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Abstract: Background: Information from speech and gesture is often integrated to comprehend a message. This integration process requires the appropriate allocation of cognitive resources to both the gesture and speech modalities. People with aphasia are likely to find integration of gesture and speech difficult. This is due to a reduction in cognitive resources, a difficulty with resource allocation or a combination of the two. Despite it being likely that people who have aphasia will have difficulty with integration, empirical evidence describing this difficulty is limited. Such a difficulty was found in a single case study by Cocks et al. in 2009, and is replicated here with a greater number of participants. Aims: To determine whether individuals with aphasia have difficulties understanding messages in which they have to integrate speech and gesture. Methods & Procedures: Thirty‐one participants with aphasia (PWA) and 30 control participants watched videos of an actor communicating a message in three different conditions: verbal only, gesture only, and verbal and gesture message combined. The message related to an action in which the name of the action (e.g., ‘eat’) was provided verbally and the manner of the action (e.g., hands in a position as though eating a burger) was provided gesturally. Participants then selected a picture that ‘best matched’ the message conveyed from a choice of four pictures which represented a gesture match only (G match), a verbal match only (V match), an integrated verbal–gesture match (Target) and an unrelated foil (UR). To determine the gain that participants obtained from integrating gesture and speech, a measure of multimodal gain (MMG) was calculated. Outcomes & Results: The PWA were less able to integrate gesture and speech than the control participants and had significantly lower MMG scores. When the PWA had difficulty integrating, they more frequently selected the verbal match. Conclusions & Implications: The findings suggest that people with aphasia can have difficulty integrating speech and gesture in order to obtain meaning. Therefore, when encouraging communication partners to use gesture alongside language when communicating with people with aphasia, education regarding the types of gestures that would facilitate understanding is recommended. [ABSTRACT FROM AUTHOR]

Background: No previously published research has investigated public awareness and knowledge ofRight Hemisphere Communication Disorders(RHCD). In comparison, there are a handful of published studies that have investigated public awareness and knowledge of aphasia. The results of these studies indicate that awareness and knowledge is low but has marginally increased in recent years, due to international efforts to raise the public profile of the disorder. Aims: The current study investigated public awareness and knowledge of RHCD and compared it to that of aphasia. Information regarding awareness and knowledge of stroke was also determined for those participants who did not have awareness of RHCD or aphasia. Methods & Procedures: A face-to-face survey of 87 members of the public was undertaken in North West London, United Kingdom. Outcomes and Results: Of the 87 survey respondents, only 9.2% reported having heard of RHCD and 4.6% met the criteria for having basic knowledge of this disorder. In comparison, 32.2% of participants had heard of aphasia and 24% had basic knowledge about it. While the results show that fewer people were aware and had knowledge of RHCD compared to aphasia, this difference was not significant. Of those participants who had heard of neither disorder, all had heard of and the majority had knowledge of stroke. Conclusions: The findings suggested that awareness of RHCD amongst members of the public is low. It is suggested that in order to improve quality of services, funding and social re-integration following a right hemisphere stroke, raising public awareness and knowledge is necessary. [ABSTRACT FROM AUTHOR]

This study explored age-related changes in gesture to better understand the relationship between gesture and word retrieval from memory. The frequency of gestures during tip-of-the-tongue (TOT) states highlights this relationship. There is a lack of evidence describing the form and content of iconic gestures arising spontaneously in such TOT states and a parallel gap addressing age-related variations. In this study, TOT states were induced in 45 participants from 2 age groups (older and younger adults) using a pseudoword paradigm. The type and frequency of gestures produced was recorded during 2 experimental conditions (single-word retrieval and narrative task). We found that both groups experienced a high number of TOT states, during which they gestured. Iconic co-TOT gestures were more common than noniconic gestures. Although there was no age effect on the type of gestures produced, there was a significant, task-specific age difference in the amount of gesturing. That is, younger adults gestured more in the narrative task, whereas older adults generated more gestures in the single-word-retrieval task. Task-specific age differences suggest that there are age-related differences in terms of the cognitive operations involved in TOT gesture production. [ABSTRACT FROM AUTHOR]

Accessible summary It is important to notice problems with eating, drinking and swallowing in people with a learning disability., People who have problems with eating, drinking and swallowing need support from staff to help them stay healthy., This study shows that training gives staff a better understanding and more confidence when identifying problems and supporting a person with eating, drinking and swallowing difficulties., Summary This study investigated the effectiveness of a 1-day dysphagia training package delivered to support workers who work with adults with a learning disability. Thirty-eight support staff took part in this study. Twenty-five support staff received training, and 13 did not receive training and therefore acted as a control group. Three questionnaires were completed by each participant: immediately before, immediately after and a month after the training delivery. Questionnaires measured both confidence and knowledge. Findings indicated that there was a significant increase in knowledge and confidence scores in the trained group. These increases were largely maintained over a 1-month period. There was no significant change in confidence or knowledge scores in the untrained group. [ABSTRACT FROM AUTHOR]

Background: Previous research has found that people with aphasia produce more spontaneous iconic gesture than control participants, especially during word-finding difficulties. There is some evidence that impaired semantic knowledge impacts on the diversity of gestural handshapes, as well as the frequency of gesture production. However, no previous research has explored how impaired semantic knowledge impacts on the frequency and type of iconic gestures produced during fluent speech compared with those produced during word-finding difficulties. Aims: To explore the impact of impaired semantic knowledge on the frequency and type of iconic gestures produced during fluent speech and those produced during word-finding difficulties. Methods & Procedures: A group of 29 participants with aphasia and 29 control participants were video recorded describing a cartoon they had just watched. All iconic gestures were tagged and coded as either “manner”, “path only”, “shape outline” or “other”. These gestures were then separated into either those occurring during fluent speech or those occurring during a word-finding difficulty. The relationships between semantic knowledge and gesture frequency and form were then investigated in the two different conditions. Outcomes & Results: As expected, the participants with aphasia produced a higher frequency of iconic gestures than the control participants, but when the iconic gestures produced during word-finding difficulties were removed from the analysis, the frequency of iconic gesture was not significantly different between the groups. While there was not a significant relationship between the frequency of iconic gestures produced during fluent speech and semantic knowledge, there was a significant positive correlation between semantic knowledge and the proportion of word-finding difficulties that contained gesture. There was also a significant positive correlation between the speakers’ semantic knowledge and the proportion of gestures that were produced during fluent speech that were classified as “manner”. Finally while not significant, there was a positive trend between semantic knowledge of objects and the production of “shape outline” gestures during word-finding difficulties for objects. Conclusions: The results indicate that impaired semantic knowledge in aphasia impacts on both the iconic gestures produced during fluent speech and those produced during word-finding difficulties but in different ways. These results shed new light on the relationship between impaired language and iconic co-speech gesture production and also suggest that analysis of iconic gesture may be a useful addition to clinical assessment. [ABSTRACT FROM AUTHOR]

Background Spatial communication consists of both verbal spatial language and gesture. There has been minimal research investigating the use of spatial communication, and even less focussing on people with aphasia. Aims The aims of this exploratory study were to describe the frequency and variability of spatial language and gesture use by three participants with aphasia in comparison to nine control participants. This included: 1) frequency of gestures; 2) types of gesture; 3) number of spatial descriptions described by gestures but no language; and 4) frequency and variety of locative prepositional, verb, and noun phrases. Methods & Procedures Each participant was videoed undertaking 11 spatial communication tasks: four description tasks, and seven tasks involving directing the researcher in the placement of objects or pictures. Gestures and language produced were transcribed and analysed. Outcomes & Results Participants with aphasia used significantly more gesture. Participants with aphasia also used more gesture without spoken phrases when spatial vocabulary was unavailable. Finally, there were differences between the participants with regards to the types of gesture that they used when they were unable to access language. Conclusion & Implications The results suggest that the analysis of gesture produced by people with aphasia may provide insight into their underlying language impairment. As this was an exploratory study, with just three participants with aphasia, further research is needed. [ABSTRACT FROM AUTHOR]

Background: Although several treatments for acquired reading difficulties exist, few studies have explored the effectiveness of treatment formildreading difficulties and treatment for reading difficulties associated with cognitive impairment. Aims: This study explored the effectiveness of an individual strategy-based reading treatment of 11 sessions given to a female participant (IW) who had mild reading difficulties following a subarachnoid haemorrhage (SAH). The impact of treatment on reading ability, confidence and emotions associated with reading were investigated. Methods & Procedures: Treatment focused on the use of strategies to support IW's memory when reading books, the use of a checklist to select appropriate reading materials, and methods for increasing IW's confidence in discussing the book she was reading with others. A person-centred approach and personally relevant materials were used throughout the treatment. Reading ability was assessed using the Gray Oral Reading Tests (GORT-4; Wiederholt & Bryant, 2001), and IW's perspective was obtained using the Reading Confidence and Emotions Questionnaire (RCEQ; see Cocks et al., 2010). Pre-treatment, post-treatment and maintenance (7 weeks post) assessments were undertaken, with an additional exit interview at the final time point. Outcomes & Results: Gains were noted in reading rate, accuracy, comprehension, and confidence, with parallel increased pleasure gained from reading and reduced negative emotions and frustration. Self-reported gains included conversing with others about material read, verbal communication, and re-engagement with the identity of being a reader. Conclusions: Strategy-based treatment resulted in positive gains in reading for pleasure, conversation, and identity, for an individual with mild chronic reading difficulties. Participant self-report and interview revealed the true value of this treatment for the individual. The positive results suggest that further research is warranted that investigates the effectiveness of strategy-based reading therapy approaches for others with acquired reading difficulties. [ABSTRACT FROM AUTHOR]

Background: Although several treatments for acquired reading difficulties exist, few studies have explored the effectiveness of treatment formildreading difficulties and treatment for reading difficulties associated with cognitive impairment. Aims: This study explored the effectiveness of an individual strategy-based reading treatment of 11 sessions given to a female participant (IW) who had mild reading difficulties following a subarachnoid haemorrhage (SAH). The impact of treatment on reading ability, confidence and emotions associated with reading were investigated. Methods & Procedures: Treatment focused on the use of strategies to support IW's memory when reading books, the use of a checklist to select appropriate reading materials, and methods for increasing IW's confidence in discussing the book she was reading with others. A person-centred approach and personally relevant materials were used throughout the treatment. Reading ability was assessed using the Gray Oral Reading Tests (GORT-4; Wiederholt & Bryant, 2001), and IW's perspective was obtained using the Reading Confidence and Emotions Questionnaire (RCEQ; see Cocks et al., 2010). Pre-treatment, post-treatment and maintenance (7 weeks post) assessments were undertaken, with an additional exit interview at the final time point. Outcomes & Results: Gains were noted in reading rate, accuracy, comprehension, and confidence, with parallel increased pleasure gained from reading and reduced negative emotions and frustration. Self-reported gains included conversing with others about material read, verbal communication, and re-engagement with the identity of being a reader. Conclusions: Strategy-based treatment resulted in positive gains in reading for pleasure, conversation, and identity, for an individual with mild chronic reading difficulties. Participant self-report and interview revealed the true value of this treatment for the individual. The positive results suggest that further research is warranted that investigates the effectiveness of strategy-based reading therapy approaches for others with acquired reading difficulties. [ABSTRACT FROM PUBLISHER]

There has been little research on the provision and adaptation of oral care for patients with dysphagia in nursing homes. This study collected data via a questionnaire specifically on the knowledge of oral hygiene and the current oral care practices for patients with dysphagia. Fifty-three registered nurses (RNs) completed the questionnaires. The results of the questionnaire indicated that although RNs gave more oral care daily to their patients with dysphagia than to their patients without dysphagia, they had limited knowledge of drugs that affect oral care and of medical conditions associated with poor oral hygiene. Of particular concern was the limited knowledge of the link between dysphagia, oral hygiene and pneumonia and that some of the current oral care practices may be putting patients who have dysphagia at increased risk of developing pneumonia. These results are discussed in light of previous research on the topic and recommendations are made with regards to oral care training. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists rarely analyse iconic gesture when assessing a client with aphasia, despite a growing body of research suggesting that language and gesture are part of either the same system or two highly integrated systems. This may be because there has been limited research that has systematically analysed iconic gesture production by people with aphasia. Aims: The aim was to determine whether the gesture production of a participant with conduction aphasia was able to provide information about her language system. Methods & Procedures: The iconic gestures produced by a participant with conduction aphasia (LT) and five control participants produced during the retelling of a cartoon were analysed. In particular, the iconic gestures produced during lexical retrieval difficulties (co-tip-of-the-tongue (co-TOT) gestures) were compared with the iconic gestures produced during fluent speech (co-speech gestures). Outcomes & Results: It was found that LT produced 57 co-speech gestures that were similar in form to the co-speech gestures produced by the control participants (mean = 34.2, standard deviation (SD) = 22.2). LT also produced an additional eleven co-TOT gestures that were unlike her co-speech gestures and unlike the co-speech gestures produced by the control participants. While the co-speech gestures depicted events, the co-TOT gestures depicted 'things' (for example, objects and animals). Furthermore, all but one of the co-TOT gestures produced by LT was classified as a shape-outline gesture, whereas co-speech gestures were rarely classified as shape-outline gestures. LT also produced a new type of gesture that has not previously been described in the literature: a homophone gesture. This co-TOT homophone gesture depicted the homophone of the target word. The iconic gestures produced by LT suggest that she had an intact semantic system but had difficulties with phonological encoding, consistent with a diagnosis of conduction aphasia. This raises the possibility that iconic gesture production can provide evidence about the level of breakdown in the language system. Conclusions & Implications: A larger study exploring the gestures produced by participants with aphasia is required. The research also highlights the importance of including gesture assessments in SLT's work with adults with acquired language disorder. [ABSTRACT FROM AUTHOR]

Background: In order to comprehend fully a speaker's intention in everyday communication, information is integrated from multiple sources, including gesture and speech. There are no published studies that have explored the impact of aphasia on iconic co-speech gesture and speech integration. Aims: To explore the impact of aphasia on co-speech gesture and speech integration in one participant with aphasia and 20 age-matched control participants. Methods & Procedures: The participant with aphasia and 20 control participants watched video vignettes of people producing 21 verb phrases in three different conditions, verbal only (V), gesture only (G), and verbal gesture combined (VG). Participants were required to select a corresponding picture from one of four alternatives: integration target, a verbal-only match, a gesture-only match, and an unrelated foil. The probability of choosing the integration target in the VG that goes beyond what is expected from the probabilities of choosing the integration target in V and G was referred to as multi-modal gain (MMG). Outcomes & Results: The participant with aphasia obtained a significantly lower multi-modal gain score than the control participants (p<0.05). Error analysis indicated that in speech and gesture integration tasks, the participant with aphasia relied on gesture in order to decode the message, whereas the control participants relied on speech in order to decode the message. Further analysis of the speech-only and gesture-only tasks indicated that the participant with aphasia had intact gesture comprehension but impaired spoken word comprehension. Conclusions & Implications: The results confirm findings by Records (1994) that reported that impaired verbal comprehension leads to a greater reliance on gesture to decode messages. Moreover, multi-modal integration of information from speech and iconic gesture can be impaired in aphasia. The findings highlight the need for further exploration of the impact of aphasia on gesture and speech integration. [ABSTRACT FROM AUTHOR]

Many people with intellectual disability live with swallowing, eating, and drinking difficulties (dysphagia). People living with both intellectual disability and dysphagia may require a range of supports in order to have the opportunity to participate in different eating and drinking environments of their choice. Understanding the nature of those supports is important to ensure that people with intellectual disability living with dysphagia can continue to create a good life for themselves at home and in their community. This study aimed to identify the nature of supports provided to people with intellectual disability and dysphagia when eating and drinking in different environments, as described in the published literature. A scoping review, underpinned by an a priori protocol, was conducted by a team of four reviewers. Four databases were searched. Sixteen papers were included for full‐text review. The review identified that studies most frequently reported support in the form of safety strategies to prevent the ill‐health consequences of dysphagia and training carers in those safety strategies by speech‐language pathologists. To a much lesser extent, studies identified the psychosocial needs of people with intellectual disability and dysphagia and how these were being considered in the design of training support. Overall, this review identified a significant need for future research into supports for eating outside the home and collaboration with people with intellectual disability and dysphagia about dysphagia training content which reflects the experience of living with dysphagia in social community environments. [ABSTRACT FROM AUTHOR]

Background: Discourse in adults with aphasia is increasingly the focus of assessment and therapy research. A broad range of measures is available to describe discourse, but very limited information is available on their psychometric properties. As a result, the quality of these measures is unknown, and there is very little evidence to motivate the choice of one measure over another. Aims: To explore the quality of a range of discourse measures, targeting sentence structure, coherence, story structure and cohesion. Quality was evaluated in terms of the psychometric properties of acceptability (data completeness and skewness), reliability (inter‐ and intra‐rater), and validity (content, convergent, discriminant and known groups). Methods & Procedures: Participants with chronic mild‐to‐moderate aphasia were recruited from community groups. They produced a range of discourses which were grouped into Cinderella and everyday discourses. Discourses were then transcribed orthographically and analyzed using macro‐ and microlinguistic measures (Story Grammar, Topic Coherence, Local Coherence, Reference Chains and Predicate Argument Structure—PAS). Data were evaluated against standard predetermined criteria to ascertain the psychometric quality of the measures. Outcomes & Results: A total of 17 participants took part in the study. All measures had high levels of acceptability, inter‐ and intra‐rater reliability, and had good content validity, as they could be related to a level of the theoretical model of discourse production. For convergent validity, as expected, 8/10 measures correlated with the Western Aphasia Battery—Revised (WAB‐R) spontaneous speech scores, and 7/10 measures correlated with the Kissing and Dancing Test (KDT) scores (r ≥ 0.3), giving an overall positive rating for construct validity. For discriminant validity, as predicted, all measures had low correlations with Raven's Coloured Progressive Matrices (RCPM) and WAB‐R Auditory Verbal Comprehension scores (r < 0.3), giving an overall positive rating for construct validity. Finally, for known groups validity, all measures indicated a difference between speakers with mild and moderate aphasia except for the Local Coherence measures. Overall, Story Grammar, Topic Coherence, Reference Chains and PAS emerged as the strongest measures in the current study because they achieved the predetermined thresholds for quality in terms of each of the psychometric parameters profiled. Conclusions & Implications: The current study is the first to psychometrically profile measures of discourse in aphasia. It contributes to the field by identifying Story Grammar, Topic Coherence, Reference Chains and PAS as the most psychometrically robust discourse measures yet profiled with speakers with aphasia. Until further data are available indicating the strength of other discourse measures, caution should be applied when using them. [ABSTRACT FROM AUTHOR]

Abstract: Background: Speech pathologists have a pivotal role in palliative care, assisting patients with swallowing and communication disorders, yet very little is known about the preparedness of speech pathologists to work in this field. Aims: To investigate the preparedness of speech pathologists for working in palliative care. The term ‘palliative care’ was viewed as an encompassing umbrella term incorporating the management/reduction of symptoms and improvement in a person's quality of life at any point of the disease progression. Methods & Procedures: Participants were Australian‐trained speech pathologists who provided adult palliative care services. An online questionnaire was used to gather both quantitative and qualitative data from practising speech pathologists. Qualitative data were analysed and interpreted using conventional content analysis. Descriptive statistics were analysed via the Statistical Package for the Social Sciences (SPSS) for Windows Version 22. Non‐parametric tests (chi‐square and Mann–Whitney U‐test) were used for further analysis. Outcomes & Results: The majority (70%) of participants indicated that their university training did not prepare them to practice in palliative care. Participants who received palliative care education at the tertiary level were significantly more prepared to work with palliative patients than those who had not; however, only a minority (27%) had received such training. Just over half (57%) reported having completed post‐university professional development in palliative care. The speech pathologist's role in palliative care was also highlighted, with speech pathologists outlining their contribution to the assessment of patients’ communication and swallowing abilities. In addition, recommendations for palliative care content to be incorporated into university curriculum were suggested. Conclusions & Implications: Speech pathologists can make important contributions to end‐of‐life care, but there is much scope for improving the availability and quality of university and post‐university palliative care training opportunities so that people receiving palliative care are best supported. [ABSTRACT FROM AUTHOR]

Background Discourse is fundamental to everyday communication, and is an increasing focus of clinical assessment, intervention and research. Aphasia can affect the information a speaker communicates in discourse. Little is known about the psychometrics of the tools for measuring information in discourse, which means it is unclear whether these measures are of sufficient quality to be used as clinical outcome measures or diagnostic tools. Aims To profile the measures used to describe information in aphasic discourse, and to assess the quality of these measures against standard psychometric criteria. Methods & Procedures A scoping review method was employed. Studies were identified using a systematic search of Scopus, Medline and Embase databases. Standard psychometric criteria were used to evaluate the measures' psychometric properties. Main contribution The current review summarizes and collates the information measures used to describe aphasic discourse, and evaluates their quality in terms of the psychometric properties of acceptability, reliability and validity. Seventy-six studies described 58 discourse information measures, with a mean of 2.28 measures used per study (SD = 1.29, range = 1-7). Measures were classified as 'functional' measures ( n = 33), which focused on discourse macrostructure, and 'functional and structural' measures ( n = 25), which focused on micro-linguistic and macro-structural approaches to discourse. There were no reports of the acceptability of data generated by the measures (distribution of scores, missing data). Test-retest reliability was reported for just 8/58 measures with 3/8 > 0.80. Intra-rater reliability was reported for 9/58 measures and in all cases percentage agreement was reported rather than reliability. Per cent agreement was also frequently reported for inter-rater reliability, with only 4/76 studies reporting reliability statistics for 12/58 measures; this was generally high (>.80 for 11/12 measures). The majority of measures related clearly to the discourse production model indicating content validity. A total of 36/58 measures were used to make 41 comparisons between participants with aphasia (PWA) and neurologically healthy participants (NHP), with 31/41 comparisons showing a difference between the groups. Four comparisons were made between discourse genres, with two measures showing a difference between genres, and two measures showing no difference. Conclusions There is currently insufficient information available to justify the use of discourse information measures as sole diagnostic or outcome measurement tools. Yet the majority of measures are rooted in relevant theory, and there is emerging evidence regarding their psychometric properties. There is significant scope for further psychometric strengthening of discourse information measurement tools. [ABSTRACT FROM AUTHOR]

Primary objective: To further examine the proposed relationship between executive impairments in inhibitory control and social communication difficulties reflecting poor inhibition following TBI. Method: Inhibitory control was assessed in 14 adults with TBI on the Hayling Sentence Completion Test (HSCT). Errors on Part B (failed inhibition) and Part B-Part A response latencies (delayed inhibition) were examined. A relative, friend or frequent communication partner of each participant with TBI completed the La Trobe Communication Questionnaire (LCQ) on the communication difficulties of the person with TBI. The Inhibitory Control Factor (ICF) score of the LCQ based on seven items relating to poor inhibition was specifically analysed against performance on the HSCT. Results: Multiple regression analysis indicated that 58% (51% adjusted) of the variance in LCQ ICF scores was accounted for by measures on the HSCT. Only B–A response latencies on the HSCT explained a significant proportion of the variability in LCQ ICF scores. Conclusions: Reduced inhibition speed may more strongly contribute to disinhibited communication behaviours than failures in inhibition. These findings contribute to understanding of the cognitive processes underlying social communication and have the potential to support and inform the use and development of management practices for individuals following TBI. [ABSTRACT FROM PUBLISHER]

Background Social perception is an important skill. One assessment that is commonly used to assess social perception abilities is The Awareness of Social Inference Test (TASIT). The only normative data available for this test are for Australian younger adults. Despite no normative data being available for British adults, the test is widely used in the UK with older and younger adults. There is a growing body of research that suggests that older adults have difficulty with skills associated with social perception. There is therefore a need to determine whether British adults, and more specifically British older adults, perform similarly to the Australian normative TASIT scores available in the manual. Aims To explore the differences between older and younger British adults' performance on TASIT, and to determine whether younger and older British adults perform similarly to the data from Australian adults in TASIT manual. Methods & Procedures TASIT was administered to a total of 42 native British English speaking participants. The participants were split into two age groups 18-45 and 60-90 years. Comparisons were made between the two groups and the Australian data in TASIT manual. Outcomes & Results The younger British and Australian adults obtained similar scores on all parts of TASIT. The older British adults though, obtained significantly lower scores than the Australian younger adults on all parts of TASIT and when education was controlled for they obtained significantly lower scores than the British younger adults. Conclusions & Implications The findings are discussed in the light of previous research that has found that older adults are worse than younger adults at social inferences. The findings of the current study suggest that caution should be used when using TASIT with older British adults to assess social perception abilities. [ABSTRACT FROM AUTHOR]

Conversations are an important part of our daily lives, enabling us to interact with others and participate in a range of activities. For people with Parkinson's, conversation can be challenging when communication is impacted. This qualitative exploratory study investigated the experiences of people with Parkinson's and their close communication partners in conversations. The study explored influences on conversational participation, considering perceived barriers and facilitators to participation in conversation for people with Parkinson's. Interviews were conducted with eight dyads, with participants interviewed both jointly and separately (24 interviews). Five themes revealed that conversation appears to be influenced not only by the communication skills of the person with Parkinson's, but also by factors associated with the communication partner, the complex nature of conversations, the communication environment, and the impact of experience in shaping participation in conversation. Specific barriers and facilitators to conversational participation were identified. This study offers important insight into the lived experience of people with Parkinson's affected by communication difficulties. The findings support the notion that it is more than simply the communication skills of the person with Parkinson's that influence conversations. It is important that other factors influencing conversational success should be included in interventions supporting communication for people with Parkinson's. [ABSTRACT FROM AUTHOR]

Aim: To explore the range and use of communication strategies by Parkinson's nurse specialists, and describe key communication strategies, to support health professionals in their healthcare interactions with people with Parkinson's. Design: A qualitative descriptive study. Methods: Due to the COVID‐19 pandemic, the study took place in an online setting. Online semi‐structured interviews were conducted with eight Australian Parkinson's nurse specialists and one UK Parkinson's nurse between August and October of 2020. Interviews explored healthcare communication, specifically (1) ways Parkinson's nurse specialists support communication during healthcare interactions, (2) factors influencing the use of communication strategies, and (3) how the nurses learned to communicate effectively with people with Parkinson's disease. Reflexive thematic analysis was used to analyse the data. Results: Parkinson's nurse specialists described the importance of establishing strong therapeutic relationships, the key role of the communication partner, adapting communication to reduce cognitive load, ensuring two‐way understanding, and enabling expressive communication for people with Parkinson's. Knowing the person and family, knowing the disease and understanding the symptoms appeared to influence the choice of communication strategies in healthcare interactions. Learning through others, learning through experience and learning through education and research were considered important parts of becoming a skilled healthcare communicator when working with people with Parkinson's. Conclusion: Knowledge and use of effective communication strategies to support people with Parkinson's is crucial for all health professionals working with this population, in order to reduce the occurrence of poor healthcare outcomes. A deep understanding of how Parkinson's disease affects communication and experience in implementing communication strategies were reported as contributing to the success of Parkinson's nurses in communicating with their patients. Impact This study provides a description of the key, translational communication strategies that can be used by all health professionals to support healthcare interactions with people with Parkinson's. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the authors investigated whether gesture, naming, and strategic treatment improved the communication skills of 14 people with severe aphasia. Method: All participants received 15 hr of gesture and naming treatment (reported in a companion article [Marshall et al., 2012]). Half the group received a further 15 hr of strategic therapy, whereas the remaining 7 participants received no further input. The effects of therapy on communication were assessed with 2 novel measures. These measures required each participant to convey simple messages and narratives to his or her communication partner. In both assessments, a subset of the stimuli featured items that had been targets in gesture or naming treatment. Results: Performance on the communication measures was stable over 2 baseline assessments but improved after gesture and naming treatment. Those participants who received additional strategic therapy made further gains on the message but not on the narrative task. Communication gains were not specific to the stimuli featuring trained items. Conclusions: This study suggests that gesture and naming treatments can benefit interactive communication. The additional benefits of strategic therapy were less clear-cut but did have an impact on the transmission of simple messages. Gains seem to reflect the development of general communication skills rather than the use of trained gestures and/or words. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the authors (a) investigated whether a group of people with severe aphasia could learn a vocabulary of pantomime gestures through therapy and (b) compared their learning of gestures with their learning of words. The authors also examined whether gesture therapy cued word production and whether naming therapy cued gestures. Method: Fourteen people with severe aphasia received 15 hr of gesture and naming treatments. Evaluations comprised repeated measures of gesture and word production, comparing treated and untreated items. Results: Baseline measures were stable but improved significantly following therapy. Across the group, improvements in naming were greater than improvements in gesture. This trend was evident in most individuals' results, although 3 participants made better progress in gesture. Gains were item specific, and there was no evidence of cross-modality cueing. Items that received gesture therapy did not improve in naming, and items that received naming therapy did not improve in gesture. Conclusions: Results show that people with severe aphasia can respond to gesture and naming therapies. Given the unequal gains, naming may be a more productive therapy target than gesture for many (although not all) individuals with severe aphasia. The communicative benefits of therapy were not examined but are addressed in a follow-up article. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the authors (a) investigated whether a group of people with severe aphasia could learn a vocabulary of pantomime gestures through therapy and (b) compared their learning of gestures with their learning of words. The authors also examined whether gesture therapy cued word production and whether naming therapy cued gestures. Method: Fourteen people with severe aphasia received 15 hr of gesture and naming treatments. Evaluations comprised repeated measures of gesture and word production, comparing treated and untreated items. Results: Baseline measures were stable but improved significantly following therapy. Across the group, improvements in naming were greater than improvements in gesture. This trend was evident in most individuals' results, although 3 participants made better progress in gesture. Gains were item specific, and there was no evidence of cross-modality cueing. Items that received gesture therapy did not improve in naming, and items that received naming therapy did not improve in gesture. Conclusions: Results show that people with severe aphasia can respond to gesture and naming therapies. Given the unequal gains, naming may be a more productive therapy target than gesture for many (although not all) individuals with severe aphasia. The communicative benefits of therapy were not examined but are addressed in a follow-up article. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan.Method: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level.Results: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6-52.7) for drooling, 50.4% (95% CI 36.0-64.8) for swallowing problems, and 53.5% (95% CI 40.7-65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding.Interpretation: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life.What This Paper Adds: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP. [ABSTRACT FROM AUTHOR]

Background: The WHO definition of trachomatous trichiasis (TT) is “at least one eyelash touching the globe, or evidence of recent epilation of in-turned eyelashes”, reflecting the fact that epilation is used as a self-management tool for TT. In Fiji’s Western Division, a high TT prevalence (8.7% in those aged ≥15 years) was reported in a 2012 survey, yet a 2013 survey found no TT and Fijian ophthalmologists rarely see TT cases. Local anecdote suggests that eyelash epilation is a common behaviour, even in the absence of trichiasis. Epilators may have been identified as TT cases in previous surveys. Methods: We used a preliminary focus group to design an interview questionnaire, and subsequently conducted a population-based prevalence survey to estimate the prevalence of epilation in the absence of trichiasis, and factors associated with this behaviour, in the Western Division of Fiji. Results: We sampled 695 individuals aged ≥15 years from a total of 457 households in 23 villages. 125 participants (18%) reported epilating their eyelashes at least once within the past year. Photographs were obtained of the eyes of 121/125 (97%) individuals who epilated, and subsequent analysis by an experienced trachoma grader found no cases of trachomatous conjunctival scarring or trichiasis. The age- and sex- adjusted prevalence of epilation in those aged ≥15 years was 8.6% (95% CI 5.7–11.3%). iTaukei ethnicity, female gender, and a higher frequency of drinking kava root were independently associated with epilation. Conclusion: Epilation occurs in this population in the absence of trichiasis, with sufficient frequency to have markedly inflated previous estimates of local TT prevalence. Individuals with epilated eyelashes should be confirmed as having epilated in-turned eyelashes in an eye with scarring of the conjunctiva before being counted as cases of TT. [ABSTRACT FROM AUTHOR]

A significant body of evidence from cross-linguistic and developmental studies converges to suggest that co-speech iconic gesture mirrors language. This paper aims to identify whether gesture reflects impaired spoken language in a similar way. Twenty-nine people with aphasia (PWA) and 29 neurologically healthy control participants (NHPs) produced a narrative discourse, retelling the story of a cartoon video. Gesture and language were analysed in terms of semantic content and structure for two key motion events. The aphasic data showed an influence on gesture from lexical choices but no corresponding clausal influence. Both the groups produced gesture that matched the semantics of the spoken language and gesture that did not, although there was one particular gesture–language mismatch (semantically “light” verbs paired with semantically richer gesture) that typified the PWA narratives. These results indicate that gesture is both closely related to spoken language impairment and compensatory. [ABSTRACT FROM PUBLISHER]

Background: Conveying instructions is an everyday use of language, and gestures are likely to be a key feature of this. Although co-speech iconic gestures are tightly integrated with language, and people with aphasia (PWA) produce procedural discourses impaired at a linguistic level, no previous studies have investigated how PWA use co-speech iconic gestures in these contexts. Aims: This study investigated how PWA communicated meaning using gesture and language in procedural discourses, compared with neurologically healthy people (NHP). We aimed to identify the relative relationship of gesture and speech, in the context of impaired language, both overall and in individual events. Methods & Procedures: Twenty-nine PWA and 29 NHP produced two procedural discourses. The structure and semantic content of language of the whole discourses were analysed through predicate argument structure and spatial motor terms, and gestures were analysed for frequency and semantic form. Gesture and language were analysed in two key events, to determine the relative information presented in each modality. Outcomes & Results: PWA and NHP used similar frequencies and forms of gestures, although PWA used syntactically simpler language and fewer spatial words. This meant, overall, relatively more information was present in PWA gesture. This finding was also reflected in the key events, where PWA used gestures conveying rich semantic information alongside semantically impoverished language more often than NHP. Conclusions: PWA gestures, containing semantic information omitted from the concurrent speech, may help listeners with meaning when language is impaired. This finding indicates gesture should be included in clinical assessments of meaning-making. [ABSTRACT FROM AUTHOR]

Background: Using gesture as a compensatory communication strategy may be challenging for people with severe aphasia. Therapy can improve skills with gesture, at least in elicitation tasks, but gains ar often modest. Raising the treatment dose with technology might improve outcomes. Aims: This feasibility study developed a computer gesture therapy tool (GeST), and piloted it with nine people who have severe aphasia. It aimed to determine whether practice with GeST would improve gesture production and/or spoken naming. It also explored whether GeST encouraged independent practice and was easy to use. Methods & Procedures: Pilot participants had 6 weeks practice with GeST, flanked by pre- and post-therapy tests of gesture and word production. Usability was explored through interviews and structured observations, and the amount of time spent in the programme was monitored. Outcomes & Results: Scores on the gesture test were evaluated by 36 independent raters. Recognition scores for gestures practised with the tool improved significantly after therapy and the gain was maintained. However, gains were small and only occurred on items that were practised with regular therapist support. There was no generalisation to unpractised gestures and no effect on spoken naming. Usability results were positive. Participants undertook an average of 64.4 practice sessions with GeST, and the average session length was just under 14 minutes. Conclusions: GeST was proved to be easy and enjoyable to use and had some effect on participants’ gesturing skills. Increasing the magnitude of gains would be desirable. The effect on everyday communication needs to be explored. [ABSTRACT FROM AUTHOR]

Cognitive impairment is acknowledged as a feature of Parkinson's disease (PD), and the most common cognitive declines are in executive function (EF) and memory. Cognitive reserve (CR) may offer some protection against cognitive dysfunction in PD. The present study used two proxies of CR (years of education, premorbid IQ) to examine the relationship between CR and (i) EF (ii) memory in a large PD sample (n = 334). Two aspects of EF were examined, including verbal fluency and planning skills. Two aspects of verbal memory were examined, including immediate recall and delayed recall. For EF, both CR proxies significantly predicted verbal fluency, but only years of education predicted planning skills. Years of education significantly predicted immediate recall, but premorbid IQ did not. Neither CR proxy predicted delayed recall. These findings suggest that CR, in particular years of education, may contribute to EF and memory function in those with PD. A key finding of this study is the varying contribution of CR proxies to different aspects of the same cognitive domain. The findings indicate that using only one proxy has the potential to be misleading and suggest that when testing the relationship between CR and cognition, studies should include tasks that measure different aspects of the cognitive domain(s) of interest. [ABSTRACT FROM AUTHOR]