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This paper explores the challenge of establishing a meaningful connection between a neurotypical therapist and a neurodiverse patient who inhabit different Umwelts, that is, perceptual worlds.1 It discusses how addressing anxiety is crucial in preventing communication difficulties from escalating for individuals with autism who may have heightened stress due to an overgrown amygdala. Embodied mirroring is introduced to focus on perceptions and reduce stress. Furthermore, the potential for epigenetic changes due to unaddressed anxiety is raised. The paper emphasises the importance of responding to individual differences in sensory and perceptual experiences to promote effective communication and positive outcomes in therapy. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultConclusionEthiopia is the second most populous country in sub-Saharan Africa. While Ethiopia’s health care system includes primary health centres, general, and specialised hospitals, allied health care like speech-language pathology was not available until 2003. This article was written with the aim of sharing the experience of establishing speech-language pathology as a profession and the first speech-language pathology training program in Ethiopia.In this paper, we retrospectively examine how the leadership of local stakeholders, a multidisciplinary team, and the development of a professional infrastructure led to the success of the program. The authorship group, who were involved in the program from inception to implementation, share their experiences.The speech-language pathology undergraduate program at Addis Ababa University graduated its first class in 2019. Plans to grow the training program at the graduate level are ongoing.This novel program, grown from several international partnerships, is an example of how low- and middle-income countries can improve access to the service providers necessary to treat their populations. [ABSTRACT FROM AUTHOR]

This paper describes the current situation of the provision of speech-language services in East Africa. An overview of the educational opportunities, workforce density, communication rehabilitation planning, caseload, and ethical and/or cultural challenges is provided. A narrative review was performed. All papers referring to communication disorders in East African countries were identified from EMBASE, PubMed, ISI Web of Science: Science Citation Index Expanded, and ISI Web of Science: Conference Proceedings Citation Index-Science using the following search terms: speech therapy, speech pathology, speech-language pathology, speech-language rehabilitation, speech-language therapy, logopedics, East Africa, communication disorders, communication difficulties. Two concepts were combined with a Boolean operator 'AND'. At present, there is an alarming shortage of speech-language pathologists in East Africa. This issue is mainly related to the limited availability of educational programs in speech-language pathology. Although more and more universities are beginning to offer such educational programs, the number of available speech-language pathologists is still too low to meet the needs of all children with communication disorders. In addition, speech-language pathologists are often faced with different cultural and ethical obstacles when they provide intervention to East African children with communication disorders. These speech-language pathologists are therefore challenged to take a broader view of their role as a therapist. These alternative roles often include training of other individuals in the context of community-based rehabilitation. In the future, it will be important to carefully consider the development of sustainable learning opportunities in East African contexts. Initiatives, for example, "train-the-trainer" workshops, are needed to support the speechlanguage pathologists. Existing models like the communication disability model can aid to create holistic frameworks for the development of sustainable speech-language services in the East African countries. [ABSTRACT FROM AUTHOR]

Facilitated communication (FC) has been a heavily debated and documented topic across multiple disciplines, including sociology, education, psychology, pediatrics, speech-language pathology, and disability studies. Although many professionals from various disciplines and advocates have offered opinions, suggestions, and research on the topic, there has been minimal input from the occupational therapy (OT) profession. The lack of OT input is noteworthy as OTs are experts in enabling upper extremity performance and independence through a variety of training, adaptation and modification strategies, and use of external supports. Because of their professional code of ethics and a specific knowledge base, OTs are uniquely positioned to provide a host of ethical and evidence-based strategies that enable independent access to communication technology. The consideration of multiple access options is contrary to the typical facilitated encounter where facilitators exclusively choose to manipulate an upper extremity in order for letters to be selected on a display or keyboard. The purpose of this paper is threefold: (a) To offer insight into the standard of care by OTs including their ethical standards; (b) to identify varied accommodations that enable access using a feature-matching standard of care that eliminates the need for a facilitator; and (c) to highlight how to increase independent assistive technology/augmentative and alternative communication access, thus dissuading the need or use of facilitated access to letters. [ABSTRACT FROM AUTHOR]

Copy number variants (CNVs) found in individuals with communication deficits provide a valuable window to the genetic causes of problems with language and, more generally, to the genetic foundation of the human-specific ability to learn and use languages. This paper reports on the language and communication problems of a patient with a microduplication in 22q11.23 and a microdeletion in 7q31.1-q1.33 encompassing FOXP2. The proband exhibits severe speech problems and moderate comprehension deficits, whereas her pragmatic abilities are a relative strength, as she uses gestures quite competently to compensate for her expressive issues. This profile is compatible with the deficiencies found in patients with similar CNVs, particularly with people bearing microdeletions in 7q31.1-q31.33. [ABSTRACT FROM AUTHOR]

Augmentative and alternative communication (AAC) approaches offer expressive and receptive supports for the segment of the population of individuals with autism spectrum disorder (ASD) who have little or no functional speech. The National Center for Autism Evidence and Practice (NCAEP) declared augmentative and alternative communication (AAC) interventions for individuals with autism an "evidence-based practice." Following a brief analysis of the breakdown of studies included in NCAEP by dependent variable, we introduce each of the four papers published as part of this special issue on Advances in Augmentative and Alternative Communication Research for Individuals with Autism Spectrum Disorder. In addition to elucidating the contributions and advances of each paper to the research base, including the NCAEP report, we provide a critical commentary as applicable in the hopes of stimulating and guiding further research. [ABSTRACT FROM AUTHOR]

Communication between patients and clinicians influences the development of therapeutic relationships. Communication is disrupted when the patient has communication impairments after stroke. However, how these communication disruptions influence therapeutic relationships is not well-understood. This qualitative metasynthesis explores the perspectives of people with communication impairment to understand how interpersonal communication influences therapeutic relationships. Four databases were searched for qualitative studies which discussed how communication influenced therapeutic relationships from the perspectives of people with aphasia, dysarthria or apraxia of speech. Additional papers were identified through citation searching and subject experts. Nineteen eligible papers were included and analysed using thematic analysis. Four themes were constructed from the analysis: (1) Relationships provide the foundation for rehabilitation; (2) Different relational possibilities arise from "reading" the clinician; (3) Creating therapeutic relationships through validating interactions and connections; and (4) Creating therapeutic disconnections through invalidating, exclusionary interactions. A therapeutic relationship develops, at least in part, in response to the clinician's communication and how this is received and experienced by the patient. Understanding the characteristics of relationship-fostering communication and knowing how communication influences relationships can help clinicians critically reflect on their communication and better develop therapeutic relationships with people with communication impairment. Practitioner-patient communication can facilitate therapeutic relationships or create therapeutic disconnections. Communication patterns that are commonly evident when a patient has communication impairments can impede therapeutic relationships. Clinicians need to attend to how their communication is received and how it influences people's sense of self. Communication partner training should address the existential and relational needs of people with communication impairment after stroke. [ABSTRACT FROM AUTHOR]

Children and youth with severe motor and communication impairment (SMCI) have difficulty providing self-expression through typical speech, writing with a paper and pencil, or using a standard keyboard. Their emotional expressions can be missed by peers and novel caregivers. To describe the indicators and components of emotional experiences for children/youth with SMCI. Primary guardians of nine children/youth with SMCI were involved in photo/video data collection and follow-up qualitative interviews. Twenty-one familiar people (e.g., friends, family members, and/or care team) participated in semi-structured qualitative interviews. A conceptual understanding of emotional well-being specific to the population has been developed consisting of nine themes, encompassed by four domains i) Core Attributes, ii) Personal Experiences, iii) Surroundings, iv) Expression and Reception. Emotional experiences of children/youth with SMCI are diversely expressed. Primary guardian and familiar person insight can be amplified to positively impact care and participation. [ABSTRACT FROM AUTHOR]

Assessing the impact of dysarthria on a patient's ability to communicate should be an integral part of patient management. However, due to the high demands on reliable quantification of communication limitations, hardly any formal clinical tests with approved psychometric properties have been developed so far. This study investigates a web-based assessment of communication impairment in dysarthria, named KommPaS. The test comprises measures of intelligibility, naturalness, perceived listener effort and communication efficiency, as well as a total score that integrates these parameters. The approach is characterized by a quasi-random access to a large inventory of test materials and to a large group of naïve listeners, recruited via crowdsourcing. As part of a larger research program to establish the clinical applicability of this new approach, the present paper focuses on two psychometric issues, namely specificity and sensitivity (study 1) and retest-reliability (study 2). Study 1: KommPaS was administered to 54 healthy adults and 100 adult persons with dysarthria (PWD). Non-parametric criterion-based norms (specificity: 0.95) were used to derive a standard metric for each of the four component variables, and corresponding sensitivity values for the presence of dysarthria were identified. Overall classification accuracy of the total score was determined using a ROC analysis. The resulting cutscores showed a high accuracy in the separation of PWD from healthy speakers for the naturalness and the total score. Study 2: A sub-group of 20 PWD enrolled in study 1 were administered a second KommPaS examination. ICC analyses revealed good to excellent retest reliabilities for all parameters. [ABSTRACT FROM AUTHOR]

The prevalence of autism spectrum disorders (ASD) is increasing, and the correlates of involvement of this population in the criminal justice system have been reported. People with ASD have specific deficits such as difficulties in social communication and behavior, impulsivity, misinterpretation of rules, obsessions, and restricted interests, increasing their vulnerability to becoming victims and offenders. Herein, we report the case of a male 40 high-functioning ASD patient accused of stalking. This paper highlights clinical and forensic challenges when assessing patients with ASD prosecuted for stalking behaviors. [ABSTRACT FROM AUTHOR]

Explore methods used in peer-reviewed literature for obtaining self-expression of well-being information from children with severe motor and communication impairment (SMCI). A comprehensive search was conducted on 22 August 2019 through academic databases: CINAHL; Embase; MEDLINE; PsycINFO; InSpec; Compendex. Search strategies were informed by keywords under the following areas: (1) population: children with SMCI, (2) assessment methods: alternative to natural speech, paper and pencil report or standardized keyboard use (e.g., eye gaze) and (3) target information: well-being (e.g., quality of life). Studies were excluded if they focused on individuals over 25-years old, exclusively autism or typically developing children. Non-duplicate studies of 10,986 were screened; 49 studies met inclusion criteria. Most studies used high-tech methods of self-expression in a single context (n = 17). Familiar partners play a significant role in self-expression; 18 studies required a familiar partner for children with SMCI to self-express. Thirty-five studies involved children self-expressing to solely adults, in comparison to 14 studies which involved peers. Findings highlight the advancement of high-tech communication devices restricted to application in single contexts. Familiar partner knowledge of children with SMCI has the potential to be shared with others (e.g., respite care providers), enhancing both caregiver and child well-being. Future research that would enhance the literature could explore the assessment of emotional well-being for application in various contexts using multimodal methods. Opportunities for children with SMCI to express their emotional well-being can further influence the understanding and enhancement of participation, social connections, and experiences. Use of lower tech methods of self-expression to obtain information directly from children with severe motor and communication impairment (SMCI) remain more feasible in home and school contexts. By utilizing familiar partners' experiences and knowledge of the child, respite care providers, novel support workers, and others involved in the lives of children with SMCI can become further informed. Current high-tech methods for obtaining the emotional expressions of children with SMCI may benefit from incorporating multimodal approaches including lower tech methods, to be feasibly applied in real world contexts where well-being takes place. Further research on this topic is imperative to enable children with SMCI to self-express their emotional well-being which can enhance participation, activities, social connections, and experiences. [ABSTRACT FROM AUTHOR]

Attention and communication difficulties are common yet often invisible following Traumatic Brain Injury (TBI). The focus of this paper is to use practice-based evidence from health professionals working with individuals following TBI to gain a deep and relevant understanding of the impact that attention and communication can have in the lives of individuals following TBI. This dataset comes from a larger mixed-methods study that includes a survey with both open and closed questions and focus group data sources. Thematic analysis was completed on a single open-ended question from the survey of health professionals. It asked health professionals about the outcomes they believe are directly related to attention difficulties that result in specific communication difficulties. Responses from 73 health professionals who work in neurorehabilitation generated five themes: behavior, connections, self, purpose, and empowerment. The themes were pervasive across all aspects of the recovery journey for individuals post-TBI The implications for clinical practice and future research indicate a need to focus on attention-related strategies for language deficits; treating communication difficulties related to relationships and friendships; and redefining a sense of self following TBI. [ABSTRACT FROM AUTHOR]

Corpora of speech of individuals with communication disorders (CSD) are invaluable resources for education and research, but they are costly and hard to build and difficult to share for various reasons. DELAD, which means 'shared' in Swedish, is a project initiated by Professors Nicole Müller and Martin Ball in 2015 that aims to address this issue by establishing a platform for researchers to share datasets of speech disorders with interested audiences. To date four workshops have been held, where selected participants, covering various expertise including researchers in clinical phonetics and linguistics, speech and language therapy, infrastructure specialists, and ethics and legal specialists, participated to discuss relevant issues in setting up such an archive. Positive and steady progress has been made since 2015, including refurbishing the DELAD website () with information and application forms for researchers to join and share their datasets and linking with the CLARIN K-Centre for Atypical Communication Expertise () where CSD can be hosted and accessed through the CLARIN B-Centres, The Language Archive () and TalkBank (). The latest workshop, which was funded by CLARIN (Common Language Resources and Technology Infrastructure) was held as an online event in January 2021 on topics including Data Protection Impact Assessments, reviewing changes in ethics perspectives in academia on sharing CSD, and voice conversion as a mean to pseudonomise speech. This paper reports the latest progress of DELAD and discusses the directions for further advance of the initiative, with information on how researchers can contribute to the repository. [ABSTRACT FROM AUTHOR]