An Exploratory Study of Pragmatic Language Use Across Contexts With the Pragmatic Rating Scale-School Age Among Autistic Boys and Boys With Fragile X Syndrome Plus Autism.

PURPOSE: Autistic boys and boys with co-occurring fragile X syndrome and autism spectrum disorder (FXS + ASD) demonstrate similar pragmatic language difficulties. The Pragmatic Rating Scale-School Age (PRS-SA) captures ecologically valid metrics of pragmatic language impairments in these populations. It is traditionally scored based on the Autism Diagnostic Observation Schedule (ADOS), which may limit the use of the PRS-SA more broadly in research and clinical contexts. METHOD: This study evaluated the feasibility of the PRS-SA based on a shorter, semistructured conversational context compared to the ADOS in school-age autistic boys (n = 16) and boys with FXS + ASD (n = 16), matched on ASD traits. Differences across ADOS and conversational contexts and associations with ASD-related social difficulties were evaluated. RESULTS: Findings revealed differences in PRS-SA scores between ADOS and conversational contexts, but only for the FXS + ASD group. Limited associations were observed between PRS-SA scores and ASD traits. CONCLUSIONS: Results from this study indicate the feasibility of using the PRS-SA in a shorter conversational context than the ADOS to assess pragmatic language among autistic boys. For boys with FXS + ASD, contextual differences warrant careful consideration in future work.

How Is Quality of Life Assessed in People With Dementia? A Systematic Literature Review and a Primer for Speech-Language Pathologists.

Purpose The purpose of this study was to determine how quality of life (QoL) is measured in people with dementia involved in interventions designed to improve well-being and to explore how those measures align with principles of person-centered care. Method A systematic literature review was conducted utilizing PsychInfo, CINAHL, and PubMed and combinations of the search terms: "dementia," "outcome measure," "creative engagement," "creative intervention," "TimeSlips," "art," "quality of life," and "well-being." The search was limited to studies published in peer-reviewed journals that reported outcomes for people with dementia in response to a creative intervention. Results Across the 24 reviewed studies, 30 different outcome measures were reported including eight self-reported, nine observational, and 13 proxy-reported measures. Self-report of QoL was elicited 16 times, observational measures were reported 17 times, and proxy-reported measures were used 28 times. All measures were used with participants across the dementia severity spectrum. Conclusion Current clinical practice of QoL evaluation does not align well with person-centered care principles of self-determination based on the low proportion of self-report. The previously reported limitations of proxy-report have been in part confirmed with this study. Implications of the findings for speech-language pathologists are discussed.

Service-Learning with older adults in care communities: Measures of attitude shifts in undergraduate students.

Background: Clinicians' attitudes toward older adults can influence the quality of the care they provide. The purpose of this study was to demonstrate how to measure the impact of service-learning on undergraduate healthcare students' attitudes toward elders and people with dementia using a theory-grounded qualitative and quantitative assessment, beyond the commonly used pre-test/post-test model. Methods: One-hundred forty-five undergraduate students across two midwestern universities participated in service-learning experiences in a long-term care or assisted living environment during one semester. Students completed the Dementia Attitudes Scale (DAS) before they began service-learning and at the end of the experience. Students also completed reflective journal entries throughout their experiences. Results: Significant, positive changes in knowledge and comfort were noted in ratings from pre-to post-assessment on the DAS. Of the 4165 sentences produced by students in three analyzed journal entries, 2045 (49%) reflected the Awareness-Application Attitude theoretical framework. For the first journal entry, the proportion of positive attitude statements was significantly lower than that for neutral and negative statements while the reversed effect was observed for the last journal entry. Conclusions: Service-learning is an evidence-based pedagogy associated with positive attitude shifts for undergraduate students.