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PubMed1999

Interdisciplinary pilot project in a rehabilitation setting.

This project qualitatively evaluated the planning, implementation, and outcome of an interdisciplinary model of clinical education. Expectations of physiotherapy (PT), occupational therapy (OT), and speech-language pathology (SLP) students and clinicians were assessed to determine whether the model allowed for the acquisition of the interdisciplinary knowledge and skills needed for current practice. Students from OT (n = 5), PT (n = 3), and SLP (n = 1) undertook normally scheduled five-to-eight-week clinical placements, beginning on the same start date. All students were at intermediate or senior levels in their programs. Discipline-specific activities were supervised by clinical instructors from the disciplines. Interdisciplinary sessions during the first five weeks covered cross-disciplinary activities related to clinical reasoning, interviewing techniques, professionalism, and communication skills for team reporting. Themes related to the clinical experience were derived from student and supervisor responses to pre-and post-placement questionnaires, post-placement focus group interviews, and student journals. The response to the model was positive. The students felt they had gained insights into developing interdisciplinary skills, although they did feel that some discipline-specific needs were not met. The instructors were less enthusiastic but, given better planning and communication before the placement, welcomed the opportunity to try it again.

Canada↗
PubMed1997

The use of metaphor by an artless first-time psychotherapist.

The experience in a psychiatric residency of being a psychotherapist for the first time can be overwhelming and anxiety-provoking. This paper examines a first psychotherapy case which utilizes a theory-distant approach based on the use of metaphor. Metaphorical theory is reviewed, and potential benefits and pitfalls of using metaphor are examined. An in-depth case study is done, focusing on the following six metaphors: Art as Psychotherapy; Psychotherapy as Art; The World Is a Trap; Mothers Are Martyrs; StepMothers Are Evil; and Artists Are Crazy. Each metaphor was utilized in multiple layers through the course of the therapy. Some of the current research in the use of metaphor in psychotherapy is reviewed. Through this approach, I was able to develop necessary psychotherapeutic skills without being overwhelmed by traditional theories such as Freudian, Object Relations or Self Psychology. I conclude that the use of metaphor with my first psychotherapy patient strengthened the therapeutic alliance, allowed an idiosyncratic language to develop in the therapy, structured recurrent themes, and permitted me to respect the patient's defenses.

Adolescent↗
PubMedDate not supplied

Artificial intelligence techniques for cancer treatment planning.

An artificial intelligence system, NEWCHEM, for the development of new oncology therapies is described. This system takes into account the most recent advances in molecular and cellular biology and in cell-drug interaction, and aims to guide experimentation in the design of new optimal protocols. Further work is being carried out, aimed to embody in the system all the basic knowledge of biology, physiopathology and pharmacology, to reason qualitatively from first principles so as to be able to suggest cancer therapies.

Animals↗
PubMed1991

Management of vocal nodules: a regional survey of otolaryngologists and speech-language pathologists.

This study surveyed 21 otolaryngologists (70% return) and 32 speech-language pathologists (46% return) in Maine about the treatment of vocal nodules in children and adults, referral patterns, effectiveness of therapy, and adequacy of speech-language pathologists' training. Differences in opinions between the two professional groups were found in treatment of children and referral patterns.

Adult↗
PubMed1982

A code for assessing teaching skills of parents of developmentally disabled children.

The reliability of a code to measure teaching skills was assessed by using it to evaluate a behavioral training program for parents of developmentally disabled children. Twelve sets of parents participated in a program to give them the skills needed to be teachers in the areas of behavior management and language acquisition. Using group meetings and home visits, parents were taught general principles of behavior change as well as intervention strategies for specific problems. A sample of parents' teaching behaviors with their children was videotaped three times before and once after treatment. There were no significant changes in teaching behavior before treatment. After training, the results showed that the observation code could discriminate reliably between parents' correct and incorrect use of eight discrete and specifiable behavior modification skills. The significance of these findings and the uses and limitations of the code were discussed.

Behavior Therapy↗
PubMedDate not supplied

Investigation of a new intervention for children with word-finding problems.

BACKGROUND: Around one-quarter of children attending language support services have difficulty in retrieving words. Therapy studies with such children have shown that both semantic and phonological techniques can improve word finding. A new approach to intervention is described using a computerized aid that converts letters into sound cues. AIMS: (1) To assess the word-finding abilities in a small series of children with word-finding difficulties. (2) To investigate whether intervention with a computerized aid can improve children's ability to find words. (3) To evaluate the effect of therapy on connected speech (using the Test of Word Finding in Discourse) and in relation to children's, parents' and other practitioners' views (using a questionnaire). (4) To understand the outcome in relation to an interactive model of speech production. METHODS & PROCEDURES: Five children (aged 6:10-10:7) were assessed on a variety of background measures. Following baseline assessment, two sets of items were included in therapy: a research set (with matched control items) and a further set selected for their functional relevance for each child. Intervention using the computerized aid took place once a week for half a term (6 weeks). OUTCOMES & RESULTS: The children differed from one another in their language development and non-verbal abilities, but all had difficulties in word retrieval. All children showed significant improvement in naming intervention items after therapy. This effect was maintained half a term later. Despite very different profiles, the children benefited similarly from the intervention, suggesting a common processing source for change. After the intervention, two children showed a significant reduction in word-finding behaviours (e.g. use of substitutions, repetitions and empty words) on the Test of Word Finding in Discourse. The views of participants, parents and professionals were varied but generally positive. CONCLUSIONS: The main effect of therapy can be understood, in relation to an interactive model of speech production, as strengthening links from meaning to form. Use of the aid in therapy improved word finding for targeted items and this occurred within a clinically realistic timeframe. The finding that the gains in word retrieval maintained suggests that the intervention can be functionally useful if target items are chosen appropriately. Measurable change for two children in connected speech suggests wider benefits can also occur. Overall, the aid can be a useful additional tool for therapists/teachers working with children with this difficulty.

Attitude of Health Personnel↗
PubMed1992

Innovative instructional programs for students with language or behavioral disorders.

We described creative and innovative language programs for students with LLD and BD, or both. There are three models of learning that have had considerable impact on how language services have been designed and executed for these two populations of students. Our principal argument is that there is a fourth approach or model based on empowerment. We presented the premises and principles of the empowerment model and described two programs using empowerment as the foundation for the provision of communication and language services. Language and communication programs grounded in an empowerment model offer greater possibilities for students to acquire the discourses necessary for successful participation in the culture of school, as well as the cultures in which they participate outside of school. Discovering strengths and competencies across a wide spectrum of learning affords students opportunities for developing self-knowledge based in capability and adeptness rather than in deficiency and impairment. The emergence, unfolding, and eventual maturation of these competencies and capabilities are critical not only to those students who discover them, but also to the future of all of us.

Behavior Therapy↗
PubMed2003

[Bilateral total deafness due to mumps and the outcome of cochlear implantation].

OBJECTIVE: Bilateral deafness due to mumps is rare. Here report three cases of bilateral total deafness due to mumps and their outcome of cochlear implantation. METHOD: Three cases of bilateral total deafness due to mumps were reviewed. RESULT: All patients had sudden bilateral total deafness in 3 to 7 days after mumps. 2 had vestibular symptoms. Cochlear implantation has been successful in all 3 patients. Three month after the initial mapping, Case 2 who has been wearing bilateral hearing aids and received one-year language training has the best outcome of hearing and speech than the other two. Case 1 who has been wearing one-side hearing aid and received language training of 6 months has the better outcome than case 3 who has never worn hearing aid and never received language training. CONCLUSION: Hearing loss caused by Mumps is often sudden in onset, conservative therapy have no help. Hearing aid and language training are very important to the outcome of speech perception and speech production after cochlear implantation.

Adolescent↗
PubMed1990

Cell therapy in children with Down syndrome: a retrospective study.

Cell therapy, the administration of freeze-dried or lyophilized cells derived from fetal tissue of animals, has been suggested and accepted by some parents as a treatment for Down syndrome. Such therapy regimens have been purported to ameliorate dysmorphic features and to result in improvement in IQ, motor skills, social behavior, height, language, and memory. Interest in this therapy continues despite a lack of empirical support for its use and its illegality in the United States. In this study, 190 subjects of whom 21 had received cell therapy (from sources external to this study) were studied for 18 variables in the areas of growth, motor development, cognitive development, and adaptive/social status. Comparing the cell-treated group with a control group matched for sex, age, socioeconomic status, and cardiac history showed no statistically significant differences for any of the developmental or growth variables measured. These findings fail to support continued claims of improved functioning following cell therapy in persons with Down syndrome.

Adolescent↗
PubMed1986

The symptom as metaphor in Lacan's theory of the unconscious.

An analysis of Freud's forgetting of the name Signorelli provides a framework for an explication of some central concepts in Lacan's theory of the unconscious. The parapraxis is viewed as a symptom which is structured like a metaphor. The creation of a symptom during the process of repression produces a gap in conscious discourse. The analysis of such symptoms provides evidence for Lacan's assertion that the unconscious is structured like a language.

Freudian Theory↗
PubMed1997

Object relations couple therapy.

The authors describe Fairbairn's view of the personality as a system of parts of self and object in dynamic relation, formed in the context of dependent early relationships and replayed in the intensely intimate and physical relationship of marriage. Through Klein's concept of projective identification, a spouse finds lost parts of the self in the partner, where they may flourish and be reintegrated into the self or they may be held hostage. Marriage is an opportunity for reworking the dynamic relation of parts of the self as they are modified through mutual unconscious interaction with the spouse, but it may become a closed system that inhibits growth of the individual partners. Object relations couple therapy aims to breach the closed system of the unhappy marriage, and offers an enlarged space for understanding that encourages the spouses to provide a better holding environment for each other. Not directive, didactic or symptom-focused, object relations therapy values affect, silence, body language, fantasy, dreams, and transference phenomena as necessary for reaching the unconscious in order to achieve insight. The object relations therapist interprets defenses against anxieties that underlie repetitive patterns of unhelpful behavior, and works toward understanding. As the clinical vignettes show, therapists use countertransference to understand the couple's shared transference from inside their experience. The engine of therapeutic change in this model is the therapist's self. The process of therapy improves the couple's capacity for containing each other's projections instead of refusing to resonate with them or being overtaken by them to the detriment of the self. A cycle of regression and progression in the couple's ability for containment is found as therapy proceeds. The goal of therapy is to enable the projective and introjective identificatory system of the marriage to function with greater concern for the other and respect for the self.

Adult↗
PubMed2005

A case study of mediated learning, delayed auditory feedback, and motor repatterning to reduce stuttering.

A case study of DW, an 11-yr. old monolingual, English-speaking boy who exhibits stuttering, language delay, and ADHD is presented. DW experienced only limited improvement during stuttering therapy received in public schools, according to parents and the public school clinician. The purpose of this case study was to assess whether fluency treatment which incorporated Mediated Learning, Delayed Auditory Feedback, and Speech Motor Repatterning would enhance progress. Therapy was delivered in two treatments, with each treatment being 5 wk. of intense therapy, separated by one year. Treatment 1 of combined Mediated Learning and Delayed Auditory Feedback yielded improvement in fluency, judged by parents and the teacher to be clinically significant. The improved fluency was maintained for one year when DW was pretested for participation in Treatment 2, which combined Mediated Learning, Delayed Auditory Feedback, and Speech Motor Repatterning Exercises. As no conclusions are possible, further study is needed.

Attention Deficit Disorder with Hyperactivity↗