Typical vs. atypical: Combining auditory Gestalt perception and acoustic analysis of early vocalisations in Rett syndrome.

BACKGROUND: Early speech-language development of individuals with Rett syndrome (RTT) has been repeatedly characterised by a co-occurrence of apparently typical and atypical vocalisations. AIMS: To describe specific features of this intermittent character of typical versus atypical early RTT-associated vocalisations by combining auditory Gestalt perception and acoustic vocalisation analysis. METHODS AND PROCEDURES: We extracted N = 363 (pre-)linguistic vocalisations from home video recordings of an infant later diagnosed with RTT. In a listening experiment, all vocalisations were assessed for (a)typicality by five experts on early human development. Listeners' auditory concepts of (a)typicality were investigated in context of a comprehensive set of acoustic time-, spectral- and/or energy-related higher-order features extracted from the vocalisations. OUTCOMES AND RESULTS: More than half of the vocalisations were rated as 'atypical' by at least one listener. Atypicality was mainly related to the auditory attribute 'timbre', and to prosodic, spectral, and voice quality features in the acoustic domain. CONCLUSIONS AND IMPLICATIONS: Knowledge gained in our study shall contribute to the generation of an objective model of early vocalisation atypicality. Such a model might be used for increasing caregivers' and healthcare professionals' sensitivity to identify atypical vocalisation patterns, or even for a probabilistic approach to automatically detect RTT based on early vocalisations.

Maximizing the persuasiveness of a salesperson: an exploratory study of the effects of nonverbal immediacy and language power on the extent of persuasion / Cómo maximizar la capacidad de persuasión de un vendedor: estudio exploratorio de los efectos de la cercanía no verbal y el poder del lenguaje en el grado de persuasión

The present study investigated the effects of a salesperson’s use of language power and nonverbal immediacy on the persuasiveness of the salesperson. A high level of language power and a high level of nonverbal immediacy were hypothesized to singularly and jointly increase a salesperson’s level of persuasiveness. A sample of 211 undergraduate students voluntarily completed an online survey, which displayed a video clip of a sales presentation. Each participant randomly viewed one of four video clips, which differed in terms of the salesperson’s levels of language power (powerful vs. powerless) and nonverbal immediacy (high vs. low). A three-way ANOVA indicated that language power had a significant main effect on persuasion in the expected direction, and also revealed a significant interaction between nonverbal immediacy and participant biological sex. However, there were no main effects for nonverbal immediacy and participant biological sex, and no interaction effect was found between language power and nonverbal immediacy. Subsequent data analysis revealed that the perceived power of the speaker mediated the relationship between language power and the extent of persuasion. We conclude the article with a discussion of the implications of our findings for both researchers and practitioners (AU)

Este estudio investiga los efectos de la utilización por parte de los vendedores del poder del lenguaje y de la cercanía no verbal en la persuasión del vendedor. Se postula que un grado elevado de poder del lenguaje y de cercanía no verbal aumentarán tanto individualmente como conjuntamente el nivel de persuasión del vendedor. Una muestra compuesta por 211 estudiantes universitarios cumplimentó voluntariamente una encuesta online que mostraba un video de una presentación de ventas. Cada participante vio al azar uno de los cuatro videos, que se diferenciaban en el grado de poder del lenguaje (poderoso vs. incapaz) y de cercanía (elevada vs. baja) no verbal del vendedor. Un ANOVA de tres factores indicaba que el poder del lenguaje tenía un efecto principal significativo en la persuasión en la dirección esperada, así como una interacción significativa entre la proximidad no verbal y el sexo biológico de los participantes. No obstante, no había efectos principales para la cercanía no verbal o el sexo biológico de los participantes ni se encontró interacción entre el poder del lenguaje y la proximidad no verbal. Un análisis de datos posterior reveló que el poder percibido del hablante mediatizaba la relación entre el poder del lenguaje y el grado de persuasión. El artículo finaliza con un debate sobre las implicaciones de los resultados para investigadores y los profesionales (AU)

Effects of cue modality and emotional category on recognition of nonverbal emotional signals in schizophrenia.

BACKGROUND: Impaired interpretation of nonverbal emotional cues in patients with schizophrenia has been reported in several studies and a clinical relevance of these deficits for social functioning has been assumed. However, it is unclear to what extent the impairments depend on specific emotions or specific channels of nonverbal communication. METHODS: Here, the effect of cue modality and emotional categories on accuracy of emotion recognition was evaluated in 21 patients with schizophrenia and compared to a healthy control group (n = 21). To this end, dynamic stimuli comprising speakers of both genders in three different sensory modalities (auditory, visual and audiovisual) and five emotional categories (happy, alluring, neutral, angry and disgusted) were used. RESULTS: Patients with schizophrenia were found to be impaired in emotion recognition in comparison to the control group across all stimuli. Considering specific emotions more severe deficits were revealed in the recognition of alluring stimuli and less severe deficits in the recognition of disgusted stimuli as compared to all other emotions. Regarding cue modality the extent of the impairment in emotional recognition did not significantly differ between auditory and visual cues across all emotional categories. However, patients with schizophrenia showed significantly more severe disturbances for vocal as compared to facial cues when sexual interest is expressed (alluring stimuli), whereas more severe disturbances for facial as compared to vocal cues were observed when happiness or anger is expressed. CONCLUSION: Our results confirmed that perceptual impairments can be observed for vocal as well as facial cues conveying various social and emotional connotations. The observed differences in severity of impairments with most severe deficits for alluring expressions might be related to specific difficulties in recognizing the complex social emotional information of interpersonal intentions as compared to "basic" emotional states. Therefore, future studies evaluating perception of nonverbal cues should consider a broader range of social and emotional signals beyond basic emotions including attitudes and interpersonal intentions. Identifying specific domains of social perception particularly prone for misunderstandings in patients with schizophrenia might allow for a refinement of interventions aiming at improving social functioning.

Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.

OBJECTIVES: This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. METHODS: During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. RESULTS: Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (ß=0.90; CI: 0.45-1.35; p<0.00 and ß=1.32; CI: 0.18-2.47; p=0.025, respectively). Clients "psychosocial communication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (ß=0.59; CI: 0.20-099; p=0.004). CONCLUSIONS: In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. PRACTICE IMPLICATIONS: In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making.

Expressive body movement responses to music are coherent, consistent, and low dimensional.

Embodied music cognition stresses the role of the human body as mediator for the encoding and decoding of musical expression. In this paper, we set up a low dimensional functional model that accounts for 70% of the variability in the expressive body movement responses to music. With the functional principal component analysis, we modeled individual body movements as a linear combination of a group average and a number of eigenfunctions. The group average and the eigenfunctions are common to all subjects and make up what we call the commonalities. An individual performance is then characterized by a set of scores (the individualities), one score per eigenfunction. The model is based on experimental data which finds high levels of coherence/consistency between participants when grouped according to musical education. This shows an ontogenetic effect. Participants without formal musical education focus on the torso for the expression of basic musical structure (tempo). Musically trained participants decode additional structural elements in the music and focus on body parts having more degrees of freedom (such as the hands). Our results confirm earlier studies that different body parts move differently along with the music.

Recognition of nonverbal communication of emotion after traumatic brain injury.

BACKGROUND: Individuals who have had a traumatic brain injury (TBI) often have difficulty processing nonverbal communication (Ekman, 1976) The published research in this area has focused on a TBI patient's ability to recognize facial expression, vocal intonation, and postural expression (Croker, 2005; Hopkins, Dywan & Segalowitz, 2002). OBJECTIVE: This study compared the non-verbal processing skills of brain-injured patients versus non-injured controls in all three domains. METHODS: The stimuli were photographs of facial and postural expressions and audio recordings of intonational expressions. RESULTS: The results indicated that persons with TBI have particular difficulty recognizing non-verbal communication resulting from vocal intonations. CONCLUSIONS: The TBI patients had difficulty processing tonality, therefore, it is reasonable to suggest that clinicians, friends, and family members should emphasize the explicit verbal content of spoken language when speaking to a person with TBI.

An exploration of adolescent nonsuicidal self-injury and religious coping.

Many adolescents who engage in nonsuicidal self-injury (NSSI) self-identify as religious, but the role of religion in their NSSI is not known. This exploratory study examined the relationship between religious coping and religiousness among adolescents who self-injure and the function of their NSSI. Thirty adolescents aged 12-19 years who had engaged in NSSI participated in an interview and completed questionnaires. Multiple regressions were used to examine the relationship between religious coping and NSSI, and Pearson correlations were used to assess the relationship between religiousness and function of NSSI. Greater use of positive religious coping was associated with lower likelihood of engaging in NSSI to rid oneself of unwanted emotions, whereas greater use of negative religious coping was associated with greater likelihood of engaging in NSSI for this reason as well as to avoid punishment or unwanted responsibility. Higher religiousness was associated with greater use of NSSI to communicate with or gain attention from others, whereas lower religiousness was associated with greater use of NSSI to relieve unwanted emotions. Having a greater understanding of how religious constructs are related to the various functions served by NSSI may inform treatment of this population, particularly among religious youth who self-injure.

Relación del feed-back y las barreras de comunicación del docente con la motivación intrínseca de estudiantes adolescentes de educación física / Relations of feed-back and teacher communication barriers with in-trinsic motivation among adolescent students in physical education

Este estudio examinó la relación entre los diferentes tipos de feed-back y la evitación de las barreras de la comunicación por parte del docente con la motivación intrínseca del alumnado en clases de educación física. Los estudiantes (n = 214) cumplimentaron varios cuestionarios que valoraban la percepción del feed-back del docente, el uso de estrategias de comunicación para evitar las barreras de comunicación con el alumnado y la motivación intrínseca. Los resultados mostraron que los tipos de feed-back general positivo percibido, conocimiento del rendimiento percibido y no verbal positivo general correlacionaban tanto positivamente entre sí, como también con la evitación de barreras de la comunicación y la motivación intrínseca del alumnado. Además, los análisis de regresión realizados revelaron que el uso del feed-back general positivo percibido y del conocimiento del rendimiento percibido predijeron un clima de aula exento de barreras de la comunicación. Los resultados son discutidos en el marco de una mejora de la calidad de la docencia en clases de educación física (AU)

This study examined the relationship between different types of feed-back and avoiding the teacher’s communication barriers with students and intrinsic motivation in physical education classes. Students (n = 214) completed a set of questionnaires that assessed the perception of the teacher feedback, the use of communication strategies to overcome the barriers of communication with students and intrinsic motivation. The results showed positive relationships between the general positive feedback received, the knowledge of perceived performance and general positive and nonverbal feedback, as well as the avoidance of barriers to communication and students’ intrinsic motivation. In addition, regression analysis revealed that use of the generally positive feedback and the knowledge of the perceived performance predicted a classroom atmosphere free of communication barriers. The results are discussed in the context of improving the quality of teaching in physical education classes (AU)

Non-verbal communication of compassion: measuring psychophysiologic effects.

BACKGROUND: Calm, compassionate clinicians comfort others. To evaluate the direct psychophysiologic benefits of non-verbal communication of compassion (NVCC), it is important to minimize the effect of subjects' expectation. This preliminary study was designed to a) test the feasibility of two strategies for maintaining subject blinding to non-verbal communication of compassion (NVCC), and b) determine whether blinded subjects would experience psychophysiologic effects from NVCC. METHODS: Subjects were healthy volunteers who were told the study was evaluating the effect of time and touch on the autonomic nervous system. The practitioner had more than 10 years' experience with loving-kindness meditation (LKM), a form of NVCC. Subjects completed 10-point visual analog scales (VAS) for stress, relaxation, and peacefulness before and after LKM. To assess physiologic effects, practitioners and subjects wore cardiorespiratory monitors to assess respiratory rate (RR), heart rate (HR) and heart rate variability (HRV) throughout the 4 10-minute study periods: Baseline (both practitioner and subjects read neutral material); non-tactile-LKM (subjects read while the practitioner practiced LKM while pretending to read); tactile-LKM (subjects rested while the practitioner practiced LKM while lightly touching the subject on arms, shoulders, hands, feet, and legs); Post-Intervention Rest (subjects rested; the practitioner read). To assess blinding, subjects were asked after the interventions what the practitioner was doing during each period (reading, touch, or something else). RESULTS: Subjects' mean age was 43.6 years; all were women. Blinding was maintained and the practitioner was able to maintain meditation for both tactile and non-tactile LKM interventions as reflected in significantly reduced RR. Despite blinding, subjects' VAS scores improved from baseline to post-intervention for stress (5.5 vs. 2.2), relaxation (3.8 vs. 8.8) and peacefulness (3.8 vs. 9.0, P < 0.05 for all comparisons). Subjects also had significant reductions in RR (P < 0.0001) and improved HRV (P < 0.05) with both tactile and non-tactile LKM. CONCLUSION: It is possible to test the effects of LKM with tactile and non-tactile blinding strategies; even with blinding in this small preliminary study, subjects reported significant improvements in well-being which were reflected in objective physiologic measures of autonomic activity. Extending compassion is not only good care; it may also be good medicine. TRIAL REGISTRATION NUMBER: US National ClinicalTrials.gov registration number, NCT01428674.

Physical and psychological effects of 6-week tactile massage on elderly patients with severe dementia.

Tactile massage is a soft massage that improves physical relaxation and psychological well-being. The purpose of this study was to clarify the effects of a 6-week tactile massage on changes in physical and mental function, symptoms of behavioral and psychological symptoms of dementia (BPSD) among elderly patients with dementia. In addition, chromogranin A (CgA) levels as an index of stress examined the effects of tactile massage intervention. A tactile massage group consisting of elderly patients with dementia received tactile massage therapy a total of 30 times each for about 20 minutes between 16:00 and 17:00 hours. In the control group, the mean scores for ''intellectual'' and ''emotional function'' score decreased significantly after 6 weeks (P < .05); however, no change was observed in the tactile massage group. Both the ''aggressiveness'' score (P < .05) and CgA levels decreased significantly after 6 weeks in the tactile massage group. These results suggest that tactile massage reduces aggressiveness and stress level in patients with dementia.

Universal lessons learned by a gastroenterologist from a deaf and mute patient: the importance of nonverbal communication and establishing patient rapport and trust.

Deaf and mute patients may require minimal extra attention to establish trust and allay anxieties before minor medical maneuvers such as rectal examination. An extreme case is reported of the consequences from failure to accomplish this. A generally cooperative deaf and mute patient struggled and suffered a rectal tear and perforation during enema insertion that required emergency colorectal surgery; his nurse had failed to establish a trusting relationship before enema insertion. Ironically, the patient's physician had earlier easily performed digital rectal examination, a similar medical maneuver, with patient cooperation after establishing patient rapport. This report demonstrates the importance of treating individuals with disabilities like everyone else in addressing anxieties before medical maneuvers. The health care worker has the same responsibility of calming the patient, whether deaf or not; the sole difference is that communication between deaf and hearing requires greater skill and patience.

El lenguaje de los cuidados / No disponible

Los cuidados intraoperatorios deben incluir comunicación afectiva no sólo verbal, también mediante el tacto y el contacto visual, de escuchay respuesta a las necesidades del paciente.Como objetivo nos planteamos evidenciar la importancia de la comunicación no verbal en la práctica enfermera.Para ello realizamos un estudio observacional, descriptivo, entre los pacientes operados en los quirófanos de Urgencias del 15 de mayoal 15 de agosto de 2008. Mediante encuesta personal se analizó la importancia que el paciente concede a la comunicación no verbal ysu satisfacción con los cuidados intraoperatorios.A tenor de los resultados obtenidos podemos concluir que las habilidades de comunicación y de relación interpersonal suponen una delas bases fundamentales de la práctica enfermera y un factor determinante en la calidad de la atención (AU)

The intraoperating care must include affective communication, not only verbal but also through touch and visual contact, of listening andanswering to the needs of patients.As an objective, we expect to make evident the importance of the non verbal communication in nurse practice.For that reason, we carry out an observable study, descriptive, among the patients operated on in the OperatingTheaters of Emergencyfrom the 15th of May to the 15th of August 2008.Through personal survey the importance that the patient grants to the not verbalcommunication and their satisfaction with the intraoperating care was analyzed.In accordance with the obtained results we can conclude that the skills of communication and of interpersonal relationship mean one ofthe basic bases of the practical nurse and a determining factor in the quality of the attention (AU)

Engagement in group therapy for aphasia.

For group therapy for aphasia to be maximally effective, group members must be engaged in the clinical interaction. Engagement is a process through which people establish, maintain, and terminate collaborative exchanges. To investigate the interactive resources employed for managing and monitoring engagement in group therapy interactions, two videotaped conversation therapy groups for aphasia were analyzed via conversation analysis. Examples of clinician behaviors that engaged group members included gaze, body orientation, gesture, and mirrored acts. In addition, gaze, gesture, body position, and shared laughter provided evidence of engagement of group members. The study of these subtle interactive elements within clinical discourse provides information about the mechanisms that promote successful clinical interactions.

Laughter and communicative engagement in interaction.

We examined if and how laughter functioned communicatively as an indicator of engagement in group interactions involving adults with traumatic brain injury (TBI). Engagement refers to the intensity and manner of interpersonal involvement displayed by participants in social situations, and it reflects the extent to which they are mutually engrossed in, and alive to, the unfolding interaction. Analysis revealed that laughter functioned communicatively to support the "face," or public self-image, of those with TBI and to foster rapport and social closeness. The distribution of laughables, or verbal and nonverbal behaviors that occasion laughter, between participants was also examined and compared with data collected by Simmons-Mackie and Schultz in their analysis of humor during traditional aphasia therapy. Results revealed that laughter and laughables are sensitive to how individuals engage one another in interaction. Implications are considered with respect to more recent models of intervention that seek to promote more discourse equality between participants.

Transcultural nursing: its importance in nursing practice.

Transcultural nursing is an essential aspect of healthcare today. The ever-increasing multicultural population in the United States poses a significant challenge to nurses providing individualized and holistic care to their patients. This requires nurses to recognize and appreciate cultural differences in healthcare values, beliefs, and customs. Nurses must acquire the necessary knowledge and skills in cultural competency. Culturally competent nursing care helps ensure patient satisfaction and positive outcomes. This article discusses changes that are important to transcultural nursing. It identifies factors that define transcultural nursing and analyzes methods to promote culturally competent nursing care. The need for transcultural nursing will continue to be an important aspect in healthcare. Additional nursing research is needed to promote transcultural nursing.