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About me

I am a speech language pathologist and professor in speech language pathology, since Dec 2008 employed at the Department of Clinical Science, Intervention, and Technology/and Head of Division of Speech and Language Pathology at the Karolinska Institute (KI). The position is conjoint with the Clinical Department of Speech and Language Pathology at Karolinska University Hospital. Director of the Speech and Language Pathology Programme 2000-2008 at University of Gothenburg, and 2009 at KI. Since 2012 member of the Board of Higher Education at KI.

My clinical work, lecturing and research are within the field of cleft palate and related orofacial anomalies/dysfunctions. Graduated (KI) and worked as a speech pathologist from 1982, BA (GU) in Philosophy and Linguistics 1983, received my doctoral degree in Speech and Language Pathology from GU, 1996, associate professor 2003, and professor 2007.

Education

Teaching interests

Lecturers on speech development and disorders associated with cleft palate, early speech development and deviances, methods for speech assessment, course coordinator and supervises master’s theses and PhD students (Kristina Klintö, Jill Nyberg, Petra Petersson, Ann Malmenholt, and Anna Persson at KI, Ann Nordberg at GU).

Development of homepages for training and research within the area of cleft palate and speech disorders. PUMA-Cleft palate is a Swedish website with interactive activities for undergraduate students and clinicians. CLeft palate International SPeech Issue – CLISPI, is an international website originally developed via the Eurocran project, which can be of support the development of best practice for clinical work and research. It can also be used for calibration within research projects.

Research description

Research interests

Speech Development and Precursors for Speech Disorders in Individuals with Cleft Palate and other adverse conditions, Implications for Intervention, and Evaluation of Treatment

Speech development from babbling to speech in children with cleft palate and typically developing children is longitudinally investigated with the purpose to find predictors for the development of speech disorders. Impact of type and timing of palatal surgery (Scandcleft samt Timing of Primary Surgery in cleft palate, TOPS) and hearing impairment (Tidig Utveckling av Tal och Hörsel, TUTH) on the development is investigated. The purpose is also to identify and develop efficient intervention procedures (surgical, audiological, speech/communicative) in order to predict or minimize the impact of the structural defect of dysfunction on speech and the impact of speech deviances on communicative activity and participation. The area comprise:

1 )Speech development and speech and language disorders in individuals born with cleft palate, and the impact of surgical procedure & timing, and ear and hearing problems.

2) Early identification of individuals at risk for speech disorders related to cleft palate, hearing impairment or other adverse conditions.

3) Assessment methods: screening, documentation and analysis (perceptual, acoustic and physiological) including cross-linguistics aspects.

4) Treatment strategies for speech disorders

Aims of the projects are to

  • Describe the speech development and speech and communication disorders (babbling, speech and language characteristics, intelligibility, self-reported attitude to speech and communication) in individuals born with cleft lip and/or palate.
  • Develop methods for assessment of speech and communications disorders related to orofacial clefts and dysfunction.
  • Explore early precursors and prevention possibilities for later speech disorders in individuals with cleft lip and/or palate (surgical, audiological).
  • Develop treatment methods and strategies of persistent speech and communication disorders related to orofacial clefts and dysfunction.

Examples of current subprojects are

I. Effect of surgical strategy for primary palatal repair on speech outcome at age 5 years in children born with unilateral cleft lip and palate - the Scandcleft project: a prospective randomised trial.

II. Audiological characteristics of children with cleft lip and/or palate by cleft type and age and comparison with children without cleft lip and palate.

III. Relationship between speech production in babbling and in later speech years of age in children with and without cleft lip and palate.

IV. Development of a screening procedure for infants at risk for speech disorders.

V. Effectiveness of visual feedback from Electropalatography (EPG) on persistent articulation disorders and the effect on intelligibility.

VI. Development of early speech and hearing in babies born with cleft palate or without cleft palate but with early otitis media with effusion (TUTH – Tidig Utveckling av Tal och Hörsel)

Collaboration/Collaborators

Within two RCT projects with universities and hospitals in the Nordic countries, UK, and Brazil.

Associate professor Christina Persson, University of Gothenburg

Associate professor Elisabeth Willadsen, University of Copenhagen

Professor Fransisco Lacerda, University of Stockholm

Professor Gunvor Semb, University of Manchester

Professor Bill Shaw, University of Manchester

Professor Inge Trindade, University of Sao Paolo

* The Scandcleft-project – a prospective randomized multicenterstudy of the impact of method for operation of the cleft palate on speech, hearing, occlusion and growth in children born with unilateral cleft lip and palate. Leader of the Speech project. Participation of ten treament centres in Sweden, Finland, Norway, Denmark and the UK.

* Timing of Primary Surgery in infants with Cleft Palate (TOPS) – a prospective randomized multicenterstudy of the impact of method for operation of the cleft palate on speech and hearing in children born with isolated cleft palate. The study is financed by the NIH. Member of the team management group and the speech core group with a large number of participating cleft palate teams in Sweden, Norway, Denmark, The UK, and Brazil.

* Steering group member in the EuroCleftNet aiming for optimum treatment of orofacial clefting and prevention while building research capacity in collaboration with the World Health Organisation (WHO) the European Cleft Organisation (ECO) (2011-).

* Working group member in the Cleft lip and palate target condition for International Consortium for Health Outcomes Measurement ICHOM (2014-)

Professor Sara Howard, University of Sheffield, UK, Eds a book entitled Speech Production in Cleft Palate: Assessment and Intervention, Wiley Publ, UK, 2011.

Academic honours, awards and prizes

Received the pedagogical award "Pedalen" from the Medical Student Organisation (Medicinska föreningens i Göteborg pedagogiska pris).

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