Frequency Of Utterances Research Articles

270 Understanding Patient Provider Conversations: What Are We Talking About?

Study Objectives: Effective patient-provider communication is a critical aspect of the delivery of high quality patient care; however, research regarding the conversational dynamics of an overall emergency, department (ED) visit is lacking. Identifying both patterns and relative frequency of utterances within these interactions will help to guide future efforts to improve the communication between patients and providers within the ED setting. The objective of this study was to analyze audio recordings of complete ED visits to characterize these conversations and determine the proportion of the conversation spent on different functional categories of communication.

Lexical and syntactic development in Italian children with Down's syndrome

Although children with Down's syndrome show some delays in each area of language development, their morphosyntactic competence appears to be more severely compromised than their lexical skills and, therefore, they are frequently mentioned as an example of dissociation between grammar and lexicon. The principal aim of the present study was to compare the lexical and syntactic development of Italian children with Down's syndrome with that of typically developing children, considering their spontaneous production. Particular attention was given to the relationships between these linguistic areas and the transition from single-word utterances to multiword combinations (that is, transitional forms). Twenty-four children participated in the study: twelve with Down's syndrome and twelve typically developing children. On average, the children with Down's syndrome participating in the study had a vocabulary size of about 450 words; and their mean chronological age was 54 months, whereas their mean developmental age was 30 months. The criteria for inclusion in the typically developing children group were a mean vocabulary size similar to that of the participants with Down's syndrome and a mean chronological age equivalent to the mean developmental age of the children with Down's syndrome. Each child's spontaneous verbal production was assessed during a parent-child play session. Data analyses focused on both lexical variables (type and tokens, vocabulary composition) and syntactic variables (frequency and types of transitional forms, frequency of utterances with different degree of complexity, and argument structure of verbs). The vocabulary composition of the children with Down's syndrome appeared to be simpler than that of the typically developing children at the same lexical size. Children with Down's syndrome used a higher number of transitional forms, but their production of multi-word utterances was less frequent; they were able to use word combinations, but they produced a low number of morphologically complete sentences. In addition, a significant relationship emerged between the development of the lexicon and the production of multi-word utterances. Children with Down's syndrome seem to have greater difficulties in expressing sentences in a grammatically correct form, though they are able to combine words. The theoretical relevance of the study lies in the fact that individuating a significant relationship between lexical and syntactic skills supports the hypothesis of interdependence between these two language domains; the practical relevance of the results lies in the fact that intervening on lexical abilities could have a beneficial effect on syntactic skills.

Effects of a Cross-Linguistic Storybook Intervention on the Second Language Development of Two Preschool English Language Learners

The purpose of this study was to examine the effects of a shared reading experience between parent and child in the child’s home language on the emergent literacy and language acquisition in English of preschool-age English Language Learners. Parents of Spanish-speaking four-year-old Head Start students read storybooks in Spanish with their children concurrently with the use of the English language version of the books in the classroom. A single subject design with multiple baselines across subjects and settings was applied. Observed variables included changes in the frequency of utterances, the Mean Length of Utterance-word, and the frequency of spontaneous or child-initiated utterances in various settings within the Head Start classroom. The results indicated that there might be a relation between the shared reading experience in the home language and the child’s second language acquisition. Additionally, there appeared to be a relation between the behaviors and the settings. Finally, implications of this study were discussed.

Exploring Emergency Physician–Hospitalist Handoff Interactions: Development of the Handoff Communication Assessment

We develop and evaluate the Handoff Communication Assessment, using actual handoffs of patient transfers from emergency department to inpatient care. This was an observational qualitative study. We derived a Handoff Communication Assessment tool, using categories from discourse coding described in physician-patient communication, previous handoff research in medicine, health communication, and health systems engineering and pilot data from 3 physician-hospitalist handoffs. The resulting tool consists of 2 typologies, content and language form. We applied the tool to a convenience sample of 15 emergency physician-to-hospitalist handoffs occurring at a community teaching hospital. Using discourse analysis, we assigned utterances into categories and determined the frequency of utterances in each category and by physician role. The tool contains 11 content categories reflecting topics of patient presentation, assessment, and professional environment and 11 language form categories representing information-seeking, information-giving, and information-verifying behaviors. The Handoff Communication Assessment showed good interrater reliability for content (kappa=0.71) and language form (kappa=0.84). We analyzed 742 utterances, which provided the following preliminary findings: emergency physicians talked more during handoffs (67.7% of all utterances) compared with hospitalists (32.3% of all utterances). Content focused on patient presentation (43.6%), professional environment (36%), and assessment (20.3%). Form was mostly information-giving (90.7%) with periodic information-seeking utterances (8.8%) and rarely information-verifying utterances (0.4%). Questions accounted for less than 10% of all utterances. We were able to develop and use the Handoff Communication Assessment to analyze content and structure of handoff communication between emergency physicians and hospitalists at a single center. In this preliminary application of the tool, we found that emergency physician-to-hospitalist handoffs primarily consist of information giving and are not geared toward question-and-answer events. This critical exchange may benefit from ongoing analysis and reformulation.

LINGUISTIC PERFORMANCE AS A FUNCTION OF ABSTRACT TASK DEMANDS IN CHILDREN WITH SPINA BIFIDA

Children with spina bifida and hydrocephalus (SBH) have been observed to have deficits in discourse, characterized by a high frequency of irrelevant utterances and poorer performance with abstract than concrete language. The Preschool Language Assessment Instrument (PLAI) was used to compare children with SBH and language-age controls on discourse skills at four levels of abstraction. In addition, a qualitative assessment of differences in types of inadequate productions was conducted. Children with SBH performed comparably to controls on concrete levels of the PLAI, but they produced significantly more 'no response' and irrelevant responses than the controls.

Sex differences in vocal communication among adult rhesus macaques

In female-bonded primate species, females invest more time in grooming than males, and the majority of this grooming occurs in intra- rather than intersexual interactions. These clear sex differences in sociability reflect females' need to forge and maintain complex networks of social relationships with other females in the group. Increasing evidence indicates that vocal signals can have a similar function to grooming in mediating social interactions and relationships, and sex differences in patterns of use of vocal communication comparable to those seen for grooming might therefore be expected to occur. In this study of free-ranging adult rhesus macaques, we tested for such patterns, focusing on the frequency of utterance of three types of vocalisations given during close-range social interactions: coos, grunts, and girneys. As predicted, we found that females gave such calls significantly more frequently than males and also directed more of these vocalisations towards other females than to males; males' rate of vocalising towards the two sexes was not significantly different. To our knowledge, these results provide the first evidence for a sex difference in the rate of production of social vocalisations among adult nonhuman primates. The finding that increased sociability is associated with increased reliance on vocal communication may have important implications for theories of language evolution.

Verbal Marking of Affect by Children with Asperger Syndrome and High Functioning Autism during Spontaneous Interactions with Family Members

Verbal marking of affect by older children with Asperger Syndrome (AS) and high functioning autism (HFA) during spontaneous interactions is described. Discourse analysis of AS and HFA and typically developing children included frequency of affective utterances, affective initiations, affective labels and affective explanations, attribution of affective responses to self and others, and positive and negative markers of affect. Findings indicate that children with AS and HFA engaged in a higher proportion of affect marking and provided a higher proportion of affective explanations than typically developing children, yet were less likely to initiate affect marking sequences or talk about the affective responses of others. No significant differences were found between groups in terms of the marking of positive and negative affect.

The Development of Proto-Performative Utterances in Deaf Toddlers

The purpose of this study was to examine and compare the development of proto-imperative and proto-declarative utterances in normally developing, non-neonatally screened, profoundly deaf toddlers. Both types of proto-declarative are considered to be the most basic prelinguistic and early linguistic communicative functions. Eighteen normally developing, non-neonatally screened, profoundly deaf toddlers participated in a longitudinal study. All children were enrolled in the same oral-aural home guidance program. At the time of the study, none of the children had received a cochlear implant. At the ages of 18, 24, and 30 months, proto-imperative utterances were elicited using an adapted version of M. Casby and J. A. Cumpata's (1986) Protocol for the Assessment of Prelinguistic Intentional Communication. For eliciting proto-declarative intentions, a video clip was used. Results revealed a significant increase in both frequency and level of utterances for both types of proto-performatives. Although there was a clear development from nonlinguistic toward linguistic communication, utterances remained predominantly deictic-gestural for the imperative intentions and referential-gestural for declaratives. The data support the notion from the literature that both types of performatives are susceptible to elicitation. Results also suggest that after neonatal screening, both total communication and oral-aural approaches might accelerate conventionalization of the earliest communicative utterances of profoundly deaf toddlers.

Surgical Simulation

Surgical Simulation

Maternal responsive and directive behaviours and utterances as predictors of children's lexical development

Predictive relations were examined between measures of 20 mothers' behavioural and verbal general and specific responsiveness and intrusive and supportive directiveness and their children's subsequent expressive vocabularies during three developmental periods with endpoints at the beginning, middle, and end of the second year: 0; 10 to 1; 1, 1 ; 1 to 1; 5, and 1;5 to 1;9. Regression analyses, controlling for mothers' utterance frequencies and children's initial lexicons, revealed considerable consistency between reported and observed lexicons but changing patterns of predictive relations with development. During the first period, behavioural, but not verbal, measures of maternal responsiveness and supportive directiveness were positively predictive. In period two, verbal, but not behavioural, measures predicted children's vocabularies, with specific responsiveness and supportive directiveness as positive predictors and intrusive directiveness as a negative predictor. During the final period, mothers' behavioural and verbal responsiveness and behavioural supportive directiveness positively predicted and their verbal intrusive directiveness negatively predicted children's lexical growth.

Predictors and correlates of the frequency and the length of verbal communications between nursing staff and elderly residents in geriatric care facilities

AbstractAim: The present study was conducted to clarify the type and frequency of verbal communication between caregivers and elderly residents in geriatric care facilities. The relationship of this verbal communication was studied in terms of the caregivers talking to elderly residents and the utterances issued by the elderly residents. The attributes of the elderly residents were also studied.Methods: There were 35 eldery residents living in three metropolitan geriatric care facilities. Observations were made of caregivers talking to elderly residents and of elderly residents talking to caregivers in order to conduct a content analysis that categorized the types of verbal communication observed. A statistical analysis of the relationship between the frequency and duration of verbal communication and attributes of the elderly residents was carried out.Results: There were two category types of talking to elderly residents by a caregiver: ‘talking to elicit the ‘activities of daily living (ADL)‐related behavior/performance or physical functioning’ (type I: instrumental communication) and ‘talking to facilitate psychosocial life activities’ (type II: affective communication), of which the former accounted for 75.9%. The number of spontaneous utterances from elderly residents was very low, with most utterances being responses to caregivers talking to them. There was a tendency for utterances from the elderly residents to increase as the total time of being talked to by caregiver increased (r = 0.47, P < 0.01). The total amount of time a caregiver spent talking to elderly residents was longer for people with low versus high mobility and for people with dementia versus people without dementia (t = 3.4, P < 0.01).Conclusion: The correlation between type II communication and the mean frequency of utterances by elderly residents was high (r = 0.72, P < 0.01) compared with type I, suggesting that the former type of communication is more likely to elicit utterances by elderly residents.

Client commitment language during motivational interviewing predicts drug use outcomes.

Client language from a motivational interview (MI) and drug use outcome were investigated. Interview videotapes of 84 drug abusers were coded for frequency and strength of utterances expressing commitment, desire, ability, need, readiness, and reasons to change or maintain their habit. Cluster analysis of proportion days abstinent (PDA) revealed 3 groups: high PDA at intake and follow-up (3, 6, 9, 12 months; maintainers); low intake PDA/high follow-up PDA (changers); and low intake PDA/low to moderate follow-up PDA (stragglers). Distinct group patterns emerged for commitment strength (CS) during MI. Clients dishonest in checklist self-report exhibited CS similar to stragglers. CS for client evaluation of a change plan predicted outcome PDA. CS was predicted by strength of desire, ability, need, and reasons, but more strongly predicted outcome PDA, suggesting CS is a pathway for their influence on behavior.

Effect of backchannel utterances on facilitating idea-generation in Japanese think-aloud tasks.

The relation between backchannel utterance and idea-generation has hardly been studied. Based on preliminary investigations, we formulated a hypothesis that a listener's backchannel utterances facilitate a speaker's idea-generation. This study experimentally manipulated the frequency of backchannel utterances by listeners during speakers' idea-generation for think-aloud tasks. 16 Japanese female undergraduates participated. Analysis indicated that frequent backchannel utterances increased not only the number of ideas generated but also the speaking time for the tasks.

Pitch and Communicative Intent in Mother's Speech: Adjustments for Age and Sex in the First Year

This study investigated pitch and communicative intent in mothers' infant‐directed speech spoken to their infants at birth, 3, 6, 9, and 12 months. Audio recordings of mothers (6 with female, and 6 with male infants) talking to another adult and to their infant at 5 ages were low‐pass filtered and rated by 60 adults on 5 scales (Positive or Negative Affect, Express Affection, Encourage Attention, Comfort or Soothe, and Direct Behavior). Mean fundamental frequency (F0) and pitch range of utterances were also measured. Utterances associated with positive affect tend to peak at 6 and 12 months, whereas more directive utterances peaked at 9 months. Mean F0 followed the age trend for affective utterances, and pitch range followed the trend for directive utterances. The results suggest mother speech patterns reflect, complement, and perhaps facilitate infant development.

Memory aids as an augmentative and alternative communication strategy for nursing home residents with dementia

The effect of memory aids on conversations between nursing aides and residents with dementia during 5-minute conversations was examined. Nursing home units in seven nursing homes were randomly assigned to treatment and control conditions. Residents in the treatment condition were given 12-page memory books consisting of autobiographical, daily schedule, and problem resolution information. Their assigned nursing aides were trained to use the memory books during care interactions and throughout the day. The duration and quality of verbal interactions between dyads of a resident and their nursing aide during 5-minute conversations were measured pre- and post-treatment using computer-assisted observational techniques and verbatim transcriptions of videotaped conversations (N = 66; 33 treatment dyads and 33 control dyads). The results revealed improvements on a variety of quantitative conversational measures (e.g., duration of speaking time, frequency of utterances) between treatment and control conditions as a function of memory book use. Similarly, the quality of conversations, as measured by the frequency of discourse characteristics (e.g., facilitative behaviors), improved as a function of memory book use for treatment dyads. Nursing aides' judgment of residents' depressive symptoms improved with memory aid use, suggesting changes in resident quality of life as a result of an AAC technique that enhanced information sharing and social closeness.

Using Shannon Entropy on Measuring the Individual Variability in the Rufous-bellied Thrush Turdus rufiventris Vocal Communication

We applied the information theory concepts to notes repertoire characteristics combined with temporal parameters of the Rufous-bellied thrush Turdus rufiventris song, using this particular case to test a new method of analysing quantitatively complex animal communication systems. Like most Turdus thrushes, Rufous-bellied thrushes are remarkable for their long, varied and melodious songs. For the analysis of the species repertoire, we used recordings of 44 individuals from 24 localities covering its full geographical range. We measured the repertoire size, note duration and rhythm (frequency of note utterance), and combined these parameters with the Shannon entropy values calculated for each individual. Although individuals maintain species-specific recognition capacity, we find a large variation between their song parameters and show that the information theory can be useful to analyse large and varied animal vocal repertoires. We are introducing two new parameters, temporal average entropy (Et) and utterance frequency average entropy (Ef), for measuring such communication systems.

Gender Differences in Preschoolers' Help-Eliciting Communication

Gender differences in help-eliciting communication and the relationship of such utterances with ability were explored. A sample of 71 preschoolers (38 boys, 33 girls; mean age 4 years 3 months) were videotaped as they solved a difficult puzzle. Spontaneous talk was analyzed for orientation (to whom or to what an utterance referred) and for the frequency of utterances coded as help eliciting. Significant main effects for gender were observed, with more frequent help-eliciting utterances (HEUs) made by the girls than by the boys, particularly HEUs about themselves (self-disclosing). Although the girls' HEUs were not predictive of ability on the puzzle, the boys' were. No gender differences in puzzle-solving ability were observed. Findings are discussed with regard to problem solving and social/linguistic development.

The Communication of Differential Relationships in Preschool Children: Preference and Social Theme

We examined the conversations of 14 preschool children to explore differences in communication between friends and nonfriends in a well‐established group. Children's social preferences were identified by analysing relative utterance frequencies which revealed a network structure of 4 cliques. We then examined whether the integration (inclusion/exclusion) and social theme (person/action) content of children's utterances, and the responses (accept/oppose) to these utterances, discriminated relationships in the social network. Our main findings were 1) Exclusive utterances were more likely to occur between nonfriends and to be opposed. Inclusive utterances were more likely to occur between friends and to be accepted. 2) Person and action themes were used differentially. In exclusion statements, nonfriends were more likely to be personally rejected whereas friends were more likely to have their actions rejected. In inclusion statements, personal references were more likely to be accepted between friends whereas references to a peer's actions tended to be accepted by both friends and nonfriends. We concluded that children adapted the integration and social theme content of their utterances to relationship context in order to establish more intimate interactions between friends and more distant interactions between nonfriends.

The effect of stressful and protective communicative events on the autonomic response in schizophrenic and healthy persons

Comparative single-case analyses of specific communicative features and their physiological concomitants in two dialogues between (1) a healthy male partner (A) and a healthy female index person (H), and (2) partner A and a male schizophrenic index person (S) show similarities and differences between persons H and S. Partner A's communicative reactions to the index person's stress reaction are dassified as protectors, stressors or mixed; utterances by the index persons following their stress reaction are classified as self-modificatory. A X 2 analysis reveal no significant association between the category of utterance and the index person's physiological response in either conversation. However, in index persons H and S there are clear tendencies: increases or non-decreases in activation accompany partner A's mixed or ambiguous reactions, clear protectors and stressors are accompanied by a decrease of activation. The main difference between index persons H and S lies in their frequency of self-modificatory utterances; despite being accompanied by activation decrease in both index persons H and S, self-modificatory reactions are comparably rare in index person S. The projection of these results onto a model of instrumental learning allows formulation of tentative hypotheses to explain index person S's reluctance to adopt a self-protective behaviour.

Influencia del habla materna en los inicios de la adquisición del lenguaje: primeras palabras y primeros enunciados de más de una palabra

AbstractIn this work we approach the relations between maternal speech and early language acquisition through the analysis of mother-child joint activity episodes. We analyze the data of a castillian mother-daughter couple. Specifically, we attend to the relations between maternal speech and a) the first child’s single-word utterances and b) the child’s multiword utterances with the next structural pattern: «Demostrative pronoun + X». Our results show a great coincidence between the communicative intents expressed by the child’s single- word utterances and by the precedent maternal ones including the infant’s words. In relation to the second aim of our analysis, the results suggest that this couple have negotiated demonstrative pronouns as a verbal procedure to refer to the joint focus of activity, the conversation topic. We propose as an hypothesis to consider that the high frequency of utterances with demonstratives in initial position in maternal speech would have constituted the ORIGINALES functional input for the infant’s learning of the procedure «Pronoun (Topic) + X (Comment)». Finally, the analysis of the position of the child’s words in precedent maternal speech suggests that the initial and final segments of the utterance would be privileged for language processing and learning