Effets d’une thérapie intensive de groupe pour les adolescentes et adolescents franco-québécois qui bégaient : résultats d’une étude rétrospective = Impact of intensive group therapy for Québec-French-speaking adolescents who stutter: Findings of a retrospective study

Abrégé Le bégaiement développemental est un trouble complexe qui affecte non seulement la parole, mais également les relations sociales et le développement identitaire chez plusieurs adolescentes et adolescents qui bégaient. Les thérapies de groupe semblent une modalité appréciée et efficace auprès de cette population. L’Association des jeunes bègues du Québec propose depuis 1993 une thérapie intensive de groupe, sous forme de camp de vacances, aux jeunes de 13 à 17 ans. Au total, les adolescentes et adolescents reçoivent environ 50 heures d’intervention orthophonique, lesquelles sont consacrées depuis 2011 à une application adaptée du programme Camperdown accompagnée d’activités d’éducation psychologique inspirées de la thérapie cognitivocomportementale. L’objectif de la présente étude est d’évaluer les effets de cette thérapie intensive de groupe sur le plan de la parole. Pour y parvenir, une étude clinique rétrospective a été effectuée. Les données sociodémographiques et cliniques ont été extraites d’un échantillon de 44 dossiers de jeunes de 13 à 17 ans ayant bénéficié de la thérapie de groupe de l’Association des jeunes bègues du Québec de 2011 à 2019. Des statistiques descriptives ont permis d’obtenir un portrait détaillé des participantes et participants. Des analyses statistiques non paramétriques ont démontré une diminution significative (p < 0,01) des valeurs de pourcentage de syllabes bégayées et de sévérité subjective du bégaiement au terme des six jours de thérapie intensive. De plus, la majorité des jeunes avaient amorcé la phase III du programme Camperdown — qui comporte quatre phases au total. D’autres recherches sont nécessaires afin d’étudier l’efficacité de l’intervention auprès des adolescentes et adolescents qui bégaient, notamment en regard des facteurs psychosociaux associés au bégaiement. Abstract Developmental stuttering is a complex disorder that affects not only speech, but also social interactions and identity formation in many adolescents who stutter. Group therapy appears to be a popular and effective treatment modality for working with this population. Since 1993, the Association des jeunes bègues du Québec [Québec Association of Young Stutterers] has been offering intensive group therapy during summer camps to young people aged 13 to 17 years. In total, the adolescents receive approximately 50 hours of speech-language pathology therapy, which has been devoted to an adapted form of the Camperdown Program with cognitive behaviour therapy inspired activities since 2011. The aim of this study was to evaluate the impact of this intensive group therapy on adolescents’ speech abilities using a retrospective clinical study design. Sociodemographic and clinical data were drawn from the clinical files of 44 individuals aged 13 to 17 who took part in the group therapy offered by the Association des jeunes bègues du Québec between 2011 and 2019. Descriptive statistics provided a detailed profile of the participants. Nonparametric statistical analyses showed a significant decrease (p < .01) in the percentage of syllables stuttered and in the subjective severity of stuttering after 6 days of intensive therapy. In addition, most of the individuals had begun Stage III of the four-stage Camperdown Program. Further research is needed to investigate the effectiveness of this intervention with adolescents who stutter, particularly with regard to the psychosocial factors associated with stuttering. © 2023, Canadian Association of Speech-Language Pathologists and Audiologists. All rights reserved

Fear of reprisal and change agency in the public health and social service system: Protocol for a sequential mixed methods study

Abract Background:   Since they are key witnesses to the systemic difficulties and social inequities experienced by vulnerable patients, health and social service (HSS) professionals and clinical managers must act as change agents. Using their expertise to achieve greater social justice, change agents employ a wide range of actions that span a continuum from the clinical (microsystem) to the societal (macrosystem) sphere and involve actors inside and outside the HSS system. Typically, however, clinical professionals and managers act in a circumscribed manner, that is, within the clinical sphere and with patients and colleagues. Among the hypotheses explaining this reduced scope of action is the fear of reprisal. Little is known about the prevalence of this fear and its complex dynamics. Objective:   The overall aim is to gain a better understanding of the complex dynamic process leading to clinical professionals’ and managers’ fear of reprisal in their change agent actions and senior administrators’ and managers’ determination of wrongdoing. The objectives are (1) to estimate the prevalence of fear of reprisal among clinical professionals and managers; (2) to identify the factors involved in (a) the emergence of this fear among clinical professionals and managers, and (b) the determination of wrongdoing by senior administrators and managers; (3) to describe the process of emergence of (a) the fear of reprisal among clinical professionals and managers, and (b) the determination of wrongdoing by senior administrators and managers; and (4) to document the legal and ethical issues associated with the factors identified (objective 2) and the processes described (objective 3). Methods:   Based on the Exit, Voice, Loyalty, Neglect model, a 3-part sequential mixed methods design will include (1) a web-based survey (objective 1), (2) a qualitative grounded theory design (objectives 2 and 3), and (3) legal and ethical analysis (objective 4). Survey: 77,794 clinical professionals or clinical managers working in the Québec public HSS system will be contacted via email. Data will be analyzed using descriptive statistics. Grounded theory design: for each of the 3 types of participants (clinical professionals, clinical managers, and senior administrators and managers), a theoretical sample of 15 to 30 people will be selected via various strategies. Data will be independently analyzed using constant comparison process. Legal and ethical analysis: situations described by participants will be analyzed using, respectively, applicable legislation and jurisprudence and 2 ethical models. Results:   This ongoing study began in June 2022 and is scheduled for completion by March 2027. Conclusions:   Instead of acting, fear of reprisal could induce clinical professionals to tolerate situations that run counter to their social justice values. To ensure they use their capacities for serving a population that is or could become vulnerable, it is important to know the prevalence of the fear of reprisal and gain a better understanding of its complex dynamics. International Registered Report Identifier (IRRID): PRR1-10.2196/4840

A quick test to objectify smell and taste dysfunction at home: A proof of concept for the validation of the chemosensory perception test

Abstract Recent studies have shown the efficacy of a home test for the self-evaluation of olfactory and gustatory functions in quarantined coronavirus disease-2019 (COVID-19) patients. However, testing was often limited to COVID-19 participants, and the accuracy of home test kits was rarely compared to standardized testing. This study aims at providing proof of concept for the validation of the new Chemosensory Perception Test (CPT) developed to remotely assess orthonasal olfactory, retronasal olfactory, and gustatory functions in various populations using common North American household items. In the 2 experiments, a total of 121 participants irrespective of having olfactory and/or gustatory complaints from various causes (COVID-19, sinunasal, post-viral, idiopathic) were tested first, with one or many of the following tests: (i) a brief chemosensory questionnaire, (ii) an olfactory test—Sniffin’ Sticks Test (SST) or University of Pennsylvania Smell Identification Test (UPSIT), and/or (iii) a gustatory test—Brief Waterless Empirical Taste Test (B-WETT). We then applied the CPT which yielded 3 different subscores, namely orthonasal, retronasal, and gustatory CPT scores. The orthonasal CPT score was significantly correlated with SST (ρ = 0.837, P &lt; 0.001) and UPSIT (ρ = 0.364, P &lt; 0.001) scores, and exhibited an excellent accuracy to identify olfactory dysfunction (OD) as compared to SST (area under the curve [AUC]: 0.923 [95% confidence interval {CI}, 0.822–1.000], P &lt; 0.001). The retronasal CPT score but not the gustatory CPT score allowed to distinguish between participants with or without subjective gustatory complaint (AUC: 0.818 [95% CI, 0.726–0.909], P &lt; 0.001). The CPT has the ability to identify OD and to quantify subjective gustatory complaints