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

Abstract

Aim: To identify management practices of Australian speech-language pathologists (SLPs) in the treatment of non-progressive dysarthria using a subsystem approach, and to explore SLPs’ consideration and implementation of the theoretical underpinnings of non-progressive dysarthria management. Method: A 39-item online survey was distributed to Australian SLPs, with 80 responses suitable for data analysis. Results: Practices of SLPs were variable for the management of the speech subsystems. The Lee Silverman Voice Treatment (LSVT®) was the most commonly used manualised treatment program, and was employed by 63.77% of respondents. Almost all SLPs (>88%) provided strategies to improve functional communication. There was no clear preference for low tech alternative and augmentative communication (AAC) devices. Speech generating devices were the most commonly employed high tech device. Almost two-thirds of respondents used non-speech oral motor exercises (NSOMEs) in treatment. SLPs had varied frequencies and models of service delivery for intervention. SLPs valued interventions targeting the activity and participation domains of the ICF, however this was restricted by the treatment context and resources available. The majority of SLPs (92.06%) were aware of the principles of motor learning, however many were unsure regarding the specifics of implementation. Conclusion: There is a clear need for further research into the efficacy of treatment techniques to guide decision-making.

Checklist of relevant ICF categories for speech and language development

“…The development of action skills based on a vast variety of data collection methods and documentation tools helps speech therapists communicate accurately the results from services rendered, thus improving the clinical decision-making process (25) . Such a scenario directly impacts the understanding of the action dimension for the speech therapy field and the need for a greater focus on the aspects of functionality, especially those linked to communication (14) .…”

“…In this context, health professionals are responsible for developing ICF-based tools and actions that stimulate approach, practicality, and reliability in the care process (9,13) , in addition to showing the relationships among the categories of activities and participation, communication skills, and environmental factors (14) , also linked to child development (15) and related assessment practices (16) .…”

Checklist das categorias da CIF relevantes para o desenvolvimento de fala e linguagem

“…O desenvolvimento de competências de atuação fundamentado em uma ampla variedade de métodos de coleta de dados e ferramentas de documentação, ajuda os fonoaudiólogos a comunicarem com precisão os resultados dos serviços que prestam, aumentando assim a capacidade de tomar decisões clínicas (25) . O que impacta diretamente no entendimento da dimensão de atuação da área fonoaudiológica e a necessidade de maior foco nos aspectos de funcionalidade, principalmente relacionados à comunicação (14) .…”

“…Nesse cenário, cabe aos profissionais da saúde desenvolverem ferramentas e ações pautadas na CIF que estimulem a aproximação, praticidade e confiabilidade no processo de cuidar (9,13) e que mostrem a relação entre as categorias de atividades e participação, habilidades de comunicação e fatores ambientais (14) , sendo também relativos ao desenvolvimento infantil (15) e suas práticas de avaliação (16) .…”

Speech and language therapists' management practices, perceived effectiveness of current treatments and interest in neuromuscular electrical stimulation for acquired dysarthria rehabilitation: An international perspective

“…Surveys of speech and language therapists’ (SLTs) management practices for acquired dysarthria conducted in the United Kingdom, the Republic of Ireland, Lebanon and Australia provide insights into the approaches taken by therapists to assess and treat acquired dysarthria (Collis & Bloch, 2012; Conway & Walshe, 2015: Gracia et al., 2020; Miller & Bloch, 2017; Rumbach et al., 2019; Summaka et al., 2021). Primarily, these studies indicate that informal assessments are the most frequently employed testing method in acquired dysarthria, followed by formal tests and lastly by instrumental measures.…”