Cases reported "Communication Disorders"

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11/35. A comparison of multiple reinforcer assessments to identify the function of maladaptive behavior.

    Functional analysis results indicated that maladaptive behaviors displayed by a 25-year-old man with profound mental retardation were maintained by attention from caregivers and possibly, to a lesser degree, by access to tangible items. A concurrent-schedules procedure was then used to study the relative reinforcing value for maladaptive behavior of attention versus tangible items. Results of the concurrent-schedules assessment and subsequent functional communication training indicated that preference for attention versus access to a tangible object varied.
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ranking = 1
keywords = communication
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12/35. 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.
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ranking = 5
keywords = communication
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13/35. Development of communication and speech skills after cochlear implant in a sign language child.

    In selecting patients to undergo cochlear implant, a pre-existing use of sign language gives rise to two problems that have been widely debated in the literature. First, the caution shown toward the candidacy of patients using this mode of communication, since it is considered a possible element of interference in the acquisition of speech. Secondly, refusal of the cochlear implant procedure, on the part of the deaf community, on the grounds both of cultural identity and of it being more "natural" for a deaf person to use an unimpaired visual channel rather than an impaired hearing channel. In order to establish whether knowledge of sign language does, indeed, affect speech production negatively and evaluate which mode of communication, oral or gestual, is preferred, the present investigation was carried out on a preverbal deaf child who had undergone cochlear implant at about 7 years of age and has always used both languages. His verbal skills were evaluated in the precochlear implant stage, then at 6 and 12 months after, together with the changes in his use of sign language and in the relationship between the two modes. Results, besides observing the presence of linguistic evolution at each level examined and already evident at 6 months, also documented a progressive reduction in the spontaneous use of sign language. In conclusion, the present experience revealed no temporal or qualitative differences in post-cochlear implant evolution of speech skills, in comparison with that observed in patients with an exclusively aural-oral approach. Furthermore, the increased use of the hearing pathway, made possible by cochlear implant, determined a spontaneous choice of verbal language as the most natural and economic mode of communication.
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ranking = 7
keywords = communication
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14/35. Determining decision-making capacity in individuals with severe communication impairments after stroke: the role of augmentative-alternative communication (AAC).

    A speech-language pathologist and occupational therapist specializing in assistive technology were requested to assess an individual 2 years post hemorrhagic lesion in his brainstem, with significant medial issues, limited expressive communication skills, and motor function. The family wanted to determine if he had an adequate quality of life and whether he could provide informed consent if asked about the continuation or withdrawal of medical treatment to maintain his life. Issues discussed include determining competency for decision making regarding quality of life with individuals who cannot speak, write, or type, and what role the speech-language pathologist and occupational therapist can play in attempting to find these answers. A means of communication for this individual was identified that allowed him to provide information related to his preferences including physical state. Use of appropriate augmentative-alternative communication equipment and techniques became the means to further explore more complex medical decisions for this individual.
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ranking = 11
keywords = communication
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15/35. Speech and language therapy in hyperactivity: a United Kingdom perspective in complex cases.

    In the United Kingdom, multidisciplinary teams within the National health Service (NHS) usually manage children and adolescents with disorders of hyperactivity. These multidisciplinary teams do not routinely include speech and language therapists (SLTs), and therefore speech and language therapy services for children and adolescents with disorders of hyperactivity are limited. Consequently, research and service delivery for children and adolescents with disorders of hyperactivity in the United Kingdom is only starting to emerge. Two case studies are used to show how speech and language therapy in the United Kingdom can be involved in the treatment of hyperactivity through various types of service delivery. The cases are used to highlight the importance of detecting speech, language, and communication impairments in children with diagnoses of hyperactivity. The potential role of speech and language therapy in the assessment and management of these clients in the United Kingdom is discussed.
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ranking = 1
keywords = communication
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16/35. research directions in augmentative and alternative communication for preschool children.

    PURPOSE: To review issues related to the use of augmentative systems with young children and present a case study of one child and family's experience with the System for Augmenting Language (SAL). METHOD: The case involved a preschool child with severe developmental delays who had little functional speech. Acquisition and use of graphic symbols on a speech-output communication device was studied in home and clinical settings. Language and communication behaviours of the child and his communication partners were observed and language assessment measures were collected. RESULTS: child engagement state varied across the two settings with a stable profile seen in the therapy setting and a clear increase at home. child communicative attempts increased following the introduction of the augmented system. parents reported successful use of the SAL. CONCLUSION: SAL is a viable communication intervention approach for young children.
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ranking = 8
keywords = communication
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17/35. Assessing and managing medically fragile children: tracheostomy and ventilatory support.

    Over the past decade, there has been an increase in premature births. Children born prematurely often present with complex medical conditions; some require a tracheostomy. Although many children with tracheostomies require assistance to achieve effective communication, speech-language pathologists may have limited information with respect to the medical issues and communication needs of this population. The purpose of this article is twofold. First, a review of basic information on tracheostomy and ventilatory support in the pediatric population is provided. Second, information on the assessment of communication skills and intervention specific to voice for the child with a tracheostomy is detailed. Two case studies are presented. The case studies illustrate the diversity and medical complexity common to this population and provide practical information for the clinician working with a child with a tracheostomy.
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ranking = 3
keywords = communication
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18/35. ADHD couple and family relationships: enhancing communication and understanding through Imago Relationship Therapy.

    This article reviews the relationship deficits experienced by many individuals who have attention deficit hyperactivity disorder (ADHD) and proposes effective strategies, based on Imago Relationship Therapy (IRT), to assist them in communicating more effectively. The neurological underpinnings of the disorder often contribute to the development of poor social and communication skills and can lead to a lifetime of relationship difficulties. IRT, a brain-based approach, is compatible with the neurological challenges of living with ADHD because it slows the communication process, provides structure, reduces reactivity, and helps individuals to be fully present so that their loved one can feel fully heard and understood. The couple's dialogue strengthens relationships by encouraging the development of stronger listening skills, better self-control, and problem solving. Two case examples illustrate the clinical methods used.
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ranking = 6
keywords = communication
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19/35. "Do I know what I need to do?" A social communication intervention for children with complex clinical profiles.

    PURPOSE: Speech-language pathologists frequently address social communication difficulties in children with diverse clinical profiles. The purpose of this study was to investigate the feasibility of a social communication intervention for a school-age child with a complex cognitive and behavioral profile secondary to diagnosis of a fetal alcohol spectrum disorder. METHOD: A case study is presented to describe the implementation of the intervention targeting mental state verb production and social cognitive skills. The intervention included group role play of social scripts and a checklist to elicit the participant's statements about others' perspectives and strategies for completing the social script. Treatment data monitored the participant's responses to the checklist questions. Probe sessions, consisting of theory of mind false belief tasks, were used to examine mental state verb use. RESULTS: Treatment data demonstrated that the participant stated more strategies in response to checklist questions. The participant did not produce any mental state verbs during baseline probes, but did produce mental state verbs during the treatment phase. CLINICAL IMPLICATIONS: The results support use of this intervention to change children's linguistic and social cognitive skills. Suggestions for extending this intervention to include a generalization plan targeting classroom social communication interactions are provided.
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ranking = 7
keywords = communication
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20/35. Examining communication repairs of 2 young children with autism spectrum disorder: the influence of the environment.

    PURPOSE: The purpose of this study was to examine the repair strategies of 2 young children with autism spectrum disorder from an environmental rather than a developmental perspective. METHOD: A scripted protocol that included opportunities for requests and repair was followed. The environmental variables investigated were activity type (e.g., puzzle, shapes, book) and breakdown type (i.e., request for clarification, wrong response, and ignore). The sessions were videotaped, and each child's behavior was coded. RESULTS: The results revealed that (a) both participants repaired the majority (70%) of their unsuccessful initial requests and (b) the repair strategies varied across children, activities, and breakdowns. CONCLUSIONS: The findings of this study suggest that the 2 young children with autism and limited expressive language discriminated among environmental variables (i.e., type of activity and type of breakdown). The participants modified their repair topographies to correspond to changes in the environment. The findings from this study offer ways to enhance assessment and intervention of early communication. Implications for future research and practice are discussed.
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ranking = 5
keywords = communication
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