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  • 1.
    Bakke, Merete
    et al.
    Köpenhamns Universitet.
    Bergendal, Birgitta
    Jönköping.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine.
    Sjogreen, L.
    Göteborg University.
    Asten, P.
    Lovisenberg Diakonale Hospital.
    Development and evaluation of a comprehensive screening for orofacial dysfunction.2007In: Swedish Dental Journal, ISSN 0347-9994, Vol. 31, no 2, 75-84 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test - Screening (NOT-S), consisting of a structured interview and clinical examination, was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English.

             The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more “yes” for impairment in a domain resulted in one point (maximum NOT-S score 12 points).

             The mean NOT-S score (±SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1±2.6, and 0.4±0.6 in 60 control subjects (3-78 yr). The screening was easy to administer and the time spent 5-13 min. The scores from the clinic-referred sample differed significantly from the controls, and the sensitivity of the screening was 0.96 and specificity 0.63. Repeated evaluations of videotapes of 20 patients by 3 examiners, speech-language pathologists and dentists, with at least two-week intervals, showed inter- and intraexaminer agreement on the points given in the domains at respectively 83% and 92-95% which increased after recalibration to 85% and 95-99%. Kappa values for interexaminer agreement on the NOT-S scores were 0.42-0.44 (i.e. fair), and the method error was 5.3%. To conclude, NOT-S gave a reliable and valid screening for orofacial dysfunction.

  • 2.
    Bergendal, Birgitta
    et al.
    Institute Postgrad Dent Educ, Sweden.
    Bakke, Merete
    University of Copenhagen, Denmark.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Sjogreen, Lotta
    National Orofacial Resource Centre Rare Disease, Sweden.
    Asten, Pamela
    Lovisenberg Diakonale Hospital, Norway.
    Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)-A review2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, 578-584 p.Article, review/survey (Refereed)
    Abstract [en]

    Objective. The Nordic Orofacial Test-Screening (NOT-S) was developed as a comprehensive method to assess orofacial function. Results from the screening protocol have been presented in 11 international publications to date. This study reviewed these publications in order to compile NOT-S screening data and create profiles of orofacial dysfunction that characterize various age groups and disorders. Materials and methods. NOT-S results of nine reports meeting the inclusion criteria were reviewed. Seven of these studies not only provided data on the mean and range of total NOT-S scores, but also on the most common domains of orofacial dysfunction (highest rate of individuals with dysfunction scores), allowing the construction of orofacial dysfunction profiles based on the prevalence of dysfunction in each domain of NOT-S. Results. The compiled data comprised 669 individuals, which included healthy control subjects (n = 333) and various patient groups (n = 336). All studies reported differences between individuals with diagnosed disorders and healthy control subjects. The NOT-S data could measure treatment effects and provided dysfunction profiles characterizing the patterns of orofacial dysfunction in various diagnoses. Conclusions. This review corroborates previous results that the NOT-S differentiates well between patients and healthy controls and can also show changes in individuals after treatment. NOT-S could be used as a standard instrument to assess orofacial dysfunction, evaluate the outcomes of oral habilitation and rehabilitation and improve comparability in clinical practice and research.

  • 3.
    Bergendal, Birgitta
    et al.
    Institute Postgrad Dent Educ, Natl Oral Disabil Centre, SE-55111 Jonkoping, Sweden Umea University, Fac Med, Department Odontol, Umea, Sweden .
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Stecksen-Blicks, Christina
    Umea University, Fac Med, Department Odontol, Umea, Sweden .
    Orofacial dysfunction in ectodermal dysplasias measured using the Nordic Orofacial Test-Screening protocol2009In: ACTA ODONTOLOGICA SCANDINAVICA, ISSN 0001-6357, Vol. 67, no 6, 377-381 p.Article in journal (Refereed)
    Abstract [en]

    Objective. To screen orofacial function in people with various ectodermal dysplasia (ED) syndromes and compare with a healthy reference sample. Material and methods. The ED group comprised 46 individuals (30 M and 16 F; mean age 14.5 years, range 3-55). Thirty-two had hypohidrotic ED, while 14 had other ED syndromes. The reference sample comprised 52 healthy individuals (22 M and 30 F; mean age 24.9 years, range 3-55). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S) protocol containing 12 orofacial function domains (maximum score 12 points). Results. The total NOT-S score was higher in the ED group than in the healthy group (mean 3.5 vs. 0.4; pandlt;0.001). The dysfunctions most frequently recorded in the subjects with ED occurred in the domains chewing and swallowing (82.6%), dryness of the mouth (45.7%), and speech (43.5%). Those with other ED syndromes scored non-significantly higher than those with hypohidrotic ED (mean 4.6 vs. 3.0; pandgt;0.05). Conclusions. Individuals with ED scored higher than a healthy reference sample in all NOT-S domains, especially in the chewing and swallowing, dryness of the mouth, and speech domains. Orofacial function areas and treatment and training outcomes need to be more closely evaluated and monitored.

  • 4.
    Eklund, Robert
    et al.
    Linköping University, Department of Culture and Communication, Language and Culture. Linköping University, Faculty of Arts and Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Division of Speech and Language Pathology, CL INTEC, Karolinska Institute, Stockholm, Sweden; .
    An acoustic analysis of ‘kulning’ (cattle calls) recorded in an outdoor setting on location in Dalarna (Sweden)2015In: Proceedings of ICPhS 2015, Glasgow, Scotland, UK: University of Glasgow , 2015Conference paper (Refereed)
    Abstract [en]

    The Swedish cattle call singing style ‘kulning’ issurprisingly understudied, despite its almostmythical status in Swedish folklore. While somephysiological-productive aspects of kulning havebeen treated in previous work, acoustic propertiesare still much lacking description. This paper addsto and extends the results presented in a previousstudy [7], where kulning and head voice (“falsetto”)was acoustically analysed in two indoor settings:a normal room and an anechoic chamber. In thepresent study, the same singer, singing the samekulning in the same two modes (kulning and headvoice), was recorded in an outdoor setting (close tothe singer’s home), thus allowing for a comparisonbetween “clinical” and more ecologically valid data.

  • 5.
    Eklund, Robert
    et al.
    Linköping University, Department of Culture and Communication, Language and Culture. Linköping University, Faculty of Arts and Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Fanny, Pehrson
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience.
    An acoustic comparison of voice characteristics in ‘kulning’, head and modal registers.2013In: Robert Eklund (ed.), Proceedings of Fonetik 2013, the XXVIth Swedish Phonetics Conference, Studies in Language and Culture, no. 21, ISBN 978-91-7519-582-7, eISBN 978-91-7519-579-7, ISSN 1403-2570, pp. 21–24. / [ed] Robert Eklund, 2013, 21-24 p.Conference paper (Other academic)
    Abstract [en]

    The Swedish folk singing style ‘kulning’ issurprisingly understudied, despite its almostmythical status in Swedish folklore. While somephysiological–productive aspects of kulninghave been treated in previous work, acousticproperties are still much lacking description.This paper compares kulning, head (‘falsetto’)and modal voice from an acoustic perspective.

  • 6.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Royal Inst Technol KTH, Dept Speech Mus & Hearing, Stockholm, Sweden; Boston Univ, Dept Speech Language & Hearing Sci, Boston, MA 02215 USA.
    Herbst, Christian T.
    Dept. of Cognitive Biology, University of Vienna, Vienna, Austria; Palacky Univ Olomouc, Fac Sci, Dept Biophys, Voice Res Lab, Olomouc, Czech Republic.
    Sundberg, Johan
    Dept. of Speech, Music and Hearing, Royal Institute of Technology (KTH), Stockholm, Sweden.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Dept CLINTEC, Stockholm, Sweden.
    Comparing vocal fold contact criteria derived from audio and electroglottographic signals2016In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 30, no 4, 381-388 p.Article in journal (Refereed)
    Abstract [en]

    Collision threshold pressure (CTP), i.e., the lowest subglottal pressure producing vocal fold contact during phonation, is a parameter likely to reflect relevant vocal fold properties. The amplitude of an electroglottographic (EGG) signal or the amplitude of its first derivative (dEGG) has been used as the criterion of such contact. Manual measurement of CTP is time-consuming, making the development of a simpler, alternative method desirable. In this investigation we compare CTP values automatically derived from the dEGG signal to values measured manually, and to values derived from a set of alternative parameters, some obtained from audio and some from EGG signals. One of the parameters was the novel EGG wavegram, which visualizes sequences of EGG or dEGG cycles, normalized with respect to period and amplitude. Raters with and without previous acquaintance with EGG analysis marked the disappearance of vocal fold contact in dEGG and in wavegram displays of /pa:/-sequences produced with continuously decreasing vocal loudness by seven singer subjects. Vocal fold contact was equally accurately identified in displays of dEGG amplitude as of wavegram. Automatically derived CTP values showed high correlation with those measured manually, and with those derived from the ratings of the visual displays. Seven other parameters were tested as criteria of such contact. Mainly due to noise in the EGG signal, most of them yielded CTP values differing considerably from those derived from the manual and the automatic methods, while the EGG spectrum slope showed a high correlation. The possibility of measuring CTP automatically seems promising for future investigations.

  • 7.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Sundberg, Johan
    Department of Speech, Music and Hearing, KTH, Royal Institute of Technology, Stockholm, Sweden.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Collision and phonation threshold pressures before and after loud, prolonged vocalization in trained and untrained voices2013In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 27, no 5, 527-530 p.Article in journal (Refereed)
    Abstract [en]

    The phonation threshold pressure (PTP) is defined as the lowest subglottal pressure needed for obtaining and sustaining vocal fold oscillation. It has been found to increase during vocal fatigue. In the present study, PTP is measured together with the threshold pressure needed for vocal fold collision; henceforth, the collision threshold pressure (CTP). PTP and CTP are compared before and after loud, prolonged vocalization in singer and nonsinger voices. Ten subjects repeated the vowel sequence /a, e, i, o, u/ at a Sound Pressure Level of at least 80 dB at 0.3 m for 20 minutes. Audio and electroglottography signals were recorded before and after this exercise. At the same time, oral pressure was registered while the subjects produced a diminuendo repeating the syllable /pa:/, thus acquiring an approximate of the subglottal pressure. CTP and PTP increased significantly after the vocal loading in the nonsinger subjects. On the other hand, singers reported no substantial effect of the exercise, and most singers had a mean after-to-before ratio close to 1 for both CTP and PTP.

  • 8.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Sundberg, Johan
    Kungliga Tekniska Högskolan, Stockholm.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Effects of vocal warm-up, vocal loading, and tube phonation on phonation and collision threshold pressures2012In: The Voice Foundation's 41st annual Symposium: Care of the Professional Voice / [ed] Robert Sathaloff, Philadelphia: The Voice Foundation , 2012Conference paper (Other academic)
    Abstract [en]

    Collision threshold pressure (CTP) is defined as the lowest subglottal pressure producing vocal fold collision. It has been measured in three studies, to analyze the effects of (1) vocal warm-up, (2) vocal loading and (3) the voice therapy method resonance tube phonation, which implies phonation into a tube, the end of which is placed a few cm under water. Also, phonation threshold pressure (PTP) was determined. This threshold pressure, however, although more commonly used, is often difficult to measure; the coefficient of variation has been found mostly to be higher for PTP than for CTP.

                          Before and after data for CTP and PTP were determined from audio, electroglottographic (EGG) and pressure signals. Subjects repeated the syllable /pa:/ with gradually decreasing vocal loudness at several fundamental frequencies. Subglottal pressure was estimated from oral pressure during the p-occlusion. CTP was determined using EGG or dEGG spike amplitude as criteria of vocal fold collision, while vocal fold vibration for PTP measurement was determined from the audio signal.

    The first investigation, with 15 amateur singers, suggested that vocal warm-up tended to lower both CTP and PTP. The effect of vocal loading, studied in seven subjects two of whom had trained voices, was that CTP and PTP rose, especially in the untrained voices. Resonance tube phonation exercise (tube length 27 cm, Æ 8 mm) caused an increase of CTP and PTP in 12 mezzo-soprano voices, with different levels of voice training. The effect on both CTP and PTP was greater in less trained singers, and was perceived as an improvement in a pair-wise comparison listening test with seven voice experts.

    The three studies support the conclusion that CTP can be used as a valuable complement to or replacement of PTP.

  • 9.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Sundberg, Johan
    Kungliga Tekniska Högskolan.
    Romedahl, Camilla
    ABC Logopedtjänst, Stockhom .
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Effects of Tube Phonation on Collision and Phonation Threshold Pressures in Mezzo-soprano Voices2011In: Pan European Voice Conference (PEVOC9) / [ed] Antoine Giovanni & Nathalie Henrich,, 2011Conference paper (Refereed)
    Abstract [en]

    Tube phonation is a voice therapy method widely used in Scandinavia and Germany. Invented by Sovijärvi (1965 & 1969) in the sixties, it is now used to treat several kinds of voice pathologies but also to solve passaggio and speech problems among singers. The subject phonates into a 26-28 cm long tube, typically made of glass, with the other end placed a few cm under water in a bowl. The resulting bubbling causes a modulation of intraoral pressure. Tube phonation is supposed to contribute to the development of appropriate combinations of air flow and subglottal pressure needed for a healthy voice control and/or vocal skill.

     The present study is part of a project aiming at exploring the potentials of the collision threshold pressure (CTP) (Enflo and Sundberg, 2009; Enflo et al., 2009), defined as the lowest subglottal pressure needed for vocal fold collision. This pressure may be a valuable complement to the commonly used phonation threshold pressure (PTP), defined as the lowest subglottal pressure needed to obtain and sustain vocal fold vibration. In the present investigation we analysed the effects of tube phonation on these threshold pressures. Twelve mezzo-sopranos with differing levels of singing training participated in the experiment, six highly advanced classically trained singers with daily  singing practise, and six modestly experienced choir singers without daily  singing practise. Subglottal pressure, EGG and audio were recorded before and after a tube phonation exercise. The tube phonation induced intraoral pressure modulation amplitude of about five cm H2O. Perceptual effects of the tube phonation in these subjects was assessed by a listening test. On average across singers CTP tended to rise, particularly in the less well trained singers. The listening test indicated that tube phonation was associated with a clearly audible improvement of voice function, at least in the less well-trained singers.

  • 10.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Sundberg, Johan
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Romedahl, Camilla
    Speech-Language Pathologist, Stockholm, Sweden.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Effects on vocal fold collision and phonation threshold pressure of resonance tube phonation with tube end in water2013In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 56, 1530-1538 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively.

    Method: Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel which also rated the subjects’ singing experience.

    Results: Resonance tube phonation significantly increased CTP, and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced.

    Conclusion: Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP failed to reach significance.

  • 11.
    Ericsson, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    LundeborgHammarström, Inger
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology .
    Graf, Jonas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery .
    McAllister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Child behavior and quality of life before and after tonsillotomy versus tonsillectomy2008In: International conference in pediatric otorhinolaryngology,2008, 2008, 40-40 p.Conference paper (Other academic)
    Abstract [en]

    Introduction: The objective of the present investigation was to compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefit due to surgery. Methods: 67 children (4,5-5,5 years) with tonsillar hypertrophy and obstructive sleep related distress with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE)(n=32) or intracapsular tonsillectomy/tonsillotomy (TT) (n=35) with Radiofrequency surgical technique (Ellman Int) Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA18 (Obstructive Sleep Apnea-18) and a standardized assessment of their children-s behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Children´s Benefit Inventory (GCBI). Results: In the TT group, the children recorded less pain from the first day after surgery onwards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there was no significant difference between TT and TE with regard to snoring and ENT-infections. The differences were all significant in the total scores and in all the individual domains between the initial OSA-18 and post-surgery scores (p<0.0001). The improvement in the total problem score measured with CBCL was also significant (p<0.01) and there were no differences between the TT and TE children. The improvements in all sub scores of the GCBI indicated a significant health benefit of both TT and TE. Conclusions: TT with RF-surgery is a safe method, which causes less pain and postoperative morbidity than regular TE and has a similar effect on snoring and recurrent infections. Young children with tonsillar hypertrophy and different degrees of obstructive sleep related distress all show an impact on HRQL and behavior. All improve dramatically after a tonsillar operation-improving just as much after TT as after TE. Based on these results, TT should be the first choice for treatment of these small children. Support: Financial support from the Research Council of South East Sweden (FORSS).

  • 12.
    Ericsson, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    LundeborgHammarström, Inger
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology.
    Marcusson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Mc Allister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Graf, Jonas
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Oralmotorik, artikulation och livskvalitet. Sexmånadersuppföljning efter tonsillotomi respektive tonsillektomi2007In: Rikstämman 2007,2007, 2007, 53-53 p.Conference paper (Other academic)
  • 13.
    Gauffin, Helena
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences.
    van Ettinger-Veenstra, Helene
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Clinical and Experimental Medicine, Neurobiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Ulrici, Daniel
    Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Karlsson, Thomas
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Engström, Maria
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Cognitive problems in young adults with epilepsy: Language deficits correlate to brain activation and self-esteemManuscript (preprint) (Other academic)
    Abstract [en]

    People with epilepsy often display cognitive decline. Language function in epilepsy has been most thoroughly studied in temporal lobe epilepsy, but the impact of language deficits in epilepsy is not fully understood. The aim of this study was to evaluate the effect of epilepsy on language function with functional magnetic resonance imaging of brain activation, with behavioral methods and to relate language performance to demographic data, self-esteem and Quality of life. We specifically aimed to investigate if variation in epilepsy origin would relate to differences in language performance and if these differences could be associated with specific language activation patterns in the brain. We recruited people with epilepsy (29 in total), with focal onset seizures in either the left or right hemispheres or with generalized epilepsy; and 27 matching healthy controls. The participants’ language skills were measured with a phonemic word fluency test and a broader test measuring higher language functions. Functional magnetic resonance images of the brain were obtained during a word fluency and a sentence reading paradigm. Questionnaires on self-esteem and quality of life were collected. People with epilepsy of both focal and generalized origin had impaired function in semantic and verbal fluency tasks compared to the controls. The causes of language impairment were multifactorial; the most important determinants were education and onset age of epilepsy. Impaired language function was correlated to low self-esteem for participants with focal onset seizures; however Quality of life did not seem to be affected by language impairment. The functional magnetic resonance imaging investigation demonstrated altered functional activity during language tasks for participants with epilepsy compared to healthy controls. In epilepsy with focal seizures originating in the left hemisphere we found increased bilateral  activation of supporting areas in the anterior mid-cingulate cortex and the left anterior ventral insula, indicating a compensational functional reorganization. In generalized epilepsy, the functional language network showed an imbalance expressed as an inadequate  suppression of activation in the left anterior temporal lobe during semantic processing. Our study shows not only that reduced language functioning is present in people with epilepsy other than in the temporal lobe, but also that frequency of convulsive seizures correlates to language impairment. For patients with focalized seizures, low self esteem correlated also to language impairment. Our results highlight the importance of addressing the negative consequences of language decline in people with epilepsy of both focal and generalized origin.

  • 14.
    Gauffin, Helena
    et al.
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences.
    van Ettinger-Veenstra, Helene
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Ulrici, Daniel
    Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Karlsson, Thomas
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Engström, Maria
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Impaired language function in generalized epilepsy: Inadequate suppression of the default mode network2013In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 28, no 1, 26-35 p.Article in journal (Refereed)
    Abstract [en]

    We aimed to study the effect of a potential default mode network (DMN) dysfunction on language performance in epilepsy. Language dysfunction in focal epilepsy has previously been connected to brain damage in language-associated cortical areas. In this work, we studied generalized epilepsy (GE) without focal brain damage to see if the language function was impaired. We used functional magnetic resonance imaging (fMRI) to investigate if the DMN was involved. Eleven persons with GE and 28 healthy controls were examined with fMRI during a sentence-reading task. We demonstrated impaired language function, reduced suppression of DMN, and, specifically, an inadequate suppression of activation in the left anterior temporal lobe and the posterior cingulate cortex, as well as an aberrant activation in the right hippocampal formation. Our results highlight the presence of language decline in people with epilepsy of not only focal but also generalized origin.

  • 15.
    Hemingway, H
    et al.
    Department of Epidemiology and Public Health, University College London, UK.
    Henriksson, Martin
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Chen, R.
    Department of Epidemiology and Public Health, University College London, UK.
    Damant, J.
    Department of Epidemiology and Public Health, University College London, UK.
    Fitzpatrick, N.
    Department of Epidemiology and Public Health, University College London, UK.
    Abrams, K.
    Department of Health Sciences, University of Leicester, UK.
    Hingorani, A.
    Department of Epidemiology and Public Health, University College London, UK.
    Janzon, Magnus
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Shipley, M.
    Department of Epidemiology and Public Health, University College London, UK.
    Feder, G.
    Department of Primary Health Care, University of Bristol, UK.
    Keogh, B.
    Department of Health, London, UK.
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    McAllister, K.
    1Department of Epidemiology and Public Health, University College London, UK.
    Kaski, J-C
    Cardiovascular Biology Research Centre, St George’s, University of London, UK.
    Timmis, A.
    Barts and the London NHS Trust, London, UK.
    Palmer, S.
    Centre for Health Economics, University of York, UK.
    Sculpher, M.
    Centre for Health Economics, University of York, UK.
    The effectiveness and cost-effectiveness of biomarkers for the prioritisation of patients awaiting coronary revascularisation: a systematic review and decision model.2010In: Health Technology Assessment, ISSN 1366-5278, Vol. 14, no 9, 1-178 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine the effectiveness and cost-effectiveness of a range of strategies based on conventional clinical information and novel circulating biomarkers for prioritising patients with stable angina awaiting coronary artery bypass grafting (CABG).

    DATA SOURCES: MEDLINE and EMBASE were searched from 1966 until 30 November 2008.

    REVIEW METHODS: We carried out systematic reviews and meta-analyses of literature-based estimates of the prognostic effects of circulating biomarkers in stable coronary disease. We assessed five routinely measured biomarkers and the eight emerging (i.e. not currently routinely measured) biomarkers recommended by the European Society of Cardiology Angina guidelines. The cost-effectiveness of prioritising patients on the waiting list for CABG using circulating biomarkers was compared against a range of alternative formal approaches to prioritisation as well as no formal prioritisation. A decision-analytic model was developed to synthesise data on a range of effectiveness, resource use and value parameters necessary to determine cost-effectiveness. A total of seven strategies was evaluated in the final model.

    RESULTS: We included 390 reports of biomarker effects in our review. The quality of individual study reports was variable, with evidence of small study (publication) bias and incomplete adjustment for simple clinical information such as age, sex, smoking, diabetes and obesity. The risk of cardiovascular events while on the waiting list for CABG was 3 per 10,000 patients per day within the first 90 days (184 events in 9935 patients with a mean of 59 days at risk). Risk factors associated with an increased risk, and included in the basic risk equation, were age, diabetes, heart failure, previous myocardial infarction and involvement of the left main coronary artery or three-vessel disease. The optimal strategy in terms of cost-effectiveness considerations was a prioritisation strategy employing biomarker information. Evaluating shorter maximum waiting times did not alter the conclusion that a prioritisation strategy with a risk score using estimated glomerular filtration rate (eGFR) was cost-effective. These results were robust to most alternative scenarios investigating other sources of uncertainty. However, the cost-effectiveness of the strategy using a risk score with both eGFR and C-reactive protein (CRP) was potentially sensitive to the cost of the CRP test itself (assumed to be 6 pounds in the base-case scenario).

    CONCLUSIONS: Formally employing more information in the prioritisation of patients awaiting CABG appears to be a cost-effective approach and may result in improved health outcomes. The most robust results relate to a strategy employing a risk score using conventional clinical information together with a single biomarker (eGFR). The additional prognostic information conferred by collecting the more costly novel circulating biomarker CRP, singly or in combination with other biomarkers, in terms of waiting list prioritisation is unlikely to be cost-effective.

  • 16.
    Hengen, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Peterson, Malin
    Sollentuna.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Röstbehandling: Kartläggning av patienter och utvärdering av interventionseffekt med Rösthandikappindex2014In: Norsk tidsskrift for logopedi, ISSN 0332-7256, no 2, 26-30 p.Article in journal (Refereed)
    Abstract [sv]

    Denna studie är ett samarbetsprojekt mellan Linköpings Universitet och fyra landsting i sydöstra och södra sjukvårdsregionen. Syftet är att kartlägga patienter i röstbehandling samt jämföra patienternas RHI-skattningar före och efter genomgången röstbehandling för att undersöka huruvida ålder, kön samt antalet behandlingstillfällen påverkar resultatet. Studien bygger på 350 patienters självskattningar. Wilcoxon teckenrangtest visar en signifikant skillnad i RHI-poäng före och efter behandling med en minskning av 19 medianpoäng i RHI-index med stor effektstyrka (0,55). Kvinnor utgjorde en majoritet av patienterna (74,3 %) och medelåldern totalt var 55 år. Äldre patienter hade högre medianvärde på RHI vid behandlingsstart och behandlingsslut. En högre ålder påverkade dock inte den observerade skillnaden mellan skattningarna.

  • 17.
    Larsby, Birgitta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Nilsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. CLINTEC, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm; Speech and Language Pathology Clinic, Karolinska University Hospital, Stockholm, Sweden.
    The influence of female versus malespeakers’ voice on speech recognitionthresholds in noise: Effects of low and high-frequency hearing impairment2015In: Speech, Language and Hearing, ISSN 2050-571X, Vol. 18, no 2, 84-90 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effect of female versus male speakers’ voice on the ability to recognize speech innoise in two groups of sensorineural hearing-impaired listeners, one group with impairment at lowfrequencies and the other at high frequencies.Method: Eight participants with high-frequency hearing impairments (Hf-HI) and seven with low-frequencyhearing impairments (Lf-HI) participated. Sixteen normal hearing (NH) participants served as reference.The sentences from the hearing in noise test, read by a female or a male speaker, were presentedmonaurally with a background noise. In an adaptive procedure, the mean speech recognition threshold,for 50% correctly recognized sentences, was calculated for the female and male voice and each test subject.Results: The Hf-HI group had significantly greater difference in signal-to-noise ratio (SNR) results betweenfemale and male voices. Irrespective of hearing impairment, the female voice required 2.1 dB better SNR.In addition, the NH group showed a small but significant difference in favor of the male voice.Conclusions: Results indicate that speaker gender matters for hearing impaired and NH individuals’ ability torecognize speech in noise.

  • 18.
    Lindstrom, Fredric
    et al.
    University of Gothenburg.
    Persson Waye, Kerstin
    University of Gothenburg.
    Sodersten, Maria
    Karolinska Institute.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Ternstrom, Sten
    Royal Institute of Technology.
    Observations of the Relationship Between Noise Exposure and Preschool Teacher Voice Usage in Day-Care Center Environments2011In: JOURNAL OF VOICE, ISSN 0892-1997, Vol. 25, no 2, 166-172 p.Article in journal (Refereed)
    Abstract [en]

    Although the relationship between noise exposure and vocal behavior (the Lombard effect) is well established, actual vocal behavior in the workplace is still relatively unexamined. The first purpose of this study was to investigate correlations between noise level and both voice level and voice average fundamental frequency (F-0) for a population of preschool teachers in their normal workplace. The second purpose was to study the vocal behavior of each teacher to investigate whether individual vocal behaviors or certain patterns could be identified. Voice and noise data were obtained for female preschool teachers (n = 13) in their workplace, using wearable measurement equipment. Correlations between noise level and voice level, and between voice level and F-0, were calculated for each participant and ranged from 0.07 to 0.87 for voice level and from 0.11 to 0.78 for F-0. The large spread of the correlation coefficients indicates that the teachers react individually to the noise exposure. For example, some teachers increase their voice-to-noise level ratio when the noise is reduced, whereas others do not.

  • 19.
    Lundeborg Hammarström, Inger
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology.
    Ericsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Influence of adenotonsillar hypertrophy on /s/-articulation in children-effects of surgery2011In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, Vol. 36, no 3, 100-108 p.Article in journal (Refereed)
    Abstract [en]

    Tonsillar hypertrophy is common in young children and affects several aspects of the speech such as distortions of the dento-alveolar consonants. The study objective was to assess s-articulation, perceptually and acoustically in children with tonsillar hypertrophy and compare effects of two types of surgery, total tonsillectomy and tonsillotomy. Sixty-seven children, 50-65 months, on waiting list for surgery, were randomized to tonsillectomy or tonsillotomy. The speech material was collected pre-operatively and six months post-operatively.  Two groups of age-matched children were controls. /S/-articulation was affected acoustically with lower spectral peak locations and perceptually with less distinct /s/-production before surgery, in comparison to controls.  After surgery /s/-articulation was normalized perceptually, but acoustic differences remained. No significant differences between surgical methods were found.

  • 20.
    Lundeborg Hammarström, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ericsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy —effects of surgery2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 26, no 4, 480-487 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate outcome of two types of tonsil surgery (tonsillectomy+adenoidectomy or tonsillotomy +adenoidectomy) on vocal function perceptually and acoustically.

    Study Design: Sixty-seven children, aged 50-65 months, on waiting list for tonsil surgery were randomized to tonsillectomy (n=33) or tonsillotomy (n=34). Fifty-seven age and gender matched healthy pre-school children were controls. Twenty-eight of them, aged 48-59 months, served as control group before surgery, and 29, aged 60-71 months, after surgery

    Methods: Before surgery and six months postoperatively, the children were recorded producing three sustained vowels (/A, u, i/) and 14 words. The control groups were recorded only once.

    Three trained speech and language pathologists performed the perceptual analysis using Visual Analogue Scales (VAS) for eight voice quality parameters. Acoustic analysis from sustained vowels included average fundamental frequency, jitter percent, shimmer percent, noise-to-harmonic ratio and the centre frequencies of formants 1-3

    Results: Before surgery the children were rated to have more hyponasality and compressed/throaty voice (p<0,05) and  lower mean pitch (p<0,01) in comparison to the control group. They also had higher perturbation measures and lower frequencies of the second and third formant. After surgery there were no differences perceptually. Perturbation measures decreased but were still higher compared to the control group’s, p<0, 05. Differences in formant frequencies for /i/ and /u/ remained. No differences were found between the two surgical methods.

    Conclusion: Voice quality is affected perceptually and acoustically by adenotonsillar hypertrophy. After surgery the voice is perceptually normalized but acoustic differences remain. Outcome was equal for both surgical methods.

  • 21.
    Lundeborg Hammarström, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Larsson, Maria
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Wiman, Sara
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Voice onset time in Swedish children and adults2012In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, Vol. 37, no 3, 117-122 p.Article in journal (Refereed)
    Abstract [en]

    Voice onset time (VOT) is a temporal acoustic parameter, which reflects the timing of speech motor control. The objective of the work was to obtain normative VOT data in Swedish children. Thus, 150 children aged 8-11 years old and 36 adults were audio-recorded when producing the plosives in minimal pairs. Measures were made using waveforms and spectro-grams. Results show that Swedish children developed adult-like VOT values between 9 and 10 years. By the age of 10 years prevoicing was also found to be completely adultlike in length. The results indicate that all Swedish adults do not produce voiced plosives with prevoicing. No evident gender differences were found. The obtained VOT values can be used as normative data when assessing children with speech and language disorders.

  • 22.
    Lundeborg Hammarström, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Nordin, Elin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Zeipel-Stjerna, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Mcallister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden.
    Voice onset time in Swedish children with phonological impairment2015In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 40, no 4, 149-155 p.Article in journal (Refereed)
    Abstract [en]

    Mastering spatial and temporal co-ordination in speech production is a challenge for children. Voice onset time (VOT) reflects timing in speech. The objective was to study VOT in Swedish children with a diagnosed phonological impairment and compare results with normative data. Thus 38 children, aged 4-11 years, in three age-groups were audio-recorded when producing minimal pairs with the plosives /p b t d k g/. Waveforms and spectrograms were analysed. Results show that children with phonological impairment produced plosives with deviant VOT values and greater variability compared to normative data. No developmental trend was seen with increasing age. Also, no relationship was found between VOT values and degree of impairment measured by percentage phonemes correct. Furthermore no relation was found between number of errors on auditory discrimination of nine minimal pairs with the different plosives and number of deviant VOT. Findings were interpreted as displaying motor co-ordination difficulties.

  • 23.
    Lundeborg, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Treatment with a combination of intra-oral sensory stimulation and electropalatography in a child with severe developmental dyspraxia2007In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, Vol. 32, no 2, 71-9 p.Article in journal (Refereed)
    Abstract [en]

    This paper describes the use of a combination of intra-oral sensory stimulation and electropalatography (EPG) in the treatment of a case with severe developmental verbal dyspraxia. A multiple-baseline design was used. The treatment duration was 11 months and started when the subject was 5 years old. The efficacy of the treatment was assessed by calculations of percentage of correctly articulated words, percentage of consonants correct, percentage of phonemes correct and percentage of words correct. Intelligibility assessments were conducted by both naïve and expert listeners. The experts also assessed visual deviances in articulatory gestures from video recordings. Qualitative analysis of EPG data was made. The subject's speech was significantly improved by the treatment in all aspects. The results and their generalization to other cases of developmental verbal dyspraxia are discussed.

  • 24.
    Lundeborg, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Graf, Jonas
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences.
    Ericsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Oral motor dysfunction in children with adenotonsillar hypertrophy-effects of surgery2009In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, Vol. 34, no 3, 111-116 p.Article in journal (Refereed)
    Abstract [en]

    Adenotonsillar hypertrophy is associated with a wide range of problems. The enlargement causes obstructive symptoms and affects different functions such as chewing, swallowing, articulation, and voice. The objective of this study was to assess oral motor function in children with adenotonsillar hypertrophy using Nordic Orofacial Test-Screening (NOT-S) before and 6 months after surgery consisting of adenoidectomy combined with total or partial tonsil removal. A total of 67 children were assigned to either tonsillectomy (n=33) or partial tonsillectomy, 'tonsillotomy' (n=34); 76 controls were assessed with NOT-S and divided into a younger and older age group to match pre- and post-operated children. Most children in the study groups had oral motor problems prior to surgery including snoring, open mouth position, drooling, masticatory, and swallowing problems. Post-surgery oral motor function was equal to controls. Improvement was independent of surgery method.

  • 25.
    Lundeborg, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Samuelsson, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences.
    Ericsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Phonological development in children with obstructive sleep-disordered breathing2009In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 23, no 10, 751-61 p.Article in journal (Refereed)
    Abstract [en]

    Adeno-tonsillar hypertrophy with obstructive sleep disordered breathing (OSDB) is known to affect oral-motor function, behaviour, and academic performance. Adeno-tonsillectomy is the most frequently performed operation in children, with total tonsillectomy (TE) being more common than partial resection, 'tonsillotomy' (TT). In the present study 67 children, aged 50-65 months, with OSBD were randomized to TE or TT. The children's phonology was assessed pre-operatively and 6 months post-operatively. Two groups of children served as controls. Phonology was affected in 62.7% of OSBD children before surgery, compared to 34% in the control group (p < .001). Also, OSBD children had more severe phonological deficits than the controls (p < .001). Phonology improved 6 months equally after both surgeries. Despite improvement post-operatively, the gap to the controls increased. Other functional aspects, such as oral motor function, were normalized regardless of surgical method--TE or TT. The impact of OSBD should be considered as one contributing factor in phonological impairment.

  • 26.
    LundeborgHammarström, Inger
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology .
    Ericsson, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    McAllister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Effects of tonsil surgery on speech and oral motor function2008In: The 12th Congress of the International Clinical Phonetics and Linguistics association,2008, 2008, 119-119 p.Conference paper (Refereed)
    Abstract [en]

     Large tonsils decrease the upper airways and cause oral breathing in children. If oral breathing persists, it leads to muscular and postural alterations, which, in turn cause dentoskeletal changes. In Sweden 6% of all children, have tonsil surgery performed. The indications are usually recurrent tonsillitis or severe snoring and/or sleep apneoa. Oral motor dysfunction including swallowing problems , disordered speech and aberrant dentofacial growth are less recognized problems as indications for treatment. We report results from a project aiming at comparing oral motor function and speech in children trated with two different surgical methods, tonsillectomy (TE) and partial tonsil resection, tonsillotomy (TT). 67 children aged 4-5 years old on ordinary waiting list for tonsil surgery were randomized to either TE or TT. They were assessed with the Swedish version of Nordic Orofacial Test (NOT-S) and a Swedish phonological test. A voice recording was also made. The assessment was repeated 6 months after surgery. The results were compared to a control group without tonsil problems. No significant differences were found between the children operated with TE or TT. Both groups performed significantly better on the oral motor test at the postoperative assessment, and voice quality had improved. However, compared to the control group, the children with enlarged tonsils had a delay in phonological development, preoperatively that remained at the 6-month postoperative control   

  • 27.
    Malmenholt, Ann
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Lohmander, Anette
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Mcallister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Childhood apraxia of speech: A survey of praxis and typical speech characteristics2017In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 42, no 2, 84-92 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to investigate current knowledge of the diagnosis childhood apraxia of speech (CAS) in Sweden and compare speech characteristics and symptoms to those of earlier survey findings in mainly English-speakers. Method: In a web-based questionnaire 178 Swedish speech-language pathologists (SLPs) anonymously answered questions about their perception of typical speech characteristics for CAS. They graded own assessment skills and estimated clinical occurrence. Results: The seven top speech characteristics reported as typical for children with CAS were: inconsistent speech production (85%), sequencing difficulties (71%), oro-motor deficits (63%), vowel errors (62%), voicing errors (61%), consonant cluster deletions (54%), and prosodic disturbance (53%). Motor-programming deficits described as lack of automatization of speech movements were perceived by 82%. All listed characteristics were consistent with the American Speech-Language-Hearing Association (ASHA) consensus-based features, Strands 10-point checklist, and the diagnostic model proposed by Ozanne. The mode for clinical occurrence was 5%. Number of suspected cases of CAS in the clinical caseload was approximately one new patient/year and SLP. Conclusions: The results support and add to findings from studies of CAS in English-speaking children with similar speech characteristics regarded as typical. Possibly, these findings could contribute to cross-linguistic consensus on CAS characteristics.

  • 28.
    Malmenholt, Ann
    et al.
    Karolinska Institutet, Stockholm.
    Lohmander, Anette
    Karolinska Institutet, Stockholm.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Childhood Apraxia of Speech (CAS): a survey of knowledge and experience of Swedish Speech-Language Pathologists2012In: / [ed] Alice Lee & Fiona Gibbon, Cork University College, 2012, 143- p.Conference paper (Other academic)
    Abstract [en]

    Background: Children with Childhood Apraxia of Speech (CAS) are seen by many speech and language pathologists (SLPs) in Sweden. It is commonly believed that these patients are difficult to diagnose and treat due to the absence of a validated list of diagnostic features (American Speech-Language-Hearing Association, 2007) and lack of evidence for a wide range of treatment approaches reported (Morgan & Vogel, 2009). Speech-language pathologists’ perspectives on assessment of CAS have been studied by Forrest (2003). She asked SLPs about which three characteristics they thought were crucial for diagnosing CAS. The diversity of SLPs view on CAS diagnostic markers was documented. Not less than 50 different characteristics were listed, making inconsistent productions the most frequently noted feature (14.1%).  Experience and knowledge about the typical symptoms of CAS among Swedish SLPs would be a valuable first step towards a common routine for diagnosis of this group of patients in Sweden. Aim: The aim of this paper was to perform a survey among Swedish clinical SLPs regarding symptoms, praxis for clinical diagnosis and description of patients with CAS. Methods & Procedures: A web-based questionnaire was sent to Swedish SLPs working with pre- and primary school-aged children asking 25 questions about the clinicians background, years of clinical experience, skills of assessment and intervention, estimation of own competence and opinion about need for further education concerning this particular group. The SLPs were asked to estimate the prevalence for CAS based on their own clinical experience.Outcomes & Results: One hundred-seventy-five clinical SLPs with varying experience responded, which equals a response rate of 60%. About half of them usually diagnosed CAS. In the rating of typical symptoms of CAS 85% suggested inconsistent errors as the core feature of the disorder, 82% noticed difficulties with automaticity and 71% difficulties with sequence maintenance. In 88 % of answers children with CAS were considered to make slow progress in treatment and 80% estimated that these children typically had persisting difficulties and constraints even in primary school. There was a wide range of estimated prevalence figures for CAS from less than 1% to around 50%. Almost all SLPs who answered the questionnaire reported a need for further education about CAS.Conclusions: Although Swedish SLPs rated their own knowledge about CAS as insufficient, the rating of the key classification criterion for the disorder was high, as was the view that these children make slow progress in treatment. Estimation of prevalence for CAS was highly diverse, reflecting the difficulties with the broad definition and large variation within this disorder. The collected data of the Swedish clinical SLPs experience and knowledge about CAS revealed an important consensus on the core diagnostic features but also a vagueness regarding best treatment. This reflects the current knowledge in this field and will be taken into account in continuing work towards a common and evidence based practice.

    References

    American Speech-Language-Hearing Association. Childhood Apraxia of Speech [Position Statement] 2007. Available from www.asha.org/policy.)

    Forrest, K. (2003). Diagnostic criteria of developmental apraxia of speech used by clinical speech-language pathologists. American Journal of Speech-Language Pathology, 12, 376–380.

    Morgan & Vogel. Cochrane review of treatment for childhood apraxia of speech. Eur J Phys Rehabil Med. 2009 Mar;45(1):103-10.)

  • 29.
    Mc Allister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Effects of tonsil surgery on speech and oral-motor function2007In: IALP - the International Association of Logopedics and Phoniatrics,2007, 2007Conference paper (Other academic)
  • 30.
    Mc Allister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Oralmotoriska störningar vid tal hos barn: dysartri, dyspraxis och försenad oralmotorisk utveckling2007In: Logopedi / [ed] Lena Hartelius,Ulrika Nettelbladt och Britta Hammarberg, Lund: Studentlitteratur , 2007, 1, 377-386 p.Chapter in book (Other academic)
    Abstract [sv]

       Logopedi definieras som läran om språk-, röst- och talstörningar och deras behandling. Detta är den första heltäckande läroboken i logopedi på svenska och består av 40 kapitel av 44 olika författare. I en introducerande del beskrivs funktion och utveckling med anknytning till de fyra logopediska huvudområdena röst, språk, tal och sväljning. Därefter beskrivs karakteristik, diagnostik och intervention vid språkstörningar, röststörningar och talstörningar hos barn, ungdomar och vuxna. Vidare behandlas alternativ och kompletterande kommunikation samt sväljningsstörningar. Boken avslutas med en del som beskriver logopedi ur ett historiskt perspektiv, i nutid och med utblickar mot framtiden

  • 31.
    Mc Allister, Anita
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Lindestad, Per-Åke
    Södersten, Maria
    Röststörningar hos barn och ungdomar2007In: Logopedi / [ed] Lena Hartelius,Ulrika Nettelbladt och Britta Hammarberg, Lund: Studentlitteratur , 2007, 1, 279-285 p.Chapter in book (Other academic)
    Abstract [sv]

      Logopedi definieras som läran om språk-, röst- och talstörningar och deras behandling. Detta är den första heltäckande läroboken i logopedi på svenska och består av 40 kapitel av 44 olika författare. I en introducerande del beskrivs funktion och utveckling med anknytning till de fyra logopediska huvudområdena röst, språk, tal och sväljning. Därefter beskrivs karakteristik, diagnostik och intervention vid språkstörningar, röststörningar och talstörningar hos barn, ungdomar och vuxna. Vidare behandlas alternativ och kompletterande kommunikation samt sväljningsstörningar. Boken avslutas med en del som beskriver logopedi ur ett historiskt perspektiv, i nutid och med utblickar mot framtiden.

  • 32.
    Mc Allister, Anita
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sjögreen, Lotta
    Åsten, P
    Bakke, M
    Bergendal, B
    The development and evaluation of a global screening fo orofacial dysfunctions2007In: IALP - the International Association of Logopedics and Phoniatrics,2007, 2007Conference paper (Other academic)
  • 33.
    Mc Allister, Anita
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Södersten, Maria
    Barnröstens utveckling2007In: Barn och Sång: om rösten, sångerna och vägen dit / [ed] Gunnel Fagius, Lund: Studentlitteratur , 2007, 1, 41-54 p.Chapter in book (Other academic)
    Abstract [sv]

    I vårt sångbara svenska språk äger vi ovärderliga skatter: Sånger som vill bli sjungna, melodier som vill bli nynnade, ramsor som vill bli trallade. Men hur blir det i framtiden? Hur tar vi i vår snabbt föränderliga tid vara på detta levande arv, på rätten till vår egendom? Det är i de tidiga barnaåren allt grundläggs, också sången. Den här boken presenterar kunskaper om spädbarnets tidiga melodiliknande joller, om barnröstens anatomiska byggnad och klangliga möjligheter och hur barnets hjärna tar emot tidiga musikaliska impulser. Rytmik, rörelse, improvisation har betydelse för att väcka barns sånglust. Boken innehåller en teoretisk och en praktisk del. Den senare presenterar övningar och sånger för barn från förskola och upp i 10-årsåldern. Med boken följer en CD som ger exempel på en del av bokens övningar och sånger, tillsammans med exempel på sjungande barn från äldre och nyare inspelningar.

  • 34.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    A comparison of studio recordings and recordings of spontaneous speech: assessments of voice quality in pre-school children2011In: Pan European Voice Conference (PEVOC9), Marseille, France / [ed] Antoine Giovanni & Nathalie Henrich, Marseille, 2011Conference paper (Refereed)
    Abstract [en]

    A well controlled recording in a studio is the basis for voice rehabilitation. However, this laboratory like recording method can be questioned since voice use in a natural environment may be quite different. In children’s natural environment high background noise levels are common and an important factor contributing to voice problems. The noise exposure often occurs in day-care centers with the children themselves as the primary noise source (McAllister, Granqvist, Sjölander, Sundberg 2009). The aim of the present study was to compare perceptual evaluations of voice quality from a controlled recording to recordings of spontaneous speech in children’s natural environment in a day-care setting. Ten five-year-old children were recorded three times during a day at the day-care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated times three. The recordings were randomized and analyzed acoustically and evaluated perceptually by three expert listeners. Statistic analyses of all recordings showed that the laboratory sentences represent spontaneous speech characteristics regarding degree of hoarseness (r=.52) and to a lesser extent also for breathiness (r=. 401). For boys a correlation was found only for the parameter breathiness (r=.539) and for girls only for hoarseness (r=.648).  

     

    References

    McAllister, A., Granqvist, S. Sjölander, P. Sundberg, J. (2009). Child voice and noise: A pilot study of the effect of a day at the day-care on ten children’s voice quality according to perceptual evaluation. J Voice, Sep;23(5):587-93.

  • 35.
    McAllister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Intra oral stereognosis in children with persistent speech problems2008In: Internationa Conference on Clinical Phonetics and Linguistics Association,2008, Istanbul: Anadolu University , 2008, 142- p.Conference paper (Refereed)
    Abstract [en]

     Background Intra-oral sensory function is a complex perception and difficult to assess clinically. On the other hand, it seems important to establish intra-oral sensory function in order to give appropriate advice regarding therapy in children with speech problems. The tactile sensibility of the anterior portion of the tongue has been suggested to be particularly important (Grossman & Hattis, 1967; Williams & LaPoint, 1971; Calhoun et al, 1992). The stereognosis test assesses the ability to identify an object primarily by sensory surface receptors. In an earlier case study of a child with persistent speech difficulties intra oral sensory stimulation produced good results regarding speech intelligibility (Lundeborg Hammarström & McAllister 2007). Thus, could a low result on a test of intra oral stereognosis serve as a diagnostic marker suggesting treatment including intra oral sensory stimulation? The aim of the present study was to investigate intra oral stereognosis in children with persistent speech problems. Method Twenty children with persistent speech problems including childhood apraxia of speech - CAS, twelve girls and eight boys, were tested using a set of four shapes in two sizes based on Calhoun et al, (1992) to assess intra oral stereognosis. Results were compared to a previous study of intra oral stereognosis in typically developed children (Norström & Sjöberg 2003). Statistical analyses to assess significance will be provided. Results The children with CAS showed lower results on both the large and small shapes as compared to the typically developed children. Discussion The relevance of intra oral sensory function in relation to choice of therapy will be discussed. References Calhoun KH, Gibson B, Hartley L, Minton J, Hokanson JA. (1992) Age-related changes in intra oral sensation. Laryngoscope, 102, 109-116. Grossman R C. (1967). Methods of determining oral tactile experience. In J F Bosma ed. Oral sensation and perception. Charles C Thomas, publisher, Springfield, Illinois, USA, 161-181. Lundeborg Hammarström, I., McAllister, A. (2007). Treatment outcome using intra-oral sensory stimulation and EPG in a 6 year old child with persistent speech difficulties. Log Phon Vocol, 32 (2):71 Norström H, Sjöberg P. (2003). Intraoral stereognosi hos 4:0 - 5:5 åriga barn med normal talutveckling. Masters thesis in Speech and Language Pathology, Karolinska Institue. Williams WN, LaPoint LL. (1971). Intra-oral recognition of geometric forms by normal subjects. Perc Mot Skills, 32, 419-426.  

  • 36.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Institutionen för klinisk vetenskap, intervention och teknik, Logopedi, Karolinska institutet, Stockholm.
    Oral and Verbal Apraxia in Children: Assessment, intervention and outcome2013Collection (editor) (Other (popular science, discussion, etc.))
    Abstract [en]

    Two advanced courses on oral and verbal apraxia in children have been held at Linköping University in the spring of 2009 and 2011. Several international researchers participated as lecturers and contributed to the success of the courses and the high course evaluations. As an examination assignment several students chose to do case studies investigating the treatment outcome of different methods for children or teenagers with oral and verbal apraxia. Many were inspired by the method Dynamic Temporal and Tactile Cueing, DTTC that was thoroughly described by Professor Edythe Strand during the course. The case studies are presented as chapters in the present publication. Most chapters are written in English but some also in Swedish depending on the requirements of the specific course. At present there is a significant lack of treatment efficacy research in the area of childhood verbal apraxia, and many publications have indicated the need for this type of clinical research. Since these reports represent an important contribution to the limited number of outcome studies in children with diagnosed or suspected CAS we decided to make them available to a larger audience.

  • 37.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Treatment of oral dysfunction2012In: 5th International Conference on Ectodermal Dysplasia: Care and Clinical Trials / [ed] Prof. Dr. Holm Schneider, 2012Conference paper (Other academic)
    Abstract [en]

    The orofacial area is central for several vital functions in man such as breathing and eating.  The orofacial area also acts as the basis for social interaction, emotional communication, facial expression and speech communication. Normal orofacial sensorimotor development is necessary for these functions to develop and mature in the child, hence orofacial dysfunction may be severely disabling. In the oral cavity, saliva lubricates the hard and soft tissues. Lack of saliva impairs speech clarity, chewing and swallowing, taste and voice quality. The complexity of these functions means that several clinical professionals, such as dentists, gastroenterologists, ENT specialists, phoniatricians or laryngologists, and speech and language pathologists, are needed to address the problems. Through a multiprofessional Nordic cooperation an assessment instrument for orofacial functions was developed, the Nordic Orofacial Test-Screening, NOT-S. In a previous study 46 individuals with Ectodermal Dysplasia was investigated using NOT-S. The most frequently recorded dysfunctions were in the domains chewing and swallowing (82.6%), dryness of the mouth (45.7%) and speech (43.5%). Also hoarseness, a parameter that was added to the test, was found in 32.6% of individuals with ED.

     

    The treatment alternatives for these problems include above mentioned specialists and a number of different treatment options, such as surgery to improve anatomical conditions, subscribing artificial saliva to lubricate oral mucosa, sensorimotor training to improve chewing and swallowing or speech and language therapy to address problems with speech production or voice quality.

  • 38.
    McAllister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology.
    Voice disorders in children with oral motor dysfunction: Perceptual evaluation pre and post oral motor therapy2003In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, Vol. 28, no 3, 117-125 p.Article in journal (Refereed)
    Abstract [en]

    A few clinical investigations of children's voices have suggested a relation between voice deviation and oral motor and sensory dysfunction. This motivated the present retrospective study of the occurrence of voice disorders in a group of children with oral motor problems. A further aim was to evaluate the effect of an oral motor and articulatory treatment programme upon voice function in this patient group. Subjects were 38 children with oral motor deficits who had received and finished therapy at the clinic. The recordings of a picture naming task, before onset of therapy and at therapy ending, were selected. The voices were presented in random order on a test tape and perceptually evaluated by an expert panel of speech pathologists. Eleven perceptual parameters were selected, based on previous investigations of children's voices. Ten of these parameters were represented by a 100 mm visual analogue scale. Register was represented by a categorical scale with the options chest, falsetto, and child voice register. The results were compared with previous investigations of child voice function. Results indicated: 1) The occurrence of voice disorders in the present group of children with oral motor difficulties was somewhat lower than in children with normal articulation. 2) Oral motor treatment also influenced and improved the perceptual impression of voice quality in this group.

  • 39.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Aanstoot, Janna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Lundeborg Hammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Samuelsson, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Johannesson, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Sandström, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Berglind, Ulrika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Learning in the tutorial group: A balance between individual freedom and institutional control2014In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 28, no 1-2, 47-59 p.Article in journal (Refereed)
    Abstract [en]

    The study investigates factors in problem-based learning tutorial groups which promote or inhibit learning. The informants were tutors and students from speech-language pathology and physiotherapy programmes. Semi-structured focus-group interviews and individual interviews were used. Results revealed three themes: Responsibility, Time and Support. Under responsibility, the delicate balance between individual and institutional responsibility and control was shown. Time included short and long-term perspectives on learning. Under support, supporting documents, activities and personnel resources were mentioned. In summary, an increased control by the program and tutors decreases students motivation to assume responsibility for learning. Support in tutorial groups needs to adapt to student progression and to be well aligned to tutorial work to have the intended effect. A lifelong learning perspective may help students develop a meta-awareness regarding learning that could make tutorial work more meaningful.

  • 40.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Bergendal, Birgitta
    Kompetenscenter, Odontologiska Institutionen, Jönköping.
    Sjögreen, Lotta
    Mun-H-Center, Folktandvården, Västra Götalandsregionen.
    Applications and results using the Nordic Orofacial Test–Screening protocol2011In: / [ed] Professor Göran Koch, Jönköping, Jönköping: Swedish Dental Association and the Swedish Dental Society , 2011Conference paper (Refereed)
    Abstract [en]

    Aim: Orofacial function includes a multitude of actions, some of them vital, such as breathing, chewing and swallowing, and also acts as the basis for social interaction in terms of speech, emotional communication, facial expression and appearance. Impaired orofacial function is a common feature in many inherited disorders or may be acquired as a consequence of disease and trauma. The Nordic Orofacial Test–Screening (NOT-S) is a comprehensive method for screening of orofacial function developed by a Scandinavian network of dentists and speech and language pathologists. NOT-S comprises evaluation of twelwe domains of orofacial function. They are assessed from a structured interview and a clinical examination with a picture manual illustrating the different tasks in the examination. A method study of 120 individuals with chronic disease or disability compared to 60 healthy controls showed good intra- and interexaminer agreement. The aim was to present current applications and results from publications on the use of NOT-S.

    Materials and Methods: Beside the method study published in 2007 to date four studies has been published. One was a study in individuals with Parkinson´s disease (n=15), two were studies in individuals with rare disorders; Ectodermal dysplasia (n=46), and Prader-Willi Syndrome (n=45), and one was a study evaluating surgical treatment in children with tonsillar hyperthophy (n=67). In order o visualize to what degree the domains of orofacial function are affected in different conditions, connected plots were made from the mean NOT-S scores for the twelwe domains of NOT-S, here called dysfunction profiles.

    Results: The groups with different diagnoses showed specific dysfunction profiles indicating patterns of domains with impaired orofacial function. The use of NOT-S to assess orofacial function before and after surgery in children with tonsillar hypertrophy showed that the method can also be used to evaluate interventions.

    Conclusions: Screening with NOT-S proved to be a quick and reliable way of assessing orofacial function. NOT-S discriminated between groups with different diagnoses and also in evaluation of treatment. The results indicate that NOT-S has good reliability and discriminant validity.

  • 41.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Brandt, Signe Kofoed
    Habilitation Services, Kullbergska Hospital, Katrineholm, Sweden.
    A Comparison of Recordings of Sentences and Spontaneous Speech: Perceptual and Acoustic Measures in Preschool Children's Voices.2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 26, no 5, 13- p.Article in journal (Refereed)
    Abstract [en]

    A well-controlled recording in a studio is fundamental in most voice rehabilitation. However, this laboratory like recording method has been questioned because voice use in a natural environment may be quite different. In children's natural environment, high background noise levels are common and are an important factor contributing to voice problems. The primary noise source in day-care centers is the children themselves. The aim of the present study was to compare perceptual evaluations of voice quality and acoustic measures from a controlled recording with recordings of spontaneous speech in children's natural environment in a day-care setting. Eleven 5-year-old children were recorded three times during a day at the day care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated three times. Recordings were randomized and analyzed acoustically and perceptually. Statistic analyses showed that fundamental frequency was significantly higher in spontaneous speech (P<0.01) as was hyperfunction (P<0.001). The only characteristic the controlled sentences shared with spontaneous speech was degree of hoarseness (Spearman's rho=0.564). When data for boys and girls were analyzed separately, a correlation was found for the parameter breathiness (rho=0.551) for boys, and for girls the correlation for hoarseness remained (rho=0.752). Regarding acoustic data, none of the measures correlated across recording conditions for the whole group.

  • 42.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. CLINTEC, Karolinska Institute, Stockholm, Sweden.
    Eklund, Robert
    Linköping University, Department of Culture and Communication, Language and Culture. Linköping University, Faculty of Arts and Sciences.
    An acoustic analysis of the cattle call “kulning”,performed outdoors at Säter, Dalarna, Sweden2015In: Proceedings from Fonetik 2015. Working Papers 55/2015, 8–10 June 2015, Centre for Languages and Literature, General Linguistics/Phonetics, Lund University, Lund, Sweden, Lund, Sweden: Lund University , 2015, 81-84 p.Conference paper (Other academic)
    Abstract [en]

    This paper summarizes recent research on ‘kulning’, a surprisingly understudiedSwedish cattle call singing style. In a previous study (Eklund, McAllister & Pehrson, 2013), we compared kulning and head voice (‘falsetto’) as recorded in a normal room and in an anechoic chamber. This paper reports from an analysisof the same “kulning” song recorded outdoors on location in Säter, Dalarna (Sweden), close to the singer’s home, which makes the data more ecologically validand allows comparisons between “clean” indoor recordings and more authentic outdoor recordings. Several recordings were made, but the present article analysesrecordings made simultaneously at 1 meter and 11 meters from the singer. Results indicate that for the vowels [a] and [u] partials in kulning, as compared to head voice, are visible at both higher frequencies and at a longer distance, which provides an acoustic rationale for the development of the singing style, intended to be heard at a long distance.

  • 43.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ferreira, Janna
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    LundeborgHammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Samuelsson, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Johannesson, Eva
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Sandström, Karin
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Rehabilitation Medicine.
    Berglind, Ulrika
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Learning in the tutorial group – a challenge between freedom and control2011In: The Third International Conference on Problem Based Learning in Speech Language Pathology and Audiology / [ed] Tara Whitehill & Susan Bridges, Hong Kong: University of Hong Kong , 2011Conference paper (Refereed)
    Abstract [en]

    Introduction: In order to improve and clarify the demands within tutorial groups in the speech and language pathology (SLP) and physiotherapy (PT) programs a joint study was conducted exploring problem areas in the tutorial groups.

    The aim was to investigate and further develop the requirements for a passing grade in the tutorial group. A long term goal was that the results could form a base for future changes regarding instructions and requirements in tutorial groups.

    Methodology:  Focus-group interviews were used to collect data. Three different groups were interviewed, two consisting of tutors from the SLP and PT programs and one consisting of last year student tutors from the SLP-program.  This data was also augmented by individual interviews of four SLP-students and five PT-students on different levels in the education.  A semi structured interview guide was used.  The interviews were analyzed using content analyses.

    Results: The analyses revealed three important themes for work in tutorial groups: Responsibility, Time and Support. Within these themes, several categories were also identified. Responsibility: Within this theme the main category was the importance of balance between individual and institutional responsibility. The students, the tutorial group, the tutor and the program all need to assume their part of the responsibility in order to clarify requirements. Time: Here different aspects of time management and work in the tutorial group were identified. These categories also related to aspects of support and continuous or lifelong learning. Support: Within this theme different support functions were identified such as documents, activities and personnel resources in the tutorial groups.  No suggestions were made in the interviews regarding the requirements for a passing grade in the tutorial groups. 

    Discussion/Conclusion: The main finding was the delicate balance between institutional control and the students own responsibility for the work within the tutorial groups.  An increased control decreases the students’ motivation to assume responsibility for their own learning. Also, study programs should adapt requirements in tutorial groups depending on years in the education.  Different support functions need to be closely coupled to tutorial work in order to have the intended effect.   

  • 44.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences.
    Granqvist, Svante
    Royal Institute of Technology (KTH).
    Sjölander, Peta
    Royal Institute of Technology (KTH).
    Sundberg, Johan
    Royal Institute of Technology (KTH).
    Child Voice and Noise: A Pilot Study of Noise in Day Cares and the Effects on 10 Children's Voice Quality According to Perceptual Evaluation2009In: Journal of Voice, ISSN 0892-1997, ISSN 0892-1997, Vol. 23, no 5, 587-593 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6dBA Leq, ranging from 81.5 to 83.6dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

     

  • 45.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Samuelsson, Christina
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Röst, tal och språk ur ett genusperspektiv2010In: Genus och kön inom medicin och vårdutbildningar / [ed] Wijma B, Smirthwaite G, Swahnberg K, Lund: Studentlitteratur , 2010, 1:1, 429-439 p.Chapter in book (Other (popular science, discussion, etc.))
  • 46.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Sjölander, Peta
    KTH Royal Institute Technology, Sweden .
    Children's Voice and Voice Disorders2013In: Seminars in Speech and Language, ISSN 0734-0478, Vol. 34, no 2, 71-79 p.Article in journal (Refereed)
    Abstract [en]

    This article discusses the differences between children's voices and adult voices. We give an overview of the anatomy in the head and neck and specifically the anatomy of the respiratory system and the larynx. We also describe the development of children's voices including different physiological measures and voice quality. The development and consequences for voice production and voice quality are addressed and related to gender differences in the growing child. We also discuss the prevalence of voice problems and hoarseness in children. Environmental and other factors contributing to voice problems in children are described, and finally, issues related to intervention and evidence-based practice are discussed.

  • 47. Nienkerke-Springer, Anke
    et al.
    Mc Allister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sundberg, Johan
    Effects of family therapy on children's voices2005In: Journal of Voice, ISSN 0892-1997, Vol. 19, no 1, 103-113 p.Article in journal (Refereed)
    Abstract [en]

    The families of nine children with deviant voice qualities were selected for family treatment according to the SYGESTI model. Recordings of the children's speech were made before and after therapy. Perceptual evaluation of their voice quality showed significant improvement in various perceptual parameters after the therapy. Acoustical analysis confirmed changes of voice quality and mean fundamental frequency in speech. The therapy also was found to improve relations between family members, conflict management and other aspects of communication. The results suggest that these children's deviant voices were related to family conditions. © 2005 The Voice Foundation.

  • 48.
    Nygren, Mariana
    et al.
    Umeå University, Sweden .
    Tyboni, Mikaela
    Umeå University, Sweden .
    Lindstrom, Fredric
    University of Gothenburg, Sweden .
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    van Doorn, Jan
    Umeå University, Sweden .
    Gender Differences in Childrens Voice Use in a Day Care Environment2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 26, no 6Article in journal (Refereed)
    Abstract [en]

    Background. The prevalence of dysphonia is higher in boys than in girls before puberty. This could be because of the differences in boys and girls voice use. Previous research on gender differences in prepubescent childrens voice parameters has been contradictory. Most studies have focused on examining fundamental frequency. Objectives. The purpose of this study was to investigate voice use in boys and girls in a day care environment based on the voice parameters fundamental frequency (Hz), vocal intensity (dB SPL), and phonation time (%) and to ascertain whether there were any significant gender differences. Study Design. Prospective comparative design. Method. The study was conducted in a day care environment where 30 children (17 boys and 13 girls aged 4-5 years) participated. The participants voices were measured continuously for 4 hours with a voice accumulator that registered fundamental frequency, vocal intensity level, phonation time, and background noise. Results. Mean (standard deviation) fundamental frequency was 310 (22) and 321 (16) Hz, vocal intensity was 93 (4) and 91 (3) dB SPL, and phonation time was 7.7 (2.0)% and 7.6 (2.5)% for boys and girls, respectively. No differences between genders were statistically significant. Conclusion. The finding of no statistically significant gender differences for measurements of voice parameters in a group of children aged 4-5 years in a day care environment is an important finding that contributes to increased knowledge about young boys and girls voice use.

  • 49.
    Rayner, Manny
    et al.
    University of Geneva, Switzerland.
    Gerlach, Johanna
    University of Geneva, Switzerland.
    Starlander, Marianne
    University of Geneva, Switzerland.
    Tsourakis, Nikos
    University of Geneva, Switzerland.
    Kruckenberg, Anita
    KTH, Stockholm, Sweden.
    Eklund, Robert
    Linköping University, Department of Culture and Communication, Language and Culture. Linköping University, Faculty of Arts and Sciences.
    Jönsson, Arne
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Chua, Cathy
    Swinburne University, Melbourne, Australia.
    A web-deployed Swedish spoken CALL systembased on a large shared English/Swedish feature grammar2012In: Proceedings of the SLTC 2012 workshop on NLP for CALL / [ed] Lars Borin and Elena Volodina, Linköping University Electronic Press, 2012, 37-46 p.Conference paper (Refereed)
    Abstract [en]

    We describe a Swedish version of CALL-SLT,a web-deployed CALL system that allows beginner/intermediate students to practise generativespoken language skills. Speech recognitionis grammar-based, with language modelsderived, using the Regulus platform, fromsubstantial domain-independent feature grammars.The paper focusses on the Swedishgrammar resources, which were developedby generalising the existing English featuregrammar into a shared grammar for Englishand Swedish. It turns out that this can be donevery economically: all but a handful of rulesand features are shared, and English grammaressentially ends up being treated as a reducedform of Swedish. We conclude by presentinga simple evaluation which compares theSwedish and French versions of CALL-SLT.

  • 50.
    Samuelsson, Christina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Lundeborg, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Experiences from Two Swedish Speech and Language Pathology Education Programmes Using Different Approaches to Problem-Based Learning2012In: Problem-Based Learning in Clinical Education: The Next Generation / [ed] Susan Bridges, Colman McGrath and Tara L. Whitehill, Dordrecht: Springer Netherlands, 2012, 47-58 p.Chapter in book (Other academic)
    Abstract [en]

    In many programmes within higher education, including speech language pathology (SLP) education, students are expected to develop collaborative skills alongside acquisition of theoretical knowledge. The focus of the present chapter is to evaluate SLP graduates’ opinions on how well prepared for the professional life they feel after their education. A questionnaire, focusing on perceived professional skills in relation to education, was distributed to former SLP students from two programmes with different applications of problem-based learning (PBL). A total of 55 students (69%) completed the questionnaire. PBL has been identified as one efficient way to facilitate the development of speech and language pathology students’ abilities to meet the demands of self-directed learning in everyday worklife. Moreover, it has been shown that the use of PBL throughout the programme is beneficial to the perception of attaining general competencies. It is also demonstrated that the students from both the PBL throughout and the semi-PBL curricula rated themselves high on many specific competencies.

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