Advances in Communication and Swallowing

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.

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.