Alternative Communication Approaches Research Articles

Older women's perspectives on the ethics of persuasion in doctor-patient communication.

Public health campaigns have often used persuasive techniques to promote healthy behaviors but the use of persuasion by doctors is controversial. We sought to examine older women's perspectives. We conducted semi-structured interviews with 20 community-dwelling older women from the Baltimore metropolitan area. We asked whether participants thought it was ethically appropriate for doctors to try to persuade patients and explored their rationales. We probed about commonly used persuasive techniques and two example decisional contexts-stopping mammograms and moving out of one's house after multiple falls. We used qualitative thematic analysis to code the transcripts and summarized results into major themes. We found mixed views on the ethical appropriateness of persuasion (theme 1); supporters of persuasion were motivated by the potential benefit to patients' health, whereas opponents thought patients should be the ultimate decision-makers. Perspectives depended on the persuasive technique (theme 2), where emotional appeals elicited the most negative reactions while use of facts and patient stories were viewed more positively. Perspectives also varied by the decisional context (theme 3), where higher severity and certainty of harm influenced participants to be more accepting of persuasion. Participants suggested alternative communication approaches to persuasion (theme 4) that emphasized respect for patients. Our findings suggest that the type of persuasive technique and the decisional context are important considerations in the ethical debate around the use of persuasion. Limiting the use of persuasion to high-stakes decisions and using facts and patient stories rather than emotional appeals are likely more acceptable.

Privacy-Preserving Wireless Sensor Networks for E-Healthcare Applications

Wireless sensor networks (WSNs) are a powerful support system for the fundamental infrastructure that is required to monitor physiological and activity parameters (WSN). Wearable devices, which are also referred to as wireless nodes in the scientific world, are what are used in order to measure one or more of the user’s vital signs. Each and every wireless node is a teeny-tiny device that is meant to be supplied with enough amounts of storage space, power, and transmission capability. The loss of data packets may occur during the transmission of data via a wireless medium for a number of reasons. These reasons include interferences, improper deployment circumstances, distance, and inadequate signal strength. The monitoring of a user’s physiological information and postural activity information in various applications, such as home care and hospital care, is the primary emphasis of this study. In this work, the WSN was shown thanks to the introduction of wireless sensor nodes that were created locally. These wireless sensor nodes are used in the process of analyzing many aspects of a network, such as the received signal strength, transmission offset, packet delivery ratio (PDR), and signal-to-noise interference. The work significantly improves the capabilities of conventional WSN by implementing a variety of alternative communication approaches, such as network-coded cooperative communication (NC-CC) and cooperative communication (CC). The system that is being shown makes it feasible to localize the user’s approximate position inside an indoor setting without making use of any camera network connections. This is made possible by the system’s ability to determine the user’s location via triangulation. This is one of the benefits that the system provides. A hospital sensor network, an example of which is being shown here, is capable of doing real-time monitoring of a patient’s postural activity as well as their general health. The method is being promoted in order to ensure that the patient will get assistance in a timely manner that is adequate to his/her needs. Involving NC-CC enables the effective sharing of real-time data among the group of privileged duty nurses while simultaneously minimizing the amount of network traffic, latency, and throughput. This is possible because of NC-CC protocol. The findings of the experiments showed that the proposed method of communication, which is known as dynamic retransmit/rebroadcast decision control, is a significant advancement in the network coding approach that is presently being utilized. This was demonstrated by the fact that the method was shown to be significantly more effective.

Reaktualisasi Pendidikan Agama Islam untuk Anak dengan Gangguan Speech Delay

This research aims to actualize Islamic religious education for children with Speech Delay disorders. This type of research is a literature review. Data collection method with documentation from Google Scholar. Data analysis using a systematic literature review. The research results of the Reactualization of Islamic Religious Education for children with Speech Delay disorders are an important effort to ensure inclusivity and diversity in religious education. Through learning methods adapted to the needs of these children, such as the use of visualization, interactive media, and alternative communication approaches, this re-actualization aims to provide equal access to religious understanding and experience. With a more holistic and supportive approach, children with Speech Delay disorders can develop their religious skills while still paying attention to their special needs in communication.

Assessing Language and Literacy of Students with Developmental Disabilities and Complex Communication Needs

Students with developmental disabilities and complex communication needs are impacted by assessments that may not show their ability or address their needs. Multiple modes of assessment presentation and response formats, augmentative and alternative communication approaches, and assistive technology may help students engage more equitably in literacy assessment activities. The Nonverbal Literacy Assessment (NVLA) is an example of a tool used to assess the language and literacy skills of students with disabilities in various formats. Augmentative and Alternative Communication (AAC), eye-gazing, and speech-generating device (SGD) technology are also used to make assessment more accessible to students with developmental disabilities and speech difficulties.

Perspectives and preferences regarding genomic secondary findings in underrepresented prenatal and pediatric populations: A mixed-methods approach

PurposePatients undergoing clinical exome sequencing (ES) are routinely offered the option to receive secondary findings (SF). However, little is known about the views of individuals from underrepresented minority pediatric or prenatal populations regarding SF. MethodsWe explored the preferences for receiving hypothetical categories of SF (H-SF) and reasons for accepting or declining actual SF through surveying (n = 149) and/or interviewing (n = 47) 190 families undergoing pediatric or prenatal ES. ResultsUnderrepresented minorities made up 75% of the probands. In total, 150 families (79%) accepted SF as part of their child/fetus’s ES. Most families (63%) wanted all categories of H-SF. Those who declined SF as part of ES were less likely to want H-SF across all categories. Interview findings indicate that some families did not recall their SF decision. Preparing for the future was a major motivator for accepting SF, and concerns about privacy, discrimination, and psychological effect drove decliners. ConclusionA notable subset of families (37%) did not want at least 1 category of H-SF, suggesting more hesitancy about receiving all available results than previously reported. The lack of recollection of SF decisions suggests a need for alternative communication approaches. Results highlight the importance of the inclusion of diverse populations in genomic research.

Communicating about Mental Health with Youth and Their Families: A Scoping Review of Best Practices and Implications for Youth with Disabilities

ABSTRACT Minimal attention has been placed on supporting the mental health needs of youth with disabilities. Due to a dearth of research on best practices in mental health communication with youth with disabilities, the aim of the scoping review was to identify existing peer-reviewed evidence regarding mental health communication for the general youth population in clinical settings. Three electronic databases were searched. Inclusion criteria were: 1) published in English between 2009 and 2019; 2) children and youth and/or their parents/caregivers; 3) addressed communication-based mental health practices; 4) based in pediatric health care settings. Seven articles were included. Promoting autonomy and engagement, building collaboration and trust, and supplementing conversations with alternative communication approaches were identified as important for having mental health conversations. While implications can be drawn, more work is needed for clinicians to have a rigorous evidence base to draw upon when having these conversations with youth with disabilities.

An analysis of the five year outcomes of a cohort of 46 deaf children with severe (SLD) or profound and multiple learning difficulties (PMLD) and associated complex needs, including autism (ASD), tracked using the Nottingham Early Cognitive and Listening Links (Early CaLL): This framework monitors the relationship between sound processor use and listening, spoken language, cognition and communicative development, following

Objectives: In 2018, routine data of the five year outcomes from a cohort of 46 children, (18 PMLD and 28 SLD, including nine SLD children with an additional diagnosis of ASD), was analysed to investigate the type and amount of benefit provided by cochlear implantation and to examine any differences in outcome patterns across the populations.Methods: The level of functional sound processor use achieved over time was reviewed in relation to listening and spoken language outcomes, alongside social engagement, communicative and cognitive development. The extent to which children were able to close the gap between their overall development and their listening abilities was quantified. The outcomes of the children with an additional diagnosis of ASD, was compared to those of the SLD population as a whole.Results: Although equipment management presented long term challenges, after five years, 80% of children were able to attach some meaning to sound. Children with SLD acquired more auditory skills and spoken language than those with PMLD. Most of the children used a mix of augmentative and alternative communication approaches (AAC), with 7%, all SLD children, acquiring some simple spoken language. An additional diagnosis of ASD had a negative effect on outcomes.Discussion: For 80% of the patients, the provision of cochlear implants provided benefits, although changes were slow to develop and required high levels of adult persistence.Conclusion: Outcomes measures which are population specific and acknowledge challenges, alongside providing ways to recognise individual achievements, by matching them against individual capacity, are of great value to families and practitioners.

What Is Meant by "Multimodal Therapy" for Aphasia?

Purpose Multimodal therapy is a frequent term in aphasia literature, but it has no agreed upon definition. Phrases such as "multimodal therapy" and "multimodal treatment" are applied to a range of aphasia interventions as if mutually understood, and yet, the interventions reported in the literature differ significantly in methodology, approach, and aims. This inconsistency can be problematic for researchers, policy makers, and clinicians accessing the literature and potentially compromises data synthesis and meta-analysis. A literature review was conducted to examine what types of aphasia treatment are labeled multimodal and determine whether any patterns are present. Method A systematic search was conducted to identify literature pertaining to aphasia that included the term multimodal therapy (and variants). Sources included literature databases, dissertation databases, textbooks, professional association websites, and Google Scholar. Results Thirty-three original articles were identified, as well as another 31 sources referring to multimodal research, all of which used a variant of the term multimodal therapy. Treatments had heterogeneous aims, underlying theories, and methods. The rationale for using more than 1 modality was not always clear, nor was the reason each therapy was considered to be multimodal when similar treatments had not used the title. Treatments were noted to differ across 2 key features. The 1st was whether the ultimate aim of intervention was to improve total communication, as in augmentative and alternative communication approaches, or to improve 1 specific modality, as when gesture is used to improve word retrieval. The 2nd was the point in the treatment that the nonspeech modalities were employed. Discussion Our review demonstrated that references to "multimodal" treatments represent very different therapies with little consistency. We propose a framework to define and categorize multimodal treatments, which is based both on our results and on current terminology in speech-language pathology. Video Abstract and Supplemental Material https://doi.org/10.23641/asha.7646717.

The Way It Used To Be

The Way It Used To Be

Effects of multimodal communication program on patients with chronic aphasia: a single-subject A-B-A design study.

Background and aimAphasia as a common consequence of stroke, is an acquired neurologic communication disorder that can affect symbol language processing. Different types of intervention approaches have been introduced. Multimodal Communication Program (MCP) is a new augmentative alternative communication approach in chronic aphasia. The aim of this study was to investigate the effect of MCP on communication skills of patients with chronic aphasia.MethodsThis prospective, single subject, A-B-A design study was done during 2016 in Semnan, Iran. Participants were two patients with severe aphasia with a single left-hemisphere stroke. Three phases, including baseline, intervention and follow-up were administered. The patients received nine-hour intervention, over 10 working days.ResultsThree different scores were calculated for each patient: verbal efforts, the frequency of each modality and the accuracy of switching between modalities and the reaction time. The frequency of verbal modality increased for both patients. They could switch between modalities more successfully than before the intervention. The results for the reaction time, however were challenging. The onset reaction time decreased for patient 1, and increased during switching between modalities, and patient 2 showed the opposite.ConclusionThe MCP can improve the communication skills in patients with chronic post stroke aphasia. However, some factors, such as reduction of the patients’ reaction time is probably related to the amount of allocated resources during intervention.Trial registrationThe trial was registered at IRCT center with ID: IRCT2016032325194N3.FundingThe study was financed by Semnan University of Medical Sciences (Grant no.: A-10-333-3).

Picture Exchange Communication System and Pals: A Peer-Mediated Augmentative and Alternative Communication Intervention for Minimally Verbal Preschoolers With Autism.

This study was conducted to investigate the effectiveness of a social intervention that integrates peer-mediated approaches and the Picture Exchange Communication System (PECS). Effects were evaluated using a series of A-B designs replicated across 4 children with severe autism and limited verbal skills. Seven peers without disabilities were trained to use PECS and facilitative social skills. Measures of changes included rates of communication behaviors, modes, functions, and engagement. Outcomes revealed an intervention effect for 1 child with autism, and this effect was replicated across 3 other children. All children improved in peer-directed communication, with greater increases for 2 children during snack time. For each child with autism, the primary communication behavior was to initiate with picture symbols to request; the peer's primary communication was to respond. Two children increased communicative functions to comment and to share, and all 4 children showed improved social engagement. All peers increased their communication with the children with autism. These findings add to the limited research on the benefits of teaching typically developing peers to be responsive listeners to preschoolers with autism by learning to use PECS. These results invite further investigation of teaching peers other augmentative and alternative communication approaches and how to increase children's communication with peers for different purposes.

Giving a Voice to the Person in My Dental Chair: Communication with People with Learning Disabilities

This article aims to increase the dental teams' awareness of communicating with people with learning disabilities who have additional communication impairments. The paper presents a brief account of the factors behind why some people with learning disabilities may find it difficult to verbally communicate, and highlights the importance of ensuring high levels of care for all patients. It provides an overview of the principles of communication development and some of the most commonly used augmentative and alternative communication approaches. The paper concludes with suggestions of simple communication techniques as well as practical ideas, which can be easily incorporated into daily general dental practice in order to increase opportunities for successful interactions and minimise communication breakdown. By becoming more aware of the range of communication methods used to support those who have learning disabilities, the dental team will be more able to provide a better experience to their patients and ensure that their needs are met.

Development and evaluation of an early detection intervention for mouth cancer using a mass media approach

Background:Scotland has a high incidence of mouth cancer, but public awareness and knowledge are low compared with other cancers. The West of Scotland Cancer Awareness Project sought to increase public awareness and knowledge of mouth cancer and to encourage early detection of symptoms among an at-risk population of people aged over 40 years from lower socio-economic groups using a mass media approach. The media campaign aimed to increase people's feelings of personal risk, while also enhancing feelings of efficacy and control. To achieve this, a testimonial approach (using real people to tell their own stories) was adopted.Methods:Campaign impact and reach was assessed using in-home interviews with a representative sample of the target population in both the campaign area and controls outside of the target area. Surveys were conducted at three stages: at baseline before the campaign was launched, and at 7 and 12 months thereafter.Results:Awareness of media coverage was higher at both follow-up points in the intervention area than in the control area, the differences largely being accounted for by television advertising. The campaign had a short-term, but not a long-term impact on awareness of the disease and intention to respond to the symptoms targeted by the campaign. Awareness of two of the symptoms featured in the campaign (ulcers and lumps) increased, post-campaign, among the intervention group.Conclusions:While the study provides evidence for the effectiveness of the self-referral model, further work is needed to assess its ability to build public capacity to respond appropriately to symptoms and to compare the cost-effectiveness of a mass media approach against alternative communication approaches and more conventional mass screening.

Communication from a Human Rights Perspective: Responding to the HIV/AIDS Pandemic in Eastern and Southern Africa

This paper focuses on one of the most critical issues of the international response to the HIV/AIDS pandemic and it certainly adds to the growing body of literature on approaches that attempt to move beyond behavior change communication-focused (BCC) interventions into more context-based dialogue-based approaches. The authors take into account some of the most relevant conceptual approaches and models that fueled the international debate around HIV/AIDS communication (i.e. Rockefeller Foundations Communication for Social Change; UNAIDS HIV/AIDS Communication Framework) and propose a Communication from a Human Rights Perspective Approach which reflects the human rights-based route undertaken by UNICEF over the past few years in the area of communications. The paper makes several important conceptual contributions. First it enriches the international debate on HIV/AIDS communication and the effectiveness of BCC in the context of HIV/AIDS. Second it brings into the academic literature an alternative communication approach based on years of field experience that responds to the growing HIV/AIDS pandemic. Third it puts community participation and ownership at the very center of the communications response to HIV/AIDS. Fourth it highlights the relevance of various community-based interventions to combat HIV/AIDS. (excerpt)

Using augmentative and alternative communication approaches to promote participation of preschoolers during book reading: a pilot study

Literacy development is important, especially for individuals using augmentative and alternative communication (AAC). Early exposure to reading and writing through joint book reading is important in this development. This article describes a project examining the impact of an interactive book reading programme on four preschool-aged children and their mothers. Two of the children were typically developing and two relied on nonverbal communication means. The program used AAC techniques and adaptations to promote the participation of all children. The children's participation was examined in the group and during book reading in the home before and after the group programme.

Sign systems in special education: some experiences of their use with deaf children

The recent and striking growth in the use of sign-systems with communication-handicapped children other than the deaf has not been monitored by systematic research. Sign-systems have been in use with deaf children, however, for a considerable number of years and much research has been undertaken aimed at evaluating their effectiveness as a means of developing communication. This research is discussed, and the conclusion is that using signs with deaf children is not unproblematic. The findings may well be applicable to the use of signs with any communication- handicapped child. Thus enthusiasm for alternative communication approaches should not be mistaken for efficacy.

Development communication expectations in occupational contexts: A Comparison of U.S. and foreign graduate students

This study focuses on the communication approaches used by experts in development. In line with recent “paradigm shift” issues, this study asks whether foreign and U.S. graduate students have inculcated alternative communication approaches instead of, or in addition to, the predominant “top to bottom” communication approach in their occupational communication roles. A total of 24 foreign and 23 U.S. graduate students from various departments at the University of Washington were asked to describe their expected communication with contact groups above, at the same and at lower status levels. All graduate students showed a marked tendency to exhibit “top to bottom” approaches with contacts of lower status and alternative communication approaches (i.e., bottom to top or interactive) only with peers. Few differences were found between U.S. and foreign, but those that were found were attributed to differing societal and occupational structures. Discussion focused on the lack of a coherent communication approach showing inculcation of more user oriented approaches suggested by the “paradigm shift.”