Melanie Kirmess

• Ingebretsen, Silje Merethe Hansen; Stubberud, Jan Egil & Kirmess, Melanie (2024). Family members’ and friends’ reports after standard and intensive group treatment for social communication difficulties following acquired brain injury–a mixed method approach. Brain Injury. ISSN 0269-9052. s. 1–12. doi: 10.1080/02699052.2024.2311345.
• Yggeseth, Tonje; Kirmess, Melanie; Stubberud, Jan Egil & Ingebretsen, Silje Merethe Hansen (2023). Kognitive kommunikasjonsvansker etter ervervet hjerneskade. Evaluering og normering av kartleggingsverktøyet La Trobe Communication Questionnaire (LCQ) – Norsk versjon. Norsk tidsskrift for logopedi. ISSN 0332-7256. 69(3), s. 8–21. Fulltekst i vitenarkiv Vis sammendrag

  En stor andel personer med ervervet hjerneskade opplever endringer i kommunikasjon og kognitive ferdigheter. Til tross for dette, finnes det få evidensbaserte kartleggingsverktøy for personer med kognitive kommunikasjonsvansker i Norge. Denne artikkelen vil derfor presentere evalueringen og normeringen av den norske versjonen av kartleggingsverktøyet La Trobe Communication Questionnaire (LCQ).

• Dignam, Jade K.; Harvey, Sam; Monnelly, Katie; Dipper, Lucy; Hoover, Elizabeth & Kirmess, Melanie [Vis alle 10 forfattere av denne artikkelen] (2023). Development of an evidence-based aphasia therapy implementation tool: an international survey of speech pathologists’ access to and use of aphasia therapy resources. Aphasiology. ISSN 0268-7038. doi: 10.1080/02687038.2023.2253994. Fulltekst i vitenarkiv Vis sammendrag

  ABSTRACT Background: Speech and language therapy can reduce the level of impairment and disability caused by aphasia (Brady et al., 2016). Selecting a therapy can be challenging for clinicians who may struggle to stay abreast of the best evidence to support therapy selection (Rose et al., 2014). Once a therapy is selected, accessing relevant resources is a significant barrier to implementation (Shrubsole et al., 2019). The Aphasia Therapy Finder (ATF) is proposed to be an online repository of therapy resources designed to aid selection of evidence-based aphasia therapies and to bridge the evidence-practice gap in aphasia rehabilitation. Aims: In this study, we aimed to explore speech pathologists’ selection and use of aphasia therapy approaches, and access to aphasia therapy resources in clinical practice. We further aimed to explore speech pathologists’ perspectives on the proposed ATF. Methods & Procedures: A cross-sectional, mixed-methods, survey design was employed. A 22-item web-based survey was developed and disseminated to speech pathologists via professional networks internationally. Data analyses included descriptive statistics and conventional content analysis. Outcomes & Results: Eligible responses from 176 speech-pathologists across 19 countries were included in the analyses (86.3% completion rate). Speech pathologists reported using a range of therapy approaches (n = 43) in aphasia rehabilitation, consistent with previous findings (Rose et al., 2014). Information regarding new therapy approaches was predominantly obtained from academic sources including conferences, research literature, and professional development workshops. Speech pathologists placed high importance on research evidence when selecting therapy approaches. Resource limitations, including time and budget constraints, were identified as key barriers to implementing evidence-based aphasia therapy approaches in clinical practice. There was strong support for development of the ATF; 91.7% of respondents indicated they would use it in clinical practice. Recency of research, equity of access with the inclusion of linguistically and culturally diverse resources, and usability of resources were identified as priorities when developing the ATF. Conclusions: While speech pathologists report using a range of aphasia therapy approaches in clinical practice and consider research evidence when selecting therapy approaches, resource limitations continue to present a barrier to the implementation of evidence-based practice. The development of the ATF may support the translation of research evidence into clinical practice.

• Kirmess, Melanie; Guttormsen, Linn Stokke; Hofslundsengen, Hilde Christine; Næss, Kari-Anne Bottegård & Kefalianos, Elaina (2023). Norwegian speech-language pathologists treatment practices for preschool children who stutter: An explorative study. Journal of Fluency Disorders. ISSN 0094-730X. 77. doi: 10.1016/j.jfludis.2023.105999. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: This study investigated the treatment practices of speech-language pathologists (SLPs) with preschool children who stutter to explore variations in service delivery and, consequently to better inform and support evidence-based practice. Method: 121 Norwegian SLPs completed an online survey about stuttering treatment for preschool children aged up to six years. They reported on treatment training, choices, setting, dosage, and outcomes. Data was analysed descriptively. Correlation analyses between years of clinical experience and clinician perceived outcomes were conducted. Result: Sixty-eight percent of SLPs were trained in one or more stuttering treatment programs. The majority of SLPs (83 %) provided treatment in person in preschool centers; 59 % reported providing treatment once a week. Thirty-four percent of SLPs reported that they often or always delivered the whole treatment program. Treatment practice addressed various elements, including advising parents about language and communication strategies, supporting the child’s self-image, and perceived outcomes. The SLPs reported their clinician perceived outcomes as ‘always’ or ‘often’ reduction of audible stuttering (70 %), reduced cognitive and emotional reactions (55 %), and improved communication skills (58 %). Factors influencing treatment choices were identified at the systemic level (e.g., work place regulations) and individual level (e.g., SLPs competency, child’s best). Conclusion: Stuttering treatment services in Norway differ from those reported in existing literature as treatment is given in preschool settings, only 34 % of SLPs deliver programs as intended whilst the majority use treatment elements only, and still experience positive changes. Provision is variable, and seems influenced by SLP training and competence.

• Ingebretsen, Silje Merethe Hansen; Kirmess, Melanie; Småstuen, Milada Cvancarova; Hawley, Lenore; Newman, Jody & Stubberud, Jan Egil (2023). Rehabilitation of Social Communication Skills in Patients With Acquired Brain Injury With Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. ISSN 0003-9993. 104(7), s. 1016–1025. doi: 10.1016/j.apmr.2023.02.023. Vis sammendrag

  Objective: To determine the efficacy of group interactive structured treatment (standard GIST) for improving social communication difficulties in a wider acquired brain injury (ABI) population compared to a waitlist control (WL). Secondary objectives were to (a) explore GIST across delivery formats by comparing the results to an intensive inpatient version of GIST (intensive GIST) and (b) compare the within-subject results for WL and intensive GIST. Design: Randomized controlled trial with WL and repeated measures (pre- and posttraining, 3- and 6-month follow-ups). Setting: Community and rehabilitation hospital. Participants: Forty-nine persons (27-74 years) with ABI and social communication difficulties (26.5% traumatic brain injury, 44.9% stroke, 28.6% other), minimum 12 months postinjury. Intervention: Standard GIST (n=24) consisted of 12 weekly outpatient interactive group sessions (2.5 hours/session) and follow-up. Intensive GIST (n=18) consisted of 4 weeks with daily 4-hour inpatient group sessions (2 £ 3 d/wk, 2 £ 4 d/wk) and follow-up. Main Outcome Measures: La Trobe Questionnaire, a self-report questionnaire measuring social communication. Secondary measures: Social Communication Skills Questionnaire−Adapted, Goal Attainment Scale, Mind in the Eyes test, and questionnaires addressing mental and cognitive health, self-efficacy, and quality of life. Results: When comparing the standard GIST and WL results, a trend of improvement was found for the main outcome, La Trobe Questionnaire, and a statistically significant improvement was found for the secondary outcome Social Communication Skills Questionnaire−Adapted. Comparing standard GIST and intensive GIST, improvement in social communication skills after both treatments was detected and maintained at 6-month follow-up. No statistically significant difference was found between groups. Goal attainment was achieved and maintained during follow-up for both standard and intensive GIST.

• Kefalianos, Elaina; Guttormsen, Linn Stokke; Hansen, Elisabeth Holm; Hofslundsengen, Hilde Christine; Næss, Kari-Anne Bottegård & Antypas, Konstantinos [Vis alle 7 forfattere av denne artikkelen] (2022). Early Childhood Professionals' Management of Young Children Who Stutter: A Cross-Sectional Study. American Journal of Speech-Language Pathology. ISSN 1058-0360. 31(2), s. 923–941. doi: 10.1044/2021_AJSLP-21-00148. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Early childhood professionals must accurately identify, refer, and treat children who stutter (CWS) within the scope of their respective roles to ensure each child receives the best possible care. This study aimed to investigate similarities and differences between the practices of speech-language pathologists (SLPs), preschool teachers, and public health nurses when they initially meet a young child reported as stuttering. Method: This cross-sectional study was conducted in Norway. A sample of 342 early childhood professionals (126 preschool teachers, 95 public health nurses, and 121 SLPs) completed an online survey about their management practices with young children reported as stuttering. Descriptive statistics, ordinal regression, and chi-square analyses were used to analyze data. Results: Initial management practices reflected the different roles and competencies of each profession. Less than 15% of SLPs reported they have access to guidelines for working with CWS. This figure was even lower for public health nurses (6.5%) and preschool teachers (12%). The most common recommendations provided to parents by all professions was giving the child time to talk and maintaining eye contact. Each profession's referral for further speech-language pathology management was most commonly influenced by stuttering severity. All professions reported collaborating about management of CWS; the most common reported collaboration was with preschool teachers. Conclusions: Initial management practices varied between professions; however, differences largely reflected the roles and competencies of each profession. The development of guidelines and interdisciplinary seminars is recommended to develop a more complementary approach across professions to improve management practices and ensure young CWS receive the best possible care.

• Hofslundsengen, Hilde Christine; Kirmess, Melanie; Guttormsen, Linn Stokke; Næss, Kari-Anne Bottegård & Kefalianos, Elaina (2021). Systematic review of implementation quality of non-pharmacological stuttering intervention trials for children and adolescents. Journal of Fluency Disorders. ISSN 0094-730X. 71. doi: 10.1016/j.jfludis.2021.105884. Fulltekst i vitenarkiv Vis sammendrag

  Purpose This narrative systematic review in line with PRISMA guidelines aims to investigate the implementation quality of previously published group comparison clinical trials of stuttering interventions for children and adolescents (under age 18 years). Methods We searched for publications in the databases Eric, PsychInfo, PubMed and Web of Science using the search terms ‘stutt*’ or ‘stamm*’and ‘intervention’, ‘trial’ or ‘treatment’. We reviewed the implementation elements reported in studies and how these elements were used to report intervention outcomes. Results 3,017 references published between 1974–2019 were identified. All references were screened for eligibility using predefined selection criteria resulting in 21 included studies. The implementation quality details reported varied between studies. Existing studies most commonly lacked details about the support system provided to SLPs administering the interventions and monitoring of treatment fidelity both in the clinical setting and in the home environment. Support systems for participant’s parents and treatment dosage were generally well reported. Dosage was the most common implementation quality element considered in analyses of treatment effect and within discussions of findings. Conclusion Findings highlight the need for future clinical trials of stuttering interventions to closely adhere to systematic guidelines for reporting implementation quality to ensure reliability of trial outcomes. A checklist for reporting clinical trials of non-pharmacological stuttering interventions is proposed.

• Sjøstrand, Åse; Kefalianos, Elaina; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Kirmess, Melanie & Lervåg, Arne [Vis alle 8 forfattere av denne artikkelen] (2021). Non-pharmacological interventions for stuttering in children six years and younger. Cochrane Database of Systematic Reviews. ISSN 1469-493X. 2021(9), s. 1–63. doi: 10.1002/14651858.CD013489.pub2. Fulltekst i vitenarkiv
• Dipper, Lucy T.; Franklin, S.; de Aguiar, V.; Baumgaertner, A; Brady, Marian C. & Best, Wendy [Vis alle 20 forfattere av denne artikkelen] (2021). An Umbrella Review of Aphasia Intervention descriPtion In Research: the AsPIRE project. Aphasiology. ISSN 0268-7038. doi: 10.1080/02687038.2020.1852001. Fulltekst i vitenarkiv
• Sønsterud, Hilda; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud; Kirmess, Melanie & Ward, David (2020). What works for whom? Multidimensional individualized stuttering therapy (MIST). Journal of Communication Disorders. ISSN 0021-9924. 88:106052, s. 1–20. doi: 10.1016/j.jcomdis.2020.106052. Fulltekst i vitenarkiv
• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Sørli, Hilde & Becker, Frank (2020). Technical Features, Feasibility, and Acceptability of Augmented Telerehabilitation in Post-stroke Aphasia—Experiences From a Randomized Controlled Trial. Frontiers in Neurology. ISSN 1664-2295. 11(671). doi: 10.3389/fneur.2020.00671. Fulltekst i vitenarkiv
• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Partee, Iselin Anne Cecilia; Hognestad, Randi Bjor & Johannessen, Beate Bertheau [Vis alle 8 forfattere av denne artikkelen] (2020). The effect of augmented speech-language therapy delivered by telerehabilitation on post stroke aphasia – a pilot randomized controlled trial. Clinical Rehabilitation. ISSN 0269-2155. 34(3), s. 369–381. doi: 10.1177/0269215519896616. Fulltekst i vitenarkiv
• Rivelsrud, Maribeth Caya; Kirmess, Melanie & Hartelius, Lena (2019). Cultural adaptation and validation of the Norwegian version of the swallowing quality of life questionnaire (SWAL-QOL). Health and Quality of Life Outcomes. ISSN 1477-7525. 17(1), s. 1–11. doi: 10.1186/s12955-019-1248-0. Fulltekst i vitenarkiv
• Sønsterud, Hilda; Feragen, Kristin Judith Billaud; Kirmess, Melanie; Halvorsen, Margrethe S. & Ward, David (2019). What do people search for in stuttering therapy: Personal goal-setting as a gold standard? Journal of Communication Disorders. ISSN 0021-9924. s. 1–15. doi: 10.1016/j.jcomdis.2019.105944. Fulltekst i vitenarkiv
• Hansen, Silje Merethe; Hjertstedt, Marianne; Kirmess, Melanie; Snekkevik, Hildegun & Stubberud, Jan (2019). Intensiv gruppebehandling for personer med sosiale kommunikasjonsvansker : en pilotstudie . Norsk tidsskrift for logopedi. ISSN 0332-7256. 65(2), s. 24–34. Fulltekst i vitenarkiv
• Hansen, Silje Merethe; Stubberud, Jan; Hjertstedt, Marianne & Kirmess, Melanie (2019). Intensive and standard group-based treatment for persons with social communication difficulties after an acquired brain injury: Study protocol for a randomised controlled trial. BMJ Open. ISSN 2044-6055. 9(9). doi: 10.1136/bmjopen-2019-029392. Fulltekst i vitenarkiv
• Sønsterud, Hilda; Kirmess, Melanie; Howells, Kirsten; Ward, David; Feragen, Kristin Judith Billaud & Halvorsen, Margrethe S. (2019). The working alliance in stuttering treatment: a neglected variable? International journal of language and communication disorders. ISSN 1368-2822. s. 1–14. doi: 10.1111/1460-6984.12465. Fulltekst i vitenarkiv
• Nordbø, Bodil; Sønsterud, Hilda & Kirmess, Melanie (2018). Norske normer for OASES-A – et kartleggingsverktøy for voksne som stammer. Norsk tidsskrift for logopedi. ISSN 0332-7256. 64(3), s. 12–19. Fulltekst i vitenarkiv
• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Winsnes, Ingvild Elisabeth; Hansen, Silje Merethe & Becker, Frank (2018). Telerehabilitation for aphasia - Protocol of a pragmatic, exploratory, pilot randomized controlled trial. Trials. ISSN 1745-6215. 19(208). doi: 10.1186/s13063-018-2588-5. Fulltekst i vitenarkiv
• Kirmess, Melanie (2015). Constraint induced språkterapi - en praktisk guide for implementering av metoden i afasirehabilitering i Norge. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(1), s. 26–33.
• Becker, Frank; Kirmess, Melanie; Tornås, Sveinung & Løvstad, Marianne (2014). A description of cognitive rehabilitation at Sunnaas Rehabilitation Hospital - Balancing comprehensive holistic rehabilitation and retraining of specific functional domains. NeuroRehabilitation (Reading, MA). ISSN 1053-8135. 34(1), s. 87–100. doi: 10.3233/NRE-131015.

Se alle arbeider i Cristin

• Berg, Karianne; Hofslundsengen, Hilde Christine & Kirmess, Melanie (2024). Tverrfaglig samarbeid rundt stamming i barnehagealder.
• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C & Becker, Frank (2023). Telerehabilitation for post-stroke aphasia - Results and experience from a randomised controlled trial on speech-language therapy by videoconference .
• Brady, Marian C.; Partee, Iselin Anne Cecilia; Becker, Frank & Kirmess, Melanie (2023). Telerehabilitation for post-stroke aphasia – results and experience from a randomised controlled trial on speech-language therapy by videoconference .
• Brady, Marian C.; Partee, Iselin Anne Cecilia; Becker, Frank & Kirmess, Melanie (2023). Telerehabilitation for post-stroke aphasia – results and experience from a randomised controlled trial on speech-language therapy by videoconference .
• Kirmess, Melanie & Ingebretsen, Silje Merethe Hansen (2023). Referat: Disputas Maribeth Rivelsrud. Norsk tidsskrift for logopedi. ISSN 0332-7256. 69(3), s. 44–45.
• Næss, Kari-Anne Bottegård; Sjøstrand, Åse; Guttormsen, Linn Stokke; Melle, Ane Hestmann; Hoff, Karoline & Hofslundsengen, Hilde Christine [Vis alle 8 forfattere av denne artikkelen] (2022). Common Component Treatment Program.
• Kirmess, Melanie & Holm Hansen, Elisabeth (2021). Norsk publisering: Helsesykepleieres vurderinger rundt tidlig identifisering av barn som stammer (blog post).
• Kirmess, Melanie (2021). Oxford dysfluency conference going digital - reflections from the EST team (blog post).
• Kirmess, Melanie; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Hansen, Elisabeth Holm & Næss, Kari-Anne Bottegaard (2021). Do early childhood professionals in Norway distinguish between stuttering and normal dysfluencies.
• Kirmess, Melanie & Nordeide, Trude Beseth (2021). MA-thesis about stuttering guidelines (Blog post).
• Kirmess, Melanie & Melle, Ane Hestmann (2020). "Sen hjelp er heller ikke for sent" – Hilda Sønsterud presenterer fra sin doktorgradsavhandling på NIFS’ Høstweekend 2020 (Blog post).
• Kirmess, Melanie & Melle, Ane Hestmann (2020). Throwback: Open seminar on “Individualization of stuttering treatment”, March 3rd 2020. (Blog post).
• Kirmess, Melanie; Lagerberg, Tove; Samson, Ineke & McAllister, Anita (2020). A warm welcome to our Swedish collaborators (Blog post).
• Kirmess, Melanie (2020). Today is the International Awareness day for Stuttering (Blog post).
• Kirmess, Melanie (2020). The EST project – What is going on autumn 2020? (Blog post).
• Berdal, Stig; Døli, Hedda Ruth; Hide, Øydis; Hvistendahl, Anne Katherine; Haaland-Johansen, Line & Kirmess, Melanie [Vis alle 9 forfattere av denne artikkelen] (2020). DIAS – Diagnostisk verktøy for taleapraksi. Norsk tidsskrift for logopedi. ISSN 0332-7256. 66(4), s. 17–23. Fulltekst i vitenarkiv
• Øra, Hege Prag; Kirmess, Melanie & Becker, Frank (2020). Språktrening rett hjem - intensiv språktrening via videokonferanse. Afasiposten. ISSN 0803-2467. s. 12–14.
• Kirmess, Melanie; Vanebo H., Kristin & Becker, Frank (2020). 10 års jubileum for Sunnaas intensive språkgrupper «SunCIST». Afasiposten. ISSN 0803-2467. s. 12–14.
• Kirmess, Melanie (2020). Hjelp – jeg kan ikke snakke! Vis sammendrag

  Afasi er en diagnose som rammer en av fire voksne hjerneslagpasienter. Hjernen er blitt skadet slik at området som styrer kommunikasjon får problemer. Ikke bare blir det vanskelig å føre en samtale, det kan plutselig bli vanskelig å lese aviser, høre på nyheter eller sende meldinger. Noen personer har mindre utfordringer, mens andre opplever alvorlige utfordringer. I dette foredraget får du svar på spørsmålene: Hva skjer egentlig i hjernen når vi prater? Og hvorfor oppstår problemene etter et hjerneslag? Hva kan man gjøre med det? Blir man frisk igjen?

• Kirmess, Melanie (2020). Klitgården part II - Including closing the multidisciplinary survey and drawing the winners (Blog post).
• Sjøstrand, Åse; Kefalianos, Elaina; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Kirmess, Melanie & Lervåg, Arne [Vis alle 8 forfattere av denne artikkelen] (2019). Non-pharmacological interventions for stuttering in children aged between birth and six years. Cochrane Database of Systematic Reviews. ISSN 1469-493X. 2019:CD013489(11), s. 1–36. doi: 10.1002/14651858.CD013489.
• Kirmess, Melanie (2019). EST in progress - The multidisciplinary survey (Blog post).
• Kirmess, Melanie & Sjøstrand, Åse (2019). The Cochrane Protocol is published! (Blog post).
• Hansen, Silje Merethe; Kirmess, Melanie & Stubberud, Jan (2019). Group Based Treatment for Persons With Social Communication Disorder: Participant Evaluation Post-treatment.
• Våge, Kristine & Kirmess, Melanie (2019). “Twice as good?” - The outcome of participating twice in an intensive group treatment for aphasia .
• Tinbod, Unn; Löfkvist, Ulrika; Thijn Sverdrup, Anne-Cathrine & Kirmess, Melanie (2019). New ways of measuring every day communication - The application of LENA™ to persons with aphasia.
• Kirmess, Melanie; Hvistendahl, Anne-Kathrine; Kjølberg, Eli Anne; Koot, Karin; Hide, Øydis & Døli, Hedda [Vis alle 7 forfattere av denne artikkelen] (2019). ”Sopp-kopp-topp” – Experience from the validation of the Norwegian version of the Diagnostic Instrument for Apraxia of Speech (DIAS).
• Kirmess, Melanie (2019). Writing retreat at Engø Gård, Norway – March 2019 (Blog post).
• Sjøstrand, Åse; Kefalianos, Elaina; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Kirmess, Melanie & Lervåg, Arne [Vis alle 8 forfattere av denne artikkelen] (2019). Protocol: Non-pharmacological interventions for stuttering in children aged between birth and six years. Cochrane Database of Systematic Reviews. ISSN 1469-493X. Fulltekst i vitenarkiv Vis sammendrag

  This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Primary objective To assess the immediate and long‐term effects of non‐pharmacological interventions for stuttering on speech outcomes in children aged between birth and six years. Secondary objective To describe the relationship between intervention effects and participant characteristics (i.e. child age, child’s communication attitudes and the impact stuttering has on the child’s QoL).

• Kirmess, Melanie (2018). New minds, new thoughts – Feedback for the EST presentation at the ComPros seminar with Cathrine Snow (Blog post).
• Kirmess, Melanie (2018). Wrapping up for Christmas and preparing for the new year (Blog post).
• Sønsterud, Hilda; Kirmess, Melanie; Feragen, Kristin Judith Billaud; Ward, David & Halvorsen, Margrethe S. (2018). Minding the body in speecy: Individualized therapy for adults who stutter.
• Sønsterud, Hilda; Howells, Kirsten; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud; Ward, David & Kirmess, Melanie (2018). The importance of the working alliance in stuttering therapy: Client perceptions.
• Sønsterud, Hilda; Kirmess, Melanie; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud & Ward, David (2018). Individualized therapy for adults who stutter: An evaluation on speech and avoidance behaviour. Vis sammendrag

  Abstract. Purpose: Evidence suggests that there is considerable individual variation in response to stuttering interventions. Despite this knowledge, stuttering research has so far mainly focused on demonstrating outcomes from a particular stuttering treatment approach at the time. There is a need to investigate personal variation in stuttering symptoms and manage that variability through personalized and holistic based management plans. This approach is context sensitive and places the individual’s specific concerns at the core of therapy. One approach which has increased in popularity within the stuttering field, is Acceptance and Commitment Therapy (ACT). The main goal in ACT is to foster psychological flexibility, which is achieved through the six core processes of acceptance, diffusion, self as context, committed action, values, and contact with the present moment. In this study ACT was used as a working frame. Based on the individual’s perspective, ACT was used flexibly, and was combined with stuttering-, and speech modification elements. We categorized stuttering- and speech modification-, and mindfulness-based elements into five areas of focus: 1) Awareness of body tension and posture, 2) Awareness of breath support in speech production, 3) Awareness in speech production to promote easier voicing, 4) Awareness of acceptance, affective and mindfulness-based strategies, and 5) Awareness presentation skills. We call this the ‘Minding the body in speech’-approach. Aims: The aims of this study were twofold: 1) To evaluate whether the ‘Minding the body in speech’-approach reduces stuttering severity for participants with overt stuttering. 2) To evaluate the extent to which the ‘Minding the body in speech’-approach has a positive impact on confidence in communication, avoidance behavior, and quality of life. Methods: Eighteen adults, age 21-61 years (mean age 35,5) took part in a multiple single case design study. Participants underwent a six-week pre-clinic assessment phase, followed by an eight-week explorative therapy period comprising a total of 10 hours within four therapy sessions administered by an experienced speech and language therapist specialized in fluency disorders. Each participant was re-tested for speech and a range of cognitive and emotional variables immediately after therapy, and again at six, and 12 months post-therapy. Results: Sustained improvements are demonstrated in the participants’ speech behavior, communication, and quality of life. Significant reduction in avoidance behavior on both individual-, and group-level is documented. At group level, the ‘Minding the body in speech’-approach was associated with positive statistical, clinical and personal significance. On an individual basis, the variability in response to the holistic multi-faceted approach was substantial. The findings indicated significantly greater improvement in outcomes for participants who reported an intensive home-based training compared to those who reported ‘now-and then’-training. Conclusion: As shown in this study, the relative weighting between the areas of focus needed to vary from individual to individual. Multiple factors were found to influence stuttering and stuttering related psychological variables at post-therapy. The intensity of the self-managed practice was a key factor in achieving long-lasting, positive change.

• Hansen, Silje Merethe; Stubberud, Jan & Kirmess, Melanie (2018). Group Based Treatment for Persons With Social Communication Disorder: A Randomized Controlled Trial Protocol.
• Kirmess, Melanie (2018). Disputation Linn Stokke Guttormsen (Blog post).
• Kirmess, Melanie (2018). Writing retreat at Klitgården Refugium, Denmark (Blog Post).
• Kirmess, Melanie (2018). Intervju med logoped Elaina Kefalianos, University of Melbourne. Norsk tidsskrift for logopedi. ISSN 0332-7256. 64(3), s. 30–31.
• Kirmess, Melanie (2017). "Jeg har hatt det inspirerende og gøy!" Intervju med Anne-Lise Rygvold. Norsk tidsskrift for logopedi. ISSN 0332-7256. 63(3), s. 48–51.
• Sønsterud, Hilda; Kirmess, Melanie; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud & Ward, David (2017). Individualized stuttering therapy for adults - what works for whom?
• Sønsterud, Hilda; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud; Ward, David & Kirmess, Melanie (2017). What do people search for in stuttering therapy -personal goal-setting as a gold standard? Aim.
• Sønsterud, Hilda; Howells, Kirsten; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud; Ward, David & Kirmess, Melanie (2017). The working alliance in stuttering therapy: A neglected variable?
• Feiken, Judith & Kirmess, Melanie (2017). Foreign Accent Syndrome (FAS) - A type of kinetic Apraxia of Speech (AOS).
• Winsnes, Ingvild Elisabeth; Øra, Hege Prag; Kirmess, Melanie & Becker, Frank (2017). Aphasia telerehabilitation - A digital enterprise (experience from the SLT intervention).
• Øra, Hege Prag; Kirmess, Melanie; Bergersen, Hilde; Winsnes, Ingvild Elisabeth; Erlenkamp, Sonja & Myklebost, Marthe Brurok [Vis alle 7 forfattere av denne artikkelen] (2017). Evidence-based aphasia rehabilitation guidelines - Multidisciplinary implementation through an E-learning program.
• Aven, Synne L.; Sortland, Ida Gaarder; Hansen, Silje M. & Kirmess, Melanie (2017). How did you like to participate in the SunCIST program - and was it useful? Vis sammendrag

  Background and Aims: In general, there is still a lack of acknowledged recommendations concerning the effectiveness of aphasia rehabilitation programs, whereas constrained induced language therapy has been described as one of the positive trends in several Chochrane-reviews. Sunnaas rehabilitation hospital offers a 3-week intensive aphasia program based on the principles of CILT within a holistic, multi-disciplinary group setting, called SunCIST. Intervention outcomes are usually presented by various forms of test results, whereas there seems to be distinctly fewer reports of user evaluation of the meaningfulness of aphasia programs. Therefore, the aim of this study was to explore the evaluation by the person with aphasia (PWA) themselves who had participated in the SunCIST program. Methods: As part of the assessment battery, all SunCIST participants are asked to evaluate the SunCIST program by the end of the intervention period. The evaluation form consists of four open ended questions for an overall impression, as well as 14 questions with a 5-point Likert-scale choice for detailed feedback on subjects as content, picture material, intensity, usefulness, tiredness etc. The evaluation form is provided in an aphasia friendly format, with illustrating pictures and all possibilities for support by the SLP in order to promote a response by the PWA. Data analyses included both quantitative and qualitative data. The main focus of this presentation is on the qualitative data from the open ended questions. Results: The study included evaluation forms from a 4 year period, in total from 95 PWA, aged 22-78 years (M=57.6) with varying degrees of aphasia from severe to mild. Time post onset varied from 4 months to 34 years (M=4.4 years, SD =5.8). The majority of the participants were generally satisfied and reported overall positive feedback to the SunCIST program. Preliminary data analyses point to few significant differences between participants; however there are tendencies that women, the oldest participants, and PWAs after cerebral insults report a higher degree of satisfaction. Interestingly, there is no strong correlation in satisfaction and meaningfulness of the program connected to the changes in language test outcomes pre to post test. Discussion: The main critical point of the analysed data concerns the data collection by the treating SLP and incomplete answers. Conclusions: SunCIST receives generally a high score on satisfaction, with constructive critical comments on improvement concerning as different parts as e.g., the picture material, intensity, and group member’s aphasia severity. Implications for clinical practice: This is one of the rare studies based on evaluation of an intervention program by the PWA. Hence, it offers relevant insight in how SunCIST fits persons with various degrees of aphasia and gives valuable feedback on which parts of the program that could be even more tailored for individual needs and better outcome. This form of feedback provides thereby the PWA with an important voice for user participation.

• Kirmess, Melanie (2017). Challenges and examples from measuring treatment outcome following constraint induced language therapy and relating types of aphasia intervention.
• Kirmess, Melanie (2017). Evidensbasert praksis, PICO-spørsmål, kjernespørsmål - Hvordan påvirker dette din logopediske hverdag?
• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Winsnes, Ingvild Elisabeth & Becker, Frank (2016). Aphasia telerehabilitation early post stroke.
• Kirmess, Melanie (2016). SunCIST i et brukerperspektiv - Evaluering og tilrettelegging.
• Kirmess, Melanie; Røste, Ingvild & Karlsen, Jannicke (2016). Redaktøren har ordet. Norsk tidsskrift for logopedi. ISSN 0332-7256. 62(2), s. 3–3.
• Kirmess, Melanie (2016). Redaktøren har ordet: Logopediens dag fokuserer på verbal dyspraksi. Norsk tidsskrift for logopedi. ISSN 0332-7256. 62(1), s. 3–3.
• Kirmess, Melanie (2016). Sunnaas intensive afasiprogram(SunCIST) i et langtidsperspektiv.
• Kirmess, Melanie (2015). Praktiske vurderinger rundt afasigrupper basert på constraint induced språkterapi.
• Kirmess, Melanie (2015). Sunnaas intensive afasitreningsprogram (SunCIST).
• Kirmess, Melanie (2015). Constraint induced språkterapi (CIST) - et gruppetilbud for intensiv afasirehabilitering.
• Kirmess, Melanie (2015). Nettressurser for støttet samtale for afasirammede. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(4), s. 38–40.
• Kirmess, Melanie (2015). Revisjon av Nasjonal retningslinje for behandling og rehabilitering av hjerneslag. Referat fra møte i referansegruppen. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(4), s. 36–37.
• Kirmess, Melanie (2015). Redaktøren har ordet. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(4), s. 3–3.
• Kirmess, Melanie (2015). Kildebruk. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(3), s. 3–3.
• Kirmess, Melanie (2015). Skattekisten: Intervju med Liv Stabell Kulø. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(2), s. 20–22.
• Kirmess, Melanie; Røste, Ingvild & Vøyne, Jannicke (2015). Referat: Norsk logopedlagets vinterkurs. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(2), s. 10–14.
• Kirmess, Melanie (2015). Redaktøren har ordet. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(2), s. 3–3.
• Kirmess, Melanie (2015). Disputas Marianne Klem. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(1), s. 44–45.
• Kirmess, Melanie (2015). Kompetanse og veiledning. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(1), s. 3–3.
• Kirmess, Melanie; Heiberg, Ellen; Kjeldaas, Hege; Krohn, Silje & Wennberg, Ulrika (2015). The long term outcome of the SunCIST program.
• Erlenkamp, Sonja; Kirmess, Melanie; Bergersen, Hilde; Audestad, Solveig & Becker, Frank (2015). Promoting evidence-based aphasia rehabilitation – guidelines at Sunnaas Rehabilitation Hospital.
• Kirmess, Melanie (2014). Bokanmeldelse: Klinisk forskningsmetode for logopeder og audiopedagoger. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(2), s. 44–45.
• Kirmess, Melanie (2014). Bokanmeldelse: Evidensbasert praksis i logopedi. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(2), s. 42–43.
• Kirmess, Melanie (2014). Logopedisk tips 1 "Støttet samtale". Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), s. 42–42.
• Kirmess, Melanie (2014). Disputas Jannicke Karlsen. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), s. 40–41.
• Kirmess, Melanie & Hansen, Silje Merethe (2014). Referat: Afasidagene 13. og 14. november 2014. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), s. 36–38.
• Kirmess, Melanie (2014). Logopeden – hvem er du og hvor vil du? Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), s. 3–3.
• Kirmess, Melanie; Vøyne, Jannicke & Røste, Ingvild (2014). Referat: Norsk logopedlagets etterutdanningskurs og landsmøte 2014. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(3), s. 32–37.
• Kirmess, Melanie (2014). Høsttakk. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(3), s. 3–3.
• Kirmess, Melanie (2014). Språktrening døgnet rundt. Kommunikasjon og rehabilitering i hverdagen.
• Kirmess, Melanie (2014). Constraint induced language therapy for aphasia rehabilitation. The SunCIST program.
• Kirmess, Melanie; Nordli, Heidi & Becker, Frank (2014). ”Kan man være for god for deltakelse på CIST?” – Erfaringer fra Sunnaas intensive afasitilbud (SunCIST) for godt fungerende afasirammede.
• Ingebretsen, Silje Merethe Hansen; Kirmess, Melanie & Stubberud, Jan Egil (2023). Treatment of social communication difficulties following acquired brain injury: Efficacy of Group Interactive Structured Treatment. Universitetet i Oslo. Vis sammendrag

  The purpose of this thesis was to investigate the efficacy of Group Interactive Structured Treatment (GIST) for persons with social communication difficulties (SCDs) after acquired brain injury (ABI). The study included a wider sample than previous studies (including traumatic brain injury, stroke, brain tumor and anoxic brain injury), and examined the effect across delivery formats by comparing the treatment given in two different ways. Standard GIST was given in an outpatient setting once a week, while a newly adapted intensive GIST was given as a four-week inpatient group treatment at Sunnaas Rehabilitation Hospital. The study design is a two-arm RCT with a waiting list control group and repeated measures. Forty-nine pairs of participants, consisting of persons with SCDs and ABI and one of their family members/friends were randomly allocated to the two treatment arms. The results were examined from several perspectives and included reports from people with social communication difficulties and their family members/friends. After the two treatments, the subjects with social communication difficulties reported a trend of improved social communication skills on the primary outcome measure (La Trobe Communication Questionnaire [LCQ]) and a significant improvement on the secondary outcome measure (Social Communication Skills Questionnaire-Adapted [SCSQ-A]) when compared to the waiting list control group. Significant improvement over time was reported after both treatments (standard and intensive GIST) and there were no reported differences in outcomes between the two treatments. The findings were confirmed by reports from family members/friends. However, this study had a small sample (n = 49), and further investigations that include a larger sample and objective outcome measures are warranted. The results from this study and the information presented in this thesis have the potential to influence clinical practice in Norway, and have a significant clinical impact on the treatment of SCDs as the findings validate a Norwegian version of the GIST for clinical use. By focusing on the efficacy of treatment for SCDs and ABI, and the delivery and dosage of GIST, this thesis addresses some key research gaps in the field. The inpatient delivery of intensive GIST might not be transferable to all healthcare systems, especially those where inpatient treatment in the chronic phase is not available. However, our findings provide further validation of GIST and its components and highlight new research questions for further investigation, such as the importance of the components and intensity of GIST.

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