Use of pointing in parent-child interactions by hearing children of deaf and hearing parents: A follow-up from 1- to 3-years of age.

Pointing plays a significant role in communication and language development. However, in spoken languages pointing has been viewed as a non-verbal gesture, whereas in sign languages, pointing is regarded to represent a linguistic unit of language. This study compared the use of pointing between seven bilingual hearing children of deaf parents (Kids of Deaf Adults [KODAs]) interacting with their deaf parents and five hearing children interacting with their hearing parents. Data were collected in 6-month intervals from the age of 1;0 to 3;0. Pointing frequency among the deaf parents and KODAs was significantly higher than among the hearing parents and their children. In signing dyads pointing frequency remained stable, whereas in spoken dyads it decreased during the follow-up. These findings suggested that pointing is a fundamental element of parent-child interaction, regardless of the language, but is guided by the modality, gestural and linguistic features of the language in question.

Bodily-tactile early intervention for a mother and her child with visual impairment and additional disabilities: a case study.

PURPOSE: Congenital visual impairment and additional disabilities (VIAD) may hamper the development of a child's communication skills and the quality of overall emotional availability between a child and his/her parents. This study investigated the effects of bodily-tactile intervention on a Finnish 26-year-old mother's use of the bodily-tactile modality, the gestural and vocal expressions of her one-year-old child with VIAD, and emotional availability between the dyad. MATERIALS AND METHODS: Mixed methods were used in the video analysis. The child's and his mother's bodily-tactile and gestural expressions were analyzed using a coding procedure. Applied conversation analysis was used to further analyse the child's emerging gestural expressions in their sequential interactive context. Emotional availability scales were used to analyze the emotional quality of the interaction. RESULTS: The results showed that the mother increased her use of the bodily-tactile modality during the intervention, especially in play and tactile signing. The child imitated new signs and developed new gestural expressions based on his bodily-tactile experiences during the intervention sessions. His vocalizations did not change. Emotional availability remained stable. CONCLUSIONS: The case study approach allowed the in-depth investigation of the components contributing to the emergence of gestural expressions in children with VIAD.Implications for rehabilitationBodily-tactile modality may compensate for the absence of a child's vision in child-parent interactions.Bodily-tactile early intervention may be effective in guiding caregivers to use bodily-tactile modality in interacting with their child with VIAD.Caregivers' use of bodily-tactile modality in interactions may contribute to the development of gestural expressions in a child with VIAD.The use of bodily-tactile modality in interactions may improve the emotional connection between children with VIAD and their caregivers.

Working-age first-time hearing aid users' self-reported outcomes.

OBJECTIVE: To study patient-reported hearing aid (HA) rehabilitation outcomes, social-communicative functioning, and expectations/experiences during eight months of HA use. DESIGN: Three self-reporting instruments, the International Outcome Inventory for Hearing Aids (IOI-HA), the Quantified Denver Scale of Communicative Function (QDS), and questionnaires tapping pre-rehabilitation expectations (HA-EXP-Q1) and post-rehabilitation experiences (HA-EXP-Q2) were administered. STUDY SAMPLE: 144 patients ages 23-66 with gradually acquired, adult-onset, mild-to-moderate sensorineural hearing loss affecting both ears who acquired their first HAs. RESULTS: According to self-reports, HA rehabilitation outcomes were good, and everyday social-communicative functioning improved after one month and after eight months of HA use. When the effects from demographic and audiological variables were analysed, younger age and positive expectations of HAs were associated with better outcomes and social-communicative functioning. The form or hearing loss severity, and the type or number of HAs did not affect outcomes. CONCLUSION: Working-age HA users reported better HA outcomes than older adults in previous studies. Coping in work life may be a strong motivator for active HA use. Considering that younger age and positive expectations resulted in better outcomes, early rehabilitation that supports positive and realistic expectations of HA performance is essential.

Studies on stigma regarding hearing impairment and hearing aid use among adults of working age: a scoping review.

PURPOSE: Research on stigma has been criticized for centering on the perceptions of individuals and their effect on social interactions rather than studying stigma as a dynamic and relational phenomenon as originally defined by Goffman. This review investigates whether and how stigma has been evaluated as a social process in the context of hearing impairment and hearing aid use. MATERIALS AND METHODS: Systematic literature searches were conducted within four major databases for peer-reviewed journal articles on hearing impairment and hearing aid rehabilitation. In these, 18 studies with stigma, shame or mental wellbeing as the primary research interest were identified. The reports were examined for their methodology, focus and results. RESULTS: The reviewed studies used both quantitative and qualitative methodologies, questionnaires and interviews being the most common methods. All studies concentrated on the participants' experiences or views concerning stigma. Studies examining the social process of stigmatization were lacking. Most studies pointed out the negative effect of stigma on the use of hearing aids. CONCLUSIONS: In order to understand the process of stigmatization, more studies using observational methods are needed. Moreover, additional research should also focus on how stigma as a social and relational phenomenon can be alleviated. IMPLICATIONS FOR REHABILITATION Low adherence in hearing aid use is connected to fear of stigma related to hearing impairment and hearing aids. Hearing health services should include counseling to deal with individual's experiences and fear of stigma. Stigmatization is a social process that concerns individuals with hearing impairment in contact with their social environment. Hearing health professionals should consider including close relatives and/or partners of hearing impaired individuals in discussions of starting hearing aid rehabilitation. In consulting patients with hearing impairment professionals should give advice about how to deal with questions of hearing aid, hearing impairment and fear of stigma at work.

Comparison of Disfluent and Ungrammatical Speech of Preadolescents with and without ASD.

This paper analyses disfluencies and ungrammatical expressions in the speech of 11-13-year-old Finnish-speaking boys with ASD (N = 5) and with neurotypical development (N = 6). The ASD data were from authentic group therapy sessions and neurotypical data from teacher-led group discussions. The proportion of disfluencies and ungrammatical expressions was greater in the speech of participants with ASD (26.4%) than in the control group (15.5%). Furthermore, a qualitative difference was noted: The ASD group produced long, complex disfluent turns with word searches, self-repairs, false starts, fillers, prolongations, inconsistent syntactic structures and grammatical errors, whereas in the control group, the disfluencies were mainly fillers and sound prolongations. The disfluencies and ungrammatical expressions occurring in the ASD participants' interactions also caused comprehension problems.

Effect of Tactile Imitation Guidance on Imitation and Emotional Availability. A Case Report of a Mother and Her Child With Congenital Deafblindness.

Interaction between parents and children with congenital deafblindness (CDB) is easily hampered due to dual sensory loss. This case report examines imitation and emotional availability in interaction between a mother and her 3-year-old child with CDB first in unguided play and then in three play sessions with tactile imitation guidance. The video recorded play sessions were analyzed for frequency, length, and modality of imitation. Emotional Availability Scales were used to code the emotional quality of interaction. The results showed that before the guidance the mother imitated the child mainly vocally. After the guidance, the use of tactility in imitations increased. Imitation exchanges lasted longest in the last session. The emotional availability between the mother and the child was higher after the guidance. Further research is needed to confirm the positive outcomes of this case study.

Other-initiations of repair by children with developmental language disorder in speech-language therapy and non-institutional play.

This study explores the use of other-initiations of repair by children with developmental language disorder (DLD). The data are children's video-recorded language assessment sessions, speech-language therapy sessions and two kinds of non-institutional play sessions, parent-child and peer play. The videotapes were transcribed following CA conventions focusing on speech and relevant embodied actions. Other-initiations of repair were identified, collected and analyzed. The analysis focuses on open requests and candidate understandings which were the two most common types of other-initiation of repair in the data. The types of other-initiation of repair were similar to those found in adult interactions and by neurotypical children. Repair sequences were regularly short consisting only of three turns. Other-initiations of repair typically emerged in certain contexts: open requests were regularly used after sudden topical shifts, child's inattention, or long and complex setting of language tasks in assessment and therapy, whereas candidate understandings were mostly used for confirming the children's inferences of the meaning of unclear references or wider semantic content in free conversation. This indicates that the local sequential context influences the types of problems the children with DLD encounter, and the types of problems determine how the children other-initiate repair to solve these problems. Thus, the sequential context should be considered in a detailed manner when assessing children's communication skills and studying other-initiations of repair.

Other-initiation of repair by speakers with mild to severe hearing impairment.

Hearing impairment is a common chronic condition in middle-aged and elderly adults. The number of individuals with hearing impairment is expected to rise because of the longer life expectancies and trends in the population growth. Acquired hearing impairment in adulthood is not just a disorder of the sense of hearing. It is primarily a social disability because its handicapping effect is experienced in interaction with other people. This paper aims to explore how the repair of problems in hearing is initiated by hearing-impaired individuals with acquired mild to severe hearing impairment. By using the method of conversation analysis (CA), this paper examines the occurrence of other-initiations of repair (OIR) and how it is typically resolved in actual mundane interaction. In addition, this paper reveals the challenges and the impact of hearing impairment as the state of hearing deteriorates. This article argues that the frequency of OIR in mild hearing impairment does not differ from normally hearing individuals. However, in a more severe grade of hearing impairment, the OIR sequences are longer, more frequent, multimodal and may require more vigilance from the normally-hearing conversation partner. Implications for counselling are suggested.

Discussing Hearing Aid Rehabilitation at the Hearing Clinic: Patient Involvement in Deciding upon the Need for a Hearing Aid.

The quality of interaction between hearing health professionals and patients is one prominent, yet under-studied explanation for the low adherence in acquiring and using a hearing aid. This study describes two different ways of introducing hearing aid to the patients at their first visits at the hearing clinic: an inquiry asking patients opinion followed by offer, and an expert evaluation of the necessity of a hearing aid; and shows two different trajectories ensuing from these introductions. The trajectories represent two extreme ends of a continuum of practices of starting a discussion about hearing aid rehabilitation, in terms of how these practices affect patient participation in decision-making. The analysis shows how granting different degrees of deontic and epistemic rights to professionals and patients has different consequences with regard to the activity of reaching shared understanding on the treatment. The data consist of 17 video-recorded encounters at the hearing clinic. The method used is conversation analysis.

Ungrammatical utterances and disfluent speech as causes of comprehension problems in interactions of preadolescents with high functioning autism.

This study describes the role of ungrammatical utterances and disfluent speech in the creation of comprehension problems between the participants in group therapy sessions of preadolescents with autism. The speech of the autistic preadolescents included frequent disfluencies and morpho-syntactic problems, such as wrong case endings, ambiguous pronominal references, grammatically incoherent syntactic structures and inaccurate tenses, which caused problems of comprehension. Three different interactional trajectories occurred when solving the potential problems of comprehension following the morpho-syntactically disfluent turns. First, the disfluent turn sometimes led to a clarification request by a co-participant, either a therapist or another participant with ASD. The preadolescents with ASD showed interactional skilfulness in requesting clarification when faced with comprehension problems. Second, in contrast, other occurrences included one or several self-repairs by the speaker with ASD. In these cases, the other group participants either did not react or they encouraged the speaker to continue using discourse particles. If the self-repairing disfluencies led to a persisting problem of comprehension, the therapists sometimes intervened and resolved the problem. However, direct interventions by the therapists were infrequent because the participants with ASD were mostly able to resolve the comprehension problems by themselves. Third, some disfluent and/or grammatically incorrect turns were not treated as problematic by the co-participants nor by the speaker himself. Abbreviations: ADE: Adessive; ALL: Allative; CLI: clitic; GEN: Genitive; INE: Inessive; NOM: Nominative; PER: person; PL: plural; PRT: particle; SG: singular.

Open-class repair initiations in conversations involving middle-aged hearing aid users with mild to moderate loss.

BACKGROUND: To manage conversational breakdowns, individuals with hearing loss (HL) often have to request their interlocutors to repeat or clarify. AIMS: To examine how middle-aged hearing aid (HA) users manage conversational breakdowns by using open-class repair initiations (e.g., questions such as sorry, what and huh), and whether their use of repair initiations differs from their normally hearing interlocutors. METHODS & PROCEDURES: Eighteen 45-64-year-old adults with acquired mild to moderate HL participated in the study. The participants were videotaped in everyday interactions at their homes and workplaces and in clinical encounters with hearing health professionals. Interactions were transcribed and open-class repair initiations of participants with HL and their interlocutors were identified using conversation analysis. The frequencies of initiations were analyzed statistically between the groups, and the contexts and structure of repair sequences dealing with communication breakdown were analyzed. OUTCOMES & RESULTS: Before acquiring HA the participants with HL reported intense use of open-class repair initiation. After HAs were acquired, there was no statistically significant difference in the frequency of open-class repair initiations between HA users and their interlocutors. The most common means for open-class repair initiation in the data was interrogative word mitä ('what'). Vocalization hä ('huh'), apologetic expression anteeksi ('sorry') and clausal initiations (e.g., 'what did you say'/'I didn't hear') occurred less often. Open-class repair initiations emerged in contexts where they typically occur in conversation, such as topical shifts, overlapping talk and action, background noise, and disagreements. When used, open-class repair initiations most often led to repetition by the interlocutor, which immediately repaired the conversational breakdown. Long clarification sequences with multiple repair initiations did not occur. CONCLUSIONS & IMPLICATIONS: Participants with mild to moderate HL using hearing amplification initiate open-class repair similarly to their normally hearing conversational partners when the frequency, types, contexts and structure of repair are considered. The findings diminish the stigma related to HL, HAs and the use of open-class repair. The findings suggest that HA amplifies hearing successfully in everyday conversation when the level of HL is mild to moderate. However, the evidence for the benefit of HAs remains indirect.

Promoting lexical learning in the speech and language therapy of children with cochlear implants.

This study examines lexical intervention sessions in speech and language therapy for children with cochlear implants (CIs). Particular focus is on the therapist's professional practices in doing the therapy. The participants in this study are three congenitally deaf children with CIs together with their speech and language therapist. The video recorded therapy sessions of these children are studied using conversation analysis. The analysis reveals the ways in which the speech and language therapist formulates her speaking turns to support the children's lexical learning in task interaction. The therapist's multimodal practices, for example linguistic and acoustic highlighting, focus both on the lexical meaning and the phonological form of the words. Using these means, the therapist expands the child's lexical networks, specifies and corrects the meaning of the target words, and models the correct phonological form of the words. The findings of this study are useful in providing information for clinicians and speech and language therapy students working with children who have CIs as well as for the children's parents.

Recipient participation in conversations involving participants with fluent or non-fluent aphasia.

The present study compares the ways in which conversational partners manage expressive linguistic problems produced by participants with fluent vs. non-fluent aphasia. Both everyday conversations with family members and institutional conversations with speech-language therapists were examined. The data consisted of 110 conversational sequences in which the conversational partners addressed expressive aphasic problems. Most problems of the speaker with fluent aphasia were locally restricted phonological and word-finding errors, which were immediately repaired. In contrast, the sparse expression of the speaker with non-fluent aphasia was co-constructed by conversational partners in long negotiation sequences to establish shared understanding. Some differences between recipient participation in everyday and institutional conversation were found. The results emphasise the relevance of the nature of the expressive linguistic problems on participation in interaction. They also add to the clinical knowledge of handling aphasic problems in conversation. This knowledge can be used for developing interaction-focused intervention.

Dilemmatic group memberships of hard-of-hearing employees during the process of acquiring and adapting to the use of hearing aids.

We describe how hard-of-hearing (HOH) employees renegotiate both their existing and new group memberships when they acquire and begin to use hearing aids (HAs). Our research setting was longitudinal and we carried out a theory-informed qualitative analysis of multiple qualitative data. When an individual discovers that they have a hearing problem and acquire a HA, their group memberships undergo change. First, HOH employees need to start negotiating their relationship with the HOH group. Second, they need to consider whether they see themselves as members of the disabled or the nondisabled employee group. This negotiation tends to be context-bound, situational, and nonlinear as a process, involving a back-and-forth movement in the way in which HOH employees value different group memberships. The dilemmatic negotiation of new group memberships and the other social aspects involved in HA rehabilitation tend to remain invisible to rehabilitation professionals, occupational healthcare, and employers.

Halting aphasic interaction: creation of intersubjectivity and spousal relationship in situ.

This article discusses a communicative phenomenon that is relatively less studied: getting stuck in an aphasic conversation. Although aphasia as a medical and linguistic condition has been widely examined, the more social and participatory aspects of the symptom are not so well-known. Aphasia forms a threat to the emergence of a shared understanding, as well as to the experience of being in the shared, i.e., in the intersubjective, social world. In our analysis, we closely explore how understanding is constructed in the sequential organization of conversation. We use two data corpora when analysing the halting interaction. In our data, we detected two kinds of interactive halts that emerged in connection with aphasic word searching. First, 'real halts' were caused by the aphasic person's inability to find correct words and the co-participants were also not able to resolve the problem. Second, 'exam halts' occurred when the co-participant did not provide the missing words despite knowing what the aphasic speaker was trying to say. We discuss how this halting phenomenon is linked with the notions of intersubjectivity and face-work and conclude that real halts are more directly caused by the aphasic condition, whereas exam halts reflect the spousal relationship in the form of face-work.

Sole ulcers in Finnish dairy cattle.

The Finnish Healthy Hooves project was set up to determine the frequency of, and risk factors for various hoof lesions in Finnish dairy herds. Data were collected in the years 2003 and 2004. A large dataset of over 74,000 cow-level observations recorded by hoof trimmers was merged with production data from the Finnish Agricultural Data Processing Centre Ltd. Ultimately, data from a single lactation from each of 16,792 cows in 703 herds were used for the analyses in this paper. Three-level hierarchical logistic models with hoof trimmer and farms (within hoof trimmer) as random effects were fit to data sets of tie stall (TS) and loose housing (LH) herds separately. The outcome of interest was the presence or absence of a sole ulcer in one or more legs of a cow during the lactation of interest. Cows examined once had a risk of sole ulcer 5.23% in tie stall herds and 7.58% in LH herds. As the number of examinations increased the odds of a diagnosis of sole ulcer increased substantially (2 and 3+ examinations had odds ratios (ORs) of 1.42 and 3.42 in TS herds and 2.77 and 6.89 in LH herds). Breed had a large effect on the risk of sole ulcer with Holsteins 2.89 times more likely to be affected than Ayrshires in TS herds and 2.94 times in LH herds. In TS herds, the presence of other hoof lesions such as haemorrhages (OR = 2.97), heel-horn erosions (OR = 2.10) and corkscrew claw (OR = 2.83) increased the risk of a sole ulcer developing. In LH herds, only haemorrhages (OR = 1.80) were a significant risk factor when parity was > or = 2. In TS herds, use of mats (compared to hard flooring) significantly reduced the risk of sole ulcers (OR = 0.49). The effect of parity on the risk of sole ulcer was greatest when parity > or = 4 but this effect was only significant in tie stalls (OR = 1.86). When analyses were restricted to cows with parity > or = 2, similar results were obtained for the risk factors identified above. In addition, parity became highly significant in TS and LH (OR 2.31 and 2.23, respectively when parity was 4+). In TS herds, herd average milk production was significantly associated with a decrease risk of sole ulcer (OR = 1.28 per 1000 kg decrease) but there was no effect of production at the cow level (measured as deviation from the herd mean). No significant effects of production were observed in LH herds.

Self-repair of speech by four-year-old Finnish children.

ABSTRACTThe aim of this study was to examine what four-year-old children repair in their speech. For this purpose, conversational self-repairs (N=316) made by two typically developing Finnish-speaking children (aged 4 ; 8 and 4 ; 11) were examined. The data comprised eight hours of natural interactions videotaped at the children's homes. The tapes were analyzed using conversation analysis. The children made phonological, morphological, syntactic, lexical and non-linguistic self-repairs, and also inserted additional material into their utterances. Finnish-speaking children made more syntactic and fewer morphological self-repairs than the previous research on English-speaking children suggests. Furthermore, most self-repairs were found in talk during pretend play. In designing and engaging in such play, the children skilfully used self-repair to match their talk to meet the requirements of different interactive activities and co-participants. Finally, contextual analysis of children's self-repairs showed that these were also socially motivated, and not just related to slips or errors in speech.

Language abilities of children with Asperger syndrome.

Current diagnostic taxonomies (ICD-10, DSM-IV) emphasize normal acquisition of language in Asperger syndrome (AS). Although many linguistic sub-skills may be fairly normal in AS there are also contradictory findings. There are only few studies examining language skills of children with AS in detail. The aim of this study was to study language performance in children with AS and their age, sex and IQ matched controls. Children with AS had significantly lower scores in the subtest of Comprehension of Instructions. Results showed that although many linguistic skills may develop normally, comprehension of language may be affected in children with AS. The results suggest that receptive language processes should be studied in detail in children with AS.