Objective The anatomical location of oral cavity cancer (OCC), plus its usual treatment options of surgery with or without (chemo-)radiotherapy, may impact profoundly on speech and swallowing outcomes. The aim of this scoping review was to identify and summarise speech and language therapy (SLT) intervention types and service delivery models employed in OCC over the last 25 years, in order to summarise current practice. Method Systematic searches were conducted in three databases and via Google Scholar for papers published from 2000 to November 2025. The inclusion criteria were SLT-led interventions and OCC. Articles relating to other HNCs, therapy carried out by other healthcare professionals, articles solely reporting outcomes and non-English-language publications were excluded. Results A total of 443 publications were retrieved, resulting in 14 papers that were analysed: five focused solely on swallowing, three on speech alone and five on both functions. One paper described swallowing and trismus intervention. The most common study designs were single group cohorts/case series (57%, n = 8). Oromotor exercises, other direct therapy and compensatory strategies were regularly used for both speech and swallowing. There was significant variation in the timing, frequency and intensity of therapy offered. Conclusion SLT-led speech and swallowing interventions typically include a combination of oromotor exercises, other direct therapy and compensatory strategies. The quality of evidence relating to swallowing intervention is higher than that for speech. While long-established interventions form the basis of rehabilitation interventions, new approaches to SLT intervention are being trialled.
Dysarthria is a common motor speech disorder following stroke, affecting approximately 52% of stroke survivors. As dysarthria affects speech production, its impact varies across languages depending on each language’s unique features. Arabic is the fifth most widely spoken language worldwide. However, limited evidence exists regarding the clinical management of dysarthria in Arabic-speaking populations. This study aimed to identify the assessment and treatment practices used by speech-language therapists (SLTs) working with Arabic-speaking stroke survivors and to identify the ICF domains targeted in clinical management. A cross-country online survey was conducted using non-probability sampling. The survey collected information on clinician background, dysarthria screenings/assessments, and dysarthria treatments. Descriptive statistics were used to analyse the data. Seventy-two participants completed the demographic and assessment sections, while 55 participants completed the survey through the treatment section. Most respondents (57%) were based in Saudi Arabia, and the rest were from other Gulf and Western countries. Only one-third of respondents used formal assessments, often adapted for Arabic use. The remaining two-thirds used informal assessments. Respondents targeted impairment, activity, and participation domains in equal proportions during their assessment and treatment, demonstrating comprehensive application of the ICF framework. All respondents trained communication partners as part of their management plan, and nearly all (91%) supported patient-specific goals. Respondents emphasised the need for clinical resources based on normative data from Arabic-speaking individuals and culturally and linguistically appropriate tools. Findings suggest that developing Arabic-specific tools that account for its unique phonemic and morphological features is essential to support effective and equitable dysarthria management.
To investigate the perspectives of parents on their treatment decisions for the management of their child’s ankyloglossia (tongue-tie). Ninety-eight parents across Australia responded to an online survey about their perspectives on treatment for their infant’s ankyloglossia. Descriptive statistics were used to analyse quantitative data, and thematic analysis was used to describe qualitative data. Participants were from all Australian states and territories. Ankyloglossia was most often diagnosed by lactation consultants and midwives within the first week of life, with nearly all cases identified during the first year. While all parents were offered non-surgical treatments, most reported persistent feeding difficulties. Surgical treatment, typically conventional or laser frenotomy, was offered to almost all parents. Surgical intervention was successful for most infants, though spontaneous recovery of feeding difficulties without intervention was also observed. Key reasons for declining surgery included positive experiences with non-surgical treatment, concerns about surgical risks, and conflicting information. Overall, parents were more likely to consent to surgical than non-surgical treatment in the future, though experiences of shared decision-making were rated more positively with non-surgical providers. Parental involvement and engagement in managing infant ankyloglossia was linked to positive perceptions of outcomes. Surgical treatment showed favourable results, though some infants improved without intervention, underscoring the need for standardised protocols. Findings emphasise the need for clear communication and shared decision-making to support parents and reduce unnecessary treatment.
This study aimed to determine the validity and reliability of the Indonesian version of the Eating and Drinking Ability Classification System (EDACS) in children with cerebral palsy. The EDACS was translated and culturally adapted into Bahasa Indonesia using the FACIT (Functional Assessment of Chronic Illness Therapy) translation methodology, aligning with established international cross-cultural adaptation guidelines such as. Content validity was confirmed through expert review and cognitive debriefing interviews. Inter-rater reliability (κ) was assessed across three pairings: Speech Therapists (STs), Physical Medicine and Rehabilitation (PM&R) Residents, and cross-professionally. A total of 30 children with cerebral palsy (range 3–16 years) were classified. Inter-rater reliability showed very strong agreement among STs (κ level = 0.871; κ assistance = 1.000). Strong agreement was found among Residents (κ level = 0.703; κ assistance = 0.788), with the highest disagreement reaching 2 levels on EDACS Level I classifications. Cross-professional agreement was very strong (κ level = 0.828; κ assistance = 0.895). The Indonesian EDACS is confirmed to be valid and reliable for clinical use. The demonstrated strong to very strong cross-professional reliability supports its consistent use as an effective, multidisciplinary communication tool for STs and PM&R Residents.
Sensory Processing Disorder (SPD) is a complex neurological condition that significantly affects emotional, social, and cognitive development. Its diverse manifestations can disrupt communication and learning, presenting notable challenges for clinical intervention. Despite its relevance, SPD continues to be under-recognized within the domain of speech language pathology. The present study assesses the awareness, knowledge, and attitudes toward sensory processing and its disorders among practicing Speech Language Pathologists (SLPs) in Maharashtra and examines how these vary based on factors such as educational qualification, work setting, area of expertise, and years of experience. A cross-sectional descriptive research design was employed. Data were collected via an online survey using a validated questionnaire, where 100 SLPs with a minimum of six months’ clinical experience completed the survey. Participants demonstrated moderate levels of awareness and knowledge, coupled with a generally positive attitude toward SPD. Neither educational background nor years of experience significantly influenced these domains. However, notable differences in knowledge were observed across workplace settings, with SLPs employed in hospitals and private clinics reporting higher knowledge scores. The area of expertise was also found to influence awareness levels. Enhanced knowledge in hospital and private practice settings suggested that exposure to diverse clinical cases and interdisciplinary collaboration may be critical for developing clinical competence in SPD. Despite strong positive attitudes, limited implementation suggests gaps in training and resources. Higher awareness among adult-focused SLPs challenges common assumptions, highlighting the need for practical, interdisciplinary training to bridge the gap between knowledge and application.
Developmental Language Disorder (DLD) is a persistent difficulty with the use and understanding of language, emerging in childhood and enduring into adulthood. Despite research on DLD increasing in recent years, there is a dearth of literature on adult life with DLD. Increasing our understanding of the lived experience of DLD has the potential to lead to more targeted and meaningful interventions, enhance intervention outcomes, and increase client satisfaction with interventions. This study aimed to explore the lived experience of DLD for adults. Specifically, it examined the impact of DLD on education, employment, relationships, and recreational activities. Semi-structured interviews were completed with seven adults with DLD, aged from 24 to 66 years. Interview questions were developed following a review of the literature, and centred on five topics: education, employment, relationships, recreational activities and personal strengths. Interviews were conducted in person and online. Reflexive thematic analysis was used to analyse the data. Two themes and five subthemes were identified. The themes were: Society’s reduced awareness and understanding of DLD and its impact on the individual and Participation in daily living activities. This study illustrates the profound impact that DLD has on an individual’s life. Speech and language therapists working with this client group should be cognisant of this multifaceted impact and ensure that intervention is person-centred and tailored to an individual’s specific goals. Future research should continue to explore the impact of DLD on the lives of adults, and ensure their voices are adequately represented in the literature.
A significant proportion of patients requiring Extra Corporeal Membrane Oxygenation (ECMO) are now considered safe for earlier tracheostomy insertion, allowing for sedation wean and commencement of rehabilitation. Speech and Language Therapy (SLT) clinical swallow assessment usually occurs following tracheostomy cuff deflation, when signs of dysphagia and aspiration are detectable. Cuff deflation can be difficult to establish in patients on ECMO with complex ventilation requirements, with prolonged cuff inflation delaying oral feeding. Flexible Endoscopic Evaluation of Swallowing (FEES) is used routinely in critical care, but application in the ECMO cohort is a new development. FEES offers the potential for earlier accurate swallowing assessment irrespective of cuff status. Safety, utility and outcomes of FEES in cardiothoracic patients with tracheostomies requiring ECMO has not previously been reported. This case series demonstrates the outcomes and benefits of FEES for expediting earlier, safe oral intake in this population.
Many individuals with Huntington’s disease (HD) experience significant difficulties with eating, drinking, and swallowing, with aspiration pneumonia being the leading cause of death. Although dysphagia is a major clinical concern, little is known about the range of evidence based interventions for this population or the outcome measures being used to determine change. This scoping review aims to (i) identify dysphagia interventions investigated for adults with HD and (ii) determine the outcome measures used to evaluate their impact on swallowing and quality of life (QoL) for individuals and caregivers. This scoping review will be completed using the Arksey & O’Malley (2005) framework and reported using the PRISMA-ScR guidelines. Articles dicussing adults with HD who require interventions to treat eating, drinking and swallowing difficulties will be included. CINAHL, EMBASE, MEDLINE, Web of Science, ProQuest Dissertations & Theses, and ClinicalTrials.gov will be searched using two search strings (dysphagia and Huntington’s disease) without date or language restrictions. Two reviewers will independently screen, extract, and categorize data according to intervention type and outcome measures used. Findings from this scoping review will capture the current evidence base for dysphagia intervention in HD. By mapping available interventions and outcome measures, this review will identify gaps in dysphagia research in HD, and inform the design of future clinical studies.
Aphasia is a risk factor for poor psychological functioning. Coordinated care across Speech and Language Therapists (SLTs) and other professionals with a role in psychological health, such as Psychologists (PSYs) and Occupational Therapists (OTs), is key to improving outcome. Health professionals’ skills in aphasia communication are linked with ability to provide effective health and psychological care. Prior to effective design and implementation of aphasia communication training, it is necessary to understand local contexts and clinician perspectives. This study examined current practices and needs of PSYs and OTs in Ireland in relation to supporting psychological needs of people with aphasia. This was an online, self-administered cross-sectional survey targeting OTs and PSYs, minimally a year post-qualification, currently working with people with aphasia in Ireland. Data were subjected to descriptive statistics and reported narratively. Forty-four clinicians took part (30 OTs, 14 PSYs). Respondents reported high prevalence of psychological concerns among their clients with aphasia. Despite a lack of formal training, respondents reported use of a wide range of communication techniques and experienced good collegial support. Confidence in delivering psychological support and supporting complex conversations was lower. Aphasia training, interdisciplinary working, including with SLTs, and managerial support were identified as key needs. There is a need to develop and pilot aphasia training interventions that meet the needs of clinicians working with people with aphasia across different settings. The findings will have relevance for delivering coordinated aphasia psychological care in Ireland and internationally.
The importance of involving healthcare consumers in service user experience has yet to be consistently embraced by Child and Adolescent Mental Health Services (CAMHS), despite recognition from the UN’s Convention of the Rights of the Child, which emphasises the value of including children in clinical research. The Secret Agent Society (SAS) is an intensive, CBT-informed intervention for children, which aims to support emotion regulation and social problem-solving skills. SAS has a substantial international research base; however, little is known regarding the personal experiences of children who have completed the programme. This descriptive qualitative study aimed to explore children’s experiences of attending SAS groups facilitated by Senior Speech and Language Therapists (SLT) in CAMHS in Ireland. Data was collected using semi-structured, one-to-one interviews, with 47 children aged 8–12 years (mean age 10:11). Children’s diagnoses included ADHD, anxiety disorder and/or autism. Interviews were transcribed and analysed qualitatively using content analysis. Themes highlight the value children placed on mastering new skills and the hope that this new learning offered them for the future. A fun intervention, supported by a strong therapeutic alliance and a favourable emotional climate, were of importance to them. Completing home practice tasks was not. Findings give a voice to neurodivergent children attending SLT-led group therapy in CAMHS, beyond what previous research has established using quantitative methods. The depth of experiences described emphasise the importance of optimising the therapeutic environment and have implications for future neuro-affirmative group interventions.
Speech and language therapy services for children with disabilities in Ireland have undergone a significant change in the recent past. There are many reports of parent views about access to interventions, but to date the perspectives of SLTs on their role has not been established. This study aimed to gather the experiences of SLTs working in CDNTs regarding their ability to deliver interventions. We circulated an online survey to Irish clinicians and invited them to attend online focus groups or interviews to discuss their perspectives and experiences in delivering services and interventions within reconfigured services. The results were analysed quantitatively using descriptive statistics and qualitatively via thematic analysis. Twenty eight SLTs completed the full survey and five people took part in the focus groups/ interviews. The clinicians reported to be spending just a quarter of their time providing interventions, and most were not satisfied with their intervention provision. They discussed the challenging working environment, including large and varied caseloads, unclear policies, and a lack of clinical supervision which were impacting on their ability to provide a range of interventions, their relationships with parents and colleagues, and overall job satisfaction. The study paints a picture of a very challenging work environment for SLTs in CDNTs. There remain significant challenges for how services are configured and delivered to retain staff and best serve families of children with disabilities. These need to be considered by those responsible for planning and organising disability services as a matter of urgency.
Children with neurodevelopmental disabilities (NDDs) have complex therapeutic needs which require tailored models of service delivery. To profile the characteristics of the optimal service for children with complex neurodevelopmental disabilities in policy and professional guidelines in addition to the empirical literature. An integrative review was conducted. A systematic search of electronic databases ( n =4) for Ireland, New Zealand and Finland and a manual search of policy and professional guidelines for Ireland was completed in October 2023. A total of 18 papers were included in the analysis. Qualitative content analysis was undertaken independently by two researchers. Five descriptive categories were identified across the dataset: (i) Person-centred, (ii) Empowering, (iii) Evidence-based, (iv) Accountable, and (v) Safe. A coherent vision of the optimal services for children and young people with complex NDDs is evident across policy, professional guidelines and empirical literature. Currently there is a discord between this vision and the realities of service delivery in the Irish healthcare context. Implementation science theories and frameworks have the potential to bridge the research-practice gap and improve services for this vulnerable population.
Home practice is an integral component of the therapeutic process for children with speech and language difficulties, facilitating effective collaborative practice between parents and speech and language therapists (SLTs) and increasing the dosage of intervention received. However, numerous challenges have been documented. Understanding how home practice is currently perceived by parents and SLTs may help address these challenges, enhance home practice approaches and strategies, and subsequently optimise therapy outcomes for children. This study aimed to gather views of parents and speech and language therapists on home practice, including how home practice is currently being implemented, its benefits and challenges, and how it could be improved. A mixed-methods, cross-sectional, anonymous, online survey was developed and distributed to parents and SLTs via social media. Data were analysed using descriptive statistics and content analysis. A total of 117 responses were received with a relatively balanced representation between parents (43%) and SLTs (57%). Survey findings suggest that home practice is a valued and common practice within SLT intervention, across countries and settings, that supports a positive parent-SLT alliance. Specific factors to ensure high-quality home practice were identified by participants, in addition to a range of challenges that can frequently impede the benefits of home practice being reaped and warrant attention. Home practice may be currently underutilised and not consistently nurtured to support effective collaborative working with families. Technological solutions may offer a valuable aid to improve how home practice is construed, provided, monitored, evaluated, and enhanced.
The ‘thickened liquid challenge’, where for a period of time health care staff are encouraged to consume only thickened liquids, and subsequent challenges where participants consume only pureed food, have been popular on social media for many years. The #challenges have played a valuable role in highlighting the impact that thickened liquid and modified texture diets have on people. We suggest that recent posts on these challenges, however well-intentioned, show a shift from the original intention of encouraging staff to reflect on the appropriateness of their use. Some seek to promote empathy and awareness; some seem primarily performative. Encouraging staff to try such diets still has a role as a teaching tool for students or for those who doubt the impact of modified diets on intake of food or liquid or on quality of life. However, this should not be an end in itself. Use of modified diets remains unnecessarily high. The real challenge is changing current practice.
Background Let’s Grow Together! Infant & Childhood Partnerships (LGT) is a place-based prevention, promotion and intervention programme based in Cork city that supports early childhood development to mitigate the intergenerational impact of poverty. An innovative component of LGT is ‘Babbling Babies’ which offers parents an opportunity to meet a speech and language therapist (SLT) in coordination with their routine 9–11 month developmental check-up with a public health nurse (PHN). The programme explores how parents can support high-quality interaction opportunities to improve communication and early literacy in daily activities. Objective The aim of the study was to establish how feasible it is to measure the efficacy of the ‘ Babbling Babies’. This paper focuses on parental and practitioner views and experiences with the programme. Method A research protocol was co-designed with the LGT team to evaluate the programme. Interviews and focus groups were conducted with families and practitioners to gather their experiences and analysed using reflexive thematic analysis. Results Results indicated that parents found the programme to be acceptable, felt reassured by the information provided and felt empowered to promote their own child’s communication development. The practitioners also valued the programme and the opportunities to collaborate with each other, but indicated a number of structural and systemic barriers that affected successful implementation. Conclusions The programme was acceptable and feasible for families and practitioners and the outcomes will contribute to future research on early interventions aimed to address the inequalities of growing up in socially disadvantaged communities in Ireland.
Developmental disability is a universal issue, affecting millions of children, adolescents and families globally. Many children and young people will require access to and support from disability services. Development of such services has often been piecemeal and requiring reconfiguration, which is a complex process. The aim of this research was to evaluate the evidence-base underpinning the programme of disability reconfiguration in Ireland. A review of relevant policy documents highlighted limited analysis of research and practice evidence to inform policy development and implementation. Many challenges have arisen during reconfiguration such as lengthy waiting lists and high staff turnover. While there are plans in train to increase disability resourcing, it is contended that a root and branch review of the underlying policy is undertaken, with a focus on integrating best available research and practice evidence.
Speech and language therapists (SLTs) are generally aware of and skilled in managing ethical issues in providing services to individual clients and families. However they may struggle with ethical concerns as they strive to deliver the best possible services in the context of increasing caseload volume and complexity, changing models of service delivery, service restructures and changes in support and professional development. This paper overviews the language of ethics, approaches to ethics and ethical decision-making, as tools for SLTs to analyse, articulate and manage ethical concerns associated with changing services and professional supervision contexts, in order to advocate for their clients and services and demonstrate ethical leadership in their workplaces.
The aim of the paper is to facilitate speech and language therapists to reclaim agency and demonstrate ethical leadership as they advocate for their clients, services and profession. Building on the language of ethics introduced in the first of these two linked papers (anonymised for peer review), we apply the language of ethics to two hypothetical scenarios situated in childhood disability services in Ireland; we discuss three levels of ethical leadership: ethical leadership in, ethical leadership of and ethical leadership for. We argue that the use of an ethical approach may be valuable for the speech and language therapist, especially in a context of resource limitations. We hope that use of ethical approaches will facilitate speech and language therapists to embed ethical leadership in everyday practice and that the speech and language therapy community and service providers consider ethics more explicitly in service planning and delivery.
BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.
