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Communication augmentation systems: quantification in natural settings.

Although observation in clinical settings of communication augmentation system use by severely physically handicapped nonspeaking persons is important, monitoring of such use in natural settings can yield valuable information about the system, communication frequency, and unique communication needs of the individual. This study was designed to evaluate the use of communication partners as data recorders. For nonspeaking, severely physically handicapped subjects were observed in the home, school or treatment settings by a trained observer and a minimally trained communication partner. Issues of partner training and length of time required to obtain a representative sample of communication arose as a result of this study. More work in the areas of automated data collection systems or use of communication partners as data collectors is required before claiming that accurate communication interactions can be recorded in natural settings.

Adolescent

Partner sensitivity to communication behavior of young children with developmental disabilities.

Aspects of partner sensitivity to communication behaviors of 24 presymbolic children with developmental disabilities were examined. The children were grouped according to their movement abilities (normal vs. abnormal patterns) and communication status (intentional vs. preintentional). Participating communication partners were those with whom the children interacted on a regular basis and included their mothers, early childhood special educators, and speech-language pathologists. Procedures were developed whereby the partners served as informants in order to provide information regarding (a) recognition of the children's communicative cues and (b) consistency of cue recognition and descriptions across partners. Results indicated wide individual variability in the partners' basic recognition abilities as well as their consistency with each other. Further, the observed variations could not be attributed to the children's movement and communication abilities. It was concluded that sensitivity, as measured in the present investigation, was highly partner-child specific, with some children likely to be exposed to more optimal interactions than others.

Child, Preschool

Predicting contraceptive behavior among college students: the role of communication, knowledge, sexual anxiety, and self-esteem.

Undergraduate students were surveyed about their sexual behavior and contraceptive behavior. In addition, measures of their self-esteem, knowledge about contraception, communication with their dating partners, communication about sexual matters with their sexual partners, and sexual anxiety were taken. Consistent with Byrne's (1983) model of effective contraception, it was found that general and sexual communication with one's partner were significant predictors of contraception use. Directional, but statistically weak, support was obtained for the predictions that knowledge about contraception and sexual anxiety would be related to contraception use. No support was found for the prediction that general self-esteem would be associated with contraceptive behavior.

Anxiety

Communication aids for children: procedures and problems.

This paper describes the organisation and procedures of the Communication Aids Centre for children at the Wolfson Centre, London, including a model for assessment and recommendation of appropriate aids, such as symbol charts, switches and speech synthesisers. Of the children seen over an 18-month period, most had cerebral palsy and two-thirds were wheelchair-dependent. Almost half were assessed before the age of five years. A detailed follow-up of nine children is presented which reveals how long children may have to wait for the provision of an aid in the UK. Possible problems in establishing use of an aid are discussed; these include inadequate training of children and their communication partners. Suggestions for future improvements of communication-aids services are explored.

Adolescent

[Communicative and social behavior of speech disordered children].

The spheres covering behaviour disorders, social behaviour and communicative behaviour of speech impaired pupils which until now have been analyzed on a more theoretical level, ought to be studied using psychometric testing procedures and an esperimental observational situation in order to gain base data with which to set up a concrete catalogue of aims (learning program) based on the deficits thereby obtained. The study took place at the special school in Esslinger-Berkheim (Baden-Wurttemberg). By taking into account relevant specialized literature and the results of other studies, the following general hypotheses were advanced, namely, that the communication of speech handicapped children is troubled in respect of its content and relation, and that their social behaviour shows more egoistic than cooperative features. In order to determine social motivations and attitudes, we used Muller's "Social Motivation Test" (SMT) and Jorger's "Group test for the social attitude" (S-E-T). Due to the inconsistency between the attitudes measured by means of psychometric methods and the sbusequent free and genuine behaviour, an observational situation was developed during which the pupils, either in pairs or in groups of four and using puppets, took turns in thinking up a story, discussing the plot, roles, etc. and finally putting on the play. The whole was then analyzed by means of tape recordings and film shots, the interaction of the communicating partners being analyzed and categorized in two separate assessment stages: communicative behaviour and social behaviour. The pragmatic axioms of P. Watzlawick, the communication researcher, functioned as theoretical background. Flanders's linear time diagram was used as assessment system. Communicative and social learning aims were prepared in accordance with confirming hypotheses to enable a "preliminary area" for the practical work in (special) education to be defined. In addition, a rough outline was made of the conditional areas pertaining to social and communicative education of the speech impaired for the purpose of carrying out a systematic change.

Child

Family-centered early intervention: an opportunity for creative practice in speech-language pathology.

Services for developmentally delayed children from birth to age three consider the family first. Eligibility for services is determined through a multidisciplinary assessment. Once a child qualifies for service, a multidisciplinary team that includes the family develops an IFSP. The SLP may serve as the service coordinator for the plan or as a team member. The plans must contain specific information that includes documentation of current status and major outcomes for the coming year. An SLP may find that contributing effectively to an IFSP requires new competencies. First, the SLP will need to learn to function in the family-centered, multidisciplinary process of early intervention. Second, the SLP may need to develop creative models to deliver effective service. SLPs can contribute valuable information to the IFSP by finding ways to activate daily life routines to promote a child's communication skills. SLPs can explore the child's life-space, including routines and partners, as a source of contexts for treatment. SLPs also can explore partner communication strategies, note their effects on the child's communication experiences, and recommend additional strategies for treatment. The case study illustrated an individual, home-based intervention program (Gillette, 1989; Lombardino and Magnan, 1983). Other service delivery models can include classroom-based approaches (Wilcox, Kouri, and Caswell, 1991); group parent training approaches (Weistuch, Lewis, and Sullivan, 1991; Cheseldine and McConkey, 1979); and video-assisted approaches (McConkey, 1988; Johnson and Harrison, 1990; Gillette, in press). Many SLPs may find that the process of early intervention with the birth-to-three population offers unique opportunities for practice in their profession. To function effectively in this process, the SLP needs communication-based information to promote the child's communication skills within his or her daily life and sensitivity with which to design a plan that considers the family first, yet meets the needs of the child. Although alternative models of delivering speech-language service have been explored, the process of early intervention will continue to require professionals who can creatively match family priorities with the child's intervention needs.

Child

Effects of SV40 transformation on intercellular gap junctional communication in human fibroblasts.

The effect of SV40 viral transformation of human fibroblasts on intercellular gap junctional communication (IJC) was investigated using a short-term quantitative assay. IJC was measured using metabolic cooperation in a coculture system of argininosuccinate synthetase- and argininosuccinate lyase-deficient human fibroblasts. These cell lines were transformed with origin-defective adenovirus/SV40 recombinant virions, and IJC was determined both between transformed cells (homologous IJC) and between transformed and untransformed cells (heterologous IJC). At equivalent cell densities, homologous IJC between transformed cells was reduced to 25-55% of the level between untransformed cells. Intermediate levels of IJC (50-70% of normal) were observed in heterologous cocultures of transformed with untransformed cells. Transformed and untransformed cells were equally sensitive to inhibition of IJC by phorbol esters and by glycyrrhetinic acid, and also did not differ in the degree of upregulation of IJC by forskolin. We conclude that SV40 transformation of human fibroblasts leads to a partial impairment of IJC which is additive when both communicating partners are transformed.

Cell Communication

Cell-to-cell communication competence in simian virus 40-transfected rat ovarian cells is reduced following tumor selection.

A pSV3neo-transfected rat ovarian cell line (SV-GC) was developed from a primary granulosa culture (GC) to study gap junctional intercellular communication (GJIC) during Simian virus 40 (SV40) transformation. SV-GC expressed SV40 large T-antigen (T-ag), grew indefinitely in culture without luteinization, was anchorage independent, and formed tumors in nude mice. Ultrastructural analysis identified abundant gap junctional membrane and suggested that SV-GC was arrested at an early stage of differentiation. Functional GJIC, measured by a dye transfer technique (gap FRAP), was comparable to that observed in normal granulosa cells, suggesting that the expression of T-ag alone was insufficient to reduce GJIC. However, there was approximately a 50% loss in the rate of GJIC in the nude mouse SV-GC-tumor derived and G418 selected cell line (T-SV-GC). SV-GC----T-SV-GC also resulted in a transition from migration of cells as an epithelial sheet to the dissociation of individual fibroblastoid cells. Tumor cell detachment was also seen in migrating malignant human (A2780 and 547) and rat (DC3) ovarian cell lines. Co-culture combinations of normal (GC)----transformed (SV-GC)----tumor-derived (T-SV-GC) cells indicated that the rate of heterologous GJIC was characteristic of the least communicating partner. Taken together, these data suggested that SV-GC----T-SV-GC represented progression toward metastasis with concomitant reduction of GJIC and adhesiveness. These sequentially derived cell lines may be a useful in vitro model system for studies focusing on the mechanism involved in the detachment of cells during the progression of ovarian cancer.

Animals

[Speech intelligibility and psychosocial adaptation in various voice rehabilitation methods following laryngectomy].

Intelligibility and psychosocial adjustment are measured by the PLTT (Post-Laryngectomy-Telephone-Test) and a newly developed questionnaire (FPAL). 110 male patients with total or partial laryngectomies are tested. Three different groups are compared with each other: laryngectomees with voice prostheses, laryngectomees with oesophageal voice or artificial larynx, and patients with partial laryngectomies. As was to be expected, intelligibility (single words and sentences) was best in patients with partial laryngectomies. The intelligibility of the laryngectomees with voice prostheses is significantly higher than the intelligibility of patients with oesophageal voice or artificial larynx. There was no difference between the groups with regard to the subjective assessment of intelligibility in relation to various communication partners. Partial laryngectomies have the lowest negative impact on the social and psychological situation of the patients. Laryngectomees, however, are more lonely, indicate more psychological stress in social interactions, and have a less positive evaluation of their life. Statistical analyses reveal no difference in psychosocial adjustment between laryngectomees with voice prostheses, oesophageal voice and artificial larynges.

Adaptation, Psychological

[Subjective and objective voice assessment following partial resection of the larynx].

There is no generally accepted, standardized approach for evaluation of voice quality and of intelligibility after partial laryngectomy. A voice evaluation which considers some aspects of voice quality is possible by assessing physical and acoustic voice parameters. But this approach does not consider how the patient subjectively assesses his postoperatively altered voice and how the patient believes he is understood by various communication partners. In this study objective and subjective variables of the voice quality of 32 patients with partial laryngectomies were measured. First, selected physical and acoustic variables of voice quality were quantified. Second, subjective criteria of voice quality and of intelligibility were assessed by a questionnaire. A significant correlation between variables of objective and subjective voice quality was found. The maximum vocal intensity, the maximum pitch, and the intensity range correlated significantly with the subjective assessment of intelligibility. No relationship was found between the acoustic variables and the subjectively perceived degree of vocal disability.

Humans

Emotional communication in close relationships.

Emotional communication patterns characterizing interactions between partners in close relationships were investigated by asking 29 couples who were married or living together to engage in a videotaped discussion of a problem they were having in their relationship. In a later experimental session, partners identified specific communications that they believed had an important influence on the discussion and then rated the communications in terms of the feelings the communicator intended to convey and the recipient's reactions. Partners attempted to reciprocate both the positive and negative feelings that they perceived their partner to express toward them. However, only negative feelings were actually reciprocated. This was because subjects were sensitive to differences in the negative feelings their partners reported expressing and interpreted those feelings correctly, but they were inaccurate in perceiving their partners' expressions of positive feelings. Men (but not women) interpreted their partners' failures to express love as an indication of hostility, whereas women (but not men) interpreted their partners' lack of hostility as an indication of love. These and other results were conceptualized in terms of a general model of emotional communication. Parameters of the model pertaining to the hostility of partners' communications were often related to women's satisfaction with their relationship and their beliefs about relationships in general. However, they were unrelated to men's satisfaction and general beliefs. This suggested that women are generally more adversely affected by overt expression of hostility than are men.

Adolescent

Does choice make a difference to contraceptive use? Evidence from east Java.

This study investigates sustained use of contraceptives among women in East Java, Indonesia. Interest is focused on the effect of whether the client's choice of contraceptive method was granted or denied, and the interaction between whether choice was granted or denied and husband-wife concurrence concerning method choice. Data were collected twice in a panel survey. The first round was conducted in family planning clinics among women initiating contraceptive use; the second was a follow-up household survey carried out 12 months later. Whether the user was granted her choice of method was found to be a very important determinant of sustained use of contraceptives. The interaction between whether choice was granted and whether there was husband-wife concurrence on method choice was also important. The highest rate of discontinuation occurred when method choice was denied in the presence of husband-wife agreement on method choice, and the lowest rate occurred when method choice was granted in the presence of such concurrence. The results imply that contraceptive continuation can be enhanced either when family planning workers pay more attention to the stated desires of their clients, or when policy is instituted allowing clients to use their method of choice.

Choice Behavior

Sex therapy for erectile dysfunction: characteristics of couples, treatment outcome, and prognostic factors.

Outcome and prognostic factors were studied in 36 couples who entered sex therapy because of the male partners' erectile dysfunction. Treatment was completed by two thirds. Noncompletion was associated with lower socioeconomic status, the female partner having a history of psychiatric treatment, pretreatment poorer motivation of the male partner, poor communication in the general relationship, and less sexual pleasure experienced by the female. A positive treatment outcome occurred in 69.4%, and was associated with better pretreatment communication and general sexual adjustment, especially the female partner's interest and enjoyment of sex, absence of a positive psychiatric history in the female partner, and a couple's early engagement in homework assignments. Results highlight important aspects of the initial assessment, indicate couples for whom the initial phase of treatment should be prolonged and modified or an alternative approach considered, and have implications for assignment of couples to treatment groups in evaluative studies of therapy.

Adult

Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome.

A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.

Abdomen

Initiation of prenatal care by adolescents. Associations with social support, stress, and Hispanic ethnicity.

The purpose of this study was to determine the social factors associated with initiation of prenatal care by adolescents. Eighty-one postpartum adolescents aged 17 years and under were interviewed within 24 hours of delivery about background factors, living situation, experiences, and behaviors during pregnancy. Of the adolescents, 58 were of Hispanic (Mexican) origin; the remainder were non-Hispanic whites. The first prenatal visit occurred at a mean of 4.04 months' gestation for Hispanics and 4.39 months' gestation for the non-Hispanics, one month after the pregnancy test. Differences between the ethnic groups were not significant. Controlling for ethnicity, both age and social support from the partner and his family were associated with initiation of care (P less than .01). In a separate analysis, age and partner-family support were unaffected by the introduction of stress and parental support (P less than .01). These findings highlight the importance of the partner and his family as a source of support to pregnant adolescents. To whom and when the adolescent communicates about the pregnancy may be the key linking social support to initiation of prenatal care. Providers who work with sexually active adolescents should emphasize the importance of early communication with partners and with family members if a pregnancy is suspected.

Adolescent