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PubMed1996

The Profile of Functional Impairment in Communication (PFIC): a measure of communication impairment for clinical use.

This article describes the construction of the Profile of Functional Impairment in Communication (PFIC), a scale designed for the assessment of communication impairments following traumatic brain injury. The measure comprises 10 feature summary scales, assessing severity of impairment, and 84 specific behaviour items, assessing the frequency of specific communication impairments. To assess the psychometric properties of the scale, videotaped dyadic social interactions of 20 patients with traumatic brain injury were rated by eight trained raters. The feature summary scales were found to have acceptable inter-rater reliabilities, and high concurrent validity and internal consistency. Four case descriptions are presented to illustrate the clinical application of the PFIC. It is concluded that the PFIC is a useful measure for the identification of specific communication impairments in clinical practice.

Adolescent↗
PubMed2006

The role of music therapy in an interdisciplinary approach to address functional communication in complex neuro-communication disorders: a case report.

PURPOSE: This paper presents a case report of collaborative work between speech and language therapy (SLT) and music therapy (MT) in the case of an individual presenting with complex communication difficulties and lability caused by pseudo-Parkinsonian vascular disease. DESIGN: MT intervention was used to investigate whether participation could be enabled in a client presenting with complex problems as well as facilitate change in communication parameters which remained unresponsive to conventional SLT intervention. A single case design measured communication and well-being parameters using pre-, during and post-intervention measures. In addition, analysis of the client's musical responses was undertaken to examine changes in vocal functioning which are involved in communication. RESULTS: Analysis of the client's performance during MT intervention revealed improvements in prosody and phonation, with positive reports of participation, reduced incidence of lability and improvements in measures of well-being. CONCLUSIONS: The results indicate the value of such collaborative working in addition to making recommendations for the modification of existing treatment protocols. The findings highlight that fatigue is a major consideration when working with people with severe and complex clinical presentations.

Aged↗
PubMedDate not supplied

A study of doctors' and patients' communication during a primary care consultation: implications for communication training.

Previous coding schemes used to assess doctor-patient interaction have been inadequate with respect to the scope of categories used to identify: (a) information exchange and relational communication, and (b) thematic topics of talk. Thirty-two doctor-patient interviews were analyzed with a new coding scheme that includes multiple categories of information exchange and relational communication, and allows for identification of thematic topics of talk. The results revealed both effective and less effective patterns of information exchange and relational communication between doctors and patients. These patterns were further elaborated by examining the topics of talk with which they occurred. Particular attention was given to implications the results have for communication skills training for doctors and patients.

Adult↗
PubMedDate not supplied

Preferred communication modes: prelinguistic and linguistic communication in non-speaking preschool children with cerebral palsy.

Seven non-speaking preschool children with severe cerebral palsy, 5-7 years of age, were studied with respect to the amount of prelinguistic versus linguistic modes of communication used in communicative interaction with a previously unknown adult. An attempt was also made to analyse this in relation to the childrens' physical, cognitive and linguistic capacities. No significant correlations were found, however. Given that all participants had reached preschool age and were of normal intelligence, the amount of linguistic communication used (12%) was much less than could be expected. Explanations for the results were suggested, including limited interaction possibilities with the environment due to motor dysfunction, which in turn might prevent development of linguistic skills necessary to take part in more complex communicative interaction later in life.

Cerebral Palsy↗
PubMed1996

Induction of gap junctional intercellular communication by vitamin D in human skin fibroblasts is dependent on the nuclear Induction of gap junctional intercellular communication by vitamin D in human skin fibroblasts is dependent on the nuclear vitamin D receptor.

The physiologically active metabolite of vitamin D, 1alpha,25-dihydroxyvitamin D3 (calcitriol), induces gap junctional intercellular communication in human skin fibroblasts 161BR at a concentration of 10(-7) M. In human skin fibroblasts, FIB5, devoid of a functional nuclear vitamin D receptor (VDR), there is no effect on gap junctional intercellular communication. Parallel to the increase in cell-cell communication, we observed a VDR-dependent increase in connexin43 protein and connexin43 mRNA levels. These results suggest that 1alpha,25-dihydroxyvitamin D3 affects gap junctional intercellular communication at the level of transcription or of mRNA stability via the nuclear VDR.

Calcitriol↗
PubMed2000

Information and communication technology needs for distributed communication and coordination during expedition-class spaceflight.

AO-lU. Expedition-class missions are distinct from historical human presence in space in ways that significantly affect information flow and information technology designs for such missions. The centrality of Mission Control in these missions is challenged by the distances, associated communication delays, and durations of expeditions, all of which require crews to have more local resources available to manage on-board situations. The author's current research investigates how ground controllers effectively allocate communications bandwidth, cognitive resources, and knowledge sharing skills during time critical routine and non-routine situations. The research focus is on team-based information and communication technology (ICT) use to provide recommendations for improvements to support adaptive bandwidth allocations and improved sharing of data and knowledge in Mission Control contexts. In order to further improve communication and coordination between controllers and crew, additional ICT support resources will be needed to provide shared context knowledge and dynamic assessment of costs and benefits for accessing local information vs. remote expertise. Crew members will have critical needs to understand the goals, intentions, and situational constraints associated with mission information resources in order to use them most effectively in conditions where ground-based expertise is insufficient or requires more time to access and coordinate than local task demands permit. Results of this research will serve to improve the design and implementation of ICT systems to improve human performance capabilities and system operating tolerances for exploration missions. (Specific research data were not available at the time of publication.)

Communication↗
PubMed2001

An innovative approach to clinical communication in schizophrenia: the approaches to schizophrenia communication checklists.

Side effects from antipsychotic medications can have a profound effect on patients' lives and may adversely affect their willingness to comply with treatment. Identification of side effects through improved communication between psychiatrists, other members of the healthcare team, and their patients might increase treatment compliance. The Approaches to Schizophrenia Communication (ASC) Steering Group developed two simple, practical checklists for use in the busy clinical setting. The ASC-Self-Report (ASC-SR) checklist is completed by the patient and comprises a list of the more common or clinically important side effects of antipsychotic treatment. The ASC-Clinic (ASC-C) checklist is completed by both clinician and patient together, being used as the basis for a semi-structured interview. In a multicenter pilot study set up to evaluate the utility of checklists, 86% of patients responding considered the ASC-SR to be useful in communicating their problems to psychiatrists and other members of the healthcare team. All healthcare team respondents found both checklists to be helpful when discussing side effect problems with their patients. Moreover, 41% and 47% of healthcare team respondents reported that the ASC-SR and ASC-C, respectively, had assisted them in identifying side-effect problems not previously acknowledged. Preliminary evaluation of the ASC-SR and ASC-C in this multicenter pilot study suggests that both tools were user-friendly, encouraged communication between patients and healthcare professionals about antipsychotic drug side effects, and could readily integrated into everyday clinical practice.

Journal Article↗
PubMed2005

Objective B wave analysis in 55 patients with non-communicating and communicating hydrocephalus.

BACKGROUND: B waves, slow and rhythmic oscillations in intracranial pressure (ICP), are claimed to be one of the best predictors of outcome after surgery for normal pressure hydrocephalus (NPH). OBJECT: To determine the relation between the percentage of B waves and outcome in patients with hydrocephalus, and also the diurnal variation of B waves. METHODS: ICP and patient behaviour were recorded overnight (17 to 26 hours) in 29 patients with non-communicating hydrocephalus and 26 with NPH. The B wave activity, measured with an amplitude threshold of 0.5, 0.75, 1.0, 1.5, 2.0, 3.0, and 5.0 mm Hg, was estimated as the percentage of total monitoring time (% B waves) using a computer algorithm, and correlated with postoperative outcome, defined as changes in 12 standardised symptoms and signs. RESULTS: There was no linear correlation between improvement after surgery in the 55 patients and total % B waves, but a correlation was found between improvement and % B waves during sleep (r = 0.39, p = 0.04). The percentage of B waves was the same during sleep and wakefulness, and patients with NPH had the same proportion of B waves as the non-communicating patients. CONCLUSIONS: B waves are commonly observed in patients with both communicating and non-communicating hydrocephalus, but are only weakly related to the degree of postsurgical improvement.

Adult↗
PubMed1998

Development of the Children's Communication Checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children.

The Children's Communication Checklist (CCC) was developed to assess aspects of communicative impairment that are not adequately evaluated by contemporary standardised language tests. These are predominantly pragmatic abnormalities seen in social communication, although other qualitative aspects of speech and language were also included. Some items covering social relationships and restricted interests were incorporated, so that the relationship between pragmatic difficulties and other characteristics of pervasive developmental disorders could be explored. Checklist ratings were obtained for 76 children aged 7 to 9 years, all of whom had received special education for language impairment. In 71 cases, 2 raters (usually a teacher and speech-language therapist) independently completed the checklist, making it possible to establish inter-rater reliability. From an initial pool of 93 items, 70 items, grouped into 9 scales, were retained. Five of the subscales were concerned with pragmatic aspects of communication. A composite pragmatic impairment scale formed from these subscales had inter-rater reliability and internal consistency of around .80. This composite discriminated between children with a school diagnosis of semantic-pragmatic disorder and those with other types of specific language impairment (SLI). The majority of children with pragmatic language impairments did not have any evidence of restricted interests or significant difficulties in the domains of social relationships.

Adolescent↗
PubMed1991

The clinician rating of adult communication (CRAC): a clinician's guide to the assessment of interpersonal communication skill.

This paper reports the results of an initial investigation of the psychometric properties of a new clinical marital communication assessment instrument, the Clinician Rating of Adult Communication (CRAC). The sample consisted of 36 marital communication samples from both maritally satisfied and distressed couples. Reliability results indicated that the CRAC demonstrated high levels of internal consistency, test-retest reliability, and interrater agreement. Support for the validity of the CRAC was found in its correspondence with a marital interaction coding system, its relationship to ratings of marital satisfaction, and its concordance with couples' perceptions of their conflict management behavior. Overall, these findings support the conclusion that the CRAC may provide a useful addition to the measurement armamentarium of the marital clinician and researcher.

Adaptation, Psychological↗
PubMed2004

Effects on communicative requesting and speech development of the Picture Exchange Communication System in children with characteristics of autism.

Few studies on augmentative and alternative communication (AAC) systems have addressed the potential for such systems to impact word utterances in children with autism spectrum disorders (ASD). The Picture Exchange Communication System (PECS) is an AAC system designed specifically to minimize difficulties with communication skills experienced by individuals with ASD. The current study examined the role of PECS in improving the number of words spoken, increasing the complexity and length of phrases, and decreasing the non-word vocalizations of three young children with ASD and developmental delays (DD) with related characteristics. Participants were taught Phases 1-4 of PECS (i.e., picture exchange, increased distance, picture discrimination, and sentence construction). The results indicated that PECS was mastered rapidly by the participants and word utterances increased in number of words and complexity of grammar.

Autistic Disorder↗
PubMed1992

Variables influencing perceptions of the communicative competence of an adult augmentative and alternative communication system user.

The effects of aided message length, partner reauditorization, and observer background on perceptions of the communicative competence of an adult augmentative and alternative communication (AAC) system user were examined. Two groups of subjects participated: naive adults with minimal exposure to nonspeaking persons, and speech-language pathologists currently working with AAC users. Four scripted videotaped conversational conditions involving an AAC user and a normally speaking partner were employed to manipulate aided message length and partner reauditorization. A balanced incomplete block design was used. Following each viewing, subjects completed a questionnaire designed to assess the communicative competence of the AAC user. Results indicated a significant interaction effect involving subject group and aided message length. The speech-language pathologists were affected by aided message length. Furthermore, significant differences between subject groups were found in specific conditions. Future research directions are discussed.

Adult↗
PubMed2000

Development of a web-based picture archiving and communication system using satellite data communication.

Using the JAVA language we have developed a Web-based picture archiving and communication system (PACS) which allows a remote hospital to access medical images. An asymmetric satellite data communication system (ASDCS) provided a receive-only link for data delivery and a conventional terrestrial link (which could be the conventional telephone network) allowed data transmission. The satellite communication link was 10-30 times faster than the conventional terrestrial link. To increase image transmission speeds over the Internet connection, JPEG and wavelet compression methods were used. The resulting images were evaluated quantitatively by measuring the peak signal:noise ratio and qualitatively by radiologists. Compression ratios of 10:1 or less were deemed acceptable for diagnostic purposes. The system appears to be suitable for teleradiology and telemedicine.

Computer Communication Networks↗
PubMed2006

Communication and communication skills training in oncology: open questions and future tasks.

Based on their experience as teachers of communication skills training for oncology clinicians, the authors report their observations and reflect on open questions and future challenges with regard to communication in cancer care. Both of us have been training oncologists and oncology nurses in communication skills training (CST) for many years (Kiss 1999). This might be the reason why the editor asked us to comment on CST from a clinical point of view. We will therefore share some observations we made while doing such training and we will try to define future tasks.

Communication↗
PubMed1995

[The influence of information and communication in the orthodontic consultation and treatment visit. II. The communication style and compliance].

The establishment of a good rapport between dentist and patient is together with providing information a basic prerequisite for successfully motivating the patient to comply with the guidance the dentist provides. Both the style adopted in verbally communicating with the patient and also nonverbal communication play a decisive role in the establishment and maintenance of such a relationship. In the pilot study presented here, which draws on psychological interaction analysis of video recordings taken of the initial consultation with 27 patients and of 28 routine treatment sessions with different patients, the typical interaction patterns between the orthodontist and the patient are objectively assessed and compared. The most important findings of the study were: (1) The mean duration of the chairside sessions was lowest during routine encounters with cooperative patients. (2) During consultations approximately 2/3 of the time was taken up talking to each other. On the other hand, in treatment sessions with uncooperative patients only 1/4 of the time was devoted to verbal communication. (3) The orthodontist dominated the conversation in all groups and especially in conversing with the uncooperative patients. (4) In the consultation sessions the dentist and the patient related relatively strongly to each other. (5) Providing mere information significantly predominated over any discussion of the professional aspects of the treatment. (6) During the consultations eye contact was maintained over almost all of the sessions.(ABSTRACT TRUNCATED AT 250 WORDS)

Communication↗
PubMed2001

Assessment of medical students' communicative behaviour and attitudes: estimating the reliability of the use of the Amsterdam attitudes and communication scale through generalisability coefficients.

It is widely accepted that adequate attitudes and communicative skills are among the essential objectives in medical education. The Amsterdam attitude and communication scale (AACS) was developed to assess communicative skills and professional attitudes of medical students. More specifically, it was designed to evaluate the clinical behaviour of clerks to establish their suitability for the medical profession. The AACS covers nine dimensions. Moreover, an overall judgement of the student's performance is included. The present paper reports first results on the reliability of the use of the AACS. Data were collected in the course of an AACS training programme for future judges: senior medical and nursing staff members (N=98). Participants judged three videotapes of clerks interviewing patients at the bedside. For the assessment of videotapes, the first four dimensions of the AACS and the overall judgement are relevant. By applying Generalisability Theory to the training data we can forecast the reliability of the AACS in practice and gain insight in the number of raters that is needed to achieve sufficient reliability in clinical practice. If clerk behaviour is rated by six judges, summative assessment is sufficiently precise, i.e. <0.25. When using the full AACS, covering 10 items, the same number of judges is needed. Scores on individual AACS items are not sufficiently reliable. In conclusion, the results indicate that students' behaviour can be evaluated in a reliable manner using the AACS as long as enough judges and items are involved.

Attitude of Health Personnel↗
PubMed1999

Quality control (Part 2). Communication: implementation of the Resident Assessment Instrument (RAI): the benefits of a structured communication plan.

Following a government mandate to use the assessment portion of the Resident Assessment Instrument, S&WCHSC began to integrate the RAI into the care of its Aging Program residents. S&WCHSC have used this as an opportunity to provide a structure for assessment and care planning within the existing philosophy of Patient Focused Care. Implementation of the RAI required the development and implementation of a Communication Plan. An adaptation of a framework, "Effective Strategic Planning for Communications" provided guidelines for assessment of key stakeholders' communication needs.

Aged↗
PubMed1992

Instructing facilitators to support the communication of people who use augmentative communication systems.

A single-subject multiple-baseline design, replicated across three dyads, was used to examine the efficacy of instructing facilitators (i.e, significant others) to promote communication with people who use augmentative and alternative communication (AAC) systems. Facilitators were instructed in four 1-hour sessions to decrease their conversational control and provide more opportunities for the participants using AAC systems to communicate. Following instruction, facilitators decreased their rates of turn-taking and initiations and increased the proportion of turns that were responsive. Participants using AAC systems increased the frequency of their initiations. Following intervention, turn-taking and initiation patterns in the dyads were more reciprocal. Generalization occurred to the natural environment. Results suggest that facilitator instruction is an effective and efficient means of promoting greater participation in daily interactions by people who use AAC systems.

Adolescent↗