we’re all in it for the outcomes but which ones? - ecsf ecsf final_2.pdf · we’re all in it for...
TRANSCRIPT
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We’re all in it for the outcomes but which
ones?Rosemarie Hayhow
Speech Language TherapistSSC Radar Method
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Various terms are used. Do they mean the same?
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L5)8+-1+'M6@$E-@%5+!N"OP!Q!OSocial reformer, statistician, and the founder of modern nursingand remembered for her use of statistical measurement of nursing processes / practices to increase understanding of mortality rates and their causation
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SLT outcomes are a more recent concern BUT have been considered for several decades e.g.Andrews, G., Cutler, J. (1974) 'Stuttering Therapy - Relation between changes in symptom level and attitudes. Journal of Speech and Hearing Disorders, 39 [3], 312 - 319. Helps, R. & Dalton, P. (1979) The Effectiveness of an Intensive Group Speech Therapy Programme for Adult Stammerers. British Journal of Disorders of Communication. 14 [2] 17-30. Andrews, G., Guitar, B. & Howie, P. (1980) Meta-analysis of the effects of stuttering treatment. Journal of Speech and Hearing Disorders, 45 [3], 287 - 307. Howie, P., Tanner, S. & Andrews, G, 1981, Short-term and long-term outcome in an intensive treatment program for adult stutterers. Journal of Speech and Hearing Disorders, 46 [1], 104 - 109. Enderby, P. (1992) TOMS Outcome measures in speech therapy: impairment, disability, handicap, and distress. Health Trends, 20: 61–64.
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^%&%'&)'20??)8&'Y0%56&/'%2208%-1+'\^)-%.+(6%-'!QNO_Donabedian (1980) was one of the first to talk about structure process and outcome. Donabedian, A. (1980) The Definition of Quality and Approaches to Its Management, vol 1: Explorations in Quality Assessment and Monitoring.
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b)2+-'c'`8)1&)8'\!QN!_Rosen, A. and Proctor, E. K. (1981). Distinctions between treatment outcomes and their implications for treatment evaluation. Journal of Consulting and Clinical Psychology, 49 (3), 418-425.
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e2+8'?+82?+1EG+2'i'G%50+(')0&1),+2Roulstone,S., Coad, J., Ayre, A., Hambly, H. & Lindsay, G. (2012) The preferred outcomes of children with speech, language and communication needs and their parents. Department for Education- DFE-RR247-BCRP12 (https://www.gov.uk/government/publications/the-preferred-outcomes-of-children-with-speech-language-and-communication-needs-and-their-parents)!!
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S$65('>%5j'L6-(6-@2'2)'9%8kRoulstone et al Child Talk study- currently being written-up. Check Bristol Speech & language Therapy Research website for future publications (http://www.speech-therapy.org.uk/ )
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A-8D#$%,1'2(.3+'E''!8-5(9#+Packman et al 2014), The Lidcombe Program Treatment guide can be downloaded from: sydney.edu.au/health-sciences/asrc/docs/lp_treatment_guide_0314.pdf )
*The Lidcombe Program treatment goal in Stage1 is no stuttering or almost no stuttering, and the goal of Stage2 is for no stuttering or almost no stuttering to be sustained for a long time. (*A key goal is to improve the family's confidence and skills in managing their child's stammering. (Palin Parent-Child Interaction Therapy, http://www.stammeringcentre.org/early-intervention)
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A-8D#$%,1'2(.3+'E''!8-5(9#+Nippold, M. & Packman, A. (2012) Managing Stuttering Beyond the Preschool Years. Research Forum Prologue, Language, Speech, and Hearing Services in Schools, Vol. 43, 338–343
*'A primary goal of managing stuttering in school-agechildren and adolescents is to assist these clients to speak more fluently in a wide range of settings, with confidence, independence, and self-reliance. Under optimal learning conditions, children and adolescents should be able to adopt effective and durable strategies in an efficient manner that does not require an excessive number of treatment sessions or prolonged dependence on the SLP. (Nippold & Packman, 2012)
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A-8D#$%,1'2(.3+'E''!8-5(9#+Research commentaries Commentary in partnerships between clinicians , researchers, and people who stutter in the evaluation of stuttering treatment outcomes by J. Scott Yaruss and Robert W. Quesal by Barbara Dahm. Stammering Research Vol 1, Issue1 Online journal BSA.
Nippold, M. (2012) Letter to the Editor: When a School-Age Child Stutters, Let’s Focus on the Primary Problem. Language, Speech & Hearing Services in Schools. 43, 549–551.)
*The question of whether people who stutter want to speak fluently or feel better about communicating is totally irrelevant. When a person generates speech normally, the result is, of course, normally fluent speech and a normal ability to communicate. Both these conditions need to be part of an evaluation of treatment outcomes. (Dahm, 2004)* Presumably, if a school-age child could successfully control the stuttering, then the associated symptoms might diminish. (Nippold 2012)
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A-8D#$%,1'2(.3+'E''!8-5(9#+Yaruss, J.S. (2010). Assessing quality of life in stuttering treatment outcomes research. Journal of Fluency Disorders (Special issue: The Influence of Fluency Disorders on Quality of Life), 35, 190-202. Yaruss, J.S. (1997) A Framework for Discussing Outcome Measures in Stuttering. ASHA SID4 Leadership ConferenceTucson, AZ (slide 22)
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A-8D#$%,1'2(.3+'E''!8-5(9#+Blumgart, E., Tran,Y. & Craig, A. (in Press) Social support and its association with negative affect in adults who stutter. Journal Fluency Disorders
Results highlight the potentially harmful influence that poor social support has on mood states for adults who stutter. These findings have implications for treatment such as the necessity to address and integrate social support and social integration issues in the treatment process for adults who stutter. (Blumgart et al., In Press)
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*The differences in subjective wellbeing (SWB) ........... point to the importance of wealth and relationships as buffers against challenging living conditions. (Cummins 2005)
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The following information from the interview with parents:* Time since onset* Type of onset (sudden/gradual)* Male/female* Family history of stammering and who in the family
(relationship to child)* A question to elicit description/comment about the child’s
personality or disposition re temperament e.g. !"#$%&'(#)"*$+%+'#&%,-'$+%"',%.'#&%&/"#%-#01)2%3#4+4%)-*#&%0+0*$5%+#)%6*)/7#-8%9:&#);
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In terms of the stammering components the following would be required:
* Co-morbid conditions * Episodic nature? * Developmental milestones * Speech development, in particular, ‘Was talking clear at
the time stammering started?’ * Speech intelligibility
AN
AN
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Environmental aspects: * Child’s reaction to stammer * Parent’s reaction to stammer * How does the child respond to the parent’s response to the
stammer? * Any awareness? How was this displayed? * Parent rating scales (e.g Palin Parent Rating Scale see
http://www.stammeringcentre.org for more information)
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* Is your child still stammering? * Nature of stammer? * When did you last hear your child stammering? * Has there been any treatment? * A question to establish the level of concern
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