Kerstin Johansson

I pursued my doctoral studies 2009-2013 under the supervision of assistant professor Ellika Schalling (KI), and co-supervisors professors Lena Hartelius (Gothenberg University, GU) and Sten Fredrikson (KI). My thesis includes works on voice and speech characteristics in multiple sclerosis (MS) and cervical spinal cord injury (CSCI), and effects of respiratory training such as glossopharyngeal breating in MS and CSCI, and Expiratory Muscle Strength Training (EMST) in MS.

Clinical Area 
In 2005, I received the Åke Ljundahlsstipendiet, Parkinsonförbundet.

I got my speech-language pathology (SLP) degree 1989 at the SLP program at GU.

1997-2020 I worked as a clinical SLP at Function Area Speech-Language Pathology at the Karolinska University Hospital, where my work focused on assessment and treatment of speech and swallowing in patients with neurological conditions, such as stroke, Parkinson's disease, MS, ALS,
Huntington's disease, and in frail patients, specifically elderly with cognitive disorders or dementia. 2010-2020 affiliatied to the division of speech-language pathology at the Department of Clinical Science, Intervention and Technology (CLINTEC) at the Karolinska Institutet.
Since 2020 full time adjunct lecturer and since 2022 Assistant lecturer, In teaching in the SLP curriculum at KI, in clinical supervision, and supervision of students' theses and master theses.

Teaching Area
Course coordinator of the course Dysphagia (7.5 credits) in the SLP program at KI. Supervisor in clinical training of SLP students, and of students' and master theses. IPL promotor and member of KI IPL working group. 
In 2021 och 2023 course coordinator for the freestanding course Intervention for elderly with dysphagia (7.5 credits). In 2002, 2006 and 2010 course coordinator for the freestanding course Fiberendoscopy in SLP practice (7.5 credits), KI, in collaboration with assistant professors Ellika Schalling (in 2010) and Gunilla Henningsson (in 2002).

Research Area

Swallowing difficulties in the elderly: identification, intervention and prevention.
In clinical research collaborations, projects are persued with the aim to reduce the risk for complications (malnutrition, dehydration, airway 
complications and reduced quality of life) of dysphagia in the elderly. The overarching aim of the project is improved methods for identification and diagnostics of dysphagia in the elderly and improved intervention and prevention for dysphagia in the healthcare. Several studies have been
planned within the project:

1) prevalence of dysphagia in elderly who visit a primary care central,  

2) patient experiences of dysphagia and patient-reported needs for intervention in elderly with dysphagia,

3) validation of a clinical instrument for speech and language pathologists – KIS2018v2 – for the quantification of dysphagia and aspiration,

4) design of a multilevel screening tool to detect mealtime problems in older people with dementia in the community or residing in nursing homes, and 

5) effects of different training methods for improved swallowing.

The benefit for the individual is improved health and quality of life, for the health care increased knowledge and safer routines, for society reduced costs. The studies are carried out partly within the curriculum of students’ theses and master theses at the division of speech and language pathology and re planned in collaboration mainly with Swedish researchers.

Speech after cervical spinal cord injury, CSCI. (resting project)
After my dissertation in November 2013 in-depth studies of voice and speech in relation to respiratory function in CSCI (together with assistant professor Anita McAllister, KI). Four studies are planned with the aim of providing a basis for SLP intervention in this patient group. The project has been undertaken in collaboration with professor Johan Sundberg at the Speech Music, and Hearing, Royal Institute of Technology, Stockholm. For study II, data has been collected in the respiratory laboratory of professor Mattias Heldner, Department of Linguistics, Stockholm University (SU).

Neuromotor speech disorders.
Together with assistant professor Ellika Schalling (KI) and professor Lena Hartelius (GU), surveys on self-perceived speech changes and services
provided following MS, PD and CSCI have been performed. The questionnaires used included questions on perceived symptoms related to speech and communication, experienced restrictions in communicative participation, and services received.
In collaboration with professor Lena Hartelius and the Region Västra Götaland (Angered Hospital and Skaraborg Hospital) a clinical project is running during 2019-20 with the aim to study the Effects of Exspiratory Muscle Strength Training (EMST) on voice, speech and swallowing in
Parkinson’s disease and Multiple Sclerosis (MS). EMST is a promising training method recently introduced in Sweden. Examples of documented effects on swallowing after EMST is a more efficient swallowing and a decrease in penetration and aspiration. A service evaluation of clinical experiences (K.Johansson, presentation at the National Conference of Logopedics, 2018) from the first years EMST has been offered in Sweden shows that the method is appreciated among patients. Also, compliance is high for patients who participate in EMST. The expiratory pressure (which reflects the strength in the exspiratory musculature) increases. Patients who have participated report positive effects such as reduced cough during meals, a generally more forceful cough and improved ”wind”. However, the effects of EMST on voice, speech and swallowing needs to be further evaluated, which is the aim of the above described project.

Supervised master projects

SLP Elin Littorin - NOSH dementia checklists

SLP Diana Kandic - GUSS  for dementia nursing home residents

SLP Ann-Sofie Eriksson - ALS dysphagia

SLP Emma Lindroos – Free from dysphagia?
SLP Jeanette Telford – Effects of contagious yawning on saliva production
and swallowing in adults with traumatic brain injury – a possible treatment
method
SLP Elisabet Östlund – Perception of pitch, identification of children's 
songs, and self-reported experiences of music in children with bilateral
cochlear implants