Browsing by Subject "puheterapia"

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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.
  • 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.
  • 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.
  • Hautamäki, L; Ramadan, F; Ranta, P; Haapala, E; Suomela-Markkanen, T (Kela, 2018)
    Työpapereita 140
    Eläinavusteiset menetelmät ovat ihmisen terveyttä, hyvinvointia ja elämänlaatua edistävää toimintaa, jossa eläimellä on avustava tehtävä. Eläinavusteisessa terapiassa eläin toimii osana tavanomaista terapiaa, jonka tavoitteena on parantaa ihmisen fyysistä, kognitiivista ja sosiaalista toimintakykyä sekä tunnetaitoja. Tässä katsauksessa tavoitteena on tuottaa tietoa eläinavusteisten menetelmien käytöstä Suomessa sekä tarjota kootusti tutkimustietoa eläinavusteisten menetelmien toimivuudesta osana erilaisia terapioita ja kuntoutusprosesseja. Katsauksessa tarkastellaan eläinavusteisen terapian toimivuutta ja hyötyä ja tarpeenmukaisuutta osana kuntoutusprosessia etenkin psykoterapian, puheterapian, fysioterapian ja toimintaterapian näkökulmista. Katsauksen menetelmänä on kartoittava kirjallisuuskatsaus. Tutkimuskirjallisuutta käydään läpi vuosilta 2010–2017 ja kotimaista toimintaa kartoitetaan ammattilaisten ja kuntoutujien haastatteluiden sekä taustoittavien keskustelujen avulla. Lisäksi katsauksen yhteydessä toteutettiin Kelan verkkosivuilla kysely eläinavusteisten menetelmien käytöstä. Katsauksessa esitellään eläinavusteisen terapian hyötyjä ja haittoja sekä tutkimusnäytön että ammattilaisten ja kuntoutujien kokemusten perusteella. Lisäksi esitellään eläinavusteisista menetelmistä hyötyviä kuntoutuksen kohderyhmiä ja kuvaillaan eläimen kanssa työskentelyn toteutustapoja osana erilaisia kuntoutusprosesseja. Katsauksessa käsitellään myös työskentelyyn osallistuvan eläimen edellytyksiä toimia osana terapiaa ja terapeutilta itseltään vaadittavaa täydennyskoulutusta.
  • Niemitalo-Haapola, Elina; Heikkinen, Elisa; Kauppila, Riikka; Lainio, Raila; Piirto, Heta; Tennilä, Tanja (Kela, 2021)
    Kuntoutusta kehittämässä
    Tutkimushankkeen tavoitteena oli tarkastella ja kehittää Goal Attainment Scaling (GAS) -menetelmän käyttöä vaativassa lääkinnällisessä puheterapiakuntoutuksessa. Tutkimushankkeen aikana kerättiin kokemuksia ja mielipiteitä puheterapeuteilta sähköisellä kyselylomakkeella. Kyselyyn vastasi 296 puheterapeuttia, jotka kuntouttavat Kelan vaativan lääkinnällisen kuntoutuksen asiakkaita. Kyselyssä havaittiin, että puheterapeutit käyttivät GAS-prosessiin paljon aikaa ja kokivat GAS-menetelmän käytön vaikeaksi. Suuri osa vastaajista koki tekevänsä GAS-tavoitteita ensisijaisesti Kelaa varten. Laadullisessa teema-analyysissa nousi esiin GAS-menetelmän käyttöä tukevina tekijöinä asiakkaaseen, hänen perheeseensä ja läheisiin sekä kuntoutussuunnitelmaan liittyviä tekijöitä. Toisaalta GAS-menetelmän käyttöä haittaavina seikkoina nousi esiin mitattavuuden ja asteikollisuuden haasteet, ajanpuute ja aikataulujen yhteensovittamisen haasteet sekä kuntoutuksen tarkkojen tulosten ennakoinnin vaikeus. Hankkeen päätapahtumia olivat puheterapeuteille suunnatut ”GAS-menetelmä logopedisessä viitekehyksessä” -koulutustilaisuudet, joissa oli yhteensä 258 osallistujaa. Koulutusten tavoitteena oli lisätä puheterapeuttien osaamista GAS-menetelmän soveltamisessa ja siten parantaa menetelmän luotettavuutta. Koulutuksista tehtiin koulutustallenne Kelan Youtube-kanavalle. Lisäksi hankkeen aikana kerättiin erilaisia nimettömiä GAS-tavoitteita asteikkoineen ja niistä muodostettiin Puheterapeuttien GAS-ideapankki. Jatkossa on tärkeä huolehtia GAS-menetelmän soveltamisen yhdenmukaisuudesta, tuoda Kelan asiakkaille tietoa GAS-prosessista sekä löytää aikaa GAS-menetelmän mukaisten tavoitteiden laatimiselle.
  • 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.
  • 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.
  • Ukkola, Ismo; Miettinen, Sari; Pulkki, Jutta; Heino, Pekka; Poikkeus, Leena (Kela, 2022)
    Työpaperissa tarkastellaan mahdollisia järjestelmätason syitä alueiden välisiin eroihin Kelan kuntoutukseen ohjautumisessa ja osallistumisessa neljän Kelan kuntoutuspalvelun osalta (työllistymistä edistävä ammatillinen kuntoutus, puheterapia, kuntoutuspsykoterapia ja aivoverenkiertohäiriön sairastaneen kuntoutuskurssi (AVH-kurssi)). Tutkimuksen teoreettisena viitekehyksenä toimi kuntoutuspalvelujen saatavuus ja sen muodostama monitahoinen kokonaisuus. Aineistona käytettiin keväällä 2021 toteutettua, kuntoutuksen ammattilaisille suunnattua kyselyä. Vastaajia yhdisti näkemys asiakkaan kuntoutukseen ohjautumisen sujuvuudesta, resurssien niukkuudesta ja kuntoutukseen hakemisen puutteista. Erityisvastuualueiden (erva) välisissä tarkasteluissa huomattiin, että Helsingin yliopistollisen keskussairaalan erityisvastuualueen vastaukset erottuivat muista alueista pääsääntöisesti myönteisemmillä arvioilla. Erityisesti näin oli asiakkaan kuntoutusprosessin sujuvuuden, toimintamallien käytön, työnjaon selkeyden sekä kuntoutustarpeen arvioinnin ja kuntoutussuunnitelman laatimisen osalta. Avovastauksista tunnistettiin seitsemän pääteemaa, jotka koskevat: tietoa, yhteistyötä, työnjakoa, palveluihin osallistumista, resursseja, kuntoutusmyönteisyyttä ja tukiverkkoa. Työnjaossa tunnistettiin kaksi alateemaa: asiakkaan ohjaukseen liittyvä työnjako ja asiakkaan prosessin jatkuvuutta turvaava työnjako eivät toimi sujuvasti. Toimintamalliteemassa tunnistettiin neljä alateemaa: tiedon tai osaamisen puute etenemisestä, prosessin vaikeaselkoisuus ja monimutkaisuus, epäselvät käytännöt ja toimintamalli ei toimi. Tulosten perusteella tulisi kiinnittää huomiota kuntoutuksen hakemiseen sekä asiakkaan kuntoutustarpeen arviointiin ja kuntoutussuunnitelman laatimiseen. Näissä vaiheissa tulisi tarkastella erityisesti toimijoiden välistä työnjakoa ja käytössä olevia toimintamalleja. Kaikkia alueita koskevat kehittämiskohteet ovat resurssien niukkuus ja palveluiden saatavuus.
  • Vuokko, Leena (Helsingin yliopisto, 2020)
    Objectives. Interprofessional collaboration has become increasingly important in health and social care. Collaboration with professionals in other fields is also part of the work of many speech therapists and the method has been found to benefit the work in many ways. The number of studies on interprofessional collaboration is also increasing, although the perspective of speech therapists is rarely considered. The purpose of this study was to investigate the experiences speech and language therapists and their team members of other professions have on interprofessional collaboration. The participants were primary health care employees working in two municipalities of the Helsinki Metropolitan Area. The interviewees were also asked about their views on the benefits and challenges of cooperation. In addition, it was investigated what skills the study period provided for the interviewees’ interprofessional work, as well as what qualities close cooperation requires from the employee. Methods. The study was conducted in February and March 2020 in two separate group interviews involving a total of six speech therapists, three psychologists, three occupational therapists and one nurse. The interviews were videotaped and transcribed into text files. The data was analysed by means of inductive content analysis, and the results were reviewed in the light of previous research and literature. Results and conclusions. The work of the speech therapists interviewed involved a variety of multidisciplinary practices, and the speech therapists collaborated with professionals in many other fields. The closest co-operation was in the employees' own offices, where professionals from different fields, among other things, consulted each other and met customers together. Interprofessional collaboration was thought to benefit the work in many ways, while the disadvantages were perceived to be minor. Interviewees felt that little attention was paid to interprofessional cooperation during their studies. Many felt that it would have been useful to get to know the job descriptions of future partners in particular during their studies. Based on the results of this study, speech therapists in primary health care seem to appreciate the opportunity for interprofessional collaboration. Cooperation seems to benefit their work as well as reduce work-related stress. For example, challenges in schedules, information flow, and workplace space solutions seem to make it difficult for workers to collaborate. Studies in speech therapy appear to provide rather limited skills for multidisciplinary work on the basis of this study. As cooperation with workers in other fields is usually part of the job description of speech therapists, the inclusion of multidisciplinarity more closely as part of speech therapy studies would be justified.
  • Kankaanpää, Miia (Helsingfors universitet, 2015)
    Aim. Approximately 50-60 children are born with severe to profound hearing impairment in Finland every year. Speech therapy for hearing impaired (HI) children consists of many different methods depending on the child's and his/hers family's individual needs. The main emphasis in HI children's speech therapy in Finland is in the auditory-verbal method. There is only a little information to be found in the literature about the contents of speech therapy for HI children (who use cochlear implants (CI) or hearing aids (HA)). The aim of this study was to find out how much Finnish speech and language therapists (SLTs) have experience about the rehabilitation of HI children. In addition the goal was to find out what components are used in HI children's speech therapy and what role does the children's parents have in their child's linguistic rehabilitation. Method. This study was carried out as a survey. An electronic questionnaire was send via the Finnish Association of Speech Therapists to 1154 SLTs in Finland. A total of 85 responses were received so the response rate was 7.4 %. The data was analyzed using IBM SPSS Statistics 22 -program. Frequencies, percentages and descriptive statistical analysis were computed (for example average and standard deviation). The data was demonstrated graphically. Rank correlation of ordinal variables was measured using Spearman's rho (ρ), Kendall's tau-c (τ) and Goodman and Kruskal's gamma (γ) rank correlations. Results and conclusions. The results show that Finnish SLTs have only little experience about the rehabilitations of HI children. The most common components in HI children's speech therapy were supporting and guiding children's early vocalizations, auditory training and training of vocabulary. The contents of CI- and HA- children's speech therapy seems to be very similar. The most common approach used in speech and language therapy was auditory-verbal method but total communication and pictures were commonly used as well. The results show that parent's role in HI children's rehabilitations varied quite a lot. It was quite common that parents were not present during their child's speech therapy and the SLTs reported that they would ask separately if they wanted the parents to be present in some speech therapy session. However the results show that most of the SLTs and parents were equal partners in HI children's linguistic rehabilitation. More research is needed to discover factors that influence the contents of HI children's speech therapy and the parent's role in their child's linguistic rehabilitation.
  • Sunervo, Ilona (Helsingfors universitet, 2015)
    Aim. Aphasia impacts not only the aphasic person, but also the significant others. There has been a largely grown interest on different types of intervention and services directed to significant others. However, there is little evidence how SLPs implement these practices in the clinical rehabilitation process. The aim of this study was to investigate how significant others participate in the rehabilitation process for people with aphasia in the SLPs point of view. Also, the resources and the causes behind these practices were studied. Methods. This study was carried out as a survey for Finnish speech and language therapists working with people with aphasia. The questionnaire was conducted in e-form and sent via the Finnish Association of Speech Therapists to its members. A total of 56 SLPs participated in the survey. The closed questions of the questionnaire were analyzed quantitatively, by representing percentages and frequencies of the answers. The qualitative analysis was based on the classification of recurring themes in the open-ended questions. Results and conclusions. According to 60 % of the respondents, significant others were part of the evaluation process frequently or always. In planning the rehabilitation, significant others were involved frequently or always according to 68 % of the respondents. Significant others were frequently or always part of the rehabilitation according to 58 % of the respondents. SLPs used varying methods working with significant others, although structured methods described in the literature were seldom used. The participation of significant others was considered fairly important. SLPs recognized the importance of significant others in supporting communication and overall progress in rehabilitation. Structural/organizational constraints were often mentioned and SLPs also felt that significant others weren't always motivated to participate in the rehabilitation process. Time, therapy materials and education were among the resources that were needed more. As a conclusion, this study shows that practices concerning participation of significant others in the aphasia rehabilitation process are somewhat unestablished in Finland, and that communication partner training hasn't quite yet reached clinicians. There are no clinical guidelines concerning aphasia therapy and significant others participation in it, which based on the results, would be needed.
  • Mäkinen, Anna (Helsingin yliopisto, 2019)
    Objective. The proportion of clients with immigrant background among clients receiving speech therapy has grown following an increase in immigration to Finland over the past few decades. Today, parents’ role in a child’s speech therapy is considered significant thus examination of their views is important for developing the services. In the city of Espoo, children’s habilitation services have discovered that there’s a need for surveying the views of the immigrant parents concerning therapy. The objective of this study was to investigate what kind of experiences and perceptions immigrant parents have about the speech therapy which their child has received in the city of Espoo’s habilitation services for children. In addition to the entirety of speech therapy, the study focused especially on the speech therapy material and the guidance in using the material and to support child’s speech and language development. Furthermore, the study investigated parent’s experiences and perceptions about cultural sensitivity in speech therapy and multi-professional cooperation between parents, speech therapist and personnel in early childhood education. Additionally, parents’ wishes and suggestions for development concerning the above-mentioned themes were examined. Moreover, parents’ experiences and perceptions of child’s speech and language development and difficulties related to them were investigated. Method. This study used a semi-structured theme interview as the data collection method. The interviewees were first generation immigrants whose children had received speech therapy in the city of Espoo’s habilitation services for children. The interview process included seven separate interviews and six of these required interpreters. Recorded interview data was transcribed, and the data was analyzed with inductive content analysis method with the help of the ATLAS.ti 7 software. Results and conclusions. Parents were mainly satisfied with speech therapy and speech therapy material as well with the guidance in using the material and supporting child’s speech and language development. Parents considered speech therapy as culturally sensitive. They experienced multi-professional cooperation mainly as functional and important. Parents had very little information about the cooperation between speech therapist and personnel in early childhood education, but they didn’t express a need for additional information concerning the cooperation. Parents emphasized the importance of wide social environment in child’s speech and language development and didn’t underline their own role as much. Parents expressed very little wishes and suggestions for development. Most of all they suggested utilizing technology in providing speech therapy and in speech therapy exercises. They also expressed a wish about using an interpreter in speech therapy, who would know the same language and dialect than the child. Parents also wished more social contacts for their children in their spare time, which would improve child’s speech and language development. This study indicates that immigrant parents would also benefit from information related to speech therapy and child’s speech and language development emphasizing especially the parents’ role in the development of child’s mother tongue.
  • Vinberg, Martta (Helsingin yliopisto, 2017)
    Aims. The aim of this study was to find out how speech and language pathologists use musical methods in speech therapy in Finland. The purpose of the survey was to gather experiences and opinions about this subject. The data was collected in spring 2016. Methods. The survey was made with web-based survey-tool provided by Helsinki University. It was sent to 1209 members of Finnish association of Speech Therapists. The questionnaire was answered by 122 responders (response rate was 10%). There were 25 questions in the survey, with open, closed and combined question types. Open questions were analysed with qualitative methods: answers were categorized and sorted into themes. Closed questions were analysed by quantitative methods by calculating means and frequencies with SPSS-program. Combined questions types were analysed with both methods. Results and conclusions. The responders who had direct speech therapy as part of their job description (N=112) did use diverse musical methods as part of the therapy, but the amount of utilization varied considerably. The methods were used all around Finland, by therapists from different kind of backgrounds concerning the age and the graduate university. Musical methods were used in many patient groups. According to the answers, these methods were especially important if the patient didn't have any kind of speaking ability to use. The most common musical method mentioned was MIT (melodic intonation therapy) which was used by 32% of the responders who did direct speech therapy. The MIT was also the most popular method from which responders would like to have more education of. In the whole sample (N=122), musical methods were used widely in the part of so called indirect or consultative speech therapy, meaning that the speech and language therapists gave recommendations of using music as part of the rehabilitation process at homes, during day care and in the rehabilitation centres. Some responders utilized musical methods also as part of the speech-language assessments. In addition, based on answers the collaboration between speech therapists and music therapists is almost non-existent in Finland. Collaboration with music therapists was hoped. Many responders were interested in the practical education of this subject.
  • Santapukki, Saara (Helsingfors universitet, 2015)
    Aims: Repair is one the three structures that organizes conversation. Repair organization is used for solving problems in speaking, hearing and understanding in conversation. Self-repair is initiated by the person who has produced the trouble source turn. Language deficits affect person's possibilities to communicate with speech. Different kinds of language deficits affect in different ways to person's possibilities to participate in conversation and to be understood. Self-repair is a way to maintain intersubjectivity in conversation. If one of the participants in conversation can't self-repair his speech because of the language deficit, the intersubjectivity between the participants might be endangered. The aim of this study is to describe self-repairs made by a 4-year-old boy and how his language deficits affect on his self-repairs. Methods: The main approach to this study was conversation analytic. Conversation analysis is a qualitative method. It is used for finding recurrent structures in conversation. The study examined self-repairs made by a 4-year-old boy who has deficits in speech understanding, naming and inflection. The material for the study was from speech therapy sessions. Speech therapy was held 20 times and a partner in the conversations was a logopedics student. The study observes three types of situations in speech therapy. The conversation topics were limited in different ways. Results & Conclusions: The participant made lots of fluent self-repairs despite his language deficits. He also made self-repairs when they were started by the other. The deficits of speech understanding and naming caused self-repairs. The deficits of naming caused multiple self-repairs one after the other. To the inflection the participant made just few self-repairs. The participant had not acquired the language skills of inflection at the time.
  • Manninen, Emmi (Helsingin yliopisto, 2021)
    Tiivistelmä - Referat – Abstract Objectives. Previous research has shown that different types of speech and language impediments are very common amongst young offenders. These difficulties can affect different linguistic subskills, such as speaking, understanding, reading and writing. They are often undiagnosed and can be confused with other afflictions, for example, behavioural problems. Difficulties can affect education and can weaken an offender’s ability to cope in different situations during the judicial process and prison sentences. In previous international studies, speech and language difficulties have been apparent both using objective measurements and also according to the offenders’ own opinions of their capabilities. In Finland, this is the first study of its kind. The objective of this study was to investigate Finnish-speaking young adult offenders’ own perspectives of their language and literacy skills. In addition, the aim was to investigate how possible language and literacy difficulties have had an effect on them in different situations, and whether these young adult offenders are willing to improve their skills. This study also investigated whether they are interested in receiving external support, such as speech and language therapy Methods. This was an empirical, qualitative research project, and the data was collected using semi-structured interviews. In total, ten Finnish-speaking young adult (male) offenders aged between 18 and 29 from two prisons in Finland participated in this study. Findings and conclusions. Young adult offenders mostly assessed their own language and literacy skills to be average, though they also mentioned different problems affecting their speech, understanding, reading and writing skills. Such difficulties had an impact on their interactions with different authorities, but also their abilities to cope within the judicial process and any prison sentence. They felt that their lawyers had provided important help in linguistically challenging situations. Most of the participants were keen to develop their language and literacy skills with external support. The results show that it is important to recognise offenders with language and literacy difficulties in the Finnish legal system, and to train authorities and staff working with them to recognise these difficulties more effectively. This could be a task for a speech-language therapist (SLT) or a special legal interpreter with the guidance of an SLT. Recognising language and literacy difficulties and supporting offenders who struggle with them can help to create a non-discriminatory judicial process, improving offenders’ commitment to rehabilitative activities and promoting their integration in society.
  • Haaman, Alisa (Helsingin yliopisto, 2019)
    Aims and objectives. Feeding difficulties are complex and multifactorial disorders that cause multiple challenges for children and their families. Previous studies have focused on parents’ experiences and treatment in specialised healthcare, but speech and language pathologists’ perspectives in the primary healthcare have not been studied. The incidence of feeding difficulties is expected to increase and the number of children with feeding difficulties is likely to increase in primary healthcare. The intervention requires multidisciplinary collaboration. However, clinicians across disciplines lack common working practices. The objective of this study was to increase the knowledge about feeding difficulties that speech and language pathologists encounter in primary healthcare. The aim was also to describe speech and language pathologists’ experiences and perspectives on multidisciplinary work and their readiness to work with the children. In addition, the assessment and intervention methods they use were studied. Therefore, it would be possible to pay more attention to the experiences of speech and language pathologists and to create more functional working practices based on these experiences. Method. The method in this qualitative study was a semi-structured interview. Seven speech and language pathologists working in primary healthcare were interviewed for the study, and they all had worked children with feeding difficulties in the past year. Speech and language pathologists’ work experience in primary healthcare varied from 1 to 25 years. Themes for the interview were formed based on the previous research. The interviews were carried out in November and December 2018. The interviews were recorded and transcribed into Word-files, and the data were analysed using content analysis. The data were divided into thematic groups and the results were examined in the light of earlier studies and literature. Results and conclusions. Based on this study, speech and language pathologists’ work with children with feeding difficulties is diverse in primary healthcare. Work requires the ability to detect several different areas and special features compared to many other disorders. When talking about assessment and intervention during the interviews, speech and language pathologists did point out various challenges. Complexity of feeding disorders, working with multilingual and multicultural families, speech and language pathologists’ insecurity and lack of common working practices hinder the work. The most important factors developing their readiness were work experience, multidisciplinary collaboration, collegial support and additional education. The findings of this study indicate that the speech and language pathologist working in primary healthcare play a major role in the treatment of children with feeding difficulties but the division of disciplines should be clearer. This study suggests that multidisciplinary collaboration has a positive effect on supporting the family and work readiness of speech and language pathologists. Feeding difficulties can be positively affected in primary healthcare and family welfare can also be supported. Due to the responsibility of speech and language pathologists’ work, active learning and maintaining professional skills with the help of clinical and theoretical knowledge are required.
  • Paltamaa, J; Erkkilä, J; Kanelisto, K; Mustonen, O; Nousiainen, E (Kela, 2017)
    Sosiaali- ja terveysturvan raportteja
    Tässä tutkimuksessa selvitettiin kuntoutumisen merkityksiä pitkään yhtäjaksoisesti avomuotoista yksilöterapiaa saaneille kuntoutujille ja kuntoutuksen toteutumista kuntoutujan, palveluntuottajan ja hoitavan tahon näkökulmasta. Tutkimus on osa Kelan Pitkät yhtäjaksoiset yksilöterapiat -tutkimusta. Tutkimuksen kohderyhmä olivat vuoden 2015 Kelan kuntoutustietojen mukaan avomuotoista fysio-, musiikki-, puhe- ja toimintaterapiaa sekä neuropsykologista kuntoutusta yhtäjaksoisesti yli 5 vuotta saaneet kuntoutujat. Tutkimukseen osallistui 30 kuntoutujaa (8–64 vuotta), 30 terapeuttia ja 6 lääkäriä. Aineisto kerättiin teemahaastatteluilla, jotka nauhoitettiin ja litteroitiin. Haastattelujen lisäksi laadullisen sisällönanalyysin aineistona olivat kuntoutussuunnitelmat, -palautteet ja -päätökset. Kaikki haastatellut kokivat avokuntoutuksen hyödylliseksi, terapian jatkumiselle löytyi perusteita ja kaikki olivat edistyneet tai heidän toimintakykynsä oli pysynyt ennallaan viimeisimmänkin terapiavuoden aikana. Pitkään jatkuneen avokuntoutuksen merkitys haastatelluille kuntoutujille rakentuu laaja-alaisista hyödyistä kuntoutujan arkeen, osallistumiseen ja elämänlaatuun. Aineistossa toistuu hyvin toimivan kuntoutuksen moninainen hyöty myös yhteiskunnalle. Tämän tutkimuksen perusteella pitkiä yhtäjaksoisia yksilöterapioita tulisi kehittää hyödyntämällä toimintakyvyn arviointimenetelmiä, näyttöön perustuvaa toimintaa ja suosituksia sekä kuntoutuspalautteiden kirjaamista niin, että palautteissa tulisi selkeämmin esille niin kuntoutujan toimintakyvyn, tavoitteiden kuin terapian toteutuksenkin muutokset. Haastattelut tehtiin keväällä 2016, jolloin uusi laki Kelan vaativasta kuntoutuksesta oli juuri tullut voimaan. Tutkimusaineisto kuvaa vanhan lain ja Kelan standardien mukaan toteutettua pitkää vaikeavammaisten avokuntoutusta, eikä tuloksista voi tehdä johtopäätöksiä uuden vaativan lääkinnällisen kuntoutuksen lain mukaisesta tai määrittämästä kuntoutuksen toteutuksesta.
  • Kataja, Ulla (Helsingfors universitet, 2015)
    Aims: Public health care in Finland has the main responsibility of rehabilitation, which means that public health care has to provide for persons with the severe disabilities the therapy or the rehabilitation needed. If a person fulfills the criteria of having severe disablity he is admitted Disability Allowance at its middle or highest rate. This is required for getting medical rehabilitation for persons with severe disabilities, which in Finland is financed by KELA. The speech therapy for the severely disabled organized by KELA is mainly carried out by private sector. There were approximately 500 private speech therapists under the contract of KELA during 2011-2014. Altogether 7439 persons were receiving speech therapy by KELA in 2014. The speech therapists under the contract of KELA are divided somewhat unevenly in Finland, therefore the availability of speech therapy is not equal in the whole land. Particularly areas with less inhabitants seem to suffer from inequality. The UN Convention on the Rights of Persons with Disabilities in 3.5.2008 was aimed at guaranteeing equal human rights to disabled people and to promote and support their human value. Methods: This Master's thesis looks at the availability of speech therapy in Finland both quantitatively based on open statistics by KELA and qualitatively on the nature of positive and negative decisions in the Medical District of Kanta-Häme. Results and Conclusions: The availability of speech therapy for persons with severe disabilities is not by KELAs statistics fully equal in Finland. The uneven division of speech therapists has lead to the fact that there are for example, at the insurance district of Oulu considerably more speech therapists than at the insurance district of Satakunta.The speech therapists under contract of KELA are like many other highly educated people situated close by the universities and other schooling areas, By U.N agreement the persons with disabilities should have rehabilitation near where they live and timing it optimally.The severity of language impairment was the main reason in positive decisions in the Medical District of Kanta-Häme and the insufficiency of arguments in the negative ones, which seem to refer to the fact that there, with an adequate application, speech therapy is guaranteed for the persons with most severe disabilities. One of the aims of the future social welfare and health care reform is to improve the availability of speech therapy in Finland. It remains to be seen how successfully it will answer the growing need.
  • Niemi, Miia (Helsingfors universitet, 2015)
    Background and aim. Bilingualism is a worldwide and old phenomenon. It is also a current topic in speech therapy. Bilingualism can be defined in many ways, for example by the age when a person has been exposed to his/her languages. Bilingual children are common clients in Finnish speech therapy field due to increased immigration. When evaluating the linguistic skills of a bilingual child the speech therapist might need to co-operate with an interpreter. In this research the aim was to identify how the SLT's feel the co-operance with the interpreters in evaluation situations. There is only few former studies about this subject, especially in Finland. Some studies have been made to examine the co-operation of the interpreter and another healthcare provider. In this study we also asked if there are some typical challenges in the co-operation and could something be done to develop this liaison. Methods. In this study 12 SLT's were interviewed. They worked in the capital area of Finland. I contacted the leading SLT's to recruit the examinees. The SLT's had been working 2-34 years and they all had evaluated bilingual children in co-operation with an interpreter. The semistructured interview material was gathered and transcribed in the autumn 2014. After transcribing the material was separated into four main themes for reporting the results. Results and discussion. Co-operation between SLT and interpreter shows out to be working mainly fine. Typical challenge mentioned is for example achieving a natural interaction. There are still some lacks in the language skills of the interpreters and the SLT's hope to develop the co-operation with a better guidance (also in the training program of logopedics) and diverse co-operation opportunities. The SLT's seem to appreciate interpreters' social skills, language proficiency, natural interaction with children and flexibility in diverse therapy situations.