SPHY602 - Advanced Speech Pathology Practice 2 Optimising Motor Speech and Voice Function

Year

Credit points

Campus offering

Prerequisites

HLSC632 Holistic Rehabilitation and Restoration 2 AND (SPHY603 Advanced Speech Pathology Practice 1 Optimising Swallowing Function OR SPHY604 Advanced Speech Pathology Practice 3 Optimising Language Function )

Teaching organisation

Unit rationale, description and aim

This unit provides post graduate speech pathology students with the opportunity to update and enhance theoretical and clinical knowledge and skills to a Master's level with the aim of optimizing motor, speech and voice rehabilitation for clients with rehabilitation or restorative needs. An enhanced understanding of the principles of motor learning, neural plasticity and underlying impairments will be developed. Practical components focus on current evidence-based assessment and intervention rationales and practices as well as enhancing and refining clinical skill s to optimize speech and voice function. Specifically, designed workplace activities present opportunities for speech pathologists to align theory and research through interpretation and translation of evidence based knowledge and skills to their practice. Within their clinical settings students can develop and apply their enhanced knowledge and skills and demonstrate critical analysis of motor speech and voice assessment, goal setting use of functional and collaborative rehabilitation person centred rehabilitation models and application of evidence based techniques.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate advanced knowledge and application of motor learning and neural plasticity principles to optimally implement rehabilitation programs with people with speech pathology disorders (GA 4, 5).

LO2 - Critically assess and analyse motor speech and voice problems associated with neurological clients to select, plan and implement evidence based interventions at an advanced practice level (GA3, 4, 5, 7)  

LO3 - Synthesise findings from advanced assessment and intervention skills to develop and demonstrate optimal management of neurological patients with motor speech or voice impairments (GA 3,4,5,6,7,8,9)

LO4 - Demonstrate proficiency in interpretative assessment and practical skill applications (GA5)

LO5 - Evaluate the role of advanced technology for people requiring rehabilitation and apply this information to the management of people requiring augmentative and alternative communication options (GA5, GA10)

LO6 - Reflect on the knowledge and experiential learning in the clinical setting to analyse the implications for the assessment and interventions for optimal development of motor, speech and voice rehabilitation and for your personal and professional growth as a speech pathologist (GA3,4,5,8)

Graduate attributes

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

GA10 - utilise information and communication and other relevant technologies effectively.

Content

Topics will include:

Motor skill rehabilitation 

• Principles of motor skill acquisition/ motor learning / repetition  / providing feedback  
• Intensity of practice – individualised programs for increasing functional recovery 
• principles underpinning intensity of practice (in common) 
• evidence of efficacy when applied with neurological patient groups.  
• Review of self-awareness and self-efficacy as a basis for goal setting with patients (OT / PT) 
• Considerations for motor skill rehabilitation in swallowing 
• Considerations for motor skill rehabilitation in speech and voice 

Motor Speech impairment in older adults and neurological disorders 

• Advanced review of the neurological basis for motor speech impairment
• Considerations for advanced management across the continuum of care
• Differential diagnosis of motor speech disorders
• Advanced assessment and goal formulation using the ICF framework
• Presentations of motor speech disorders in the neurological and aged population
• Critique of the evidence for treatment and rehabilitation of motor speech disorders 
• Barriers to implementation of the evidence
• Application of theory to practice: advanced cases (e.g, stroke, CHI, degenerative CNS disease) and within the clinical environment to:
• Develop speech pathology assessment 
• Set goals with the client utilising the ICF framework 
• Select evidence based interventions 
• Measure outcomes achieved 
• Provide a framework for critique of assessment / goal setting and monitoring outcomes

Voice disorders in older adults and neurological disorders 

• An advanced review of the neurological basis for voice impairment
• Considerations for management across the continuum of care – management principles
• Differential diagnosis of voice disorders: Presentations of voice disorders in the neurological and across the lifespan
• Advanced assessment and goal formulation for voice disorders
• Critique of the evidence for treatment and rehabilitation of voice disorders 
• Barriers to implementation of the evidence
• Apply this knowledge to speech pathology practice in a range of advanced cases (e.g., stroke, Parkinson’s Disease, myasthenia gravis, spasmodic dysphonia) and within the clinical environment to:
• Develop speech pathology assessment 
• Set goals with the client utilising the ICF framework 
• Select evidence based interventions 
• Measure outcomes achieved 
• Provide a framework for critique of assessment / goal setting and monitoring outcomes

Advanced technologies

• Technology in rehabilitation – using technology to enhance speech pathology outcomes 
• Augmentative and alternative communication devices (high tech): 
• Evidence base for use of high tech augmentative and alternative aids 
• Understanding the assessment process
• Understanding and evaluating the options
• Evaluation of outcomes for use of high tech aids 

Rehabilitation for Vocational and Leisure Activities 

• Principles of Vocational Rehabilitation/Study/ Engagement in Purposeful Occupations
• Steps towards return to work/ study following neurological injury; assessments, risks and rehabilitation
• Employment Law; support services to aid return to work and study.
• Maintaining study/employment; with deteriorating or chronic conditions
• Managing issues in the workplace or educational setting; communication, cognition, behaviour, fatigue, interpersonal relations.
• Purposeful activity e.g. volunteering.

Learning and teaching strategy and rationale

This unit is offered through multi-mode and online delivery for specific on and offshore cohorts. Both modes aim to facilitate learner centred activities and workplace learning. Learning and teaching strategies for this Masters level practicum unit are based on a blend of constructivism, social constructivism, and experiential learning within a framework of active participation within a community of inquiry.  Content and types of activities that are the same or similar for all participants regardless of the mode of delivery have been identified. This has led to the development of purposefully designed learning activities that are transferable and work well across both delivery mediums whilst maintaining the flexibility to create and deliver mode specific activities focusing on inquiry based learning principles aimed at encouraging critical thinking, application of knowledge and skills, evidence for practice, collaborative peer learning and self-reflection. 

Multi-mode delivery requires participation in a workshop providing underpinning knowledge and skills that are enhanced throughout the unit. Where possible, workshop activities are designed as reusable learning objects able to be provided online or modified slightly as required for current information and communication technologies for online delivery.  As required, for example in different time zones learning and teaching strategies will be adapted for online delivery for specific cohorts. In addition, students participate in individual and small group activities based on analysis of current practice, assimilation and application of enhanced knowledge leading to the development of tools to facilitate translation of learning into personal clinical practice. 

Assessment strategy and rationale

SPHY603 assessments have been purposefully designed to replicate authentic clinical practice. The unit’s assessments have also been designed from an “Assessment for Learning” approach in order to not only provide evidence for judgement of learning, but also to reinforce, facilitate and support learning and application of learning.  The assessment tools have been designed to provide for a broad range of tasks aligned to andragogic principles of adult learning, facilitating choice and self-direction for the post graduate student. In addition, the range of assessment activities encourage application of evidence to practice and embed clinical reasoning, problem solving and implementation of advanced knowledge and skills.  

The first assessment task provides students with the opportunity to demonstrate advanced and critical analysis of a case study and to identify and apply optimal evidence based interventions. The focus of the final two assessment items, is to reflect on personal and collaborative practice, and communicate reflections, evidence based reasoning and decision making, to management and peers.  In the second assessment task students will identify an evidence based intervention for implementation in their work setting. Students will outline the evidence gap, appraise the relevant evidence and apply to their work setting, and communicate the implementation plan for this evidence practice gap within their work setting. Assessment task 3 enables students to demonstrate the application of advanced skills in the delivery on an evidence based intervention with a client, their clinical reasoning and clinical decision making. 

These assessments incorporate the advanced level of professional knowledge and skills, enhanced critical analysis and professional presentation modes developed throughout the Master’s program. Scheduling of assessments will be equitable for both modes of delivery. Assessment tasks may be delivered and assessed locally with moderation according to University Policies and Procedures. All assessments will be submitted electronically.

Overview of assessments

Representative texts and references

Aronson, A & Bless, D (2009). Clinical Voice Disorders (4th Ed.). New York: Thieme. 616.8556 ARO

Carding P (2017) Evaluation the effectiveness of voice therapy: functional, organic and neurogenic voice disorders. 2nd Edition. Oxford Comptom Publishing.  616.8556 CAR 

Constantinescu, G, Theodoros, D, Russell, T, Ward, E, Wilson, S, & Wootton, R (2010). Assessing disordered speech and voice in Parkinson's disease: a telerehabilitation application. International Journal of Language and Communication Disorders, 45(6), 630-644. doi: 10.3109/13682820903470569 

Duffy, J (2013). Motor Speech Disorders: Subtrates, Differential Diagnosis, and Management (3rd ed). Elsevier: Canada. 

Elbaum, J, & Benson, D. (2007). Acquired Brain Injury: An Integrative Neuro-Rehabilitation Approach. New York: Springer New York. 

McCue, M, Fairman, A, & Pramuka, M (2010). Enhancing Quality of Life through Telerehabilitation. Physical Medicine and Rehabilitation Clinics of North America, 21(1), 195-205. doi: 10.1016/j.pmr.2009.07.005 

Murdoch, B (2010). Acquired Speech and Language Disorders: A Neuroanatomical and Functional Approach (2nd Ed.). United Kingdom: Wiley-Blackwell. 606.855 MUR

Sataloff, R (2005). Clinical assessment of voice. Plural Publishing: San Diego, CA.

Saywell, N, Vandal Alain, C, Brown, P, Hanger, H, Hale, L, Mudge, S,Taylor, D (2012). Telerehabilitation to improve outcomes for people with stroke: study protocol for a randomised controlled trial. Trials, 13(1), 233. 

Scherer, M (2011). Assistive Technologies and Other Supports for People With Brain Impairment. New York: Springer Publishing Company.  

Stemple, J, Glaze, L, & Klaben, B (2009). Clinical voice pathology: Theory and management (4th Ed.). Plural Publishing: San Diego,CA. 616.2 STE