Temporomandibular disorders (TMD) are currently viewed as an interrelated set of clinical conditions presenting with signs and symptoms in masticatory and related muscles of the head and neck, and the soft tissue and bony components of the temporomandibular joint. Epidemiologic and clinical studies of TMD confirm its status as a chronic pain problem. In this report we present results from a randomized clinical trial which compared, at 3- and 12-month follow-ups, the effects of usual TMD treatment on TMD pain and related physical and psychological variables with the effects of a cognitive-behavioral (CB) intervention delivered to small groups of patients before usual TMD treatment began. The purpose of this study was to determine whether a minimal CB intervention followed by dental TMD treatment enhanced the effects of usual clinical dental treatment. A second purpose of the study was to determine whether patients classified as high in somatization and psychosocial dysfunction would respond less favorably to this minimal intervention than would those low in somatization and dysfunction. Patients who participated in the CB intervention followed by usual treatment showed greater long-term decreases in reported pain level and pain interference in daily activities than did patients who received only usual treatment. The benefits of CB intervention were not seen when the CB and UT groups were compared at 3-month follow-up. During the 3-12-month follow-up interval, however, the UT group maintained essentially the same level of improvement in characteristic pain while the CB group continued to improve, as hypothesized. During this same follow-up interval, the CB group also showed a strong trend toward continued improvement in pain interference. Such effects were not observed for depression, somatization, or clinical measures of jaw range of motion. Additionally, as hypothesized, dysfunctional chronic pain patients did not appear to benefit from the brief CB intervention. Intent to treat analyses were also performed to assess generalizability of the results.

No abstract

Successful collaboration among speech and language therapists (SLTs) and teachers fosters the creation of communication friendly classrooms that maximize children's spoken and written language learning. However, these groups of professionals may have insufficient opportunity in their professional study to develop the shared knowledge, perceptions and attitudes required for effective collaboration. This study examined the knowledge and perceptions of student teachers and student SLTs in the areas of language concepts, junior school literacy curriculum, service delivery and professional collaboration. An online survey was completed by 58 student primary school teachers and 37 student SLTs in their final year of professional study. The results indicated that these groups possessed limited understanding of each other's expertise in literacy curriculum and spoken language concepts. Both groups demonstrated minimal knowledge of spoken-written language relationships and how SLTs can assist to develop children's orthographic knowledge. Participants demonstrated acceptance of indirect methods of classroom-based service delivery (e.g. SLT acting as a consultant) but were less accepting of direct methods of classroom-based service delivery (e.g. shared teaching). Both groups also reported minimal experience with SLTteacher collaboration during their pre-service education. The data suggest pre-service interprofessional education (IPE) with a focus on children's early literacy learning is warranted to prepare prospective SLTs and teachers for collaborative instruction that enhances children's communication.

No abstract

We investigated the relationship between somatic and psychological symptoms and pain reported during a clinical examination for 220 patients with chronic temporomandibular disorder (TMD) pain. The clinical examination involved palpation of the muscles of the face and neck, as well as intraoral sites and non-TMD-related placebo sites. A distinction was drawn between somatization--the tendency to report numerous somatic symptoms--and psychological distress manifested by report of numerous affective and cognitive symptoms. Somatization was assessed with the Somatization scale of the SCL-90-R; cognitive/affective distress was assessed with the non-somatic items of the Anxiety and Depression scales. Heightened somatization and high-intensity pain were strong predictors of widely dispersed muscle palpation pain during the clinical examination. High-somatization patients were 3 times more likely than low-somatization subjects to report having a painful placebo site. Pain dispersion was more closely linked to report of number of somatic symptoms than to report of affective and cognitive symptoms of psychological distress.