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PubMedDate not supplied

Using computer systems as microswitches for vocal utterances of persons with multiple disabilities.

We assessed the effects of two computer systems used as microswitches for the vocal utterances of an adolescent and a young adult with multiple disabilities. The systems were to respond to three one-syllable utterances of the first participant and nine word-like utterances of the second participant by presenting favorite stimuli linked to those utterances. The computer system used for the first participant relied on a software program developed specifically for this study. The computer system used for the second participant combined a new software program with a commercially available speech recognition program. Results showed that both participants increased the frequencies of their target utterances and obtained high levels of stimulation. Positive performance was maintained at post-intervention checks. Technical and practical implications of the data are discussed.

Abnormalities, Multiple↗
PubMedDate not supplied

Augmentative and alternative communication interventions for persons with developmental disabilities: narrative review of comparative single-subject experimental studies.

Augmentative and alternative communication (AAC) as an area of clinical and educational practice involves a myriad of decisions related to the symbols, devices, and strategies from which each client must choose. These decision-making points can be productively informed through evidence from comparative intervention studies. The purpose of this review was to synthesize comparative AAC intervention studies using single-subject experimental designs involving participants with developmental disabilities. Following a systematic search, each qualifying study was reviewed in terms of a priori determined appraisal criteria, and summarized in tabular format. Studies were divided into three groups according to their study of aided approaches, unaided approaches, or a combination of both. Results are discussed in terms of methodological adequacy of the studies and their implications for future research and practice.

Child↗
PubMed2005

Is awesome really awesome? How the inclusion of informal terms on an AAC device influences children's attitudes toward peers who use AAC.

Two videotapes were created of a child communicating with a voice output augmentative and alternative communication (AAC) device. In one the child communicated using formal English only and in the other the child communicated using formal English and age appropriate informal terms. Children in grades 4 and 5 viewed either the formal English only or the formal and informal English videotape. After viewing the videotape, children completed a measure of self-reported attitudes toward children who use AAC. Results indicated effects for gender and for the gender by grade interaction. These results are discussed along with clinical implications.

Attitude↗
PubMed1997

Fluid intake in the institutionalized elderly.

OBJECTIVE: Actual fluid intake in the institutionalized elderly was compared with three established standards to determine adequacy of fluid intake. DESIGN: Consecutive 3-day food and fluid intake was observed directly and analyzed by computer for water content. Number and frequency of medications and Minimum Data Set (MDS) information about cognitive skills, physical locomotion, and ability to understand were obtained from medical records. Recommended fluid intake was determined using three established standards for two age groups: 65 through 85 years and 86 through 100 years. The standards were 30 mL/kg body weight (standard 1); 1 mL/kcal energy consumed (standard 2); and 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, and 15 mL for remaining kg (standard 3). SUBJECTS/SETTING: Data were collected in one nursing home. Subjects were 40 residents who were free from acute illness and infection and/or were not receiving enteral feedings. MAIN OUTCOME MEASURES: Fluid intake and MDS data were collected. Data about medications were obtained after preliminary data collection observations. STATISTICAL ANALYSIS PERFORMED: A two-tailed t test was used to compare actual fluid intake with recommended fluid intake. Interaction effect of age on fluid intake was analyzed using multiple analysis of variance. Correlations were used to evaluate relationships among fluid intake, number and frequency of medications, age, weight, and MDS data. RESULTS: This population received adequate or more than adequate fluid according to the standards of 30 mL/kg body weight or 1 mL/kcal energy consumed, but inadequate fluid according to standard 3, which adjusted for extremes of underweight or overweight. Age was not a factor in adequacy of fluid intake. Positive correlations existed between fluid obtained from nonmeal feedings and number and frequency of medications. APPLICATIONS: When the standard of 30 mL/kg body weight is used, underweight residents have unrealistically low fluid recommendations. Standard 3, which adjusts for extremes in body weight, is more reasonable for patients whether they are of normal weight, underweight, or overweight. This standard more closely supports other recommendations of 1,500 to 2,000 mL fluid intake per day. Number and frequency of medications influences the amount of fluid residents obtain during nonmeal feedings.

Age Factors↗
PubMed2005

Referential communication in Alzheimer's type dementia.

This paper investigates factors that underlie reduced informative content and lack of reference in the discourse of patients with Alzheimer's Type Dementia (DAT). Patients with DAT, fluent aphasics and normal controls were given a referential communication task structured to assess lexical encoding of information, pragmatic/conceptual elaboration of information and effectiveness in establishing reference. The subjects also received standardised aphasia tests (CADL, Holland, 1980; and Cookie Theft Picture Description, Nicholas and Brookshire, 1993). Comparable reduction of lexical encoding of information was found in the discourse of aphasic and DAT participants both on the referential communication task measures and on the standardised evaluation with the Cookie Theft Picture Description test. However, the DAT subjects' discourse on the referential communication task was less efficient in establishing reference than that of the aphasics since the former presented more misunderstandings and required more explicit prompts from the listener. Furthermore, the DAT language on the referential communication task contained confounding and irrelevant information; also, the number of these errors correlated negatively with their referring abilities. Results of the CADL test confirmed that the DAT participants had less communicative effectiveness than their lexical deficit alone predicted. Finally, examination of the performance of individual DAT subjects showed that lexical encoding of information could dissociate from effectiveness in making reference. These findings support the view that difficulty in pragmatic/conceptual elaboration of discourse information content plays a substantial role in the development of reduced information content and lack of reference of DAT "empty speech". These results are discussed in the framework of the hypothesis of early attentional/executive impairment in DAT (Perry and Hodges, 1999).

Aged↗
PubMed1976

Medical planning for disaster in Israel. Evaluation of the military surgical experience in the October 1973 War, and implications for the organization of the civilian disaster services.

During its 27 years of existence, Israel has experienced four wars and dozens of mass casualty situations from various causes. This experience has led to the development of a plan for the management of mass casualties. This plan was put to the test in the October War of 1973 and proved successful. Although disasters and procedures vary widely in time and location certain principles of organization and management apply to most of them. In this paper the organization of the evacuation and management of the casualties in the October War is evaluated and its implications in the organization of civilian disaster services discussed.

Civil Disorders↗
PubMedDate not supplied

The validity of functional assessments of communication and the Activity/Participation components of the ICIDH-2: do they reflect what really happens in real-life?

UNLABELLED: This paper aims to provide a better understanding of the nature of functional communication activities so that assessment and treatment efforts are based on a theoretical framework and empirical data. Three sources of information are discussed. The first is the Activity/Participation dimensions of the World Health Organization's International Classification of Functioning, Disability, and Health. The second source is existing assessments of functional communication. The final source is data obtained from observational studies conducted in our research unit. The studies have observed the everyday communication of people with aphasia, people with Traumatic Brain Injury (TBI), and patients in hospital. The simplification of real-life communication in the WHO classification scheme, the variability of item sampling in existing assessments, and the complexity of communication observed in real-life settings has led to the conclusion that there are three levels of functional communication assessment: generic, population-specific, and individualized. Clinicians may choose which level suits their purpose. When clinicians routinely choose from a range of sophisticated functional assessments to inform their therapy, the seed that Martha Taylor Sarno planted and nourished for the past 30 years or more will truly flourish throughout the world of speech-language pathology. LEARNING OUTCOMES: As a result of this activity, participants will (1) understand the theoretical framework and data base that motivates assessment and treatment of functional communication activities, (2) be able to discuss the World Health Organization's Classification of Functioning, Disability and Health and (3) gain information about functional assessment and observational sampling of real world communication activities across three levels.

Aphasia↗
PubMedDate not supplied

Service delivery framework for adolescents with communication problems who are involved in violence.

UNLABELLED: The purpose of this article is to provide speech-language pathologists (SLPs) with a framework to address the communication problems of adolescents involved in violence. Although it is not considered to be a comprehensive framework for planning intervention programs, it will provide suggestions to assist SLPs to conceptualize their role in addressing the communication needs of these individuals. Recommendations acquired through observations, interviews, and empirical data will form the basis for suggestions. Youth in correctional facilities come from schools and return to schools following their commitment, therefore, research from incarcerated adolescents serves as an appropriate foundation to form the basis for intervention recommendations. Hence, suggestions will apply to SLPs working in correctional facilities and school settings. Intervention programs containing socially and academically relevant activities that focus on assessment, general intervention principles, conversational interaction skills, and multidisciplinary interventions are included in the article. LEARNING OUTCOMES: Readers will understand (1) a framework to address the communication problems of adolescents involved in violence and (2) how research findings support the role of SLPs in addressing the needs of adolescents involved in violence.

Adolescent↗
PubMedDate not supplied

Analysis of intentional communication in severely handicapped children with Cornelia-de-Lange syndrome.

UNLABELLED: Intentional communicative acts were assessed in 13 children with Cornelia-de-Lange syndrome (CdLS) with a severe mental disability and compared to a control group of Down and 5p (Cri-du-Chat (CdC)) syndrome children. The mean number of intentional communicative acts were significantly lower. Analysis of play behaviors revealed that the differences were specific for the communicative domain. They are part of a general behavioral characteristic of CdLS children with a severe mental disability which can be described as a lack of communication, emotional reactions and motility. A syndrome-specific low rate of communicative initiatives indicates a special problem for designing intervention programs which depend on opportunities for facilitating strategies. LEARNING OUTCOMES: The reader will learn about the behavioral phenotype of CdLS, distinctive communication problems and qualities of play behavior which are relevant for planning educational interventions in children with this syndrome.

Child↗
PubMedDate not supplied

Effects of working memory deficits on the communicative functioning of Alzheimer's dementia patients.

Individuals with Alzheimer's disease experience frontal lobe pathology and deficits in working memory processes are well documented. Less documented is how various working memory deficits impact communicative functioning. The performance data of individuals with mild and moderate Alzheimer's dementia on five tests of language comprehension and four tests of language expression are presented and discussed in the context of possible contributions from impaired working memory functions. The argument is advanced that diminished scores on tests of language comprehension and production result primarily from attenuated span capacity, difficulty focusing attention, encoding, and activation of long-term knowledge rather than from loss of linguistic knowledge. Techniques that may advantage Alzheimer's patients in the comprehension and expression of linguistic information are discussed.(1) Readers will become familiar with the typical functioning of individuals with Alzheimer's disease on common linguistic expression and comprehension tasks. (2) Readers will become familiar with the distinction between language knowledge and performance and its importance in understanding the cause of communication breakdowns in individuals with Alzheimer's disease. (3) Readers will become familiar with techniques that may facilitate the communicative functioning of individuals with Alzheimer's disease.

Alzheimer Disease↗
PubMed1999

Changes in quality of life following unilateral pallidal stimulation in Parkinson's disease.

Twenty patients with Parkinson's disease (age range 38-70 years) completed the Sickness Impact Profile (SIP) 2 months before and 3 months after long-term high-frequency electrostimulation of the globus pallidus internus to improve clinical symptoms. The SIP provides an estimate of perceived quality of life on 12 health-status categories. Neurological assessment with the Hoehn and Yahr scale and the Unified Parkinson's Disease Rating Scale revealed a significant postoperative reduction in clinical symptomatology (p<0.001). The patients experienced a general improvement in self-reported quality of life that exceeded the purely motor and physical aspects of quality of life. The significant postoperative drop in perceived impairment of communication skills can be considered the most important subjective improvement. Longitudinal research on a larger sample of patients is necessary to evaluate the durability of the subjective improvement in quality of life after unilateral pallidal stimulation.

Adult↗
PubMed1982

"Mobbing".

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Civil Disorders↗