JCPSLP Vol 19 No 2 2017 low res

57 / 64

Shaping innovative services: Reflecting on current and future practice
JCPSLP Volume 19, Number 2 2017 111
In world that is becoming increasingly linguistically and
culturally diverse, this is a really excellent read for clinicians
working with clients who stutter.
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: or jcpslpeditor@
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.
Around the journals