Deficits In Communication Skills Research Articles

Somatosensory processing in neurodevelopmental disorders

The purpose of this article is to review the role of somatosensory perception in typical development, its aberration in a range of neurodevelopmental disorders, and the potential relations between tactile processing abnormalities and central features of each disorder such as motor, communication, and social development. Neurodevelopmental disorders that represent a range of symptoms and etiologies, and for which multiple peer-reviewed articles on somatosensory differences have been published, were chosen to include in the review. Relevant studies in animal models, as well as conditions of early sensory deprivation, are also included. Somatosensory processing plays an important, yet often overlooked, role in typical development and is aberrant in various neurodevelopmental disorders. This is demonstrated in studies of behavior, sensory thresholds, neuroanatomy, and neurophysiology in samples of children with Fragile X syndrome, autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), and cerebral palsy (CP). Impaired somatosensory processing is found in a range of neurodevelopmental disorders and is associated with deficits in communication, motor ability, and social skills in these disorders. Given the central role of touch in early development, both experimental and clinical approaches should take into consideration the role of somatosensory processing in the etiology and treatment of neurodevelopmental disorders.

Addressing Communication Skill Deficits in Fourth-Year Medical Students: An Intensive Remediation Curriculum

Communication skills can be taught and learned, and are assessed as part of the standard medical school curriculum. At West Virginia University, fourth-year medical students are required to pass the Clinical Performance Exam (CPX), in which students demonstrate clinical skills with simulated patients. A remediation curriculum has been instituted to facilitate experiential and didactic learning in provider-patient communication for students failing the Relationship/Communications section of the CPX. Thus far, the three students who have completed this intense curriculum have subsequently passed the CPX and successfully matriculated. Students report that the experiential component of the remediation has been the most effective learning tool. This curriculum has gained such credibility that the authors have been charged with adapting the course components to allow for inclusion of more students. Future direction of the curriculum is discussed.

Investigating the characteristics of educational computer games developed for children with autism: a project proposal

Autism is a neural developmental disorder that interfere the brain development and causes deficit in social interaction and communication skills as a result. One of the most important outcomes of education of children with autism is the functional independence skills. Effective instructional techniques and methods are immensely important for children with autism to improve their functional independence skills. At this point we think that since playing is a fundamental part of a child's physical, cognitive, linguistic, emotional and social development, educational computer games which are used effectively in education of children without developmental disorders can also be used effectively in education of children with autism. This paper proposes a project for investigating how children with autism interact with computer games, how computer games can be used for educational purposes, and what characteristics educational computer games should have in education of children with autism. For this project educational computer games for children with autism will be designed and developed. In this process, design based research methodology will be used to investigate the characteristics of educational computer games for children with autism.

Predicting Failing Performance on a Standardized Patient Clinical Performance Examination: The Importance of Communication and Professionalism Skills Deficits

The purpose is to determine which assessment measures identify medical students at risk of failing a clinical performance examination (CPX). Retrospective case-control, multiyear design, contingency table analysis, n = 149. We identified two predictors of CPX failure in patient-physician interaction skills: low clerkship ratings (odds ratio 1.79, P = .008) and student progress review for communication or professionalism concerns (odds ratio 2.64, P = .002). No assessments predicted CPX failure in clinical skills. Performance concerns in communication and professionalism identify students at risk of failing the patient-physician interaction portion of a CPX. This correlation suggests that both faculty and standardized patients can detect noncognitive traits predictive of failing performance. Early identification of these students may allow for development of a structured supplemental curriculum with increased opportunities for practice and feedback. The lack of predictors in the clinical skills portion suggests limited faculty observation or feedback.

Diagnostic Manual–Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons With Intellectual Disability, by R. Fletcher, E. Loschen, C. Stavrakaki, and M. First

Diagnostic Manual–Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons With Intellectual Disability, by R. Fletcher, E. Loschen, C. Stavrakaki, and M. First

31. Communication Skills Deficits During the Preoperative Visit

31. Communication Skills Deficits During the Preoperative Visit

Can contingently imitating vocal response increase the frequency of vocal responses?

Introduction An operant is defined as a behavior that operates on the environment and in turn gets feedback from the environment (Cooper et. al., 1997). Baum (1970) argued that operant behavior is any behavior that moves an organism from a lower valued state to a higher valued state. Operant behavior can be divided in many different ways, often based on function, topography, or the maintaining consequence. One common distinction is between social operants (those that are reinforced through people) and nonsocial operants (those reinforced through the non-people world). Children with autism often lack social operants (1); that is, behavior that produces social consequences. Given this deficit any behavior that becomes a social operant by Baum's (1970) definition will become valued by the child with autism and in turn becomes a reinforcer. Verbal operants are defined as behaviors that receive reinforcement mediated through people other than the speaker (Skinner, 1957). Such behavior includes vocal and non-vocal behaviors that require a and a speaker (Skinner, 1957). For non-vocal children with autism verbal operants can include any kind of vocalization or non-vocal communication that produces a response from the social environment. Imitating certain actions contingently for a child can lead those actions to increase. This process is called contingent imitation (Gazdag & Warren, 2000). In essence, contingent imitation gives students access to social reciprocity and thus can serve as a reinforcer. Prior research of contingent imitation shows it can serve to increase the retention of skills learned (Wurtele & Roberts, 1982). The vocalizations that are reinforced by a during contingent imitation may become part of the child's repertoire, eventually being taught to function as verbal operants for a child that previously emitted low rates or almost no verbal operants. Researchers have discovered that contingent imitation can increase the gross motor and vocal imitation skills of children and adults with disabilities (Cautilli & Dziewolska, 2006). Contingent imitation involves the listener responding to a vocalization by mimicking it. This imitation by the is contingent on the behavior of the subject being studied. The imitation of the adult/practitioner includes imitating all of the child's movements, both vocal and motor. Children with autism have a deficit in social and communication skills (APA, 2000). Typical children learn to interact and play with peers through trial and error and modeling. These children receive feedback with each attempt to initiate or reciprocate play. Trial and error and modeling are related to contingent imitation in that children are learning skills based on examples given by other people. Children learning through trial and error will attempt to mimic an action as best they can, learning that the closer the imitation the more reinforcement received. A study by Snow (1989) suggests that typical children perform spontaneous acts of imitation in response to modeling that they have previously seen, before they are able to respond to elicited imitation. Modeling is similar to contingent imitation in that one person exhibits the behavior for the other to follow, however, in contingent imitation the child demonstrates a behavior first. These skills of modeling behavior and attempting behaviors through trial and imitation are thought to be necessary in order for a child to communicate effectively in his/her environment (Trent, Kaiser, & Wolery, 2005). Gazdag and Warren (2000) studied the effects of adult contingent imitation on the vocal imitation skills of young children with mental retardation. They found that contingent imitation increased spontaneous imitation skills in the participants. All three participants increased their rates of spontaneous imitation and elicited imitation in the study. However, they did not generalize the elicited imitation outside of the study. …

Functional communication training: The role of speech pathologists and behavior analysts in serving students with autism.

Introduction Autism is a neurological disorder characterized by significant impairments in language/communication, deficits in social interaction and restricted interests/ stereotypical behavior (American Psychiatric Association, 1994). Perhaps the most central of these impairments, especially in young learners, is the communication deficit. Learners with autism have difficulty in all aspects of communication, including receptive understanding, expressive language, and comprehension. Even in learners with a well-established capacity to communicate, there are often very significant deficits in spontaneous communications, in complex communication, and in reciprocal communication. These deficits in communication and social skills place these learners at risk for developing significant behavior problems. Learners with autism often engage in stereotypical behavior (e.g., repetitive, non-goal directed behavior), aggression, self-injurious behavior (SIB), pica, elopement, disruption, property destruction, and inappropriate vocalization (Kelli Dominick, Ornstein Davis, Lainhart, Tager-Flusberg, & Folstein, 2007; Smith, Vollmer & St. Peter Pipkin, 2007). Research has indicated that the ability to communicate is often directly related to the prevalence of maladaptive behavior (Carr & Durand, 1985). In many cases, challenging behavior serves a communicative function. In the absence of more effective means of communicating wants and needs, learners with autism often communicate through aberrant behavior. Learners with autism will often engage in disruptive behavior to access positive reinforcement (e.g., access to tangibles, access to attention) or to access to negative reinforcement (e.g., escape from demands, escape from a sensation). Given the detrimental nature of maladaptive behaviors and their negative impact on social and academic functioning, it is essential for learners with autism to receive intensive intervention to address their communication deficits at the earliest available opportunity. Intervention to address communication deficits should be an integral part of both Speech/Language and Behavior Analytic programs. Challenging behavior and its relationship to the ability to communicate highlight the importance of collaborative interaction between SLPs and behavior analysts. Historically, speech pathologists and behavior analysts have both served the needs of learners on the autism spectrum. The alliance has not always been an easy one, as the disciplines sometimes approach language acquisition differently. However, increasingly, there have been attempts to bridge these two communities of professionals, as a joint and integrated approach can maximize success. Collaboration between these two fields promotes comprehensive programming, which maximizes the scope and quality of services provided to learners with autism. Addressing communication deficits When addressing communication deficits, practitioners need to consider two important factors during the intervention process, the modality for communication and the procedures for teaching the response(s). A considerable amount of evidence has shown that learners with autism may respond to a variety of different modalities of communication. For instance, learners with autism have been taught to effectively communicate using verbal speech, (e.g., Carr & Durand, 1985), sign language (Mirenda, 2003), picture exchange (e.g., Yoder & Stone, 2006) and electronic augmentative devices (e.g., Millar, Light & Schlosser, 2006). It is important for practitioners to account for the strengths and weaknesses for different learners as well as the environment that the learners exist to choose an appropriate communication modality. For instance, teaching communication through verbal speech may not be appropriate for a learner with severe apraxia. Low functioning learners may respond better to picture exchange systems as they provide visual prompts for communication. …

Behavior of 10 patients with FG syndrome (Opitz–Kaveggia syndrome) and the p.R961W mutation in the MED12 gene

Opitz and Kaveggia [Opitz and Kaveggia (1974); Z Kinderheilk 117:1-18] reported on a family of five affected males with distinctive facial appearance, mental retardation, macrocephaly, imperforate anus and hypotonia. Risheg et al. [Risheg et al. (2007); Nat Genet 39:451-453] identified an identical mutation (p.R961W) in MED12 in six families with Opitz-Kaveggia syndrome, including a surviving affected man from the family reported in 1974. The previously defined behavior phenotype of hyperactivity, affability, and excessive talkativeness is very frequent in young boys with this mutation, along with socially oriented, attention-seeking behaviors. We present case studies of two older males with FG syndrome and the p.R961W mutation to illustrate how their behavior changes with age. We also characterize the behavior of eight additional individuals with FG syndrome and this recurrent mutation in MED12 using the Vineland Adaptive Behavior Scales 2nd edition, the Reiss Profile of Fundamental Goals and Motivation Sensitivities, and the Achenbach Child Behavior Checklist. Males with this MED12 mutation had deficits in communication skills compared to their socialization and daily living skills. In addition, they were at increased risk for maladaptive behavior, with a propensity towards aggression, anxiety, and inattention. Based on the behavior phenotype in 10 males with this recurrent MED12 mutation, we offer specific recommendations and interventional strategies. Our findings reinforce the importance of testing for the p.R961W MED12 mutation in males who are suspected of having developmental and behavioral problems with a clinical phenotype that is consistent with FG syndrome.

Perspectives on Addressing the Literacy Needs of Low-Functioning Individuals with Autism

Autism is a spectrum disorder characterized, in part, by core social communication skill deficits. Consequently, educators seek to develop interventions that address these and closely related skills, such as literacy. Accordingly, this article focuses on basic issues that pertain to designing and implementing appropriate educational programs that address the literacy needs of one segment of the autism spectrum: individuals with the disorder who have been characterized as being low functioning. Issues include the following: appropriate definitions of literacy for this population, historical approaches to this population's literacy instruction, opportunities for literacy skill development within an instructional program based on recommended evidence-based practices, and ongoing impediments to appropriate literacy instruction and practical solutions.

Comparative minicolumnar morphometry of three distinguished scientists

It has been suggested that the cell minicolumn is the smallest module capable of information processing within the brain. In this case series, photomicrographs of six regions of interests (Brodmann areas 4, 9, 17, 21, 22, and 40) were analyzed by computerized image analysis for minicolumnar morphometry in the brains of three distinguished scientists and six normative controls. Overall, there were significant differences (p < 0.001) between the comparison groups in both minicolumnar width (CW) and mean cell spacing (MCS). Although our scientists did not exhibit deficits in communication or interpersonal skills, the resultant minicolumnar phenotype bears similarity to that described for both autism and Asperger's syndrome. Computer modeling has shown that smaller columns account for discrimination among signals during information processing. A minicolumnar phenotype that provides for discrimination and/or focused attention may help explain the savant abilities observed in some autistic people and the intellectually gifted.

Fetal alcohol syndrome and the developing socio-emotional brain

Fetal alcohol syndrome (FAS) is currently recognized as the most common known cause of mental retardation, affecting from 1 to 7 per 1000 live-born infants. Individuals with FAS suffer from changes in brain structure, cognitive impairments, and behavior problems. Researchers investigating neuropsychological functioning have identified deficits in learning, memory, executive functioning, hyperactivity, impulsivity, and poor communication and social skills in individuals with FAS and fetal alcohol effects (FAE). Investigators using autopsy and brain imaging methods have identified microcephaly and structural abnormalities in various regions of the brain (including the basal ganglia, corpus callosum, cerebellum, and hippocampus) that may account for the neuropsychological deficits. Results of studies using newer brain imaging and analytic techniques have indicated specific alterations (i.e., displacements in the corpus callosum, increased gray matter density in the perisylvian regions, altered gray matter asymmetry, and disproportionate reductions in the frontal lobes) in the brains of individuals prenatally exposed to alcohol, and their relations with brain function. Future research, including using animal models, could help inform our knowledge of brain-behavior relations in the context of prenatal alcohol exposure, and assist with early identification and intervention.

Neuroinflammation and Behavioral Abnormalities after Neonatal Terbutaline Treatment in Rats: Implications for Autism

Autism is a neurodevelopmental disorder presenting before 3 years of age with deficits in communication and social skills and repetitive behaviors. In addition to genetic influences, recent studies suggest that prenatal drug or chemical exposures are risk factors for autism. Terbutaline, a beta2-adrenoceptor agonist used to arrest preterm labor, has been associated with increased concordance for autism in dizygotic twins. We studied the effects of terbutaline on microglial activation in different brain regions and behavioral outcomes in developing rats. Newborn rats were given terbutaline (10 mg/kg) daily on postnatal days (PN) 2 to 5 or PN 11 to 14 and examined 24 h after the last dose and at PN 30. Immunohistochemical studies showed that administration of terbutaline on PN 2 to 5 produced a robust increase in microglial activation on PN 30 in the cerebral cortex, as well as in cerebellar and cerebrocortical white matter. None of these effects occurred in animals given terbutaline on PN 11 to 14. In behavioral tests, animals treated with terbutaline on PN 2 to 5 showed consistent patterns of hyper-reactivity to novelty and aversive stimuli when assessed in a novel open field, as well as in the acoustic startle response test. Our findings indicate that beta2-adrenoceptor overstimulation during an early critical period results in microglial activation associated with innate neuroinflammatory pathways and behavioral abnormalities, similar to those described in autism. This study provides a useful animal model for understanding the neuropathological processes underlying autism spectrum disorders.

Autisme et retard mental : étude de la communication sociale précoce

Objective To determine developmental communication profiles in young autistic children with mental retardation. Methods A group of 19 autistic children (mean age = 43 months) were matched with a group of 11 mentally retarded children (mean age = 39 months) on mental age (17,6 months). All of these children were without speech (less than 5 words of vocabulary). Communication skills were assessed with the Guidetti-Tourrette scales (ECSP), French adaptation of the Seibert-Hogan scales. Results Autistic children displayed a much lower score than mentally retarded children in the 3 functions of early social communication (behavior regulation, social interaction and joint attention). The developmental communication profiles was the same in the 2 groups. Discussion The results showed evidence of distortion in autistic children development: they displayed important deficits in communication skills, in comparison with cognitive skills. Autistic children mainly displayed requesting gestures: they used adults to help them to reach a goal, instead of regarding them as social partners. However, young children who have mental age less than 18 months mainly use the same functions of communication, with or without autistic trouble. Conclusions There is a same developmental sequence in communication skills in young children, with or without autistic trouble.

Generalization of mands in children with autism from adults to peers.

Children with autism are characterized by deficits in communication and social skills. Teaching children with autism to mand with adults is a common practice in behavioral interventions and is listed as a necessary skill to be taught in many curricular sequences (Leaf & McEachin, 1999; Lovaas, 1981; 2003; Maurice, 1996; Maurice, Green, & Foxx, 2001; Sundberg & Partington, 1998). Most of these curricular sequences also list manding with peers as a target skill in the area of socialization (Leaf & McEachin, 1999; Maurice, 1996; Maurice, Green, & Foxx, 2001; & Sundberg & Partington, 1998). The designation of these curricular sequences to include manding with adults and manding with peers as separate targets leads one to assume that this skill does not generalize across people, but must instead be specifically taught in each domain. In contrast, when analyzing the social behavior of typically developing preschool children, Tremblay, Strain, Hendrickson, and Shores (1981) found that, on average, they exhibited one initiation toward a peer every two minutes in an unstructured setting. A later study obtained similar results, showing that non-disabled children initiated with each other an average of five times in a 10--minute session (McGrath, Bosch, Sullivan & Fuqua, 2003). Research investigating the social behavior of children with autism and developmental delays repeatedly indicates impairments in socialization, including initiations toward peers (Guralnick & Weinhouse, 1984; Pierce-Jordan & Lifter, 2005; Stone & Lemanek, 1990). Many studies have been successful in teaching children with autism to initiate toward their peers using a variety of strategies including the use of a tactile prompt (Shabani et al. 2002; Taylor & Levin, 1998;), script fading (Krantz & McClannahan, 1993), visual supports ( Johnston, Nelson, Evans, & Palazolo, 2003), and peer tutors (Goldstein, Kaczmarek, Pennington, & Shafer, 1992; & Pierce & Schreibman, 1995). Hancock and Kaiser (1996) specifically taught children to mand with their siblings during play and snack times. Similarly, Taylor, Hoch, Potter, Rodriguez, Spinnato, & Kalaigian, (2005) taught children to mand for preferred items with their peers during snack time. The participants in the Taylor et al. study all were reportedly able to mand for preferred items with adults, but did not mand with peers until specifically taught to do so. Skinner (1957) described the different verbal operants as functionally independent. Establishing one verbal operant does not automatically result in the appearance of another. A word with the same topography may serve several different functions, such as a discriminative function or a reinforcing function. For example, the word or object drink may function as a discriminative stimulus which evokes a listener's echoic or tact response, but it may also function by producing a reinforcer when an establishing operation is in effect. Lamarre and Holland (1985) were the first to demonstrate empirically the functional independence of the different but related classes of verbal operants, specifically mands and tacts that were topographically the same. Since then many studies have supported their research by demonstrating that the acquisition of one verbal operant does not necessarily transfer to another class of operant. Namely, the acquisition of a mand repertoire did not generalize to the acquisition of a tact repertoire without direct teaching (Sigafoos, Doss, & Reichle, 1989; Twyman, 1995; Twyman, 1996; Nuzzolo-Gomez & Greer, 2004; & Nirgudkar, 2005). Given the empirically validated fact that a mand repertoire may not generalize to other verbal operants, it is speculated that the acquisition of a mand repertoire may also fail to generalize across settings and/or people, especially in children with autism who are known to have difficulties with the generalization of skills (Wynn & Smith, 2003; Williams, Carnerero, & Perez-Gonzalez, 2006). …

Peer-mediated social skills training program for young children with high-functioning autism

One of the most prevailing characteristics of children with autism is their deficit in social communication skills. The purpose of this study was to evaluate the effectiveness of a peer-mediated social skills training (SST) program combined with video feedback, positive reinforcement and token system in increasing social communication skills in young children with high-functioning autism. Four boys with high-functioning autism, ages 6–7 years, participated in the study. The social skills training, lasting 12 weeks, targeted six communication skills, selected after parent interviews and behavioral observation during a pre-training assessment period. One SST session was conducted each week, each session lasted 90 min and had six structured activities. The training effectiveness was evaluated through direct observation of a structured interaction period, using an observational coding system. Improvement was observed in three out of four children, although individual differences among children were seen for changes in two global scales as well as subscales. These results suggest that the social skills training was effective in improving social communication skills for some children with high-functioning autism. Clinical and research implications and future directions for social skills training as well as this study's limitations are discussed.

Social communication skills in persons with post-acute traumatic brain injury: Three perspectives

Objective: To describe social communication skills problems identified by individuals with traumatic brain injury (TBI) compared to significant other (SO) and clinician ratings; and associations between these skills and participation outcome measures.Design: Cohort study.Methods: Sixty individuals with TBI ≥ 1 year post-injury were administered measures of social communication, societal participation, social integration and life satisfaction. Clinicians and SOs rated the social communication skills of the subjects.Results: Subjects were able to identify social communication skills problems, associated with lower ratings of community integration and satisfaction with life. Males reported higher scores in social communication and social integration than females. SOs and clinicians identified more social skills problems than subjects.Conclusions: Persons with TBI experience social communication skills deficits, associated with decreased societal participation and life satisfaction. Further research is needed to determine efficacy of social communication skills treatment and association with improved participation and satisfaction with life.

Competência profissional e assistência em anticoncepção

To evaluate the technical competence of professionals carrying out activities related to contraceptive care. Evaluative research in the field of health was conducted in eight districts of the State of Ceara from July to September 2003. Data was collected by means of interviews with 29 nurses working in the Family Health Care Program within these districts and 50 people being attended by this program. Observations of the Family Health Care Units were a complementary source of data within this study. The majority of nurses had received some form of training regarding contraception and the technical norms regulating their use. However, professional barriers were reported by the nurses and others were identified by lay persons being attended by the program, that indicate the need to provide better training for professionals engaged in this area of care. The nurses recognized they had deficits in information and communication skills as well as technical deficits in dealing with contraception. There are gaps in professional competence with regard to contraceptive care that, when associated to the lack of systematization of team work, generates distortions in the quality of care. Team work was characterized by the lack of definition of team members' specific attributions and tasks.

Assessing sexual risk behaviour with the Timeline Followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients.

This paper describes a series of 4 studies, designed to provide evidence of the feasibility, reliability, and validity of the Timeline Followback (TLFB) method when used to assess sexual risk behaviour with psychiatric outpatients. This population was selected because patients often have difficulty completing assessments of sexual risk behaviours due to deficits in attention, memory, and communication skills. All 4 studies demonstrated the feasibility of the HIV-risk TLFB. Study 1 also demonstrated that it can be completed in 20 min, and scored in less than 10 min. Qualitative data revealed that both patients and assessors found the features of the TLFB helpful. Study 2 provided evidence that the HIV-risk TLFB can be reliably scored by interviewers whereas Study 3 demonstrated that this measure can be completed reliably by patients and that TLFB of sexual behaviour were consistent over time. Study 4 provided initial evidence for the validity of the HIV-risk TLFB but also suggested that the TLFB may yield frequency estimates that are slightly less than those obtained with single-item measures. We conclude that the TLFB is feasible, reliable, and valid, even in a population known to have difficulty with self-report measures.

Evaluation of problem solving and communication skills of persons with schizophrenia

Although much research has shown positive outcomes of teaching problem solving and communication skills to persons with schizophrenia, the amount of research on the assessment of these two sets of skills has been modest. The current study demonstrates an effective model for their assessment and includes a previously neglected procedure to determine if subjects attended to the skill prompts. It replicates and expands prior findings on problem solving and communication skills. Results indicated that persons with schizophrenia were generally deficit in problem solving skills. Persons without schizophrenia seemed to use more behavioral information when deciding if a problem existed and they were better able to differentiate between appropriate and inappropriate solutions to problems. Persons with schizophrenia were found to be deficit in communication skills that facilitate interaction and showed a style that subordinated their wants to those of others. © 1998 Elsevier Science Ireland Ltd.