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Communication disorders following closed head injury: new approaches to assessment and rehabilitation.

In this paper communication disorders following closed head injury are described and various forms of language assessment techniques are reviewed. The usefulness of conventional, pragmatic and cognitive approaches is considered. A new cognitive-pragmatic approach is then advocated which is an amalgam of the last two approaches. From the examples given it is argued that such an approach is practical in terms of: 1) incorporating knowledge of co-existing cognitive deficits; and 2) focusing on normal everyday communication practices. It is also suggested that the use of a cognitive-pragmatic framework has potential in refining remediation and management strategies with the closed-head-injured population.

Aphasia↗

Eradication of communicative disorders: preventive medicine in the 21st century.

Profound changes in our society occurring over the past few decades have resulted in a major shift in societal emphasis from labor to communication. The widespread use of personal computers has enhanced the importance of information-communication in daily life. People with communication disorders are at substantial risk of underemployment and lowered quality of life. Advances in medical science and hearing health care have placed us on the thresholds of being able to correct, rather than remediate, certain types of hearing loss. The finding that auditory hair cells of submammalian species regenerate has stimulated greatly the field of auditory research. A new lexicon is required to describe this emerging field. Methods exist to protect against hearing loss, repair affected structures prior to their degeneration, promote dedifferentiation-redifferentiation of undamaged structures into sensory cells, and, finally, promote regeneration of new sensory cells from precursor cells. Each of these processes has unique requirements, and all may be required to promote the restoration of hearing following damage or disease.

Cochlea↗

The relationship of communication disorders to syndrome identification.

Though birth defects and malformation syndromes often result in serious communication disorders, there has been relatively little input towards the study and delineation of congenital anomalies from speech and hearing sciences. By identifying a particular congenital malformation syndrome, the clinician is able to understand the possible symptoms which may be found in the syndrome, the progression and course of the syndrome, and its eventual prognosis. Understanding the full spectrum of possible symptoms may lead the clinician to search for anomalies which may not be readily apparent on first examination. Knowing a syndrome's progression and course, the clinician can devise realistic treatment plans in terms of both content and timing. Finally, the ability to provide a prognosis allows the clinician to counsel parents and professionals about the expected effects of treatments as well as the course of development. A partial catalogue of speech and hearing disorders associated with over 100 syndromes is included.

Congenital Abnormalities↗

Building partnerships with parents of school-age children with communication disorders.

This article discusses the strategies for building partnerships with parents and for achieving collaboration among parents, teachers, and speech-language pathologists, all of whom are agents who will influence the process of the child's speech-language learning process. The changes in educational philosophy and related laws, and in the role of parents, are discussed. Common concerns of parents of children with communication disorders are discussed.

Child↗

Expressive communication disorders in persons with multiple sclerosis: a survey.

The purpose of this study was to survey individuals with multiple sclerosis to determine (1) the presence and severity of their expressive communication disorders, (2) the extent expressive communication problems interfere with employment, and (3) the frequency of using communication augmentation equipment. An eight-page questionnaire was distributed to 656 persons diagnosed as having multiple sclerosis, who returned completed questionnaires. Twenty-three percent of the total sample reported the presence of "speech or other communication problems." Four percent of the total sample indicated that strangers were unable to understand them. Of this group 28.8% reported that they used communication augmentation equipment.

Adult↗

The University of Texas at Dallas/Callier Center for Communication Disorders Doctor of Audiology Program.

PURPOSE: The purpose of this article is to describe the history and resources of the doctor of audiology (AuD) program at the University of Texas at Dallas (UTD)/Callier Center for Communication Disorders, as well as to provide an overview of the program. METHOD: Data from 1999, when the AuD program was approved by the Texas Higher Education Coordinating Program, to the present were reviewed. CONCLUSIONS: The UTD/Callier Center AuD program includes more than 40 faculty members, spans 3 campuses, and has 8 research laboratories. Total enrollment is 32 students (8 students are admitted each year for the 4-year program). Students have access to extensive resources and learning opportunities. The clinical and research programs at the UTD/Callier Center are actively involved in providing high-quality, in-depth education to future doctors of audiology.

Audiology↗

A case-control study of EAS child and parental temperaments in selectively mute children with and without a co-morbid communication disorder.

Clarification of sub-groups of children with selective mutism (SM) may enhance the understanding of symptom development. The present case-control study compares temperament characteristics applying EAS temperament survey in SM children with a co-morbid communication disorder (CoD), SM children without CoD and matched controls. Temperament characteristics in the parents are compared as well. The results show that SM children with CoD are characterized by more emotional stability and higher sociability than SM children without CoD. The parents of the SM children with CoD did not differ in temperament characteristics from the control parents. The parents of the SM children without CoD differed from the controls on the Distress, Fear and Activity scales. The study suggests different familial transmission in the two sub-groups of children with SM.

Case-Control Studies↗

Telecommunication relay services: linking nurses to patients with communication disorders.

Telecommunication relay service (TRS) is a lifeline for deaf, deaf-blind, hard-of-hearing, and speech-disabled persons. Nurses who are technology shy and unfamiliar with TRS fail to integrate this simple telephone process into their pursuit of quality healthcare outcomes for patients with communication disorders. This article aims to increase home care nurses' awareness, comfort, and use of TRS.

Communication Devices for People with Disabilities↗

Nature-based therapy: its potential as a complementary approach to treating communication disorders.

Nature-based therapy (NBT) has been incorporated into the practice of many medical and mental health professions. Occupational therapists, physical therapists, nurses, social workers, psychologists, and to a lesser extent, speech-language pathologists have used NBT practices as a complementary means of treating a variety of physical, emotional, and cognitive disorders. This article includes a description of NBT and the three types that comprise the practice and a review of the literature demonstrating the use of NBT in the general population and, more specifically, with individuals with neurogenic communication disorders. It concludes with a discussion of directions for future research of NBT.

Adaptation, Psychological↗

Process-oriented treatment of right hemisphere communication disorders.

Lacking knowledge about the cognitive processes that underlie communication impairments in patients with right hemisphere damage (RHD) and driven by increasingly limited treatment duration, speech-language pathologists often give little thought to process-oriented treatment. However, operating from a theoretical perspective in which treatment targets the processes that underlie symptoms can result in more effective treatment of a range of symptoms due to a common processing impairment. This article provides research-driven therapeutic approaches based on sound theoretical perspectives that can be combined with task-specific therapy to maximize therapeutic outcomes with this clinical population.

Brain Diseases↗

[Communicative disorders and voluntary regulation of activity in children with schizophrenia].

Experimental psychological investigation of the peculiarities of voluntary regulation of activity was performed in 106 schizophrenic children and adolescents compared to a group of age-matched (7 to 16 years) healthy persons. Voluntary regulation of activity was studied in its relation to the communicative disorders characteristic of schizophrenic patients. The investigation was designed with due consideration of the subjects interaction and communication with the partner-experimenter. Different degrees of communication in mutual activity involved a variety of disorders in voluntary regulation of activity which had different strength and importance for the child's development.

Adolescent↗

BOEL screening: a program for the early detection of communicative disorders. Preliminary reports from a study on 1,000 Finnish infants.

Programs for infant screening of communicative disorders should cover the need for information about the development of attention functions--auditory, visual and tactile at an age when the child is on the doorstep of speech acquisition, i.e. before 1 year of age. BOEL is a new screening test, constructed to cheek the capacity of giving priority to signals for hearing, sight and motor attention in infants around 8 months of age. The child's innate program to follow an interesting signal, grasp it and investigate it with his mouth, turn his head after it, and smile responsively is tested with the help of two visual stimuli and four sound sources, ranging between 4 000 and 12 500 Hz. BOEL is meant to be used within the routine health check-ups of, for example, well-baby clinics.

Child Behavior↗

Treating memory problems in adults with neurogenic communication disorders.

Historical approaches to memory therapy have focused on rehearsal or "relearning" of memory skills and on compensation for impairments. Whereas the use of rehearsal-based approaches has received little empirical support, the use of external compensatory devices has proved helpful to patients with a variety of neurogenic communication disorders. More recent approaches have capitalized on advances in cognitive psychology, permitting the identification of strengths and weaknesses in specific memory functions, and increasing our understanding of the role of response errors in the therapy process. These advances, together with applied behavioral analysis, allow therapy to be tailored to the cognitive profile of an individual patient, and help explain the successes and failures of earlier techniques. In this article, both historical and current approaches are discussed, and memory therapy guidelines are suggested.

Brain↗

[Communication disorders in the practice of Department of Phoniatrics ad Audiology in Poznań].

The relations between audiology and phoniatrics which formed the base for the present name of Poznań Department of Phoniatrics and Audiology are presented. It is specific for this Department to include the olfacto-gustometry into clinical evaluation of sensory organs. The periodic "Informacje Foniatryczne" which were published in 1966-1972 in our Department were exception in the history of Polish phoniatrics. The communications disorders should be inspected by rehabilitation team: phoniatrician, psychologist and logopedist, but the leading role is left for the physician. The prevention, prophylaxis and rehabilitation of professional voice disorders is one of the main social goals for audiology and phoniatrics.

Academic Medical Centers↗

Communication disorders: investigator training and support needs.

There are very few "simple problems" left in the area of communication disorders, but that does not mean that there are unsolvable problems. However, in pursuit of these, present day research often requires extensive technical procedures which require teams of investigators trained in different areas. Among these should be the otolaryngologist, but, in this country, there are few involved and there is a paucity of disease-oriented research. In the 1950s and 1960s the NIH training grant provided funds for bringing doctor of philosophy researchers into clinical departments to set up laboratories and work intimately with the medical doctor. Basic research training is still essential during residency and the number of postresidency fellowships ought to be increased. The familiarity with clinical problems introduced into the research effort should improve the possibility for the conduction of disease-oriented research in addition to the present day emphasis on basic research.

Animals↗