses was F82, specific developmental disorder of motor function. According to literature children with SLI may have problems in mental health, but the results of this study did not confirm that. Children with diagnosis F80.2 had more linguistic-cognitive and comorbid symptoms than children with diagnosis F80.1. The cluster analyses based on all the symptoms revealed four subgroups of the subjects. Of the subjects 85 percent had a positive family history of developmental disorders, and the most prevalent problem in the families was delayed speech development. This study outlined the symptom profile of children with SLI and laid a foundation for the future longitudinal study. The results suggested that there are differences between linguistic-cognitive symptoms of boys and girls, which is important to notice especially when assessing and diagnosing children with SLI.