Advances in Communication and Swallowing

Waiting lists for speech and language therapy exist when services do not meet demand. Waiting lists pose practical and ethical challenges for speech and language therapists (SLTs) and workplaces to manage, with potential flow on effects for children and families.

The present study aimed to describe SLTs’ perspectives about waiting lists for children with speech, language, and communication needs (SLCN) and explore waiting list management strategies.

The present study reports on 187 SLTs’ written responses to open-ended questions in a questionnaire. SLTs were from nine countries, had an average of 12 years’ experience in the profession (range 0.2–45 years), and either currently or had previously worked with children. Data were analysed qualitatively using thematic analysis.

SLTs’ feelings about their waiting lists centred on three themes: (1) negative (e.g., “overwhelmed”, “stressed”, “anxious”, “embarrassed”); (2) neutral (e.g., “not too bad”, “okay”); and (3) positive (e.g., “manageable”, “proud”). Four themes related to waiting list management: (1) SLT service delivery (e.g., triage, use of technology in service provision); (2) workplace processes and policies (e.g., eligibility criteria, prioritisation); (3) SLT workforce (e.g., recruitment and retention of skilled SLTs); and (4) inaction (e.g., waiting list management was “out of my hands”).

Waiting lists can have negative consequences and many SLTs take action to manage waiting lists; however, waiting list management strategies are not necessarily effective which can impact children’s outcomes. There is a need to reimagine service delivery and identify effective actions for managing speech and language therapy waiting lists at a local and systemic level in order to optimise outcomes for children and families.

Interprofessional education (IPE) is considered to be a necessary step in preparing the healthcare workforce for collaborative patient care. Dysphagia, a complex health condition, requires collaboration between disciplines such as medicine (MED) and speech and language therapy (SLT). Therefore, both disciplines must have a shared understanding of dysphagia management within the context of interprofessional care.

This study investigated MED and SLT students’ shared learning about dysphagia management following an IPE workshop. The student experience of IPE was also explored.

Fifty students participated in one 3-hour classroom-based IPE dysphagia workshop which was appraised through a questionnaire completed immediately before and following the workshop. Within- and Between-Group analysis evaluated change in knowledge about dysphagia management. Comments related to student learning experiences were examined using a qualitative description approach.

98%of students (24 MED; 25 SLT) completed pre- and post-workshop questionnaires. Wilcoxon Signed-Rank tests indicated statistically significant post-workshop growth in knowledge of symptoms (p < 0.001) and medical conditions (p < 0.001) related to dysphagia. Students reported increased confidence in their ability to identify dysphagia (p < 0.001). Greater understanding of interprofessional roles was observed post-workshop, notably nursing (p < 0.05), pharmacy (p < 0.05), occupational therapy (p < 0.05) and physiotherapy (p < 0.001). While recognised as beneficial to shared learning and appreciation of different discipline perspectives, both cohorts found IPE challenging.

Classroom-based IPE is an appropriate approach for shared learning about complex health conditions which require interprofessional care. Including patient-facing activities would further enhance student learning. While students found IPE challenging, they identified several benefits related to their professional development.

People who stutter (PWS) are able to anticipate a moment of stuttering. We wished to explore whether this anticipation might be reflected by either unusual word choice and/or delayed word production during a single-word confrontation naming task.

Nine PWS and nine age- and sex-matched fluent controls completed the single-word confrontation-naming task. Groups were compared on numbers of word-finding and fluency errors, response latency, and naming accuracy, measured against a novel ‘usuality’ criterion. Regression modelling of response accuracy and latency was conducted.

The groups did not differ on naming task performance, except for a greater frequency of response latency errors in the PWS group. For both groups, responses containing word-finding or fluency errors were more likely to be non-usual names, and these were associated with longer latencies than accurate responses. For PWS, latency was positively related to participant age, and accuracy inversely related to stuttering severity.

The findings provide insights into word substitution as a generalized behaviour, its function, and associated time-cost. Group-specific relationships imply greater sensitivity in PWS to changing demands and capacities, and highlight the complexity of interactions between physical stuttering behaviour and verbal avoidance.

Advancements in neonatal care have resulted in increased survival for preterm infants, with associated risk for paediatric feeding disorders (PFDs), the prevalence of which is relatively unexplored. Risk factors for developing PFDs in this population must be identified.

The aim of this study was to determine the epidemiology and risk factors for PFDs in preterm infants with Extremely Low Birth Weight (ELBW); Very Low Birth Weight (VLBW) and Low Birth weight (LBW) in the only neonatal intensive care unit (NICU) in Cyprus.

This study comprised 2 phases: Phase 1, a retrospective 2-year file audit, informing methodology for Phase 2, a prospective epidemiological study. Profiles of 1027 preterm infants were obtained in Phase 1. In Phase 2, clinical assessment data on 458 preterm infants (N = 224) were analyzed.

The prevalence of PFDs was 36.5%. All preterm infants with ELBW and 69%with VLBW exhibited PFDs. Risk factors were birth weight (BW), gestational age (GA), bronchopulmonary dysplasia (BPD), neurological disorders, structural anomalies, and congenital heart disease (CHD).

This unique epidemiological data for one country will inform NICU service provision and direct international research on PFDs in neonates.

Post-operative dysphagia is one of the most common complications of anterior cervical spine surgery (ACSS).

Examine post-operative structural and physiologic swallowing changes in patients with dysphagia following ACSS as compared with healthy age and gender matched controls.

Videofluoroscopic swallow studies of adults with dysphagia after ACSS were retrospectively reviewed. Seventy-five patients were divided into early (≤2 months) and late (> 2 months) post-surgical groups. Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale (PAS) scores, and pharyngeal wall thickness (PWT) metrics were compared.

Significant differences were identified for all parameters between the control and early post-operative group. MBSImP Pharyngeal Total (PT) scores were greater in the early group (Interquartile Range (IQR) = 9–14, median = 12) versus controls (4–7, 5, P < 0.001) and late group (0.75–7.25, 2, P < 0.001). The early group had significantly higher maximum PAS scores (IQR = 3–8, median = 7) than both the control group (1–2, 1, P < 0.001) and late post-operative group (1–1.25, 1, P < 0.001). PWT was significantly greater in the early (IQR = 11.12–17.33 mm, median = 14.32 mm) and late groups (5.31–13.01, 9.15 mm) than controls (3.81–5.41, 4.68 mm, P < 0.001).

Dysphagic complaints can persist more than two months following ACSS, but often do not correlate with validated physiologic swallowing dysfunction on VFSS. Future studies should focus on applications of newer technology to elucidate relevant deficits.