Thesis (Ph.D.)--University of Florida, 2005. / Typescript. Title from title page of source document. Document formatted into pages; contains 84 pages. Includes Vita. Includes bibliographical references.

Afhandling, Linköpings universitet, 2007.

Kommunikativa svårigheter är en funktionsnedsättning som kan innebära språk-, röst- eller talsvårigheter och kan leda till begränsad interaktion med omgivningen. Taltjänst är en tolkservice som erbjuder ett sätt för personer med kommunikativa svårigheter att lättare kommunicera med omgivningen. Syftet med föreliggande studie är att undersöka hur taltjänsttolkar kan underlätta kommunikationen för personer med kommunikativa svårigheter i samtal mellan tolk, tolkanvändare och tredje part. Materialet består av fem olika videoinspelningar av tolksamtal samt svar från en enkätundersökning till taltjänsttolkar. Videomaterialet transkriberades utifrån samtalsanalytiska principer. Återkommande teman identifierades i svaren från enkätundersökningen. I resultatet och analysen observerades strategier för att skapa gemensam förståelse i form av begäran om förtydligande och begäran om bekräftelse av förståelse. Även upprepning/återgivning samt delad kunskap är fenomen som framkom i analysen av data. Förberedande möten visade sig spela en avgörande roll för att uppnå gemensam förståelse i samtal mellan tolk, tolkanvändare och tredje part. / Communicative disorders may involve language, voice or speech impairment and can lead to limited interaction with social surroundings. Speech Interpreter Service is an interpretation service which provides a way for people with communication disorders to communicate more easily with their surroundings. The aim of the present study is to investigate how speech interpreters can facilitate communication for people with communication disorders in conversation between the interpreter, users and third parties. The material consists of five different video recordings of interpreter conversation, and answers from a questionnaire to speech interpreters. The video material was transcribed based on conversation analytical principles. Recurring themes were identified in the answers from the survey. In the results and analysis, strategies to create common understanding were observed in the form of clarification requests and requests for confirmation of understanding. Other phenomena that appeared in the analysis were repetition/reproduction and shared knowledge. Preparatory meetings were shown to play a crucial role in achieving common understanding in conversation between the interpreter, users and third parties.

This study was developed to investigate the readiness or willingness of providers, speech language therapists (SLPs), and patients to participate in telepractice for speech-language therapy services in rural areas of Nevada. Nevada has not ranked high in healthcare for several years and was noted to have low SLP to patient ratios, especially in rural areas of Nevada. A thorough literature review identified international and national studies that have shown resistance to telepractice expressed by patients and providers, but it has also shown an increase in interest post telepractice therapy. Nevada does not have current research on readiness to participate in telepractice medical settings of rural areas of Nevada, therefore a survey was developed to ask providers and patients for their opinions about participating in telepractice. Providers were selected using an online directory search, and patient participants were chosen at the discretion of the providers. A unique survey was presented to each type of participant (provider or patient) in order to compare opinions and readiness of each participant type. Specific questions related to voice and swallowing disorders were addressed. A large sample size was not obtained, but the researcher was able to make some associations to readiness to participate in telepractice and possible factors that may or may not have affected a participant’s opinion. Age of participants, type of internet used, availability of webcam, and area of the state did not appear to have an association with the readiness to participate in telepractice. A positive response rate to engaging in telepractice of 40% was noted across patients and providers. Though the participant sample size was small, there is still some indication that telepractice could be used to address the needs of patients who need speech-language therapy services in rural areas of Nevada.

Self-determination is the ability to control one’s life and to actively participate in the decisions which affect the direction of one’s life. This ability is considered a critical life skill for individuals with developmental disabilities. The ability to make choices, plan, and self-evaluate are among the primary skills included in the development of self-determination. Currently, there is very limited emphasis on the importance of self-determination in the literature of communication disorders. This study was designed to determine if a teaching paradigm which incorporates key elements of self-determination is as or more effective and efficient in teaching syntax than a traditional, clinician-directed teaching paradigm for students with developmental disabilities. Two methods of syntax instruction were compared for 4 students with Down syndrome between the ages of 7 and 13 years using an Adapted Alternating Treatment (AAT) single subject design. In the Clinician Directed (CD) condition, the clinician selected the reinforcing activities, scheduled the order of those activities, and provided the students with feed-back on the accuracy of their productions. In the Self-Determined (SD) condition, the students chose the reinforcing activities from 4 possible choices, scheduled the order of activities, and self-evaluated the accuracy of their productions. Results of the study indicated that both the traditional clinician-directed approach (CD)and the self-determined approach (SD) were effective in teaching syntax targets with all 4 students achieving criterion at an unexpectedly rapid rate and maintaining skills regardless of the teaching condition. The CD condition was slightly more efficient than the SD condition in achieving criterion for 3 of the 4 students in the study; however, for 2 of these 3 students, there was a difference of only 1 session between the 2 conditions. In the SD condition the students were required to self-evaluate responses, a key element in the development of self-determination skills. Interestingly, students appeared to learn to self-correct errors slightly sooner in the SD than the CD condition. Further investigation is needed, but a case might be made that including elements of self-determination in syntax training could justify the slight loss of efficiency, and does so without disrupting teaching effectiveness.

While it is recognised that the burden on the caregiver of a person who has suffered a neurological event is great, research into the experience of caregiving and the effects of cognitive-communicative difficulties on intergenerational families is lacking. Studies examining these experiences within a multicultural and multilingual setting such as South Africa are few. The effects of neurogenic communication disorders in family systems also require further investigation. This study explores parent caregivers’ experiences of caring for their once-independent adult child, who are now faced with the reality of parenting for the second time. A qualitative research design was employed. Eighteen parents of adult children who have suffered TBIs, strokes or brain tumours were interviewed. The data obtained were analysed by means of thematic analysis. Themes associated with caring for an adult child, specifically in the South African context, are identified and discussed. These themes related to the parent caregiver’s experience of loss – loss of their child due to physical and cognitivecommunicative difficulties as well as the loss of their own dreams and plans for the future. Multiple roles within intergenerational family systems, support and information are identified as significant factors in either minimising or exacerbating their experience of loss. These themes are explained within a Family Systems Theory framework and assist in identifying both positive and negative factors that impact on experiences of caring for an adult child. It stresses the importance of the implementation of sustainable programmes and support services specifically catering for parents of adult children with neurological communication disorders.

Objetivo: Caracterizar e analisar os aspectos psicossociais e familiares de indivíduos com e sem distúrbios da comunicação decorrentes da fissura labiopalatina. Modelo: Estudo descritivo e comparativo de dois grupos: GI - com distúrbios da comunicação decorrentes da disfunção velofaríngea, alterações dento-oclusais e/ou atrasos no desenvolvimento da fala e GII - indivíduos sem distúrbios da comunicação. Local: Hospital de Reabilitação de Anomalias Craniofaciais - Universidade de São Paulo, Bauru. Participantes: 38 indivíduos distribuídos: GI - 20 e GII - 18; acima de 4 anos participantes do “Projeto Flórida", com fissura transforame unilateral, sem outras deficiências e/ou anomalias associadas. Intervenções: Análise documental e entrevista abordando questões sobre estratificação social, histórico e dinâmica familiar, relações sociais de indivíduos e família, tratamento reabilitador e recursos organizacionais e comunitários. Resultados/Conclusão: Não foram constatadas relações significativas entre os resultados pós tratamento no que se refere a fala e a condição socioeconômica dos pacientes. Não foram detectadas diferenças significativas entre os aspectos psicossociais e familiares entre os grupos com e sem distúrbios exceto no cotidiano escolar de uma minoria de pacientes (com distúrbios). Embora algumas categorias não apresentaram significância estatística, todas se configuraram como expressivas, e determinantes para o conhecimento qualitativo dos aspectos psicossociais e familiares e para a atuação da equipe de reabilitação que, com sua visão de totalidade, busca com os pais e a sociedade, a inclusão social do paciente. / Objetive: To characterize and analyze the psychosocial and familiar aspects of individuals with and without communication disorders related to cleft lip and palate. Design: Descriptive and comparative study of two groups: GI – group of individuals with communication disorders related to velopharyngeal dysfunction, dento-occlusal alterations and/or delays in speech development, and GII - group of individuals without communication disorders. Research Site: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. Participants: 38 individuals distributed into two groups (GI: N=20 and GII: N=18); all participants were at least four years of age and were enrolled in the “Florida Project", presenting with unilateral transforame cleft not associated to other malformations or anomalies. Methods: Interview and data analysis focusing on socioeconomic status, family dynamics and history, individuals and family social relationship, care and management of anomaly and support community resources. Results/Conclusion: There were no significant differences in the socioeconomic status between children with and without communication disorders. There were no significant differences in the psychosocial and familiar aspects between children with and without communication disorders except regarding school routine which was distinct for a minority in the group with communication disorders. Even though some of the aspects studied did not show significant, the findings provided qualitative information regarding the psychosocial and familiar aspects supporting team management in a search for patient’s inclusion in a partnership with the parents and the community.

A demência é uma síndrome caracterizada pelo declínio de memória e déficit cognitivo que influenciam no desempenho social do indivíduo. É uma junção de sinais e sintomas que culminam em uma deterioração crônica, e em geral progressiva do funcionamento do intelecto, da personalidade e da comunicação. Entre os principais tipos de demência encontra-se a demência do tipo Alzheimer, a demência vascular, a demência com corpos de Lewy e a demência frontotemporal. Independentemente do tipo de demência, um dos seus primeiros indícios é o comprometimento da memória, maior dificuldade de atenção e concentração, perda de habilidades intelectivas, desorientação espaço-temporal, mudanças no comportamento, no humor e na personalidade. Além destas alterações, conforme a doença evolui, o paciente pode apresentar dificuldades para se alimentar e deglutir, e é função do fonoaudiólogo intervir nos distúrbios de memória, fala e deglutição. O presente trabalho teve por objetivo confeccionar uma cartilha de orientações fonoaudiológicas, relacionadas à linguagem e à deglutição, aos cuidadores e/ou familiares de pacientes com demência. Teve como base as dúvidas mais frequentemente encontradas sobre as manifestações fonoaudiológicas apresentadas no questionário que foi aplicado aos cuidadores e/ou familiares dos pacientes com problemas neurológicos, assim como a contribuição de achados teóricos. / Dementia is a syndrome that is characterized by the decline in memory and cognitive deficits that influence the social performance of an individual. It is a combination of signs and symptoms that culminate in a chronic deterioration, and generally progressive operation of intellect, personality and the communication of an individual. Among the main types of dementia is the dementia of Alzheimer, vascular dementia, dementia with Lewy bodies and frontotemporal dementia. Whatever the type of dementia, the first signs are memory impairment, increased difficulty of attention and concentration, loss of skills intellect, spatial-temporal disorientation, changes in behavior, mood and in personality. In addition to these changes, as the disease progresses, patients may find it difficult to get food and swallow. This is a function of the speech pathologist involved in the disturbances of memory, speech and swallowing. The study aimed was to manufacture a book of guidelines that speech therapists, related to language and swallowing, to caregivers and / or relatives of patients with dementia. It was based on the questions most frequently found on the demonstrations phonoaudiologicals presented in the questionnaire that was applied to caregivers and / or relatives of patients with neurological problems, as well as the contribution of theoretical findings.

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