Department of Audiology, Speech and Language
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Item Speaking of Online Learning: Alternative Practice-Based Learning Experiences for Speech Pathologists in Australia, Ghana and Hong Kong(International Journal of Practice-based Learning in Health and Social Care, 2022) Skeat, J.; Bampoe, J.O.; Booth, S.; et al.Speech Pathology programs usually send students to workplaces to learn clinical skills necessary for practice. During COVID-19, programs needed to respond quickly to ensure that students continued to gain the necessary experiences and skills required to progress through their program and graduate as clinicians, while simultaneously complying with COVID-19 requirements. Case studies from seven different universities in Australia and Ghana and Hong Kong described the diverse ways in which placements were adapted to be COVID-safe, taking into account local needs. Some practices which had been included in placement education prior to the pandemic, such as telepractice and simulation-based learning, extended and developed during this time. Educators, students, clinicians and clients responded to the rapidly changing needs of the time with flexibility and innovation, utilising a variety of technologies and tools to support case-based and virtual learning opportunities. Feedback from these diverse stakeholders about the experiences was positive, despite inevitable limitations and less-than-ideal circumstances. The positive findings provided insights for consideration in the future: could strategies implemented in response to the pandemic continue to be incorporated into placement experiences, enhancing current practices and maintaining student performance outcomes? Exceptional circumstances prompted exceptional responses; flexibility and innovation were accelerated in response to the pandemic and may transform future placement-based learning opportunities.Item Community service providers’ roles in supporting communication disability rehabilitation in Majority World contexts: An example from Ghana(International Journal of Speech-Language Pathology, 2020) Wylie, K.; Davidson, B.; Bampoe, J.O.; Amponsah, C.; McAllister, L.Purpose: In Majority World countries, where speech-language pathology services are extremely limited, people with communication disabilities may seek help from a range of 3 service providers. This qualitative research aimed to explore the nature of community services offered to people with communication disabilities who seek help in Accra, Ghana. Method: Semi-structured interviews were conducted with nine individuals from three professions: pastors (3), doctors (3), and herbalists (3) exploring services that they may offer to PWCD seeking help. Interviews were analysed using Thematic Network Analysis. Result: Six global themes described beliefs about communication disability, types of intervention, explanations provided to people with communication disabilities, promoting communication, processes for selecting treatments, and links between service providers. Interventions encompassed physical, spiritual, psychosocial and environmental approaches, with the notion of plural beliefs interwoven through a number of themes. Conclusion: In Ghana, and other Majority World contexts, service providers in sectors not commonly associated with communication disability rehabilitation may have important roles to play in supporting people with communication disabilities. Understanding the contributions of other service providers may assist the growing profession of speech language pathology to collaborate across sectors, to develop specific, culturally responsive approaches to service development.Item Psychometrically Equivalent Fante Speech Recognition Threshold Materials by a Female Talker(Journal of Speech, Language, and Hearing Research, 2023) Honu-Mensah, C.M.; Offei, Y.N.; Owusu, N.A.V.; Anim-Sampong, S.Psychometrically Equivalent Fante Speech Recognition Threshold Materials by a Female Talker Abstract Purpose: This study aimed to create and evaluate digitally recorded speech materials for speech recognition threshold (SRT) testing among children and adults in Fante. Fifty-one (51) familiar trisyllabic words were chosen from a list of 107 widely used trisyllabic Fante words. They were digitally captured and edited to create the same root mean square as a 1-kHz calibration tone. Method: The study used a three-phase cross-sectional study method. Twenty native Fante speakers with normal hearing thresholds were selected at random for listener evaluation. For each of the words, the researchers used logistic regression to measure the slope, intercepts, and psychometric function slope at 50% and from 20% to 80%. In the study, the intensity of each word was modified digitally, so that the threshold at 50% of each word was equal to the mean pure-tone average (PTA) of the participants to increase the homogeneity of the thresholds of the selected words. Results: A final list of 25 familiar homogenous words with the same tone patterns of slopes greater than 7%/dB was finally selected and recorded for speech audiometry in Fante. Conclusions: Psychometrically equivalent trisyllabic words in Fante were successfully developed and evaluated for SRT testing in Ghana. There is a need for the development of speech audiometry materials in other Ghanaian languagesItem Barriers and Facilitators to Conversation: A Qualitative Exploration of the Experiences of People with Parkinson’s and Their Close Communication Partners(Brain Sciences, 2022) Wylie, K.; Carrier, H.M.; Loftus, A.M.; Thilakaratne, R.; Cocks, N.Conversations are an important part of our daily lives, enabling us to interact with others and participate in a range of activities. For people with Parkinson’s, conversation can be challenging when communication is impacted. This qualitative exploratory study investigated the experiences of people with Parkinson’s and their close communication partners in conversations. The study explored influences on conversational participation, considering perceived barriers and facilitators to participation in conversation for people with Parkinson’s. Interviews were conducted with eight dyads, with participants interviewed both jointly and separately (24 interviews). Five themes revealed that conversation appears to be influenced not only by the communication skills of the person with Parkinson’s, but also by factors associated with the communication partner, the complex nature of conversations, the communication environment, and the impact of experience in shaping participation in conversation. Specific barriers and facilitators to conversational participation were identified. This study offers important insight into the lived experience of people with Parkinson’s affected by communication difficulties. The findings support the notion that it is more than simply the communication skills of the person with Parkinson’s that influence conversations. It is important that other factors influencing conversational success should be included in interventions supporting communication for people with Parkinson’s.Item The importance of SDG 17 and equitable partnerships in maximising participation of persons with communication disabilities and their families(International Journal of Speech-Language Pathology, 2022) Dada, S.; Wylie, K.; Marshall, J.; Rochus, D.; Bampoe, J.O.Background: Equitable partnerships across borders, sectors and communities are integral in creating shared understanding, novel solutions and sustainable development. Sustainable development goal (SDG) 17: Partnerships for goals, focuses on strengthening global partnerships. This highlights the importance of partnership as a tool to support the achievement of all SDGs. Partnerships are particularly vital to creating sustainable and appropriate services to support people who experience communication or swallowing disability and their families, in under-served communities, where services and expert personnel may be limited and where innovative strategies are required for working with families and communities to improve service accessibility. Purpose: To reflect on key principles underpinning the creation of a speech–language pathologists’ (SLPs’) community of practice, designed to support SLPs from high-, low- and middle-income countries to develop equitable partnerships, aimed at supporting people who experience communication or swallowing disability their families. Result: We draw on the authors’ experiences of building partnerships to enhance participation for people who experience communication or swallowing disability. We discuss the need for global partnerships and challenges with current funding mechanisms. Conclusion: We use the principles of the speech–language pathology community of practice and concepts from the Partnership Accelerator 2030 Agenda to frame reflections and recommendations. This commentary paper focuses on partnerships for the goals (SDG 17).Item Processing of time reference in agrammatic speakers of Akan: a language with grammatical tone(Aphasiology, 2020-03-10) Amponsah, C.; Tsiwah, F.; Lartey, N.; Martínez-Ferreiro, S.; Popov, S.; Bastiaanse, R.Background: Languages of the world have several ways of expressing time reference. Many languages such as those in the Indo- European group express time reference through tense. Languages such as Chinese and Standard Indonesian express time reference through aspectual adverbs, while Akan does so through grammatical tone. Previous studies have found that time reference is selectively impaired, with reference to the past being more impaired than reference to the non-past. The PAst DIscourse LInking Hypothesis (PADILIH) posits that pastime reference is difficult because it requires discourse linking. Aims: The goal of this study was first to examine whether pastime reference is impaired also in languages that do not use grammatical affixes but rather tone, to make time reference. Second, this study aims to decouple the effect of tone from the effect of temporal reference on Akan verbs. Method and Procedures: Ten Akan agrammatic speakers and 10 non-brain-damaged speakers (NBDs) participated in this study. An Akan adapted version of the Test for Assessing Reference of Time (African TART), for both production and comprehension was used. The TART focuses on the future, present (habitual) and the pastime frames. Additionally, five of the agrammatic speakers performed two tonal discrimination tasks: a non-linguistic and a linguistic (lexical) one. Outcomes and Results: While the NBDs scored at ceiling, the agrammatic speakers made errors, and these affected past more than present and the future time references, in both comprehension and production tasks. However, the comprehension data showed a dissociation between the present habitual and the future. The substitution error analysis revealed a preference for the present. The five agrammatic speakers showed an intact performance on non-linguistic tonal discrimination task. Conclusion: The conclusion is that regardless of how time reference is expressed, whether through inflectional morphology or grammatical tone, reference to the past is problematic for individuals with agrammatic aphasia. The fact that the agrammatic speakers could perceive the non-linguistic tonal differences demonstrates that it is not tone in general that is disrupted, but rather time reference, particularly reference to the past, as predicted by the PADILIH.Item Resumption in the production of focused constructions in Akan speakers with agrammatism(Aphasiology, 2019-11-06) Amponsah, C.; Lartey, N.; Tsiwah, F.; Martinez-Ferreiro, S.; Bastiaanse, R.Background: The distribution of pronouns varies cross-linguistically. This distribution has led to conflicting results in studies that investigated pronoun resolution in agrammatic indviduals. In the investigation of pronominal resolution, the linguistic phenomenon of “resumption” is understudied in agrammatism. The construction of pronominal resolution in Akan presents the opportunity to thoroughly examine resumption. Aims: To start, the present study examines the production of (pronominal) resumption in Akan focus constructions (who-questions and focused declaratives). Second, we explore the effect of grammatical tone on the processing of pronominal (resumption) since Akan is a tonal language. Methods & Procedures: First, we tested the ability to distinguish linguistic and non-linguistic tone in Akan agrammatic speakers. Then, we administered an elicitation task to five Akan agrammatic individuals, controlling for the structural variations in the realization of resumption: focused who-questions and declaratives with (i) only a resumptive pronoun, (ii) only a clause determiner, (iii) a resumptive pronoun and a clause determiner co-occurring, and (iv) neither a resumptive pronoun nor a clause determiner. Outcomes & Results: Tone discrimination .both for pitch and for lexical tone was unimpaired. The production task demonstrated that the production of resumptive pronouns and clause determiners was intact. However, the production of declarative sentences in derived word order was impaired; wh-object questions were relatively well-preserved. Conclusions: We argue that the problems with sentence production are highly selective: linguistic tones and resumption are intact but word order is impaired in non-canonical declarative sentencesItem Community service providers' roles in supporting communication disability rehabilitation in Majority World contexts: An example from Ghana(International Journal of Speech-Language Pathology, 2019-08-22) Wylie, K.; Davidson, B.; Marshall, J.; Bampoe, J.O.; Amponsah, C.; McAllister, L.Purpose: In Majority World countries, where speech-language pathology services are extremely limited, people with communication disabilities (PWCD) may seek help from a range of service providers. This qualitative research aimed to explore the nature of community services offered to people with communication disabilities who seek help in Accra, Ghana. Method: Semi-structured interviews were conducted with nine individuals from three professions: pastors (3), doctors (3), and herbalists (3) exploring services that they may offer to PWCD seeking help. Interviews were analysed using Thematic Network Analysis. Result: Six global themes described beliefs about communication disability, types of intervention, explanations provided to people with communication disabilities, promoting communication, processes for selecting treatments, and links between service providers. Interventions encompassed physical, spiritual, psychosocial and environmental approaches, with the notion of plural beliefs interwoven through a number of themes. Conclusion: In Ghana, and other Majority World contexts, service providers in sectors not commonly associated with communication disability rehabilitation may have important roles to play in supporting people with communication disabilities. Understanding the contributions of other service providers may assist the growing profession of speech-language pathology to collaborate across sectors, to develop specific, culturally responsive approaches to service development.Item Self-Help and Help-Seeking for Communication Disability in Ghana: Implications for the Development of Communication Disability Rehabilitation Services(Globalization and Health, 2017-12) Wylie, K.; McAllister, L.; Davidson, B.; Marshall, J.; Amponsah, C.; Bampoe, J.O.Background In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. Methods A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. Results One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors – including the Western healthcare, religious, and traditional sectors. Conclusions Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.Item Communication rehabilitation in sub-Saharan Africa: The role of speech and language therapists(African Journal of Disability, 2018-04) Wylie, K.; McAllister, L.; Davidson, B.; Marshall, J.Background: Workforce factors present a significant barrier to the development of rehabilitation services for people with communication disabilities in sub-Saharan Africa (SSA). Exploring how the work of speech and language therapists (SLTs) in the region is organised and delivered can provide insight into existing services, areas for future workforce development and improved rehabilitation access for people with communication disability. Objectives: This paper describes the employment and service provision patterns and work roles of a sample of SLTs in SSA. Method: A broad, purpose-designed, mixed-methods survey was designed to collect data from SLTs living in Anglophone countries of SSA. Descriptive statistics and qualitative content analysis were undertaken. This paper reports on a subset of data from the wider survey. Results: A description of the employment and work roles of the 33 respondents to the survey and characteristics of their service users is presented. SLTs were commonly employed within private and not-for-profit sectors and frequently worked in temporary jobs. SLTs engaged in a range of work roles, including capacity building and training others. Services were provided by SLTs across age ranges, health conditions and settings, with paediatric, urban services commonly reported. Costs for service users and urban-centred services give indications of barriers to service access. Conclusion: Knowledge of the way in which speech and language therapy services are organised and provided has the potential to shape the development of communication disability rehabilitation in SSA. This research has identified a range of issues requiring consideration as the profession develops and grows.Item Interregional Newborn Hearing Screening via Telehealth in Ghana(Journal of the American Academy of Audiology, 2019-03) Ameyaw, G.A.; Ribera, J.; Anim-Sampong, S.BACKGROUND: Newborn hearing screening is a vital aspect of the Early Hearing Detection and Intervention program, aimed at detecting hearing loss in children for prompt treatment. In Ghana, this kind of pediatric hearing service is available at only one health care facility located in the Greater Accra Region. The current practice in effect has virtually cut-off infants in the other regions from accessing hearing screening and other pediatric audiological services. This has prompted a study into alternative methodologies to expand the reach of such services in Ghana. The present study was designed to assess the feasibility of using telehealth to deliver newborn hearing screening across Ghana. PURPOSE: To assess the feasibility of using telehealth to extend newborn hearing screening services across the ten regions of Ghana. RESEARCH DESIGN: A correlational study was designed to determine the extent of association between test results of telehealth and the conventional on-site methods (COMs) for conducting newborn hearing screening. The design also allowed for testing duration between the two methods to be compared. STUDY SAMPLE: Fifty infants from the Brong-Ahafo Regional Hospital (BARH) were enrolled. The infants aged between 2 and 90 days were selected through convenience sampling. There were 30 males and 20 females. PROCEDURE: Newborn hearing screening using distortion product otoacoustic emissions were performed via telehealth. By adopting the synchronous telehealth model, an audiologist located at the Korle-Bu Teaching Hospital conducted real-time hearing screening tests over the internet on infants who were at the BARH. The former and latter hospitals are located in the Greater Accra and the Brong-Ahafo Regions, respectively. As a control, similar hearing screening tests were conducted on the same infants at BARH using the conventional face-to-face on-site hearing screening method. DATA COLLECTION AND ANALYSIS: The test results and testing duration of the telehealth method and the conventional on-site approach were compared and subjected to statistical analysis. Here, the Spearman's correlation coefficient (rs) was used to determine the level of correlation between the test results, whereas the paired t-test statistic was used to test the level of significance between the testing duration of the two methods. RESULTS: Analysis of the test results showed a significantly high positive correlation between the telehealth and the COMs (rs = 0.778, 0.878, 0.857, 0.823, p < 0.05 @ 2.0, 3.0, 4.0, and 5.0 kHz respectively). Also, the difference in testing duration of the two methods was not statistically significant [t(99) = 1.309, p > 0.05]. The mean testing duration (in seconds) of telehealth was 27.287 (standard deviation = 27.373) and that of the COM was 24.689 (standard deviation = 27.169). CONCLUSION: The study showed the feasibility of establishing an interregional network of newborn hearing screening services across Ghana using telehealth. It is more efficient to deploy telehealth for pediatric hearing services than to have patients travel many hours to the Greater Accra Region for similar services. Poor road network, high transportation costs, and bad weather conditions are a few of the reasons for avoiding long distance travel in Ghana.Item Development of a Language-Independent Functional Evaluation(Archives of Physical Medicine and Rehabilitation, 2009-12) Haig, A.J.; Jayarajan, S.; Maslowski, E.; Yamakawa, K.S.; Tinney, M.; Beier, K.P.; Juang, D.; Chan, L.; Boggess, T.; Loar, J.; Owusu-Ansah, B.; Kalpakjian, C.Haig AJ, Jayarajan S, Maslowski E, Yamakawa KS, Tinney M, Beier KP, Juang D, Chan L, Boggess T, Loar J, Owusu-Ansah B, Kalpakjian C. Development of a language-independent functional evaluation. Objective: To design, validate, and critique a tool for self-report of physical functioning that is independent of language and literacy. Design: Software design and 2 prospective trials followed by redesign. Setting: United States and African university hospitals. Participants: Outpatient and inpatient competent adults with diverse physical impairments. Interventions: (1) Software design process leading to a Preliminary Language-Independent Functional Evaluation (Pre-L.I.F.E.); (2) patient surveys using a printed Pre-L.I.F.E. and a computer-animated Pre-L.I.F.E. tested in random order, followed by a questionnaire version of the standard Barthel Index; and (3) software redesign based on objective and qualitative experiences with Pre-L.I.F.E. Main Outcome Measures: Validation of the general concept that written and spoken language can be eliminated in assessment of function. Development of a refined Language-Independent Functional Evaluation (L.I.F.E.). Results: A viable Pre-L.I.F.E. software was built based on design parameters of the clinical team. Fifty Americans and 51 Africans demonstrated excellent (Cronbach α>0.8 Americans) and good (α>.425 Africans) reliability. In general, the relations between Pre-L.I.F.E. and Barthel scores were excellent in the United States (interclass correlation coefficient for stair climbing, .959) but somewhat less good in Africa, with elimination functions very poorly related. The computer-animated Pre-L.I.F.E. was faster and trended to be more reliable than the printed Pre-L.I.F.E. in both the United States and Africa. Redesign meetings corrected statistical and qualitative challenges, resulting in a new tool, the L.I.F.E. Conclusions: Literacy and language translation can be eliminated from some aspects of functional assessment. The new L.I.F.E., based on solid empirical evidence and design principles, may be a practical solution to assessment of function in the global culture. © 2009 American Congress of Rehabilitation Medicine.