Evidence-based illiteracy or illiterate evidence.
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Communication Barriers↗
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Effects of parental style of interaction on language development in very young severe and profound deaf children.
AIMS: (1) To study the influence of different styles of parent-child interaction in the language development of very young deaf children. (2) To find out if there are differences in parent-child interaction between two groups of very young deaf children following an Aural/Oral or a Bilingual approach to education. METHODS: Subjects were selected from all deaf children in the County of Avon who were under 3 years of age at the time of first assessment, had severe or profound, bilateral, sensorineural hearing loss and no associated medical problems. There were 16 children and families at the start of the project but only 13 completed all the assessments. The Bristol Language Developmental Scales (BLADES) was used to assess both sign and spoken language development. Interaction was studied through analysis of contingency and book-reading applied to selected periods of 3 min from four videorecorded sessions, taken at 3 months intervals for a period of 1 year. RESULTS: From the 13 children studied, only seven presented with some degree of expressive language measurable by the BLADES. Analysis of contingency showed that parents present with higher percentage of both Direct Related Acts and ON then their children Acts (On Acts: where both individuals are involved in the same task). Regarding bookreading, it was observed that parents often attend to child initiatives and acknowledge most of them but they make little effort to expand or use the child's message as topic for further conversation. In the reduced sample of seven children with expressive language, those with better language development had parents with: (a) higher percentage of DR acts; (b) higher percentage of ON acts; (c) higher percentage of appropriate responses to child communicative initiatives. CONCLUSIONS: In this small group language development seems to be facilitated by encouraging child participation and using a more contingent and child centred interaction. No significant differences were found between oral and bilingual families in terms of quality of interaction.
Child, Preschool↗
Electrophysiological correlates of cross-linguistic speech perception in native English speakers.
The present study examined the electrophysiological responses that Native English speakers display during a passive oddball task when they are presented with different types of syllabic contrasts, namely a labial /ba/-dental /d a/, a Hindi dental /d a/-retroflex /da/ and a within-category (two /ba/ tokens) contrasts. The analyses of the event-related potentials obtained showed that subjects pre-attentively perceive the differences in all experimental conditions, despite not showing such detection behaviourally in the Hindi and within-category conditions. These results support the notion that there is no permanent loss of the initial perceptual abilities that humans have as infants, but that there is an important neural reorganisation which allows the system to overcome the differences detected and only be aware of contrasts that are relevant in the language which will become the subjects native tongue. We also report order asymmetries in the ERP responses and suggest that the percepts and not only the physical attributes of the stimuli have to be considered for the evaluation of the responses obtained.
Adult↗
PET studies on the memory processing of word pairs in bilingual Finnish-English subjects.
This study examined the fundamental question whether verbal memory processing in two unrelated languages is mediated by a common neural system or by distinct cortical areas. Ten right-handed, male Finnish--English adult late bilinguals who had acquired the second language after the age of 10 were scanned whilst either encoding/retrieving word pairs in their mother tongue (Finnish) or in a foreign language (English). Within each language, subjects had to encode and retrieve four sets of 12 visually presented paired word associates which were not semantically related. Two sets consisted of highly imageable words (e.g. monkey-table; koira-lasi) and the other two sets of abstract word pairs (e.g. freedom-moral; uhka-suure). Presentation of pseudowords served as a reference condition. An emission scan was recorded after each intravenous administration of O-15 water. Encoding was associated with prefrontal and hippocampal activation. During memory retrieval, precuneus showed a consistent activation in both languages and for both highly imageable and abstract words. Although the brain mechanisms of the two languages share common components, differential activations were found in Broca's area and in the cerebellum as well as in the angular/supramarginal gyri according to the language used.
Adult↗
[KEZKAK: a new bilingual questionnaire to measure nursing students' stressors in clinical practice].
OBJECTIVE: To develop a bilingual questionnaire (Basque-Spanish) to measure nursing students' stressors in clinical practice. METHODS: Ideas were gathered from nursing students in group discussions. Initially, 287 nursing students from the School of Nursing in San Sebastián (Spain) completed the State-Trait Anxiety Inventory (STAI) and the 55-item version of our questionnaire. After analyzing the items, we selected 41 items for the final version. Some of the subjects completed this final version two (198 = 198) and six months (n = 211) later. RESULTS: The questionnaire presented high internal consistency (Cronbach's alpha: 0.95), considerable reliability (Spearman's correlation: 0.72 at two months and 0.68 at six months), and acceptable concurrent validity (Spearman's correlation with anxiety: 0.39). Factor analysis produced nine factors, with high internal consistency, which explained 64.4% of the variance. Based on these factors, the main stressors for nursing students in the workplace were produced by lack of competence (11.2%), contact with suffering (9.1%), relationships with tutors, workmates and classmates (8.9%), uncertainty and impotence (7.7%), lack of control in relationships with patients (7.6%), emotional involvement (5.8%), relationships with patients [being harmed by the relationship (5.2%) and patients seeking a close relationship (4.6%)], and overwork (4.3%). Methodological and practice aspects of the questionnaire are discussed, as well as its utility in planning the training of future nurses. CONCLUSION: The KEZKAK questionnaire is a useful instrument for measuring nursing students' stressors in clinical practice.
Adolescent↗
An investigation into the perceptions of primary care practitioners of their education and development needs for communicating with patients who may not be fluent in English.
This paper reports on an empirical research project that assessed educational needs of primary care practitioners for communicating with minority ethnic patients who are not fluent in English. The qualitative study was carried out in general practice settings in a northern inner city locality. Discrepancies are highlighted between patient and practitioner understandings, and between educational models and practitioner views. Educational needs are identified to enhance practitioners' specific skills, knowledge of patient perspectives, and self-awareness. Organisational influences on communication are explored. Key arguments are that "transcultural" educational models should be used critically, and education should enable practitioners to integrate their personal coping strategies with structured practice development planning.
Adaptation, Psychological↗
Characteristics [correction of charactersistics] of intercultural mentoring--a mentor perspective.
This article reports a study of Finnish preceptors' and British undergraduate nursing students' mentor-student relationship during international placement in Finland from the mentors' perspective. The study aimed to explore the characteristics of intercultural mentorship and the strategies used by the mentors to improve the students' intercultural competence. Altogether 23 mentors and five students participated in this study. The data consisted of mentoring session observations, group interviews and research diary notes. Intercultural mentorship was characterised by concern about the students' adjustment, pervasiveness of the relationship, sense of mutual learning, inadequate school-placement co-operation and concern about learning outcomes. The mentors used a variety of strategies to improve the students' intercultural competence. Mentorship was both a rewarding and a frustrating experience.
Acculturation↗
Bilingualism, brain injury, and recovery: implications for understanding the bilingual and for therapy.
Psychologists and other therapists are seeing an increasingly large number of bilingual individuals. Such clients are a special challenge when there has been some type of brain injury or disease because of the seemingly unpredictable effect such disorders may have on language skills, impacting either or both of the client's languages and interfering with internal speech that plays a role in higher cognitive functions such as insight and awareness. While there are many clinical assumptions about which language will show the least impairment or recover the best, such suppositions based on clinical lore are often contradictory. A review of the literature finds that the outcome of brain injury may be influenced by factors such as cerebral representation of a secondary language, method of language acquisition, age of acquisition, premorbid language proficiency, and style of learning in an individual. Neuropsychological concepts that can explain these findings are examined, along with their implications for therapy, and rehabilitation.
Aphasia↗
When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting.
The United States is experiencing one of its largest migratory waves, so health providers are caring for many patients who do not speak English. Bilingual nurses who have not been trained as medical interpreters frequently translate for these patients. To examine the accuracy of medical interpretations provided by nurses untrained in medical interpreting, we conducted a qualitative, cross-sectional study at a multi-ethnic, university-affiliated primary care clinic in southern California. Medical encounters of 21 Spanish-speaking patients who required a nurse-interpreter to communicate with their physicians were videorecorded. Encounters were transcribed by blinded research assistants. Transcriptions were translated and analyzed for types of interpretive errors and processes that promoted the occurrence of errors. In successful interpretations where misunderstandings did not develop, nurse-interpreters translated the patient's comments as completely as could be remembered and allowed the physician to extract the clinically-relevant information. In such cases, the physician periodically summarized his/her perception of the problem for back-translation and verification or correction by the patient. On the other hand, approximately one-half of the encounters had serious miscommunication problems that affected either the physician's understanding of the symptoms or the credibility of the patient's concerns. Interpretations that contained errors that led to misunderstandings occurred in the presence of one or more of the following processes: (1) physicians resisted reconceptualizing the problem when contradictory information was mentioned; (2) nurses provided information congruent with clinical expectations but not congruent with patients' comments; (3) nurses slanted the interpretations, reflecting unfavorably on patients and undermining patients' credibility; and (4) patients explained the symptoms using a cultural metaphor that was not compatible with Western clinical nosology. We conclude that errors occur frequently in interpretations provided by untrained nurse-interpreters during cross-language encounters, so complaints of many non-English-speaking patients may be misunderstood by their physicians.
Adolescent↗
The paradoxical use of interpreting in psychiatry.
Changes in the official status of African languages in South Africa suggested an examination of the impact of multi-lingualism on the practice of institutional psychiatry. For a range of theoretical and institutional reasons, a 'language gap' between clinician and patient can be rendered irrelevant in terms of the routine production of psychiatric texts in which 'symptoms' are described and 'cases' are constructed. In contrast to the way in which the role of interpreting is obscured in some hospital settings, it is highlighted in forensic settings. Here the extent of the dependency of the clinician on the interpreter is made more visible. Through this ethnographic exploration of the institutional management of multi-lingualism, the status of 'the patient who requires interpreting' emerges as an institutional construct, being determined in large measure by the routines of institutional practice. The requirements of the institution that the patient move through the process of a hospital admission, and the different requirements of each stage of this process, inform the decision as to whether interpreting is necessary. Furthermore, the differing requirements of the members of the multi-disciplinary teams renders the status of 'the patient who requires interpreting' as variable and contested. Through this analysis the institutional management of multi-lingualism emerges as a site at which discourses of race in psychiatry are reproduced.
Communication Barriers↗
Language following functional left hemispherectomy in a bilingual teenager.
A detailed language assessment was conducted with MM, a 17-year-old bilingual teenager with Rasmussen syndrome who had undergone a left functional hemispherectomy. Results revealed important deficits in French and English, affecting expressive and receptive language in both the written and the oral modality. MM's linguistic profile was coherent with previous description of language function following left hemispherectomy, and what is known of the linguistic potential of the right hemisphere (RH). The impairment pattern showed overall similarities between French and English, thus supporting the existence of a common underlying system for these two languages. However, the profiles in each language were not identical, implying that distinct subsystems may also be at play. These findings support previous descriptions of acquired language impairments and recovery in bilingual individuals.
Adolescent↗
The translating brain: cerebral activation patterns during simultaneous interpreting.
Brain activation was measured in professional interpreters during simultaneous interpreting (SI) vs. repetition (shadowing) of auditorily presented text by positron emission tomography (PET). SI into the native language (Finnish) elicited left frontal activation increases. SI into the non-native language (English) elicited much more extensive left-sided fronto-temporal activation increases. Our results indicate that SI activates predominantly left-hemispheric structures (particularly the left dorsolateral frontal cortex) previously related to lexical search, semantic processing and verbal working memory. Brain activation patterns were clearly modulated by direction of translation, with more extensive activation during translation into the non-native language which is often considered to a be more demanding task.
Adult↗
[Language and behavioral difficulties at age 3 and half and reading delay in grade 2].
BACKGROUND: Early detection of specific language impairment and dyslexia in children is an important public health problem. Longitudinal studies are needed for the distinction of real impairments from simple transitory delays. METHODS: Teachers filled a 29-item questionnaire on language and behavior for 695 children aged 3.5 years. Four years later (at second grade of primary school) the same children were evaluated for reading and writing. Statistical analysis focused on the relationships between teacher's early observations and reading delay 4 years later. Associated factors were age, sex, educational level and bilinguism of the parents, and area of the school. RESULTS: The delay in written language acquisition (8.5% of the children) was significantly associated with low educational level (but not bilinguism) of the parents and to the area of the school. In univariate analysis, most of the teacher's early negative assessments were significantly related to reading/writing delay, with the exception of some behavioral problems. However, when the effect of associated factors was taken into account only a few items, mainly concerning language expression, remained significantly associated with later reading/writing delay. CONCLUSION: These data show a major role of associated factors (educational level of the parents, area of the school) in reading delay, and help to select specific teacher's observations for an early prediction of this delay.
Age Factors↗
Cerebral hemodynamic response in Chinese (first) and English (second) language processing revealed by event-related functional MRI.
Comparative functional neuroimaging studies using the block design paradigm have previously demonstrated that there are no significant differences in the location of areas of cerebral activation when native Chinese speakers independently process single words or sentences in both the Chinese (first) and English (second) languages. While it has also been documented that significant domains of brain response include the inferior to middle left frontal lobe, the latency, amplitude and duration of the associated hemodynamic changes during isolated neural processing of Chinese and English languages still remain unknown. The aim of this study, therefore, was to examine the characteristics of the hemodynamic alterations in the above-mentioned regions with event-related functional MRI (ER-fMRI) when native Chinese speakers performed verb generation tasks in both the Chinese (first) and English (second) languages. Our results demonstrate the presence of a similar neural activity-induced hemodynamic response in the inferior to middle left frontal lobe during both tasks. Further, there were also no statistically significant differences among the variables that described the hemodynamic response curves. These findings strongly imply that the underlying neural mechanism for Chinese (first) and English (second) language processing may be similar in native Chinese speakers.
Adult↗
Impact of IMCI training and language used by provider on quality of counseling provided to parents of sick children in Bougouni District, Mali.
This study evaluates the impact of the Integrated Management Of Childhood Illness (IMCI) training on quality of counseling provided to caregivers about administration of antimalarials to their children. Ten community health centers in southern Mali were randomized to either training or comparison arms of the study, and health providers' consultations with caregivers were observed. Out of a 10-point counseling scale (Cronbach's alpha=0.77), IMCI-trained providers completed an average of 1.47 (95% CI, -0.25, 3.2) more tasks than did providers who had not received IMCI training in a linear regression analysis that accounted for intra-provider correlations. Drug consultations done in both French and the local language, Bambara, had higher scores than those conducted exclusively in Bambara. The effect of providers receiving IMCI training was more pronounced in bilingual consultations, with an average increase of 2.49 (95% CI, 0.76, 4.22) in IMCI, bilingual consultations, and average increase of 0.87 (95% CI, -0.95, 2.69) in IMCI monolingual (Bambara) consultations as compared to non-IMCI-trained providers in monolingual consultations. IMCI training showed a non-significant trend overall in improving drug counseling provided to caregivers, with significant improvements in bilingual consultations. The IMCI program in Mali should consider strategies such as role-playing of counseling in Bambara or other local languages during training to improve patient-provider communication. Similar problems related to counseling by health workers in local languages are likely to be present throughout Africa, and warrant further study.
Antimalarials↗
Marginalized evidence: effective knowledge translation strategies for low awareness issues.
There are particular knowledge translation (KT) challenges in communicating evidence on low awareness topics. Often considered peripheral to the main focus of health care provision, these issues may fail to "get on the agenda" of decision-makers, even when supported by strong evidence. This article describes the successful application of KT strategies to a specific low awareness issue (the importance of using trained health interpreters) within a large Canadian Regional Health Authority.
Awareness↗
Hemispheric asymmetries of visual ERPs in left-handed bilinguals.
ERPs (N1, P1, N2, P2) obtained from left and right occipital and temporal lobes were elicited in 30 left-handed highly proficient bilingual males in response to visually presented linguistic stimuli. The absence of statistically significant(P = < or =0.05) differences between left and right occipital and temporal lobes in all the components of the waveforms obtained, indicates a bilateral pattern of lateralization in left-handed males for both their native and foreign language.
Adult↗
Primary reading epilepsy.
This is a report of a 23-year-old-man with primary reading epilepsy. He had had three generalized tonic-clonic seizures, each time beginning with visual illusions and occurring while reading a political science text in English with complicated words. He also described tightness and stiffness in the jaw and musculature of mastication for the past 2 years, which only lasted for a few seconds and only appeared while reading political science books in English. He noted that this sensation was associated with misreading of foreign and difficult words and disappeared when he stopped reading. This case report supports the view that difficult words and misreading are provocative factors evoking seizures in reading epilepsy.
Adult↗