Telepractice as a Reaction to the COVID-19 Crisis: Insights from Croatian SLP Settings

Telepractice facilitates services in exceptional settings and situations. The ongoing COVID-19 pandemic is certainly such a situation. Due to pandemic-related restrictions, speech-language pathologists (SLPs) needed to adopt new approaches to their professional functioning. The aim of the paper is to examine SLP professionals’ perceptions and application of telepractice in SLP settings in Croatia during the COVID-19 pandemic. Two hundred and fifty-five SLPs completed an online survey. The results demonstrated that most SLPs had provided direct online therapy, mainly those employed in health care and private practice. The chief reasons for clients’ refusal of therapy delivered via telepractice included the lack of equipment, insufficient independence, and doubts on the effectiveness of telepractice. Although only 3% of SLPs had acquired some formal knowledge of telepractice before the pandemic, over 70% expressed satisfaction with telepractice because it allowed them to provide undisturbed clinical services in an exceptional situation

Use of Information and Communication Technology with a Boy with Language Impairment and Childhood Apraxia of Speech

Dječja govorna apraksija je poremećaj koji se javlja kao rezultat teškoća koordinacije pokreta usana, jezika ili nepca. Rezultira nejasnim govorom, nekonzistentnim greškama izgovora, poteškoćama u koartikulaciji i greškama u prozodiji. Dječju govornu apraksiju dijagnosticira logoped, a prvi znakovi poremećaja je usporen govorni razvoj djeteta. Terapija dječje govorne apraksije može uključivati rad na kontroli artikulatora, prozodiji, uvođenje potpomognute komunikacije te poboljšanje kontrole govornih pokreta. Jezične teškoće uključuju otežano usvajanje jezičnih sastavnica, a dijelimo ih na receptivne i ekspresivne jezične teškoće. Mogu utjecati na komunikaciju, proces učenja i akademski uspjeh djeteta. Kod djeteta se jezične teškoće mogu manifestirati u jednoj ili svim jezičnim sastavnicama. Potpomognuta komunikacija ima mnogo načina ostvarivanja – bez pomagala, niskotehnološkim putem ili kroz visokotehnološka sredstva. U visokotehnološka sredstva ubrajamo i informacijsko – komunikacijsku tehnologiju koja omogućava ciljan rad na određenim dijelovima jezičnih sposobnosti koje djeci s jezičnim teškoćama predstavljaju problem. U ovom diplomskom radu će biti prikazani rezultati šestomjesečne logopedske podrške dječaku s dječjom govornom apraksijom i jezičnim teškoćama. Dječak je na početku uvođenja podrške imao 6 godina i 4 mjeseca. Terapija se većinom provodila na visokotehnološkom uređaju kroz ICT-AAC aplikacije, a ciljevi su bili poticanje narativnih vještina, morfosintakse, predvještina čitanja i pisanja, proširivanje iskaza te širenje komunikacijskih funkcija i sredstava. Nije bilo očekivano da će dječak u potpunosti početi komunicirati visokotehnološkim sredstvom, ali se dječaka poticalo da što više koristi visokotehnološko sredstvo ako govorom ne uspije prenijeti svoju poruku. Nakon šestomjesečnog poticanja dječak je pokazao napredak u obliku češćeg korištenja komunikacijskih funkcija koje se mogu ubrojiti u deklarativne, jezičnom razumijevanju te određenim elementima predvještina čitanja i pisanja. Doprinos ovog diplomskog rada je prikaz poticanja djeteta s višestrukim teškoćama informacijsko – komunikacijskom tehnologijom, točnije nekomercijalnim ICT – AAC aplikacijama. Nadalje, u ovom diplomskom radu je vidljivo koliko je bitno da se obitelj i cijela okolina prilagode uvođenju potpomognute komunikacije.Childhood apraxia of speech is a disorder which appears as a result of difficulties in lips, tongue and palate movement coordination. It results in unintelligible speech, inconsistent speech errors, coarticulation difficulties and dysprosody. It is diagnosed by a speech language pathologist and the first indication of the disorder is speech delay. Childhood apraxia of speech therapy can include treating the control of the speech organs, prosody, implementing alternative and augmentative communication and improvement of speech movements control. Language impairment includes difficulties in acquiring language, and can be divided into 2 groups: receptive and expressive language impairment. There could be an effect on communication, learning process and academic achievement. A child can have an impairment in all or just one component of language. There are two types of alternative and augmentative communication: unaided and aided (basic and high – tech). Information and communication technology is a part of the high – tech AAC. It enables more focused work on specific language components. The aim of this study is to present results of speech therapy with a boy with childhood apraxia of speech and language impairment during six months. When this study began, the boy was 6 years and 4 months old. The therapy mostly consisted of working on a high – tech device and ICT – AAC application, and the primary goals were improvement in narrative skills, grammar, pre-reading and pre-writing skills, means and use of communication and enrichment of expression. Since it was unprobable that the boy will completely start using high – tech devices, the goal was for the boy to use high – tech devices when he is unable to communicate using speech. After six months of therapy, the boy used more declarative communication functions, language comprehension and certain pre-reading and pre-writing skills. The contribution of this study is showing how to use information and communication technology in speech therapy on a child with multiple disabilities, specifically, how to use non-profit applications. Furthermore, this study shows the importance of the whole family and social community adapting to the child using alternative and augmentative communication

Parental perspective on the use of high technology means of communication in children with complex communication needs

Skupini djece sa složenim komunikacijskim potrebama pripadaju djeca s motoričkim, jezičnim, kognitivnim i/ili senzoričkim teškoćama, a navedene teškoće mogu biti posljedica stanja poput poremećaja iz spektra autizma, cerebralne paralize, dječje govore apraksije ili intelektualnih teškoća. Djeca sa složenim komunikacijskim potrebama ne mogu komunicirati na uobičajen način te mogu imati slabo razumljiv govor ili govor koji je u određenoj mjeri razvijen, ali se ne koristi kao primarno sredstvo komunikacije. Jedno od rješenja prevladavanja teškoća jest uvođenje različitih sredstava potpomognute komunikacije, a u procesu njhove implementacije važnu ulogu ima djetetova obitelj. U okviru ovog rada intervjuirani su roditelji djece sa složenim komunikacijskim potrebama s ciljem pružanja uvida u njihova iskustva, osjećaje, njihov doživljaj takvog načina komunikacije te njihovo viđenje vlastite uloge u cijelom procesu. Podaci su prikupljeni pomoću polustrukturiranih intervjua sa sedam roditelja djece sa složenim komunikacijskim potrebama koja koriste visokotehnološka sredstva potpomognute komunikacije. Tematskom analizom dobivene su tri globalne teme (Komunikator kao sredstvo potpomognute komunikacije, Roditelj kao primarni komunikacijski partner, Podrška djetetu i obitelji) koje su analizirane i prikazane uz pomoć tematskih mreža. Problemi s kojima se roditelji uglavnom susreću jesu skupoća opreme i nedostatna stručna podrška. Sama uporaba komunikacijskog uređaja je ograničena, ali usprkos tome roditelji ističu njegov pozitivan utjecaj na dijete.The group of children with complex communication needs includes children with motor, language, cognitive and/or sensory impairments, which can occur as a result of conditions such as autism spectrum disorders, cerebral palsy, childhood apraxia of speech or intellectual disabilities. Children with complex communication needs cannot communicate in a conventional way and their speech may be poorly intelligible or developed to a certain degree but still not used as a primary means of communication. One of the solutions to overcoming the difficulties in question is the use of different means of augmentative and alternative communication, whose process of implementation greatly depends on the child’s family. This paper centres on parents of children with complex communication needs in order to gain insight into their experiences, emotions and thoughts on this type of communication, as well as their own role in the process. The data is collected through semi-structured interviews with seven parents of children with complex communication needs who use high technology means of augmentative and alternative communication. According to thematic analysis, three main themes emerge (Communicator as a means of augmentative and alternative communication, Parent as a primary communication partner, Supporting the child and its family), which are discussed and presented with the help of thematic networks. The most common problems are expensive equipment and scarce professional support. The very use of the communication device is limited, but nevertheless parents highlight its positive impact on the child