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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]

Since Freud, psychoanalytic case studies have been scrutinised as irredeemably subjective anecdotal reports. This paper explores criticisms at three different levels: suggestive influence and scientific judgment (case study as a form of classification and judgment); (counter)transference as a 'problem child' (case narrative as an emotionally biased communication); validation (case study as an anecdotal report with non–generalisable findings). In exploring these different criticisms, the paper also investigates different historical reactions toward the genre of psychoanalytic case study and the practice of case writing, as well as the significance of research pragmatism for psychoanalytic research in particular and psychological research more broadly. By bringing these criticisms and responses together, the paper seeks to provide a snapshot of how case studies survived the sceptics, and what past lessons can be learnt in developing the case study method further. [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]

Background: Symbol communication aids are used by children with little or no intelligible speech as an Augmentative and Alternative Communication strategy. Graphic symbols are used to help support understanding of language and used in symbol communication aids to support expressive communication. The decision making related to the selection of a symbol communication aid for a child is poorly understood and little is known about what language and communication attributes are considered in this selection. Aim: To identify from the literature the language or communication attributes of graphic symbol communication aids that currently influence AAC practice. Method and Procedure: A search strategy was developed and searches were performed on a range of electronic databases for papers published since 1970. Quality appraisal was carried out using the CCAT tool and papers rated as weak were not included in the review. Results: Eleven studies were included in the review reporting data from 66 participants. Weaknesses were identified in most studies that would limit the validity of the results for application to practice. Included studies investigated aspects of vocabulary organization and design, the process of vocabulary selection, and the choice of the symbol system and encoding method. Two studies also evaluated innovative communication aid attributes. Conclusions: Information from studies reported in the research literature provides a sparse source of information about symbol communication aids from which clinicians, children or family members may make informed decisions. This review is the first to systematically appraise the literature to answer the question what evidence exists to inform clinical decision making in relation to the language or communication attributes of graphic symbol based communication aids? The review establishes that there is a paucity of evidence from studies and that these decisions must thus be based on other information and factors. The review does establish a small number of language or communication attributes of symbol communication aids, but no synthesis of the results of these studies was possible. This review thus suggests that vocabulary design and organization, symbol system and encoding method, and the choice of vocabulary selection method are attributes that clinicians may carefully review in order to inform decisions. Clinicians encountering symbol vocabulary packages claiming to be 'evidence based' should query the nature of this evidence. The rehabilitation research community should debate and develop appropriate research designs that will facilitate future robust studies investigating the effect of specific language or communication attributes of communication aids. [ABSTRACT FROM AUTHOR]

Modern speech-language pathology practices (SLPPs) have adopted tablet games in recent years. Research is needed to take advantage of the potential benefits tablets can offer and to explore the factors that influence its introduction. This paper discusses a survey that was conducted to investigate the factors that influence speech-language pathologists’ (SLPs) beliefs and the actual use of tablets in SLPPs. The results of the survey, conducted among Slovenian SLPs, indicated that their most positive beliefs concerning tablets relate to social influence. Specifically, the beliefs relate to children’s interest and practice with tablets and have a significant impact on the decision-making of SLPs concerning introducing tablets in therapy. Conversely, SLPs’ most negative beliefs relate to the conditions for facilitating tablet use, particularly the lack of Slovenian applications. This paper discusses a separate case study that was conducted in which tablet game-supported therapy was introduced to a group of 44 children. The case study results indicated that the children accepted the use of tablet games for therapy purposes and the games had a positive impact on the children’s motivation and satisfaction. [ABSTRACT FROM AUTHOR]

Although the literature suggests that multilingual augmentative and alternative communication (AAC) interventions hold benefits for children from multilingual backgrounds, there is little guidance on how such interventions can be implemented. While various barriers to this process have been noted, language ideology has not received much attention in the AAC literature. This paper aims to highlight multilingualism as both a linguistic and a sociopolitical phenomenon. An awareness of the influence of language ideology on AAC practice may lead to more considered and reflective approaches when supporting multilingual clients and their families. A description of the multilingual experience is followed by a discussion of language ideologies and views of multilingualism and how these may translate into AAC practices. Through a series of questions, AAC practitioners are encouraged to reflect on the influence of language ideology on their practices. The influence of language ideology on the legal and policy context, service models, and family language practices and choices is then explored. By situating AAC interventions for children from multilingual backgrounds within a macrosystemic and ideological framework, researchers and practitioners may be able to identify not just constraints on but also opportunities for providing person- and family-centered intervention. [ABSTRACT FROM AUTHOR]

Objectives: Appropriate outcome measures are required for deaf children with severe (SLD) and profound and multiple learning difficulties (PMLD). This paper describes the development and structure of the Nottingham Early CaLL Framework and via a series of case-studies, demonstrates its effectiveness in tracking progress over time.Methods: The materials were developed in-house in 2011-2012 and refined through the exploration of established approaches in health and education, an inter-rater reliability study and an extended pilot of the draft materials.Results: The Framework quantifies the long term benefit of cochlear implantation by recording the amount of functional sound processor use achieved, alongside incremental changes in auditory behaviours, in the context of cognition, interaction and communication development. The case-studies demonstrate how it can provide evidence of measurable changes and help to explain some of the underlying reasons for the range of long-term outcomes.Discussion: Within this population, the key predictive, within-child factors of post cochlear implant listening and spoken language outcomes, are an individual's cognitive and physical capacities and their engagement in social communication.Conclusion: The Early CaLL Framework supports expectation counselling and decision-making in the assessment phase and post cochlear implantation provides monitoring tool, which encourages collaboration between families and professionals. [ABSTRACT FROM AUTHOR]

Individuals who have limited or no speech as a result of intellectual and developmental disabilities and who are beginning communicators (i.e., are learning early linguistic skills such as first words and early semantic relations) require augmentative and alternative communication (AAC) to build both their expressive communication and their internal language structures. Programing AAC just-in-time is a promising clinical approach to intervention for beginning communicators because of its alignment with early language development theory. Early research efforts also provide emerging evidence to support its theoretical benefits. This paper describes a six-step process for programing AAC content just-in-time for beginning communicators. It highlights clinical challenges and considerations for each step, provides case examples of using the process with beginning communicators, and highlights potential limitations and future research directions related to the just-in-time programing of AAC for beginning communicators. [ABSTRACT FROM AUTHOR]

Typing systems driven by noninvasive electroencephalogram (EEG)-based brain–computer interfaces (BCIs) can help people with severe communication disorders (including locked-in state) communicate. These systems mainly suffer from lack of sufficient accuracy and speed due to inefficient querying to surpass a hard pre-defined threshold. We introduce a novel recursive state estimation framework for BCI-based typing systems using active querying and stopping. Previously, we proposed a history-based objective called Momentum which is a function of posterior changes across sequences. In this paper, we first extend the definition of the Momentum, propose a unified framework that employs this extended Momentum objective both for querying and stopping. To provide a practical example, we employ a language-model-assisted EEG-based BCI typing system called RSVP Keyboard. Our results show that proposed framework on average improves the information transfer rate (ITR) and accuracy at least 52% and 8.7%, respectively, when compared to alternative approaches (random or mutual information). [ABSTRACT FROM AUTHOR]

This paper addresses the leader-following consensus problem of networked Lagrangian systems with unknown control directions and uncertain dynamics. For undirected graphs and directed graphs, two types of distributed control protocols are proposed without assuming that the leader's position information is linearly parameterised. It is proven that all signals in the closed-loop system are bounded, and a leader-following consensus can be achieved with the proposed corresponding protocols. These protocols are distributed in the sense that the control input for each Lagrangian system is solely based on local relative position and velocity information from its neighbourhood set and does not require additional information, e.g. acceleration or observer information of its neighbours, thus avoiding the dead-loop problem and reducing the communication burden. Simulations on networked two-link revolute joint arms are given to validate the theoretical findings. [ABSTRACT FROM AUTHOR]

Crowdsourcing has become a major tool for scholarly research since its introduction to the academic sphere in 2008. However, unlike in traditional laboratory settings, it is nearly impossible to control the conditions under which workers on crowdsourcing platforms complete tasks. In the study of communication disorders, crowdsourcing has provided a novel solution to the collection of perceptual ratings of human speech production. Such ratings allow researchers to gauge whether a treatment yields meaningful change in how human listeners' perceive disordered speech. This paper will explore some statistical considerations of crowdsourced data with specific focus on collecting perceptual ratings of human speech productions. Random effects models are applied to crowdsourced perceptual ratings collected in both a continuous and binary fashion. A simulation study is conducted to test the reliability of the proposed models under differing numbers of workers and tasks. Finally, this methodology is applied to a data set from the study of communication disorders. [ABSTRACT FROM AUTHOR]

Collaboration and information sharing are essential in the fast moving world of augmentative and alternative communication (AAC). This paper describes communities of practice, justifies their need in AAC, and introduces the Communication Matrix Community of Practice (CMCoP)—an online community of practice for professionals and family members supporting individuals at the earliest stages of communication development. Stakeholders share the goal of advancing language and communication intervention for individuals with complex communication needs. Features of the CMCoP include a community forum for discussing and sharing information; collections of posts by professionals and nonprofessionals on various topics; an events calendar of AAC-related activities relevant to stakeholders; and a shared science section offering portraits of the communication skills of various populations with severe communication disorders. The utility of these and other CMCoP features in supporting the implementation of AAC assessment and intervention strategies is discussed. [ABSTRACT FROM AUTHOR]

Background The diagnostic boundaries between autism spectrum disorder ( ASD) and specific language impairment ( SLI) are not clear-cut. Evidence of the lack of distinct boundaries between these disorders comes from research identifying a group of children who have pragmatic language difficulties that can be distinguished from those in children with SLI and those with ASD. These findings have led to the inclusion of a new diagnostic category, social (pragmatic) communication disorder ( SPCD), in the Diagnostic and Statistical Manual of Mental Disorders-5th Edition DSM-5. While this new diagnostic category appears to capture a subgroup of children who may not have been recognised in the DSM-IV, SPCD has been criticised due to a lack of empirical evidence, showing that the disorder is distinct from ASD in terms of aetiology, intervention, and prognosis. Objective The purpose of this paper was to summarise the literature that has investigated overlaps in the phenotypes of SLI, ASD, and SPCD. A secondary objective was to present a framework for the assessment and diagnosis of these three conditions. Method and Results In this paper, we review the research that has examined overlaps in the aetiologies and phenotypes of ASD, SPCD, and SLI. While the results highlighted overlaps in the language profiles and autistic symptomatology, these three conditions could also be distinguished based on the severity of the social communication deficits and the absence of rigid and repetitive behaviour in strictly defined cases of SPCD and SLI. Conclusions Strictly defined cases of SPCD and SLI can be distinguished from ASD. However, there is a lack of assessment tools that can reliably distinguish these three conditions. We consider the clinical implications of the findings and present a model of assessment and diagnosis for ASD, SLI, and SPCD. [ABSTRACT FROM AUTHOR]

Despite the well documented pragmatic deficits that can arise subsequent to Right Hemisphere Brain Damage (RHBD), few researchers have directly studied everyday conversations involving people with RHBD. In recent years, researchers have begun applying Conversation Analysis (CA) to the everyday talk of people with aphasia. This research programme has provided novel insights into the complex inter-relationship between impairment, language use, and interactional organization. This paper will argue that the detailed, inductive approach of CA is well suited to investigating pragmatic communication disorders resulting from RHBD, and will help to elaborate previous findings about RHBD and conversation. In particular, this paper will review and discuss previous investigations of conversation after RHBD, and put forward arguments relating to how CA might be applied to talk-in-interaction involving people with RHBD. [ABSTRACT FROM AUTHOR]

We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work. [ABSTRACT FROM AUTHOR]

Background : According to many aphasiologists the scientific study of aphasia dates back to the second half of the 19th century when Broca and Wernicke described the two classical forms of aphasia that now bear their names. About 100 years later, Benton and Joynt presented a historical overview of the literature on aphasia from the Hippocratic writings (c. 400 bc) to 1800. Since this seminal review (Benton & Joynt, 1960) there has been a growing interest in the history of aphasiology, resulting in many papers (cf. the Journal of the History of the Neurosciences ) and even books (e.g., Eling, 1994; Finger, 2000; Jacyna, 2000) about hitherto unknown writings about aphasia. Aims : The aim of this paper is to present a new, updated, and extensive review of the early history of aphasiology, starting with the earliest observation of “speechlessness” in an Egyptian papyrus (c. 1700 bc) and ending with Broca's discovery of the “speech centre” in 1861. Main Contribution : By presenting and discussing passages taken from major contributions to aphasiology in the past 3500 years, this literature survey offers a review of the clinical observations and theoretical analyses of aphasic phenomena preceding the pioneering article by Broca in 1861. Conclusions : Although many forms and symptoms of aphasia were described and a few theoretical explanations of its nature had been advanced before 1800, significant hypotheses about the localisation of aphasia were not formulated until the period 1800–1860. Based on his (otherwise misguided) “phrenological” theory, Gall (in Gall & Stuart, 1806) was the first to localise language in the frontal cortex. This hypothesis was then tested and supported by neuropathological data collected by Bouillaud (1825) who not only localised language in the frontal lobes, but also made the fundamental distinction between “a general faculty of language” and “the faculty of articulated speech”, thus preparing the ground for Broca's famous discovery in 1861. [ABSTRACT FROM AUTHOR]

Since the 17th century, the ‘blind restored to light’ has become a relevant epistemological figure attracting philosophical, scientific, medical and pedagogical attention. Drawing on a key text of modernity, John Locke’s An Essay Concerning Human Understanding (1690/1991), this paper analyses the historical constitution of blindness within modern epistemological concerns, whose social and political consequences can be traced to the present. Blindness is reduced to being (1) a mere function of vision (its lack); (2) an individual impairment; and (3) a state of epistemological ignorance. Moreover, Locke’s Essay introduces the bifurcation of nature into primary and secondary qualities. We will argue that this division still plays a crucial role in contemporary studies of disability, when individual and social models of disability are opposed. In concluding, the paper proposes a new epistemology that includes blindness instead of ‘othering’ it through exclusion. What allows man to resume contact with childhood and to rediscover the permanent birth of truth is this bright, distant, open naïvety of the gaze. Hence the two great mythical experiences on which the philosophy of the eighteenth century had wished to base its beginning: the foreign spectator in an unknown country, and the man born blind restored to light. (Foucault, 1997, p. 65) [ABSTRACT FROM AUTHOR]

Background : Clinicians face significant obstacles in their access to evidence for the efficacy of different communicative and cognitive treatments after brain impairment. These include the need to search across diverse journals and different clinical conditions to find potential treatments and the lack of easily accessible standards by which to evaluate the methodological rigour of treatment studies once found. Aims : We aimed to address these issues by developing a freely available, user‐friendly database of all relevant treatment trials for psychologically based disorders that arise from brain impairment. Methods & Procedures : PsycBITE TM (http:// www.psycbite.com ) was developed as an internet‐based database and was officially launched in 2004. Included on PsycBITE TM are all trials that have been published that evaluate treatment for any communication, cognitive, or psychological disorder arising from any form of acquired brain impairment in children (above the age of 5 years) and adults. PsycBITE TM also provides a rating for the methodological rigour of each trial using the previously established PEDro scale (Maher, Sherrington, Herbert, Moseley, & Elkins, 2003) for randomised controlled trials (RCT) and non‐RCT group comparisons. A PsycBITE TM rating scale for single case experimental studies is still under development. This report overviews the database, its contents, and the methodology by which papers are selected for inclusion. Outcomes & Results : As of June 2005 there are 1167 treatment studies listed on PsycBITE TM with prospective searches being conducted on a regular basis. The highest proportion of studies report treatments for communication disorders followed by behavioural problems and memory. Ratings of the randomised controlled trials, group comparisons, and single case studies are available for a proportion of papers and are being updated continuously. Conclusions : PsycBITE TM is an invaluable resource for clinicians and researchers interested in an evidence‐based practice approach to treatment. It is a free, fast, and effective way of accessing and evaluating treatments for communicative and cognitive disorders following brain impairment. [ABSTRACT FROM AUTHOR]

Background : Jargon aphasia is one of the most puzzling and clinically intractable forms of aphasia. It challenges us to think not only about the loss of normal language but also about the apparent acquisition of a strange and novel form of production. Aims : This paper aims to review the literature about jargon aphasia in order to provide an overview of our current knowledge of the condition. Main Contribution : The paper will cover five themes: nonword production, monitoring in jargon aphasia, writing in jargon aphasia, semantic jargon, and syntax in jargon aphasia. It attempts to review and appraise some of the key explanations for the phenomena of jargon. Conclusions : It is acknowledged that many of the questions posed by jargon aphasia remain unresolved. Nevertheless, some tentative explanations for the production of jargon are proposed. [ABSTRACT FROM AUTHOR]

The population of Turkey is approximately 65 million people, and another 3 million people of Turkish descent live in Europe and the United States. The purpose of the present paper is to relay information that American or European clinicians who work with Turkish clients should know about their clients’ country, including its language, education system, the current status of the profession and organization of professional services for communication disorders. The paper shows that the profession of speech-language pathology is young in Turkey; as a result, the roles of speech-language pathologists in this country are substantially different from those in the United States and in most European countries. It is envisioned that as the profession grows in Turkey its role will increasingly include direct provision of services, in-service training to service providers, and research on communication disorders. [ABSTRACT FROM AUTHOR]

Background: Accessibility is often constructed in terms of physical accessibility. There has been little research into how the environment can accommodate the communicative limitations of people with aphasia. Communication accessibility for people with aphasia is conceptualised in this paper within the World Health Organisation's International Classification of Functioning, Disability and Health (ICF). The focus of accessibility is considered in terms of the relationship between the environment and the person with the disability.Aims: This paper synthesises the results of three studies that examine the effectiveness of aphasia-friendly written material.Main Contribution: The first study (Rose, Worrall, & McKenna, 2003) found that aphasia-friendly formatting of written health information improves comprehension by people with aphasia, but not everyone prefers aphasia-friendly formatting. Brennan, Worrall, and McKenna (in press) found that the aphasia-friendly strategy of augmenting text with pictures, particularly ClipArt and Internet images, may be distracting rather than helpful. Finally, Egan, Worrall, and Oxenham (2004) found that the use of an aphasia-friendly written training manual was instrumental in assisting people with aphasia to learn the Internet.Conclusion: Aphasia-friendly formatting appears to improve the accessibility of written material for people with aphasia. Caution is needed when considering the use of illustrations, particularly ClipArt and Internet images, when creating aphasia-friendly materials. A research, practice, and policy agenda for introducing aphasia-friendly formatting is proposed. [ABSTRACT FROM AUTHOR]

This paper explores the issues involved in the linguistic characterisation of disordered discourse and the ways in which a Systemic Functional Linguistic framework addresses these issues. For many years, language disorders were described in terms of formal grammars, with “breakdown” discussed in terms of one or more of the traditional levels of language, i.e., phonology, syntax, and semantics. While it was acknowledged that an individual could have difficulty at one or more of these levels, each was viewed quite separately, with semantics viewed largely from a referential perspective. More recent approaches using functional grammar have broadened this view of language and have provided a model of language that re-conceptualises the notion of meaning and embraces context as integral to its organisation. Such a model has introduced a different perspective on language into clinical fields, and has enabled researchers and clinicians to explore the skills of speakers with language disorders across a variety of situations and contextual variables, examining the linguistic resources still available to them. This paper introduces principles involved in a functional framework and provides an overview of how these principles have been applied to language disorders to date. In addition, the notion of “disorder” itself is discussed as it is situated in this alternative model. [ABSTRACT FROM AUTHOR]

Background : Increased attention in the field of speech-language pathology is directed towards evidence-based treatment, particularly with regard to neurogenic communication disorders. Aims : The paper describes the development of an evidence-based aphasia clinic. Core principles of the clinic are the use of language treatment techniques that have support in efficacy data, and the objective measurement of treatment effectiveness. Main Contribution : Care paths for aphasia treatment are developed according to levels of evidence (Class I, II, III evidence); cognitive neuropsychological and life participation models; and the World Health Organisation International Classification of Health, Disability and Function (ICF). Multi-layered assessments are obtained at the ICF impairment and activity/participation levels throughout treatment (i.e., weekly treatment probes, monthly discourse probes, and biannual aphasia and neuropsychological assessments). Weekly multidisciplinary staffings address patient progress. The paper discusses limitations and challenges of addressing treatment effectiveness and efficacy within a typical outpatient clinical setting. Conclusions : The principles of evidence-based aphasia therapy and single-subject methodology can be applied in routine clinical rehabilitation settings. [ABSTRACT FROM AUTHOR]

Background: For many years, investigators have been exploring the reasons why there appear to be limits to human cognitive abilities. For example, it is difficult or even impossible for humans to perform several tasks simultaneously, depending on the nature of the tasks. Resource theory was developed to account for this limit. Resource theory asserts that humans possess a pool of cognitive resources that can be allocated to various cognitive tasks, but that this pool is limited. In more recent years, many aphasiologists have used resource theory to explain the mechanisms underlying the communication performance deficits of aphasia. However, there are many problems with resource theory and alternative theories exist which can better account for the limits on human cognitive abilities and for the deficits of aphasia. Aims : The first goal of this paper is to review the fundamental problems of resource theory and to describe alternative theories that can better account for the limits of human cognitive performance, especially during the simultaneous performance of two tasks. The second and primary goal of this paper is to critically evaluate studies of aphasia that have used resource theory to account for the findings and to describe how alternative theories can better account for these observations. Main Contribution : This paper provides a review and evaluation of alternative theories to resource theory, which has not been included in previous papers on aphasia and resource theory. It is important for aphasiologists to be aware of these alternative theories, so that they can critically evaluate resource theory as applied to aphasia. Conclusions : Resource theory is not a true scientific theory as defined by Popper. Aphasiologists are investing resources in testing this theory, and this distracts them from testing true scientific theories that can better account for the underlying deficits of aphasia. [ABSTRACT FROM AUTHOR]

This paper addresses blindness in a university classroom. I make use of my experience as a blind professor in order to depict the social significance in the intersection of blindness, sightedness and knowledge. The paper begins with a description of the initial classroom contact between a blind professor and students. It then depicts the presence of sightedness in the classroom in terms of the classroom's social organisation. The paper moves to a discussion of how university teaching makes use of blindness and sightedness to represent ignorance and enlightenment, respectively. The paper ends by reformulating the taken for granted conception of blindness as contingency into an understanding of blindness and the body as an essential aspect of teaching and learning. [ABSTRACT FROM AUTHOR]

This paper presents the case for a mapping theory of developmental language impairment, which branches into a theory that Specific Language Impairment (SLI) arises from impaired phonological processing and the consequent disruption of the mapping process through which the words and sentence structure of a language are established. The prelude to the case is that the mapping process, which is a sine qua non of language acquisition, is the first place to look for possible sources of deficits in language acquisition; that recent research on the mapping process points up the contribution of complex phonological processing not just in the segmentation and representation of lexical phonology, but in wider lexical and syntactic development; and that phonological processing is therefore a plausible source of the deficits observed in SLI. Detailed analysis of the mapping process and the role of phonological processing gives rise to specific predictions which are evaluated against wide-ranging research findings on children with SLI. It is argued that the phonological theory provides a better fit with this empirical evidence than theories which posit either specific grammatical deficits or low-level auditory processing deficits, and offers more far-reaching insights than theories which invoke a general limitation in processing capacity. The paper concludes with wider implications, further predictions, and further questions arising from the mapping theory of developmental language impairment and its particular instantiation in the phonological theory of SLI. [ABSTRACT FROM AUTHOR]

Purpose: Based on the bioecological model by Bronfenbrenner, this paper will provide a broad perspective on factors that need to be taken into account in order to facilitate communication and participation in preliterate children making use of electronic Augmentative and Alternative Communication (AAC) systems accessed through eye gaze. Method: Two case studies of children who have been provided with the technology described are presented. The case studies were analysed using the four nested systems of the ecology as a framework to describe not only the environment, but also the processes and interactions between the persons and their context. Results: Risk and opportunity factors are evident at all levels of the ecology. Conclusions: While a good fit between the person and the technology is an essential starting point, additional factors pertaining to the partner, the immediate environment as well as meso-, exo- and macrosystemic issues (such as societal attitudes and funding sources) have a significant influence on benefits derived. In resource-limited environments, the lack of support at more distal levels of the ecology (meso-, exo- and marosystemic levels) seems to be a factor that differentiates these environments from more resourced ones. [ABSTRACT FROM AUTHOR]

Objective: To (a) outline the background to research evaluating Twitter use by people with severe physical and communication disabilities participating actively in online communication forums for increasing information exchange and (b) illustrate a range of potential methods that might be applied in furthering research on the use of social media by people with developmental and acquired communication disabilities. Methods: The literature on communication disabilities, augmentative and alternative communication, and social media research informed the rationale for and design of three studies investigating the use of Twitter by people with communication disabilities. Results: To date, there is little information in the literature about how people with a range of communication disabilities might use Twitter to increase their access to information and help them to feel knowledgeable and in control of their own lives. Conclusion: In this paper, three studies are proposed to investigate the use of Twitter by people with communication disabilities. [ABSTRACT FROM AUTHOR]

Problem-Based Learning (PBL) is an educational model that is characterized by student-centered learning and classroom discussion using clinically based problems. This study examines students' perceptions of PBL as an alternative approach of learning in speech-language pathology and investigates if these perceptions change over time as a function of students' learning experience with PBL. Written reflections by 96 graduate-students in a graduate elective course on cognitive-communicative disorders were analyzed using content analysis. Common words or phrases in each reflection paper were identified, grouped and coded into consistent themes. Percentage changes of these themes across a semester were also followed. A total number of 883 positive and 165 negative comments were identified. Thirteen positive and seven negative themes relative to students' perception of the inclusion of PBL were yielded. The advantages of PBL were found to outweigh its disadvantages. Moreover, accumulated experience with this approach was found to eliminate some initial perceived drawbacks about PBL. The extra efforts to engage students in interactive discussion as well as higher order critical thinking and knowledge application were acknowledged through student feedback. Future studies should investigate how PBL can be of greater use in other areas in communication sciences and disorders. [ABSTRACT FROM AUTHOR]

With clinical purposes in mind, a review of the proximal/distal opposition is carried out in order to define a universal parameter of variability in semiotic procedures. By taking into consideration different-although notionally inter-related-senses of the proximal/distal opposition, a cluster of semiotic properties is proposed, which initially permits one to characterize dimensions of variability in the form and use of gestures. The subsequent and central aim of this paper is, however, to demonstrate that the same, or homologous, properties can also serve to characterize variability in the use of language, by assuming a basic connection between gesturing and linguistic behaviour. The main focus of interest and the starting point for reflections are communicative impairments as manifested in apraxia and aphasia. [ABSTRACT FROM AUTHOR]

Background: Positive interactions between caregivers and residents in long-term care institutions have been documented to improve residents' quality of life, their psychological and social well-being as well as their life expectancy. Residents with language disorders pose a unique challenge due to their difficulties understanding conversation, speaking, reading, and writing. The success and efficiency of such residents' communication can be improved by enhancing partners' abilities to communicate with them. Individualised communication plans, education and training, and staff support have been documented to be important components in this type of intervention. Aims: This paper reports on the development and evaluation of a communication training programme for nurses working with persons with language impairments in a complex continuing care facility. The specific aims of this study were (a) to explore changes in staff knowledge about language impairment, (b) to determine their perception of the training workshop, and (c) to explore staff's perceptions of the Communication Plans' usefulness in practice. Methods & Procedures: Eighteen nursing staff and nine residents with communication impairments participated in this study with a descriptive design. The intervention consisted of three components: developing Communication Plans, holding a 1-day workshop, and offering support while implementing the plans into practice. Outcomes & Results: There was a statistically significant increase in staff's knowledge of language disorders after training. Staff perceived the Communication Plans to be very useful in their interactions with residents. Conclusions: Individualised Communication Plans, a 1-day workshop, and the follow-up and support of a speech-language pathologist can have a beneficial effect on staff outcomes. Nursing staff demonstrated an enhancement in their knowledge and perceived skills in caring for residents with communication impairments. Results have implications for the speech-language pathologist's role with residents with communication impairments in complex continuing care. [ABSTRACT FROM AUTHOR]

This paper describes a matrix for clinical use in the selection of phonological treatment targets to induce generalization, and in the identification of probe sounds to monitor during the course of intervention. The matrix appeals to a set of factors that have been shown to promote phonological generalization in the research literature, including the nature of error patterns, implicational universals, developmental norms, and stimulability. A case study of a child with a phonological disorder is presented to illustrate how the matrix may be utilized in evidence-based practice. The matrix serves as a demonstration of how the translation of research to practice may be accomplished. [ABSTRACT FROM AUTHOR]

This paper presents and analyzes a finding that gives evidence of the use of a low-tech communication device long before the formal establishment of the field of augmentative and alternative communication. The device, a simple low-tech alphabet board, is portrayed in a 1920 painting of World War I veterans by German Expressionist Otto Dix. Entitled “War Cripples,” the painting shows one of the veterans, who sustained severe disfigurement and jaw mutilation resulting in speech loss, pointing to a letter on a chart pinned to his uniform. The analysis of the painting utilized Aby Warburg's methodology for researching the significance of images within the cultural context in which they are produced. [ABSTRACT FROM AUTHOR]

This paper examines the development of fieldwork methodology in a study that investigated the parenting experiences and parent support needs of a group of parents with an intellectual disability. It considers the ways in which the original planning for the project changed as the fieldwork unfolded, requiring adaptations to our methodological expectations and in the process deepening our understanding of the phenomena we were studying and reinforcing for us the importance of relationships in fieldwork-based research. Three themes in particular are considered that became central to this research: research relationships; safety for participants/positioning of the researcher; suspending assumptions about impairment and disability and influences on life experiences. [ABSTRACT FROM AUTHOR]

This paper discusses the gap between policy goals and practice in residential services for people with learning disabilities. Drawing on a nine month ethnographic study of three residential services, it outlines a range of obstacles to the promotion of choice and control that were routinely observed in the culture and working practices of the services. Issues discussed include conflicting service values and agendas, inspection regimes, an attention to the bigger decisions in a person's life when empowerment could more quickly and effectively be promoted at the level of everyday practice, problems of communication and interpretation and the pervasiveness of teaching. We offer a range of suggestions as to how these obstacles might be tackled. [ABSTRACT FROM AUTHOR]

This paper asks, in the context of recent legislative changes, what can be done to support more citizens in England and Wales with learning disabilities to vote in national elections? This issue is addressed through (i) a review of recent disability access campaigns that have reported discrimination against, and the under-representation of, adults with disabilities in UK elections; (ii) a review of recent research undertaken in the USA into the assessment of competence to vote and research undertaken in England that conclusively documents the under-representation of voters with learning disabilities in the 2005 general election. It is proposed that a 'functional approach' to developing an individual's capacity to vote could help to fulfil Article 29 of the United Nations' Convention on the rights of persons with disabilities that gives all people the same political rights. [ABSTRACT FROM AUTHOR]

This paper presents a research report on an investigation into the reading eye movements of a bilingual 10-year, 10-month old girl with language impairment secondary to Downs Syndrome. Eye movement miscue analysis (Paulson, 2000) was employed to evaluate the visual sampling and oral productions of this child as she read from complete texts presented in Spanish and English. Results are presented in relationship to misconceptions manifest in the clinical practice of intervention providers. Based upon the research and this data, readers do not fixate on every word and the miscues they produce are not the result of failing to fixate on the text. [ABSTRACT FROM AUTHOR]

Background Four elementary (primary) school students with severe speech and physical impairments (SSPI) who used augmentative and alternative communication (AAC) aids were selected to take part in an intensive, 4-week summer intervention program. The program was designed to explore effective approaches, content and contexts for supporting communication (including oral language, literacy, and technology skills) among young people who require AAC. Method Features of the intervention included (i) using an integrated approach to provide language and literacy opportunities intended to elicit the students' active involvement in meaningful, productive and expressive tasks in everyday contexts; (ii) constant modelling of AAC usage; (iii) requiring family involvement as a criterion for participation in the program; and (iv) follow-up visits to schools during which effective instructional strategies were shared with staff. Results Formative and summative assessment measures revealed that all four participants made progress during intervention. However two of the students maintained these gains into the follow-up period, whereas the other two did not. Each pair seemed to share certain characteristics, which are illustrated in this paper by two case study synopses. One relates the story of a child whose successes continued into the follow-up period, and the other chronicles the experiences of the child whose successes quickly waned. Conclusions This study provides a range of instructional approaches, curricula and contexts to promote communication for children with complex communication needs. These instructional supports are more likely to improve access to inclusion in schools that seek to work in partnership with parents, plan educational transitions, and implement adequate training and awareness-raising among their staff. [ABSTRACT FROM AUTHOR]

Augmentative and alternative communication (AAC) holds the potential to enable people with severe oral communication impairments to participate more fully in society. However, despite the development of increasingly sophisticated communication aids, as well as recent UK policy initiatives aimed at improving access to them, some major obstacles stand in the way of the inclusory potential of AAC being realized to any significant degree. Drawing on findings of a research study that explored the experiences of people who use AAC, this paper looks at the various problems that people encounter in using communication aids. It identifies the lack of consistent, structured support as a key overarching issue. The author goes on to argue that for the potential of AAC to be realized attention needs to be given to the development of coordinated systems of support within the policy domains of education, health and social services. [ABSTRACT FROM AUTHOR]