Acutely ill patients, across the age continuum, often present with complex communication needs (CCN) due to motor, sensory, cognitive and linguistic barriers they may experience during their hospital encounter. While hospital administrators recognize the importance of improving communication among the healthcare team members to increase quality and safety measures, few have focused on improving the patient-provider communication process, especially for patients with CCN. Recent Joint Commission standards mandates hospitals and healthcare providers improve communication for patients with CCN across all points of the care continuum. The study investigated the effectiveness of AAC training protocols for acute care nurses and ancillary healthcare providers using an on-line instructional medium for clinical skills teaching. The study design allowed for the measurement of learning following exposure to the tutorial and the analysis of possible clinical skill application. The current study invited a total of 377 nurses and graduate students to participate. Eight-three participated in the study and were divided randomly into two groups. Seventeen (20.5%) were assigned to in the control group, and 66 (79.5%) participants were into the test group. Both groups were directed to complete a pre-test measure. This was followed by exposure to the tutorial for the test group. The groups then were instructed to complete a post-test measure. For all participants in the test condition, the mean difference score (post-pre) was 19.2. The average pre-test score was 60.8 with a standard deviation of 12.4 while the average post-test score was 80.1 with a standard deviation of 11.3. This difference was significant (p

In recent years much interest has been focused on the manner in which the young child acquires language. Some researchers (Chomsky, 1965; McNeil) have postulated an inherent capacity to comprehend and utilize linguistic structures, while others such as Irwin, (1960), Hess and Shipman (1965), and Greenstein, et al, (1974) have focused on experiential determinants of language competence in early childhood. As with all children, the social and emotional behavior of deaf children is greatly influenced by their ability to communicate with significant others. Interactions between the normally developing child and his parents are characterized by mutual responsiveness, where each initiates and reciprocates communication. When a Child's language development is delayed or impaired(as with a hearing loss), this communication process may also become impaired, with parents being unable to respond appropriately to confused or reduced messages from the child. This paper reviews some of the pertinent research regarding the behavioral interaction between the parent and child and its effect on communication and psychosocial development. The implications of this data for the hearing-impaired child and his family are considered. It will address the question," What is it that parents with young hearing impaired children do that facilitates or impedes speech and language development?" A methodology is also presented for developing effective communication between such children and their parents.

Clinical audiologists at Utah State University have been using a master hearing aid as a basic part of hearing aid evaluation procedures . To ascertain the usefulness of the master hearing aid in predicting patient success with a wearable hearing aid , 20 subjects were given speech audiometric tests under the following conditions: (l) without amplification; (2) with the headset system of the master hearing aid (a system which utilizes chassis mounted microphones and external receivers of the type used with body-worn hearing aids); (3) with the ear-level system of the master hearing aid (a system which utilizes a microphone and receiver mounted in an ear-level hearing aid case); and (4) with a wearable ear-level hearing aid which had been previously selected for each subject on the basis of master hearing aid data. Using the ANOV procedure, statistically significant differences α=.05) were found between the mean speech reception thresholds obtained under the three aided test conditions, but differences were not clinically significant. The mean speech reception thresholds a greed within 4.0 dB. No significant difference was found between the mean speech discrimination scores obtained in quiet under the three aided test conditions. However, the mean speech discrimination score obtained in noise under the head set system condition was significantly poorer (α=.05) than the mean speech discrimination scores obtained under the ear-level system condition and also the wear able hearing aid condition. Differences as specified were 9.1 percent and 10.2 percent respectively. Conclusions were that the ear-level system of the master hearing aid and the headset system of the master hearing aid can be used to predict the SRT and speech discrimination score in quiet of hearing aid candidate using a wearable hearing aid, but that the ear-level system of the master hearing aid should be used exclusively when attempting to predict a patient's success with a wearable hearing aid on speech discrimination tasks in noise.

Many articles and textbooks which have recently been written in the field of speech correction indicate that a high percent of all children who have speech defects also have a hearing deficiency. Some even say that a higher percent of these children have hearing deficiencies than do children who are normal in speech. Because of the great interest which has been aroused in the nature of the problems of the speech defectives, and because of the desire which exists for them to be helped in their handicaps, there is a necessity for their problems to be understood as thoroughly as possible. The present investigation has therefore been undertaken to establish the type and extent of hearing loss in the speech defective children in the first six grades of the elementary schools of Cache County and of the Logan City school districts.

The purpose of this study was to explore the nature of reduced patient awareness of oropharyngeal dysphagia. While patient awareness of dysphagia has been explored in individuals before participating in formal swallowing assessments, no studies have been identified in the literature that have explored awareness after patients have participated in an examination and received information about their dysphagia. In addition, the relationship between patient compliance and reduced awareness, as well as the application of stages of change in this population were explored. Twenty-one inpatients and outpatients, newly diagnosed with oropharyngeal dysphagia, participated in this study. A retrospective analysis found that 40% of participants demonstrated reduced awareness of their dysphagia before participating in a videofluoroscopic swallowing examination. Reduced pre-examination awareness of dysphagia occurred most frequently in those with general medical diagnoses versus neurological or structural diagnoses. Reduced pre-examination awareness was not significantly associated with a reduced cough response following aspiration. Exploration of post-examination patient awareness of dysphagia, the primary intent of this study, revealed that 19% of patients demonstrated reduced awareness of their dysphagia, even after receiving specific verbal and visual information regarding their diagnosis. Reduced post-examination awareness of dysphagia occurred equally in those with structural and neurological diagnoses and was not noted in those with general medical diagnoses. Reduced post-examination awareness was not significantly associated with a reduced cough response following aspiration. Consistent with the literature on reduced patient awareness of deficit, patient awareness of dysphagia was modality specific. That is, some patients with reduced awareness of dysphagia demonstrated awareness of other deficits and vice versa. Overall, participants demonstrated more awareness of concomitant speech impairments than dysphagia and less awareness of concomitant cognitive impairments than dysphagia. No significant relationship between general cognitive impairment and reduced patient awareness of dysphagia was found. Exploration of diet compliance in inpatient participants revealed no instances of noncompliance, while hospitalized, from the day of the swallowing examination until the day of participation in the study. However, only 67% of these patients requested permissible foods or drinks when compliance was sampled during the study protocol, suggesting that inpatients with newly diagnosed dysphagia may be less compliant if restricted items become accessible. No significant relationship between patient awareness of dysphagia and diet compliance, as sampled during the study protocol, was found in both inpatients and outpatients. The relationships between patient awareness of dysphagia and patient compliance for both swallowing strategies and exercise regimens were also not significant, though these analyses were limited by the small number of participants who had been prescribed strategies and independent exercise programs at the time of their study participation. Lastly, analysis of the relationship between patient compliance and action or post-action stages of change, revealed no significant association between these variables.

The acculturative process is a continuing process beginning at the moment of contact between peoples of different cultures. This process subsumes the acquisition of new traits from concrete elements to behavioral patterns to abstractions, a growth in perception, and socialization into the host culture. The process is affected by other variables such as personality structure and national origin. Thus far, it has been difficult to find empirical studies which reveal how a person perceives and feels as he moves through these processes.

The purpose of this investigation was to determine the comparative effectiveness of two articulation carry-over techniques. It was hoped that through this comparison answers regarding carry-over results could be ascertained for purposes of aiding public school clinicians currently spending the majority of management time on carry-over. If one technique was found to be superior, its use among speech pathologists might aid in changing this time allocation trend.

The purpose of this study was to describe written narratives of language disordered adolescents by comparing their written narratives via story grammar analysis with those of normal adolescents. The written narratives were obtained by administering two tasks as required assignments within the English or communications classes of the two groups. Task A was to write about a personal experience and Task B was about an imaginary experience. This study used Merritt and Liles' adaptations (1987) of Stein and Glenn's procedures (1979) for story grammar analysis to describe the content of the narratives.

These two joint-studies used recorded versions of the Northwestern University Auditory Test Number 6 (NU-6) and the California Consonant Test (CCT) in the hearing aid evaluations (HAEs) of 12 male and one female subjects, aged 41 to 87 years. They exhibited precipitous high frequency losses beyond 1 kHz in at least one ear. All subjects were evaluated without amplification and while monaurally aided with two conventional high pass hearing aids. Ten of the subjects were evaluated in multi-talker noise and 11 were tested in quiet. Since the CCT was more heavily weighted than the NU-6 with target phonemes sensitive to high frequency losses, it was hypothesized that the CCT might be more sensitive than the NU-6 to significant differences between aided and/or unaided performances of these particularly high frequency impaired subjects. The data collected in noise and in quiet was analyzed separately with the one-way analysis of variance (ANOVA) for repeated measures. No significant differences were found in noise or quiet between the aided performances on either the CCT or the NU-6. The NU-6 in noise, however, revealed significant degrees of aided improvement at the .01 level of confidence that the CCT did not. The addition of noise seemed to make the CCT too difficult for these subjects. In quiet, both tests seemed to be as equally sensitive in revealing significant aided improvement at the .01 level of confidence. The lower mean CCT scores in quiet, however, seemed to indicate that if unaided NU-6 performances are too high to allow for significant aided improvement or significant differences between aids, the more time consuming CCT might be appropriate.

The purpose of this study was to compare the speechreading abilities of elementary school-age children with mild to severe articulation disorders with those of children with normal articulation. Speechreading ability, as determined by a speechreading test, indicates how well a person recognizes the visual cues of speech. Speech sounds that have similar visual characteristics have been defined as visemes by Jackson in 1988 and can be categorized into distinct groups based on their place of articulation. A relationship between recognition of these visemes and correct articulation was first proposed by Woodward and Barber in 1960. Dodd, in 1983, noted that speechread information shows a child how to produce a sound, while aural input simply offers a target at which to aim.