Speech Pathology Australia

Myofascial force transmission has been proposed as a mechanism by which mechanical stimuli applied to one body region can influence the behavior of distant segments through fascial continuity. The posterior spiral chain (PSC), linking the latissimus dorsi, thoracolumbar fascia, and contralateral gluteal region, has been described anatomically, but its functional relevance in vivo remains incompletely understood.A single-group pre-post experimental study was conducted on 73 healthy participants. Trunk rotation in the transverse plane was assessed using inertial digital goniometry under four conditions: two baseline assessments, isometric activation of the PSC via right hip abduction-external rotation, and post-stretching of the caudal segment of the PSC (right or left side, alternating allocation procedure). Left and right trunk rotation, total rotational range of motion (ROM), and rotational balance were analyzed.Baseline trunk rotation showed no lateral asymmetry and no sex-related differences. Isometric activation of the PSC induced a marked redistribution of trunk rotation, characterized by a significant increase in left rotation and a concomitant reduction in right rotation, with only a small reduction in total ROM. Stretching produced a partial rebalancing of the activation-induced asymmetry. While total ROM did not differ between stretching sides, rotational balance shifted toward the treated side, indicating a direction-specific effect.Modulation of myofascial tension along the posterior spiral chain alters trunk rotational patterns in vivo without increasing overall rotational amplitude. These findings support the functional relevance of the PSC and suggest that myofascial interventions may primarily act by redistributing available motion rather than by increasing total range of motion, with potential implications for the assessment and treatment of rotational dysfunctions.

Therapeutic magnetic fields are widely used in rehabilitation and physiotherapy for musculoskeletal and neurological conditions. However, their use in oncological patients has historically been approached with caution and is often considered contraindicated, despite limited clinical evidence supporting this concern. A systematic review was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE was searched for studies evaluating therapeutic magnetic fields in oncological populations. Studies were classified according to predefined research questions addressing oncological safety, supportive care during cancer treatment, and management of comorbidities. Study selection, data extraction, and qualitative synthesis were performed. A total of 3,841 records were identified. Only one randomized controlled trial specifically assessed oncological safety outcomes and found no evidence of disease progression, reduced survival, or impaired treatment response associated with magnetic field exposure. A larger body of heterogeneous evidence evaluated magnetic fields as supportive interventions during oncological treatments, particularly for chemotherapy-induced peripheral neuropathy, quality of life, and symptom burden. These studies reported improvements in neurotoxicity, patient-reported outcomes, and treatment tolerability, although methodological limitations were common. Evidence regarding pain management and rehabilitation in oncological remission was predominantly observational. Current evidence does not support the assumption that therapeutic magnetic fields are inherently harmful in oncological patients. While data on oncological safety remain limited, available studies do not indicate adverse oncological outcomes. Magnetic field therapy may represent a feasible supportive intervention for symptom management and rehabilitation in selected oncological populations. However, well-designed prospective trials are required to better define safety profiles, clinical efficacy, and appropriate indications.

ABSTRACTOver 5000 patients are newly diagnosed with Alopecia areata (AA) in Australia each year. AA severity varies from a single small patch to complete loss of scalp hair, body hair including eyelashes and eyebrows. Approximately 40% of affected individuals experience only a single patch and achieve spontaneous, complete and durable remission within 6 months (acute AA). A further 27% develop additional patches but still attain complete remission within 12 months (chronic AA). Chronic persistent AA (CPAA) is defined by an episode duration of > 12 months and occurs in approximately 33% of patients. Without systemic treatment, 55% of individuals with CPAA will have persistent multifocal relapsing and remitting disease, 30% will progress to alopecia totalis (AT) and 15% will ultimately develop alopecia universalis (AU). The physical disfigurement, unpredictable course, social isolation and rejection contribute to the psychological distress attributable to AA. A wide range of topical, intralesional and systemic agents used to treat AA were evaluated in the 2018 Australian expert consensus statement. In 2020, the international Alopecia Areata Consensus of Experts (ACE) publication stated that if reimbursed, Janus Kinase inhibitors (JAKi's) would be an ideal systemic treatment for adults with AA. TGA approval of baricitinib in 2023 and ritlecitinib in 2024 for severe AA is the first step on the pathway for these systemic medications to be reimbursed on the Australian Government Pharmaceutical Benefits Scheme (PBS). Reimbursement would significantly transform the Australian therapeutic landscape for AA. The purpose of this 2025 Update on the Australian Expert Consensus Statement on the treatment of chronic, moderate to severe AA is to augment the 2018 treatment algorithm to include these TGA‐approved medications and to address indications for initiation, continuation and dose titration of systemic JAKi treatment, appropriate choice of agent, satisfactory outcome measures and to provide guidance on when to discontinue successful or unsuccessful treatment.

Thirty-five years ago, the Lidcombe Program was introduced as a new evidence-based treatment for early stuttering. This milestone presents an opportunity to examine the Lidcombe Program and its relevance today. Four Lidcombe Program developers, together with 17 members of the Lidcombe Program Trainers Consortium, reflected on the program's historic origins, early reception, current status, and future direction. This review of the program explores its origins in the context of causal theories of stuttering and its place in the modern clinical context. We point out that the Lidcombe Program intervention process incorporates social and medical perspectives of childhood stuttering. Empirical knowledge about stuttering and its effects early in life are considered. We consider the evidence base supporting the Lidcombe Program and its implementation in the current international speech-language pathology community. We also consider future directions for the treatment.

Biallelic inactivating variants in ZNF142 underlie a clinically variable neurodevelopmental disorder. ZNF142 is a zinc-finger transcription factor with potential roles on chromatin organization, implying a possible association of ZNF142 loss of function with perturbed genome-wide DNA methylation (DNAm) pattern. We performed EPIC array-based methylation profiling of peripheral blood-derived DNA samples from 27 individuals with biallelic ZNF142 inactivating variants, together with 6 heterozygous carriers and 40 controls. A DNAm signature discovery pipeline was applied by using 440 controls for discovery and validation analyses, and a machine-learning model was trained to classify 8 individuals carrying ZNF142 variants of uncertain clinical significance. Analyses directed to explore the genome-wide DNAm landscape in affected individuals revealed 88 differentially methylated probes constituting the minimal informative set specific to ZNF142 loss of function. This reproducible pattern of DNAm changes involved regulatory regions of a small number of genes. The DNAm signature derived from peripheral blood allowed us to diagnose individuals carrying biallelic inactivating ZNF142 variants when applied to fibroblasts. Our findings provide evidence that biallelic loss-of-function ZNF142 variants result in a specific and robust DNAm signature. The identified DNAm pattern suggests occurrence of a methylation disturbance involving a small number of loci that appears to be shared by different cell lineages.

Background: Reduced mobility in patients who are critically ill is still a reality in many ICUs. This study aimed to investigate if the mobility level is associated with an extubation outcome in adult subjects. Methods: This was a prospective cohort study composed of adults who had undergone initial invasive mechanical ventilation for > 24 h and who were independently mobile before hospitalization. Subject progress was monitored from ICU admission to discharge. Data were collected daily from medical records and multidisciplinary teams by considering variables such as age, sex, body mass index, Simplified Acute Physiology Score III, type of ICU admission, comorbidities, sedation, use of vasoactive drugs, neuromuscular blockers, duration of mechanical ventilation, and ICU Mobility Scale. The primary outcome was the success of extubation. Results: ICU Mobility Scale values was not directly associated with extubation outcome. Older subjects demonstrated a reduced tendency for high ICU Mobility Scale values, as did those on prolonged usage of vasoactive drugs or mechanical ventilation. Subjects with higher ICU Mobility Scale values achieved successful extubation earlier, which suggests a link between mobility and faster extubation success. Conclusions: The level of mobility assessed 24 h after extubation was not associated with extubation success. The following characteristics were associated with a lower propensity to present a high ICU Mobility Scale value: older age, greater number of days of use of vasoactive drugs and mechanical ventilation. Subjects with higher levels of mobility had a successful extubation event earlier in the ICU course. Studies that assess mobility on a continuous basis would be more precise in identifying this association.

Research suggests various standardized assessment tools to collect and analyze the speech of the individual with cleft lip and/or palate (CLP). Despite the importance of developing an assessment framework for the growing CLP population, documentation on Bengali cleft speech is limited. This study aims to investigate the phonetic differences that happen in the speech sound production of 3 to 5-year-old Bengali-speaking CLP children in two different contexts: single word and sentence repetition. It also aims to evaluate the effects of these two speech assessment tools in those children’s phonological evaluation to identify the proper evaluation for CLP individuals. In total, 12 Bengali-speaking CLP children from 3 to 5 years old participated in each test. Thus, data has been collected from a sample of 24 with 79-word stimuli. Two types of speech materials were used: single-word naming and sentence repetition tasks. The samples were analyzed using narrow phonetic transcription for targeted speech items. The percentage of consonants correct (PCC), percentage of correct places (PCP), percentage of correct manners (PCM), as well as phonological simplification processes (PSP) were assessed from the samples. Results showed a range of word structures and place-manner features produced by CLP children in both tasks. Also, the PCC, PCP, PCM, and PSP results were considerably less accurate in the sentence repetition task, suggesting that the task may provide a more accurate assessment of the CLP population. Social Science Review, Vol. 40(2), December 2023 Page: 205-224

Background: Cochlear implants serve as a transformative solution for individuals with sensorineural hearing loss, particularly benefiting children aged 12-24 months with bilateral profound deafness who find little to no benefit from traditional hearing aids. This advanced auditory technology converts acoustic signals into electrical stimuli, directly stimulating the auditory nerve and thereby providing an essential hearing function. The determination of candidacy for cochlear implants is a collaborative process involving ENT specialists, audiologists, and speech and language pathologists. These devices significantly impact the lives of profoundly deaf individuals by offering a means to access sound and develop communication skills, crucial for their integration into a hearing world.
 Objective: To assess the awareness of health professionals about candidacy of cochlear implant.
 Methods: This cross-sectional study was meticulously designed, adhering to standardized protocols for data collection and analysis to enhance the reliability and validity of findings. The research unfolded in various government and private hospitals across Lahore, focusing on a specific cohort of health professionals—ENT specialists and speech and language pathologists. A total of 55 participants, both male and female, aged between 29 to 52 years, were systematically selected through non-probability convenience sampling. The assessment of awareness among these professionals regarding the candidacy for cochlear implants was conducted using a carefully structured pediatric checklist. This tool encompassed multiple items directly relating to the core candidacy criteria, ensuring a comprehensive evaluation of professional knowledge and awareness. The analysis was performed using statistical methods appropriate for cross-sectional data, aiming to draw meaningful insights from the responses collected.
 Results: The study's participant pool consisted of 24 ENT specialists (43.6%) and 31 speech and language pathologists (56.4%), highlighting a diverse representation of the field. Among these professionals, a significant discrepancy in awareness was observed. Those who had practical experience working in cochlear implant centers demonstrated a higher level of awareness, with nuanced understanding of both audiometric and speech-based candidacy criteria. Conversely, participants lacking this practical exposure showed considerable gaps in their knowledge, particularly in applying these criteria to pediatric cases. The numerical data revealed that only a fraction of the respondents could accurately identify all key candidacy indicators, underscoring the need for targeted educational interventions.
 Conclusion: The findings of this study underline a palpable deficiency in the awareness and understanding of cochlear implant candidacy criteria among ENT specialists and speech and language pathologists. Despite the critical role these professionals play in the identification and management of potential implant candidates, a notable portion exhibited limited knowledge, especially in aspects beyond their immediate field of expertise. This gap was more pronounced among those without direct experience in cochlear implant centers, suggesting that hands-on involvement significantly contributes to a deeper comprehension of candidacy nuances. Therefore, there is an urgent need for comprehensive training programs and continued professional development opportunities to bridge these knowledge gaps, ensuring that all children who could benefit from cochlear implants are accurately identified and referred.