Increasing understanding of environmental modifications using the Virtual Dementia Experience for professional carers of people living with dementia.

Modifications to the environment can have a positive impact on the person living with dementia. The purpose of this study was to examine the effects of a virtual reality (VR) educational workshop on improving understanding of the impact of environments for people living with dementia for carers in residential aged care facilities in Australia. Participants were nonrandomly allocated to one of two conditions: a VR condition which enabled them to take the perspective of a person living with dementia as they navigate a home environment (n = 40), or to a non-VR condition, in which participants received equivalent information in a classroom without the use of VR (n = 56). Participants completed a purpose-built pictorial measure of their understanding of environmental factors that could impact on people with dementia before and after the workshop. Following education, an analysis of covariance revealed that compared to non-VR education, those who received VR education identified a significantly greater number of appropriate environmental modifications, after adjusting for practice test scores. The results from this study demonstrate the utility of VR as a promising tool to improve carers' understanding of the ways in which the environment can be modified to assist people living with dementia.

Communication changes with laryngectomy and impact on quality of life: a review.

PURPOSE: Patients with throat cancer at later stages often undergo total laryngectomy, a procedure that removes the larynx (voice box) and directly impacts the patient's ability to produce natural voice and communication. This narrative review aimed to explore how changes to communication following laryngectomy may impact quality of life (QoL) for patients. METHODS: Literature searches were conducted using CINAHL, MEDLINE and PsychInfo databases for studies published between 2007 and 2018. The search terms (and derivatives) of laryngectomy AND communication AND quality of life were used. A synthesis and appraisal of the studies was conducted. RESULTS: Twelve studies met the inclusion criteria and were included in this review. The two main themes identified relating to changes in communication and impact on QoL were changes in communication competency (immediate changes and communication option used) and adaptation to change (e.g. self-related factors and relationships with others). Regardless of the type of communication option used, participants in all studies reported negative changes in their communication competency and QoL post-laryngectomy. Voice-related factors and aesthetics of the communication option used were noted to influence self-ratings of QoL for the participants, rather than how well others understood them. Participants using tracheoesophageal speech (TES) consistently showed the highest self-reported QoL across the majority of studies. A model incorporating the findings from this review has been proposed which outlines how changes in communication post-laryngectomy may lead to an impact on QoL. Here, the factors of changes in communication competency, self-perception and social engagement impact each other and are also influenced by adaptation to change. CONCLUSION: This review has highlighted the complex nature of changes faced by patients following laryngectomy in relation to communication and QoL. The model linking communication changes to QoL may become a useful tool for researchers and clinicians in supporting the management of patients post-laryngectomy.

Comparing Feedback Types in Multimedia Learning of Speech by Young Children With Common Speech Sound Disorders: Research Protocol for a Pretest Posttest Independent Measures Control Trial.

Children with speech sound disorders benefit from feedback about the accuracy of sounds they make. Home practice can reinforce feedback received from speech pathologists. Games in mobile device applications could encourage home practice, but those currently available are of limited value because they are unlikely to elaborate "Correct"/"Incorrect" feedback with information that can assist in improving the accuracy of the sound. This protocol proposes a "Wizard of Oz" experiment that aims to provide evidence for the provision of effective multimedia feedback for speech sound development. Children with two common speech sound disorders will play a game on a mobile device and make speech sounds when prompted by the game. A human "Wizard" will provide feedback on the accuracy of the sound but the children will perceive the feedback as coming from the game. Groups of 30 young children will be randomly allocated to one of five conditions: four types of feedback and a control which does not play the game. The results of this experiment will inform not only speech sound therapy, but also other types of language learning, both in general, and in multimedia applications. This experiment is a cost-effective precursor to the development of a mobile application that employs pedagogically and clinically sound processes for speech development in young children.