Awareness, Knowledge and Practice Patterns of Oral Health and Hygiene among Speech-Language Pathologists in India

Individuals with communication and swallowing disorders often exhibit poor oral health and hygiene (OHH), that can lead to further complications. OHH assessment and management is a part of scope of practice of Speech-Language Pathologists (SLPs). The study aims to determine the level of awareness, knowledge and practice patterns of OHH amongst the SLPs in India. A questionnaire with 20-item and three sections was developed to assess the awareness and knowledge regarding OHH among SLPs. A total of 162 participants responded to the survey. 93.2% participants were aware of the importance of OHH, however 42.6% participants did not feel confident enough to assess the same. A majority (82.7%) agreed that poor OHH can lead to different health complications. 38.8% of the participants responded that they assessed oral health only sometimes and 54.3% reported that they never used any standard screening/assessment tools to assess oral health. Only a very small percentage of participants (28.65%) counselled the patients for maintenance of oral hygiene and more than 40% never recommended appropriate OHH practices during management. Though a vast majority were aware of the importance of OHH and consequences of poor OHH, they did not feel confident and consequently did not incorporate OHH during clinical practice. Though the scope of SLP includes oral care assessment and management, Indian SLPs were not practicing this. Hence, the clinical and academic curriculum should focus on topics pertaining to oral health assessment and management, which will improve the quality-of-service delivery of the SLPs.

The analysis of gestural and verbal pragmatic markers produced by Mild Cognitive Impaired participants during longitudinal and autobiographical interviews

CONTEXT

This corpus-based study presents a multimodal analysis of verbal pragmatic markers and non-verbal pragmatic markers in elderly people with Mild Cognitive Impairment aged over 75 years.

METHODS

The corpus collection and analysis methodology has been described in the Belgian CorpAGEst transversal study and the French VintAGE longitudinal and transversal oriented pilot studies. The protocols are available online in both English and French.

RESULTS & CONCLUSION

Our general findings indicate that with ageing, verbal pragmatic markers acquire an interactive function that allows people with MCI to maintain intersubjective relationships with their interlocutor. Furthermore, at the non-verbal level, gestural manifestations are increasingly used over time with a preference for non-verbal pragmatic markers with a referential function and an adaptive function. We aim to show the benefits of linguistic and interactional scientific investigation methods through cognitive impaired ageing for clinicians and family caregivers.

Status of Identification of Communication Disorder in Children in Current Scenario: A Survey from West Bengal

To find the status of age of suspicion and identification availed for children with different communication disorders. This cross-sectional survey study was conducted on 2081 children aged 0.5 to 15 years (mean: 5.41; S.D.: ±3.77) who came to the speech-language diagnostic department of AYJNISHD(D), RC, Kolkata for availing rehabilitation service at the institute. The information was gathered from the parents and caregivers of the children. After detailed evaluation by the interdisciplinary team, the developed 14-item questionnaire was administered, and data were recorded and tabulated. Findings suggested that average age of suspicion of presence of communication problem is 2 years (SD: ±0.98). The suspicion rate increased with increasing age with a saturation in suspicion rate after 5 years. Consultation of a medical professional, primarily an ENT specialist was availed by 2.8 years (SD: ±1.89) of age and 32% of the doctors during the first visit assured the parents not to worry as the child would learn language with age and only 43.4% were referred for rehabilitation. Among them, 42.8% of children were found hearing loss, 24.5% found to have autism spectrum disorder, 20.66% of children were diagnosed with developmental delay, 6.4% were diagnosed with intellectual disability, 4.7% were diagnosed with late language emergence and 0.86% were diagnosed with cerebral palsy. From the findings we can conclude perceived cause of delay in identification is lack of awareness, lack of proper guidance from the primary consultants, and tendency to follow wait-and-watch policy.

Emergence from Disorders of Consciousness: Optimizing Self-Agency Through Communication

Language and communication deficits are intrinsic to disorders of consciousness. This article will provide an overview of language and communication deficits that can significantly confound the accuracy of diagnostic assessment in these patients. Authors will also discuss interventions to promote early communication using assistive technology and augmentative communication rehabilitation strategies. Finally, this article will discuss the importance of family education as well as ethical considerations connected to the recovery of communication and adaptive strategies to support patient autonomy and enhance self-agency.

Speech disturbances in schizophrenia: Assessing cross-linguistic generalizability of NLP automated measures of coherence

INTRODUCTION

Language disorders - disorganized and incoherent speech in particular - are distinctive features of schizophrenia. Natural language processing (NLP) offers automated measures of incoherent speech as promising markers for schizophrenia. However, the scientific and clinical impact of NLP markers depends on their generalizability across contexts, samples, and languages, which we systematically assessed in the present study relying on a large, novel, cross-linguistic corpus.

METHODS

We collected a Danish (DK), German (GE), and Chinese (CH) cross-linguistic dataset involving transcripts from 187 participants with schizophrenia (111DK, 25GE, 51CH) and 200 matched controls (129DK, 29GE, 42CH) performing the Animated Triangles Task. Fourteen previously published NLP coherence measures were calculated, and between-groups differences and association with symptoms were tested for cross-linguistic generalizability.

RESULTS

One coherence measure, i.e. second-order coherence, robustly generalized across samples and languages. We found several language-specific effects, some of which partially replicated previous findings (lower coherence in German and Chinese patients), while others did not (higher coherence in Danish patients). We found several associations between symptoms and measures of coherence, but the effects were generally inconsistent across languages and rating scales.

CONCLUSIONS

Using a cumulative approach, we have shown that NLP findings of reduced semantic coherence in schizophrenia have limited generalizability across different languages, samples, and measures. We argue that several factors such as sociodemographic and clinical heterogeneity, cross-linguistic variation, and the different NLP measures reflecting different clinical aspects may be responsible for this variability. Future studies should take this variability into account in order to develop effective clinical applications targeting different patient populations.

Why and how to publish aphasia-friendly research summaries

BACKGROUND

A common complaint of people with aphasia and their families is their inability to find information about current aphasia treatment research (Hinckley, Boyle, Lombard & Bartels-Tobin, 2014; Hinckley & El-Khouri, 2021). Plain language summaries, video summaries, and graphical summaries are three ways to disseminate research results that are more accessible to a broader audience. The purpose of this tutorial is to discuss the motivations for disseminating research in understandable ways, and to provide information and resources on how aphasia-friendly dissemination can be done.

METHOD

We report an overview of evidence on the importance of and characteristics of dissemination. Next, we provide specific characteristics and resources for producing plain language summaries, video summaries, and graphical abstracts. Finally, we conducted a systematic search for journals in the area of stroke rehabilitation after consultation with a research librarian. The publication webpages of each journal were inspected to gather information about whether and how the journal published plain language summaries, video summaries, or graphical abstracts. Editors were contacted as needed to complete the information. Sixty journals in stroke rehabilitation were identified, and a total of 43 journals (71%) publish video abstracts, graphical summaries, and/or plain language summaries either independently or through third-party platforms.

CONCLUSIONS

The findings are discussed in the context of the importance of making research consumer-friendly. We offer specific recommendations for aphasia researchers, and future directions for publishing research in ways that will have an impact on the broader public are suggested.

TBIBank: An International Shared Database to Enhance Research, Teaching and Automated Language Analysis for Traumatic Brain Injury Populations

Traumatic brain injury (TBI) has been established as a priority research area for public health, affecting an estimated 69 million individuals worldwide each year. Large-scale collaborative datasets may help to better understand this heterogenous and chronic health condition. In this paper, we present TBIBank; an innovative digital health resource that aims to establish a shared database for the study of communication disorders after TBI. We provide an overview of the current database, the standard discourse protocol used for the main TBIBank corpus, and the automated language analyses that can enable diagnostic profiling, comparative evaluation of treatment effects and profiling of recovery patterns. We also highlight the e-learning component of the digital health resource as a research translation tool. We conclude with a discussion of the potential research, clinical, and educational applications of TBIBank and future directions for expanding this digital resource.

Parent's Perspective on Teletherapy of Pediatric Population with Speech and Language Disorder During Covid-19 Lockdown in India

Aim: The pandemic COVID-19 led to the sudden imposition of lockdown and travel restrictions worldwide, that made tele practice one of the most viable options for various hospitals and healthcare centres. The present study aimed at exploring the parental perspective on teletherapy, for children having speech and language delay, during the covid-19 pandemic lockdown. Material & method: A total of 100 parents with children with speech and language delays and who have undergone a minimum of five teletherapy sessions at a tertiary care hospital during the COVID-19 pandemic lockdown were recruited. A questionnaire with 12 close-ended questions was administered over the phone call to know the parent's perspective on the impact of teletherapy and its benefits. The responses obtained were tabulated and calculated for percentage response to each question. Result: Around 95% of parents reported improved motivation for speech-language therapy for their child due to teletherapy during the COVID-19 pandemic lockdown, and 96% of parents were satisfied with receiving teletherapy services during the COVID-19 pandemic lockdown. Furthermore, 90% of parents found teletherapy is more cost-effective than in-person therapy, but 88% believe face-to-face consultation is also required after some time (approx. after six months). Conclusion: The overall result suggested that parents had a positive attitude towards the teletherapy sessions. They reported the therapy sessions to be very effective and compliant, and it can be an efficient alternative with more structured implementation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-022-03310-y.

Challenges in Delivering Tele-Practice Services for Communication Disorders Among Audiologists and Speech Language Pathologists

Outbreak of COVID-19 pandemic has affected immensely the service delivery to patients with communication disorders. Tele-rehabilitation has become a new norm for the service in the field of speech and hearing. Daily challenges in service delivery are widely being reported. The objective of study is to highlight challenges faced by Audiologists and Speech Language pathologists during tele-practice. A descriptive cross-sectional survey was carried out through a web-based questionnaire regarding challenges faced by Audiologists & Speech Language Pathologists, and their perspectives towards tele-practice was compared. Total of 18 questions were divided into three sections. Section I included questions regarding training related to tele-practice, types of cases being handled, etc. Section II comprised of questions related to tele-therapy resources and section III had questions related to evaluation and treatment by tele-mode. 118 participants (47% Postgraduate students, 29% undergraduate students and 24% Professionals) participated in the study. Only 16.1% of the clinicians were trained formally for service delivery via tele-mode. All the participants reported child language disorders, difficult to handle during sessions. Participants reported lack of evidence based tele resources for the use during their practice and also stated difficulty assessing and intervening clients via tele-mode. Results show telerehabilitation is being widely used. Challenges faced by Audiologists and Speech language pathologists are difficulty handling paediatric population, lack of evidence-based tele-resources, and difficulty in evaluation & management of the patients. Effective training regarding tele practice is the need of current scenario. Future research on developing evidence- based resources is emphasized.

Parental Occupational Exposure and Neurodevelopmental Disorders in Offspring: a Systematic Review and Meta-analysis

PURPOSE OF REVIEW

Parental occupational exposures might be associated with neurodevelopmental disorders (NDDs) in offspring. We aimed to conduct a systematic review and meta-analysis to summarize and synthesize the current literature and to estimate the pooled magnitude of the underlying association(s) between parental occupational exposures and subsequent risk of NDDs.

RECENT FINDINGS

In the meta-analysis of 20 included studies, significant associations were found between parental occupational exposure to pesticides or solvents and the risk of attention deficit hyperactivity disorder in offspring. Prenatal occupational exposure to pesticides was significantly associated with motor development or cognition disorders in children. Furthermore, some evidence showed that metals might have a role in the development of autism spectrum disorders. Further studies need to identify the level of parental occupational exposures that can be significantly associated with NDDs. Moreover, utilizing standardized outcome and exposure scales is recommended to incorporate paternal, maternal, and parental as well as both prenatal and postnatal exposure in future studies.

Theory of Mind Development in Italian Children with Specific Language Impairment and Autism Spectrum Disorder: Delay, Deficit, or Neither?

Some studies report delayed theory of mind (ToM) development in children with specific language impairment (SLI), while others do not. A ToM delay is acknowledged in children with autism spectrum disorder (ASD), while whether these children also display a deficit is still under debate. In the current study, we drew on a developmental trajectory approach to assess whether children with SLI or ASD displayed delays or deficits in their ToM performance. Forty-three children with SLI (age 4-10 years), 44 children with ASD (age 5-12 years), and 227 typically developing children (age 3-11 years) completed the ToM Storybooks. Children with SLI were not found to display either a delay or a deficit in ToM, while children with ASD were found to display a deficit.

Evidence-Based Communication with Critically Ill Older Adults

Communication is a critical component of patient-centered care. Critically ill, mechanically ventilated patients are unable to speak and this condition is frightening, frustrating, and stressful. Impaired communication in the intensive care unit (ICU) contributes to poor symptom identification and restricts effective patient engagement. Older adults are at higher risk for communication impairments in the ICU because of pre-illness communication disorders and cognitive dysfunction that often accompanies or precedes critical illness. Assessing communication disorders and developing patient-centered strategies to enhance communication can lessen communication difficulty and increase patient satisfaction.

Receipt of treatment among a nationally representative sample of US adults with communication disorders

INTRODUCTION

A robust body of literature exists on clinical research outcomes for persons with communication disorders (CD). Comparatively few studies have examined population-based health service outcomes for CD-related services, which capture persons with CDs who may not be part of clinical or administrative data. This is important to describe access to treatment and the factors impacting access. We address this gap, describing four CD-related healthcare outcomes among adults reporting problems with communication (voice, speech, and language): (1) utilization, (2) utilization determinants, (3) professionals providing CD care, and (4) patient-reported service-related outcomes.

METHODS

We conducted a retrospective, cross-sectional study of community-dwelling adults (≥18 years) in the US self-reporting CD on the nationally representative 2012 National Health Interview Survey. Separate analyses examined adults with voice (n = 1,323), speech (n = 658), and language (n = 396) disorders. We used survey weighted logistic regression to assess the likelihood of treatment, controlling for health, disorder, and sociodemographic characteristics; Pearson's chi square was calculated for other outcomes.

RESULTS

An estimated 10% of adults reporting CD described receiving care addressing their CD. Employment, sociodemographic and economic status, health insurance, level of severity, and presence of co-occurring CD were associated with receiving treatment. Over half of respondents with speech and language disorders and less than a fifth of respondents with voice disorders reported receiving care from speech-language pathologists. Adults who received CD-related services reported improvements in activities (52-69% overall) and CD (33-48% overall).

CONCLUSIONS

This population-based study shows that general access to CD services is low. Underserved populations have less access to treatment than their counterparts with more resources. Improving access to CD services requires creative interventions addressing patient and provider needs, as well as healthcare system design. Population-based follow-up studies are necessary to track progress toward improving access to care.

"It's really exciting to think where it could go": a mixed-method investigation of clinician acceptance, barriers and enablers of virtual reality technology in communication rehabilitation

PURPOSE

Acquired communication disorders can result in significant barriers to everyday life activities, and commonly require long-term rehabilitation. This research aimed to investigate usability, acceptance, barriers and enablers to the use of immersive virtual reality (VR) technology for communication rehabilitation from the perspective of speech-language pathologists (SLPs).

METHODS

Semi-structured interviews and surveys (system usability and motion sickness) were carried out with 15 SLPs following their participation in communication activities typical of daily life, experienced within an immersive VR kitchen environment.

RESULTS

The system usability scores were average. In addition, motion sickness symptoms were low after interaction with the VR system. The main findings from semi-structured interviews are discussed across five main themes: (i) attitude towards the use of VR in communication rehabilitation (ii) perceived usefulness of VR (iii) perceived ease of use of VR (iv) intention to use VR, and (v) clinical adoption barriers and enablers.

CONCLUSIONS

Overall, participants were positive about VR and its potential applications to communication rehabilitation. This study provides a foundation to inform the design, development, and implementation of a VR system to be used in the rehabilitation of individuals with acquired communication disorders.IMPLICATIONS FOR REHABILITATIONVirtual Reality applications could simulate social communication situations within the clinic.VR could be used as a rehabilitation tool for communication assessment and/or outcome measure.VR requires customisation to the specific communication rehabilitation needs of the client.Participants identified barriers and enablers to adoption of VR by speech-language pathologists.

Non-primary progressive language impairment in neurodegenerative conditions: protocol for a scoping review

BACKGROUND

Progressive language difficulties arise in many neurodegenerative conditions, causing significant impact upon patients and families. This occurs most obviously in primary progressive aphasia (PPA) but can also occur within other forms of progressive disease. In these cases, language decline may be significant, but as they are not the presenting or dominant symptom, may be overlooked in favour of more prominent cognitive, behaviour or motor deficits. To date, there has been no systematic investigation into non-primary progressive aphasia. This scoping review aims to describe the currently reported language impairments found in non-language-led dementias and identify their clinical relevance, defined as the impact on everyday living. It also seeks to identify the reported interventions for language impairment in this patient group to-date.

METHOD

We will conduct a scoping review of published studies that have assessed and/or treated aphasia in people diagnosed with a neurodegenerative condition other than primary progressive aphasia. The systematic search will include the electronic databases PubMed, MEDLINE, OVID-EMBASE, PsycINFO, and speechBITE, using search terms for specific non-language-led dementia subtypes. Findings will be mapped and described according to the type of language difficulties identified and rehabilitation approaches employed. Intervention studies will be evaluated for their methodological rigour using validated scales.

DISCUSSION

This scoping review will provide an overview of the types of aphasia found in neurodegenerative conditions where language dysfunction is not the primary focus. Current treatment approaches (and gaps in the provision of treatment) will be identified.

Evidence-Based Communication with Critically Ill Older Adults

Communication is a critical component of patient-centered care. Critically ill, mechanically ventilated patients are unable to speak and this condition is frightening, frustrating, and stressful. Impaired communication in the intensive care unit (ICU) contributes to poor symptom identification and restricts effective patient engagement. Older adults are at higher risk for communication impairments in the ICU because of pre-illness communication disorders and cognitive dysfunction that often accompanies or precedes critical illness. Assessing communication disorders and developing patient-centered strategies to enhance communication can lessen communication difficulty and increase patient satisfaction.

Use of Videos and Digital Media in Parent-implemented Interventions for Parents of Children with Primary Speech Sound And/or Language Disorders: A Scoping Review

No review to date has focused on evaluating the use of videos and digital media in parent-implemented interventions for parents of children with primary language or speech sound disorder (LD/SSD). Research objectives guiding this scoping review included an evaluation of (a) use of videos and/or other digital media in parent-implemented interventions; (b) use of videos and/or other digital media in asynchronous content; (c) the role of the parent as learner; and (d) the program impact on parents and children. This review followed a five-stage framework: (a) identify research questions; (b) identify relevant studies; (c) select studies; (d) chart the data; and (e) collate, summarize and report the results. Ten studies were included. No program included parents of children with speech disorders. One fully asynchronous program was identified, though many programs included videos concurrent with direct instruction. No study described the parent as learner and only four studies examined parent satisfaction and perceptions. These four studies directly measured specific parent behavior and results indicated that the programs had a positive impact on parents' interactions. Nine of the ten studies included child outcomes. This low volume of studies suggests limited work in this area. The review describes research gaps and future directions.

The effects of sex on prevalence and mechanisms underlying neurodevelopmental disorders

Neurodevelopmental disorders occur more frequently in boys than in girls and often differ in presentation between the sexes. The sex differences in prevalence and presentation of autism spectrum disorder, intellectual disability, communication disorders, specific learning disabilities, attention deficit/hyperactivity disorder, Tourette's syndrome, and epilepsy are discussed, as well as sex differences in the patterns of comorbidities between these disorders. Prominent theories have been proposed to explain sex biases. These include genetic factors, sex hormones, sociological factors, cognitive differences between the sexes, and environmental insult. Despite the large body of research reviewed in this chapter, many aspects of sex-related effects in neurodevelopmental disorders remain poorly understood.

The speech pathology workforce in intensive care units: Results from a national survey

BACKGROUND

Admission to the intensive care unit (ICU) with mechanical ventilation can lead to patients experiencing impaired swallowing and communication function. This can negatively affect patient experiences and outcomes. There is increasing research supporting early intervention for swallowing and communication; however, there are no published ICU workforce data to determine patient access.

PURPOSE

The purpose of this study was to describe national ICU access to speech pathology (SP) services and to describe the nature of this workforce.

METHODS

Prospective audit of Australian ICUs with a focussed workforce survey of SP service including workforce demographics, clinical practices, team environments, and training was conducted. Data are described as percentage (%, n) and as median (interquartile range). Qualitative data were analysed using thematic frameworks.

RESULTS

SP services were available at 99% (n = 165) of the sites; 62 sites provided workforce data (45% response rate). Seventy-one percent of respondents serviced the ICU ≤10 h per week, with 23% reporting dedicated funding. Almost a third (32%) reported not participating in ICU team activities, and more than half of the sites (56%) did not provide ICU-specific training with resulting varied clinical confidence ratings. Facilitator and barriers both highlighted team working relationships. Facilitator themes were building working relationships, understanding the SP role in the multidisciplinary team, physical presence in the unit, and access to resources. Barrier themes were the multidisciplinary team's understanding of SP roles and lack of presence of SP services in the ICU.

CONCLUSIONS

SP services are not standard across Australian ICUs, with variations in confidence, funding, training, and team environments. Further research into the impact of these variations on patient outcomes is needed.

Paid worker and unfamiliar partner communication training: A scoping review

BACKGROUND

Communication partner training could be employed to train people working in the community to facilitate interaction with individuals who live with a variety of communication disorders. However, current evidence syntheses are limited to a single disorder (e.g., aphasia) and focus on a variety of familiar and unfamiliar communication partners. An understanding of the scope of literature across the evidence-base of acquired neurological populations may provide a better basis to develop interventions and future research tailored for community workers.

AIMS

To explore the scope of literature on paid worker and unfamiliar partner communication training for acquired neurogenic communication disorders with a focus on describing: 1) the types of communication disorders addressed by interventions; 2) the types of learners who received the interventions; 3) the nature of the interventions; and 4) the reported effects on trainees and people with a communication disorder.

METHODS & PROCEDURES

A scoping review was conducted. Studies were selected by a systematic keyword search, undertaken through four databases. Eligibility criteria included studies that: (i) reported an intervention directed at paid workers or unfamiliar partners where the primary goal was to improve communication with people with acquired neurogenic communication disorders, (ii) reported original results, (iii) contained quantitative or qualitative data on the effects of the intervention, (iv) were written in English or French and (v) were published in a peer-reviewed journal. The PRISMA-ScR was used to guide design and reporting of the scoping review.

RESULTS

Seventy publications met the inclusion criteria. Interventions were mostly disorder-specific and addressed communication with people with dementia, aphasia or traumatic brain injury. 15/70 studies examined training programs that were not restructured to a specific population (e.g., aphasia). Learners were mostly working or studying in the healthcare field and only 2/70 studies included community workers without primarily health training. Sixty different interventions were reported and were mostly delivered by speech-language pathologists. Training varied in terms of duration (a few minutes to 46 h) and content, but many shared training methods (e.g., presentation of theory on communication disorders). Nearly all studies demonstrated positive results, 23/26 studies suggested that paid worker and unfamiliar partner communication training may increase the knowledge of trainees, 24/26 studies suggested that it could improve their confidence when interacting with people with a communication disorder and 44/46 studies suggested that it could improve the trainees' communication abilities.

CONCLUSION

A small developing evidence-base exists for communication training programs for paid and unfamiliar communications partners that focuses beyond a single diagnosis or disorder. However, there is very limited knowledge on interventions for community workers from non-health professions. Future research should focus on the evaluation of existing programs tailored to, or explicitly designed for this context with the aim of identifying active ingredients that lead to improved and sustainable outcomes.

Clinical Usefulness of the Korean Developmental Screening Test (K-DST) for Developmental Delays

Objective

To evaluate the clinical usefulness of the Korean Developmental Screening Test (K-DST) via comparison with Korean Ages and Stages Questionnaire (K-ASQ) for the diagnosis of developmental delay in pediatric patients.

Methods

The K-DST and K-ASQ were used to screen pediatric patients who visited the hospital for evaluation and diagnosis of delayed development. Korean Bayley Scales of Infant Development-II (K-BSID-II) or Korean Wechsler Preschool and Primary Scale of Intelligence III (K-WPPSI-III) were used for the standardized assessment. Moreover, the final clinical diagnosis was confirmed by three expert physicians (rehabilitation doctor, psychiatrist, and neurologist). The sensitivity and specificity of each screening tool for the final diagnosis were investigated and correlated with standardized assessments.

Results

A total of 145 pediatric consultations were conducted, which included 123 developmental disorders (40 autism spectrum disorders, 46 global developmental delay/intellectual disability, and 37 developmental language disorders) and another 22 that were not associated with any such disorders. The sensitivity and specificity of K-DST based on the final clinical diagnosis were 82.9% and 90.9%, respectively, which were not significantly different from that of K-ASQ (83.7% and 77.3%). Both K-DST and K-ASQ showed good correlation with K-BSID-II and K-WPPSI-III. No significant difference was found between the K-DST and K-ASQ measures.

Conclusion

K-DST is an excellent screening tool and is expected to replace K-ASQ with high validity.

The Influence of Linguistic Demand on Symptom Expression in Adductor Spasmodic Dysphonia

INTRODUCTION

Adductor Spasmodic Dysphonia (ADSD), a form of focal dystonia, has been defined as a neurogenic, task-specific disorder characterized by abrupt spasms of intrinsic laryngeal muscles that result in phonatory breaks. Voice breaks are typically isolated to propositional speech, and reported to increase in severity as speaking demand or complexity increases. Research to date has focused on variations in phonologic contexts and their influence on voice breaks. The influences of variables at lexical and syntactic levels of analysis have been less well-researched and yet may provide insight into observed variability of symptom manifestation in this rare voice disorder.

OBJECTIVES

This study investigated frequency of voice breaks over 20 standard sentences in 38 individuals with ADSD according to linguistic complexity measures including lexical density and a four-level lexical frequency and type paradigm. Two research questions about linguistic influences and ADSD symptom manifestation were posed: (1) does the frequency of voice breaks vary according to the lexical density of a string? and (2) does the frequency of voice breaks vary according to a measure of lexical frequency/type?

RESULTS

Results revealed a nonsignificant relationship between string length and voice break frequency, whereas a significant relationship was found between lexical density and voice break frequency (P = 0.029, r = 0.488). Lexical analysis results revealed a significant relationship between lexical frequency and voice breaks, with words within technical/academic classes relating to the highest rates of voice break across 38 subjects with ADSD.

CONCLUSIONS

Results from this secondary analysis provide support for the hypothesis that variation in linguistic demand may modulate symptom expression in SD. Specifically, lexical density and lexical frequency modulated the frequency of symptom expression in classic forms of SD in this purposive sample.

Should Heritage Languages be Incorporated into Interventions for Bilingual Individuals with Neurodevelopmental Disorders? A Systematic Review

Special education policies recognize the need for developing and preserving the heritage languages of individuals with disabilities. Yet there seems to be a disconnect between policy and practice. Should the heritage languages of bilingual individuals with neurodevelopmental disorders be incorporated into interventions? This review evaluated 18 studies that examined the effects of heritage language instruction on treatment outcomes for individuals with neurodevelopmental disorders. Overall, results suggest a small effect favoring interventions delivered in the heritage language versus interventions delivered solely in the majority language. In general, studies were also found to be of high-quality according to What Works Clearinghouse Standards. Findings are discussed in terms of recommendations for future research and practice.

Characteristics of patient communication and prevalence of communication difficulty in the intensive care unit: An observational study

PURPOSE

To summarise the patient communication status in an intensive care unit (ICU), including methods of communication used and the frequency, degree and nature of communication breakdown.

MATERIALS AND METHODS

A multidisciplinary daily ward audit was conducted on ten consecutive weekdays in a 30-bed general ICU of a tertiary Australian hospital. Data included patient demographics, patients' mode of communication and the level of difficulty in communicating. Descriptive statistics and means (standard deviation)/medians (interquartile range) were used to summarise the data.

RESULTS

Over the audit period, data were collected from 87 patients (median age 58 years, interquartile range 43 to 67; 60% males), equivalent to 232 occupied bed days. Patients from non-English-speaking backgrounds accounted for 14% of the cohort, with Mandarin the most common non-English language. Altered cognition occurred on 11% of bed days. Staff reported difficulty in communicating with patients on 35% of bed days, with an inability to communicate with patients in 49% of these cases. Alternate modes of communication were reported, with gesture the most common, but they were not used with all suitable patients.

CONCLUSIONS

About one-third of the caseload in the ICU experienced difficulty in communicating. While alternate communication methods were reported, they were not used with all patients. A multidisciplinary approach to enhance communication ability may be beneficial.

Cognitive abilities and theory of mind in explaining communicative-pragmatic disorders in patients with schizophrenia

Patients with schizophrenia usually show an impairment in their communicative-pragmatic performance; they also have difficulties in cognitive functioning and Theory of Mind (ToM). In the literature it has been proposed that ToM and cognitive deficits have a role in explaining the communicative-pragmatic difficulties of patients with schizophrenia. However, the exact interplay of these functions is still not completely clear. The present research investigates the relationship between communicative-pragmatic, ToM and cognitive impairments (i.e. general intelligence, selective attention, speed processing and EF -working memory, inhibition and flexibility-) in a sample of 26 individuals with schizophrenia and matched controls. The linguistic and extralinguistic scales of the Assessment Battery of Communication (ABaCo), and a series of ToM and cognitive tasks were administered to patients and healthy controls. The results showed that individuals with schizophrenia performed less well than controls in all the tasks investigated. However, a hierarchical regression analysis showed that only ToM, and not cognitive functions, seems to be a predictive variable of patients' performance. Finally, a Fisher's exact test showed that there was not a stable significant relationship between ToM or EF and pragmatic impairment.

An Interprofessional Team Approach to the Differential Diagnosis of Children with Language Disorders

The ability to communicate effectively with others is central to children's development. Delays or disruptions due to isolated expressive language delay, articulation errors, multiple sound production errors with motor planning deficits, or mixed expressive and receptive language delay, often bring widespread consequences. Physical anomalies, neurologic and genetic disorder, cognitive and intellectual disabilities, and emotional disturbances may affect speech and language development. Communication disorders may be misdiagnosed as intellectual impairment or autism. Interdisciplinary evaluation should include speech and language assessment, physical and neurologic status, cognitive and emotional profile, and family and social history. This article describes assessment and reviews common pediatric communication disorders.

Sources and content of popular online videos about autism spectrum disorders

Background: Our study aimed to determine source of upload and content portrayed in the100 most-viewed videos on autism spectrum disorders (ASDs) on the video sharing public forum, YouTube. ASDs have become highly prevalent in the last decade, arousing a significant response from the media and psycho-educational health professions. Utilization of and reliance on social media for information on health matters has also proliferated. Some suggest that online videos could promote early detection (and intervention) of ASD by prompting caregivers to seek guidance. However, the usefulness of the available videos is unclear.

Methods: The 100 most popular YouTube videos were examined for source of upload and information provided. Popularity was determined by number of views, using the filter tool.

Results: The videos had more than 121 million views combined. Only one video had been uploaded by a professional (a clinical psychologist). The 99 (non-professional) videos provided minimal data and research into known ASD risk factors. Interestingly, discredited vaccine-associated risks were promoted in 16% (95% CI = 09%–25%) of the 100 videos analyzed. Many videos featured a child with ASD exhibiting some characteristic patterns, such as engaging in a repetitive behavior (73%, 95% CI = 63%-81%); about as many videos referenced various therapies (75%, 95% CI = 65%-83%); and 54% (95% CI = 44%–64%) and 61% (95% CI =51%–71%) of the videos mentioned the economic and emotional toll of ASD on the family,respectively. Additional variables are discussed.

Conclusion: The most popular online videos were primarily uploaded by non-professionals and provided limited content regarding ASD. Given the wide reach of social media and its potential for providing valuable information and guidance to the public on matters pertaining to ASD, we wish to underscore the necessity for a professional presence in this medium.

Facilitating Transition from High School and Special Education to Adult Life: Focus on Youth with Learning Disorders, Attention-Deficit/Hyperactivity Disorder, and Speech/Language Impairments

Youth with learning disorders, speech/language disorders, and/or attention-deficit/hyperactivity disorder may experience significant struggles during the transition from high school to postsecondary education and employment. These disorders often occur in combination or concurrently with behavioral and emotional difficulties. Incomplete evaluation may not fully identify the factors underlying academic and personal challenges. This article reviews these disorders, the role of special education law for transitional age youth in public schools, and the Americans with Disabilities Act in postsecondary educational and employment settings. The role of the child and adolescent psychiatrist and the importance of advocacy for these youth are presented.

Speech-generating devices: effectiveness of interface design-a comparative study of autism spectrum disorders

Background

We analyzed the efficacy of the interface design of speech generating devices on three non-verbal adolescents with autism spectrum disorder (ASD), in hopes of improving their on-campus communication and cognitive disability. The intervention program was created based on their social and communication needs in school. Two operating interfaces were designed and compared: the Hierarchical Relating Menu and the Pie Abbreviation-Expansion Menu.

Methods

The experiment used the ABCACB multiple-treatment reversal design. The test items included: (1) accuracy of operating identification; (2) interface operation in response to questions; (3) degree of independent completion. Each of these three items improved with both intervention interfaces.

Results

The children were able to operate the interfaces skillfully and respond to questions accurately, which evidenced the effectiveness of the interfaces.

Conclusions

We conclude that both interfaces are efficacious enough to help nonverbal children with ASD at different levels.

Poststroke Communication Disorders and Dysphagia

Communication and swallowing disorders are common after stroke. Targeted surveillance followed by prompt evaluation and treatment is of paramount importance. The overall goals of rehabilitation for impaired swallowing and communication and swallowing deficits may differ based on the specific deficits caused by the stroke but the main goal is always to improve the patient's everyday interpersonal interactions and optimize participation in society. Fortunately, therapeutic or compensatory interventions can decrease the effects that communication and swallowing deficits have on the quality of life of stroke survivors.

How does difficulty communicating affect the social relationships of older adults? An exploration using data from a national survey

Healthy social relationships are important for maintaining mental and physical health in later life. Less social support, smaller social networks, and more negative social interactions have been linked to depression, poorer immune functioning, lower self-rated health, increased incidence of disease, and higher mortality. Overwhelming evidence suggests that communication disorders adversely affect social relationships. Much less is known about whether some or all aspects of social relationships are negatively affected by a communication disorder. The relative impact of a communication disorder on social relationships, as compared to other kinds of disability, is also poorly understood. Data were analyzed from a representative national sample of community-dwelling adults aged 65 and older living in the continental United States (n=742). Results from multiple regressions indicated that difficulty communicating was significantly associated with several parameters of social relationships even after controlling for age, gender, partnership status, health, functional limitations, and visual impairment. Communication difficulty was a significant predictor of smaller social network size, fewer positive social exchanges, less frequent participation in social activities, and higher levels of loneliness, but was not a significant predictor of negative social exchanges. These findings suggest that communication disorders may place older adults at increased risk for mental and physical health problems because of social isolation, reduced social participation, and higher rates of loneliness. In addition, it appears that communication disorders may have a greater impact on positive, rather than negative, aspects of social relationships.

LEARNING OUTCOMES

As a result of this activity, the following learning outcomes will be realized: Readers will be able to (1) describe changes in the social relationships of older adults that occur as part of normal aging, (2) identify the aspects of social relationships that were significantly impacted by a communication difficulty, and (3) discuss possible reasons for these findings including potential clinical implications.

Communicating with Patients with Special Health Care Needs

People with special health care needs (PSHCN) often have difficulty communicating with providers in health care settings, including dental practices. This difficulty can affect access to care as well as the quality of care received. This article provides practical tips and tools dental professionals can use to facilitate communication for a diverse population of PSHCNs. The article discusses communication needs of patients with communication disorders; augmentative and alternative communication; and communication for patients with intellectual disability, psychiatric conditions; and dental fears. Examples are given of communication breakdowns, and descriptions of how communication challenges can be resolved.

Auditory-perceptual analysis of voice in abused children and adolescents

INTRODUCTION

Abused children and adolescents are exposed to factors that can trigger vocal changes.

OBJECTIVE

This study aimed to analyze the prevalence of vocal changes in abused children and adolescents, through auditory-perceptual analysis of voice and the study of the association between vocal changes, communication disorders, psychiatric disorders, and global functioning.

METHODS

This was an observational and transversal study of 136 children and adolescents (mean age 10.2 years, 78 male) who were assessed by a multidisciplinary team specializing in abused populations. Speech evaluation was performed (involving the aspects of oral and written communication, as well as auditory-perceptual analysis of voice, through the GRBASI scale). Psychiatric diagnosis was performed in accordance with the DSM-IV diagnostic criteria and by applying the K-SADS; global functioning was evaluated by means of the C-GAS scale.

RESULTS

The prevalence of vocal change was 67.6%; of the patients with vocal changes, 92.3% had other communication disorders. Voice changes were associated with a loss of seven points in global functioning, and there was no association between vocal changes and psychiatric diagnosis.

CONCLUSION

The prevalence of vocal change was greater than that observed in the general population, with significant associations with communication disorders and global functioning. The results demonstrate that the situations these children experience can intensify the triggering of abusive vocal behaviors and consequently, of vocal changes.