Evaluation of different visual method used, to enhance communication skills between dental care providers and speech and hearing impaired patients.

PURPOSE: The purpose of this study is to evaluate the efficacy and retentiveness of various communication methods among speech and hearing impaired patients and dental practitioners. MATERIALS AND METHODS: A group of 33 school participants were selected for this study. An experimental task required the participants to follow routine dental instructions in the form of videotape and photographic charts and answer the questionnaire based on visual instructions. School participants were visited two times at an interval of 1 month. Participants were randomly divided into three groups, each consisting of 11 school participants, irrespective of gender and age. Group 1 received visual instructions without showing video and charts, Group 2 received video instructions, and Group 3 received photographic instructions. The questionnaires were assessed immediately and after 1 month. RESULTS: The study results were assessed in terms of improvement in knowledge concerning communication skills and long-term retention of the instructions for 1 month. ANOVA followed by post hoc Tukey test revealed a significant difference between Group 1 and other groups. However, there was no statistically significant difference between Group 2 and Group 3. The paired t-test revealed that there was a significant difference between the two visits in Group 1. However, there was no significant difference between visit 1 and visit 2 in Group 2 and Group 3. CONCLUSION: Health-care workers and patients with special needs like hearing-impaired patients should overcome communication barriers that may hinder proper diagnosis and treatment planning.

Referential interactions of Turkish-learning children with their caregivers about non-absent objects: integration of non-verbal devices and prior discourse.

This paper examines the way children younger than two use non-verbal devices (i.e., deictic gestures and communicative functional acts) and pay attention to discourse status (i.e., prior mention vs. newness) of referents in interactions with caregivers. Data based on semi-naturalistic interactions with caregivers of four children, at ages 1;00, 1;05, and 1;09, are analyzed. We report that children employ different types of non-verbal devices to supplement their inadequate referential forms before gaining mastery in language. By age 1;09, children show sensitivity to discourse status by using deictic gestures to accompany their non-lexical forms for new referents. A comparison of children's patterns with those in the input they receive reveals that caregivers choose their referential forms in accordance with discourse status information and tend to use different types of non-verbal devices to accompany their lexical and non-lexical referential forms. These results show that non-verbal devices play an important role in early referential discourse.

How Much Information Do People With Aphasia Convey via Gesture?

PURPOSE: People with aphasia (PWA) face significant challenges in verbally expressing their communicative intentions. Different types of gestures are produced spontaneously by PWA, and a potentially compensatory function of these gestures has been discussed. The current study aimed to investigate how much information PWA communicate through 3 types of gesture and the communicative effectiveness of such gestures. METHOD: Listeners without language impairment rated the information content of short video clips taken from PWA in conversation. Listeners were asked to rate communication within a speech-only condition and a gesture + speech condition. RESULTS: The results revealed that the participants' interpretations of the communicative intentions expressed in the clips of PWA were significantly more accurate in the gesture + speech condition for all tested gesture types. CONCLUSION: It was concluded that all 3 gesture types under investigation contributed to the expression of semantic meaning communicated by PWA. Gestures are an important communicative means for PWA and should be regarded as such by their interlocutors. Gestures have been shown to enhance listeners' interpretation of PWA's overall communication.

The Trifocus Framework and Interprofessional Collaborative Practice in Severe Disabilities.

PURPOSE: Individuals with severe disabilities are a diverse group of learners with complex communication needs. This article presents a synthesis of the literature addressing the five strategies of the trifocus framework, with its triadic structure of learner with disability, communication partner, and environment. The application of interprofessional collaborative practice (IPCP) to the implementation of trifocus framework communication strategies is emphasized. METHOD: A literature search was conducted using Google Scholar and EBSCO to identify literature and research studies on IPCP and communication intervention for learners with severe disabilities, published 1994-2015, and then organized within the trifocus framework. The trifocus strategies are enhancing sensitivity, utilizing routines, increasing communication opportunities, modifying the communication environment, and augmenting input. Studies that included at least one participant with severe disabilities and their communication partners were considered. A secondary search was then conducted by reviewing the articles referenced in the original articles. CONCLUSION: Effective IPCP in communication intervention considers the learner's characteristics, the knowledge and skills required of communication partners, and effective environmental arrangements to support communication. Future research should include clear participant descriptions, documentation of fidelity measures, and evidence of generalization to support professionals to know when findings are relevant to the individuals they serve.

Children and Augmentative or Alternative Communication System (AACs). A perceptive vision of the role played by families and professionals / Menores y Sistema Aumentativo o Alternativo de Comunicación (SAAC). Visión comprensiva de las familias y del papel de los profesionales

The present study accounts for the experience conducted with eight children, their families and the professionals in charge of the Early Intervention Program (EI) working with them during the whole process of learning, training and generalizing of an Augmentative or Alternative Communication System (AACs) used to try and find resources that will improve the quality of life of these participants. A qualitative paradigm has been applied and the data collection has been performed using focal groups during five one-hour-and-a-halves to two-hour sessions. Results obtained show the emotions and feelings arising within the family circles when other communication problems between the different environments where these children interact are added up to the functional diversity; professional experts in many contexts need to provide resources to respond to these necessities and requests originated by these children and their families. The resulting data underline the importance of the intervention used to enhance the attribution of competencies that capacitates families and neutralizes the attributions generating stress situations to finally find the most autonomous solutions to these issues. Reflections provided by professionals show the importance of knowing better the necessities of these children and their families for them to provide an efficient collaboration during the resource-finding process

Este estudio refleja la realidad de 8 menores, sus familias y 11 profesionales de Atención Temprana (AT) que trabajan con ellos en el proceso de aprendizaje de uso y generalización de un Sistema Aumentativo o Alternativo de Comunicación (SAAC), buscando respuestas que aporten mayor calidad de vida a sus protagonistas. Se ha realizado bajo el paradigma cualitativo y la recogida de datos a través de grupos focales en cinco sesiones de una duración de hora y media a dos horas. Los resultados obtenidos muestran las emociones y sentimientos que surgen en los entornos familiares cuando a la diversidad funcional se suma las dificultades para la comunicación en los diferentes entornos en los que se desarrollan estos menores, aportaciones que deben realizar los profesionales de los diferentes contextos buscando respuestas a las necesidades y demandas de los menores y sus familias. Los datos ponen de manifiesto la importancia de una intervención dirigida a potenciar atribuciones de competencia y capacitar a las familias para neutralizar las atribuciones generadoras de estrés, buscando soluciones de la forma más autónoma posible. Las reflexiones de los profesionales expresan la importancia de conocer las necesidades de los menores y sus familias para colaborar en la búsqueda de soluciones

Exploring Expressive Communication Skills in a Cross-Sectional Sample of Children and Young Adults With Angelman Syndrome.

PURPOSE: This study explores data on expressive communication skills of 300 individuals aged 0.0-21.11 years with Angelman syndrome (AS). These data provide a composite portrait of communication skills in a large sample of children and young adults with this rare disorder, specifying new detailed information about expressive communication. METHOD: The database associated with the Communication Matrix assessment (Rowland, 2004, 2011; Rowland & Fried-Oken, 2010) was mined for data regarding individuals with AS. We extracted data on the reasons for communicating, level of communication achieved, and use of various expressive communication modes to convey 24 specific messages. The performance of children and young adults in 5 age groups in the cross-sectional sample were contrasted. RESULTS: Results confirmed earlier studies showing that few individuals with AS use natural speech. However, in addition to using presymbolic modes, many children used alternative symbolic modes such as picture symbols, object symbols, and manual signs. Assessment scores increased slightly with age, F(4, 295) = 2.416, p = .049. CONCLUSIONS: Aggregating data on a large sample of individuals with AS provides a reference point for practitioners and family members and a basis for future investigations.

Paediatric cochlear implantation factors that affect outcomes.

Cochlear implantation is an established surgical intervention for individuals with bilateral severe to profound sensorineural hearing loss. The aim of the interevention is to provide the individual with a sensation of sound which they can learn to interpret with meaning. Outcomes vary considerably and the factors that impact on outcomes will be discussed.

Exploratory investigation of communication management in residential-aged care: a comparison of staff knowledge, documentation and observed resident-staff communication.

BACKGROUND: There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in residential-aged care and factors impacting optimal communication management is lacking. AIMS: To use data triangulation across multiple sources to describe resident-staff communication and communication management in residential-aged care. METHODS & PROCEDURES: Participants included a sample of 14 residents and 29 staff directly involved in communication interactions with residents. Data were obtained from: (1) resident file review (n = 14), (2) observation of resident-staff communication (n = 14), (3) resident surveys (n = 14) and (4) staff surveys (n = 29). Data from each source were examined separately then triangulated. OUTCOMES & RESULTS: All residents had limited opportunity for meaningful communication with staff. Documentation of residents' communication needs and strategies to facilitate resident-staff communication was insufficient to provide individualized recommendations. Although staff were observed to use various strategies to facilitate communication with residents, staff agreement about the applicability of these strategies to individual residents was inconsistent. Differences in resident-staff communication for residents who experience nil/mild versus moderate/severe communication difficulty were also found. CONCLUSIONS & IMPLICATIONS: Resident-staff communication and communication management in residential-aged care is limited in scope and challenged in meeting residents' individual communication needs. Improvements in both documentation and staff knowledge of residents' communication needs are necessary. Strategies to facilitate communication with individual residents must be tailored, evidence based, documented in care plans and delivered to staff through ongoing education. Increased involvement of specialist providers such as speech pathologists to support better communication management in residential-aged care may provide one way of facilitating such change.

Speech language therapy bilingual clinic, a written language therapeutical proposal to deaf people: case report.

PURPOSE: This study aimed to analyze the written production of a deaf person who is in the process of written language acquisition. METHODS: One person with hearing disability, called R., participated in this study together with his Speech Language Pathologist. The therapist, proficient in sign language, acted as an interlocutor and interpreter, prioritizing the interactive nature of language and interfering in the written production only when it was requested. RESULTS: During the 3 years of work with R., a change in stance toward written language was observed. In addition, he began to reflect on his texts and utilize written Portuguese in a way that allowed his texts to be more coherent. Writing became an opportunity to show his singularity and to begin reconstructing his relationship with language. CONCLUSION: Speech language pathology and audiology therapy, at a bilingual clinic, can allow people with hearing disability early access to sign language and, consequently, enable the development of the written form of Portuguese.

Clínica fonoaudiológica bilíngue, uma proposta terapêutica para surdos com a língua escrita: estudo de caso / Speech language therapy bilingual clinic, a written language therapeutical proposal to deaf people: case report

RESUMO Objetivo: O objetivo deste estudo foi analisar produções escritas de um sujeito surdo em processo de apropriação da escrita. Métodos: Participou dessa pesquisa um sujeito surdo, reconhecido pela inicial R., em conjunto com a sua fonoaudióloga. Cabe esclarecer que tal profissional, proficiente em língua de sinais, atuou como interlocutora e intérprete, priorizando a natureza interativa da linguagem e interferindo nas produções escritas apenas quando solicitada. Resultados: Durante os três anos trabalhados com R., observou-se uma mudança de postura perante a língua escrita. Além disso, ele passou a refletir sobre seus textos e a utilizar a Língua Portuguesa de maneira que seus textos tornaram-se mais coerentes para os leitores. A escrita tornou-se, assim, um espaço a mais de manifestação da singularidade de R., que passou a reconstruir sua história de relação com a linguagem. Conclusão: O trabalho fonoaudiológico em uma clínica bilíngue, por meio do qual os surdos podem ter acesso precoce à língua de sinais, pode possibilitar o desenvolvimento da modalidade escrita da Língua Portuguesa.

ABSTRACT Purpose: This study aimed to analyze the written production of a deaf person who is in the process of written language acquisition. Methods: One person with hearing disability, called R., participated in this study together with his Speech Language Pathologist. The therapist, proficient in sign language, acted as an interlocutor and interpreter, prioritizing the interactive nature of language and interfering in the written production only when it was requested. Results: During the 3 years of work with R., a change in stance toward written language was observed. In addition, he began to reflect on his texts and utilize written Portuguese in a way that allowed his texts to be more coherent. Writing became an opportunity to show his singularity and to begin reconstructing his relationship with language. Conclusion: Speech language pathology and audiology therapy, at a bilingual clinic, can allow people with hearing disability early access to sign language and, consequently, enable the development of the written form of Portuguese.

[Rethinking the Prescription's Comprehension: an Example of Care Centers for Deaf People]. / Repenser la compréhension de l'ordonnance : l'exemple des soins aux Sourds.

CONTEXT: Since the realization of the difficulties for Deaf people to access care, specific assisting services in french sign language (FSL) and adapted prevention campaigns have developed in France. Illiteracy, a significant problem among Deaf people, makes the comprehension of prescription uncertain. AIM: Exploring and describing the adaptations implemented by professional signers to avoid confusion related to prescription's directions. METHOD: This qualitative study in participant observation listed the different sources of confusion and the adaptations applied on prescriptions on a daily basis by eight practitioners and three intermediators who worked in six care cent ers for Deaf people. Interviews with deaf patients aimed to ascertain the encountered difficulties. These adaptations were presented, for a three-way correlation, during a national meeting attended by professional workers in care centers for Deaf people. They were subjected to a review by all attendees in order to generate a more consensual report. RESULTS: The sources of the identified misunderstandings turned out to be connected with time representation, the use of unknown words or words with double meaning, and the issuing of several documents. To reduce the risk of error, professional signers would use charts, calendars, drawings, replace durations by dates. Some of them requested that the patient would rephrase the understood information. Pros and cons, as well as the pat ient's profile were detailed for each adaptation. CONCLUSION: Even if no method can suppress all risks of confusion, this work leads us to a reflection on alterity through the risk of medicinal errors, on prescription in general, may it be directed to a patient with no particular vulnerability or to a handicapped or illiterate one.

Metodología para la Educación Comunitaria / Methodology for community education

La existencia de conductas ajenas a los valores revelan la necesidad de fortalecer la labor educativa en todas las esferas de la sociedad cubana, en tal sentido, la presente investigación ofrece una metodología para promover un accionar más activo y transformador de las instituciones sociales en la Educación Comunitaria desde el trabajo comunitario integrado que vincula los intereses y necesidades de la población en las tareas del desarrollo social(AU)

The existence of indifference behaviors to principles reveals the need for strengthening the educative work in all spheres of the Cuban society. In that sense, the present research provides a methodology in order to promote a more active and transforming work of social institutions in the community education from the integrated community work connecting the interests and needs of the people on duties of social development(AU)

[Potential analysis of research on speech therapy-led communication training in aphasia following stroke]. / Potenzialanalyse zu logopädischem Kommunikationstraining bei Aphasie nach Schlaganfall.

HEALTH PROBLEM: In Germany, about 100,000 people currently suffer from aphasia. This speech disorder occurs as a result of neurologic events such as stroke or traumatic brain injury. Aphasia causes major limitations in social participation and quality of life and can be associated with unemployability and social isolation. For affected persons, it is essential to regain and maintain autonomy in daily life, both at work and with family and friends. The loss of autonomy is perceived much more dramatically than the loss of speech. Clients wish to minimise this loss of autonomy in daily life. As full recovery is not achievable in chronic aphasia, treatment must focus on improved compensatory approaches and on supporting the clients' coping strategies. EVIDENCE BASE: Based on eight randomised comparisons including 347 participants, a recent Cochrane review (Brady et al., 2012) revealed that speech therapy - as compared with no treatment - had positive effects on functional communication in clients suffering from aphasia (0.30 SMD; 95% CI[0.08 to 0.52]). There was no evidence suggesting that one type of training was superior to the others. However, quality of life and social participation were not evaluated as outcomes. Recent studies found that speech therapy-led training for communication and self-efficacy and the integration of communication partners may have a positive impact on these client-centred outcomes. IMPLICATION FOR RESEARCH: Speech therapy-led training for communication within a group setting should be manualised and pilot-tested with respect to feasibility and acceptance in a German sample of people with aphasia and their communication partners. Instruments measuring quality of life and social participation can be validated within the scope of this feasibility study. These research efforts are necessary to prepare a large-scale comparative effectiveness research trial comparing the effects of both usual speech therapy and speech therapy-led group communication training on quality of life and social participation.

La televisión comunitaria en el oriente antioqueño: un ejercicio de construcción de tejido social y paz / The community television system in the eastern region in antioquia: an exercise of construction of the social fabric and peace

El presente artículo resultado de investigación, expone las diversas realidades que atraviesan los canales comunitarios del Oriente Antioqueño (Colombia). Para presentar los resultados el texto relaciona tres momentos: primero, aspectos jurídicos que en Colombia rigen la Televisión Comunitaria, normativas que ha regido a la televisión pública en el país y sus incidencias en el desarrollo de la televisión comunitaria local; dos, se ahonda en la necesidad de entender los modos de organización como asociaciones económicas y sus acciones colectivas (Actividades en Red) como estrategias co-operativas para el trabajo y tres, plantea el papel de la televisión comunitaria como órgano de expresión de las comunidades de esta subregión golpeada por la violencia, la exclusión y la impuesta llegada del desarrollo.

This current article, the result of a piece of research, introduces the various situations that the community channels, in the eastern region in Antioquia (Colombia), have to go through. In order to present the results, the text relates three moments: firstly, legal aspects governing the community television system, regulations that have controlled the public television in the country and its effects on the development of the local community television system; in Colombia; secondly, it delves into the need to understand modes of organization such as economic associations and their collective actions (Network Activities) as co-operative strategies for the work, and thirdly, it raises the role of the community television system as an organ of expression of the communities in this sub-region, struck by violence, exclusion, and the imposed arrival of development.

Language outcomes for children with cochlear implants enrolled in different communication programs.

OBJECTIVES: The aims of this study were to (a) compare language outcomes in pediatric cochlear implant users enrolled in three different communication programs: sign and spoken language, auditory-oral, and auditory-verbal therapy, and (b) examine factors influencing language outcomes. METHODS: Post-implant standard scores on language assessments of receptive vocabulary, auditory comprehension, and expressive communication were collected from files of 42 children with prelingual hearing loss who were implanted by 3;6 years of age. Early intervention history, device details, and demographic information were obtained for each child. Family involvement was evaluated using a rating scale. RESULTS: After adjusting for potential covariates, there were no significant differences in language outcomes across the three groups. Overall, there was a large degree of variability with some children achieving below average scores and others achieving above average scores. Age at diagnosis of hearing loss and family involvement were significantly associated with language outcomes. CONCLUSION: Regardless of the type of communication approach received, children diagnosed with hearing loss at an early age and children with a high level of family involvement had better post-implant language scores than children diagnosed later and with lower levels of family involvement. These findings emphasize the importance of early diagnosis and highlight the contribution families make to the language outcomes of children with cochlear implants.

An enhanced protocol for constraint-induced aphasia therapy II: a case series.

PURPOSE: The initial version of Constraint-Induced Aphasia Therapy (CIAT I) consisted of a single exercise. This study sought to evaluate the feasibility for future trials of an expanded and restructured protocol designed to increase the efficacy of CIAT I. METHOD: The subjects were 4 native English speakers with chronic stroke who exhibited characteristics of moderate Broca's aphasia. Treatment was carried out for 3.5 hr/day for 15 consecutive weekdays. It consisted of 3 components: (a) intensive training by a behavioral method termed shaping using a number of expressive language exercises in addition to the single original language card game, (b) strong discouragement of attempts to use gesture or other nonverbal means of communication, and (c) a transfer package of behavioral techniques to promote transfer of treatment gains from the laboratory to real-life situations. RESULTS: Participation in speech in the life situation improved significantly after treatment. The effect sizes (i.e., d') in this domain were ≥ 2.2; d' values ≥ 0.8 are considered large. Improvement in language ability on a laboratory test, the Western Aphasia Battery-Revised (Kertesz, 2006), did not achieve statistical significance, although the effect size was large--that is, 1.3 (13.1 points). CONCLUSION: These pilot results suggest in preliminary fashion that CIAT II may produce significant improvements in everyday speech.

Contribuições da Terapia Ocupacional na área da comunicação suplementar e/ou alternativa: análise de periódicos da Terapia Ocupacional / Contributions of Occupational Therapy in the of additional and/or alternative communication: an analysis of Occupational Therapy journals

Como a comunicação suplementar e alternativa (CSA) é um recurso de tecnologia assistiva (TA) utilizado pelos terapeutas ocupacionais junto a pessoas com severos distúrbios na comunicação oral e escrita, procurou-se selecionar os trabalhos publicados sobre a temática no país, a fim de verificar a produção científica produzida na área de Terapia Ocupacional. Os locais para realizar a busca dos artigos foram os Cadernos de Terapia Ocupacional da Universidade Federal de São Carlos, a Revista de Terapia Ocupacional da Universidade de São Paulo, Revista Brasileira de Educação Especial, Revista de Educação Especial e Revista Brasileira de Crescimento e Desenvolvimento Humano. Utilizaram-se como palavras-chave tecnologia e inclusão escolar e, por meio de critérios específicos, selecionaram-se 16 artigos. Analisaram-se os dados com base nos procedimentos quantitativos por meio da ocorrência e qualitativos no que se refere ao conteúdo. Os dados revelam que o número de autores que investigam a temática ainda é baixo, mas ocorreu um aumento na publicação de artigos nos últimos anos. Ainda encontrou-se que a maioria das informações sobre CSA foi apenas citada de forma superficial nos diferentes artigos, sendo que poucas apresentaram o aprofundamento do assunto descrito. Considera-se que ainda existe a necessidade de se investir em estudos que tenham como foco a prática da CSA na Terapia Ocupacional.(AU)

As Augmentative and Alternative Communication (AAC) is a feature of Assistive Technology (AT) used by occupational therapists with people with severe disorders in oral and written communication, we tried to select papers on the subject in the country to verify the scientific production in the area of Occupational Therapy. The following sites were consulted to search for articles: the Journal of Occupational Therapy, Federal University of São Carlos; and the Journal of Occupational Therapy, University of Sao Paulo;Brazilian Journal of Special Education; The Journal of Special Education; and Journal of Human Growth and Development. We used ?technology? and ?school enrollment? as keywords and 16 articles were selected by specific criteria. We analyzed the data based on the quantitative procedures by means of the occurrence and quality with reference to content. The data reveal that the number of authors who have investigated the issue is still low, but the number of articles has grown in recent years. It was also observed that most information about AAC found in different articles was cited only in a superficial way, and few pieces were comprehensive in the matter described. It is considered that there is still a need to invest in studies that focus on the practice of AAC in Occupational Therapy.(AU)