1/15. Development and assessment of school-age and adolescent children with human immunodeficiency virus.This article presents a review of the literature regarding the communication problems of school-age children with hiv-infection and the impact of the psychosocial and emotional reactions of these children on their social relationships. An overview of the effects of hiv infection on the central nervous system is followed by descriptions of how hearing, oral motor function, speech, language, reading and written language may be affected.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
2/15. Psychosocial issues in pediatric human immunodeficiency virus.This article discusses the psychosocial issues associated with pediatric human immunodeficiency virus and acquired immunodeficiency syndrome (hiv/AIDS). Using a psychosocial model instead of the usual medical or rehabilitation model will challenge speech-language pathologists to incorporate an understanding of the psychosocial stresses that affect a child's progression through hiv/AIDS and ensure that they receive adequate consideration in a total treatment model. A case study illustrates the relationship between communication disorders and hiv/AIDS.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
3/15. Accessibility of spoken, written, and sign language in landau-kleffner syndrome: a linguistic and functional MRI study.landau-kleffner syndrome (LKS) is an acquired aphasia which begins in childhood and is thought to arise from an epileptic disorder within the auditory speech cortex. Although the epilepsy usually subsides at puberty, a severe communication impairment often persists. Here we report on a detailed study of a 26-year old, left-handed male, with onset of LKS at age 5 years, who is aphasic for English but who learned British sign language (BSL) at age 13. We have investigated his skills in different language modalities, recorded EEGs during wakefulness, sleep, and under conditions of auditory stimulation, measured brain stem auditory-evoked potentials (BAEP), and performed functional MRI (fMRI) during a range of linguistic tasks. Our investigation demonstrated severe restrictions in comprehension and production of spoken English as well as lip-reading, while reading was comparatively less impaired. BSL was by far the most efficient mode of communication. All EEG recordings were normal, while BAEP showed minor abnormalities. fMRI revealed: 1) powerful and extensive bilateral (R > L) activation of auditory cortices in response to heard speech, much stronger than when listening to music; 2) very little response to silent lip-reading; 3) strong activation in the temporo-parieto-occipital association cortex, exclusively in the right hemisphere (RH), when viewing BSL signs. Analysis of these findings provides novel insights into the disturbance of the auditory speech cortex which underlies LKS and its diagnostic evaluation by fMRI, and underpins a strategy of restoring communication abilities in LKS through a natural sign language of the deaf (with Video)- - - - - - - - - - ranking = 3keywords = speech (Clic here for more details about this article) |
4/15. 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.- - - - - - - - - - ranking = 5keywords = speech (Clic here for more details about this article) |
5/15. 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.- - - - - - - - - - ranking = 7keywords = speech (Clic here for more details about this article) |
6/15. 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.- - - - - - - - - - ranking = 2keywords = speech (Clic here for more details about this article) |
7/15. 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.- - - - - - - - - - ranking = 5keywords = speech (Clic here for more details about this article) |
8/15. Evaluating a computer system used as a microswitch for word utterances of persons with multiple disabilities.PURPOSE: To assess the effectiveness of a computer system used as a microswitch for word utterances of two adults with multiple disabilities. The system combined a new control software programme with a commercially available speech recognition programme. METHOD: Nine word utterances were targeted for each participant. The participant's emission of those utterances triggered the occurrence of related (favourite) stimuli during the intervention and the post-intervention check. RESULTS: Intervention data showed that (1) the participants increased the frequencies of the target utterances and (2) the computer system recognized about 80% of those utterances correctly, providing the participants with high levels of favourite stimulation. The post-intervention check showed comparable data with both participants. CONCLUSIONS: The computer system proved an adequate microswitch for word utterances. Based on this evidence, microswitch programmes could be extended beyond the use of conventional motor responses.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
9/15. 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.- - - - - - - - - - ranking = 2keywords = speech (Clic here for more details about this article) |
10/15. 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.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
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