Biomedical subjects

Ralf W Schlosser

Publications and source records attributed to Ralf W Schlosser.

8 recordsLinked to original sources

PubMed2006

Asking well-built questions for evidence-based practice in augmentative and alternative communication.

UNLABELLED: Evidence-based practice (EBP) is increasingly being advocated as the preferred approach to practice in augmentative and alternative communication (AAC). The EBP process involves multiple steps. The asking of a well-built question is the first step in the quest for answers. At the same time it is also often the first stumbling block for practitioners. To facilitate the asking of well-built questions it may be helpful to follow a template. The most frequently used template is PICO, which stands for patient, intervention, comparison, and outcome [Richardson, W., Wilson, M., Nishikawa, J., & Hayward, R. (1995). The well-built clinical question: A key to evidence-based decisions. ACP Journal Club, 123, A12-A13]. In this article, we examine the suitability of the PICO template for AAC in terms of the representativeness of the components, and the appropriateness of its subcomponents, and their terminology. Based on this analysis, we propose the PESICO template, which stands for person, environments, stakeholders, intervention, comparison, and outcome. This template is then illustrated with examples representing a range of decision-making areas in AAC. Finally, directions for future research are provided. LEARNING OUTCOMES: The reader will be able to: (1) appreciate the importance of asking well-built questions, (2) name the shortcomings of the PICO template, and (3) describe the components of the proposed PESICO template for asking well-built questions.

Adult↗

PubMed2006

Assessing correspondence following acquisition of an exchange-based communication system.

Two students with developmental disabilities were taught to request six snack items. Requesting involved giving a graphic symbol to the trainer in exchange for the matching snack item. Following acquisition, we assessed the correspondence between requests and subsequent item selections by requiring the student to select the previously requested snack item from an array containing all six items. The effects of acquisition training were evaluated in a multiple-probe across subjects design. Acquisition was achieved in from 9 to 29 trials per item. Following acquisition, Jason showed a high level of correspondence between requesting and selecting, but Ryan required additional training to achieve correspondence. These data support the use of exchange-based communication systems, but suggest that some students may require explicit correspondence training.

Adolescent↗

PubMed2006

The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review.

PURPOSE: This article presents the results of a meta-analysis to determine the effect of augmentative and alternative communication (AAC) on the speech production of individuals with developmental disabilities. METHOD: A comprehensive search of the literature published between 1975 and 2003, which included data on speech production before, during, and after AAC intervention, was conducted using a combination of electronic and hand searches. RESULTS: The review identified 23 studies, involving 67 individuals. Seventeen of these studies did not establish experimental control, thereby limiting the certainty of evidence about speech outcomes. The remaining 6 studies, involving 27 cases, had sufficient methodological rigor for the "best evidence analysis" (cf. >R. E. Slavin, 1986). Most of the participants (aged 2-60 years) had mental retardation or autism; the AAC interventions involved instruction in manual signs or nonelectronic aided systems. None of the 27 cases demonstrated decreases in speech production as a result of AAC intervention, 11% showed no change, and the majority (89%) demonstrated gains in speech. For the most part, the gains observed were modest, but these data may underestimate the effect of AAC intervention on speech production because there were ceiling effects. CONCLUSIONS: Future research is needed to better delineate the relationship between AAC intervention and speech production across a wider range of participants and AAC interventions.

Adolescent↗

PubMed2006

Concomitant use of the matrix strategy and the mand-model procedure in teaching graphic symbol combinations.

Matrix strategies employing parts of speech arranged in systematic language matrices and milieu language teaching strategies have been successfully used to teach word combining skills to children who have cognitive disabilities and some functional speech. The present study investigated the acquisition and generalized production of two-term semantic relationships in a new population using new types of symbols. Three children with cognitive disabilities and little or no functional speech were taught to combine graphic symbols. The matrix strategy and the mand-model procedure were used concomitantly as intervention procedures. A multiple probe design across sets of action-object combinations with generalization probes of untrained combinations was used to teach the production of graphic symbol combinations. Results indicated that two of the three children learned the early syntactic-semantic rule of combining action-object symbols and demonstrated generalization to untrained action-object combinations and generalization across trainers. The results and future directions for research are discussed.

Child↗

PubMed2004

Effects of speech and print feedback on spelling by children with autism.

In this systematic replication of a previous study (R. W. Schlosser, D. M. Blischak, P. J. Belfiore, C. Bartley, and N. Barnett, 1998), the effects of speech and print feedback on spelling performance were evaluated. Four children with autism and no functional speech were taught to spell words with a speech-generating device under 3 feedback conditions. In the auditory-visual condition, children received both speech and print feedback, whereas in the auditory and visual conditions, only 1 type of feedback was provided. An adapted alternating treatments design was used. All 4 children reached criterion across conditions. Although 3 children reached criterion first with print or speech-print feedback, 1 child was most efficient with speech-print followed by speech feedback. Based on the findings of both studies, 2 distinct profiles of feedback efficiency are proposed. Children that exemplify the primarily visual profile spell words most efficiently when feedback involves print. Children that fit the auditory profile spell words most efficiently when feedback involves speech. The implications for understanding the learning characteristics of children with autism, as well as those for practice and further research are derived.

Autistic Disorder↗

PubMedDate not supplied

Goal attainment scaling as a clinical measurement technique in communication disorders: a critical review.

UNLABELLED: Evaluation of client progress is an important topic in communicative disorders research and clinical literature. Goal attainment scaling (GAS) is a technique for evaluating individual progress toward goals. Despite recognition of GAS as a clinical-outcome assessment technique in other clinical professions, the current debate on measuring client progress and outcome measurement in communication disorders has largely ignored GAS. The purpose of this paper is threefold: (a) to introduce GAS to the field of communication disorders, (b) to offer a critical review, and (c) to explore directions for harnessing the value of GAS for the field. In addition to the ability of GAS to evaluate individualized longitudinal change, it offers the following positive attributes: (a) grading of goal attainment, (b) comparability across goals and clients through aggregation, (c) adaptability to any International Classification of Functioning, Disability, and Health levels and domains, (d) versatility across populations and interventions, (e) linkage tied to expected outcomes, (f) facilitator of goal attainment, and (g) a focal point for team energies. The unique value of GAS could render this technique as a welcomed addition to the present set of options available to clinicians interested in assessing progress and evaluating change. Reliability and validity of GAS will be discussed. Finally, directions for harnessing the potential of GAS for communication disorders are offered for clinical practice and clinical-outcome research. LEARNING OUTCOMES: (1) As a result of this activity, the participant will be able to delineate the steps involved in GAS. (2) As a result of this activity, the participant will be able to describe the positive attributes of GAS as a method for assessing client progress. (3) As a result of this activity, the participant will be able to identify issues that enhance the reliability and validity of GAS.

Communication Disorders↗

PubMedDate not supplied

Augmentative and alternative communication interventions for persons with developmental disabilities: narrative review of comparative single-subject experimental studies.

Augmentative and alternative communication (AAC) as an area of clinical and educational practice involves a myriad of decisions related to the symbols, devices, and strategies from which each client must choose. These decision-making points can be productively informed through evidence from comparative intervention studies. The purpose of this review was to synthesize comparative AAC intervention studies using single-subject experimental designs involving participants with developmental disabilities. Following a systematic search, each qualifying study was reviewed in terms of a priori determined appraisal criteria, and summarized in tabular format. Studies were divided into three groups according to their study of aided approaches, unaided approaches, or a combination of both. Results are discussed in terms of methodological adequacy of the studies and their implications for future research and practice.

Child↗

PubMedDate not supplied

Use of information-seeking strategies for developing systematic reviews and engaging in evidence-based practice: the application of traditional and comprehensive Pearl Growing. A review.

BACKGROUND: Efficient library searches for research evidence are critical to practitioners who wish to engage in evidence-based practice (EBP) as well as researchers who seek to develop systematic reviews. AIMS: This review will propose the benefits of the search technique 'Pearl Growing' ('Traditional Pearl Growing') as well as an adaptation of this technique ('Comprehensive Pearl Growing'), until now ignored by the literature on EBP and systematic reviews, to aid in the retrieval of research evidence. These search techniques are illustrated with examples from the field of augmentative and alternative communication. MAIN CONTRIBUTIONS: Traditional Pearl Growing is proposed as an important addition to the arsenal of EBP search strategies for practitioners. The literature on Traditional Pearl Growing is extended in that EBP presents a newly identified purpose for this technique and the benefits in identifying appropriate quality filter goes beyond its previously exclusive focus on keywords. Comprehensive Pearl Growing is projected as a new strategy for researchers searching for studies to be included in systematic reviews. Not only does it provide data-based guidance in selecting effective keywords and quality filters, but also it provides appropriate databases. CONCLUSIONS: Although the techniques Traditional Pearl Growing and Comprehensive Pearl Growing are believed to be useful for locating research evidence in any field, it may be particularly important for interdisciplinary topics where the use of effective controlled vocabulary plays a greater role in bringing together evidence that may be scattered across databases.

Communication Disorders↗