Frequent Communication Partners Research Articles

Enhancing Use of Remote Microphones Among Adult Cochlear Implant Users and Their Frequent Communication Partners

Remote microphones serve as assistive devices with the potential to enhance speech perception and sound quality for cochlear implant (CI) users in challenging listening environments. However, the extent to which adult CI users and their communication partners perceive these benefits remains uncertain. To address this question, we organized support groups for adult CI recipients implanted at the University of Iowa Hospitals and Clinics and their partners residing. The primary objectives of these support groups were twofold: firstly, to provide comprehensive education on the benefits of utilizing remote microphones, and secondly, to facilitate discussions on pertinent topics, including troubleshooting device-related issues. This study focuses on identifying and addressing the barriers encountered by adult CI users and their communication partners in effectively utilizing remote microphones, while simultaneously promoting their proper use through education and guidance. During the support group sessions, we engaged in discussions focused on strategies for optimizing remote microphone utilization among CI users and their frequent communication partners. These strategies encompassed comprehensive education and training, technical assistance, addressing concerns and potential stigma, and involving family members and caregivers in the process. Following participation in the support group sessions, all attendees completed questionnaires indicating an increased motivation to utilize remote microphones effectively. This finding underscores the critical role of education and support in promoting the efficient use of assistive devices and ultimately enhancing communication outcomes for both CI recipients and their communication partners. In summary, this project indicates the potential advantages of incorporating remote microphones into the lives of adult CI recipients and their communication partners. It underscores the imperative need for robust education and support mechanisms to ensure the optimal utilization of remote microphone systems.

An Exploration of Quality of Life Perceptions of Cochlear Implant Recipients and Their Frequent Communication Partners

Purpose: Quality of life (QoL) after cochlear implantation has been investigated using a variety of QoL questionnaires. However, few studies have examined the perceived QoL of cochlear implant (CI) recipients compared between the recipient and a frequent communication partner (FCP) using both hearing-related (hearing-specific) and health-general (health-general) measures. Method: For this multiple case study, five participant pairs were recruited, consisting of five adult recipients who were implanted at least 6 months prior to the time of evaluation and five adult FCPs who lived with the recipient at the time of evaluation. All 10 participants (five pairs) completed a health-general questionnaire (Medical Outcome Study Short-Form Survey 12-Item [SF-12]), and eight participants (four pairs) completed a disease specific questionnaire (Nijmegen Cochlear Implant Questionnaire [NCIQ]). Results: Both recipients and partners tended to score similarly to each other on both measures. However, both groups scored higher on the SF-12 than the NCIQ. Results also revealed a better interrater agreement between pairs on the SF-12 compared to the NCIQ. Conclusions: Overall, scores for recipients and partners were higher for the health-general SF-12 compared to the hearing-related NCIQ. Additionally, rater agreement was better for the SF-12 compared to the NCIQ, suggesting that differences in QoL perceptions exist for more hearing-specific challenges. These results highlight potential differences in perception of recipient QoL postimplantation as illustrated through the use of multiple QoL measures. Results speak to the importance of open communication between recipients and partners.

Effects of a Coaching Intervention on Paraeducator Use of Aided Language Modeling in Classroom Settings: A Pilot Investigation

Paraeducators are the most frequent communication partners during the school day for students who use augmentative and alternative communication (AAC), yet they often lack training in AAC best practices. This intervention study examined the effect of an in-class coaching intervention on the aided language modeling (ALM) skills of paraeducators who work with students who use AAC. An intervention protocol using evidence-based coaching strategies was used to support paraeducator implementation of ALM in typical classroom activities. The multiple-baseline single-subject design measured the use of ALM by four paraeducators. Data were analyzed visually and by calculating Tau- U and gain scores. Results suggest a strong effect from the coaching intervention on ALM skills for each of the paraeducators. Challenges and benefits of paraeducator-focused interventions in classroom settings are presented.

The Development of an Internet-Based Decision Coaching Guide to Encourage Audiology Care: The Results of a Participatory Design Approach.

Purpose The purpose of the research described here is to create a theoretically based, interactive online program to motivate adults with untreated hearing loss to seek audiology care. We describe the results of the participatory design (PD) approach used to increase uptake and adherence to the Internet-based program. Method Using information gathered from field experts (n = 7), a program outline was generated by the study team. In keeping with PD principles, multiple focus groups and panels consisting of persons with hearing loss (n = 26), frequent communication partners (n = 6), audiologists (n = 9), and other area experts (n = 16) revised and expanded both content and design of the program in an iterative fashion. Results The proposed program was modified multiple times based on the input of stakeholders throughout the PD process. In particular, the scope of the program shifted from focusing on self-management strategies to decision coaching regarding the choice to visit an audiologist. Other specific program content and activities were modified based on stakeholder input. Conclusions The program evolved dramatically through the influence and input of multiple stakeholders as a result of the implementation of PD principles.

Fostering Communication Through Physical Activity

Many individuals with autism experience difficulties with reliable, meaningful communication often impacting their academic and social engagement. As the first and most frequent communication partners, parents of children with autism may struggle initiating or maintaining meaningful communicative interactions, and thus require training, tools, and support. This article describes an approach to coaching parents in fostering meaningful, reciprocal communication through recreational activities as part of a larger physical activity program for parents and families of children with autism. It describes a Cycle of Communication framework as a tool for parents to recognize opportunities to structure and support their children’s communicative attempts and are discussed herein for educators, families and practitioners to adapt and use within their local contexts.

Qualitative research methods to investigate communication within a group aural rehabilitation intervention

Objective: Aural Rehabilitation (AR) aims to minimise negative effects of hearing loss. However, there has been limited study of the lived experience of clients receiving Aural Rehabilitation services, particularly for disparity populations. The purpose of this study is to demonstrate the use of an innovative qualitative approach to investigating communication in an AR setting among Hispanic/Latino older adult dyads.Design: We developed a qualitative phenomenology approach using observation methods to document and analyse how individuals experience living with acquired hearing loss within group AR. Trained observers collected systematic, detailed notes on observations of participants over the course of a 5-week community-based AR intervention. In partnership with audiologists, Community Health Workers facilitated the intervention, which focussed on decreasing negative communication impacts of hearing loss for families. Audiometric data and subjective hearing disability results, using the HHIE-S Spanish version, are presented as additional context for observation outcomes.Study sample: Participants were older Hispanic/Latino adults with hearing loss and their frequent communication partners (five dyads).Results: Four themes related to the experience of communication emerged among dyads in the intervention: (i) emotions related to hearing loss (ii) communication dynamics, (iii) self-management of hearing loss, and (iv) hearing health advocacy.Conclusions: A mixed methods approach that includes group observation would contribute substantially to comprehensively evaluating group AR interventions.Trial registration: ClinicalTrials.gov identifier: NCT03255161.

Real-World Benefits of Hearing Aids Beyond Better Speech Understanding

Real-World Benefits of Hearing Aids Beyond Better Speech Understanding

Evaluating communication partner training in aphasia: considering qualitatively informed randomised controlled trials (RCT) in an international context

Background: In the context of the growing evidence, communication partner training (CPT) for frequent communication partners of people with aphasia is a recommended intervention in the best practic...

Auditory Training With Frequent Communication Partners.

Individuals with hearing loss engage in auditory training to improve their speech recognition. They typically practice listening to utterances spoken by unfamiliar talkers but never to utterances spoken by their most frequent communication partner (FCP)-speech they most likely desire to recognize-under the assumption that familiarity with the FCP's speech limits potential gains. This study determined whether auditory training with the speech of an individual's FCP, in this case their spouse, would lead to enhanced recognition of their spouse's speech. Ten couples completed a 6-week computerized auditory training program in which the spouse recorded the stimuli and the participant (partner with hearing loss) completed auditory training that presented recordings of their spouse. Training led participants to better discriminate their FCP's speech. Responses on the Client Oriented Scale of Improvement (Dillon, James, & Ginis, 1997) indicated subjectively that training reduced participants' communication difficulties. Peformance on a word identification task did not change. Results suggest that auditory training might improve the ability of older participants with hearing loss to recognize the speech of their spouse and might improve communication interactions between couples. The results support a task-appropriate processing framework of learning, which assumes that human learning depends on the degree of similarity between training tasks and desired outcomes.

Frontal and Temporal Structural Connectivity Is Associated with Social Communication Impairment Following Traumatic Brain Injury.

Although it has been well documented that traumatic brain injury (TBI) can result in communication impairment, little work to date has examined the relationship between social communication skills and structural brain integrity in patients with TBI. The aim of the current study was to investigate the association between self- and other-perceived communication problems and white matter integrity in patients with mild to severe TBI. Forty-four individuals (TBI=24) and people with whom they frequently communicate, as well as demographically matched normal healthy comparisons (NC) and their frequent communication partners, were administered, respectively, the La-Trobe Communication Questionnaire Self form (LCQ-SELF) and Other form (LCQ-OTHER). In addition, diffusion tensor imaging data were collected, and fractional anisotropy (FA) measures were extracted for each lobe in both hemispheres. Within the TBI group, but not within the NC group, participants who were perceived by their close others as having more communication problems had lower FA in the left frontal and temporal lobes (p<.01), but not in other brain regions. Frontotemporal white matter microstructural integrity is associated with social communication abilities in adults with TBI. This finding contributes to our understanding of the mechanisms leading to communication impairment following TBI and can inform the development of new neuromodulation therapies as well as diagnostic tools. (JINS, 2016, 22, 705-716).

A conversation analytic study of patterns of overlapping talk in conversations between individuals with dementia and their frequent communication partners.

Difficulty participating in conversation is commonly experienced by individuals with dementia, secondary to cognitive and language deficits. Frequent communication partners (FCPs), however, report being largely unaware of how to support their conversation partners with dementia during conversation. In particular, taking a turn appropriately may be difficult for either partner due to trouble predicting a partner's behaviour and, hence, difficulty with timing conversational turns appropriately, potentially resulting in overlapping talk. To investigate the patterns of overlapping talk in the interaction between individuals with dementia and their FCPs. Three participants with moderate-severe dementia participated in conversation with an FCP. Ten minutes of 'casual' and 'task-oriented' conversation were audio- and video-recorded. Patterns of overlapping talk were investigated using conversation analytic methods. Overlapping talk was a consistent feature of all three dyadic interactions during both social and task-oriented talk. All participants exhibited competitive and non-competitive forms of overlapping talk. The data reveal that FCPs commonly yielded their own turns when overlapped by a partner in order to create opportunities for their partners with dementia to communicate. Participants with dementia demonstrated some retained pragmatic abilities, both using continuers and yielding the floor to their partner when competitively overlapped in order to encourage a speaker to continue. These findings contribute to the understanding of the impact of dementia on the maintenance of sensitivity to the sequential aspects of everyday talk. From a clinical perspective, these findings can inform the training of FCPs about retained abilities and evidence-based support strategies, equipping them with knowledge and skills to structure and maintain fluent conversation.

Perceived emotional valence in clear and conversational speech for older adults with hearing loss

When asked to speak as though talking to an individual with hearing loss, talkers modify their speech from their everyday conversational style to a “clear” speaking style. Audiologists have observed in practice that individuals with hearing loss sometimes complain that their frequent communication partners are shouting at them, while the communication partners insist they are just trying to speak more clearly. A previous study investigated how individuals with normal hearing perceived emotional valence in clear and conversational speech and found that clear speech sounded angry more often than conversational speech. The present study will explore whether a similar effect is found in older individuals with hearing loss. Perceived anger has been partially attributed to increased energy in the high frequencies, where age-related hearing loss is most severe. Furthermore, aging effects have been found for visual emotion perception. Older adult listeners with hearing loss will be presented with conversational and clear sentences from the Ferguson Clear Speech Database (Ferguson, 2004) and asked to assign an emotion category to each sentence (anger, sadness, happiness, fear, disgust, or neutral). The results will indicate whether elderly listeners with hearing loss judge clear speech as sounding angry more often than typical conversational speech.

“Ward talk”: Nurses’ interaction with people with and without aphasia in the very early period poststroke

Background: Nursing staff are the most frequent communication partners, after family members, for people in hospital poststroke, and they play an essential role in the multidisciplinary team. Recent research has found that patients are more cognitively and socially active when wards provide an “enriched environment” as compared to standard care. Therefore, language enrichment on acute wards is now being considered as a possible way to discourage “learned nonuse” of language in people with aphasia.Aims: This study involved an exploration of the nature of nurses’ interactions with three patients on an acute stroke ward, two with aphasia and one without, in order to understand the nature of the communicative environment in more detail.Methods & Procedures: Following all necessary ethics approval processes and consents, continuous video recordings of 7.5 hr each were run for three male patients (two aged 68 years and one aged 48 years) on the acute stroke ward within a teaching hospital in an Australian city. Two had left hemisphere strokes resulting in a Wernicke’s aphasia (WAB AQ = 47) and a global aphasia (WAB AQ = 9.2) and one had a right hemisphere stroke and no aphasia. All instances of interaction with nurses over that period were transcribed orthographically and analysed at a discourse level using a speech function analysis based on a systemic functional linguistic framework.Outcomes & Results: Overall, nurses made most of the opening moves, used closed questions, controlled the conversational floor, and did not generally interact about issues other than physical care. The patients with aphasia had restricted opportunity to use continuing and developing moves and most commonly fell into a pattern of closed question and simple response. There was little evidence of communicative repair by nurses and few supported conversation strategies employed. Patterns of moves identified through the speech function analysis revealed the disempowered position of the patients with aphasia compared to the patient without who used a wider range of speech functions that demonstrated more assertive interactions.Conclusions: This study suggests that nurses, in their role as key communication partners on the acute stroke ward, could help counter the development of learned nonuse by integrating more effective communication strategies into their daily care routines. Further conversation partner training could relieve communication breakdown and frustration and increase opportunities for satisfying conversational exchanges in this setting.

Perceived emotional valence in clear and conversational speech

In the laboratory, talkers asked to speak as though talking to an individual with hearing loss modify their speech from their everyday conversational style to a “clear” speaking style. In the real world, individuals with hearing loss sometimes complain that their frequent communication partners seem to be shouting at them, while the communication partners insist that they are just trying to speak more clearly. Acoustic analyses have contrasted angry speech with neutral speech and clear speech with conversational speech. A comparison of these analyses reveals that angry speech and clear speech share several acoustic modifications. For example, both clear speech and angry speech show increased energy at high frequencies. The present study will explore whether clear speech sounds angry to listeners. Young adult listeners with normal hearing will be presented with conversational and clear sentences from the Ferguson Clear Speech Database (Ferguson, 2004) and asked to assign an emotion category to each sentence (anger, sadness, happiness, fear, disgust, or no emotion). The resulting data will show whether clear speech is more likely to be judged as sounding angry than typical conversational speech.

Conversation repair: Ecological validity of outcome measures in acquired hearing impairment

ObjectiveEveryday conversation is the most widely reported difficulty arising from adult acquired hearing impairment (HI), yet no clinical method currently exists by which direct observation of conversational ability can be measured. This review of recent research argues that specific patterns of conversation repair arise in interaction involving adults who have acquired HI and that they may be of utility in assessing the outcome of intervention.MethodsThis brief review paper presents a summary of data on the conduct of repair in free and unstructured conversations between HI adults and their frequent communication partners using Conversation Analysis as the guiding theory and analytic method.ResultsResults indicate that certain types of repair are influenced by one participant in the conversation having an acquired hearing impairment. Further, these patterns of repair behaviour are resolved in concert by the participants in the conversation.DiscussionPatterns of repair behaviour may be used as criterion variables in assessing the need for and outcome of audiological intervention, including implantation, hearing aid fitting and/or conversation-based therapy. Previous research has shown that these measures are both consistent across time in the absence of intervention and that they are sensitive to intervention.ConclusionThese findings support the potential for conversationally-oriented therapy models of assessment and intervention and suggest a framework by which clinical tasks might be analysed with respect to their conversation ‘reality’. This initial evidence needs to be supported by investigations across larger samples of adults with acquired hearing impairment.

Teaching Paraeducators to Support the Communication of Young Children With Complex Communication Needs

Paraeducators are frequent communication partners for young children with complex communication needs (CCN) in early childhood settings. This study examined the impact of instruction to paraeducators in two communication interaction strategies (IPLAN [Identify activities for communication, Provide means for communication, Locate and provide vocabulary, Arrange environment, use iNteraction strategies] and MORE [Model AAC, Offer opportunities for communication, Respond to communication, Extend communication]) on the number of communication opportunities provided by paraeducators during play activities with young children with CCN. Results of the study provide evidence that after 2 hr of one-on-one training, paraeducators increased the number of communication opportunities they provided for children with CCN, and children with CCN took an increased number of communication turns. In addition, paraeducators reported that they found the training beneficial, and the supervising teachers noted improvements in the communication support provided by the paraeducators. Limitations and future research directions are discussed.

A Multifaceted Living Well Approach to the Management of Hearing Loss With Adults and Their Frequent Communication Partners

Often in the context of rehabilitation for adults with hearing loss, we hear the voices of cynics. “It costs too much. It takes too much time. People are not interested.” In this paper, we advocate for an alternative viewpoint of the process of rehabilitation, one that can be implemented for low costs and has value within a community. We explain the process that occurred to secure, develop, and expand an endowed community-based program on Living Well with Hearing Loss based out of the University of Arizona with a vision of sustainability. Since its inception in 2009, the program has grown substantially. We describe the program’s early journey and underlying bases, outline preliminary outcomes, and provide suggestions for audiologists in clinical practice based on our experience to date.

Third-Party Disability in Spouses of Older People With Hearing Impairment

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment means that not only does the person with hearing impairment experience the consequences, but his or her frequent communication partners do also. In this article, the authors discuss the impact of hearing impairment in older people on spouses with normal hearing using the conceptualization of “third-party disability” created by members of the World Health Organization (WHO, 2001, p. 251). Results of a series of studies conducted by the authors demonstrate that spouses experience a range of activity limitations and participation restrictions due to their partner’s hearing impairment, including a variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. In this article, the authors highlight the important role of family-centered intervention in audiologic rehabilitation for older adults and emphasize the need to increase inclusion of spouses and significant others in the rehabilitation process.

Older Adults with Acquired Hearing Impairment: Applying the ICF in Rehabilitation

The aim of this article is to describe the disability experienced by older people with hearing impairment using the framework provided by the World Health Organization's International Classification of Functioning, Disability and Health (ICF). The nature and prevalence of hearing impairment in the older population are outlined, along with the Activity Limitations and Participation Restrictions associated with such impairments, and the contextual factors that influence the disability. Appropriate assessments of hearing Impairments, Activity Limitations, and Participation Restrictions applicable in a rehabilitation context are also described. Hearing impairment leads to breakdowns in communication, a fact that suggests that the impairment is likely to influence frequent communication partners. It is argued here that the impact of the impairment on others is a so-called Third-Party Disability. Finally, an example of how the ICF can be applied in the rehabilitation of an older person with hearing disability is presented.

Configurations of Relationships in Different Media: FtF, Email, Instant Messenger, Mobile Phone, and SMS

This study analyzes the configurations of communication relationships in Korea through face-to-face, email, instant messaging, mobile phone, and short message service media. Through a web survey, we asked respondents to identify (1) for each of the five media (2) up to five of their most frequent communication partners, (3) the partner’s social role (including colleagues, family, friends), and (4) their own employment category. Individual-level and network-level analyses were used to compare variations in communication relationships and configurations of relationships among social roles overall, within each medium, and for different employment categories, and to identify configurations of relationships across media. IM, SMS, and mobile phone are distinctive media for students, mobile phone for homeworkers, and email for organizational workers. Moreover, mobile phones tend to be used in reinforcing strong social ties, and text-based CMC media tend to be used in expanding relationships with weak ties. Finally, face-to-face (FtF) seems to be a universal medium without significant differences across respondents’ employment categories.