JCPSLP Vol 19 No 2 2017

Shaping innovative services: Reflecting on current and future practice

Around the journals

In world that is becoming increasingly linguistically and culturally diverse, this is a really excellent read for clinicians working with clients who stutter.

Cosyns, M., Einarsdóttir, J. T, & Van Borsel, J. (2015). Factors involved in the identification of stuttering severity in a foreign language . Clinical Linguistics and Phonetics , 29 (12), 909–921. Julia McCulloch This is a comprehensive study that examines the ability of a group of 19 members of the Stuttering Research and Education Network (STUREN) to accurately identify and rate stuttering severity in languages that are not their own. The group consists of 14 qualified clinicians and 5 Master of Speech Pathology students from 5 different European countries. The aims of the study were to ascertain: (a) how well clinicians can make reliable judgements about the presence of stuttering in languages other than their mother tongue, and (b) what factors may determine their ability to make such judgements. Outcomes were assessed according to the following independent variables: (a) the level of experience of the clinician, (b) the severity of stuttering in the sample, (c) the rater’s level of familiarity with the language in the sample, and (c) the genetic proximity of the language to the rater’s mother tongue. The results identified stuttering severity as being one of the most important factors in rating accuracy. Statistically significant differences were found between mild–moderate and severe stuttering suggesting that participants were able to rate severe stuttering much more accurately regardless of their level of experience and the genetic proximity of the language from their own. Consistent with the current literature was the finding that closeness of the language to the rater’s mother tongue also impacts accuracy of rating stuttering severity. All participants consistently found rating samples genetically close to their language much easier, and a direct correlation between accuracy and closeness for mild–moderate samples was also found for participants with at least 5 years’ experience in assessing stuttering. As the authors discuss, the study design is limited by the fact that all participants already knew the samples contained stuttering and thus these results must be applied very cautiously with regards to clinician ability to diagnose stuttering in other languages. In conclusion, this article highlights an important issue across the current literature regarding the problems in achieving consistency in clinician inter- and intra-rater reliability for rating samples in foreign languages. It advises that stuttering measurement training programs are needed to support clinicians in learning to rate more accurately.

Park, J. S., Oh, D. H., Chang, M. Y., & Kim, K. M. (2016). Effects of expiratory muscle strength training (EMST) on oropharyngeal dysphagia in subacute stroke patients: A randomised controlled trial . Journal of Oral Rehabilitation , 43 , 364–372. Kerstin Erfmann Park and colleagues investigated the effects of expiratory muscle strength training (EMST) – a training protocol to increase expiratory muscle strength by blowing against resistance – on stroke patients with oropharyngeal dysphagia. They evaluated the effects of EMST as an adjunct to traditional dysphagia therapy over four weeks. It is positive to note that the researchers used random allocation of patients into two groups: one with EMST and one with a placebo. They addressed potential biasing of results by blinding the examiner rating the video-fluoroscopy swallowing study to group allocation. However, the patient and the clinician providing the treatment were not blinded to group allocation. The authors did not describe which “traditional dysphagia treatment” was provided and if this treatment was the same for every patient or based on their underlying pathophysiology. Additionally, objective measures of hyoid bone displacement could give more insight into why the Penetration Aspiration Scale might have improved. Overall, their findings suggest positive effects of EMST on submental muscle group contraction and airway compromise. However, considering the comments above, more research is necessary to validate the effectiveness of EMST as an adjunctive treatment approach for dysphagia therapy. Calling for early career researchers! Are you regularly reading the literature about an area of speech pathology practice? Would you like some journal editorial experience to add to your resume? Why not consider contributing to the Journal of Clinical Practice in Speech-Language Pathology by reviewing new research articles in your area of expertise? For more information contact: chris.brebner@flinders.edu.au or jcpslpeditor@ gmail.com

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JCPSLP Volume 19, Number 2 2017

www.speechpathologyaustralia.org.au