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Women's undefined disorders--a challenge for clinical communication.

Patients presenting illness without disease are common in general practice. A clinical communicative method was developed in order to clarify women's 'undefined' disorders. Outcomes from this approach registered from 122 audiotaped consultations were qualitatively analysed, in order to explore potential conditions and premises constituting the phenomena labelled as undefined. Knowledge produced by female patients was applied for transformation of the undefined nature of the problem into various levels of medical understanding. Gender-specific illness-promotive mechanisms were identified, as well as certain communicative dilemmas distorting symptom presentation into undefinedness. Relevant medical management was also suggested.

Adult↗

Effect of concurrent distraction on communication failures in schizophrenic patients. II. Medication status correlations.

In order to examine the effects of irrelevant distracting information on speech disorder, medicated (n = 13) and unmedicated (n = 18) schizophrenics were compared to a mixed affective sample (n = 15) on the frequencies of linguistic measures of verbal communication disorder. Patients conversed with an interviewer during the presence and absence of irrelevant information inserted into their conversation. Affective patients manifested no distraction-related increase in communication disorder. Schizophrenics on medication manifested a small, but nonsignificant, increase in communication disorders during the concurrent distraction condition. Unmedicated schizophrenics manifested a substantial increase in their communication disorders during distraction. These data suggest that medication reduces the extent to which speech processes in schizophrenia are vulnerable to overload-related deterioration and provide confirmation of the hypothesis that some component of positive thought disorder in schizophrenia is due to medication-responsive attention deficits.

Adult↗

Language acquisition after mutism: a longitudinal case study of autism.

This longitudinal case study challenges the assumption that individuals with autism who have severely restricted speech and language skills have a poor prognosis for further development of expressive oral language. The study follows the development of a woman with autism from mutism at age 10 to acquisition of a range of spoken and written language skills at age 26. The intervention in which the woman participated and her skills pre- and post-intervention and at two follow-up assessments are documented. The results support the hypotheses that speech and language development may proceed after mutism associated with limited verbal imitation and phoneme production skills, that some skills may plateau or decline, and that both spoken and written language may become viable forms of communication.

Adult↗

Predictability as an index of impaired verbal communication in schizophrenic and affective disorders.

The cloze procedure was used to examine predictability in speech samples from schizophrenic, depressive, manic, schizoaffective and normal subjects. Each speech sample was also rated for particular indices of thought disorder using the Andreasen Scale for the Assessment of Thought, Language and Communication. Schizophrenics were found to be less predictable than other patient groups or normals. Depressives were found to be the most predictable. Correlational analyses of cloze scores and specific thought disorder ratings suggest that reduced predictability is associated with traditional indicators of thought disorder.

Adolescent↗

Conversational success in Williams syndrome: communication in the face of cognitive and linguistic limitations.

Williams syndrome (WS) is characterized by apparent relative strengths in language, facial processing and social cognition but by profound impairment in spatial cognition, planning and problem solving. Following recent research which suggests that individuals with WS may be less linguistically able than was once thought, in this paper we begin to investigate why and how they may give the impression of linguistic proficiency despite poor standardized test results. This case study of Brendan, a 12-year-old boy with WS, who presents with a considerable lack of linguistic ability, suggests that impressions of linguistic competence may to some extent be the result of conversational strategies which enable him to compensate for various cognitive and linguistic deficits with a considerable degree of success. These conversational strengths are not predicted by his standardized language test results, and provide compelling support for the use of approaches such as Conversation Analysis in the assessment of individuals with communication impairments.

Child↗