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PubMed2004

Tutorial: teaching communicative rejecting to children with severe disabilities.

Children with severe disabilities typically require systematic instruction to develop their communication abilities. Intervention can begin by teaching functional communication skills related to requesting and rejecting. Although a considerable amount of research has focused on teaching requesting, there is an emerging literature on teaching rejecting. The aim of this tutorial is to review the emerging literature on teaching communicative rejecting to children with severe disabilities. This review considers (a) the definition of communicative rejecting, (b) reasons for teaching communicative rejecting, (c) types of communicative rejecting, and (d) empirically validated strategies for teaching communicative rejecting to children with severe disabilities. The authors include a case study to illustrate the major steps in teaching communicative rejecting to children with severe disabilities.

Adolescent↗
PubMed2004

Effect-size reporting practices in AJSLP and other ASHA journals, 1999-2003.

A census of effect-size practices in the past 5 volumes of American Speech-Language-Hearing Association journals was accomplished. Inclusion of effect size in quantitative research reports increased from 5 reports with effect size in 1990 to 1994 to 120 reports in 1999 to 2003. Nonetheless, effect size was reported less than 30% of the time when inferential statistics were used, and only half of those reports included an interpretation of effect size. This article presents case exemplars to illustrate the use and value of effect size and includes suggestions for interpreting effect size. Researchers are encouraged to routinely report effect size and to interpret effect size in a way that facilitates the application of research to practice.

Biomedical Research↗
PubMed2005

Effect of communication disability on satisfaction with health care: a survey of medicare beneficiaries.

PURPOSE: To examine the prevalence and characteristics of community-dwelling Medicare beneficiaries reporting a communication disability and the relationship between that disability and dissatisfaction with medical care. METHOD: A total of 12,769 Medicare Current Beneficiary Survey respondents age 65 and older in 2001 were categorized by level of communication disability. Sampling weights were used to make inferences about the entire Medicare population. RESULTS: Over 16 million beneficiaries reported a communication disability. Hearing problems were most commonly reported (41.99%). The association between dissatisfaction and communication disability was statistically significant (p <or= .05) for 8 of 10 items. CONCLUSIONS: Prevalence of dissatisfaction among those with a communication disability varied, ranging from 3.43% to 19.34%. Respondents with a communication disability reported much more dissatisfaction when compared with those respondents without a communication disability.

Aged↗
PubMed2006

Measuring communicative participation: a review of self-report instruments in speech-language pathology.

PURPOSE: To assess the adequacy of self-report instruments in speech-language pathology for measuring a construct called communicative participation. METHOD: Six instruments were evaluated relative to (a) the construct measured, (b) the relevance of individual items to communicative participation, and (c) their psychometric properties. RESULTS: No instrument exclusively measured communicative participation. Twenty-six percent (n = 34) of all items (N = 132) across the reviewed instruments were consistent with communicative participation. The majority (76%) of the 34 items were associated with general communication, while the remaining 24% of the items were associated with communication at work, during leisure, or for establishing relationships. Instruments varied relative to psychometric properties. CONCLUSIONS: No existing self-report instruments in speech-language pathology were found to be solely dedicated to measuring communicative participation. Developing an instrument for measuring communicative participation is essential for meeting the requirements of our scope of practice.

Communication↗
PubMed2006

Communication in young children with fragile X syndrome: a qualitative study of mothers' perspectives.

PURPOSE: To provide descriptive and qualitative information about communication in young children with fragile X syndrome (FXS) and about how families react to and accommodate communication differences in their children. METHOD: In-depth interviews were conducted with 55 mothers of young children with FXS. Interviewers asked mothers to describe their children's communication, strategies they used to help promote their children's communication, communication-related frustrations, their expectations for their children, and the roles that they perceive for themselves. RESULTS: Over half the children were nonverbal and learning to communicate with augmentative and alternative communication. Mothers reported using strategies that were developmentally appropriate and recommended by early childhood experts, such as reading and talking to their children. Many mothers identified challenges faced in helping their child to communicate, and some cited difficulty obtaining speech-language services as a challenge. Mothers identified their roles as caregiver, teacher, therapist, and advocate. CONCLUSIONS: The perspectives offered by mothers are valuable because they indicate how children with FXS communicate in natural contexts. Information about mothers' expectations and roles may help clinicians to be sensitive to variables that will affect working with young children and their families.

Adult↗
PubMed2001

Relative treatment effects of two prelinguistic communication interventions on language development in toddlers with developmental delays vary by maternal characteristics.

This paper tests whether two prelinguistic communication interventions have a differential effect on productive and receptive language development 6 and 12 months after the end of treatment. We predicted that treatment effects on language development would vary as a function of pretreatment maternal responsivity or amount of mothers' formal education. Fifty-eight prelinguistic children with developmental delays and their mothers participated in the study. Children were randomly assigned to one of two staff-implemented treatments that were designed to increase intentional communication ability. Results confirmed the prediction that treatment effects on children's receptive and expressive language 6 and 12 months after the end of interventions vary as a function of pretreatment maternal responsivity and education level.

Child Language↗
PubMed2003

The performance of typically developing 2 1/2-year-olds on dynamic display AAC technologies with different system layouts and language organizations.

The current generation of augmentative and alternative communication (AAC) technologies is largely based on conceptual models of adults who are not disabled (J. Light & P. Lindsay, 1991). As a result, there is a large "cost of learning" placed on young children. This paper presents the results of a study designed to investigate the learning demands of dynamic display systems that differed in system layout and language organization for children approximately 2 1/2 years old (2 years 5 months to 2 years 11 months). Thirty typically developing children were asked to locate 12 vocabulary items within a play context of a birthday party. Ten children were randomly assigned to each of 3 system approaches: vocabulary in a grid format organized taxonomically, vocabulary in a grid format organized schematically, and vocabulary in an integrated scene organized schematically. The children participated in 4 learning and testing sessions and 1 generalization session. Results indicated that the children performed poorly in all conditions but were able to locate more vocabulary items in the schematic scene condition than the taxonomic grid or schematic grid conditions. There was evidence that the children failed to generalize their knowledge of the vocabulary to facilitate learning of novel vocabulary items. The current design of AAC dynamic display systems appears to be inappropriate for very young children. Rather than relying solely on technology for these young children, early intervention should target multiple modes of communication. AAC technologies should be redesigned to reduce learning demands. Results are discussed with implications for practice and suggestions for future research.

Analysis of Variance↗
PubMed2005

Do you remember? How caregivers question their spouses who have Alzheimer's disease and the impact on communication.

This study examined the types of questions caregivers use and their outcomes when conversing with their spouse with Alzheimer's disease (AD). Of particular interest was caregivers' use of yes-no and open-ended questions and the demands they make on the memory of the person with AD. It was hypothesized that communication between caregivers and their spouses would be more successful when caregivers used yes-no rather than open-ended questions; however, it was also predicted that a more positive communication outcome would occur when caregivers used open-ended questions that requested information from semantic rather than episodic memory. Eighteen caregivers and their spouses diagnosed with AD were audiotaped while they conversed for approximately 10 min on a topic of their choosing. The conversations were transcribed and coded according to the occurrence of questions, the type of question (yes-no, choice, or open-ended), the type of memory required to respond to a question (semantic or episodic), and the outcome of a response to a question (communication breakdown). The results indicated that caregivers used yes-no and open-ended questions to a similar extent, whereas episodic questions were used almost twice as frequently as semantic questions. Communication was more successful when caregivers used yes-no compared with open-ended questions and when questions placed demands on semantic rather than episodic memory. The findings from this study suggest that caregivers can reduce communication problems by avoiding the use of questions that depend on episodic memory. In addition, while yes-no questions were associated with more favorable outcomes than open-ended questions, the latter do not need to be avoided if they refer to information that draws only on semantic memory.

Aged↗
PubMed2005

Using others' words: conversational use of reported speech by individuals with aphasia and their communication partners.

Reported speech, wherein one quotes or paraphrases the speech of another, has been studied extensively as a set of linguistic and discourse practices. Researchers agree that reported speech is pervasive, found across languages, and used in diverse contexts. However, to date, there have been no studies of the use of reported speech among individuals with aphasia. Grounded in an interactional sociolinguistic perspective, the study presented here documents and analyzes the use of reported speech by 7 adults with mild to moderately severe aphasia and their routine communication partners. Each of the 7 pairs was videotaped in 4 everyday activities at home or around the community, yielding over 27 hr of conversational interaction for analysis. A coding scheme was developed that identified 5 types of explicitly marked reported speech: direct, indirect, projected, indexed, and undecided. Analysis of the data documented reported speech as a common discourse practice used successfully by the individuals with aphasia and their communication partners. All participants produced reported speech at least once, and across all observations the target pairs produced 400 reported speech episodes (RSEs), 149 by individuals with aphasia and 251 by their communication partners. For all participants, direct and indirect forms were the most prevalent (70% of RSEs). Situated discourse analysis of specific episodes of reported speech used by 3 of the pairs provides detailed portraits of the diverse interactional, referential, social, and discourse functions of reported speech and explores ways that the pairs used reported speech to successfully frame talk despite their ongoing management of aphasia.

Adolescent↗
PubMed2005

Looking while listening and speaking: eye-to-face gaze in adolescents with and without traumatic brain injury.

PURPOSE: The purpose of this study was to address the lack of quantitative data on eye-to-face gaze (also known as eye contact) in the literature on pragmatic communication. The study focused on adolescents and young adults with traumatic brain injury (TBI), as gaze often is included in social skills intervention in this population. METHOD: Gaze times were calculated for participants with TBI (n = 16) and their typically developing (TD) peers (n = 16) engaged in 3-min extemporaneous conversations. RESULTS: The TD group members looked at the face of their conversation partner an average of 62% of the time while listening and 43% of the time while speaking, versus 67% and 51%, respectively, for the TBI group. There were no significant between-groups differences in average gaze times, but the within-group variability was significantly greater in the TBI group. IMPLICATIONS: As there was no evidence of a uniform trend in gaze times among participants with TBI, general intervention to increase eye contact does not appear warranted. Instead, goals must consider that gaze is a highly complex behavior, not necessarily indicative of attention to one's partner, and that there are potential reasons for gaze aversion in individuals with cognitive limitations.

Adolescent↗
PubMed2006

Early effects of responsivity education/prelinguistic milieu teaching for children with developmental delays and their parents.

PURPOSE: To evaluate the efficacy of a 6-month course of responsivity education/prelinguistic milieu teaching (RE/PMT) for children with developmental delay and RE/PMT's effects on parenting stress in a randomized clinical trial. METHOD: Fifty-one children, age 24-33 months, with no more than 10 expressive words or signs, were randomly assigned to treatment/no-treatment groups. Thirteen children in each group had a diagnosis of Down syndrome. RESULTS: In 1 of 2 multivariate comparisons, the RE/PMT group exhibited superior gains in communication compared with the no-treatment group. The treatment effect for overall use of intentional communication acts in the child-examiner context was significant (d = .68, 95% confidence interval = 0.12-1.24). There were no effects on child outcomes due to presence or absence of Down syndrome. RE/PMT led to modest increases in recoding of child acts by parents of children who did not have Down syndrome. There were no effects on parenting stress associated with the intervention or the presence or absence of Down syndrome. CONCLUSIONS: RE/PMT may be applied clinically with the expectation of medium-size effects on the child's rate of intentional communication acts after 6 months of intervention. The approach warrants further investigation with modifications, such as delivery at higher intensity levels.

Child, Preschool↗
PubMed1990

The relationship between communication problems and psychological difficulties in persons with profound acquired hearing loss.

Communication strategies, accommodations to deafness, and perceptions of the communication environment by profoundly deaf subjects were correlated with indices of psychosocial adjustment to determine whether accommodations to deafness could play a role in the presence of psychological difficulties among deaf persons. Persons with postlingually acquired profound deafness were administered the Communication Profile for the Hearing Impaired (CPHI) and several standardized tests of psychological functioning and adjustment. Inadequate communication strategies and poor accommodations to deafness reported on the CPHI were associated with depression, social introversion, loneliness, and social anxiety. Limited communication performance at home and with friends was related to both social introversion and the experience of loneliness; perceived attitudes and behaviors of others correlated with depression as well as loneliness. In general, the pattern of correlations obtained suggests that specific communication strategies and accommodations to deafness, rather than deafness per se, may contribute to the presence of some psychological difficulties in individuals.

Adult↗
PubMed1991

Communication treatment for adults with dementia.

Intervention studies reporting improvements in communication skills in aging adults presumed to have dementia were identified and reviewed. Whereas the speech-language pathology journals have published only articles on the diagnosis and identification of communication deficits in adults with dementia, over 100 articles on treatments effecting changes in communicative deficiencies were found in psychology, social work, nursing, and gerontology journals. Much evidence supports the potential for positive outcomes from communication treatment with this population. Various design and methodological flaws, however, limit the extent to which these interventions should be applied without further research. Issues of ethics and social validity are discussed, and treatment and research needs are outlined.

Adult↗
PubMed1991

Repair strategy usage by hearing-impaired adults and changes following communication therapy.

This investigation documented how hearing-impaired individuals use communication repair strategies in structured settings and determined whether these strategies could be changed by communication therapy. Eight hearing-impaired adults with mild to severe sensorineural hearing losses practiced using five repair strategies when they did not correctly speechread a videotaped sentence. The strategies included asking the talker to (a) repeat the sentence, (b) simplify it, (c) rephrase it, (d) say an important key word, and (e) speak two sentences. Therapy consisted of computerized interactive activities and role-playing with a clinician. Seven hearing-impaired adults served as control subjects and received no therapy. Before and during therapy, subjects usually wanted a misperceived sentence to be repeated. On average, subjects changed their use of repair strategies following therapy. They utilized the repeat strategy less often and other strategies more often.

Adult↗