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Background: : Dysphagia is prevalent in subjects with Parkinson's disease (PD). Swallowing intervention to improve or maintain swallowing function is of major importance as dysphagia may considerably impact physical and psycho‐social health. Aims: : A mixed methods systematic review was conducted to summarize and appraise literature reporting (1) effects of behavioural interventions for swallowing in individuals with PD; and (2) participants' perspectives of swallowing interventions. Methods & Procedures: : Electronic databases were searched systematically in July 2020 for articles published between 2014 and 2020. In addition, studies published between 2000 and 2014 were identified non‐systematically through previous reviews. Peer‐reviewed quantitative and qualitative research in English or German documenting behavioural interventions for swallowing in individuals with a diagnosis of PD was eligible for inclusion. Participants at all disease stages were included. Behavioural interventions included rehabilitative and compensatory strategies. Studies reporting swallowing outcomes with and without a comparative group were included. For each study, the National Health and Medical Research Council level of evidence was defined. Included studies were critically appraised using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. An integrated synthesis was performed after separate analysis of effect data and data reflecting participants' experiences. This review was conducted based on published JBI methodology and the guideline from the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis system was followed. Main Contribution: : A total of 33 studies published in English met the inclusion criteria. Thirty‐one studies reported quantitative data, one was qualitative and one was mixed methods. Intervention effects on swallowing function, swallowing safety and swallowing‐related quality of life were reported for various treatment approaches. Three studies explored how participants perceived the intervention. Overriding themes including subjects' views regarding treatment schedules and levels of effort or comfort associated with the intervention were identified across these studies. Combining evidence of intervention effects and subjects' experiences was possible for one rehabilitative and one compensatory intervention. Conclusions & Implications: : Beneficial effects of swallowing interventions have been reported; however, most experiments were case studies of variable methodological quality. Randomized‐controlled trials with robust methodology to explore treatment effects in larger samples is needed to guide clinical practice. Research reporting subjects' views is scarce. More studies exploring how individuals perceive behavioural interventions for swallowing are necessary to inform clinical decision‐making. WHAT THIS PAPER ADDS: What is already known on the subject: Dysphagia is common in individuals with PD. Swallowing intervention is of major importance as dysphagia may negatively affect physical and psycho‐social health of subjects with PD. What this study adds: Beneficial effects of behavioural interventions for swallowing, including rehabilitative and compensatory strategies, have been reported; however, available data are mostly based on case studies of variable quality. Data on how participants perceive specific behavioural interventions are lacking. Based on the available data, integration of efficacy data and individuals' experiences is limited. What are the clinical implications of this work?: Given the current evidence of intervention effects and individuals' views on behavioural treatment strategies, interventions implemented into clinical practice require careful evaluation on a case‐by‐case basis. More high‐quality research is needed to examine interventions' short‐ and long‐term effects in larger samples to guide clinical practice. In addition to studies evaluating intervention effects, research exploring participants' experiences with interventions is required as a foundation for clinical decision‐making. [ABSTRACT FROM AUTHOR]

Background: Contemporary clinical and empirical perspectives indicate that management of the psychosocial features of stuttering is fundamental for effective treatment. Interventions that improve psychosocial outcomes for school‐age children who stutter are, therefore, needed. Aims: This systematic review identifies what psychosocial outcomes have been explored in existing school‐age clinical research, the measures used and the potential treatment effects. This will provide guidance for developing interventions that reflect contemporary perspectives of stuttering management. Methods & Procedures: A total of 14 databases and three conference proceedings were searched for clinical reports of psychosocial outcomes of children aged 6–12 years. The review did not include pharmacological interventions. Psychosocial measures and outcomes were analysed in each study based on data recorded pre‐treatment, immediately post‐treatment and for any follow‐up assessments. Main Contributions: Of the 4051 studies identified from the databases, a total of 22 studies met criteria for inclusion in the review. From these 22 studies, the review identified four prominent psychosocial domains that have been explored in school‐age clinical research to date: Impact of stuttering, communication attitude, anxiety and speech satisfaction. These domains vary in measurement and effect sizes. Two behavioural treatments were associated with anxiety reduction, even though they did not contain anxiolytic procedures. No evidence of potential treatment effects emerged for communication attitudes. Quality of life—an important psychosocial domain pertinent to health economics—did not feature in school‐age clinical reports. Conclusions & Implications: The psychosocial features of stuttering need to be managed during the school years. Three psychosocial domains—impact of stuttering, anxiety and speech satisfaction—show evidence of potential treatment effects. This review provides direction for future clinical research so that speech–language pathologists can effectively and holistically manage school‐age children who stutter. What this paper adds: What is already known on the subject: Elevated levels of anxiety are apparent for children and adolescents who stutter. Therefore, the need to assess and manage psychosocial features of stuttering are expertly regarded as clinical priorities. Clinical trials of such psychosocial features of stuttering for children aged 6−12 years are not well advanced and, therefore, do not reflect current best practice management of this disorder. What this study adds to existing knowledge: This systematic review identifies four different psychosocial domains measured and reported in the literature for school‐age stuttering management. For three psychosocial domains, some evidence of potential treatment effects emerged with participant numbers greater than 10: Impact of stuttering, anxiety and speech satisfaction. Though treatment effect sizes varied, there is a suggestion that cognitive behaviour therapy can improve anxiety of school‐age children who stutter. There is also suggestion that two other behavioural treatments can improve anxiety of school‐age children who stutter. What are the potential or actual clinical implications of this work?: Given the essential need for school‐age children who stutter to receive management of any speech‐related anxiety they may experience, it would be productive to discover in future clinical research what interventions could contribute to that goal—behavioural or psychosocial, or both. This review reveals that cognitive behaviour therapy, and other behavioural treatments, are associated with anxiety reductions. Such approaches should be considered for future clinical trial research to help advance the evidence base for managing school‐age stuttering. [ABSTRACT FROM AUTHOR]

Background: Debilitating speech and communication changes in Parkinson's disease (PD) lead to diminished quality of life for people with PD and their communication partners. Maintenance of the long‐term effects of treatment such as LSVT LOUD® remains equivocal. Development of supported long‐term maintenance programs is warranted. Aims: This article describes the development and preliminary outcome data for PD Check‐In, a supported self‐management intervention for the maintenance of speech and social communication for people with PD following LSVT LOUD. Methods & Procedures: A narrative literature review of the principles of self‐management and social cognitive theory of self‐regulation was conducted to develop the core elements of PD Check‐In. PD Check‐In was conducted in person by a speech and language therapist (SLT) for three participants at 6 and 12 weeks, and at 6, 12 and 24 months following LSVT LOUD. Outcome measures included vocal intensity (SPL) during monologue and the dysarthria impact profile (DIP). PD Check‐In utilized semi‐structured discussion to develop, evaluate, and support the self‐efficacy and skill of the person with PD in maintaining speech and social communication. Outcomes & Results: Six conceptual elements of PD Check‐In were identified in the development phase: partnerships, self‐reflection, maintenance issues, revision, goal‐setting and maintenance strategies. Preliminary intervention data revealed monologue vocal intensity at 24 months post‐LSVT LOUD was maintained above pre‐treatment level, but below levels achieved post‐treatment. The psychosocial impact of speech changes from pre‐LSVT LOUD to 24 months post‐treatment as measured by the DIP was variable. Qualitative statements reflected participant experiences underlying the clinical data. Conclusions & Implications: The theoretical and practical underpinnings of PD Check‐In were defined. The impact of PD Check‐In on three persons with PD was variable but positive. Further evaluation of the model is warranted. What this paper adds: What is already known on the subject: LSVT LOUD provides efficacious treatment for the speech disorder associated with PD. Long‐term maintenance of speech post‐treatment varies following self‐managed and group therapy interventions. People with PD have an unmet expectation of long‐term maintenance of speech and improved quality of life following intensive treatment. What this paper adds to existing knowledge: This study describes the development of a novel clinic‐based approach to long‐term maintenance of speech in PD based on the principles of self‐management and self‐efficacy. It provides preliminary data to demonstrate the method and its effects on three participants with varying speech difficulty, self‐management skill development and psychosocial impact. What are the potential or actual clinical implications of this work?: The positive impact of PD Check‐In on the maintenance of monologue vocal intensity above baseline 24 months post‐intensive treatment was independent of the variable impact on the quality of life of the participants. Further exploration of PD Check‐In is warranted to determine the efficacy of this approach. [ABSTRACT FROM AUTHOR]