Browsing by Subject "Magistgerprogrammet i logopedi"

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  • Holappa, Mervi (Helsingin yliopisto, 2020)
    Objective. Speech sound errors are the most common speech disorders in children that, without proper treatment, can have far-reaching effects on an individual’s quality of life. Due to limited speech therapy resources, speech sound disorders are often left without adequate treatment. In Finland, efforts have been made to reduce the geographical inequality in the availability of rehabilitation services through various time-independent teletherapy solutions. For example, the mission of Äännekoulu is to help Finnish municipalities prioritize their limited resources and enable every child to have access to speech therapy services, regardless of their place of residence. There are only few studies focusing on the use of teletherapy practicies in the treatment of speech sound disorders in Finnish-speaking children. The aim of this study was to examine whether Äännekoulu’s online therapy is an effective way to rehabilitate children's /r/-errors and to describe possible factors influencing rehabilitation results. Methods. The data used in the study consisted of demographic information and speech therapist’s notes and records on children under 10 years of age (n = 109) who participated in a three-month training period at Äännekoulu’s online therapy aiming to rehabilitate existing /r/-errors in their speech during March 2019 - April 2020. The notes and records were collected from the patient database Diarium. Participation in the study was voluntary. The collected data were categorized and analyzed using the Mann-Whitney U test and the chi-square test. Results and conclusions. More than half of the children learned to produce alveolar trill /r/ at least in isolation during a training period at Äännekoulu’s online therapy. On average children learned to produce the tongue trill on the sixth contact with the speech therapist. Most of the children learned to produce tongue trill through the dn dn dn -exercise. There was no significant difference between sexes in learning to produce the alveolar trill. The quality and the type of the speech sound error, age, sex or the children’s skill level in the beginning of the training period did not affect the rehabilitation of /r/-error. The number of contacts with the speech therapist strongly correlated with the results achieved in teletherapy. Äännekoulu’s online therapy seems to be an effective way to treat children’s /r/-errors. Learning to produce the alveolar trill correctly is significantly affected by active collaboration with the speech therapist. Further research is needed to identify the factors influencing the rehabilitation of the /r/-errors. Future research should also concentrate on the at home practice needed to treat speech sound errors in teletherapy.
  • Harmaja, Reetta (Helsingin yliopisto, 2021)
    Assessing children’s early communication skills is important for preventing possible later language difficulties. The Finnish version of Communication and Symbolic Behavior Scales, Developmental Profile (FinCSBS) is a screening tool in which parents assess their 6-24 months old child’s development in social communication, understanding and speech. Earlier studies have found connections between early communication skills and later language development. However, these language tests have been limited. The aim of this study was to examine the usability of FinCSBS for assessing 2-year-old children and the possible associations of their early communication skills with receptive and expressive language, naming and the use of inflectional forms at 3,5 years of age. This study sample is part of the validation study of the short form version of the MacArthur Communication Inventories Finnish version (Sanaseula study). Participants (N=50) were typically developed children from monolingual Finnish families. Parents filled out the FinCSBS checklist when their children were 2 years old. The same children were assessed again at 3,5 years of age with different tests (Reynell Developmental Language Scales III, Boston Naming Test and Finnish Morfological Test). Associations between early communications skills and later language skills were studied by using Spearman’s correlation coefficient and logistical regression analysis. The stability of skills was examined by comparing whether there were differencies in later language skills between those who had succeeded poorly, typically or well earlier in FinCSBS. There were no correlations between the total scores of FinCSBS at 2 years of age and language skills year and a half later. However, this study shows a trend that the level of competence is a rather stable quality so that weak early communications skills will manifest later on as weak language skills. In this study, early understanding did correlate with a later ability to use inflectional forms. It is recommended to use FinCSBS with typically developing children earlier than at 2 years of age when the prelinguistic period is ending and most children will get high scores in the assessment.
  • Toivanen, Salla (Helsingin yliopisto, 2021)
    Objectives. The aim of this study was to describe, in a single and consecutive way, self-repairs of bilingual children in a play situation and to investigate their possible differences between groups. The aim was to increase information on how and what kind of corrections children at different levels of language do, and how the level of language management affects the quality of self-corrections in Finnish. The research questions were what kind of corrections children make, how they start self-repairing and where the repairs are directed. It was also examined whether the groups differed and, if so, how. Methods. A total of 30 were supported, of whom 15 were monolingual and 15 consecutive bilingual children. The L2 language of all children was Finnish and the linguistic development of all the researchers was typical. The study methods were observation and analysis of literates. The data was analyzed both qualitatively and statistically. Elan annotation programme and SPSS statistics programme were used to analyze the data. Results and reflection. Monolingual children produced more self-repairs than bilingual children. Compared to the total number, the share of self-corrections for bilingual children was slightly higher than that of monolingual children. Both monolingual and bilingual children did the most self-repairs by searching for the next word. In the group of monolingual children, the biggest remedy was speech interruptions, while for bilinguals the largest group were different sounds. Self-repairs by both groups most often targeted the sledge hams. The results are partly in line with previous research data. However, previous studies have found that novice bilingual children prefer repetition in their self-repairs. In this study, on the other hand, monolingual children took more initiatives by repeating bilingual control.
  • Honkamaa, Milla (Helsingin yliopisto, 2022)
    Objectives. Narrative production demands coordination of many linguistic and cognitive skills and therefore it is considered as a multifaceted measurement tool in assessing children’s linguistic skills. Narratives can be observed at global and local levels, in other words through macro- and microstructures. Previous studies have shown contradictory results regarding the ability to distinguish children with developmental language disorder (DLD) from typically developing peers by examining the narrative macrostructures. Regarding the issue, there is a limited research data when examining Finnish as a second language. In this thesis the narrative macrostructures are examined in successive bilingual children with typical and atypical language development. The objective of this thesis is to examine qualitatively the macrostructures, especially story grammar and episodic GAO-structures of the narratives and the qualitative features appearing in above mentioned and in overall structures of the narratives. The thesis aims to clarify the differences and similarities between the typically developed children and children with DLD. Methods. The sample of this thesis was collected in 2021 as a part of the MULTILINGUA -research project. The sample consists of narrative assessments of eight successively bilingual 7- year-old children, four with a typical development and four with a suspected language disorder. The assessments were made with the Kissatarina assessment tool developed by Leena Mäkinen (2019). A theory-based approach was used in the analysis of the story grammar and furthermore the narratives were analyzed qualitatively through a data-driven approach. For the analysis of the story grammar, a scoring template was made using Stein and Glenn’s (1979) story grammar model and the information scoring in the Kissatarina. The expressions children used in the macrostructural elements in their narratives were analyzed in the light of the data, focus being on the settings, episodic structures, and the overall structures of the narratives. Results and conclusions. Overall production of the story grammar elements was poorer with children in the DLD-group in comparison to the children with typical development. In addition, the individual variation within the DLD-group was greater. Differences between the groups appeared most evident in the production of the narrative’s initiating events and expressing characters’ internal reactions and emotions, in which the children in the DLD-group showed weaker performance. For the qualitative analysis, typically developed children mainly produced more complex and coherent narratives. In all examined areas the qualitative differences between individuals were evident. The results of this thesis reveal that assessing the macrostructures in narratives might help in differentiating children with DLD from typically developing children.
  • Firon, Csilla (Helsingin yliopisto, 2019)
    Tavoitteet. Tutkimuksen tavoitteena oli tarkastella uudenlaisen afasian kuntoutukseen suunnatun kuorolauluintervention subjektiivisesti koettua hyötyä. Interventio oli osa Helsingin yliopiston Kognitiivisen aivotutkimuksen yksikön Laulun sanoin -hanketta ja se koostui kuorolaulusta, ryhmämuotoisesta MIT (melodinen intonaatioterapia) -kuntoutuksesta sekä laulun harjoittelusta tablettitietokoneella. Interventioon osallistui afasiaa sairastavia henkilöitä sekä heidän läheisiään. Aiemmissa tutkimuksissa on havaittu, että musiikilla ja laululla voi olla kuntoutuksellisia vaikutuksia muun muassa kielellisiin toimintoihin. Afasian kuntoutuksessa on eniten tutkittu MIT-menetelmää, mutta myös uusia musiikkia sisältäviä kuntoutusmuotoja kehitetään aktiivisesti. Subjektiivisesti koettua kuntoutuksesta saatua hyötyä ei ole afasian osalta erityisesti tutkittu, vaikka oman kokemuksen tiedetään vaikuttavan kuntoutuk- sen lopputulokseen. Tässä tutkimuksessa tarkastellaan, minkälainen subjektiivinen arvio afaattisilla henkilöillä ja heidän läheisillään oli interventiosta. Lisäksi tarkastellaan, oliko afasian vaikeusasteella, harjoittelumäärällä tai demografisilla tai kliinisillä taustatiedoilla yhteyttä koettuun hyötyyn sekä erosivatko afaattisten henkilöiden ja läheisten kokemukset toisistaan. Menetelmät. Aineiston muodosti osallistujien intervention jälkeen täyttämät kyselylomakkeet subjektiivisista kokemuksista, interventiojakson aikana toteutuneet harjoittelumäärät sekä osallistujien demografiset ja kliiniset taustatiedot. Kyselylomakkeeseen vastasi 23 afaattista henkilöä sekä 11 läheistä. Aineistoa analysoitiin tilastollisesti Friedmanin testillä, Mann–Whitney U-testillä, Spearmanin järjestyskorrelaatioanalyysilla, Wilcoxonin merkittyjen sijalukujen testillä sekä yhden otoksen t-testillä. Avointen kysymysten vastauksia analysoitiin tyypittelemällä vastauksia teemoittain ja laskemalla esiintymisfrekvenssejä. Tulokset ja johtopäätökset. Afaattiset henkilöt kokivat intervention hyödylliseksi ja myös läheiset kokivat, että interventio oli afaattisille henkilöille hyödyllinen. Afaattisten henkilöiden ja läheisten kokemukset intervention hyödyllisyydestä eivät eronneet toisistaan, eikä harjoittelumäärän, kliinisten tai musiikillisten taustatietojen ja koetun hyödyn välillä havaittu tilastollisesti merkitsevää yhteyttä. Erityisesti mielialan kohoaminen, uusiin ihmisiin tutustuminen ja vertaistuen saaminen nousivat esiin kvalitatiivisissa vastauksissa. Näiden tulosten perusteella voidaan ehdottaa, että ryhmämuotoinen kuoro- laulukuntoutus, jossa on MIT:n elementtejä, vaikuttaa positiivisesti afaattisten henkilöiden mielialaan, sekä heidän itse arvioimana että läheisten arvioimana. Interventiosta voi jatkotutkimuksen avulla ke-hittää afasian ryhmämuotoisen laulukuntoutusmuodon.
  • Peltomaa, Heidi (Helsingin yliopisto, 2022)
    Aim. This thesis investigates other-initiation of repair (OIR) made by people with aphasia (PWA). OIR means the practices used in conversation for requesting a clarification on something in the other speaker ́s turn. Aphasic conversation and repair has been studied a lot. However, there is hardly any studies about the OIR of PWA. Method. The data has been collected and the transcriptions made in a research project Managing the problems of speaking and understanding in conversations of speakers with aphasia. The data of this thesis consists of nine conversations between a PWA and one or two familiar partner(s). The OIR sequences initiated by PWA were collected, and then grouped and analyzed. Results & Conclusions. PWA did produce OIRs but for some reason there was great variation between the participants. The repair sequences were short and the problems were solved effectively. Repeat-formatted OIRs were the most frequent type of OIR and targeting question words the most rare. The problems that the OIRs were targeting were often problems of understanding or hearing of speech. There were a lot of similarities between OIRs produced by PWAs and OIRs of typical Finnish conversation. The results help to establish a better picture of the OIR by PWA and are in line with the prevoius hypothesis about the phenomenon.
  • Jussila, Anu (Helsingin yliopisto, 2020)
    Background. Aphasia is a linguistic disorder that occurs after language acquisition and is most commonly caused by stroke. Research on novel word acquisition can contribute to the development of aphasia rehabilitation because it helps understand the relearning of words lost due to aphasia. Novel word acquisition has been researched mainly in chronic aphasia, in which learning is possible but shows large individual variation. There is initial evidence that novel word learning is also possible in non-chronic aphasia. Aims. The objective of this thesis is to study recovery and novel word learning in the subacute and chronic stages of aphasia. The thesis will also look into possible connections between learning in subacute aphasia and learning in chronic aphasia. These connections have not been previously explored. Methods. The multiple case study included four aphasic participants who were examined 0–3 months after stroke and again 12 months after stroke. The examination consisted of cognitive-linguistic background tests, questionnaires and a computer-based novel word learning task. In the latter, the participant was tasked with learning the associations between given pseudo-words and images through feedback and repetition. Research data was analyzed case by case. Results and conclusions. Recovery and novel word learning in subacute and chronic aphasia varied among the participants. In both stages, some participants learned new vocabulary and were able to transfer it into their long-term memory. The changes in novel word learning from subacute to chronic aphasia also varied among the subjects. These changes were not systematically connected with the severity of the participants’ aphasia, their baseline learning ability or an alleviation of cognitive-linguistic symptoms. Learning ability in subacute aphasia does therefore not always appear to predict learning ability in chronic aphasia, but novel word learning is possible in both subacute and chronic aphasia. Aphasia recovery shows considerable individual variation.
  • Valkama, Hannele (Helsingin yliopisto, 2022)
    Aphasia is a language disorder caused by damage to the brain. People with aphasia can have difficulty in speech comprehension and production as well as reading and writing. There is considerable diversity in the patterns of speech and language impairment among patients with aphasia. Recovery from aphasia is highly variable, but there are three distinguishable phases: the acute, subacute, and chronic phase. Stud-ies have shown that some people with aphasia can learn novel words. Studying novel word learning in people with aphasia helps understand the role of new learning in recovery from aphasia. Previous studies from the chronic phase of aphasia suggest that semantic processing skills and novel word learning are linked. There is some evidence that aphasia severity and short-term verbal memory affect novel word learning ability. The objective of this study is to compare the speech and language skills and the novel word learning ability of people in the early stages of aphasia. The speech and language impairment pattern of the study participants was evaluated with the WAB (Western Aphasia Battery). The subtests Spontaneous speech, Auditory verbal comprehension, Naming and Word finding, Repetition, Reading and Writing were used as the measures for different language abil-ities. Novel word finding was evaluated with a computer-aided novel word learning task. The word learn-ing task included a practice session and two tests. The results from the tests were used as the measure for novel word learning ability. Receptive novel word learning was correlated with comprehension skills. This result strengthens the view that intact semantic processing is important in receptive novel word learning. Writing skills were also cor-related with receptive novel word learning, but reading skills were not. Repetition, naming, and spontane-ous speech were not correlated with receptive novel word learning.
  • Galab, Noora (Helsingin yliopisto, 2022)
    Aim of the study. In Finland, the number of multilingual children referred to speech and language therapy assessment is relatively higher than monolingual children. However, distinguishing abnormal linguistic development from typical multilingual development is not straightforward due to the lack of multilingual tests and speech therapists. This study aimed to provide information on the morphosyntactic structures of the expressions of typically developing and language- impaired children aged 4–5 years who speak Arabic as their mother tongue and the deviations that occur in them. The aim was also to assess whether the morphosyntactic deviations produced show a transfer effect of Arabic language. The study is significant from the point of view of differential diagnosis. The qualitative information produced makes it possible to reduce the over- and underdiagnosis of developmental language disorder in native Arabic-speaking children who successively acquire Finnish language. Methods. The study examined 18 children aged 4–5 who speak Arabic as their mother tongue and who successively acquire Finnish language from the broader material of the Multilingua-project. Six of the children were suspected of having developmental language disorder. The study material consisted of recorded assessment situations that were transcribed to evaluate the morphosyntactic structures produced. Three different semi-structured play situations and The Cat Story picture sequencing narrative task were included in the analysis for each subject. The morphosyntactic forms and structures produced by the subjects were analyzed using the FIN-LARSP method. In addition, the morphosyntactic deviations in the expressions and the transfer effect of Arabic language were examined from a qualitative point of view. Results and conclusions. There was great variation in the inflectional repertoires of typically developing and language-impaired children. However, the inflectional repertoires of typically developing children proved to be broader than those of language-impaired children in terms of nouns and verbs. The groups differed in the use of adessive case, the accuracy of verb inflection, the regularity of morphosyntactic deviations, and the use of atypical wordings. In addition, expressions of typically developing subjects appeared to have a more versatile effect of Arabic language transfer compared to language-impaired children. The results help Finnish-speaking speech therapists detect morphosyntactic features that may be signs of a language disorder in Arabic-speaking children acquiring Finnish language.
  • Lahti, Anni (Helsingin yliopisto, 2020)
    Objectives. Autism spectrum disorder (ASD) is a neurobiological developmental disorder that involves challenges in social interaction and restricted/repetitive behaviors. Since generalization and maintenance of acquired skills is essential in the rehabilitation of ASD, it is important to integrate interventions into the home environment by parental guidance. There has been some research on the rehabilitation of children with ASD in Finland, but no research has been conducted on the guidance of parents from the perspective of speech therapist. The purpose of this study is to find out the views of parental guidance from speech therapists who rehabilitate children with ASD. Interviews with speech therapists will clarify the ways in which parents of children with ASD are guided through speech therapy and the challenges and contributing factors in parental guidance. Methods.The research method was a semi-structured interview. Five speech pathologists with experience in the rehabilitation of ASD were interviewed. The interviews were recorded and transcribed. The data was analyzed by content analysis. Results and conclusion. Parental guidance of children with ASD was divided into information sharing, interaction & discussion and direct guidance. The challenges were parental strain, parent attitude and in some cases multiculturalism. Contributing factors appeared in training practices and home conditions. Challenges and benefits were influenced by the individuality of families. Speech therapists hoped for more opportunities to arrange separate parental guidance sessions so that they would be able to discuss deeper about the methods and family situation without the child’s presence. Speech therapists considered parental guidance important in the rehabilitation of children with ASD because, with the guidance of parents it helped to increase skills in everyday life and guaranteed training intensity. As parental strain was identified as a challenge in this study, it would be important to explore how they could be more effectively supported during rehabilitation. In addition, it could be explored whether separate parental guidance sessions should be increased or whether the number of parental guidance sessions has been adapted through the development of new working practices.
  • Jokela, Katri (Helsingin yliopisto, 2021)
    Aim. Compared to spoken conversations, achieving mutual understanding may be more at risk when one or more participants use aided communication. An aided communicator may take a passive role in conversations and may not have adequate strategies to repair conversational breakdowns when they occur. The aim of this study was to describe how an aided communicator may attempt to solve the problems he encounters in conversations with his speaking communication partners. Aided communicator’s repair strategies, causes of breakdowns and partners’ influence on repair phenomena were studied. This study may help professionals to acknowledge the threats that compromise achieving mutual understanding in aided conversations and recognize some of the strategies in overcoming potential communication disrupts. Method. Within the framework of data driven qualitative analysis this case study examined videotaped conversations, where an 11-year-old boy using communication book communicated with his mom, teacher and peer. The data was originally videotaped as a part of the international research project Becoming an Aided Communicator. Data driven analysis was considered as an appropriate method for studying a topic with limited previous research. Results and conclusion. Almost all of the aided communicator’s repairs were self-initiated self-repairs and the rest were other-initiated self-repairs. The former occurred mostly as responses to the partner’s misinterpretations and operational difficulties while the latter followed requests for clarifications. Aided communicator repaired by repeating or modifying his utterances or by adding new elements to the original utterance. For repairs he utilized nonverbal modalities: gaze, gestures and actions. In some exchanges, he changed modality. Reasons for the misinterpretations and requests for clarifications emerged from the linguistic limitations of the graphic communication system and partner’s difficulty in understanding the aided communicator’s nonverbal communicative acts. Operational challenges seemed to be related to partner’s experience with using communication aids that affected the fluency of communication. Partners’ varying familiarity with aided communication seemed to affect the need to repair and the effectivity of repair. In addition, the shared competence of the dyad influenced achieving mutual understanding. For the best results of support and guidance, speech and language therapists should emphasize finding out the communicator’s individual strategies in repair as well as effective practices to use a communication book. This could be implemented by video-based observations.
  • Karhu, Elisa (Helsingin yliopisto, 2021)
    Objectives. Prematurely born (<37 gestational weeks) children are at increased risk for difficulties in language development and literacy skills, including pre-reading skills, reading and writing. Previous studies investigating full-term populations suggest that language skills are strongly correlated with reading acquisition. This connection is not widely studied in preterm sample and the findings of previous investigations have incongruity. The aim of this study is to examine the language development and literacy skills of children born extremely preterm (ELGA, born <28 gestational weeks) and/or with extremely low birth weight (ELBW, birth weight <1000 grams) at seven years of age. This thesis also investigates the possible association between language abilities and literacy skills in the sample of preterm children and a full-term born comparison group (born >37 gestational weeks). This study is part of the multidisciplinary cohort study of prematurely born children called PIPARI (the Development and Functioning of Very Low Birth Weight Infants from Infancy to School Age). Methods. The sample of this Master´s thesis includes 63 ELGA/ELBW children and 107 full-term born children who participated in the PIPARI study and were living in monolingual Finnish-speaking families. The language skills were assessed using the Five to Fifteen parent questionnaire (subdomains Comprehension, Expressive language skills, Verbal Communication) and the Peabody Picture Vocabulary Test-Revised. Pre-reading and reading skills were measured with the Jyväskylä First Steps study test material (phonological awareness, letter knowledge, rapid automized naming, single word reading, single word writing) and with the Five to Fifteen parent questionnaire (subdomains Reading and writing, General learning). Results and conclusion. The language and literacy skills at seven years of age were statistically significantly weaker in children born ELGA/ELBW when compared to the full-term controls. The Five to Fifteen questionnaire subdomain Verbal communication was the only skill that did not differ significantly between the groups. There was a clear and significant association between language and literacy skills with both preterm and full-term groups. In the preterm group the connection between language and literacy skills were stronger and appeared wider among the different language components. The results of this study support the previous findings that preterm children have an elevated risk for difficulties in language and literacy skills. In addition, this study provides further evidence for the associations between language abilities and literacy skills in school age in children born ELGA/ELBW. It is important that preterm children get the appropriate developmental follow-ups and support still at school age.
  • Kavander, Lotta (Helsingin yliopisto, 2022)
    Tavoitteet: Kun terveyspalvelujen tarjonta ei vastaa kysyntää ja tarvetta, seuraa vaikeuksia hoitoon pääsyssä. Suomessa perusterveydenhuollon hoitoon pääsystä säädetään terveydenhuoltolaissa, jossa hoitoon pääsylle on asetettu tietyt määräajat (hoitotakuu). Perusterveydenhuollon lääkinnälliseen kuntoutukseen ja siten puheterapiaan tulisi päästä viimeistään kolmen kuukauden kuluessa hoidon tarpeen arvioinnista. Tämän pro gradu -tutkielman tarkoituksena oli selvittää hoitoon pääsyä perusterveydenhuollon puheterapiassa. Tarkemmin tarkoituksena oli selvittää puheterapeuttien väestövastuuta (yhden kokoaikaisesti työskentelevän puhetrapeutin vastuulla oleva väestömäärä), hoitotakuun mittaamista ja toteutumista, odotusaikoja sekä priorisointia. Puheterapian hoitotakuuta, odotusaikoja ja priorisointia ei ole Suomessa tiettävästi aiemmin tutkittu. Menetelmät: Pro gradu -tutkielma toteutettiin kyselytutkimuksena kunnissa työskenteleville puheterapeuteille ja muille ammattilaisille, jotka parhaiten tunsivat alueen puheterapiatilanteen. Tutkimuksen perusjoukkona oli Manner-Suomen 133 kuntaa ja yhteistoiminta-aluetta, joista pyrittiin saamaan maantieteellisesti mahdollisimman edustava otos. Otos muodostui 47 alueesta, joihin kysely lähetettiin. E-lomakkeelle tehty kyselylomake koostui 52 osiosta sisältäen sekä suljettuja että avoimia osioita. Aineiston tilastollinen kuvaus ja analyysi suoritettiin IBM SPSS Statistics -ohjelmalla. Avoimiin osioihin tulleet vastaukset luokiteltiin sisällön mukaan. Tulokset ja johtopäätökset: Vastauksia saatiin 34 alueelta, ja vastaajia oli yhteensä 40. Tulosten mukaan alueiden väestövastuiden keskiarvo oli 13 232 (md 10 712, kh 9 030, min.–maks. 6 801–49 701). Hoitotakuun osalta hoitotakuun mittaamisessa havaittiin vaihtelua niin alueiden sisällä kuin alueiden välillä. Yleisimmin terveydenhuoltolaissa mainittu hoidon tarpeen arviointi katsottiin tehdyksi, kun puheterapeutti oli käsitellyt asiakkaan lähetetietoja tai yhteydenottoa (43 %). Laissa mainitun hoidon taas katsottiin yleisimmin alkaneen, kun puheterapeutti oli tavannut asiakkaan ja aloittanut arvioinnin tekemisen (76 %). Hoitotakuun arvioitiin toteutuneen aina 20 %:ssa alueita, 44 %:ssa useimmiten, 12 %:ssa noin puolessa tapauksista ja harvoin 24 %:ssa alueita. Arvioiduissa keskimääräisissä odotusajoissa ensikäynnille oli alueittain vaihtelua alle kuukaudesta yli puoleen vuoteen. Merkittävää vaihtelua oli myös arvioiduissa keskimääräisissä odotusajoissa puheterapeutin ensikäynneistä kuntoutuksen alkamiseen, ja yli kolmen kuukauden odotusaika ensikäynneistä kuntoutukseen oli 38 %:ssa alueita. Priorisointia koskevissa tuloksissa tuli ilmi eritoten kouluikäisten jääminen alemman prioriteetin ryhmiin. Heidän kerrottiin usealla alueella saaneen puheterapiaa vain poikkeustapauksissa. Lisäksi tuloksissa tuli esille resurssien riittämättömyyden ilmeneminen lyhentyvinä kuntoutusjaksoina ja kuntoutustyöhön jäävän ajan vähenemisenä. Vastausten määrä eri tuloksissa vaihteli riippuen käytettävissä olevien vastausten määrästä kussakin tulososiossa. Kaiken kaikkiaan tämän tutkimuksen tulosten perusteella perusterveydenhuollon puheterapiaan pääsyssä on merkittävää vaihtelua ja siten alueellista eriarvoisuutta. Puheterapiaresurssit perusterveydenhuollossa näyttäytyvät tarpeeseen nähden riittämättöminä, ja hoitoon pääsy jää monella alueella toteutumatta lain edellyttämällä tavalla.
  • Kriikkula, Alexandra (Helsingin yliopisto, 2021)
    Aims. There is an increasing number of multilingual children in the workloads of Finnish speech language pathologists. Yet there is little research on the typical and untypical language development of multilingual children. PAULA small group intervention has been developed to support the language development of multilingual children in a daycare setting. The aim of this study is to investigate whether the small group language intervention affects the Finnish language development of multilingual children and how background factors, such as the exposure to the Finnish language, affect the development of the study and control groups. Method. Subjects included 60 typically developing multilingual children, 34 in the study group and 26 in the control group. Subjects were 4 years old at the beginning of the study and the assessment was repeated 3 times within a year. Finnish language was measured with a vocabulary score calculated from Fonologiatesti (Kunnari, Savinainen-Makkonen & Saaristo-Helin 2012) and with a form filled out by the daycare staff. The data was analyzed with IBM SPSS Statistics 26. The difference between the study and control groups was analyzed with repeated measures ANOVA, Friedman test, and Mann–Whitney U test. The effect of background factors on the vocabulary scores was analyzed with linear regression, and the effect of background factors on the assessment by the daycare staff was analyzed with Spearman’s correlation coefficient and Kruskal–Wallis test. In addition, the background factors affecting the vocabulary score at the start of the study were analyzed with linear regression. Results and conclusion. The vocabulary scores of the intervention group improved more during the intervention compared to the control group, but the effect wasn’t observed in the follow-up measurement. PAULA small group intervention can support the lexical development of multilingual children, but more research is needed to confirm the findings. Being in the study group was positively associated with the change in vocabulary scores while the months spent in a Finnish language daycare were negatively associated. The months spent in daycare and the exposure to Finnish were positively associated with the vocabulary score at the beginning of the study. The children who at the beginning of the study had spent longer in daycare and had more exposure to Finnish are likely to have bigger vocabularies at the start and therefore improve less during the intervention. The children who had the least exposure to Finnish improved the most during the intervention. There was no statistically significant difference between the groups in the daycare assessments. In the study group exposure to Finnish was positively associated with the change in the daycare assessments. In the control group, no background factors had a significant connection to the daycare assessments.
  • Airaksinen, Aino (Helsingin yliopisto, 2020)
    In recent years the number of people from foreign backgrounds in Finland has increased considerably. Consequently, more and more children who are learning Finnish as their second language are met in Finnish day-care centers and schools. In order to attain adequate language proficiency before school-age, early support for sequential multilingual children’s L2 acquisition has been considered important. There have been some promising results from research concerning small-group interventions that have aimed to promote the L2 acquisition of children below school age. Nevertheless, further research is needed. The aim of this study was to investigate the effects of a small-group intervention on the expressive vocabulary development of children learning Finnish as their second language. Both single word naming skills and lexical diversity were examined. Lexical diversity was examined separately for the whole lexicon and for verbs. This study used the data from the PAULA research project. The sample of this study consisted of 32 sequential multilingual 4-year-old children. Half of the children (n=16) belonged to a study group and the other half (n=16) to a control group. The children’s Finnish language skills were assessed three times within a year (at pre- and post-intervention and at follow-up). Between the pre- and post-intervention assessments the study group participated in a small-group intervention (PAULA-intervention) for six months. The control group attended Finnish daycare but did not receive the intervention. The follow-up assessment was performed four months post-intervention. The ability to name single words was assessed in a picture naming task and in two short play situations with an examiner. Lexical diversity was examined by calculating the number of different words and Guiraud’s indexes in spontaneous speech data consisting of a play situation and a story-telling task. The differences between the study and control groups’ vocabulary development were analyzed by using repeated-measures variance analysis. The results showed that the children’s ability to name single words and their lexical diversity in spontaneous speech increased in both groups during the follow-up period. However, a statistically significant difference between groups appeared only for single word naming; vocabulary growth was faster in the study group between pre- and post-intervention assessments. Together with earlier studies from the PAULA research project, this study gives preliminary evidence about the efficacy of the PAULA-intervention. Although the inter-group differences have been relatively small, the results encourage continued implementation of the PAULA-intervention or other small-group interventions in day-care centers to enhance sequential multilingual children’s second language acquisition.
  • Holopainen, Jonna (Helsingin yliopisto, 2021)
    Aphasia is a linguistic-cognitive disorder that impedes the understanding and production of speech and is often accompanied by disorders in non-linguistic cognitive functioning, such as working memory (WM). WM has a key role in supporting on-going linguistic processing. Earlier research shows that the impairments caused by aphasia can be alleviated with speech therapy but it is still unclear which amount of therapy is most effective, at which stage of the illness and with which intensity. Some research suggests that greater amount of therapy within a shorter time span yields greater outcome. However, research findings on the matter are difficult to synthesize as the definition of ‘intensity’ varies across studies. Language Enrichment Therapy (LET) is a systemic and developmental therapy programme for aphasia rehabilitation. LET aims to restore linguistic-cognitive functioning. LET also enables rehabilitation of working memory with “brain-jogging”. As there is hardly any prior research on the LET system, the aim of this thesis is to investigate its effectiveness as an intensive aphasia therapy programme and the role of working memory in rehabilitation and, further, to identify possible background factors predicting rehabilitation outcome. The data for this thesis was collected for a research project between 1987 and 2010. The data consists of 24 persons with aphasia (PWA) who suffered a first-time stroke and whose time post-onset at baseline was 2 to 8 months. Linguistic functioning was assessed six times within the research frame with Tsvetkova’s Speech Dynamics Test, Western Aphasia Battery and the Token test. The data was analysed statistically using Friedman’s test to analyse the change in understanding and producing speech, linear regression to analyse possible factors predicting outcome and linear correlation to analyse the connection between working memory and rehabilitation outcome. The findings show that intensive rehabilitation with the LET system improves the understanding and production of speech with PWA. LET is the most effective in ameliorating speech understanding for those PWA with greater impairment and lesser time post-onset. No factors predicting the outcome of speech production were found which might be due to the developmental nature of the LET system in which rehabilitation of understanding always precedes that of production. WM had no predictive value for rehabilitation outcome. These findings must be interpreted with caution but can still be used for clinical decision making.
  • Paasila, Bettina (Helsingin yliopisto, 2021)
    Tavoitteet. Tämän pro-gradu tutkielman tarkoituksena oli luoda katsaus siihen, millaisia kuntoutusasetelmia- ja harjoitteita on käytetty sosiaalisen kognition kuntoutuksessa virtuaalitodellisuudessa ja voiko virtuaalitodellisuus tuoda lisäarvoa kuntoutukseen. Tavoitteena oli selvittää virtuaalitodellisuudessa tehtävien kuntoutusharjoitteiden vaikuttavuutta sosiaaliseen kognitioon henkilöillä, joilla on autismikirjon häiriö ja kuinka vaikuttavuutta on mitattu. Lisäksi pyrittiin selvittämään yleistyvätkö nämä tulokset interventioiden ulkopuolelle. Menetelmät. Tutkimus toteutettiin integroivana kirjallisuuskatsauksena, jonka aineisto on koostettu tieteellisistä artikkeleista. Artikkelit ovat valikoituneet hakulausekkeen perusteella. Hakulausekkeeni ovat: (virtual* OR augmented* OR mixed* vr OR hmd* OR headset OR “head mounted” OR head-mounted* OR helmet OR glasses OR goggles OR ve OR immersive OR im-mersion OR 3d OR head-worn OR “head worn”) AND (autism* OR autism spectrum disorder* OR high functioning au-tism* OR HFA* OR Asperger* OR pervasive disorder*) AND (intervention* OR rehab* OR rehabilitation* OR therap*) AND (“social gaze” OR “social cognition” OR communic* OR social* OR gaze*) Tulokset ja johtopäätökset. Aineiston perusteella voidaan todeta, että virtuaalitodellisuudella voidaan menestyksekkäästi toteuttaa sosiaalisen kognition kuntoutusta henkilöillä, joilla on autismikirjon häiriö, tietyin reunaehdoin. Aineiston perusteella kuntoutuksessa saavutettiin paras vaikuttavuus, kun kuntoutusharjoitteena oli suora vuorovaikutusharjoitus, kun otoksena kuntoutettavia, joilla mitattu ÄO oli >70. Lisäksi nähtiin kuntoutuksen tulosten yleistymistä niissä tutkimuksissa, joissa kontrolli oli järjestetty. Virtuaalitodellisuudella voidaan tuoda lisäarvoa kuntoutukseen, sillä laitteet voidaan viedä kuntoutujan arkeen ja näin mahdollisesti taata kuntoutuksen systemaattisuus ja riittävä intensiteetti sekä säästää terapiaresursseja.
  • Pilli, Reea (Helsingin yliopisto, 2021)
    Tiivistelmä - Referat - Abstract Objectives. There is evidence on deficits in production and/or perception of word stress or its acoustic correlates in hearing impaired children. Previous research has shown that there might be beneficial effects of music and singing to perception of word stress or its acoustic correlates in hearing impaired children. Because good perception of word stress is linked to good language abilities, better perception of word stress may support language development in hearing-impaired children. Seemingly, there is no previous research on the development of production of word stress during music intervention in hearing impaired children. There is also a lack of studies comparing hearing impaired children with cochlear implants (CI) and hearing-impaired children with hearing aids (HA) in their development of production and perception of word stress. The aim of this study was to examine how music intervention and singing at home are linked to the production and perception of word stress or its acoustic correlates in hearing-impaired children with bilateral cochlear implants (CI) and/or hearing aids (HA). This pilot study is a part of MULAPAPU research project which aims to study the effects of music and singing to perception and production of language in children aged from 0 to 7 years. Methods. The participating children (n=16) with bilateral CIs and/or HAs were aged from 2 to 7 years. They were grouped based on their hearing devices (children with bilateral CI and children with bilateral HAs or unilateral CI and contralateral HA). Other groups were made based on their signing at home (singers and non-singers). Non-word repetition-task invented in MULAPAPU research project was used to test the production of word stress. The perception of word stress and its acoustic correlates (pitch, intensity, duration) were assessed with previously used non-word /tata/-task. The children were tested before music intervention (T1) and after music intervention (T2). Results and conclusions. Only children with CIs improved in their production of word stress during music intervention. Overall, age was linked to the production of word stress but not the perception of word stress. Closer analysis showed a significant link between age and the development of production of word stress in hearing impaired children with HAs. Higher age was also linked to better development of perception of duration in children with CIs, and poorer development of perception of word stress in children with HAs. There were no significant differences between singers and non-singers in development of the production or the perception of word stress. However, more singers than non-singers improved their performance during music intervention. It seems that singing, and music intervention could be a valuable asset on rehabilitation of hearing-impaired children.
  • Katainen, Sallamari (Helsingin yliopisto, 2021)
    Kuulovamma on riski lapsen sanaston kehitykselle. Sanaston kehitystä voidaan arvioida sanojen määrän lisäksi nimeämisen taidoilla. Musiikin harjoittelun on todettu parantavan lasten kielellistä kehitystä, myös sanaston kasvua. Ohjatun musiikki-intervention yhteyttä kuulovammaisten lasten sanaston kasvuun ja nimeämiseen ei ole aiemmin tutkittu. Tämän pro gradu -tutkielman tarkoituksena on selvittää lasten sanastoa mittaavien vanhemmille suunnatun kyselyn ja nimeämistehtävän välistä yhteyttä, miten näillä mitattuna kuulovammaisten lasten sanasto kehittyy ohjatun ja tavoitteellisen musiikki-intervention aikana, ja miten tutkittavien taustatekijät ovat yhteydessä kehitykseen. Lisäksi tarkastellaan, eroaako sanaston ja nimeämisen kehitys enemmän tai vähemmän lapsilleen laulavien vanhempien lapsilla. Tutkielma on osa MULAPAPU-hanketta, jossa tutkitaan CIsumusa-puhemuskarin vaikutuksia 0–7-vuotiaiden kuulovammaisten lasten kielenkehitykseen. Tutkittavat (n=14) olivat 2–6-vuotiaita, suomenkielisiä, bilateraalisesti kuulovammaisia lapsia, joilla ei ollut kuulovamman lisäksi muita vammoja, ja jotka olivat osallistuneet CIsumusa-puhemuskariin vuosina 2019–2020. Tutkittavilla oli käytössään kuulokojeet, sisäkorvaistutteet tai molemmat. Sanaston kehitystä arvioitiin vanhemmille suunnatun LEINIKKI-menetelmän sanastopisteillä ja sanastoon liittyvää nimeämistä arvioitiin Bo Ege -sanaston käytön testillä. Arviointi toteutettiin ennen musiikki-interventiota (T1) ja sen jälkeen (T2). Aineisto analysoitiin tilastollisin menetelmin. LEINIKKI-menetelmän sanastopisteet ja Bo Ege -testi olivat tilastollisesti merkitsevästi yhteydessä toisiinsa, joten ne todennäköisesti mittaavat samaa asiaa eli lasten sanastoa. Tutkittavien sanasto kasvoi musiikki-intervention aikana. Vaikeampi kuulovamma oli yhteydessä parempaan nimeämiseen ennen musiikki-interventiota ja sen jälkeen. Sisäkorvaistutetta käyttävien lasten nimeäminen oli musiikki-intervention jälkeen parempaa kuin kuulokojetta käyttävien lasten. Äidin korkeampi koulutus oli yhteydessä lasten suoriutumiseen Bo Ege -nimeämistehtävässä ennen musiikki-interventiota ja kehitykseen sen aikana. Lasten, joiden vanhemmat lauloivat paljon lapsilleen, sanaston koon ja nimeämisen pisteiden keskiarvot nousivat enemmän kuin lasten, joiden vanhemmat lauloivat heille vähän. Musiikki-interventio vaikuttaa tulosten perusteella olevan toimiva kuntoutusmuoto kuulovammaisten lasten sanaston kehitykseen.
  • Palola, Jemina (Helsingin yliopisto, 2021)
    Aims of the study. Aphasia can be studied from the aspect of functional communication, in which case the focus is on how a person with aphasia is able to use language in their everyday environment. One way to study the functional communication of people with aphasia is to analyse discourse, as word-finding difficulties, which are common in aphasia, can affect discourse. Discourse can also be studied to determine whether the effects of an intervention are generalized to the level of functional communication. The aim of this thesis is to study the discourse of people with chronic aphasia, elicited using interview questions, in different phases of an intervention consisting of rTMS treatment (repetitive transcranial magnetic stimulation) and Intensive Language Action Therapy (ILAT). The discourse features which are analysed include lexical diversity (verbs and nouns) and informativeness (correct information units). The results of the discourse analysis are compared to the results of linguistic tests (Boston Naming Test for nouns and Action Naming Test for verbs). Methods. The data consisted of the discourse of three participants. The discourse was elicited using interview questions. All the participants had chronic fluent aphasia. They participated in the University of Helsinki research project “Treatment-Induced Speech and Language Improvement and Neuroplasticity after Stroke”, during which they received both rTMS treatment and ILAT therapy. They were examined four times during the intervention: at baseline, after rTMS treatment period, after combined rTMS and ILAT period, and at follow-up (3 months after the intervention). The discourse samples were analysed using discourse analysis. The chosen measurements were measures of lexical diversity, i. e. verbs and nouns, and measures of information units. The results were analysed visually. In addition, group effect sizes were calculated. Regression lines were used to compare the results of the discourse analysis to the results of linguistic tests. Results and discussion. No clear changes were detected in lexical diversity and informativeness of the discourse of people with chronic aphasia during rTMS and ILAT. Thus, the intervention did not have effect on functional communication at group level. However, there was much variation between the participants as well as between the results of different measures. The efficiency of informativeness increased for all the participants and it also had the largest group effect size. There was a stronger correlation between the use of nouns in discourse and the results of Boston Naming Test than between the use of verbs in discourse and the results of Action Naming Test