Editor in chief: Luigi Marotta
Deputy Editors: Annagiulia De Cagno, Valeria Di Martino
Founded by
Adriana De Filippis
Periodicity: january, may, october

Vol. 15, n. 1, 2019

Table of Contents

Ricerca internazionale

Hazel Roddam

Il ragionamento clinico in logopedia

DOI: 10.14605/LOG1511901 | ISSN: 1825-6724

Questo breve articolo propone una riflessione su aspetti del ragionamento clinico che sono rilevanti per i Logopedisti e per tutti i professionisti coinvolti nell’ambito logopedico. L’articolo illustra brevemente quattro temi su cui riflettere: le sfide del ragionamento clinico in logopedia; i fattori che influenzano il nostro ragionamento clinico: le conoscenze che possiamo acquisire dalla variabilità che incontriamo nella nostra pratica clinica e la dimostrazione che la nostra percezione della evidence-based practice (EBP) sta cambiando ed evolvendo; le ricadute del nostro ragionamento clinico: che cosa sappiamo degli effetti che ha l’implementazione pratica delle evidenze di ricerca; gli approcci strategici per sostenere meglio il ragionamento clinico.

Gli attuali modelli di pratica basata sulle evidenze si fondano sul coinvolgimento di pazienti/utenti nelle decisioni che riguardano la loro assistenza sanitaria. Nel Regno Unito (UK), i regolamenti e la legislazione inerenti all’assistenza sanitaria richiedono al personale sanitario di fornire supporto al processo decisionale e, se necessario, di effettuare una valutazione delle capacità cognitive per verificare che gli utenti siano in grado di prendere decisioni informate. Le persone con disabilità comunicative possono avere delle difficoltà a comprendere, a pensare e a parlare delle decisioni e possono avere bisogno di supporto comunicativo. In questo articolo, vengono discusse le attuali sfide associate alla valutazione delle capacità cognitive e al processo decisionale supportato. Si suggerisce che i professionisti dell’assistenza sanitaria dovrebbero guardare al di là degli imperativi legali e procedurali per considerare le fondamenta etiche della propria pratica, quando affrontano queste sfide. Sono messi a confronto due approcci concettuali al ragionamento etico e si descrive una soluzione pratica alla sfida clinica: lo sviluppo del MCAST, un kit di strumenti per supportare staff multidisciplinari nella valutazione delle capacità cognitive e per fornire supporto agli utenti con disabilità cognitive durante il processo decisionale.

EtÀ evolutiva

Monica Panella

Preterm Infant: From NICU to Home

DOI: 10.14605/LOG1511903 | ISSN: 1825-6724

Preterm infant very often presents oral feeding difficulties. Early treatment, beginning from the permanence in NICU, is the tool of prevention and containment of difficulties. The speech and language pathologist is the reference figure in this path. The relief continuity in the return to the domicile and the follow-up in the strategic food stages represent a cornerstone point of the taking charge of preterm infant.

EtÀ evolutiva

Sara Panizzolo

The Speech Therapist in Neonatal Intensive Care Unit: Oral Feeding Management

DOI: 10.14605/LOG1511904 | ISSN: 1825-6724

The article aims to give an insight about the role of the speech therapist in the Neonatal Intensive Care Unit (NICU) as a health professional skilled in the rehabilitation for premature infants with difficulties in the transition from enteral nutrition to oral feeding.

EtÀ evolutiva

Emanuela Leone Sciabolazza Enrico Iurato Giovanni Masciarelli

When Speaking and Communication Do not Go Together. Case-Studies on Social (Pragmatic) Communication Disorder

DOI: 10.14605/LOG1511905 | ISSN: 1825-6724

In this series of three case studies, we transversely highlight the behavioral and cognitive phenotype of social communication disorder (pragmatic) at different ages. These cases come from a larger study that is still ongoing. In order to assess the cognitive profile of our patients, we carried out a comprehensive battery of neuropsychological tests, which also served to highlight every case’s cognitive and behavioral features and the core deficit in the theoretical framework of cognitive pragmatics. Considering results obtained and their interpretation, we developed a systematic intervention program called Communication and Pragmatic skill – training (CaPs-T). This programme brings togheter cognitive, emotional and social dimensions of patients with Social Communication Disorder (Pragmatic). CaPs-T is articulated to cover social-communicative and pragmatic competences over three age groups (preschool, primary school and adolescence) and in different domains of pragmatic competence.

EtÀ adulta

Anna Rita Dellomonaco Valentina Lavermicocca

Action Observation Therapy in Chronic Aphasic Patients: Applications in Speech and Language Therapy Clinical Practice

DOI: 10.14605/LOG1511906 | ISSN: 1825-6724

Mirror neurons have been largely studied, from their localization and activation to their function, giving an important contribute to neuroscience. Several evidences support Action Observation Therapy (AOT), an approach based on mirror neurons activation, used in addition to the traditional interventions in neuro-rehabilitation, concerning motor recovery in post-stroke patients. The studies about mutual influence between gestures and language and the wide presence of mirror neurons in the Broca’s area made it possible to hypothesize that using the AOT in the rehabilitation of aphasic patients’ communication could be useful. The aim of this study is the application of AOT techniques to improve communication effectiveness in chronic aphasic patients. Nine patients with chronic non-fluent aphasia underwent an intensive training, preceded and followed by the assessment of language and communication skills. The training lasted four consecutive weeks, four sessions per week of 30 minutes each. The videos showed, were realized respecting the essential characteristics to activate mirror neurons. The statistical analysis of the evaluation before and after training didn’t reach statistical significance, as the evaluation after the training and at the follow-up. The statistical analysis of the modification of communication effectiveness showed a significant variation. This study shows the potential of AOT in speech and language rehabilitation and highlights the fact that AOT could support the traditional interventions.

Logopedia e societÀ

Valentina Pasian Cristian Leorin

Assistive Technology and Innovation in Speech Therapy

DOI: 10.14605/LOG1511907 | ISSN: 1825-6724

Innovation technology and tools provided by Augmentative and Alternative Communication are pivotal in speech therapy, both with adults and with children. Speech therapists are at the centre of this process: nowadays they not only have to be prepared in their own scientific area, they also need to have technological skills, so that they can identify helpful devices for their patients. They also need to be able to adapt and use devices that were originally created for different purposes. The development of new technologies is a driving force in our world. Be it hardware or software, a physical object or a stream of information and data, technology surrounds us in our everyday lives and its use in the scientific and medical field have improved life quality and life expectancy for millions of people in the world.

Logopedia e societÀ

Giuseppe Mancini Donatella Tomaiuoli

Multiculturalism: Speech and Language Therapy Clinic for Migrants

DOI: 10.14605/LOG1511908 | ISSN: 1825-6724

The refugee crisis in Europe has highlighted many of the difficulties in creating appropriate services for vulnerable populations. Refugee adults and children suffer the adverse effects of forced migration which can lead to chronic disorders, if not treated. Many studies have shown that, though European governments and policy makers are aware of the specific difficulties encountered by the refugee population, medical and rehabilitation services often do not have a consistent and cohesive plan to operate the most effective programmes (when they do exist, are fragmented and poorly coordinated). Further barriers to treatment include cultural and communication difficulties, lack of access to intervention services, lack of continuity of care, as well as lack of empowerment on the part of the refugees themselves. Furthermore, most refugees are unfamiliar with Western mental health and rehabilitation services and their treatment expectations may be very different from services offered, leading to a lack of mutual understanding of the approaches used. The speech and language therapist as part of the multiprofessional team has a pivotal part to play in the development of refugee-competent services. As the stakeholder of communication and integration process, will attempt to sensitize first of all the SLTs, in their role in the development of appropriate service delivery, analyze the procedures, and outline the barriers to appropriate treatment, while attempting to offer some insights into ways in which these services may be improved from the SLT perspective.

Qualitative research studies and interprets social phenomena; for this reason, if applied to communication problems, it could offer a contribution to their better understanding and management. In line with the social psycho-social model and the anthropological concept of Kleinman’s disease, qualitative research allows to investigate the patient’s perception of the disease and the meaning attributed to it in an EBM perspective. The characteristics, the critical aspects and the relapses in the clinical logopedic practice related to the application are presented, drafting in collaboration with other professionals and even more, the possibility of drawing up specific guidelines in speech therapy. The most recent experiences are therefore presented (guidelines for speech therapy in the Parkinson disease of the Dutch Speech Therapy Association and the network speech therapy guidelines on stuttering of the Dutch Speech Therapy Association), in particular by making a comparison analysis between the Italian reality and what is proposed by the most recent logopedic guidelines.

Professione logopedista

Anna Accornero Giovanna Lovato Paola Sperindé

Advanced Speech Therapist Skill and Revision of Core Curriculum

DOI: 10.14605/LOG1511910 | ISSN: 1825-6724

The formation and construction of the cultural heritage of each individual is a moment of fundamental importance for living the existential reality, both personal and professional. There are many aspects to consider in the processes of learning ideas, concepts that manifest themselves through attitudes and acts on which man must constantly reflect for personal development to build and update his skills. Advanced skills of the speech pathologist are presented and analyzed, after having outlined the most recent historical and legislative context, inserting them with a precise criterio in the organization of the basic and post-base training paths.

Our communication acts are the vectors we use to transmit, thoughts, needs, emotions and relationships. This, in the field of speech therapy and not only, requires the ability to observe and listen, to be empathetic, flexible, creative but also competent, precise and meticulous, in order to identify, plan and guide the best therapeutic path for each individual patient. To this end, there are no absolute truths but the knowledge, skills, rules and attitudes shared by the international scientific and academic community, which must be able to build on the personal training path, so as to be modeled on the new specificities that will arise in the professional exercise. The rule is the skeleton of every therapy and every relationship and in the rule we find the fixed points to lean on to achieve one goal after another but in the imagination, in the intuition, in the adaptability of a path that rule can give us the better than himself. None of this can be effectively accomplished without a permanent training work that the speech therapist must perform on himself to refine and enhance his personal tools, which can be expressed through a conscious and competent use of his body self, both perceptive and communicative.

Professione logopedista

Daniele Rodriguez

Towards a Unitary Code of Ethics for the Healthcare Professions of the New Multiprofessional Order

DOI: 10.14605/LOG1511912 | ISSN: 1825-6724

The Law 11 January 2018 n. 3 has modified the discipline of the Orders of health professions and has introduced new rules on the deontological codification that belongs to the Orders. The Law n. 3 has created a new Order that includes the 19 professions that refer to the three different areas of rehabilitation, technical-health and prevention techniques. Among the complex questions concerning the institution of this new multi-professional Order, is that of the code of ethics: unique for the whole Order or a different code of ethics for each profession? Each of the pre-existing associations representing the various professions now part of the multi-professional Order, as well as the College of Medical Technicians of Medical Radiology, had developed its own deontological code. The analysis of the Law n. 3 highlights that the option to be privileged is that of a single code of ethics. Its layout would however involve some problems. The question of how to safeguard the autonomy and the identity of each of the 19 professions in the context of a unitary code of ethics is examined and some solutions are proposed. The topic of responsibility, considered, also in relation to the Law 8 March 2017 n. 24, in the double meaning of commitment in the interests of health of the person and of the susceptibility to respond from a disciplinary point of view in the case of reprehensible conduct is analyzed.