This prospective study was undertaken to assess the predictive value of esophageal insufflation on the acquisition of tracheoesophageal (TE) speech. Fourteen total laryngectomy patients were evaluated prior to tracheoesophageal puncture (TEP) using objective esophageal pressure measurements. These patients then were followed prospectively for 6 to 13 months. Speech was assessed at the time of prosthesis fitting, at 1 month, at less than 6 months, and at greater than 6 months post-TEP. No patient underwent pharyngeal myotomy. Pre-TEP esophageal insufflation pressure was associated (P = .065) with successful TE speech at the time of prosthesis fitting, but was not associated with successful TE speech acquisition after 6 months. This study's results suggest that patients with poor pre-TEP esophageal insufflation test results will usually obtain successful TE speech given adequate time and training, even without pharyngeal myotomy.

A prospective study was carried out to evaluate a new technique of pharyngeal repair following laryngectomy. The purpose of this study was to see whether satisfactory healing would occur if the pharyngeal constrictors were not sutured across the closure in the pharynx. If healing proved to be satisfactory the procedure might eliminate the need for primary or secondary myotomy or pharyngeal plexus neurectomy to facilitate tracheoesophageal speech. The results indicate that healing is as good in the group who did not have muscle closure as in those who did.

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The COVID-19 global pandemic has had large impacts on practice education opportunities for students enrolled in health professional courses. In response, educators and clinical supervisors have been required to change the ways in which pre-clinical and clinical education opportunities are delivered. This chapter presents several methods (tele-placement, tele-supervision, online simulated placements, and online facilitated reflective learning) which were adopted for occupational therapy students in response to the impacts of COVID-19 and provides practice examples implemented in Australia alongside lessons learned.

Recently, some attention has been focused on acquired stuttering, disfluencies that begin in adulthood. The nature of acquired stuttering differs in several respects from developmental stuttering. A case of acquired stuttering following drug overdose is presented and contrasted with previously reported cases. The case is noteworthy in that, while many characteristics of acquired stuttering are evidenced, several symptoms associated with developmental stuttering are also observed. The findings are discussed in terms of a possible link between developmental and acquired forms of stuttering.