Day 2 :
- Augmentative and Alternative Communication | Cultural and Linguistic Issues | Fluency | Language in Infants, Toddlers and Preschoolers | Language and Learning in School Age Children and Adolescents
Location: Hall 1
Session Introduction
Alan H. Shikani
The Union Memorial Hospital, USA
Title: Assessment and Comparison of the Different Tracheotomy Speaking Valves
Time : 12:40-13:10
Biography:
Alan H Shikani did his Residency and Fellowship training in Otolaryngology-Head & Neck Surgery at the Johns Hopkins Hospital in Baltimore and is currently the Chief of Otolaryngology-Head & Neck Surgery at the LifeBridge Sinai Hospital and MedStar Union Memorial Hospital. He is also an active Member of many distinguished societies including the Alpha Omega Honor Medical Society, the Triologic Society, the American College of Surgeons, the American Academy of Otolaryngology and the American Rhinologic Society. He has published numerous articles and book chapters in the field of otolaryngology-head & neck surgery. He is the Inventor of the Shikani speaking valve and Shikani HME and the Founder of the Airway Company.
Abstract:
Tracheotomy affects the patient at a very basic level: The ability to communicate. One-way speaking valves are designed to direct exhaled air over the vocal folds and restore speech. A variety of speaking valves has been described in the literature; the most commonly used being the Passy-Muir valve and the Shiley Phonate valves, which are flapper type valves. A newer type of unidirectional speaking valve, the Shikani Ball valve is based on a moving ball inside a chamber. Upon inspiration, the ball moves further back and air enters the trachea. On exhalation, the ball is flipped forward and seats into the valve opening, hence forcing the air to flow through the larynx and allowing speech. One advantage of the Shikani ball valve over the Passy-Muir or Shiley flapper valves speaking valves is that it offers substantially lower airflow resistance. The resistance inherent to the flapper valves may affect patient tolerance of the valves, thereby directly affecting both patient and valve selection. Hyposmia is a well-recognized phenomenon in patients who have had their nasal airflow diverted through a tracheotomy, believed to be due to elevated olfactory detection thresholds. The redirection in airflow that occurs with the use of a speaking valve has been theorized to be the cause of smell improvement. This study shows that the Shikani Ball valve significantly improves the loss of smell, as compared to the Shiley or the Passy Muir valves. Acoustic and perceptual evaluation was also generally more favorable with the Ball valve, most significantly with regards to speech naturalness. We did not note any significant difference in oxygen saturation levels. Eight out of 10 subjects subjectively preferred the ball valve, especially with regards to its low profile and ease of breathing and two preferred the Passy Muir valve.
Biography:
Thandeka Mdlalo is a South African Speech-Language Therapist. Her area of interest is linguistic and cultural diversity and currently forms part of the Linguistic and Cultural Committee of the Health Professionals Council of South Africa. She has acquired experience and extensive training in both private and public sectors, academia as a Lecturer to Speech-Language Pathologists in training and currently works as a Speech-Language Therapist and Audiologist at a remedial school and has a private practice. She has presented papers and workshops at local and international conferences, co-authored books and published in local and international journals.
Abstract:
The South African multicultural and multilingual society is a microcosm of the diversity within the global community. This diversity is reflected in the communities that require the services of the profession of Speech Language Pathology. Furthermore, this pluralism has implications for the manner in which assessments are conducted. It is against this background that a survey was conducted on Speech-Language Therapists (SLTs) regarding current practices in the assessment of English Additional Language (EAL) speakers in South Africa. It forms part of the rationale for a broader, critically evaluates the assessment of English Additional Language (EAL) speakers who are from an indigenous linguistic and cultural background, using an English expressive language screening tool, the Renfrew Action Picture Test (RAPT) as an example. The cultural and linguistic relevance of this commonly used screening tool is interrogated from four different viewpoints, firstly, the perspective of the children, who are the target population of the tool; secondly, that of the parents and community, who play a significant role in the socialization of the children; thirdly, from the perspective of the academics, who provide an academic perspective of the tool; and finally, speech-language therapists (SLTs) who administer the tool and interpret the results. The results of this survey highlight the challenges of human and material resources and the dominance of English in the profession in South Africa. The findings contribute to understanding critical factors for acquiring reliable and valid assessment results with diverse populations, particularly the implications from a cultural and linguistic perspective.
Marivic Beebee and Cynthia Constance Brewster
Tobii Dynavox Regional Consultant, USA and Integra Rehabilitation, USA
Title: Workshop on "My Patient Needs An AAC Device, She’s in a Skilled Nursing Facility, What Should I Do? "
Time : 13:55-14:55
Biography:
Cynthia Constance Cee Cee Brewster has worked in the field of speech language pathology for well over 27 years. She has a BS in Speech Language Pathology from Illinois State University and MS in Speech Language Pathology from Southern Illinois University, Carbondale, Illinois. She has a background in adult neurological disorders specializing in the areas of swallowing disorders, cognitive language disorders and use of augmentative communication devices with stroke patients. Her work as a traveling Speech Language Pathologist (SLP) has allowed her to work in many areas of the country and in a variety of clinical settings: Acute, outpatient, day rehabilitation, acute rehabilitation, skilled nursing and home health. She has served as an Adjunct Faculty and as a Clinical Supervisor. She has also served the Huntsville Community in providing speech services to the Mentees of the 100 Black Men of America-Huntsville Chapter, participated in local health fairs as well as lectures to educate the public regarding speech and language disorders through the Alpha Kappa Alpha, Rho Chi Omega Chapter as a Member. She has been employed with Integra Rehabilitation as a Regional Traveler for more than 4 years in Greensboro, Georgia.
Abstract:
Many residents in skilled nursing facilities (SNF’s) will not get an augmentative alternate communication (AAC) or a Speech Generating (SGD) device, unless they or their families pay for it. Medicare currently does not fund these devices unless residents are members of the community and are not SNF residents. States such as Georgia have technology departments that will offer permanent loaners for such residents. This session will be hosted by a SLP and a representative from Tobii Dynavox who have carried out joint assessments and interventions for SNF residents with Tobii Dynavox AAC devices. Participants will be given ideas for carrying out assessments to determine when a resident is eligible for a device. Examples of how the SNF SLP, the Tobii Dynavox representative and the Georgia state technology department work together to obtain a successful assessment, as well as treatment using the AAC, permanent loaner device in the SNF for ADL’s will be illustrated. Information will also be provided on what not to do to obtain successful out comes. Lastly, 3 case studies will be presented to illustrate the response of SNF residents to the AAC devices.
Maureen Dykinga
Spoon Foundation, USA
Title: Feeding Techniques and Practices for Children With Disabilities Living Outside of Permanent Family Care Around the Globe
Time : 15:15-16:00
Biography:
Maureen Dykinga has completed her Master of Science degree in Communication Disorders from Arizona State University, USA. After providing pediatric clinical care in her own private practice for 13 years, she expanded her scope of work to include infants and children around the globe, by becoming the Feeding and Disability Specialist at SPOON, an NGO that specializes in feeding and nutrition for children living outside of permanent family care.
Abstract:
Feeding techniques that are considered best practice and assist infants and children with disabilities (CWD) to remain safe during mealtimes have been studied in the United States. What is less well understood is how applying best feeding practices to those living in institutional care around the globe has a positive impact on health and nutrition indicators. Unsafe feeding practices and respiratory health issues are frequently observed in these settings and SPOON has collected nutrition data that shows high rates of wasting, stunting and anemia in this population. In order to better understand the relationship between feeding practices and health/nutrition indicators, SPOON developed a feeding assessment tool to assist with training and act as a guided observation that leads to recommended interventions that address feeding practices including positioning, pacing, responsiveness and texture modification. Paper versions were reviewed, modified and integrated into a smart digital application (app) that assesses mealtime practices and uses built-in logic to customize the assessment. SPOON’s work in the field has taught us that addressing feeding or nutrition practices in isolation is not as effective as integrating these interventions and this is a primary feature of the digital app. The data collected will be used to monitor health and nutrition indicators and correlate these to the change in feeding practices during mealtime. Contributing to this body of knowledge and increasing our understanding of the impact that feeding practices have on health and nutrition, for infants and CWD living in institutional care around the globe is critical.
Alan H. Shikani
The Union Memorial Hospital, USA
Title: Workshop on "Overview of Tracheotomy Procedures, of Speaking Valves and of Heat-Moisture Exchangers"
Time : 16:00-17:00
Biography:
Alan H Shikani did his Residency and Fellowship training in Otolaryngology-Head & Neck Surgery at the Johns Hopkins Hospital in Baltimore and is currently the Chief of Otolaryngology-Head & Neck Surgery at the LifeBridge Sinai Hospital and MedStar Union Memorial Hospital. He is also an active Member of many distinguished societies including the Alpha Omega Honor Medical Society, the Triologic Society, the American College of Surgeons, the American Academy of Otolaryngology and the American Rhinologic Society. He has published numerous articles and book chapters in the field of otolaryngology-head & neck surgery. He is the Inventor of the Shikani speaking valve and Shikani HME and the Founder of the Airway Company.
Abstract:
Tracheotomy is a surgical procedure which is frequently performed to relief obstruction of airflow through the larynx and upper trachea. One of its main side-results is loss of essential functions including warming and filtering of air, coughing, smelling, tasting, swallowing and more devastatingly speaking. When a tracheotomy is present, exhaled air follows the path of least resistance and goes through the tube, reducing the vibratory movement of the vocal cords and hence limiting perceptual speech. A tracheotomy speaking valve redirects the air through the vocal cords, allowing speech. There are several speaking valves on the market including the Passy-Muir valve (Passy-Muir, Inc.), the Shiley Phonate™ valve (Mallinckrodt Medical) and the Montgomery speaking valve (Boston Medical Products) which are all flapper valves, which are based on a bias-closed membrane that is closed at all times and open only upon inspiration. The Shikani Speaking Valve is a novel speaking valve based on a ball design rather than a flapper design, which is improvement on the flapper speaking valves and is associated with a significantly lower airway resistance. The Shikani Heat Moisture Exchanger (HME) also has a novel HME designed to redirect airflow inside the HME in a turbulent fashion, which is extremely efficient. It has a highly efficient hygroscopic media made of porous reticulated ester-type polyurethane foam impregnated with calcium chloride) traps moisture and heat, and provides a very effective filter from unwanted particles. A unique feature of the Shikani Speaking valve and the Shikani HME is that they can be used in unison for the sake of speech and humidification, warming and filtration of air. This course is an overview and comparison of the different tracheotomy procedures and the different speaking valves and HME’s on the market.
Cynthia Constance Brewster and David R. Larsen
Integra Rehabilitation, USA and The American Brain Council, USA
Title: Workshop on "Synergistic Interventions for Aphasia and Cognitive Language Deficits in Cerebral Vascular Disease"
Time : 17:00-18:00
Biography:
Cynthia Constance Cee Cee Brewster has worked in the field of speech language pathology for well over 27 years. She has a BS in Speech Language Pathology from Illinois State University and MS in Speech Language Pathology from Southern Illinois University, Carbondale, Illinois. She has a background in adult neurological disorders specializing in the areas of swallowing disorders, cognitive language disorders and use of augmentative communication devices with stroke patients. Her work as a traveling Speech Language Pathologist (SLP) has allowed her to work in many areas of the country and in a variety of clinical settings: Acute, outpatient, day rehabilitation, acute rehabilitation, skilled nursing and home health. She has served as an Adjunct Faculty and as a Clinical Supervisor. She has also served the Huntsville Community in providing speech services to the Mentees of the 100 Black Men of America-Huntsville Chapter, participated in local health fairs as well as lectures to educate the public regarding speech and language disorders through the Alpha Kappa Alpha, Rho Chi Omega Chapter as a Member. She has been employed with Integra Rehabilitation as a Regional Traveler for more than 4 years in Greensboro, Georgia.
Abstract:
Speech Language Pathologists receive professional training in the use of techniques and strategies to improve communication for patients who present with a variety of aphasias and cognitive deficits after a Cerebral Vascular Accident (CVA). These deficits consist of receptive and expressive aphasia, dysarthria, oral apraxia or verbal apraxia. Cognitive language deficits may present as well, after a single neurological episode. However they are more common after the patient has suffered several CVA's. Once called multi infarct dementia, now referred to as vascular dementia. SLP's typically use speech & language cognitive techniques based upon evidence based practices to improve the patient’s level of functioning. New developments in the field of neurobiology suggest that a synergistic approach involving a variety of complimentary interventions may be the most effective overall approach to addressing cognitive dysfunctions. This paper will discuss the potential benefits of adding other components to the traditional speech-language cognitive therapy. The effects and advantages of a synergistic approach involving enhanced nutrition, physical activity, meditation and music on the brain and the use of brain stimulation exercises and computer games will be explained and discussed. The audience will complete the course with a better understanding of other variables and protocols that can have a positive and possibly greater and more enduring effect on brain rehabilitation when paired with speech and language interventions.
- Augmentative and Alternative Communication | Language Disorders | Literacy Assessment and Intervention | Speech and Language Science | Speech Sound Disorders | Swallowing and Swallowing Disorders
Location: Hall 1
Session Introduction
Sandra M. Grether
University of Cincinnati, USA
Title: Workshop on "Using Core Vocabulary with AAC for Developing and Supporting Language and Literacy Skills in the Classroom with Learners with Special Needs"
Time : 11:15-13:15
Biography:
Sandra M Grether is a Speech-Language Pathologist III at Cincinnati Children’s Hospital Medical Center in the Division of Developmental and Behavioral Pediatrics and Adjunct Associate Professor at the University of Cincinnati, College of Allied Health Sciences. She is responsible for interdisciplinary student leadership training and research in prelinguistic communication with individuals with significant intellectual disabilities, impact of cognition on language in pediatric hearing loss and cognitive disabilities, childhood apraxia of speech and augmentative communication. She has been with CCHMC and UC for 17 years and a Practicing Clinician for 43 years.
Abstract:
For students to have future academic and personal success, it is important for them to be competent using both oral and written communication. This workshop will focus on using a core language system to support students in developing language to be competitive in the classroom. Participants will learn how to incorporate core language using both low and high tech augmentative and alternative communication (AAC) systems. Case studies will be shared and participants will have the opportunity to collaborate with other participants applying this core language approach with learners across settings. Additional interventions and strategies will focus on teaching students with special needs emergent and conventional literacy skills.
Kerri Phillips
Louisiana Tech University, USA
Title: Supervision of Support Personnel
Time : 14:00-14:30
Biography:
Kerri R Phillips is a Professor and Program Director of the Graduate Program in Speech-Language Pathology at Louisiana Tech University, USA. She holds the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) from the American Speech-Language-Hearing Association (ASHA) and is licensed to practice Speech-Language Pathology in the State of Louisiana. She has practiced as a speech-language pathologist in a variety of settings including public schools, hospital/rehab, private practice and higher education. She is a Past Member of the Louisiana Licensure Board, having served as Chair and Vice Chair. Currently she serves on the ASHA Continuing Education Board. She is a Member and Past-President of the Board of Directors of the National Council of the State Boards of Examiners for Speech-Language Pathology and Audiology. She has been actively engaged in state and national associations where she has served in various leadership capacities.
Abstract:
Practicing speech-language pathologists and audiologists have an opportunity to assume positions that require a leadership role in clinical supervision/clinical education for support personnel. The practitioner has a challenging task of converting doing skills into leading skills. Unfortunately, many professionals typically evolve from the role of supervisee to supervisor without any formal instruction or training in supervision. In theory, supervision seems easy; in reality, it is far from easy. Many times supervisors’ find that interactions in the supervisory process may feel like a constant battle of the wills and those you supervise are not speaking in the same language. There are many challenges to being a good supervisor. Understanding your role in supervising support personnel is crucial in order to be an effective supervisor.
Li-Hsin Ning
National Taiwan Normal University, Taiwan
Title: The Internal Models of Pitch in Tone Speakers and Adult Second Language Learners: Evidence from Sensorimotor Responses in the Pitch-shift Paradigm
Time : 14:30-15:00
Biography:
Li-Hsin Ning has received her PhD in Linguistics at the University of Illinois at Urbana-Champaign. She formerly worked at Google as a Speech Data Evaluator and currently is an Assistant Professor in the Department of English (Linguistics Track) at National Taiwan Normal University. She has her expertise in phonetics and psycholinguistics. Her research primarily investigates the internal models for tone in native speakers of Mandarin and second language learners of Mandarin. She used the pitch-shift paradigm to examine the reflex-like responses represented by point estimation and F0 contours. She is additionally interested in speech technology (such as speech recognition) and sentence processing (both in the behavioral level and the neurophysiological level).
Abstract:
Adult second language learners of Mandarin have to acquire new perceptual categories for discriminating and identifying lexical pitch variation of lexical tones, along with new sensorimotor skills to produce the rapid tone changes. Pitch-shift paradigm in which a short and artificial change in pitch is fed back to speakers during vocalization has been used to investigate how sensory information affects the way we control our speech motor activities. The pitch-shift response (i.e., vocal responses to auditory perturbation, PSR for short) is a reflex-like auditory-vocal response elicited by artificial shifts in auditory feedback. Speakers typically respond to the pitch stimulus by shifting the fundamental frequency (F0) of their voice in a compensatory direction. The pitch-shift paradigm can also be used to understand the stability of internal models for tone production. Controversy exists in the literature regarding whether this rapid response can be volitionally suppressed, which would suggest speakers can modulate the reflex-like aspects and reduce short-term pitch fluctuations. My previous research suggests that native Mandarin speakers demonstrate reduced PSR gain when producing Mandarin tones and even non-linguistic vowel vocalizations relative to native English speakers. The results suggest that Mandarin speakers have more stable internal models for tones, as their ability to control F0 is in general (in both linguistic and nonlinguistic domains) superior to native English speakers. The L2 learners bear some resemblance to Mandarin speakers in terms of PSR suppression. However, they may require more learning in order to reshape their internal models and make them more native-like. Trained vocalists reduced PSR gain compared to non-musicians. However, although trained vocalists have the potential to produce tonal contours, regulation of voice F0 in a linguistic domain may still require intensive tone training. On the other hand, online visual F0 feedback on the magnitude and timing of the PSR could facilitate suppression of the PSR. The results show that augmenting F0 feedback via online visual monitoring contributes to suppression of the PSR in both Mandarin and English speakers. Apparently, the auditory-vocal integration system of the human brain can be modified rapidly to suppress F0 fluctuations in comparison with typical auditory feedback conditions. Visual F0 feedback offers opportunities for pitch control that may have application to musical training and language learning.
Stephen N. Calculator
University of New Hampshire, USA
Title: Workshop on "Functional Considerations and Approaches to Assessing and Treating Communication Challenges in Individuals With Severe Disabilities"
Time : 15:45-17:45
Biography:
Stephen Calculator is a consulting Speech-Language Pathologist and Emeritus Professor in the Department of Communication Sciences and Disorders at the University of New Hampshire, USA. Since earning his Doctorate in Communicative Disorders from the University of Wisconsin-Madison in 1980, he has published and lectured extensively in the areas of augmentative and alternative communication (AAC) and inclusive services for individuals with severe disabilities, drawing upon his ongoing experiences as a consultant to numerous schools and other agencies in the USA and beyond. His greatest contributions have been devoted to enhancing our understanding of the role communication and assistive technology can play in fostering the participation of individuals with severe disabilities in their communities.
Abstract:
This presentation will highlight functional assessment (e.g., circles of communication partners, ecological inventories and discrepancy analysis) and intervention strategies (e.g., vision statements, skill clusters and instructional matrices) that have been found to be highly useful in fostering communication, educational and related skills in individuals with severe disabilities. Particular emphasis will be placed on those with accompanying severe intellectual challenges. Limitations of standardized testing will be discussed and viable alternatives (i.e., non-standardized approaches) presented. While the greatest emphasis will be placed on the role of Augmentative and Alternative Communication and that of the speech-language pathologist, content will be readily applicable to other related services as well as overall instruction. Authentic assessment and intervention will be discussed with multiple practical examples of how these principles can be applied to foster functional and meaningful abilities. Overarching themes of the workshop will be participation, membership and inclusion. Rather than examining communication (i.e., AAC) as an isolated skill, this presentation will frame it as an essential component of an integrated program in which the broader objectives relate to functional life skills and quality of life. Strategies discussed will be those found to contribute to individuals’ establishment and maintenance of relationships with others (i.e., friendships) as well as increased levels of participation in educational, vocational, leisure and other events. Emphasis will be placed on practices that foster, rather than hinder individuals’ self-determination and independence. Practical considerations for selecting and then addressing instructional goals will be reviewed, once again emphasizing approaches that target communication skills in broader contexts. These include school and other community settings that support inclusive practices.