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Peters B, O'Brien K, Fried-Oken M. A recent survey of augmentative and alternative communication use and service delivery experiences of people with amyotrophic lateral sclerosis in the United States. Disabil Rehabil Assist Technol 2024; 19:1121-1134. [PMID: 36448513 DOI: 10.1080/17483107.2022.2149866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE The objective of this study was to explore and describe current trends in the augmentative and alternative communication (AAC) use and service delivery experiences of people with amyotrophic lateral sclerosis (PALS) in the U.S. METHODS Cross-sectional data were collected from 216 PALS via an anonymous online questionnaire in 2021. RESULTS Over 70% of participants reported at least some detectable speech disturbance, and approximately half used aided communication during face-to-face interactions. Among respondents with severe speech impairment, over 90% reported using speech-generating devices, and just over half reported using low-tech AAC. Most participants had met with an SLP to discuss speech and communication, but varied in both timing of the initial intervention and frequency of ongoing intervention. Fewer than half reported that their family members or other important people had received education or support related to communication for PALS. Participants also shared their use of and experiences with telephone and video calls, access methods, mounting systems, word prediction and stored phrases, and message and voice banking. CONCLUSIONS Results highlight the importance of early referral for AAC intervention, ongoing re-evaluation and treatment, involvement of communication partners and support for multimodal communication and adaptation to changing needs.
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Affiliation(s)
- Betts Peters
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
- Systems Science Program, Portland State University, Portland, OR, USA
| | - Kerth O'Brien
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Melanie Fried-Oken
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
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Shah NP, Willsey MS, Hahn N, Kamdar F, Avansino DT, Fan C, Hochberg LR, Willett FR, Henderson JM. A flexible intracortical brain-computer interface for typing using finger movements. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.22.590630. [PMID: 38712189 PMCID: PMC11071346 DOI: 10.1101/2024.04.22.590630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Keyboard typing with finger movements is a versatile digital interface for users with diverse skills, needs, and preferences. Currently, such an interface does not exist for people with paralysis. We developed an intracortical brain-computer interface (BCI) for typing with attempted flexion/extension movements of three finger groups on the right hand, or both hands, and demonstrated its flexibility in two dominant typing paradigms. The first paradigm is "point-and-click" typing, where a BCI user selects one key at a time using continuous real-time control, allowing selection of arbitrary sequences of symbols. During cued character selection with this paradigm, a human research participant with paralysis achieved 30-40 selections per minute with nearly 90% accuracy. The second paradigm is "keystroke" typing, where the BCI user selects each character by a discrete movement without real-time feedback, often giving a faster speed for natural language sentences. With 90 cued characters per minute, decoding attempted finger movements and correcting errors using a language model resulted in more than 90% accuracy. Notably, both paradigms matched the state-of-the-art for BCI performance and enabled further flexibility by the simultaneous selection of multiple characters as well as efficient decoder estimation across paradigms. Overall, the high-performance interface is a step towards the wider accessibility of BCI technology by addressing unmet user needs for flexibility.
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Gallée J, Cartwright J, Grasso S, Jokel R, Lavoie M, McGowan E, Pozzebon M, Beber BC, Duboisdindien G, Montagut N, Norvik M, Sugimoto T, Townsend R, Unger N, Winsnes IE, Volkmer A. Global Perspectives on the Management of Primary Progressive Aphasia. RESEARCH SQUARE 2024:rs.3.rs-4100219. [PMID: 38562789 PMCID: PMC10984010 DOI: 10.21203/rs.3.rs-4100219/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Speech-language therapists/pathologists (SLT/Ps) are key professionals in the management and treatment of primary progressive aphasia (PPA), however, there are gaps in education and training within the discipline, with implications for skills, confidence, and clinical decision-making. This survey aimed to explore the areas of need amongst SLT/Ps working with people living with PPA (PwPPA) internationally to upskill the current and future workforce working with progressive communication disorders. One hundred eighty-five SLT/Ps from 27 countries who work with PwPPA participated in an anonymous online survey about their educational and clinical experiences, clinical decision-making, and self-reported areas of need when working with this population. Best practice principles for SLT/Ps working with PwPPA were used to frame the latter two sections of this survey. Only 40.7% of respondents indicated that their university education prepared them for their current work with PwPPA. Competency areas of "Knowing people deeply," "Practical issues," "Connectedness," and "Preventing disasters" were identified as the basic areas of priority and need. Respondents identified instructional online courses (92.5%), sample tools and activities for interventions (64.8%), and concrete training on providing care for advanced stages and end of life (58.3%) as central areas of need in their current work. This is the first international survey to comprehensively explore the perspectives of SLT/Ps working with PwPPA. Based on survey outcomes, there is a pressing need to enhance current educational and ongoing training opportunities to better promote the well-being of PwPPA and their families, and to ensure appropriate preparation of the current and future SLT/P workforce.
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Affiliation(s)
- Jeanne Gallée
- Center for Psychometric Analyses of Aging and Neurodegeneration, Department of Medicine, University of Washington
| | | | - Stephanie Grasso
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Regina Jokel
- Temerty Faculty of Medicine, University of Toronto
| | - Monica Lavoie
- Chaire de recherche sur les aphasies primaires progressives - Fondation de la famille Lemaire, Université Laval
| | | | | | - Bárbara Costa Beber
- Department of Speech, Language, and Hearing Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)
| | - Guillaume Duboisdindien
- Chaire de recherche sur les aphasies primaires progressives - Fondation de la famille Lemaire, Université Laval
| | - Núria Montagut
- Alzheimer's Disease and other Cognitive Disorders Unit, Neurology Service, Hospital Clinic Barcelona
| | - Monica Norvik
- Department of Linguistics and Scandinavian studies, University of Oslo
| | - Taiki Sugimoto
- Center for Psychometric Analyses of Aging and Neurodegeneration, Department of Medicine, University of Washington
| | | | - Nina Unger
- Department of Neurology, University Medicine Greifswald
| | - Ingvild E Winsnes
- Department of Linguistics and Scandinavian studies, University of Oslo
| | - Anna Volkmer
- Department of Psychology and Language Science, University College London
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Canny E, Vansteensel MJ, van der Salm SMA, Müller-Putz GR, Berezutskaya J. Boosting brain-computer interfaces with functional electrical stimulation: potential applications in people with locked-in syndrome. J Neuroeng Rehabil 2023; 20:157. [PMID: 37980536 PMCID: PMC10656959 DOI: 10.1186/s12984-023-01272-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/23/2023] [Indexed: 11/20/2023] Open
Abstract
Individuals with a locked-in state live with severe whole-body paralysis that limits their ability to communicate with family and loved ones. Recent advances in brain-computer interface (BCI) technology have presented a potential alternative for these people to communicate by detecting neural activity associated with attempted hand or speech movements and translating the decoded intended movements to a control signal for a computer. A technique that could potentially enrich the communication capacity of BCIs is functional electrical stimulation (FES) of paralyzed limbs and face to restore body and facial movements of paralyzed individuals, allowing to add body language and facial expression to communication BCI utterances. Here, we review the current state of the art of existing BCI and FES work in people with paralysis of body and face and propose that a combined BCI-FES approach, which has already proved successful in several applications in stroke and spinal cord injury, can provide a novel promising mode of communication for locked-in individuals.
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Affiliation(s)
- Evan Canny
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mariska J Vansteensel
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sandra M A van der Salm
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gernot R Müller-Putz
- Institute of Neural Engineering, Laboratory of Brain-Computer Interfaces, Graz University of Technology, Graz, Austria
| | - Julia Berezutskaya
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
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Kofi Opoku E, Peprah Opoku M, Frimpomaa L, Nketsia W, Kwadwo Wisdom M, Akoto Y, Safi M. Understanding adults with communication disorders in Ghana: Accessing rehabilitation and support systems. Soc Sci Med 2023; 336:116231. [PMID: 37774531 DOI: 10.1016/j.socscimed.2023.116231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023]
Abstract
Communication is pivotal to our societal experiences; therefore, the onset of a communication disorder will negatively affect an individual's social capabilities. However, in sub-Saharan African countries, there is limited public discourse on the development of individuals with communication disorders. From the perspective of critical disability theory, there have been few opportunities for adults with communication disorders to share stories about their experiences and their developmental progress. A semi-structured interview guide was designed to collect data from 23 adults with communication disorders recruited from 10 communities in three districts in a region in Ghana. The findings are thematized under the following criteria: diagnosis and rehabilitation, familial support and impact on development. The study concludes with an invitation to policymakers to prioritize the rehabilitation needs of individuals with communication disorders and a discussion on additional study implications.
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Affiliation(s)
| | - Maxwell Peprah Opoku
- Special Education Department, United Arab Emirates University, United Arab Emirates.
| | - Lilian Frimpomaa
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Ghana
| | - William Nketsia
- School of Education; University of Western Sydney, Australia
| | - Mprah Kwadwo Wisdom
- Department of Disability and Education, Kwame Nkrumah University of Science and Technology, Ghana
| | - Yaw Akoto
- Department of Educational Studies and Leadership, University of Canterbury, New Zealand
| | - Mohammed Safi
- Department of Speech Language Pathology, United Arab Emirates University, United Arab Emirates
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Francis R, Attrill S, Radakovic R, Doeltgen S. Exploring clinical management of cognitive and behavioural deficits in MND. A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 116:107942. [PMID: 37597466 DOI: 10.1016/j.pec.2023.107942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES Little is known about how cognitive and behavioural decline in MND is managed clinically. This review aimed to summarise clinical management approaches of cognitive and behavioural decline in MND reported in peer-reviewed and grey literature. METHODS A scoping review was conducted across Embase, Medline, Psychinfo and Emcare in October 2022. Grey literature was also searched across Google Scholar and Google in October 2022. RESULTS A total of N = 26 studies and 8 documents were included. Thematic analysis revealed six key areas of clinical management: i. Assessment, ii. Education, iii. Advance Care Planning, iv. Adaptation of Care Plan, v. Communication and vi. Carer Support. CONCLUSIONS The literature on management of cognitive and behavioural decline in MND is sparse. Most peer-reviewed literature consists of expert commentary and there is a lack of primary data to guide practitioners and families on how to manage cognitive and behavioural change in MND. PRACTICE IMPLICATIONS Determining as early as practicable the presence of cognitive and behavioural changes in pwMND will enable practitioners to make adaptations to communication, provide education and supported decision-making for forward planning. This will enable individualised care, planned in partnership with families with MND, which incorporates personal needs and wishes.
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Affiliation(s)
- Rebecca Francis
- Speech Pathology, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, Australia; Swallowing Neurorehabilitation Research Laboratory, Caring Futures Institute, Flinders University, Adelaide, Australia.
| | - Stacie Attrill
- Speech Pathology, School of Allied Health Science and Practice, Faculty of Health and Medicine, The University of Adelaide, Adelaide, Australia
| | - Ratko Radakovic
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK; Euan MacDonald Centre for Motor Neuron Disease Research, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Sebastian Doeltgen
- Speech Pathology, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, Australia; Swallowing Neurorehabilitation Research Laboratory, Caring Futures Institute, Flinders University, Adelaide, Australia
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Gallée J, Volkmer A. Role of the Speech-Language Therapist/Pathologist in Primary Progressive Aphasia. Neurol Clin Pract 2023; 13:e200178. [PMID: 37529299 PMCID: PMC10389170 DOI: 10.1212/cpj.0000000000200178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 05/18/2023] [Indexed: 08/03/2023]
Abstract
In recent years, the role of the speech-language therapist/pathologist (SLT/P) has become increasingly established in the assessment, care, and management of primary progressive aphasia (PPA). Throughout the progression of the condition, the role of SLT/P encompasses 5 notable domains: behavioral assessment, impairment-based intervention, compensatory strategy intervention, communication partner training, and informational counseling. The SLT/P brings a unique perspective and clinical arsenal to address the linguistic, functional, and psychosocial effects that PPA can have on a person's life. Ongoing training opportunities are warranted to deliver evidence-based and person-centered SLT/P services to people living with PPA. Therefore, in this commentary, our aim is to clarify the role of SLT/P to advocate for our patients and their options for care.
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Affiliation(s)
- Jeanne Gallée
- Department of Psychology (JG), Institute for Learning and Brain Sciences, University of Washington, Seattle; Department of Communication Sciences and Disorders (JG), MGH Institute of Health Professions, Charlestown, MA; and Division of Psychology and Language Sciences (AV), University College London, United Kingdom
| | - Anna Volkmer
- Department of Psychology (JG), Institute for Learning and Brain Sciences, University of Washington, Seattle; Department of Communication Sciences and Disorders (JG), MGH Institute of Health Professions, Charlestown, MA; and Division of Psychology and Language Sciences (AV), University College London, United Kingdom
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Peters B, Wiedrick J, Baylor C. Effects of Aided Communication on Communicative Participation for People With Amyotrophic Lateral Sclerosis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1450-1465. [PMID: 37335771 PMCID: PMC10473367 DOI: 10.1044/2023_ajslp-22-00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE Many people with amyotrophic lateral sclerosis (PALS) experience speech changes, which may interfere with participation in communication situations. This study was designed to investigate the effects of aided communication on self-rated communicative participation among PALS and the relationship between speech function and communicative participation for PALS at various stages of speech impairment and communication aid use. METHOD Participants with amyotrophic lateral sclerosis completed an online questionnaire in which they identified their current communication methods, rated their speech function, and rated their communicative participation in various situations on a modified version of the Communicative Participation Item Bank short form. PALS who reported using aided communication rated their communicative participation under two conditions: with unaided communication only and with access to all of their communication methods. RESULTS Communication aids appeared to support communicative participation for many participants with dysarthria. Across all levels of speech function, PALS who use aided communication reported better participation under the all-methods condition than the unaided-only condition, with the largest benefits for participants with anarthria (Revised ALS Functional Rating Scale [ALSFRS-R] speech rating = 0). Communicative participation ratings worsened with more severe speech impairment under both conditions for most levels of speech function, but PALS with anarthria (ALSFRS-R speech rating = 0) reported better participation under the all-methods condition than those who used residual speech in combination with non speech methods (ALSFRS-R speech rating = 1). CONCLUSIONS Aided communication can help PALS continue to participate in various communication situations as their speech function deteriorates. Variability in self-rated communicative participation, even for PALS at the same level of speech function, highlights the need for an individualized approach and consideration of personal and environmental factors in augmentative and alternative communication intervention. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22782986.
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Affiliation(s)
- Betts Peters
- Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, Portland
- Systems Science Program, Portland State University, OR
| | - Jack Wiedrick
- Biostatistics & Design Program, Oregon Health & Science University, Portland
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Yamaki T, Hatakeyama N, Murayama T, Funakura M, Hara T, Onodera S, Ito D, Yakufujiang M, Odaki M, Oka N, Kobayashi S. Prediction of voluntary movements of the upper extremities by resting state-brain regional glucose metabolism in patients with chronic severe brain injury: A pilot study. Hum Brain Mapp 2023; 44:3158-3167. [PMID: 36929226 PMCID: PMC10171500 DOI: 10.1002/hbm.26270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
Confirmation of the exact voluntary movements of patients with disorder of consciousness following severe traumatic brain injury (TBI) is difficult because of the associated communication disturbances. In this pilot study, we investigated whether regional brain glucose metabolism assessed by 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) at rest could predict voluntary movement in severe TBI patients, particularly those with sufficient upper limb capacity to use communication devices. We visually and verbally instructed patients to clasp or open their hands. After video capture, three independent rehabilitation therapists determined whether the patients' movements were voluntary or involuntary. The results were compared with the standardized uptake value in the primary motor cortex, referring to the Penfield's homunculus, by resting state by FDG-PET imaged 1 year prior. Results showed that glucose uptake in the left (p = 0.0015) and right (p = 0.0121) proximal limb of the primary motor cortex, based on Penfield's homunculus on cerebral cartography, may reflect contralateral voluntary movement. Receiver operating characteristic curve analysis showed that a mean cutoff standardized uptake value of 5.47 ± 0.08 provided the best sensitivity and specificity for differentiating between voluntary and involuntary movements in each area. FDG-PET may be a useful and robust biomarker for predicting long-term recovery of motor function in severe TBI patients with disorders of consciousness.
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Affiliation(s)
- Tomohiro Yamaki
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan.,Division of Radiology, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Naoya Hatakeyama
- Division of Rehabilitation, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Takemi Murayama
- Division of Rehabilitation, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Mika Funakura
- Division of Rehabilitation, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Takuya Hara
- Division of Rehabilitation, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Shinji Onodera
- Division of Radiology, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Daisuke Ito
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Maidinamu Yakufujiang
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Masaru Odaki
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Nobuo Oka
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan.,Division of Radiology, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
| | - Shigeki Kobayashi
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan
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Donaldson AL, Corbin E, Zisk AH, Eddy B. Promotion of Communication Access, Choice, and Agency for Autistic Students. Lang Speech Hear Serv Sch 2023; 54:140-155. [PMID: 36332142 DOI: 10.1044/2022_lshss-22-00031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Families and professionals often consider augmentative and alternative communication (AAC) a "last resort" for persons with communication challenges; however, speaking autistic adults have reported that they would have benefited from access to AAC as children. This tutorial discusses the history of this "last resort" practice and its perpetuation within the medical model of disability. The tutorial focuses on communication access, choice, and agency for autistic students. METHOD We provide a brief overview of the AAC community and their preferred terminology, review the history of traditional approaches to research on AAC and autism, and then examine the relationship between disability models and ableism to views of spoken language as a priority of intervention. Studies on this topic are rare, and resisting ableism requires acknowledging and honoring disabled people's experiences and expertise. Therefore, we promote autistic expertise within the framework of evidence-based practice and discuss the experiences of autistic people and spoken language. Finally, we consider the role of the speech-language pathologist (SLP) in assessment and offer autistic-based strategies and recommendations for communication support. CONCLUSIONS Speaking autistic students who could benefit from AAC may not have access to AAC due to the prioritization of spoken language and lack of awareness of the benefit of AAC. We recommend that SLPs and school-based professionals support and facilitate access, communicative choice, and agency by implementing multimodal communication strategies to include AAC use for autistic students regardless of their spoken language status. Promoting all types of communication and ensuring opportunities for communication across multiple modalities are paramount to a child's agency and self-determination, as is normalization of AAC.
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Affiliation(s)
- Amy L Donaldson
- Department of Speech & Hearing Sciences, Portland State University, OR
| | | | | | - Brandon Eddy
- Department of Speech & Hearing Sciences, Portland State University, OR
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11
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Mooney AR, Bravo M, Roberts A, Salley E, Blaze E, Esparza M, Fried-Oken M, Khayum B, Rao L, Rademaker A, Rogalski E. Use and Perceived Effectiveness of Communication Modes Reported by Persons With Primary Progressive Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:298-305. [PMID: 36472941 PMCID: PMC10023145 DOI: 10.1044/2022_ajslp-21-00386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/22/2022] [Accepted: 08/11/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Primary progressive aphasia (PPA) is a clinical neurodegenerative dementia syndrome characterized by early, selective, and progressive language impairment. PPA onset is gradual, providing time to potentially identify additional or alternative expressive communication modes; however, reports of communication mode use and effectiveness by persons with PPA have not been described. This study characterized the use, frequency, and perceived effectiveness of communication modes reported by individuals with PPA. METHOD Forty-one participants with mild-to-moderate PPA completed a structured interview detailing the type, frequency, and perceived effectiveness of 12 potential communication modes, categorized by technology required (no-tech, low-tech, and high-tech). The ratio of modes used was compared across technology categories with a repeated-measures generalized linear model assuming a binomial distribution with an overall Wald chi-square statistic, followed by pairwise post hoc t-test comparisons. RESULTS Of the 12 communication modes assessed, participants reported using a median of eight (range: 5-10). All participants affirmed using speech, facial expressions, and talking on the phone. Frequency and perceived effectiveness ratings for these three modes were endorsed at the "some/most of the time" level for more than 80% of the participants. No-tech mode use was significantly higher than reported high-tech and low-tech modes (p = .004 and p < .0001, respectively). Even so, while some high-tech modes (apps) and some low-tech modes (nonelectronic augmentative and alternative communication) had fewer users, effectiveness ratings were moderate to high for all but one user. CONCLUSIONS Persons with mild-to-moderate language impairment due to PPA report using a range of communication modes with moderate-to-high frequency and perceived effectiveness. These outcomes provide practical information when considering mode refinement or expansion during intervention to maximize communication participation. Barriers to modality use may include low awareness or access, which could be queried by future studies and supported by speech and language interventions. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21614262.
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Affiliation(s)
| | - Megan Bravo
- Oregon Health & Science University, Portland
| | - Angela Roberts
- School of Communication Sciences and Disorders and Department of Computer Science, Western University, London, Ontario, Canada
| | - Elizabeth Salley
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Erin Blaze
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Marissa Esparza
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Becky Khayum
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Leela Rao
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alfred Rademaker
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Towards clinical application of implantable brain-computer interfaces for people with late-stage ALS: medical and ethical considerations. J Neurol 2023; 270:1323-1336. [PMID: 36450968 PMCID: PMC9971103 DOI: 10.1007/s00415-022-11464-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 12/05/2022]
Abstract
Individuals with amyotrophic lateral sclerosis (ALS) frequently develop speech and communication problems in the course of their disease. Currently available augmentative and alternative communication technologies do not present a solution for many people with advanced ALS, because these devices depend on residual and reliable motor activity. Brain-computer interfaces (BCIs) use neural signals for computer control and may allow people with late-stage ALS to communicate even when conventional technology falls short. Recent years have witnessed fast progression in the development and validation of implanted BCIs, which place neural signal recording electrodes in or on the cortex. Eventual widespread clinical application of implanted BCIs as an assistive communication technology for people with ALS will have significant consequences for their daily life, as well as for the clinical management of the disease, among others because of the potential interaction between the BCI and other procedures people with ALS undergo, such as tracheostomy. This article aims to facilitate responsible real-world implementation of implanted BCIs. We review the state of the art of research on implanted BCIs for communication, as well as the medical and ethical implications of the clinical application of this technology. We conclude that the contribution of all BCI stakeholders, including clinicians of the various ALS-related disciplines, will be needed to develop procedures for, and shape the process of, the responsible clinical application of implanted BCIs.
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Dupont C, Smets T, Monnet F, Eneslätt M, Tishelman C, Van den Block L. The cultural adaptation of the go wish card game for use in Flanders, Belgium: a public health tool to identify and discuss end-of-life preferences. BMC Public Health 2022; 22:2110. [PMID: 36397020 PMCID: PMC9672613 DOI: 10.1186/s12889-022-14523-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background Public health tools like the Go Wish card game from the US, have been found useful to support people in reflecting on their end-of-life preferences, but a cultural adaptation is essential for their success. In the present study, we explore the necessary cultural adaptations to the Go Wish cards by applying an extensive, systematic, and community-engaging negotiating procedure to facilitate the use of the cards in the general population of Flanders, Belgium. Methods We used an iterative cultural adaptation process with repeated discussions with various community organizations and representatives of minority and religious groups. After that, the cards were evaluated by 12 healthcare professionals in relation to: linguistic equivalence to the original version, applicability, comprehensibility, and relevance per card. Additional testing with potential users preceded final adjustments. Results We found that stakeholders were keen to engage throughout the process of cultural adaptation and we were able to make a range of cultural adaptations for the use of the cards in Flanders. All original statements were rephrased from passive to more active statements. Sixteen out of 36 cards were adjusted to make them more culturally appropriate for use in Flanders, e.g., “to meet with clergy or a chaplain” to “having a spiritual counselor as support.” Three new cards were added: two with statements appropriate to the Belgian patient rights and euthanasia legislation and one extra Wild Card. Potential users (n = 33) felt that the cards supported conversations about end-of-life preferences. Conclusion By making community engagement a cornerstone of our adaption process, we developed a card set that potential end-users considered a supportive public health tool for reflecting and discussing end-of-life values and preferences. The described process is particularly valuable for culturally adapt interventions, especially given that community engagement in adapting interventions is essential to creating grounded interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14523-9.
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Oliver D, Baker I, Borasio GD, Cras P, Faull C, Hepgul N, Lorenzl S, Stockdale C, de Visser M, Vanopdenbosch L, Voltz R, Veronese S. The involvement of palliative care with neurology – a comparison of UK, Switzerland and Italy. Amyotroph Lateral Scler Frontotemporal Degener 2022; 24:256-262. [PMID: 36288469 DOI: 10.1080/21678421.2022.2136993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To ascertain the involvement of palliative care with neurology services in the care of people with amyotrophic lateral sclerosis (ALS) in the United Kingdom, Italy and Switzerland, in particular the collaboration with and referral from neurology, the involvement in multidisciplinary team care and in the respiratory support of ALS patients. METHODS In 2019, two online surveys were undertaken of palliative care specialists, using specialist groups of the European Academy of Neurology, European Association of Palliative Care and the Association of Palliative Medicine for Great Britain and Ireland. RESULTS The respondents were specialist palliative care professionals, predominantly senior doctors, involved in the care of people with ALS. As the numbers of respondents from many countries were in single figures the analysis was restricted to the United Kingdom, Italy and Switzerland. The time of involvement varied, with early involvement commonest in the UK. Barriers to referral included neurologists not referring and financial issues, particularly in Switzerland. The reluctance of patients and families to see palliative care services was reported as less than 20% in all countries. Respondents were often involved in the care of people receiving noninvasive ventilation (NIV), in all countries. and with tracheostomy ventilation (TV), particularly in Italy. CONCLUSIONS Palliative care services are often involved in the care of people with ALS, but the extent and timing of involvement varies. The use of clinical guidelines and education on palliative care for neurology services may encourage collaboration, for the benefit of people with ALS and their families.
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Affiliation(s)
- David Oliver
- Tizard Centre, University of Kent, Canterbury, United Kingdom
| | - Idris Baker
- Morriston Hospital, Swansea, Wales, United Kingdom
| | - Gian Domenico Borasio
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrick Cras
- Department of Neurology, Antwerp University, Antwerpen, Belgium
| | | | - Nilay Hepgul
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College, London, United Kingdom
| | - Stefan Lorenzl
- Institute of Nursing Sciences and Practice, Paracelsus Medical University, Salzburg, Austria
| | | | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | | | - Raymond Voltz
- Department of Palliative Medicine, University Hospital, Cologne, Germany
| | - Simone Veronese
- Department of Research in Palliative Care, Fondazione FARO, Turin, Italy
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Mitchell CL, Cler GJ, Fager SK, Contessa P, Roy SH, De Luca G, Kline JC, Vojtech JM. Ability-Based Methods for Personalized Keyboard Generation. MULTIMODAL TECHNOLOGIES AND INTERACTION 2022; 6:67. [PMID: 36313956 PMCID: PMC9608338 DOI: 10.3390/mti6080067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study introduces an ability-based method for personalized keyboard generation, wherein an individual's own movement and human-computer interaction data are used to automatically compute a personalized virtual keyboard layout. Our approach integrates a multidirectional point-select task to characterize cursor control over time, distance, and direction. The characterization is automatically employed to develop a computationally efficient keyboard layout that prioritizes each user's movement abilities through capturing directional constraints and preferences. We evaluated our approach in a study involving 16 participants using inertial sensing and facial electromyography as an access method, resulting in significantly increased communication rates using the personalized keyboard (52.0 bits/min) when compared to a generically optimized keyboard (47.9 bits/min). Our results demonstrate the ability to effectively characterize an individual's movement abilities to design a personalized keyboard for improved communication. This work underscores the importance of integrating a user's motor abilities when designing virtual interfaces.
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Affiliation(s)
| | - Gabriel J. Cler
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98105, USA
| | - Susan K. Fager
- Institute of Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE 68506, USA
| | - Paola Contessa
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
| | - Serge H. Roy
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
| | - Gianluca De Luca
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
| | - Joshua C. Kline
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
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McKenna MC, Tahedl M, Lope J, Chipika RH, Li Hi Shing S, Doherty MA, Hengeveld JC, Vajda A, McLaughlin RL, Hardiman O, Hutchinson S, Bede P. Mapping cortical disease-burden at individual-level in frontotemporal dementia: implications for clinical care and pharmacological trials. Brain Imaging Behav 2022; 16:1196-1207. [PMID: 34882275 PMCID: PMC9107414 DOI: 10.1007/s11682-021-00523-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 01/25/2023]
Abstract
Imaging studies of FTD typically present group-level statistics between large cohorts of genetically, molecularly or clinically stratified patients. Group-level statistics are indispensable to appraise unifying radiological traits and describe genotype-associated signatures in academic studies. However, in a clinical setting, the primary objective is the meaningful interpretation of imaging data from individual patients to assist diagnostic classification, inform prognosis, and enable the assessment of progressive changes compared to baseline scans. In an attempt to address the pragmatic demands of clinical imaging, a prospective computational neuroimaging study was undertaken in a cohort of patients across the spectrum of FTD phenotypes. Cortical changes were evaluated in a dual pipeline, using standard cortical thickness analyses and an individualised, z-score based approach to characterise subject-level disease burden. Phenotype-specific patterns of cortical atrophy were readily detected with both methodological approaches. Consistent with their clinical profiles, patients with bvFTD exhibited orbitofrontal, cingulate and dorsolateral prefrontal atrophy. Patients with ALS-FTD displayed precentral gyrus involvement, nfvPPA patients showed widespread cortical degeneration including insular and opercular regions and patients with svPPA exhibited relatively focal anterior temporal lobe atrophy. Cortical atrophy patterns were reliably detected in single individuals, and these maps were consistent with the clinical categorisation. Our preliminary data indicate that standard T1-weighted structural data from single patients may be utilised to generate maps of cortical atrophy. While the computational interpretation of single scans is challenging, it offers unrivalled insights compared to visual inspection. The quantitative evaluation of individual MRI data may aid diagnostic classification, clinical decision making, and assessing longitudinal changes.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Marlene Tahedl
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Institute for Psychology, University of Regensburg, Regensburg, Germany
| | - Jasmin Lope
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mark A Doherty
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Jennifer C Hengeveld
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Alice Vajda
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Russell L McLaughlin
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | - Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.
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Burshnic-Neal VL, Knollman-Porter K, Topper RH, McConnell ES, VanHaitsma K, Abbott KM. Examining Face Validity of Visual Stimuli Used in Preference Assessments for Older Adults With Communication Impairments. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1297-1318. [PMID: 35344450 DOI: 10.1044/2022_ajslp-21-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Preference assessment is integral to person-centered treatment planning for older adults with communication impairments. There is a need to validate photographs used in preference assessment for this population. Therefore, this study aimed to establish preliminary face validity of photographs selected to enhance comprehension of questions from the Preferences for Everyday Living Inventory-Nursing Home (PELI-NH) and describe themes in older adults' recommendations for revising photographic stimuli. METHOD This qualitative, cognitive interviewing study included 21 participants with an average age of 75 years and no known cognitive or communication deficits. Photographic stimuli were randomized and evaluated across one to two interview sessions. Participants were asked to describe what the preference stimuli represented to them. Responses were scored to assess face validity. Participants were then shown the PELI-NH written prompt and asked to evaluate how well the photograph(s) represented the preference. A semideductive thematic analysis was conducted on interview transcripts to summarize themes in participant feedback. RESULTS Forty-six (64%) stimuli achieved face validity criteria without revisions. Six (8%) stimuli achieved face validity after one partial revision. Twenty (28%) stimuli required multiple revisions and reached feedback saturation, requiring team review for finalization. Thematic analysis revealed challenges interpreting stimuli (e.g., multiple meanings) and participant preferences for improving photographs (e.g., aesthetics). CONCLUSIONS Cognitive interviewing was useful for improving face validity of stimuli pertaining to personal care topics. Abstract and subjective preferences (e.g., cultural traditions) may be more challenging to represent. This study provides a framework for further testing with older adults with cognitive, communication, and hearing impairments.
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Affiliation(s)
- Vanessa L Burshnic-Neal
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Medical Center, NC
| | | | - Rachel H Topper
- Department of Speech Pathology and Audiology, Miami University, Oxford, OH
| | - Eleanor S McConnell
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Medical Center, NC
- Duke University School of Nursing, Durham, NC
| | - Kimberly VanHaitsma
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park
- Polisher Research Institute, Abramson Senior Care, Blue Bell, PA
| | - Katherine M Abbott
- Department of Sociology and Gerontology, Scripps Gerontology Center, Miami University, Oxford, OH
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Apreleva Kolomeytseva AT, Brylev L, Eshghi M, Bottaeva Z, Zhang J, Fachner JC, Street AJ. Home-Based Music Therapy to Support Bulbar and Respiratory Functions of Persons with Early and Mid-Stage Amyotrophic Lateral Sclerosis-Protocol and Results from a Feasibility Study. Brain Sci 2022; 12:494. [PMID: 35448025 PMCID: PMC9027911 DOI: 10.3390/brainsci12040494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 01/27/2023] Open
Abstract
Respiratory failure, malnutrition, aspiration pneumonia, and dehydration are the precursors to mortality in ALS. Loss of natural communication is considered one of the worst aspects of ALS. This first study to test the feasibility of a music therapy protocol for bulbar and respiratory rehabilitation in ALS employs a mixed-methods case study series design with repeated measures. Newly diagnosed patients meeting the inclusion criteria were invited to participate, until the desired sample size (n = 8) was achieved. The protocol was delivered to participants in their homes twice weekly for six weeks. Individualised exercise sets for independent practice were provided. Feasibility data (recruitment, retention, adherence, tolerability, self-motivation and personal impressions) were collected. Bulbar and respiratory changes were objectively measured. Results. A high recruitment rate (100%), a high retention rate (87.5%) and high mean adherence to treatment (95.4%) provide evidence for the feasibility of the study protocol. The treatment was well tolerated. Mean adherence to the suggested independent exercise routine was 53%. The outcome measurements to evaluate the therapy-induced change in bulbar and respiratory functions were defined. Findings suggest that the protocol is safe to use in early- and mid-stage ALS and that music therapy was beneficial for the participants' bulbar and respiratory functions. Mean trends suggesting that these functions were sustained or improved during the treatment period were observed for most outcome parameters: Maximal Inspiratory Pressure, Maximal Expiratory Pressure, Peak Expiratory Flow, the Center for Neurologic Study-Bulbar Function Scale speech and swallowing subscales, Maximum Phonation Time, Maximum Repetition Rate-Alternating, Maximum Repetition Rate-Sequential, Jitter, Shimmer, NHR, Speaking rate, Speech-pause ratio, Pause frequency, hypernasality level, Time-to-Laryngeal Vestibule Closure, Maximum Pharyngeal Constriction Area, Peak Position of the Hyoid Bone, Total Pharyngeal Residue C24area. Conclusion. The suggested design and protocol are feasible for a larger study, with some modifications, including aerodynamic measure of nasalance, abbreviated voice sampling and psychological screening.
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Affiliation(s)
| | - Lev Brylev
- Bujanov Moscow City Clinical Hospital, 115419 Moscow, Russia;
- Institute of Higher Nervous Activity and Neurophysiology, 115419 Moscow, Russia
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia
| | - Marziye Eshghi
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA 02129-4557, USA;
| | - Zhanna Bottaeva
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, 119180 Moscow, Russia;
| | - Jufen Zhang
- Faculty of Health, Education, Medicine & Social Care, School of Medicine, Anglia Ruskin University, Cambridge CM1 1SQ, UK;
| | - Jörg C. Fachner
- Music, Health and the Brain, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CM1 1SQ, UK;
| | - Alexander J. Street
- Music, Health and the Brain, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CM1 1SQ, UK;
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Dada S, van der Walt C, May AA, Murray J. Intelligent assistive technology devices for persons with dementia: A scoping review. Assist Technol 2022:1-14. [PMID: 34644248 DOI: 10.1080/10400435.2021.1992540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Assistive technology (AT) with context-aware computing and artificial intelligence capabilities can be applied to address cognitive and communication impairments experienced by persons with dementia (PwD). This paper aims to provide an overview of current literature regarding some characteristics of intelligent assistive technology devices (IATDs) for cognitive and communicative impairments of PwD. It also aims to identify the areas of impairment addressed by these IATDs.A multi-faceted systematic search strategy yielded records. Predefined criteria were applied for inclusion and data extraction. Thereafter data was thematically analysed and synthesised. This review demonstrates that almost all of the research involving IATDs has focused on cognitive impairments of PwD and has not yet evolved past the conceptual or prototype stages of development. Summaries of commercially available IATDs for PwD and relevant prototypes are provided at the end of this review.This research concluded that IATDs for PwD targeting cognition and communication problems primarily focus on social robots, and that they address cognitive impairments of attention, affect, and social-pragmatic communicative impairments. Future research endeavours concerning AT for PwD should explore collaboration between computer engineering and health practitioners to address the identified gaps. This may contribute to the available information for evidence-based decision making for PwD.
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Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria
| | | | - Adele A May
- Centre for Augmentative and Alternative Communication, University of Pretoria
| | - Janice Murray
- Centre for Augmentative and Alternative Communication, University of Pretoria
- Manchester Metropolitan University
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20
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Costello J, Smith M. The BCH message banking process™, voice banking, and double-dipping™. Augment Altern Commun 2022; 37:241-250. [PMID: 35000518 DOI: 10.1080/07434618.2021.2021554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Significant advances have been made in interventions to maintain communication and personhood for individuals with neurodegenerative conditions. One innovation is Message Banking, a clinical approach first developed at Boston Children's Hospital (BCH). This paper outlines the Message Banking process as implemented at BCH, which includes the option of "Double Dipping," where banked messages are mined to develop personalized synthesized voices. More than a decade of experience has led to the evolution of six core principles underpinning the BCH process, resulting in a structured introduction of the associated concepts and practices with people with amyotrophic lateral sclerosis (ALS) and their families. These principles highlight the importance of assigning ownership and control of the process to individuals with ALS and their families, ensuring that as a tool it is empowering and offers hope. Changes have been driven by feedback from individuals who have participated in the BCH process over many years. The success of the process has recently been extended through partnerships that allow the recorded messages to be used to develop individual personalized synthetic voices to complement banked messages. While the process of banking messages is technically relatively simple, the full value of the process should be underpinned by the values and principles outlined in this tutorial.
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Affiliation(s)
- John Costello
- Augmentative Communication Program and Jay S. Fishman ALS Augmentative Communication Program, Boston Children's Hospital, Adjunct Faculty Boston University, Boston, MA, USA
| | - Martine Smith
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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21
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Roman A, Baylor C, Johnson L, Barton M. Expanding Availability of Speech-Generating Device Evaluation and Treatment to People With Amyotrophic Lateral Sclerosis (pALS) Through Telepractice: Perspectives of pALS and Communication Partners. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2098-2114. [PMID: 34411491 DOI: 10.1044/2021_ajslp-20-00334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose To examine the experiences of people with ALS (pALS) and their communication partners (cALS) regarding receiving speech-generating device (SGD) evaluation and treatment via telepractice. Method Eight pALS along with a primary cALS participated in telepractice SGD evaluation and treatment with an augmentative and alternative communication (AAC) specialist and representatives from multiple SGD vendors. Participants were interviewed postevaluation and post-SGD training to examine their experiences. Mixed methods data were collected through Likert scale responses and qualitative interviews. Results Telepractice SGD evaluation and training were feasible and resulted in all pALS receiving SGDs they were able to use to communicate. In both Likert rating items and qualitative interviews, participants rated the telepractice experience very highly in terms of giving them access to AAC services via an AAC specialist that they would not have otherwise been able to access, and doing so in a format that was possible given their limitations in mobility, endurance, and caregiver availability. Suggestions for improving the telepractice experience were provided. Conclusions Telepractice should be considered as an option to provide vital SGD services to patients who are geographically remote, mobility impaired, unable to leave their home, experience fatigue with travel, or otherwise would not have access to these specialized services. Telepractice allows patients to preserve their time and energy for the assessment and treatment sessions, resulting in perhaps deeper and more frequent engagement in evaluation and training. Telepractice could serve as an alternative to outpatient, in-person evaluations, or be utilized in conjunction with in-person appointments. Supplemental Material https://doi.org/10.23641/asha.15094257.
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Affiliation(s)
- Amy Roman
- Forbes Norris ALS Research and Treatment Center, San Francisco, CA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Lindsay Johnson
- Department of Speech, Language and Hearing Sciences, San Francisco State University, CA
| | - Maya Barton
- Department of Speech, Language and Hearing Sciences, San Francisco State University, CA
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de la Sablonnière J, Tastevin M, Lavoie M, Laforce R. Longitudinal Changes in Cognition, Behaviours, and Functional Abilities in the Three Main Variants of Primary Progressive Aphasia: A Literature Review. Brain Sci 2021; 11:1209. [PMID: 34573229 PMCID: PMC8466869 DOI: 10.3390/brainsci11091209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022] Open
Abstract
Primary progressive aphasias (PPAs) are a group of neurodegenerative diseases presenting with insidious and relentless language impairment. Three main PPA variants have been described: the non-fluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA). At the time of diagnosis, patients and their families' main question pertains to prognosis and evolution, but very few data exist to support clinicians' claims. The objective of this study was to review the current literature on the longitudinal changes in cognition, behaviours, and functional abilities in the three main PPA variants. A comprehensive review was undertaken via a search on PUBMED and EMBASE. Two authors independently reviewed a total of 65 full-text records for eligibility. A total of 14 group studies and one meta-analysis were included. Among these, eight studies included all three PPA variants. Eight studies were prospective, and the follow-up duration was between one and five years. Overall, svPPA patients showed more behavioural disturbances both at baseline and over the course of the disease. Patients with lvPPA showed a worse cognitive decline, especially in episodic memory, and faster progression to dementia. Finally, patients with nfvPPA showed the most significant losses in language production and functional abilities. Data regarding the prodromal and last stages of PPA are still missing and studies with a longer follow-up observation period are needed.
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Affiliation(s)
| | | | | | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, Faculté de Médecine, Université Laval, Quebec City, QC G1J 1Z4, Canada; (J.d.l.S.); (M.T.); (M.L.)
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23
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Gibson RC, Bouamrane MM, Dunlop MD. Alternative and Augmentative Communication Technologies for Supporting Adults With Mild Intellectual Disabilities During Clinical Consultations: Scoping Review. JMIR Rehabil Assist Technol 2021; 8:e19925. [PMID: 34106087 PMCID: PMC8235287 DOI: 10.2196/19925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/31/2020] [Accepted: 04/02/2021] [Indexed: 12/25/2022] Open
Abstract
Background People with intellectual disabilities (IDs) face significant communication barriers when accessing health care services; they find it difficult to identify and describe conditions clearly enough to support practitioners in making an accurate diagnosis. In addition, medical professionals generally have little knowledge and understanding of the needs of people with ID, which may result in the use of consultation techniques that do not cater to their patients’ skills. Objective This review aims to identify and synthesize the literature on alternative and augmentative communication technologies that are used to support adults with mild ID during the exchange of information with medical practitioners. Methods We performed a scoping review of studies published in English that describe the technologies that are used to promote communication with patients with mild ID during medical consultations. The databases searched were PubMed, ACM Digital Library, and Google Scholar. A qualitative framework-based approach was used to synthesize the data and discern key recurring themes across the identified literature. Results Of the 1557 articles screened, 15 (0.96%) met our inclusion criteria. The bulk of the communication aids used focused on low-tech solutions, including patient passports, note-based prompts, Talking Mats, health diaries, and easy-read information sheets. Their influence on current practice ranged from advancing medical professionals’ knowledge of the health and communication needs of people with ID to increasing interagency collaboration, patient advocacy skills, and health promotion activities. The major barriers to the implementation of low-tech aids were a lack of portability and increased maintenance efforts. Only 3 studies explored the use of mobile apps to promote communication. Their findings indicated that high-tech solutions offer greater customization with regard to the accessibility and health care needs of people with ID. Conclusions Alternative and augmentative communication technologies have the potential to increase the quality of care provided to patients with mild ID; however, little work has been carried out in this area. Greater emphasis must be placed on (high-tech) two-way communication aids that empower patients to become involved in decisions regarding their care. Quantitative evaluation methods should be used to discern the true benefits of such aids, and researchers should describe their study protocols in depth to promote replication and generalizability.
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Affiliation(s)
- Ryan Colin Gibson
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Matt-Mouley Bouamrane
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark D Dunlop
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Taylor-Rubin C, Croot K, Nickels L. Speech and language therapy in primary progressive aphasia: a critical review of current practice. Expert Rev Neurother 2021; 21:419-430. [PMID: 33641570 DOI: 10.1080/14737175.2021.1897253] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Primary progressive aphasia (PPA) is a complex language-led dementia syndrome whereby disproportionate deterioration of speech and language occurs subsequent to neurodegenerative disease in the early to mid-stages of the condition. As no effective pharmacotherapies are currently available, speech and language therapies are the optimum treatment to maximize communication for as long as possible. AREAS COVERED The authors present an overview of current speech-language therapy practices in PPA, highlighting recent research on effective treatments. EXPERT OPINION The challenges in this complex field of practice are described. We highlight the challenge of improving access to speech-language therapy by advocating for increased referral rates. The authors also suggest effective incorporation of innovative technologies in treatment and an enhanced evidence base for the utility of lexical retrieval treatment in improving everyday communication as challenges for the future. Finally, increased provision of PPA-specific education and support for individuals and their families is required.
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Affiliation(s)
- Cathleen Taylor-Rubin
- Department of Cognitive Science, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 3, Australian Hearing Hub, 16 University Road, Macquarie University, Sydney, NSW, Australia.,Department of Speech Pathology, Uniting War Memorial Hospital, South Eastern Sydney Local Health District War Memorial Hospital, Waverley, NSW, Australia
| | - Karen Croot
- Department of Cognitive Science, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 3, Australian Hearing Hub, 16 University Road, Macquarie University, Sydney, NSW, Australia.,Faculty of Science, School of Psychology, Brennan MacCallum Building, Camperdown, NSW, Australia
| | - Lyndsey Nickels
- Department of Cognitive Science, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 3, Australian Hearing Hub, 16 University Road, Macquarie University, Sydney, NSW, Australia
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Wiebe E, Kelly M, McMorrow T, Tremblay-Huet S, Hennawy M. Assessment of capacity to give informed consent for medical assistance in dying: a qualitative study of clinicians' experience. CMAJ Open 2021; 9:E358-E363. [PMID: 33849985 PMCID: PMC8084565 DOI: 10.9778/cmajo.20200136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Under the Canadian Criminal Code, medical assistance in dying (MAiD) requires that patients give informed consent and that their ability to consent is assessed by 2 clinicians. In this study, we intended to understand how Canadian clinicians assessed capacity in people requesting MAiD. METHODS This qualitative study used interviews conducted between August 2019 and February 2020, by phone, video and email, to explore how clinicians assessed capacity in people requesting MAiD, what challenges they had encountered and what tools they used. The participants were recruited from provider mailing listserves of the Canadian Association of MAiD Assessors and Providers and Aide médicale à mourir. Interviews were audio-recorded and transcribed verbatim. The research team met to review transcripts and explore themes as they emerged in an iterative manner. We used abductive reasoning for thematic analysis and coding, and continued to discuss until we reached consensus. RESULTS The 20 participants worked in 5 of 10 provinces across Canada, represented different specialties and had experience assessing a total of 2410 patients requesting MAiD. The main theme was that, for most assessments, the participants used the conversation about how the patient had come to choose MAiD to get the information they needed. When the participants used formal capacity assessment tools, this was mostly for meticulous documentation, and they rarely asked for psychiatric consults. The participants described how they approached assessing cases of nonverbal patients and other challenging cases, using techniques such as ensuring a quiet environment and adequate hearing aids, and using questions requiring only "yes" or "no" as an answer. INTERPRETATION The participants were comfortable doing MAiD assessments and used their clinical judgment and experience to assess capacity in ways similar to other clinical practices. The findings of this study suggest that experienced MAiD assessors do not routinely require formal capacity assessments or tools to assess capacity in patients requesting MAiD.
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MESH Headings
- Attitude of Health Personnel
- Canada
- Clinical Decision-Making/ethics
- Clinical Decision-Making/methods
- Codes of Ethics
- Euthanasia, Active, Voluntary/ethics
- Euthanasia, Active, Voluntary/legislation & jurisprudence
- Euthanasia, Active, Voluntary/psychology
- Guidelines as Topic
- Humans
- Informed Consent/standards
- Mental Competency
- Nurses
- Physicians
- Practice Patterns, Physicians'/ethics
- Practice Patterns, Physicians'/standards
- Professional Practice/statistics & numerical data
- Qualitative Research
- Right to Die/ethics
- Right to Die/legislation & jurisprudence
- Social Control, Formal/methods
- Suicide, Assisted/ethics
- Suicide, Assisted/legislation & jurisprudence
- Suicide, Assisted/psychology
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Affiliation(s)
- Ellen Wiebe
- Department of Family Practice (Wiebe), University of British Columbia, Vancouver, BC; University of London (Kelly), London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Health, London, UK; Ontario Tech University (McMorrow), Faculty of Social Science and Humanities, Legal Studies, Oshawa, Ont.; Université de Sherbrooke (Tremblay-Huet), Faculty of Law, Sherbrook, Que.; University of British Columbia (Hennawy), Kelowna, BC
| | - Michaela Kelly
- Department of Family Practice (Wiebe), University of British Columbia, Vancouver, BC; University of London (Kelly), London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Health, London, UK; Ontario Tech University (McMorrow), Faculty of Social Science and Humanities, Legal Studies, Oshawa, Ont.; Université de Sherbrooke (Tremblay-Huet), Faculty of Law, Sherbrook, Que.; University of British Columbia (Hennawy), Kelowna, BC
| | - Thomas McMorrow
- Department of Family Practice (Wiebe), University of British Columbia, Vancouver, BC; University of London (Kelly), London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Health, London, UK; Ontario Tech University (McMorrow), Faculty of Social Science and Humanities, Legal Studies, Oshawa, Ont.; Université de Sherbrooke (Tremblay-Huet), Faculty of Law, Sherbrook, Que.; University of British Columbia (Hennawy), Kelowna, BC
| | - Sabrina Tremblay-Huet
- Department of Family Practice (Wiebe), University of British Columbia, Vancouver, BC; University of London (Kelly), London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Health, London, UK; Ontario Tech University (McMorrow), Faculty of Social Science and Humanities, Legal Studies, Oshawa, Ont.; Université de Sherbrooke (Tremblay-Huet), Faculty of Law, Sherbrook, Que.; University of British Columbia (Hennawy), Kelowna, BC
| | - Mirna Hennawy
- Department of Family Practice (Wiebe), University of British Columbia, Vancouver, BC; University of London (Kelly), London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Health, London, UK; Ontario Tech University (McMorrow), Faculty of Social Science and Humanities, Legal Studies, Oshawa, Ont.; Université de Sherbrooke (Tremblay-Huet), Faculty of Law, Sherbrook, Que.; University of British Columbia (Hennawy), Kelowna, BC
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Pitt KM, Brumberg JS. Evaluating person-centered factors associated with brain-computer interface access to a commercial augmentative and alternative communication paradigm. Assist Technol 2021; 34:468-477. [PMID: 33667154 DOI: 10.1080/10400435.2021.1872737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Current BCI-AAC systems largely utilize custom-made software and displays that may be unfamiliar to AAC stakeholders. Further, there is limited information available exploring the heterogenous profiles of individuals who may use BCI-AAC. Therefore, in this study, we aimed to evaluate how individuals with amyotrophic lateral sclerosis (ALS) learned to control a motor-based BCI switch in a row-column AAC scanning pattern, and person-centered factors associated with BCI-AAC performance. Four individuals with ALS completed 12 BCI-AAC training sessions, and three individuals without neurological impairment completed 3 BCI-AAC training sessions. To assess person-centered factors associated with BCI-AAC performance, participants completed both initial and recurring assessment measures including levels of cognition, motor ability, fatigue, and motivation. Three of four participants demonstrated either BCI-AAC performance in the range of neurotypical peers, or an improving BCI-AAC learning trajectory. However, BCI-AAC learning trajectories were variable. Assessment measures revealed that two participants presented with a suspicion for cognitive impairment yet achieved the highest levels of BCI-AAC accuracy with their increased levels of performance being possibly supported by largely unimpaired motor skills. Motor-based BCI switch access to a commercial AAC row-column scanning may be feasible for individuals with ALS and possibly supported by timely intervention.
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Affiliation(s)
- Kevin M Pitt
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Jonathan S Brumberg
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence, Kansas, USA
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Stasolla F, Matamala-Gomez M, Bernini S, Caffò AO, Bottiroli S. Virtual Reality as a Technological-Aided Solution to Support Communication in Persons With Neurodegenerative Diseases and Acquired Brain Injury During COVID-19 Pandemic. Front Public Health 2021; 8:635426. [PMID: 33665181 PMCID: PMC7921156 DOI: 10.3389/fpubh.2020.635426] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 poses an ongoing threat to lives around the world and challenges the existing public health and medical service delivery. The lockdown or quarantine measures adopted to prevent the spread of COVID-19 has caused the interruption in ongoing care and access to medical care including to patients with existing neurological conditions. Besides the passivity, isolation, and withdrawal, patients with neurodegenerative diseases experience difficulties in communication due to a limited access to leisure opportunities and interaction with friends and relatives. The communication difficulties may exacerbate the burden on the caregivers. Therefore, assistive-technologies may be a useful strategy in mitigating challenges associated with remote communication. The current paper presents an overview of the use of assistive technologies using virtual reality and virtual body ownership in providing communication opportunities to isolated patients, during COVID-19, with neurological diseases and moderate-to-severe communication difficulties. We postulate that the assistive technologies-based intervention may improve social interactions in patients with neurodegenerative diseases and acquired brain injury-thereby reducing isolation and improving their quality of life and mental well-being.
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Affiliation(s)
| | - Marta Matamala-Gomez
- Department of Human Sciences for Education "Riccardo Massa", Center for Studies in Communication Sciences "Luigi Anolli" (CESCOM), University of Milano-Bicocca, Milan, Italy
| | - Sara Bernini
- Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS), Mondino Foundation, Pavia, Italy
| | - Alessandro O Caffò
- Department of Educational Sciences, Psychology and Communication, University of Bari, Bari, Italy
| | - Sara Bottiroli
- "Giustino Fortunato" University of Benevento, Benevento, Italy.,Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS), Mondino Foundation, Pavia, Italy
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Kilgore B, Harriger C, Gaeta L, Sharpp TJ. Unmasking misunderstandings: Strategies for better communication with patients. Nursing 2021; 51:56-59. [PMID: 33346620 DOI: 10.1097/01.nurse.0000724368.90257.74] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Positive patient outcomes depend on successful communication. Increased use of personal protective equipment such as face masks during the COVID-19 pandemic can exacerbate communication difficulties. This article describes situations in which miscommunications may occur, identifies sources of communication breakdowns, and offers strategies to prevent them in real-life scenarios.
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Affiliation(s)
- Bradley Kilgore
- Bradley Kilgore is a doctoral student in audiology at California State University, Sacramento. Cassandra Harriger is a nursing student intern at Orlando Regional Medical Center in Orlando, Fla. Also at California State University, Sacramento, Laura Gaeta is an assistant professor and Tara J. Sharpp is an associate professor
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29
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Kuyler A, Johnson E. Patient and nurse content preferences for a communication board to facilitate dialogue in the intensive care unit. Intensive Crit Care Nurs 2020; 63:103005. [PMID: 33358517 DOI: 10.1016/j.iccn.2020.103005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The main aim of this study was to identify patient and nurse content preferences for a communication board to facilitate effective communication (dialogue) in the critical care unit. RESEARCH DESIGN A qualitative research design focusing on explorative and descriptive components was used to address the aim of the research study. The study employed two participant groups. Semi-structured interviews and focus group discussions were conducted with critically ill patients (N = 10) and critical care nurses (N = 30). SETTING The study was conducted in four different private hospitals of the same hospital group in Gauteng, South Africa. FINDINGS Four distinct themes were identified in the research regarding the vocabulary items that participants would like to have included. CONCLUSION The findings suggest that patients perceive a communication board to be valuable in enhancing communication in the critical care unit; that cultural and linguistic diversity should be considered; and that patients and nurses have varying opinions on topics of priority during communication.
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Affiliation(s)
- Ariné Kuyler
- Centre for Augmentative and Alternative Communication, University of Pretoria, Private Bag X20 Hatfield, 0028, South Africa.
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Private Bag X20 Hatfield, 0028, South Africa.
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30
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Peters B, Bedrick S, Dudy S, Eddy B, Higger M, Kinsella M, McLaughlin D, Memmott T, Oken B, Quivira F, Spaulding S, Erdogmus D, Fried-Oken M. SSVEP BCI and Eye Tracking Use by Individuals With Late-Stage ALS and Visual Impairments. Front Hum Neurosci 2020; 14:595890. [PMID: 33328941 PMCID: PMC7715037 DOI: 10.3389/fnhum.2020.595890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/30/2020] [Indexed: 12/13/2022] Open
Abstract
Access to communication is critical for individuals with late-stage amyotrophic lateral sclerosis (ALS) and minimal volitional movement, but they sometimes present with concomitant visual or ocular motility impairments that affect their performance with eye tracking or visual brain-computer interface (BCI) systems. In this study, we explored the use of modified eye tracking and steady state visual evoked potential (SSVEP) BCI, in combination with the Shuffle Speller typing interface, for this population. Two participants with late-stage ALS, visual impairments, and minimal volitional movement completed a single-case experimental research design comparing copy-spelling performance with three different typing systems: (1) commercially available eye tracking communication software, (2) Shuffle Speller with modified eye tracking, and (3) Shuffle Speller with SSVEP BCI. Participant 1 was unable to type any correct characters with the commercial system, but achieved accuracies of up to 50% with Shuffle Speller eye tracking and 89% with Shuffle Speller BCI. Participant 2 also had higher maximum accuracies with Shuffle Speller, typing with up to 63% accuracy with eye tracking and 100% accuracy with BCI. However, participants' typing accuracy for both Shuffle Speller conditions was highly variable, particularly in the BCI condition. Both the Shuffle Speller interface and SSVEP BCI input show promise for improving typing performance for people with late-stage ALS. Further development of innovative BCI systems for this population is needed.
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Affiliation(s)
- Betts Peters
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- REKNEW Projects, Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Steven Bedrick
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
- Center for Spoken Language Understanding, Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Shiran Dudy
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- Center for Spoken Language Understanding, Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Brandon Eddy
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- REKNEW Projects, Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Matt Higger
- Khoury College of Computer Science, Northeastern University, Boston, MA, United States
| | - Michelle Kinsella
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- REKNEW Projects, Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Deirdre McLaughlin
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- REKNEW Projects, Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Tab Memmott
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Barry Oken
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | | | - Scott Spaulding
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- College of Education, University of Washington, Seattle, WA, United States
| | - Deniz Erdogmus
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- Cognitive Systems Laboratory, Center for Signal Processing, Imaging, Reasoning, and Learning (SPIRAL), Department of Electrical and Computer Engineering, Northeastern University, Boston, MA, United States
| | - Melanie Fried-Oken
- Consortium for Accessible Multimodal Brain-Body Interfaces (CAMBI), Portland, OR, United States
- REKNEW Projects, Institute on Development & Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
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Geronimo A, Simmons Z. TeleBCI: remote user training, monitoring, and communication with an evoked-potential brain-computer interface. BRAIN-COMPUTER INTERFACES 2020; 7:57-69. [PMID: 33763499 DOI: 10.1080/2326263x.2020.1848134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Brain-computer interfaces (BCIs) are a movement-independent form of augmentative and alternative communication (AAC) for individuals with amyotrophic lateral sclerosis (ALS). The rare utilization of such devices in the homes of patients stems from a number of factors, one of which is the complexity of providing training and support for users. This paper describes the teleBCI interface used to train the patient and facilitator in the operation of a virtual keyboard using an evoked potential BCI. Fifteen patients with motor neuron disease and their communication partners were included in the study, participating from their homes while receiving remote support from the research team. Patient/caregiver teams completed 8 sessions each of P300 BCI training virtually with the researcher. As they participated in subsequent training sessions, participant teams required less help to complete physical, computer, and BCI-specific tasks associated with device use. A subset of users experienced improved performance over sessions, progressing to utilize the full functionality of the speller and communicate with a nurse partner over a telemedicine interface. Perceptions of device utility varied with accuracy of the BCI system. In the management of ALS, the integration of telemedicine provides new opportunities for care delivery, including how BCI-AAC are deployed and used.
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Affiliation(s)
- A Geronimo
- Department of Neurosurgery, 500 University Drive, Hershey, PA 17033
| | - Zachary Simmons
- Departments of Neurology and Humanities, 500 University Drive, Hershey, PA 17033
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32
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VandeVrede L, Ljubenkov PA, Rojas JC, Welch AE, Boxer AL. Four-Repeat Tauopathies: Current Management and Future Treatments. Neurotherapeutics 2020; 17:1563-1581. [PMID: 32676851 PMCID: PMC7851277 DOI: 10.1007/s13311-020-00888-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Four-repeat tauopathies are a neurodegenerative disease characterized by brain parenchymal accumulation of a specific isoform of the protein tau, which gives rise to a wide breadth of clinical syndromes encompassing diverse symptomatology, with the most common syndromes being progressive supranuclear palsy-Richardson's and corticobasal syndrome. Despite the lack of effective disease-modifying therapies, targeted treatment of symptoms can improve quality of life for patients with 4-repeat tauopathies. However, managing these symptoms can be a daunting task, even for those familiar with the diseases, as they span motor, sensory, cognitive, affective, autonomic, and behavioral domains. This review describes current approaches to symptomatic management of common clinical symptoms in 4-repeat tauopathies with a focus on practical patient management, including pharmacologic and nonpharmacologic strategies, and concludes with a discussion of the history and future of disease-modifying therapeutics and clinical trials in this population.
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Affiliation(s)
- Lawren VandeVrede
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA.
| | - Peter A Ljubenkov
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Julio C Rojas
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Ariane E Welch
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
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Brown MN, Grames LM, Skolnick GB. Augmentative and Alternative Communication (AAC) Use Among Patients Followed by a Multidisciplinary Cleft and Craniofacial Team. Cleft Palate Craniofac J 2020; 58:324-331. [PMID: 32783478 DOI: 10.1177/1055665620947606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To establish preliminary data describing the number of patients who visit a multidisciplinary cleft and craniofacial team who use augmentative and alternative communication (AAC) supports. DESIGN This retrospective study consisted of chart reviews for all patients who visited a single site's multidisciplinary cleft and craniofacial team for 1 calendar year. SETTING A single multidisciplinary craniofacial team at a tertiary teaching hospital. PARTICIPANTS Four hundred sixty-four patients met the inclusion criteria for this study. Of these, 59.9% (n = 278) were male and 40.1% (n = 186) were female. RESULTS Of the sample population, 6.9% (n = 32) were AAC users as they received AAC intervention in a therapeutic context, while 93.1% (n = 432) were not. The AAC group had a mean age of 5.1 years (standard deviation [SD]: 4.2) and was 68.8% (n = 22) male. The non-AAC group had a mean age of 6.3 (SD: 4.9) and was 59.3% (n = 256) male. Within the AAC group, 40.6% (n = 13) were found to have an identified syndromic diagnosis in comparison to 17.6% (n = 76) of the non-AAC group (P = .003). CONCLUSIONS This is the first study to report the prevalence of AAC use among patients in the care of multidisciplinary cleft and craniofacial teams. Our findings suggest that a subset of craniofacial team patients may have complex communication disorders that require AAC supports. Craniofacial teams should be aware of resources available for these patients so that the patients' communication needs are met in the hospital, in school, and in the community.
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Affiliation(s)
| | | | - Gary B Skolnick
- 12275Washington University School of Medicine, St Louis, MO, USA.,Division of Plastic and Reconstructive Surgery, Department of Surgery, 7548Washington University in St Louis School of Medicine, The Cleft Palate-Craniofacial Institute, St Louis Children's Hospital, MO, USA
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34
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Allison BZ, Kübler A, Jin J. 30+ years of P300 brain-computer interfaces. Psychophysiology 2020; 57:e13569. [PMID: 32301143 DOI: 10.1111/psyp.13569] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 11/28/2022]
Abstract
Brain-computer interfaces (BCIs) directly measure brain activity with no physical movement and translate the neural signals into messages. BCIs that employ the P300 event-related brain potential often have used the visual modality. The end user is presented with flashing stimuli that indicate selections for communication, control, or both. Counting each flash that corresponds to a specific target selection while ignoring other flashes will elicit P300s to only the target selection. P300 BCIs also have been implemented using auditory or tactile stimuli. P300 BCIs have been used with a variety of applications for severely disabled end users in their homes without frequent expert support. P300 BCI research and development has made substantial progress, but challenges remain before these tools can become practical devices for impaired patients and perhaps healthy people.
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Affiliation(s)
- Brendan Z Allison
- Cognitive Science Department, University of California at San Diego, La Jolla, CA, USA
| | - Andrea Kübler
- Psychology Department, University of Würzburg, Würzburg, Germany
| | - Jing Jin
- Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai, P.R. China
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Wilson R, Cochrane D, Mihailidis A, Small J. Mobile Apps to Support Caregiver-Resident Communication in Long-Term Care: Systematic Search and Content Analysis. JMIR Aging 2020; 3:e17136. [PMID: 32267236 PMCID: PMC7177427 DOI: 10.2196/17136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/02/2020] [Accepted: 01/02/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In long-term residential care (LTRC), caregivers' attempts to provide person-centered care can be challenging when assisting residents living with a communication disorder (eg, aphasia) and/or a language-cultural barrier. Mobile communication technology, which includes smartphones and tablets and their software apps, offers an innovative solution for preventing and overcoming communication breakdowns during activities of daily living. There is a need to better understand the availability, relevance, and stability of commercially available communication apps (cApps) that could support person-centered care in the LTRC setting. OBJECTIVE This study aimed to (1) systematically identify and evaluate commercially available cApps that could support person-centered communication (PCC) in LTRC and (2) examine the stability of cApps over 2 years. METHODS We conducted systematic searches of the Canadian App Store (iPhone Operating System platform) in 2015 and 2017 using predefined search terms. cApps that met the study's inclusion criteria underwent content review and quality assessment. RESULTS Although the 2015 searches identified 519 unique apps, only 27 cApps were eligible for evaluation. The 2015 review identified 2 augmentative and alternative cApps and 2 translation apps as most appropriate for LTRC. Despite a 205% increase (from 199 to 607) in the number of augmentative and alternative communication and translation apps assessed for eligibility in the 2017 review, the top recommended cApps showed suitability for LTRC and marketplace stability. CONCLUSIONS The recommended existing cApps included some PCC features and demonstrated marketplace longevity. However, cApps that focus on the inclusion of more PCC features may be better suited for use in LTRC, which warrants future development. Furthermore, cApp content and quality would improve by including research evidence and experiential knowledge (eg, nurses and health care aides) to inform app development. cApps offer care staff a tool that could promote social participation and person-centered care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/10.2196/17136.
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Affiliation(s)
- Rozanne Wilson
- School of Audiology and Speech Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Diana Cochrane
- School of Audiology and Speech Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Alex Mihailidis
- Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Jeff Small
- School of Audiology and Speech Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Hogden A, Paynter C, Hutchinson K. How can we improve patient-centered care of motor neuron disease? Neurodegener Dis Manag 2020; 10:95-101. [DOI: 10.2217/nmt-2019-0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This perspectives paper discusses patient-centered care for people living with motor neuron disease. We identify challenges and offer solutions from the patient-centered care literature for this population in frontline care, service delivery, research and health system organization. Examples from Australian and international motor neuron disease care are used to illustrate interrelated issues for practice and policy.
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Affiliation(s)
- Anne Hogden
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Camille Paynter
- Centre for Neuroscience of Speech, University of Melbourne, Melbourne, Victoria, Australia
| | - Karen Hutchinson
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Bilingualism in Primary Progressive Aphasia: A Retrospective Study on Clinical and Language Characteristics. Alzheimer Dis Assoc Disord 2020; 33:47-53. [PMID: 30640254 DOI: 10.1097/wad.0000000000000288] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive deterioration of language. Being rare, reports of PPA in multilingual individuals are scarce, despite more than half of the world population being multilingual. METHODS We describe clinical characteristics of 33 bilingual patients with PPA, including symptom presentation and language deficits pattern in their first (L1) and second language (L2), through a systematic literature review and new cases retrospectively identified in 5 countries. RESULTS In total, 14 patients presented with nonfluent/agrammatic variant, 6 with semantic variant, and 13 with logopenic variant, with a median symptom onset of 2 years. Word-finding difficulties was the first symptom in 65% of all cases, initially noticed in L2, and not always the dominant language. Our group had 22 different languages as L1, and 9 as L2. At the whole-group level there was a tendency for parallel impairment in both languages, in line with the shared bilingual neural substrate hypothesis, but each PPA variant showed some heterogeneity. DISCUSSION Each PPA variant showed heterogeneity, showing the need for comprehensive language and cognitive assessment across languages, as well as further clarification on the role of language mediators.
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Abstract
Locked-in syndrome (LIS) is characterized by an inability to move or speak in the presence of intact cognition and can be caused by brainstem trauma or neuromuscular disease. Quality of life (QoL) in LIS is strongly impaired by the inability to communicate, which cannot always be remedied by traditional augmentative and alternative communication (AAC) solutions if residual muscle activity is insufficient to control the AAC device. Brain-computer interfaces (BCIs) may offer a solution by employing the person's neural signals instead of relying on muscle activity. Here, we review the latest communication BCI research using noninvasive signal acquisition approaches (electroencephalography, functional magnetic resonance imaging, functional near-infrared spectroscopy) and subdural and intracortical implanted electrodes, and we discuss current efforts to translate research knowledge into usable BCI-enabled communication solutions that aim to improve the QoL of individuals with LIS.
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Vaughan TM. Brain-computer interfaces for people with amyotrophic lateral sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2020; 168:33-38. [DOI: 10.1016/b978-0-444-63934-9.00004-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Carvalho DND, Queiroz ÍDP, Araújo BCL, Barbosa SLDES, Carvalho VCBD, Carvalho SD. Augmentative and alternative communication with adults and elderly in the hospital environment: an integrative literature review. REVISTA CEFAC 2020. [DOI: 10.1590/1982-0216/202022516019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to carry out an integrative review about the augmentative and alternative communication strategies used with adults and the elderly in the hospital environment and their impact on communication. Methods: this research study used the integrative review methodology with descriptors in English and Portuguese: 'communication', 'hospitals', 'communication aids for the disabled', in the following databases: LILACS, PubMed, Cinahl, Cochrane Library, SciELO, Scopus, Web of Science. Several articles in English and Portuguese, from the last 14 years, which addressed alternative communication strategies used with hospitalized adults and the elderly, were included. Studies on children, as well as duplicates, reviews, and those that addressed other methods of communication were excluded. Results: 13 articles characterized the alternative communication strategies used with adults and the elderly. There was a prevalence of intubated or tracheostomized patients, and health professionals, nurses being the ones with the highest citation, and researches on a qualitative approach. Six studies have used high and low technologies; however, most have shown a greater use of low-tech tools. Conclusion: a variety of high and low-tech strategies were identified, a reduction in communication difficulties being noted, as well as improvements in the quality of life and communication with professionals. The most used tool was the communication board, due to its hospitals' availability and its simple use. The evaluation and the effectiveness of communication tools in distinct clinical settings and profiles should be studied.
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Maniati MS, Maniati M, Yousefi T, Ahmadi‐Ahangar A, Tehrani SS. New insights into the role of microRNAs and long noncoding RNAs in most common neurodegenerative diseases. J Cell Biochem 2019; 120:8908-8918. [DOI: 10.1002/jcb.28361] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/29/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Mohammad Saeed Maniati
- Student Research Committee, Babol University of Medical Sciences Babol Iran
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran
| | - Mahmood Maniati
- Department of English Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Tooba Yousefi
- Student Research Committee, Babol University of Medical Sciences Babol Iran
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran
| | - Alijan Ahmadi‐Ahangar
- Mobility Impairment Research Center, Babol University of Medical Sciences Babol Iran
| | - Sadra Samavarchi Tehrani
- Student Research Committee, Babol University of Medical Sciences Babol Iran
- Mobility Impairment Research Center, Babol University of Medical Sciences Babol Iran
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Light J, McNaughton D, Beukelman D, Fager SK, Fried-Oken M, Jakobs T, Jakobs E. Challenges and opportunities in augmentative and alternative communication: Research and technology development to enhance communication and participation for individuals with complex communication needs. Augment Altern Commun 2019; 35:1-12. [DOI: 10.1080/07434618.2018.1556732] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Janice Light
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
| | - David McNaughton
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA, USA
| | - David Beukelman
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Susan Koch Fager
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Melanie Fried-Oken
- Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
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Nuyujukian P, Albites Sanabria J, Saab J, Pandarinath C, Jarosiewicz B, Blabe CH, Franco B, Mernoff ST, Eskandar EN, Simeral JD, Hochberg LR, Shenoy KV, Henderson JM. Cortical control of a tablet computer by people with paralysis. PLoS One 2018; 13:e0204566. [PMID: 30462658 PMCID: PMC6248919 DOI: 10.1371/journal.pone.0204566] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 09/11/2018] [Indexed: 12/16/2022] Open
Abstract
General-purpose computers have become ubiquitous and important for everyday life, but they are difficult for people with paralysis to use. Specialized software and personalized input devices can improve access, but often provide only limited functionality. In this study, three research participants with tetraplegia who had multielectrode arrays implanted in motor cortex as part of the BrainGate2 clinical trial used an intracortical brain-computer interface (iBCI) to control an unmodified commercial tablet computer. Neural activity was decoded in real time as a point-and-click wireless Bluetooth mouse, allowing participants to use common and recreational applications (web browsing, email, chatting, playing music on a piano application, sending text messages, etc.). Two of the participants also used the iBCI to "chat" with each other in real time. This study demonstrates, for the first time, high-performance iBCI control of an unmodified, commercially available, general-purpose mobile computing device by people with tetraplegia.
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Affiliation(s)
- Paul Nuyujukian
- Department of Neurosurgery, Stanford University, Stanford, CA, United States of America
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
- Department of Bioengineering, Stanford University, Stanford, CA, United States of America
- Neurosciences Institute, Stanford University, Stanford, CA, United States of America
- Bio-X Institute, Stanford University, Stanford, CA, United States of America
- Neurosciences Program, Stanford University, Stanford, CA, United States of America
| | - Jose Albites Sanabria
- School of Engineering, Brown University, Providence, RI, United States of America
- Carney Institute for Brain Science, Brown University, Providence, RI, United States of America
| | - Jad Saab
- School of Engineering, Brown University, Providence, RI, United States of America
- Carney Institute for Brain Science, Brown University, Providence, RI, United States of America
- Center for Neurorestoration and Neurotechnology, Rehabilitation Research and Development Service, VA Medical Center, Providence, RI, United States of America
| | - Chethan Pandarinath
- Department of Neurosurgery, Stanford University, Stanford, CA, United States of America
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
- Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, Atlanta, GA, United States of America
- Department of Neurosurgery, Emory University, Atlanta, GA, United States of America
| | - Beata Jarosiewicz
- Department of Neurosurgery, Stanford University, Stanford, CA, United States of America
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
- Carney Institute for Brain Science, Brown University, Providence, RI, United States of America
- Department of Neuroscience, Brown University, Providence, RI, United States of America
| | - Christine H. Blabe
- Department of Neurosurgery, Stanford University, Stanford, CA, United States of America
| | - Brian Franco
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
| | - Stephen T. Mernoff
- Center for Neurorestoration and Neurotechnology, Rehabilitation Research and Development Service, VA Medical Center, Providence, RI, United States of America
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Emad N. Eskandar
- Department of Neurosurgery, Harvard Medical School, Boston, MA, United States of America
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States of America
| | - John D. Simeral
- School of Engineering, Brown University, Providence, RI, United States of America
- Carney Institute for Brain Science, Brown University, Providence, RI, United States of America
- Center for Neurorestoration and Neurotechnology, Rehabilitation Research and Development Service, VA Medical Center, Providence, RI, United States of America
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
| | - Leigh R. Hochberg
- School of Engineering, Brown University, Providence, RI, United States of America
- Carney Institute for Brain Science, Brown University, Providence, RI, United States of America
- Center for Neurorestoration and Neurotechnology, Rehabilitation Research and Development Service, VA Medical Center, Providence, RI, United States of America
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Neurology, Harvard Medical School, Boston, MA, United States of America
| | - Krishna V. Shenoy
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
- Department of Bioengineering, Stanford University, Stanford, CA, United States of America
- Neurosciences Institute, Stanford University, Stanford, CA, United States of America
- Bio-X Institute, Stanford University, Stanford, CA, United States of America
- Neurosciences Program, Stanford University, Stanford, CA, United States of America
- Department of Neurobiology, Stanford University, Stanford, CA, United States of America
- Howard Hughes Medical Institute at Stanford University, Chevy Chase, MD, United States of America
| | - Jaimie M. Henderson
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
- Neurosciences Institute, Stanford University, Stanford, CA, United States of America
- Bio-X Institute, Stanford University, Stanford, CA, United States of America
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Olthof-Nefkens M, Kruse H, Derksen E, de Swart B, Nijhuis-van der Sanden M, Kalf J. Improving Communication between Persons with Mild Dementia and Their Caregivers: Qualitative Analysis of a Practice-Based Logopaedic Intervention. Folia Phoniatr Logop 2018; 70:124-133. [DOI: 10.1159/000491081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/15/2018] [Indexed: 11/19/2022] Open
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Linse K, Aust E, Joos M, Hermann A. Communication Matters-Pitfalls and Promise of Hightech Communication Devices in Palliative Care of Severely Physically Disabled Patients With Amyotrophic Lateral Sclerosis. Front Neurol 2018; 9:603. [PMID: 30100896 PMCID: PMC6072854 DOI: 10.3389/fneur.2018.00603] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/06/2018] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease, leading to progressive paralysis, dysarthria, dysphagia, and respiratory disabilities. Therapy is mostly focused on palliative interventions. During the course of the disease, verbal as well as nonverbal communicative abilities become more and more impaired. In this light, communication has been argued to be “the essence of human life” and crucial for patients' quality of life. High-tech augmentative and alternative communication (HT-AAC) technologies such as eyetracking based computer devices and brain-computer-interfaces provide the possibility to maintain caregiver-independent communication and environmental control even in the advanced disease state of ALS. Thus, they enable patients to preserve social participation and to independently communicate end-of-life-decisions. In accordance with these functions of HT-AAC, their use is reported to strengthen self-determination, increase patients' quality of life and reduce caregiver burden. Therefore, HT-AAC should be considered as standard of (palliative) care for people with ALS. On the other hand, the supply with individually tailored HT-AAC technologies is limited by external and patient-inherent variables. This review aims to provide an overview of the possibilities and limitations of HT-AAC technologies and discuss their role in the palliative care for patients with ALS.
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Affiliation(s)
- Katharina Linse
- Department of Neurology, Technische Universität Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE) Dresden, Dresden, Germany
| | - Elisa Aust
- Department of Neurology, Technische Universität Dresden, Dresden, Germany
| | - Markus Joos
- Interactive Minds Dresden GmbH, Dresden, Germany
| | - Andreas Hermann
- Department of Neurology, Technische Universität Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE) Dresden, Dresden, Germany
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46
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Bandini A, Green JR, Wang J, Campbell TF, Zinman L, Yunusova Y. Kinematic Features of Jaw and Lips Distinguish Symptomatic From Presymptomatic Stages of Bulbar Decline in Amyotrophic Lateral Sclerosis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1118-1129. [PMID: 29800359 PMCID: PMC6195078 DOI: 10.1044/2018_jslhr-s-17-0262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/25/2018] [Indexed: 05/05/2023]
Abstract
PURPOSE The goals of this study were to (a) classify speech movements of patients with amyotrophic lateral sclerosis (ALS) in presymptomatic and symptomatic phases of bulbar function decline relying solely on kinematic features of lips and jaw and (b) identify the most important measures that detect the transition between early and late bulbar changes. METHOD One hundred ninety-two recordings obtained from 64 patients with ALS were considered for the analysis. Feature selection and classification algorithms were used to analyze lip and jaw movements recorded with Optotrak Certus (Northern Digital Inc.) during a sentence task. A feature set, which included 35 measures of movement range, velocity, acceleration, jerk, and area measures of lips and jaw, was used to classify sessions according to the speaking rate into presymptomatic (> 160 words per minute) and symptomatic (< 160 words per minute) groups. RESULTS Presymptomatic and symptomatic phases of bulbar decline were distinguished with high accuracy (87%), relying only on lip and jaw movements. The best features that allowed detecting the differences between early and later bulbar stages included cumulative path of lower lip and jaw, peak values of velocity, acceleration, and jerk of lower lip and jaw. CONCLUSION The results established a relationship between facial kinematics and bulbar function decline in ALS. Considering that facial movements can be recorded by means of novel inexpensive and easy-to-use, video-based methods, this work supports the development of an automatic system for facial movement analysis to help clinicians in tracking the disease progression in ALS.
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Affiliation(s)
- Andrea Bandini
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
| | - Jordan R. Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Jun Wang
- Department of Bioengineering, The University of Texas at Dallas, Richardson
- Callier Center for Communication Disorders, The University of Texas at Dallas
| | - Thomas F. Campbell
- Callier Center for Communication Disorders, The University of Texas at Dallas
| | - Lorne Zinman
- Neurology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Brain Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Yana Yunusova
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
- Brain Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
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Stans SEA, Dalemans RJP, Roentgen UR, Smeets HWH, Beurskens AJHM. Who said dialogue conversations are easy? The communication between communication vulnerable people and health-care professionals: A qualitative study. Health Expect 2018; 21:848-857. [PMID: 29671920 PMCID: PMC6186534 DOI: 10.1111/hex.12679] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2018] [Indexed: 11/30/2022] Open
Abstract
Objective To gain insight into how communication vulnerable people and health‐care professionals experience the communication in dialogue conversations, and how they adjust their conversation using augmentative and alternative communication (AAC) or other communication strategies. Methods Communication vulnerable clients and health‐care professionals in a long‐term care institution were observed during a dialogue conversation (n = 11) and subsequently interviewed (n = 22) about their experiences with the conversation. The clients had various communication difficulties due to different underlying aetiologies, such as acquired brain injury or learning disorder. Results from the observations and interviews were analysed using conventional content analysis. Results Seven key themes emerged regarding the experiences of clients and professionals: clients blame themselves for miscommunications; the relevance of both parties preparing the conversation; a quiet and familiar environment benefitting communication; giving clients enough time; the importance and complexity of nonverbal communication; the need to tailor communication to the client; prejudices and inexperience regarding AAC. The observations showed that some professionals had difficulties using appropriate communication strategies and all professionals relied mostly on verbal or nonverbal communication strategies. Conclusion Professionals were aware of the importance of preparation, sufficient time, a suitable environment and considering nonverbal communication in dialogue conversations. However, they struggled with adequate use of communication strategies, such as verbal communication and AAC. There is a lack of knowledge about AAC, and professionals and clients need to be informed about the potential of AAC and how this can help them achieve equal participation in dialogue conversations in addition to other communication strategies.
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Affiliation(s)
- Steffy E A Stans
- Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands.,Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Ruth J P Dalemans
- Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Uta R Roentgen
- Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Hester W H Smeets
- Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Anna J H M Beurskens
- Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands.,Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Corallo F, Bonanno L, Lo Buono V, De Salvo S, Rifici C, Pollicino P, Allone C, Palmeri R, Todaro A, Alagna A, Bramanti A, Bramanti P, Marino S. Augmentative and Alternative Communication Effects on Quality of Life in Patients with Locked-in Syndrome and Their Caregivers. J Stroke Cerebrovasc Dis 2017; 26:1929-1933. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 06/12/2017] [Accepted: 06/18/2017] [Indexed: 12/13/2022] Open
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49
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Morhardt DJ, O'Hara MC, Zachrich K, Wieneke C, Rogalski EJ. Development of a Psycho-Educational Support Program for Individuals with Primary Progressive Aphasia and their Care-Partners. DEMENTIA 2017; 18:1310-1327. [PMID: 29149795 DOI: 10.1177/1471301217699675] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Primary progressive aphasia is a language-based dementia that initially spares other cognitive domains; however, aphasia interferes with many life roles such as work and interpersonal relationships. Psycho-educational programs, such as support groups have been shown to be effective for persons with Alzheimer's dementia; however, little is known regarding their effectiveness for persons with primary progressive aphasia. This paper describes the development of a program that offers support, education and activities for persons with primary progressive aphasia and their care-partners and its feasibility. Development and structure of pilot and formal intervention groups are described. Thematic analysis of both groups included the following themes: (1) coping with limitations and language decline; (2) dealing with increased dependency; (3) expressing resilience and making adaptations; (4) experiencing stigma (pilot group) and confronting stigma (intervention group); (5) experiencing self-confidence; and (6) feeling a sense of belonging. The knowledge gained from this process may be useful in designing programs for individuals with aphasic dementia and preserved insight. Evidence-based data from supportive interventions for persons with primary progressive aphasia and their care-partners are needed.
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Affiliation(s)
- Darby J Morhardt
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, USA
| | - Mary C O'Hara
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, USA
| | - Kristine Zachrich
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, USA
| | - Christina Wieneke
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, USA
| | - Emily J Rogalski
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, USA
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50
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Jokel R, Meltzer J, D R J, D M L, J C J, A N E, D T C. Group intervention for individuals with primary progressive aphasia and their spouses: Who comes first? JOURNAL OF COMMUNICATION DISORDERS 2017; 66:51-64. [PMID: 28412599 DOI: 10.1016/j.jcomdis.2017.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 03/23/2017] [Accepted: 04/05/2017] [Indexed: 06/07/2023]
Abstract
Primary progressive aphasia (PPA) is a neurodegenerative dementia in which language impairment is the first and most dominant symptom. There is a considerable dearth of interventions for PPA although language rehabilitation has made headway in managing the disorder. Thus far, no comprehensive services have been proposed for PPA clients and/or their spouses. This paper describes the first structured group intervention program designated exclusively for people with PPA and their caregivers. This pilot project originates from a clinical service and presents supporting evidence for initiation of a larger study to establish an evidence-based intervention for PPA. A 10-week intervention program comprised working on language activities, learning communication strategies, counselling and education. Outcome measures administered to participants and their spouses before and after the intervention were compared showed improvements in quality of communication and coping skills in the PPA group compared to controls. Qualitative comments from all 10 participants in the active treatment group highlighted the necessity of intervention that is tailored specifically to the PPA population and addresses the needs of both individuals with PPA and their caregivers. All participants in the intervention group contributed to the study and are also co-authors of this paper.
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Affiliation(s)
- Regina Jokel
- Rotman Research Institute, Baycrest Health Sciences, University of Toronto, Toronto, Canada.
| | - Jed Meltzer
- Rotman Research Institute, University of Toronto, Toronto, Canada
| | - J D R
- Baycrest Health Sciences, Toronto, Canada
| | - L D M
- Baycrest Health Sciences, Toronto, Canada
| | - J J C
- Baycrest Health Sciences, Toronto, Canada
| | - E A N
- Baycrest Health Sciences, Toronto, Canada
| | - C D T
- Baycrest Health Sciences, Toronto, Canada
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