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Biomedical subjects

Tim Pring

Publications and source records attributed to Tim Pring.

4 recordsLinked to original sources

Phoneme frequency effects in jargon aphasia: a phonological investigation of nonword errors.

This study investigates the nonwords produced by a jargon speaker, LT. Despite presenting with severe neologistic jargon, LT can produce discrete responses in picture naming tasks thus allowing the properties of his jargon to be investigated. This ability was exploited in two naming tasks. The first showed that LT's nonword errors are related to their targets despite being generally unrecognizable. This relatedness appears to be a general property of his errors suggesting that they are produced by lexical rather than nonlexical means. The second naming task used a set of stimuli controlled for their phonemic content. This allowed an investigation of target phonology at the level of individual phonemes. Nonword responses maintained the English distribution of consonants and showed a significant relationship to the target phonologies. A strong influence of phoneme frequency was identified. High frequency consonants showed a pattern of frequent but indiscriminate use. Low frequency consonants were realised less often but were largely restricted to target related contexts rarely appearing as error phonology. The findings are explained within a lexical activation network with the proposal that the resting levels of phoneme nodes are frequency sensitive. Predictions for the recovery of jargon aphasia and suggestions for future investigations are made.

Aged↗

Developing communication in adults with profound and multiple learning difficulties using objects of reference.

Objects of reference were used to develop communication in adults with profound and multiple learning difficulties (PMLD). The use of objects specific to individuals is recommended, but it makes heavy demands on care staff who implement such programmes. This study investigated the effectiveness of using a standard set of objects with a group of 13 adults with PMLD. Progress was monitored over a 20-week training period using an assessment based upon the cues provided by staff to promote the use of the objects. Results indicated that the group as a whole made significant gains, although a plateau effect was reached after the first 10 weeks of training. Some individuals within the group were near to ceiling performance after training, while others, though progressing, still made limited use of the objects. There was evidence, as suggested in the literature, that greater and more sustained progress was made with objects at the index level of representation. The views of the care staff who implemented the training programme were sought through semistructured interviews. Although the use of a standard set of objects presents a number of difficulties, it is concluded that it is desirable in situations where the use of individual objects with each client is unfeasible. It has the additional advantages that it instructs and motivates care staff and provides a means by which the use of objects of reference by individual clients may be assessed and planning for the development of their communication may be informed.

Adult↗

Ask a silly question: two decades of troublesome trials.

BACKGROUND: Randomized control trials and the use of meta-analysis in systematic reviews are the basis of evidence-based practice. The paper reviews their use in the development of evidence-based practice in speech and language therapy. AIMS: It is accepted that clinical outcome research should develop in a sequence of phases. A model of this process is described. Examples of outcome research in speech and language therapy are used to illustrate the use of the model and the problems that result when it is not followed. MAIN CONTRIBUTION: Existing research has largely ignored the agreed procedures for outcome research. Particular problems have arisen when randomized control trials are used to examine therapy provision for a client group. Clients are often a heterogeneous group and receive different therapies. Consequently, it is unlikely that trials can obtain significant results, nor, if they do, can they provide clinicians with useful information about the choice of treatment. Systematic reviews are equally uninformative. Many of the studies on which they are based have methodological problems and their frequent failure adequately to describe the therapies used mean that reviews cannot evaluate or compare different types of therapy. CONCLUSIONS: Researchers in speech and language therapy have given too little attention to the basics of clinical outcome research. This requires that clinical and theoretical insights are used to identify specific therapies for well-defined groups of clients. These therapies must be tested first in efficacy, then in effectiveness studies, and their results should be disseminated to clinicians. Only then is it meaningful to carry out large-scale trials of the effectiveness of therapy provision for a client group or to conduct systematic reviews of existing research.

Child↗