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Many studies support the notion of semantic and/or pragmatic difficulties in people with mental illness. This paper describes a framework (based on a discourse analysis model) for the assessment and reassessment of communication in mentally ill persons.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Unfortunately, in spite of the advances in foetal and perinatal medicine in the last twenty years, the incidence of cerebral palsy has remained unchanged (1.5-2.5 per 1000 live births). It has even possibly risen slightly in premature babies of low birth weight, in parallel with the increased survival of these babies. In spite of modern techniques of rehabilitation, 25% of these patients cannot walk and 35% are mentally retarded. This costs society 5,000 million dollars annually, not counting the loss of opportunity and the emotional and economic burden imposed on these families. The development of new preventive measures such as the use of antagonists of the cortical excitatory amino acids (which when in excess may cause irreversible cerebral damage in cases of hypoxic-ischaemic encephalopathy of the new born). Intramuscular botulinum toxin and continuous intrathecal baclofen seem to promise a reduction in the incidence and functional incapacity of cerebral palsy.
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Three questions are raised with respect to the use of sign language as an alternative system of communication for nonverbal autistic children. First, does teaching a child to sign facilitate speech development? The data suggest that following simultaneous communication training, mute children are not likely to learn to talk; however, a combination of simultaneous communication training and separate vocal training may have a synergetic effect on speech development. In contrast, children who initially have good verbal imitation skills apparently show gains in speech following simultaneous communication training alone. Second, what is the upper limit of sign acquisition? Data suggest that abstract concepts, syntax, and generative skills can be taught. Procedures used in the operant conditioning of speech may prove useful in training complex signing skills. Third, does sign acquisition result in a general improvement in adaptive functioning? It appears that following sign training, some children do show increases in spontaneous communication, decreases in self-stimulatory behavior, and improvement in social skills. However, these outcomes are often difficult to interpret. Some data are described that help clarify the relationship between sign training and general behavioral improvement.
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Using simultaneous communication (speech plus gesture), each of four nonverbal autistic children were taught the receptive and expressive use of eight signed words. In a within-subject comparison, each child was taught four words expressively (signing) first and then receptively, and four other words receptively first and then expressively (signing). The results indicated (1) that it took fewer trials to teach expressive and receptive use when teaching was done in the order expressive then receptive; (2) the teaching of expressive use facilitated the learning of receptive use; (3) the teaching of receptive use interfered with the learning of expressive use; and (4) by the end of training, good receptive control by the spoken word alone, had developed.
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Twelve nonverbal, hearing, retarded children were matched and then randomly assigned to sign language training, speech training, and placebo groups. Four of the subjects received speech training using the Bricker. Dennison, and Bricker (1976) program, and four subjects received sign language training using an adaptation of the Bricker et al. program. The results indicated no statistically significant difference between the verbal and sign language groups through the sign group and verbal group did learn significantly more than the placebo group. A closer examination of the findings indicated that although all four of the sign language subjects learned some signs, only two of the four speech training subjects learned to say words. The findings were interpreted as indicating that some nonverbal retarded children will benefit from sign language than speech training. Suggestions for the direction of future research are given.
Generalization of verbal behavior by autistic-type children across physically different settings was assessed. Four boys learned responses to common questions in two settings at school and were probed to determine transfer of learning to home. Three of the children demonstrated little generalization to home when trained in a cubicle. Greater generalization was indicated when they received training at varied locations. The fourth child generalized most responses to his home regardless of training setting. Simple manipulations of the school environment to more closely simulate home conditions may facilitate transfer of training to the natural environment.
If one understands the physical manifestation of minor depressions or multiple functional disorders in the elderly as being indirectly expressed dissatisfaction because of unfulfilled aims in life, a practical recovery process is necessary in order to confront the underlying psychic process. The aging person has to come to terms with his eventual demise. If he faces this, he will have a chance at renewed energy to accomplish incomplete aims. Many people need help in order to continue the recovery process. Even if speech or reflexive possibilities are inhibited, it is possible accomplish therapy by the medium of sound, which is a preverbal language. Music therapy is able to work at a psychotherapeutic level in persons seemingly unable to be influenced by conventional psychotherapeutic-methods. Two case studies with different techniques (singing of well known songs and free improvisation) illustrate this theses.
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Simultaneous sign and spoken language training was conducted with young, language-disordered children under standardized training and follow-up conditions with a stringent learning criterion to determine if language learned was stable over time. Twenty-one children between 36 and 86 months with no or nonfunctional language participated in the study. Diagnoses included autism, mental retardation, combined autism and mental retardation, and developmental aphasia. Children completed a mean of 74 signed speech training sessions. Sessions were twice daily, 5 days a week. Follow-up evaluations were made approximately 6 months after training. Of the 21 children, 17 learned at least one word and 7 children learned multiple-word phrases during the training. Most language learned in training was found to be retained at follow-up approximately 6 months later. Gestural imitation, play style, language age, developmental age, and fine motor skills had strong correlations with language learning and retention.