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PubMed1978

Social interactions and communication patterns in mentally retarded children.

An observational approach and videorecordings were used to investigate a group of four mentally retarded kindergarten children with minimal language development. Results showed that when a facilitator (teacher) was present, there were more social interactions and vocalizations, but there was no significant increase in meaningful verbal content. Nonverbal communication rose sharply in the presence of the facilitator. The findings indicate that an observational analysis of patterns of interaction is useful in planning intervention programs in the area of social and communication development.

Aggression↗
PubMed2006

The development of siblings of children with autism at 4 and 14 months: social engagement, communication, and cognition.

AIMS: To compare siblings of children with autism (SIBS-A) and siblings of children with typical development (SIBS-TD) at 4 and 14 months of age. METHODS: At 4 months, mother-infant interactional synchrony during free play, infant gaze and affect during the still-face paradigm, and infant responsiveness to a name-calling paradigm were examined (n = 21 in each group). At 14 months, verbal and nonverbal communication skills were examined as well as cognition (30 SIBS-A and 31 SIBS-TD). RESULTS: Most SIBS-A were functioning as well as the SIBS-TD at 4 and 14 months of age. However, some differences in early social engagement and later communicative and cognitive skills emerged. Synchrony was weaker in the SIBS-A dyads, but only for infant-led interactions. Infant SIBS-A revealed more neutral affect during the still-face procedure and were less upset by it than was true for the SIBS-TD. A surprising result was that significantly more SIBS-A responded to their name being called by their mothers compared to SIBS-TD. At 14 months, SIBS-A made fewer nonverbal requesting gestures and achieved lower language scores on the Bayley Scale. Six SIBS-A revealed a language delay of 5 months and were responsible for some of the significant differences between SIBS-A and SIBS-TD. Furthermore, infant SIBS-A who showed more neutral affect to the still face and were less able to respond to their name being called by their mothers initiated fewer nonverbal joint attention and requesting behaviors at 14 months, respectively. DISCUSSION: Focused on the genetic liability for the broad phenotype of autism as well as the possible influence of having a sibling with autism.

Age Factors↗
PubMed2006

The effect of a therapy dog on the communication skills of an adult with aphasia.

UNLABELLED: Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech and language therapy within a rehabilitation setting. The researchers conclude that the presence of the dog does have the potential to stimulate both overt social-verbal and social-nonverbal communication. LEARNING OUTCOMES: As a result of this activity the reader will be able to (1) describe the beneficial role of dogs to serve as catalysts for human communication (2) describe ways in which a person with aphasia may be assisted by a therapy dog and (3) become familiar with an animal-assisted therapy (AAT) program set-up for patients with communication disorders within a rehabilitation setting.

Affect↗
PubMedDate not supplied

An interactive model of chiropractic practice: reconstructing clinical reality.

OBJECTIVE: This study proposes an interactionist model of chiropractic care, uses practice observation to ascertain whether this framework is compatible with clinical reality and explores a novel explanation of how chiropractic clinical communication may contribute to healing. DESIGN: A constructivist inquiry paradigm based upon purposive sampling, grounded theory, inductive analysis and contextual interpretation was used. The compatibility of chiropractic clinical reality with an evolving interactionist model was ascertained through reflection on contemporary literature and practice observation of 208 consultations undertaken by 34 chiropractors working in geographically dispersed areas of Australia. Sample selection used a maximum variation strategy. Triangulation of data collected was undertaken by mailing the clinical communication scenario constructed by the investigator to participating chiropractors for comment and by having 144 patients complete a questionnaire. RESULTS: Interaction observed in chiropractic practice is bidirectional, is both task- and relationship-oriented, and seems to be verbal and nonverbal in nature. Touch, whether diagnostic or therapeutic, emerged as an fundamental feature of chiropractic care. CONCLUSION: Verbal and nonverbal communication in chiropractic practice, when analyzed within a interactionist framework, can be construed to create an environment conducive to healing by establishing a shared clinical reality. The ability of the consultation to change perceptions and reduce anxiety is presented as a substantial factor contributing to the potency of the chiropractic care. The interactionist model proposed for chiropractic care was found to provide a useful framework for reconceptualizing chiropractic clinical practice. By providing an additional perspective of chiropractic practice, this model enhances discourse on the variables contributing to the success of chiropractic care.

Australia↗
PubMed1999

Nurses' self-reflection via videotaping to improve communication skills in health counseling.

The purpose of this qualitative research was to describe nurses' opinions of their communication skills in health counseling situations and to analyze the levels of reflectivity in their evaluations according to Mezirow. Nineteen nurses participated in the research on a voluntary basis and evaluated their interaction with patients on video on two occasions half a year apart. Nurses gave verbal feedback in an interview immediately after videotaping, after which they read education materials, watched their counseling on video and wrote an evaluation of their communication skills. Transcribed audiotaped interviews and written evaluations were analyzed using content analysis. Nurses said that they were able to use familiar language, to listen and to encourage patients to express their feelings and ask questions. Nurses gave little feedback on nonverbal communication. They wanted to develop their listening skills and their ability to encourage patients to ask and express their feelings. They also wanted to improve their preparations for counseling sessions. On Mezirow's scale, nurses' evaluations weighted heavily towards the lower levels of reflectivity. Only one nurse's evaluations were on the sixth level and no evaluations were on the seventh level. The results indicated a need for training programs dealig with communication skills and self-reflection. Using the videotape and self-reflection were found to be good methods to enhance the quality of health counseling.

Adolescent↗
PubMed2004

Introducing and negotiating the use of female condoms in sexual relationships: qualitative interviews with women attending a family planning clinic.

Safe sex skills training often teach women to be assertive in condom use negotiations. However, it has been suggested that assertiveness training may be inappropriate for women who lack power in their sexual relationship. Our qualitative study of 62 women attending a family planning clinic explored various communication styles they used to introduce and negotiate female condom use in their sexual relationships. We further examined how different introduction and negotiation styles were related to actual use of the device. The device was introduced using a direct, semidirect, indirect, or nonverbal communication approach. Use of the female condom was negotiated by avoiding sex, using humor, discussing the possibility of using the condom, or being argumentative with partners. The outcome of introducing and negotiating female condom use was often mediated by other factors including partner characteristics, relationship power dynamics, situational context, and use of additional discourse strategies (e.g., describing the female condom as a sexual toy or taking the opportunity to educated partners about the female condom). Less direct approaches appeared to be as effective in facilitating use of the female condom as more direct approaches. Female condom introduction and negotiation styles that continued to engage their partners by using additional discourse strategies led to more frequent use of the device. Implications of our findings for HIV risk reduction program development are discussed.

Adult↗
PubMed1994

Atopic dermatitis and stress: possible role of negative communication with significant others.

Clinical reports have related stressful social interactions to the course of atopic dermatitis (AD). Controlled behavioral observations of interaction patterns of AD patients and their significant others, however, were lacking. In two studies, adult AD patients and their mothers (N1 = 26) or partners (N2 = 67) engaged in a discussion of a mutual problem. Their verbal and nonverbal communication behavior was analyzed with a reliable standardized interactional coding system and compared to that of control dyads (N1 = 18, N2 = 28). Although AD patients and their significant others did not differ from controls in their self-reported satisfaction with the relationship, the behavioral observations showed less positive and more negative communication patterns compared to the control dyads. Negative interactions with significant others may prevent the solution of everyday problems and may add to the patients' stress level.

Journal Article↗
PubMed1995

Marital communication in eating disorder patients: a controlled observational study.

In order to investigate the communication between 21 eating disorder (ED) patients and their husbands, an observational study was carried out using two matched control groups of 21 maritally distressed (MD) and 21 nondistressed (ND) couples. During some discussion tasks the interaction was videotaped and the (verbal and nonverbal) communication skills were rated afterwards according to the Kategoriensystem für Partnerschaftliche Interaktion (KPI) coding system. Unexpectedly, compared with the control groups ED couples do not show a greater disequilibrium (between patient and husband) in the emission rate of positive and negative messages. Also striking is the generally higher degree of self-disclosure in ED couples than in ND couples, but this may reflect their experience of distress. Overall and most importantly, ED couples appear to lack some of the ND couples' skills of constructive communication, but manage to avoid the destructive communication style of MD couples.

Adult↗
PubMedDate not supplied

Perspectives of nurses and patients on the need for sexual counseling of MI patients.

The concept of sexual integrity was used to analyze nurses' and patients' perceptions of the need to provide sexual counseling for patients in the acute care setting who have had a myocardial infarction. A qualitative approach with content analysis was used. Data were categorized using the determinants of sexual integrity: self-identity, communication, and environment. For patients, self-identity and communication were the predominant themes that emerged from the data. A lack of information related to issues of sexual functioning was the most prominent subcategory. The nurses' responses contained all three determinants of sexual integrity; roles, lack of information, use of verbal and nonverbal communication, and lack of time were the most prominent subcategories emerging from the data. The findings indicate a need to provide information to patients and nurses on sexual counseling.

Adult↗
PubMed1996

Language, communication, and transference in child analysis. I. Selective mutism: the medium is the message.

Selective mutism is a psychiatric condition in which children stop speaking to all except their closest family members. Analytic material from a 4 1/2-year-old selectively mute child demonstrates how his symptom of mutism was embedded in a character structure in which not only verbal dialogue but play and other nonverbal communication were disrupted. Because communication was severely limited, I modified my analytic technique. Despite obstacles to communication, conflicts from different developmental levels were revived in the transference. Even in these difficult circumstances, analytic work in the transference resulted in significant change.

Child Language↗
PubMed1991

Basic skills for successful client relations.

Today's veterinary professional must not only be medically adept but must also possess good communications and client relations skills. Clients are far more likely to judge a practitioner by his or her interpersonal abilities rather than by medical judgment. This chapter stresses the importance of having "a counselor's attitude" toward clients. It will also make clinicians more aware of their verbal and nonverbal communication, hone the ability to listen and empathize, develop the art of questioning and explaining, and teach clinicians to constructively handle anger. These skills will go a long way to enhance relationships, build the practice, and reduce the people-to-people stresses that always arise when a beloved pet's life is compromised, threatened, or ended.

Animals↗
PubMed2000

[Communication between nurses' aides and patients with chronic renal failure].

This article makes considerations about the communication in the nursing assistance to the chronic renal patient, submitted to hemodialysis, which treatment is characterized by a frequent relation and sometimes a "closed" professional relation between nurse and patient. The object of this article is to analyse and give examples of the way to use consciently the verbal and nonverbal communication in order to establish a therapeutic interaction of these patients.

Communication↗
PubMed2001

The meaning of skilled care providers' relationships with stroke and aphasia patients.

Little is known about the reciprocal influence of communication difficulties on the care relationship. To illuminate care providers' lived experiences of relationships with stroke and aphasia patients, narrative interviews were conducted with providers particularly successful at communicating with patients. A phenomenological hermeneutic analysis of the narratives revealed three themes: Calling forth responsibility through fragility, restoring the patient's dignity, and being in a state of understanding. The analysis disclosed caring with regard to the patient's desire, which has its starting point in intersubjective relationship and interplay, in which nonverbal communication is essential--that is, open participation while meeting the patient as a presence. Thus, care providers prepare for deep fellowship, or communion, by being available. They described an equality with patients, interpreted as fraternity and reciprocity, that is a necessary element in presence as communion. The works of Marcel, Hegel, Stern, and Ricoeur provided the theoretical framework for the interpretation.

Adult↗
PubMed1991

Being an effective speaker.

Communication in a group is an essential quality for success in nursing. Despite this, many nurses who must have communication skills to advance have little training in public speaking. Some nurses seek to correct such deficiencies in their education by taking courses in the evenings or on weekends to improve their understanding of the elements of effective speaking. Other nurses learn by self-reflection, study, and ongoing practice. This article has presented guidelines for speaking in a group that can offer assistance in mastering this important nursing skill. Elements of nonverbal communication are crucial for effective communication. However, despite the importance of non-verbal communication to the message, language is what makes communication possible. It is language that allows people to communicate new ideas and thoughts and to solve problems.

Communication↗
PubMed2000

Effects of continuing paediatric education in interpersonal communication skills.

UNLABELLED: Paediatric care places great demands on interpersonal communication skills, especially as regards the handling of psychosocial issues. Recent shifts in paediatric morbidity and increases in patient empowerment furthermore emphasize the need for continuing paediatric education in communication skills. It is, however, debatable, whether after residency paediatric education can influence paediatrician performance. This study evaluated the effects of a 5-day experiential communication training by means of a pretest/post-test control group design. A total of 21 consulting paediatricians (10 experimental, 11 control group paediatricians) videotaped two series of consecutive outpatient encounters. Compared with the untrained control group, trained paediatricians asked more psychosocial questions and looked at the patients and their parents more often. In addition, they gave patients and parents more room to talk. No difference was found in the length of the outpatient visits. CONCLUSION: Paediatric education after residency influences paediatricians' verbal and nonverbal communication skills positively, especially as regards handling psychosocial issues. On the basis of these findings, it appears worthwhile to encourage continuing paediatric education in interpersonal communication skills.

Adult↗
PubMed2004

Discussing those not present: comprehension of references to absent caregivers.

The ability to understand references to the absent enables conversation to move beyond the here-and-now to matters distant in both space and time. Such understanding requires appreciating the relation between language and communicative intent: one must recognize speakers' intentions to use language to converge on a shared conversational focus that is at least somewhat independent of the current context. Despite its centrality to language development, the emergence of absent reference understanding has received little systematic attention. The present research investigated the responses of 60 infants aged 1;0 to 2 ; 6 to a researcher talking about both present and absent caregivers. When infants aged 1 ; 3 and older heard talk about absent caregivers they displayed a complex of nonverbal communicative responses that were divergent from their responses to talk about a present person. Infants aged 2 ; 0 and older provided responses indicating understanding of absent reference. The findings suggest that by 1 ; 3 infants may have at least a tacit appreciation of language as a device for coordinating conversational focus, and hint at increased sophistication in infants' absent reference comprehension skills at 2 ; 0.

Caregivers↗
PubMed1992

Comparison of DSM-III-R and childhood autism rating scale diagnoses of autism.

The purpose of this study was to clarify the issue of whether DSM-III-R (American Psychological Association [APA], 1987) over- or underdiagnoses autism by comparing this diagnostic system to a well-established objective measure of diagnosis, the Childhood Autism Rating Scale (CARS). A secondary goal was to determine which of the 16 criteria are the best discriminators of autism. DSM-III-R, CARS, and clinical diagnoses of 138 consecutive admissions to a statewide program for the diagnosis and treatment of autistic and related communication-handicapped individuals (Division TEACCH in North Carolina) were compared. Results indicated a generally high degree of agreement on the diagnosis of autism using the three systems. Within this treatment-oriented program, the CARS and clinical ratings diagnosed a greater number of cases as autistic than did the DSM-III-R criteria, suggesting that DSM-III-R slightly underdiagnosed autism. The criteria that most strongly related to the diagnosis of autism regardless of the system were lack of awareness of others, abnormal social play, an impaired ability to make friends, abnormal nonverbal communication, stereotypic body movements, and restricted range of interests.

Adolescent↗
PubMed1995

Increasing reading and communication skills in children with autism through an interactive multimedia computer program.

This paper reports on the effect of using an interactive and child-initiated microcomputer program (Alpha) when teaching three groups of children (N = 30) reading and communications skills: (a) 11 children with autism (M chronological age, CA = 9:4 years), (b) 9 children with mixed handicaps (M CA = 13:1), and (c) 10 normal preschool children (M CA = 6:4 years). Their mental age varied from 5:8 years to 6:9 years and all children received computer instruction supplementary to their regular reading and writing activities. Tests of reading and phonological development were carried out at the onset of the training (Start), at the end (Post 1), and at a follow-up evaluation (Post 2). In addition, video observations of the childrens' verbal and nonverbal communication were added at Start and Post 1. The children with autism increased both their word reading and their phonological awareness through the use of the Alpha program. Clearly significant gains were observed during the intervention, but none during the follow-up period. A similar but weaker pattern is observed for the children with mixed handicaps. In contrast, the normal preschool children increased their scores regardless of the program. Analyses of the children's classroom behavior indicate that the intervention succeeded in stimulating verbal expressions among the children with autism and mixed handicap. A significant increase in enjoyment was also noted for the children with autism. It is concluded that the intervention with a motivating multimedia program might stimulate reading and communication in children with various developmental disabilities, but that such interventions must be individually based and include both detailed planning and monitoring from teachers, and parents, as well as from clinicians in charge.

Adolescent↗