{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:32:09Z","timestamp":1771065129678,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>After total laryngectomy, surgical voice restoration is used to establish communication via tracheoesophageal voice prosthesis. Once voice is established, there is a paucity of information on what speech and language therapists (SLTs) should do to improve tracheoesophageal voice quality to ensure functional communication. No existing surveys or studies investigate this specific question. There is also a disconnect between guidelines, knowledge and clinical practice, whereby clinical guidelines stipulate the requirement for SLT intervention, but do not detail what this entails in the rehabilitation context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>(1) To advance understanding of current clinical practice beyond voice prosthesis management and care. (2) To explore what approaches are implemented in clinical practice across the UK and Republic of Ireland to rehabilitate tracheoesophageal voice. (3) To investigate the barriers and facilitators to provision of tracheoesophageal voice therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>A self\u2010administered 10\u2010min online survey was developed using Qualtrics software and piloted before dissemination. Survey development was informed by the Behaviour Change Wheel to identify barriers, facilitators and additional factors contributing to SLTs\u2019 provision of voice therapy to tracheoesophageal speakers. The survey was disseminated via social media and professional networks. Eligibility criteria included SLTs with at least one year post\u2010registration experience and with experience of working with laryngectomy in the past 5 years. Descriptive statistics were used to analyse closed answer questions. Open question responses were analysed using content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>The survey received 147 responses. Participants were representative of the head and neck cancer SLT workforce. SLTs believe that tracheoesophageal voice therapy is an important aspect of laryngectomy rehabilitation; however, there was a lack of knowledge about therapy approaches and insufficient resources for implementing therapy. SLTs expressed a desire for more training, specific guidelines and a stronger evidence base to inform clinical practice. Some SLTs expressed feelings of frustration and lack of acknowledgement for the specialist skills required to undertake laryngectomy rehabilitation and tracheoesophageal work in general.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The survey identifies the need for a robust training approach and detailed clinical guidelines to promote consistent practice across the profession. The evidence base within this clinical area is emergent, hence there is a need for increased research and clinical audit to inform practice. Under\u2010resourcing was highlighted, which should be considered in service planning to ensure that adequate staff, access to expert practitioners or time ring\u2010fenced for therapy are available for tracheoesophageal speakers to receive the support they require.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT THIS PAPER ADDS<\/jats:title><jats:sec><jats:title>What is already known on this subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Total laryngectomy results in life\u2010altering changes to communication. Clinical guidelines advocate for speech and language therapy intervention; however, there is no clear information on what SLTs should do to optimize tracheoesophageal voice and the evidence base to support practice is lacking.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this study adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This survey identifies what interventions SLTs provide in clinical practice to rehabilitate tracheoesophageal voice; and it explores the barriers and facilitators that influence the provision of tracheoesophageal voice therapy.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Specific training, clinical guidelines, increased research and audit are required to support clinical practice in laryngectomy rehabilitation. Service planning should address the under\u2010resourcing of staff, expert practitioners and therapy allocated time.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12873","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T12:37:38Z","timestamp":1680525458000},"page":"1481-1495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Approaches to tracheoesophageal voice rehabilitation: a survey of the UK and Irish speech and language therapists\u2019 current practice and beliefs"],"prefix":"10.1111","volume":"58","author":[{"given":"Freya","family":"Sparks","sequence":"first","affiliation":[{"name":"Department of Language and Communication Sciences, City University of London  London UK"},{"name":"Barts Health NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Dipper","sequence":"additional","affiliation":[{"name":"Department of Language and Communication Sciences, City University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Coffey","sequence":"additional","affiliation":[{"name":"Imperial College Academic Health Science Centre  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katerina","family":"Hilari","sequence":"additional","affiliation":[{"name":"Department of Language and Communication Sciences, City University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"BAHNO (British Association of Head and Neck Oncologists). 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