Melanie Kirmess

• Wallace, Sarah E.; Hill, Anne J.; Kirmess, Melanie; Nichol, Leana; Pierce, John E. & Rose, Miranda L. (2026). International survey of technology use in aphasia clinical practice. Aphasiology. ISSN 0268-7038. p. 26–26. doi: 10.1080/02687038.2025.2609799. Full text in Research Archive Show summary

  Background: Limited current information exists about which technologies speech-language pathologists are using as part of aphasia rehabilitation. Improved understanding of usage patterns and barriers to implementation can help enhance the implementation of technology as a support for clinical practice. Aims: The purpose of this study was to scope the breadth of technology use in aphasia rehabilitation and management from the perspective of speech-language pathologists. Methods & Procedures: A cross-sectional, qualitative and quantitative survey design was employed. A 36-item internet-based branching-logic survey was developed and disseminated to speech-language pathologists internationally. Data analyses included descriptive statistics across four main areas of interest: assessment, interventions, compensatory, and service delivery. Outcomes & Results: The number of respondents varied across questions from 115 to 225. The 115 participants who completed demographic information represented 20 countries with the highest representation from the United States (n = 30; 27%) and Australia (n = 23; 21%). The most frequent categories of technology use were intervention programs (59.56%) and compensatory (58.57%) with less frequent selection of service delivery (37.78%) and assessment (20.44%). While the majority of respondents indicated confidence in using technology, 28% expressed neutral or poor confidence. Barriers to uptake of technology included poor access to funding, lack of a client support person, and the confidence, motivation, and cognitive abilities of people with aphasia. Finally, participants reported learning about technology options most frequently from colleagues and/or supervisors, as part of professional development events, and/or from reading research articles. Conclusions: Speech-language pathologists reported using a range of technology in clinical practice for various purposes across the four main areas of interest. However, not all respondentsreported being confident in using technology. Dissemination ofinformation about technology may reach most speech-languagepathologists through word of mouth or professional developmentsessions. More information is needed about methods which canhelp speech-language pathologists overcome barriers to technol-ogy implementation in their clinical practice.

• Windsor, Catriona; Næss, Kari‐Anne Bottegård; Kirmess, Melanie; Deckers, Stijn; Ballentine, Natalie & Yoon, Sangwon [Show all 7 contributors for this article] (2025). Reliability and Validity of Questionnaires to Assess Communication Skills in People With Intellectual Disabilities: A Systematic Review. Journal of Intellectual Disability Research. ISSN 0964-2633. doi: 10.1111/jir.70063. Full text in Research Archive Show summary

  Background Assessing communication in individuals with intellectual disabilities is essential yet challenging because of the complexity of the construct and limited availability of psychometrically robust tools. This review aimed to evaluate the validity and reliability of communication questionnaires used with this population. Method A systematic review was conducted following PRISMA 2020 guidelines and COSMIN definitions for validity and reliability. Five databases (Cinahl, Embase, Eric, PsycINFO and PubMed) were searched for studies published from 2000 to 2024. Inclusion criteria required questionnaires to assess communication in individuals with intellectual disabilities and report on validity or reliability. Methodological quality was appraised using the QualSyst tool. Results Six questionnaires described in five studies and three manuals met the inclusion criteria. Validity evidence was more frequently reported than reliability, though both were inconsistently documented. No questionnaire demonstrated a comprehensive evaluation of validity or reliability. Content validity was often limited by a lack of stakeholder involvement. Conclusions Current questionnaires show promise but require further validation. Future research should prioritise stakeholder engagement, content and structural validity to ensure an inclusive, reliable communication assessment.

• Harvey, Sam; Wilcox, Cassie; Bunker, Lisa; Dignam, Jade K.; Dipper, Lucy & Hoover, Elizabeth [Show all 12 contributors for this article] (2025). Development of an evidence-based aphasia therapy implementation tool: introducing the Aphasia Therapy Finder. Aphasiology. ISSN 0268-7038. doi: 10.1080/02687038.2025.2499521. Full text in Research Archive Show summary

  Background Clinical practice guidelines support the use of aphasia therapy to reduce language impairment and communication disability. Aphasia is a heterogeneous condition and many therapy approaches are used in clinical practice. Selecting appropriate therapies and accessing therapy resources can be challenging for clinicians. The Aphasia Therapy Finder (ATF) is an implementation tool for speech-language pathologists designed to bridge the evidence-practice gap in aphasia rehabilitation. Methods & Procedures Discussions with speech-language pathologists (SLPs) and an international survey confirmed that therapists struggle to stay abreast of the latest aphasia rehabilitation evidence. SLPs priorities informed the development of the ATF. Initially, a prototype web-based repository of therapy descriptions and resources was developed and tested with clinicians around the world. Following user testing, additional content was developed and deployed on the ATF. Outcomes The ATF is a free searchable database (www.aphasiatherapyfinder.com) that contains detailed therapy descriptions for 25 evidence-based aphasia therapies and links to the resources clinicians need to use the therapies in their clinics. Therapy descriptions have been rigorously produced with input from over 60 aphasia researchers. User testing has validated the ATF functionality and content. Conclusion The Aphasia Therapy Finder provides a mechanism to reduce the evidence-practice gap in aphasia rehabilitation and, thereby, improve access to high quality evidence-based therapy for people with aphasia around the world. Future work will expand the ATF and evaluate its utility as an implementation tool.

• Kirmess, Melanie; Berg, Karianne; Hansen, Elisabeth Holm; Hoff, Karoline; Hofslundsengen, Hilde Christine & Guttormsen, Linn Stokke (2025). Interdisciplinary collaboration and clinical management for Norwegian preschool children who stutter: ‘Who, what, when, and where?’. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. p. 14–14. doi: 10.1080/02813432.2025.2531965. Full text in Research Archive Show summary

  Purpose Childhood stuttering may have long-lasting effects on a child’s linguistic and psychosocial development. Early interventions have shown promising results, however, clarity in professional roles and collaboration with parents is warranted to ensure equal and best practice. This study investigated early childhood professionals’ and parents’ experience with interdisciplinary collaboration around preschool children who stutter. Method Three focus groups and eight individual digital interviews were conducted with a total of 18 participants: general practitioners (n = 2), public health nurses (n = 3), speech-language pathologists (n = 4), preschool teachers (n = 4) and parents (n = 5). Results Qualitative content analysis resulted in three themes: collaboration routines, competencies in early intervention, and organization of services. Our informants described dual collaborations among the professionals, typically between speech-language pathologists and preschool teachers, especially if the children did not have any other difficulty than stuttering. The professionals had different views on the wait-and-see approach. Both parents and professionals indicated that the system around a child who stutter could be person-dependent in referral and management. Some of the parents experienced that they had to actively seek information themselves to get what their child needed. Conclusion This potential inequality of services for preschool children who stutter implies a need for a systematic structure and increased professional knowledge in the healthcare and educational setting.

• 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. p. 1–12. doi: 10.1080/02699052.2024.2311345. Full text in Research Archive Show summary

  Objective To examine family members/friends’ perception of change following standard and intensive group interactive structured treatment (GIST) for persons with social communication difficulties (SCDs). Methods A parallel mixed methods design combining data from questionnaires, the Goal Attainment Scale, and interviews. Participants Forty-nine adult (>18 years) family members/friends (69.4% female) of persons with SCDs and acquired brain injury (ABI) (cohabitating partner, 53.1%; other relatives, 30.6%; friends, 16.3%). Intervention Standard GIST consisted of 12 weekly outpatient sessions (2.5 h). Intensive GIST consisted of 4 weeks of inpatient rehabilitation (2 × 3 days/week, 2 × 4 days/week). Both treatments included 3- and 6-month follow-ups. Main outcome measures Quantitative measures (n = 49) included the following informant reports: Latrobe Communication Questionnaire (LCQ), Social Communication Skills Questionnaire-Adapted (SCSQ-A), Behavior Rating Inventory for Executive Functions-Adult version (BRIEF-A), and Goal Attainment Scale. The qualitative measure (n=9) was an interview performed at 6-month follow-up. Results Converging results were found, suggesting a perceived positive change over time for both standard and intensive GIST, with no substantial differences reported between the treatments. Conclusions Family members/friends reported improved social communication skills of the persons with SCDs following standard and intensive GIST. However, the integration of data showed the complexity of assessing SCDs and the need for further investigation.

• 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), p. 8–21. Full text in Research Archive Show summary

  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).

• 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), p. 1016–1025. doi: 10.1016/j.apmr.2023.02.023. Full text in Research Archive Show summary

  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.

• 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. Full text in Research Archive Show summary

  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.

• Dignam, Jade K.; Harvey, Sam; Monnelly, Katie; Dipper, Lucy; Hoover, Elizabeth & Kirmess, Melanie [Show all 10 contributors for this article] (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. Full text in Research Archive Show summary

  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.

• Kefalianos, Elaina; Guttormsen, Linn Stokke; Hansen, Elisabeth Holm; Hofslundsengen, Hilde Christine; Næss, Kari-Anne Bottegård & Antypas, Konstantinos [Show all 7 contributors for this article] (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), p. 923–941. doi: 10.1044/2021_AJSLP-21-00148. Full text in Research Archive Show summary

  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.

• Sjøstrand, Åse; Kefalianos, Elaina; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Kirmess, Melanie & Lervåg, Arne [Show all 8 contributors for this article] (2021). Non-pharmacological interventions for stuttering in children six years and younger. Cochrane Database of Systematic Reviews. 2021(9), p. 1–63. doi: 10.1002/14651858.CD013489.pub2. Full text in Research Archive
• Dipper, Lucy T.; Franklin, S.; Aguiar, V. de; Baumgaertner, A; Brady, Marian C. & Best, Wendy [Show all 20 contributors for this article] (2021). An Umbrella Review of Aphasia Intervention descriPtion In Research: the AsPIRE project. Aphasiology. ISSN 0268-7038. doi: 10.1080/02687038.2020.1852001. Full text in Research Archive Show summary

  Background: Recent reviews conclude that aphasia intervention is effective. However, replication and implementation require detailed reporting of intervention is and a specification of participant profiles. To date, reviews concentrate more on efficacy than on intervention reporting quality. Aims: The aim of this project is to review the descriptions of aphasia interventions and participants appearing in recent systematic reviews of aphasia intervention effectiveness. The relationship between the quality of these descriptions and the robustness of research design is explored, and the replicability of aphasia interventions is evaluated. Methods and Procedures: The scope of our search was an analysis of the aphasia intervention studies included in the and EBRSR 2018 systematic reviews, and in the RCSLT 2014 literature synthesis. Intervention descriptions published separately from the intervention study (i.e. published online, in clinical tools, or a separate trial protocols) were not included. The criteria for inclusion were that participants had aphasia, the intervention involved language and/or communication, and included the following research designs: Randomised Controlled Trial (RCT), comparison or control, crossover design, case series. Exclusion criteria included non-SLT interventions, studies involving fewer than four participants, conference abstracts, studies not available in English. Studies were evaluated for completeness of intervention description using the TIDieR Checklist. Additionally, we rated the quality of patient and intervention description, with particular reference to replicability. Outcomes and Results: Ninety-three studies were included. Only 14 studies (15%) had >50 participants. Fifty-six studies (60%) did not select participants with a specific aphasia profile, and a further 10 studies only described participants as non-fluent. Across the studies, an average of eight (of 12) TIDieR checklist items were given but information on where, tailoring, modification and fidelity items was rarely available. Studies that evaluated general aphasia intervention approaches tended to use RCT designs, whereas more specific intervention studies were more likely to use case series designs. Conclusions: Group studies were generally under-powered and there was a paucity of research looking at specific aphasia interventions for specific aphasia profiles. There was a trade-off between the robustness of the design and the level of specificity of the intervention described. While the TIDieR framework is a useful guide to information which should be included in an intervention study, it is insufficiently sensitive for assessing replicability. We consider possible solutions to the challenges of making large-scale trials more useful for determining effective aphasia intervention.

• 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. Full text in Research Archive Show summary

  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.

• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Partee, Iselin Anne Cecilia; Hognestad, Randi Bjor & Johannessen, Beate Bertheau [Show all 8 contributors for this article] (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), p. 369–381. doi: 10.1177/0269215519896616. Full text in Research Archive Show summary

  Pilot a definitive randomized controlled trial of speech-language telerehabilitation in poststroke aphasia in addition to usual care with regard to recruitment, drop-outs, and language effects. Pilot single-blinded randomized controlled trial. Telerehabilitation delivered from tertiary rehabilitation center to participants at their home or admitted to secondary rehabilitation centers. People with naming impairment due to aphasia following stroke. Sixty-two participants randomly allocated to 5 hours of speech and language telerehabilitation by videoconference per week over four consecutive weeks together with usual care or usual care alone. The telerehabilitation targeted functional, expressive language. Main measures: Norwegian Basic Aphasia Assessment: naming (primary outcome), repetition, and auditory comprehension subtests; Verb and Sentence Test sentence production subtest and the Communicative Effectiveness Index at baseline, four weeks, and four months postrandomization. Data were analyzed by intention to treat. No significant between-group differences were seen in naming or auditory comprehension in the Norwegian Basic Aphasia Assessment at four weeks and four months post randomization. The telerehabilitation group ( n = 29) achieved a Norwegian Basic Aphasia Assessment repetition score of 8.9 points higher ( P = 0.026) and a Verb and Sentence Test score 3 points higher ( P = 0.002) than the control group ( n = 27) four months postrandomization. Communicative Effectiveness Index was not significantly different between groups, but increased significantly within both groups. No adverse events were reported. Augmented telerehabilitation via videoconference may be a viable rehabilitation model for aphasia affecting language outcomes poststroke. A definitive trial with 230 participants is needed to confirm results.

• 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, p. 1–20. doi: 10.1016/j.jcomdis.2020.106052. Full text in Research Archive Show summary

  Purpose This study reports outcomes from a stuttering therapy approach that combines value and awareness-based elements from Acceptance and Commitment Therapy (ACT) with those of stuttering and speech modification interventions. The approach, entitled Multidimensional Individualized Stuttering Therapy (MIST), includes a combined clinician and client selection of factors across five areas: 1) general breathing patterns and body tension, 2) breathing patterns during speech production, 3) vocal features in speech production, 4) value and mindfulness-based strategies, and 5) general communication and/or presentation skills. The aims of this study were to evaluate whether the MIST a) reduces the impact of stuttering and stuttering severity, and b) has a positive impact on speaking ability, confidence in communication, avoidance-behavior, and quality of life. Method Eighteen adults, age 21–61 years took part in an A-B-A multiple case study design. Participants underwent a pre-clinic assessment phase, followed by 10 h of therapy over four sessions administered by an experienced speech-language therapist. Outcome measures examined both psychosocial and behavioral aspects of therapy three-, six- and twelve-months post-therapy. Results Most participants chose elements from at least four of the five areas of focus. There was a significant reduction in the impact of stuttering at both 6- and 12-months post-therapy, with moderate (d = .71) to very large (d = 1.06) effect sizes. A strong association was found between overall satisfaction with MIST and improved speaking abilities. Moderate to strong associations were also found between experienced speaking abilities, confidence in communication, reduction in avoidance behaviors and improved quality of life. Discussion Findings indicate that MIST can be effective in managing adult stuttering. The findings highlight the importance of shared decision making and personal considerations using flexible therapy approaches that integrate stuttering and speech modification interventions with value and awareness-based skills. The nature of a multidimensional individualized approach, as shown in this study, highlights the importance of adjusting the relative weighting of different subcomponents according to each individual’s needs and goals. Conclusion MIST was shown to be efficacious in clinical settings and effective in real life settings. Findings were promising, despite a relatively small sample, and replication by other SLPs and with larger samples is warranted.

• 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. 11(671). doi: 10.3389/fneur.2020.00671. Full text in Research Archive Show summary

  Background: Post-stroke aphasia is a communication disorder where existing evidence favors intensive therapy methods. Telerehabilitation represents a service model for geographically remote settings, or other barriers to clinic attendance or to facilitate an augmentation of therapy across a continuum of care. Evidence to support efficiency, feasibility, and acceptability is however still scarce. Appraising aphasia telerehabilitation in controlled trials beyond its effectiveness, by investigating feasibility and acceptability, may facilitate implementation into clinical practice. Methods: In our pilot randomized controlled trial, we investigated the feasibility and acceptability of speech and language therapy by videoconference, in addition to usual care, in people with aphasia following stroke. To improve functional, expressive language, a tailored intervention was given 1 h per day, five times per week over four consecutive weeks. Feasibility measures included evaluation of technical setup using diary logs. Acceptability was investigated by examining adherence and satisfaction with therapy alongside evaluation of data safety and privacy. Results: Feasibility and acceptability data were collected in relation to 556.5 h of telerehabilitation delivered to 30 participants over a 2-years intervention period by three speech-language pathologists. Protocol adherence was high, with a tolerable technical fault rate; 86 faults were registered over 541 video sessions. Most (80%; n = 30) of the participants experienced zero to three faults. The main cause of technical failures was flawed internet connection, causing delayed or interrupted therapy. Total satisfaction with telerehabilitation was rated good or very good by 93.1% (n = 29) of participants and two of three speech-language pathologists. Within a moderate variance of technical failure, participants experiencing more faults were more satisfied. No serious events regarding security and privacy were reported. Our model is feasibly and ready to be implemented across a range of clinical settings and contexts. Conclusions: Synchronous telerehabilitation for post-stroke aphasia is feasible and acceptable and shows tolerable technical fault rates with high satisfaction among patients and pathologists. Within a low rate of faults, satisfaction was not negatively influenced by fault frequency. Access to clinical and technical expertise is needed when developing telerehabilitation services. Telerehabilitation may be a viable service delivery model for aphasia rehabilitation.

• 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. p. 1–14. doi: 10.1111/1460-6984.12465. Full text in Research Archive Show summary

  Background Multiple factors can influence the working alliance and treatment outcome in speech and language therapy. The ‘working alliance’ is an important concept in treatment and can be described as the degree to which a treatment dyad is engaged in collaborative, purposive work. To date, relatively little attention has been paid to this concept within speech and language treatment in general, and within stuttering treatment research in particular. Aims To investigate the role of the working alliance within stuttering treatment, and to evaluate whether the quality of the working alliance correlated with clients’ concept of motivation and treatment outcomes 6 months post‐therapy. Methods & Procedures Eighteen adults (21‐61 years) participated in this multiple single‐case treatment study, with treatment facilitated by an experienced speech and language therapist. The working alliance was investigated using the Working Alliance Inventory—Short Version Revised (WAI‐SR), an Extended version of the Client Preferences for Stuttering Treatment (CPST‐E), the Overall Assessment of Speakers’ Experience of Stuttering—Adult version (OASES‐A), the Wright & Ayre Stuttering Self‐Rating Profile (WASSP) and the Hospital Anxiety and Depression Scale (HADS). Outcomes & Results Analyses demonstrated significant associations between the working alliance and client motivation (r = 0.781) and treatment outcomes (r = 0.644) 6 months post‐treatment. The association between client‐led goals and therapy tasks appeared particularly important. Conclusions & Implications The working alliance between speech and language therapists and persons who stutter matters. Within the alliance, the level of client–clinician agreement on treatment goals and therapy tasks may be of greater importance than the bond between client and clinician. Further research with greater numbers of participants is warranted.

• 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. p. 1–15. doi: 10.1016/j.jcomdis.2019.105944. Full text in Research Archive Show summary

  Purpose Stuttering affects people in individual ways, and there are multiple factors which may influence a person’s goals when seeking therapy. Even though there is a common consensus that speech-language pathologists should discuss the individual’s goals and expectations for stuttering therapy and outcomes, few studies have systematically investigated this issue. The aims of the present study were to investigate individual motivations and goal-setting related factors in stuttering therapy. The associations between self-reported impact of stuttering and the participants’ perceptions of stuttering interference in communication, speaking abilities, and relationships with other people were also investigated. Method This study is part of a wider-ranging treatment study of individualized stuttering management tailored to the participants’ personal goals and preferences. A mixed method, multiple single-case design was used to address the research questions. Twenty-one adults, age 21–61 years, took part in a pretherapy interview, which also included two quantitative measures: the Client Preferences for Stuttering Therapy-Extended version (CPST-E) and the Overall Assessment of Speakers’ Experience of Stuttering-Adult version (OASES-A). Findings from the study sample was compared with a Norwegian reference group, in order to check for the representativeness of the study sample. Results Quantitative data showed that most participants wanted to focus on both physical and psychological aspects of therapy, and that 95% considered ‘to gain a sense of control over the stuttering’ as important. Participants’ perspectives on their speaking ability and stuttering interference in communication were identified as central factors, particularly in social and professional settings. These outcomes aligned well with the finding of avoidance behaviors, such as avoiding words and speaking situations. Qualitative data identified four main areas that the participants wanted to improve: speech fluency, emotional functioning, activity and participation, and understanding of their stuttering. Conclusion The study confirms that multiple and individual factors may influence the person’s goals for therapy. Goals were mainly anchored in participants’ wish of better coping in real world settings. A high degree of avoidance behavior was reported, suggesting that anxiety, and in particular linguistic-related anxiety needs to be taken into account when addressing social anxiety in fluency disorders.

• 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. 17(1), p. 1–11. doi: 10.1186/s12955-019-1248-0. Full text in Research Archive Show summary

  Introduction Oropharyngeal dysphagia (OD) is a disorder that can have devastating and long lasting effects on a person’s medical, mental and psychosocial well-being, thus negatively impacting quality of life. There is currently no validated dysphagia-specific quality of life instrument in Norway. This project aims to evaluate the psychometric properties of the culturally adapted Norwegian version of SWAL-QOL (Nor-SWAL-QOL). Methods The original SWAL-QOL was translated into Norwegian according the international translation guidelines. A group of 102 persons with OD and a group of 123 healthy controls were recruited to assess the validity and reliability of the Nor-SWAL-QOL. Correlation analysis of the Nor-SWAL-QOL and the Short Form 36 (SF-36) and correlation analysis of OD group and control group Nor-SWAL-QOL subscale scores were computed to determine convergent, discriminant, and known-groups validity which help comprise construct validity. Internal consistency, test-retest reliability and intraclass correlation coefficient (ICC) were computed for reliability. Results Convergent and discriminant validity was demonstrated between Nor-SWAL-QOL subscales and SF-36 domains, and distinguished between persons with and those without oropharyngeal dysphagia on all subscales and on the symptom frequency battery (p < 0.001). Additionally, the Nor-SWAL-QOL differentiated between symptom severity levels within the OD group; those requiring food and liquid modifications and those who are tube fed and not tube fed. Nor-SWAL-QOL showed good reliability with adequate internal consistency (Cronbach’s α ≥0.70), test-retest reliability (Spearman’s rho values 0.68–0.90) and ICC values (0.67–0.89) for all subscales and for the symptom frequency battery. Conclusion Access to valid and reliable dysphagia-specific QoL outcome measures for health care practitioners, dysphagia clinicians and researchers is necessary for comprehensive assessment and treatment outcome measures. The Nor-SWAL-QOL exhibits sufficient psychometric properties for implementation in the Norwegian population.

• 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. 9(9). doi: 10.1136/bmjopen-2019-029392. Full text in Research Archive Show summary

  Introduction: Social communication difficulties (SCDs) occur frequently after an acquired brain injury (ABI) and have disabling consequences, but effective interventions are scant. Group Interactive Structured Treatment (GIST) is a holistic group treatment targeting SCD that has received empirical support. Objective: To determine the efficacy of two GIST protocols, standard GIST and a newly developed intensive GIST, comparing standard GIST results to a wait-list control group (WL), as well as to intensive GIST received by participants following WL. The within subject results for WL and intensive GIST will also be examined. Methods and analysis: Sixty adults (18–75 years) with SCD after ABI will be recruited for this randomised controlled trial. Standard GIST (n=30) will be delivered via outpatient sessions for 2.5 hours once per week for 12 weeks, plus one initial orientation session. Participants will be assessed at preintervention and postintervention and at 3-month and 6-month follow-ups (T1-T4). Intensive GIST (n=30) participants will be admitted to an inpatient rehabilitation unit for 4 weeks (two times 3 days/week, two times 4 days/week) and receive full-day sessions each week. Those participants will complete four assessments (T1-T4) in 12-week intervals as part of WL, assessments preintensive and postintensive GIST and at 3-month and 6-month follow-ups (T4-T7). The primary outcome measure is the La Trobe Questionnaire (self-report). Secondary outcome measures include the Profile of Pragmatic Impairment in Communication, a test of emotion recognition, the Goal Attainment Scale and questionnaires addressing social, emotional and cognitive functions, self-efficacy and quality of life. Ethics and dissemination: Results will be communicated through international, peer-reviewed and popular science journals and presentations at scientific conferences. The study is approved by the Regional Committees for Medical and Health Research Ethics Norway (2017/1360). The trial will be conducted in accordance with the Declaration of Helsinki and reported in accordance with the Consolidated Standards of Reporting Trials 2010 statement and Standard Protocol Items: Recommendations for Interventional Trials recommendations.

• 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), p. 24–34. Full text in Research Archive Show summary

  I Norge har vi manglende evidensbaserte behandlingsprogrammer for personer som opplever sosiale kommunikasjonsvansker etter ervervede hjerneskader, dette til tross for at vanskene er svært utbredt og får store konsekvenser for den enkeltes sosiale liv og reintegrering i samfunnet. Vi vil i denne artikkelen gi en kort oversikt over kunnskapsstatus på området og presentere våre erfaringer fra en pilotstudie hvor vi prøvde ut en intensiv gruppebehandling for seks personer med sosiale kommunikasjonsvansker. Resultatene fra pilotstudien viste at deltakere, pårørende og terapeuter rapporterte gruppebehandlingen som gjennomførbar og at den opplevdes som nyttig.

• 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), p. 12–19. Full text in Research Archive Show summary

  I denne artikkelen presenteres en oppsummering av normeringsarbeidet for kartleggingsverktøyet the Overall Assessment of the Speakers Experience of Stuttering – Adult version (OASES-A). Utprøving av verktøyet var del av Bodil Nordbøs masteroppgavearbeid (Nordbø, 2016), og er tilknyttet Hilda Sønsteruds doktorgradsprosjekt: «Stammebehandling – hva hjelper for hvem? Individualisert stammebehandling for voksne».

• 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. 19(208). doi: 10.1186/s13063-018-2588-5. Full text in Research Archive Show summary

  Background The Cochrane review on the effectiveness of speech and language therapy for aphasia following stroke suggests intensity of therapy is a key predictor for outcome. Current aphasia services cannot provide intervention at the intensity observed within trial contexts because of resource limitations. Telerehabilitation could widen access to speech-language pathologists (SLPs) in geographically remote contexts and reduce the time spent on travel by the therapist and patient. The current academic literature within this field is in its infancy, with few trials of speech and language therapy (SLT) delivered by videoconference. Our pilot randomized controlled trial (RCT) will explore feasibility aspects and effectiveness of telerehabilitation for aphasia in addition to standard SLT. Method/design Our study is a pragmatic, exploratory, pilot randomized controlled trial, where participants will be randomized to a telerehabilitation group or a control group. Both groups receive standard SLT (usual care) but the telerehabilitation group receives an additional 5 h of telerehabilitation per week over 4 weeks through videoconference. This additional telerehabilitation focuses on spoken language with an emphasis on word naming. We aim to include 40 patients in each group, with inclusion criteria being aphasia any time post stroke. Participants will be assessed blindly at pre-randomization (baseline), and 4 weeks and 4 months after randomization. The primary endpoint is naming ability 3 months after the completed intervention, measured by the Norwegian Basic Aphasia Assessment (NGA) naming subtest. Secondary endpoints include other subtests of the NGA, the VAST (Verb and Sentence Test) subtest sentence production, Communicative Effectiveness Index (CETI) and the Stroke and Aphasia Quality of Life scale (SAQOL-39). Experiences of patients and SLPs with telerehabilitation are assessed using questionnaires and semi-structured interviews. Statistical between group comparisons will be in line with an intention-to-treat analysis. Discussion This pilot RCT of intensive language training by videoconference will contribute new scientific evidence to the field of aphasia telerehabilitation. Here, we describe our trial which will explore the feasibility of telerehabilitation for aphasia as an intervention, our choice of primary and secondary outcome measures and proposed analyses. Our trial will provide information for the development and delivery of future definitive RCTs. Trial registration ClinicalTrials.gov, ID: NCT02768922 . Registered on 11 May 2016. Last updated on 17 November 2017.

• 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), p. 26–33. Full text in Research Archive
• 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), p. 87–100. doi: 10.3233/NRE-131015. Full text in Research Archive

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• Kirmess, Melanie; Døli, Hedda; Hide, Øydis; Erikstad, Nina Helen; Günther, Live & Kjølberg, Eli Anne [Show all 9 contributors for this article] (2025). Experiences from the adaptation of the «Therapeutisch Instrument voor Apraxie van de Spraak" (TIAS) into Norwegian. Full text in Research Archive
• Aslaksen, Sopary Min; Marshall-Brown,, Mats; Partee, Iselin Anne Cecilia & Kirmess, Melanie (2025). Adding time for home practice – participant experience from the revised SunCIST-program for aphasia. Full text in Research Archive
• Berg, Karianne; Hofslundsengen, Hilde Christine & Kirmess, Melanie (2024). Tverrfaglig samarbeid rundt stamming i barnehagealder. Full text in Research Archive
• Kirmess, Melanie (2024). Logopedisk tips: "Aphasia Therapy Finder". Norsk tidsskrift for logopedi. ISSN 0332-7256. 70(4), p. 33–33. Full text in Research Archive
• Næss, Kari-Anne Bottegård & Kirmess, Melanie (2024). Referat: Avslutningsseminar i prosjektet The effective stuttering treatment (EST). Norsk tidsskrift for logopedi. ISSN 0332-7256. 70(2), p. 23–26. Full text in Research Archive
• Dipper, Lucy T.; Best, Wendy; Brady, Marian C; Bunker, Lisa; Hoover, Elizabeth & Kirmess, Melanie [Show all 12 contributors for this article] (2024). TIDieR Aphasia - Reporting Checklist for Aphasia Treatment Studies. Full text in Research Archive
• Rose, Miranda L; Harvey, Sam; Dignam, Jade K.; Dipper, Lucy T.; Hoover, Elizabeth & Kirmess, Melanie [Show all 11 contributors for this article] (2024). The Aphasia Therapy Finder: A novel evidence-based practice implementation tool. Full text in Research Archive
• Ingebretsen, Silje Merethe Hansen; Kirmess, Melanie & Stubberud, Jan Egil (2024). Response to Letter to the Editor: 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. 106(1), p. 151–152. doi: 10.1016/j.apmr.2024.09.009. Full text in Research Archive
• Kirmess, Melanie & Ingebretsen, Silje Merethe Hansen (2023). Referat: Disputas Maribeth Rivelsrud. Norsk tidsskrift for logopedi. ISSN 0332-7256. 69(3), p. 44–45. Full text in Research Archive
• 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. Full text in Research Archive
• 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. Full text in Research Archive
• 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. Full text in Research Archive
• 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. Full text in Research Archive
• Øra, Hege Prag; Kirmess, Melanie & Becker, Frank (2020). Språktrening rett hjem - intensiv språktrening via videokonferanse. Afasiposten. ISSN 0803-2467. p. 12–14. Full text in Research Archive
• Kirmess, Melanie; H., Kristin Vanebo & Becker, Frank (2020). 10 års jubileum for Sunnaas intensive språkgrupper «SunCIST». Afasiposten. ISSN 0803-2467. p. 12–14. Full text in Research Archive
• Kirmess, Melanie (2020). Hjelp – jeg kan ikke snakke! Full text in Research Archive Show summary

  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?

• Berdal, Stig; Døli, Hedda Ruth; Hide, Øydis; Hvistendahl, Anne Katherine; Haaland-Johansen, Line & Kirmess, Melanie [Show all 9 contributors for this article] (2020). DIAS – Diagnostisk verktøy for taleapraksi. Norsk tidsskrift for logopedi. ISSN 0332-7256. 66(4), p. 17–23. Full text in Research Archive
• Hansen, Silje Merethe; Kirmess, Melanie & Stubberud, Jan (2019). Group Based Treatment for Persons With Social Communication Disorder: Participant Evaluation Post-treatment. Full text in Research Archive
• Sjøstrand, Åse; Kefalianos, Elaina; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Kirmess, Melanie & Lervåg, Arne [Show all 8 contributors for this article] (2019). Non-pharmacological interventions for stuttering in children aged between birth and six years. Cochrane Database of Systematic Reviews. 2019:CD013489(11), p. 1–36. doi: 10.1002/14651858.CD013489. Full text in Research Archive
• Sjøstrand, Åse; Kefalianos, Elaina; Hofslundsengen, Hilde Christine; Guttormsen, Linn Stokke; Kirmess, Melanie & Lervåg, Arne [Show all 8 contributors for this article] (2019). Protocol: Non-pharmacological interventions for stuttering in children aged between birth and six years. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.CD013489. Full text in Research Archive Show summary

  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).

• Våge, Kristine & Kirmess, Melanie (2019). “Twice as good?” - The outcome of participating twice in an intensive group treatment for aphasia. Full text in Research Archive
• Tinbod, Unn; Löfkvist, Ulrika; Sverdrup, Anne-Cathrine Thijn & Kirmess, Melanie (2019). New ways of measuring every day communication - The application of LENA™ to persons with aphasia. Full text in Research Archive
• Kirmess, Melanie; Hvistendahl, Anne-Kathrine; Kjølberg, Eli Anne; Koot, Karin; Hide, Øydis & Døli, Hedda [Show all 7 contributors for this article] (2019). ”Sopp-kopp-topp” – Experience from the validation of the Norwegian version of the Diagnostic Instrument for Apraxia of Speech (DIAS). Full text in Research Archive
• 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. Full text in Research Archive
• 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. Full text in Research Archive
• 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. Full text in Research Archive Show summary

  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. Full text in Research Archive
• Kirmess, Melanie (2018). Intervju med logoped Elaina Kefalianos, University of Melbourne. [Journal]. Norsk tidsskrift for logopedi. Full text in Research Archive
• 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? Full text in Research Archive Show summary

  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. Full text in Research Archive
• Winsnes, Ingvild Elisabeth; Øra, Hege Prag; Kirmess, Melanie & Becker, Frank (2017). Aphasia telerehabilitation - A digital enterprise (experience from the SLT intervention). Full text in Research Archive
• Øra, Hege Prag; Kirmess, Melanie; Bergersen, Hilde; Winsnes, Ingvild Elisabeth; Erlenkamp, Sonja & Myklebost, Marthe Brurok [Show all 7 contributors for this article] (2017). Evidence-based aphasia rehabilitation guidelines - Multidisciplinary implementation through an E-learning program. Full text in Research Archive
• 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. Full text in Research Archive
• Sønsterud, Hilda; Kirmess, Melanie; Halvorsen, Margrethe S.; Feragen, Kristin Judith Billaud & Ward, David (2017). Individualized stuttering therapy for adults - what works for whom? Full text in Research Archive
• 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? Full text in Research Archive
• Kirmess, Melanie (2017). "Jeg har hatt det inspirerende og gøy!" Intervju med Anne-Lise Rygvold. [Journal]. Norsk tidsskrift for logopedi. Full text in Research Archive
• Feiken, Judith & Kirmess, Melanie (2017). Foreign Accent Syndrome (FAS) - A type of kinetic Apraxia of Speech (AOS). Full text in Research Archive
• Kirmess, Melanie (2017). Evidensbasert praksis, PICO-spørsmål, kjernespørsmål - Hvordan påvirker dette din logopediske hverdag? Full text in Research Archive
• Kirmess, Melanie (2016). Sunnaas intensive afasiprogram(SunCIST) i et langtidsperspektiv. Full text in Research Archive
• Kirmess, Melanie (2016). Redaktøren har ordet: Logopediens dag fokuserer på verbal dyspraksi. Norsk tidsskrift for logopedi. ISSN 0332-7256. 62(1), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2016). SunCIST i et brukerperspektiv - Evaluering og tilrettelegging. Full text in Research Archive
• Kirmess, Melanie; Røste, Ingvild & Karlsen, Jannicke (2016). Redaktøren har ordet. Norsk tidsskrift for logopedi. ISSN 0332-7256. 62(2), p. 3–3. Full text in Research Archive
• Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Winsnes, Ingvild Elisabeth & Becker, Frank (2016). Aphasia telerehabilitation early post stroke. Full text in Research Archive
• Kirmess, Melanie (2015). Kildebruk. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(3), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2015). Redaktøren har ordet. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(2), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2015). Skattekisten: Intervju med Liv Stabell Kulø. [Journal]. Norsk tidsskrift for logopedi. Full text in Research Archive
• Kirmess, Melanie (2015). Nettressurser for støttet samtale for afasirammede. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(4), p. 38–40. Full text in Research Archive
• Kirmess, Melanie (2015). Disputas Marianne Klem. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(1), p. 44–45. Full text in Research Archive
• 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), p. 36–37. Full text in Research Archive
• Kirmess, Melanie (2015). Redaktøren har ordet. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(4), p. 3–3. Full text in Research Archive
• Kirmess, Melanie; Røste, Ingvild & Vøyne, Jannicke (2015). Referat: Norsk logopedlagets vinterkurs. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(2), p. 10–14. Full text in Research Archive
• Kirmess, Melanie; Heiberg, Ellen; Kjeldaas, Hege; Krohn, Silje & Wennberg, Ulrika (2015). The long term outcome of the SunCIST program. Full text in Research Archive
• Kirmess, Melanie (2015). Kompetanse og veiledning. Norsk tidsskrift for logopedi. ISSN 0332-7256. 61(1), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2015). Constraint induced språkterapi (CIST) - et gruppetilbud for intensiv afasirehabilitering. Full text in Research Archive
• Kirmess, Melanie (2015). Sunnaas intensive afasitreningsprogram (SunCIST). Full text in Research Archive
• Kirmess, Melanie (2015). Praktiske vurderinger rundt afasigrupper basert på constraint induced språkterapi. Full text in Research Archive
• Erlenkamp, Sonja; Kirmess, Melanie; Bergersen, Hilde; Audestad, Solveig & Becker, Frank (2015). Promoting evidence-based aphasia rehabilitation – guidelines at Sunnaas Rehabilitation Hospital. Full text in Research Archive
• Kirmess, Melanie (2014). Bokanmeldelse: Klinisk forskningsmetode for logopeder og audiopedagoger. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(2), p. 44–45. Full text in Research Archive
• Kirmess, Melanie (2014). Logopeden – hvem er du og hvor vil du? Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2014). Logopedisk tips 1 "Støttet samtale". Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), p. 42–42. Full text in Research Archive
• Kirmess, Melanie & Hansen, Silje Merethe (2014). Referat: Afasidagene 13. og 14. november 2014. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), p. 36–38. Full text in Research Archive
• Kirmess, Melanie (2014). Constraint induced language therapy for aphasia rehabilitation. The SunCIST program. Full text in Research Archive
• Kirmess, Melanie (2014). Høsttakk. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(3), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2014). Bokanmeldelse: Evidensbasert praksis i logopedi. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(2), p. 42–43. Full text in Research Archive
• Kirmess, Melanie (2014). Disputas Jannicke Karlsen. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(4), p. 40–41. Full text in Research Archive
• Kirmess, Melanie (2014). Språktrening døgnet rundt. Kommunikasjon og rehabilitering i hverdagen. Full text in Research Archive
• 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. Full text in Research Archive
• Kirmess, Melanie; Vøyne, Jannicke & Røste, Ingvild (2014). Referat: Norsk logopedlagets etterutdanningskurs og landsmøte 2014. Norsk tidsskrift for logopedi. ISSN 0332-7256. 60(3), p. 32–37. Full text in Research Archive
• Kirmess, Melanie & Becker, Frank (2013). Intensive afasigrupper på Sunnaas: SunCIST-programmet. Afasiposten. ISSN 0803-2467. 24(3), p. 13–17. Full text in Research Archive
• Kirmess, Melanie & Becker, Frank (2013). From word level training to social communication – Experience from an intensive group program for persons with mild to moderate aphasia. Full text in Research Archive
• Kirmess, Melanie (2013). Kurs og faglig oppdatering. Norsk tidsskrift for logopedi. ISSN 0332-7256. 59(2), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2013). Flerspråklighet på dagsorden. Norsk tidsskrift for logopedi. ISSN 0332-7256. 59(4), p. 3–3. Full text in Research Archive
• Kirmess, Melanie (2013). Melanie Kirmess, Postdoktor og fagsjef for spesialpedagoger, Sunnaas Sykehus HF i samtale med forfatter Margareta Lindholm. [Journal]. Afasiposten. Full text in Research Archive
• Kirmess, Melanie (2013). Teori og praksis. Norsk tidsskrift for logopedi. ISSN 0332-7256. 59(3), p. 3–3. Full text in Research Archive
• 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. Full text in Research Archive Show summary

  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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