Functional Communication Skills Research Articles

The impact of a university-based intensive comprehensive aphasia programme (ICAP) on language, functional communication and quality of life in people with chronic aphasia

ABSTRACT Background Intensive Comprehensive Aphasia Programmes (ICAPs) are increasingly considered the preferred option for high intensity aphasia rehabilitation. This is due to the emerging evidence that shows the potential of the programme to improve language impairment as well as psychosocial wellbeing and quality of life (QoL) in persons with chronic aphasia. Aims The aim of the study was to investigate whether a university-based, student-led, online ICAP led to measurable improvements in language, functional communication and QoL in persons with aphasia (PwAs). Methods & Procedures Eleven PwAs (six women, five men; M age = 60.4 years; M time post onset = 14.6 months) participated in a 10-week ICAP that provided 36 hours of treatment in total. Outcome measures relating to language impairment, functional communication and QoL were administered before and after the ICAP and included a range of subtests of the Comprehensive Aphasia Test (CAT) and the Communication Activities of Daily Living – second edition (CADL-2), the Assessment for Living with Aphasia (ALA), the Aphasia Impact Questionnaire (AIQ-21) and the Communication Outcomes after Stroke Scale (Carer COAST). Pre- and post-ICAP performances were tested for significance using Wilcoxon signed-rank tests. In addition, effect sizes were calculated. Outcomes & Results Post-ICAP, significant gains occurred in the CAT subtests of auditory and reading comprehension as well as naming objects, with large effect sizes being noted for the subtests of reading comprehension and naming objects. Significant changes were also observed between the pre- and post-assessment scores for the AIQ-21 and the Carer COAST, whereby the latter yielded large effect sizes. By contrast, CADL-2 and ALA scores did not change significantly as a result of the ICAP intervention. Conclusions Results indicate that the ICAP effectively improved participants’ language and functional communication skills, as well as QoL for both PwAs and their communication partners. Findings further indicate that a student-led ICAP implemented in a university setting can be considered a viable and pragmatic solution to offering ICAPs to achieve the high intensity needed to effect positive changes in communication.

Performance of Malayalam Speaking Children Fitted with Hearing Aids on PEACH Scale

Abstract: Parental questionnaires impart a better understanding of hearing technology utilization by children with Hearing loss(HL). They provide insights into the functional abilities and accomplishments of children equipped with Hearing Aids (HA). The present study aimed to translate and adapt the PEACH questionnaire into Malayalam language and evaluating its effectiveness in discriminating the functional hearing abilities of Malayalam speaking children with HL fitted with HAs at various stages of life. The Malayalam PEACH questionnaire was aPdministered to parents/caregivers of 40 Malayalamspeaking children aged 3 to 6, divided into two groups based on whether they received HA before or after the age of 2. Results revealed that children fitted with HA before 2 years of age demonstrated superior performance in quiet, noisy, and overall situations compared to those fitted after 2 years of age highlighting the importance of early identification of HL in children. Additionally, the questionnaire exhibited high reliability upon retesting across all of the three hearing situations (quiet,noise and overall). Therefore, the Malayalam PEACH questionnaire emerges as a dependable and effective tool for evaluating and monitoring the functional hearing abilities and communication skills of children fitted with HA or Cochlear Implants (CI) in their everyday lives

Beyond words: an investigation of fine motor skills and the verbal communication spectrum in autism.

This study investigated the associations between fine motorskills and expressive verbal abilities in a group of 97 autistic participants (age 8-17, mean=12.41) and 46 typically developing youth (age 8-17, mean=12.48). Participants completed assessments of motor and verbal communication skills, including finger tapping speed, grooved pegboard, grip strength, visual-motor integration tasks, and measures of speech and communication skills. ASD group performance on motor tests was compared to controls. Non-parametric tests were used to analyze group differences and correlations between motor and verbal communication skills. Based on prior research, we hypothesized that individuals on the autism spectrum would exhibit deficits in fine motor speed, dexterity, pencil motor control, but not manual motor strength. Additionally, we expected that impaired fine motor skills would be linked to poorer performance on standardized measures of verbal abilities. The results indicated that 80% of autistic participants demonstrated an impairment on at least one measure of motor skills, and as a group, they exhibited significantly poorer fine motor performance compared to the non-ASD group in dominant hand finger tapping speed, bilateral fine motor dexterity measured via the grooved pegboard task, and pencil motor coordination and visual-motor integration measured on the Beery-Buktenica Developmental Test of Visual-Motor Integration-Sixth Edition. Moreover, impaired fine motor skills were associated with poorer performance on standardized clinical measures of verbal abilities, including articulation errors, receptive and expressive language and vocabulary, rapid naming, oromotor sequencing, and parent reported functional communication skills and social communication symptoms. Overall,our findings suggest there is a high prevalence of fine motor impairments in ASD, and these impairments were associated with a range of verbal abilities. Further research is warranted to better understand the underlying mechanisms of these associations and develop targeted interventions to address both fine motor and verbal impairments in ASD.

A study on the reliability and validity of the Japanese version of the Scenario Test for people with chronic stroke-induced aphasia: A cross-sectional study.

The Scenario Test is recognised for its effectiveness in assessing the interactive aspects of functional communication in people with post-stroke aphasia (PWA). To develop a Japanese version of the Scenario Test (Scenario Test-JP) and assess its reliability and validity. Among 66 participants, we selected 61 individuals: 34 PWA and 27 healthy controls (HCs). We modified the Scenario Test-JP based on the UK version and subsequently evaluated its reliability (internal consistency, test-retest and intra-rater and inter-rater reliabilities) and validity (convergent and discriminant) by comparing PWA and HCs. The Scenario Test-JP showed strong reliability with a Cronbach's α of 0.93, test-retest reliability with an intraclass correlation coefficient (ICC) of 0.97, intra-rater reliability with an ICC of 0.95-1.00, and inter-rater reliability with an ICC of 0.96. The validity of the test was confirmed with concurrent scores ranging from ρ = 0.37 to 0.76 (p < 0.05) and known-groups validity (p < 0.001, r = -0.56). The reliability and validity of the Scenario Test-JP align with those of the original Dutch version and the UK and Greek versions. Additionally, the assessment can now include extended alternative communication methods, such as digital devices, indicating the potential of the Scenario Test-JP for modern Japanese speech-language therapy. What is already known on the subject Interactive communication is a facet of functional communication and is crucial for evaluating engagement and participation of people with aphasia (PWA) in speech-language therapy. The Scenario Test provides valuable information for planning speech-language treatment strategies by assessing dialogic communication. What this study adds This study describes the development of the Scenario Test-JP for use with Japanese speakers and Japanese PWA, which is adapted from the Scenario Test UK version. This study evaluated the reliability and validity of this assessment tool and provided supporting evidence. What are the clinical implications of this work? The reliability and validity of the Scenario Test-JP were consistent with those of the Dutch, UK and Greek versions. The Scenario Test-JP contributes to speech-language therapy in Japan, where high-quality support for the activities and participation of PWA is required. Insights from the Scenario Test The Scenario Test plays a crucial role in evaluating the functional communication skills of people with post-stroke aphasia (PWA). Enhancing functional communication has been linked to improved social engagement among PWA, which in turn influences their overall quality of life (QOL). Issues addressed by the Scenario Test The Scenario Test aids in delineating rehabilitation objectives for activities and participation among PWA, particularly concerning functional communication. The test facilitates tailored support for PWAs' interactive communication and forms the foundation for appropriate speech-language therapy interventions. Transformation of speech-language therapy (SLT) in Japan through the introduction of the Scenario Test-JP The integration of the Scenario Test-JP could enhance the SLT services provided to PWA in Japan. With Japan experiencing an unprecedented ageing population, the prevalence of social isolation and diminished QOL resulting from communication disorders like stroke-induced aphasia is expected to rise. Consequently, the SLT rehabilitation sector in Japan is actively seeking effective interventions to support functional communication among PWA. Hence, the adoption of the Scenario Test-JP is anticipated to streamline the evaluation of functional communication, facilitating the judicious selection and timely provision of assistance to PWA in SLT, including guidance on communication partner support and communication skill training.

Social skill and social withdrawal outcomes in children following pediatric stroke

ABSTRACT Pediatric stroke can result in long-term impairments across attention, functional communication and motor domains. The current paper utilized parent reports of the Behavioral Assessment System for Children 2nd Edition and the Pediatric Stroke Outcome Measure to examine children’s social skills and withdrawal behavior within a pediatric stroke population. Using the Canadian Pediatric Stroke Registry at The Hospital for Sick Children, data were analyzed for 312 children with ischemic stroke. Children with ischemic stroke demonstrated elevated parent-reported social skills problems (observed = 20.51%, expected = 14.00%) and clinically elevated social withdrawal (observed = 11.21%, expected = 2.00%). Attentional problems significantly contributed to reduced social skills, F (3,164) = 30.68, p < 0.01, while attentional problems and neurological impairments accounted for increased withdrawal behavior, F (2, 164) = 7.47, p < 0.01. The presence of a motor impairment was associated with higher social withdrawal compared to individuals with no motor impairment diagnosis, t(307.73) = 2.25, p < .025, d = 0.25, 95% CI [0.42, 6.21]. The current study demonstrates that children with stroke who experience motor impairments, attentional problems, reduced functional communication skills, and neurological impairments can experience deficits in their social skills and withdrawal behavior.

Cerebellar tDCS enhances functional communication skills in chronic Aphasia

ABSTRACT Background Transcranial direct current stimulation (tDCS) has emerged as a possible neuromodulatory tool to augment language therapy in post-stroke aphasia. However, there is limited information on whether tDCS may help to improve everyday functional communication. Aims To investigate whether cerebellar tDCS combined with computerized aphasia treatment improves functional communication skills in individuals with chronic aphasia. Methods and Procedures In a randomized, double-blind, sham-controlled, within-subject crossover study, participants received 15 sessions of anodal (n = 14) or cathodal (n = 14) cerebellar tDCS plus computerized aphasia treatment then sham plus computerized aphasia treatment, or the opposite order. Linear mixed-effects regression models were performed to evaluate (1) the effect of tDCS treatment on change in functional communication skills on the two dimensions of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA-FACS): Communication Independence (CI) scale and Qualitative Dimension of Communication (QDC) scale, and (2) the relationship between functional communication skills and trained and untrained naming abilities. Outcomes and Results The results showed significant tDCS-induced gains for the overall QDC mean score, but not for the overall CI mean score. Cerebellar stimulation was more effective than sham for the overall QDC mean score immediately post-treatment, 2-weeks post-treatment and 2-months post-treatment. Follow up analysis separated by group showed that the change in the overall QDC mean score (combining both phases) were similar in participants receiving anodal or cathodal stimulation. We also found a significant linear association between the ASHA-FACS overall CI mean change scores and trained and untrained naming change scores for the tDCS condition but not sham. Conclusions Our study provides preliminary evidence that cerebellar tDCS coupled with computerized aphasia treatment has the potential to improve the overall qualitative dimensions of functional communication skills in individuals with chronic aphasia. Clinical Trial Registration Cerebellar Transcranial Direct Current Stimulation and Aphasia Treatment [NCT02901574]

Implementing intensive comprehensive aphasia programs in Brazil: Challenges and solutions

ABSTRACT Aphasia, a communication disability prevalent among stroke survivors, significantly impacts psychosocial well-being and quality of life. Intensive Comprehensive Aphasia Programs (ICAPs) provide intensive and comprehensive treatment, incorporating individual and group therapy, patient and family education, and technology utilization. Despite positive outcomes, global implementation of ICAPs remains limited. In Brazil, preliminary evidence supports the development of intensive and comprehensive aphasia programs, such as the Brazilian Aphasia House—a program inspired by the successful Aphasia House model in the United States. The Brazilian Aphasia House offers personalized and intensive therapy in a simulated domestic environment, encompassing individual and group therapy sessions, and patient and family education, with the goal of enhancing functional communication skills and overall quality of life. Operating as a teaching clinic within a public university, it also serves as a training ground for future therapists to expand ICAP availability in Brazil. Challenges in implementing ICAPs in Brazil include socioeconomic barriers, limited public aphasia awareness, a shortage of specialized professionals, transportation, and session costs. Sustainable implementation requires committed leadership and financial resourcing, with involvement from public institutions and universities. By increasing awareness and nationwide implementation of ICAPs, access to aphasia rehabilitation services can be improved, potentially leading to better outcomes for individuals with aphasia and their caregivers. The Brazilian Aphasia House serves as an exemplar of an ICAP, offering intensive and personalized therapy to enhance communication abilities and promote social participation for people with aphasia.

"We were the best people to do the job": Caregivers' reported outcomes of a virtual caregiver-delivered program for autistic preschoolers.

Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them. This study explored caregivers' perceived outcomes following one virtual caregiver-delivered program, The Hanen Centre's More Than Words® (MTW) program. This study was a secondary analysis of data from individual interviews conducted with 21 caregivers who had recently participated in a virtual MTW program. A hybrid codebook thematic analysis approach was taken to analyze the interview data. Program outcomes were coded and analyzed within the International Classification Functioning, Disability, and Health (ICF) framework. Additionally, caregivers completed an online survey and rated Likert Scale items about perceived program outcomes, which were analyzed descriptively. Five themes were identified: (1) caregivers learned new strategies to facilitate their child's development, (2) caregivers developed a new mindset, (3) children gained functional communication skills, (4) caregiver-child relationships improved, and (5) caregivers gained a social and professional support network. These themes fell within four of five ICF framework components (activities, participation, personal factors, and environmental factors). No themes were identified under Body Structures and Functions. Survey results indicated most caregivers reported learning new communication strategies (n = 20, 95%), and identifying new teaching opportunities with their child (n = 21, 100%). Some reported outcomes, related to Activities and Participation, were consistent with previous reports in the literature on the MTW program. In line with previous research, caregivers learned strategies to support their child's communication development. Contrary to previous quantitative studies, caregivers in this study rarely commented on gains in vocabulary and instead focused on gains in skills that positively impacted their child's ability to engage in meaningful social interaction. Novel outcomes were identified within the Participation, Personal Factors, and Environmental Factors components of the ICF framework. Caregivers in this study identified important outcomes for themselves and their child that have not been the focus of prior research, suggesting it is important to integrate their perspectives in the development and evaluation of caregiver-delivered programs. Clinicians should include goals that address outcomes identified as important by caregivers, including those that address children's Participation, and those that target caregivers' Personal and Environmental Factors. Developers of caregiver-delivered programs could integrate identified goals to ensure they are meeting families' needs.

71 Profiles of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children with Autism Spectrum Disorder who are Deaf and Hard of Hearing

Objective:Standardized assessment measures can provide data to inform a diagnosis of Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, demonstrating listening response), and are often not appropriate for use with children who are Deaf and Hard of Hearing (DHH), especially with individuals who use signed languages. Few studies have reported on the Behavioral Assessment System for Children, Third Edition (BASC-3) for DHH children, and we aim to describe BASC-3 profiles in children with ASD who are DHH.Participants and Methods:Participants include eight DHH patients diagnosed with ASD through interdisciplinary team evaluations by developmental-behavioral pediatricians, speech-language pathologists, and neuropsychologists with expertise in DHH child development. Demographics include a mean age of 6.17 years, and 62.5% were Male. Self-reported racial distribution was 75% White, 12.5% Black and 12.5% declined to answer. Average Area Deprivation Index (marker of socioeconomic status) was 32.13%tile. As a part of the evaluation, parents rated their children using the BASC-3. Languages include spoken English (75%) and American Sign Language (25%). Relevant co-occurringneurodevelopmental/psychological diagnoses include Global Developmental Delay (n=1), Moderate Intellectual Disability (n=1), and Depression (n=1). Types of hearing loss include sensorineural (75%), conductive (12.5%), and mixed (12.5%). Three participants had different degrees of bilateral hearing loss in each ear: mild sloping-severe, moderate rising-mild (n=1), profound, moderate rising-normal level (n=1), and profound, moderate (n=1). Four participants had the same level of hearing loss in both ears: moderate-moderately severe (n=1), moderately severe-severe (n=1), severe-profound (n=1), and profound (n=1). One child had a unilateral moderate hearing loss. Technology utilized: unilateral hearing aid (n=2), bilateral hearing aids (n=2), unilateral cochlear implant (n=1), bilateral cochlear implants (n=2), and bimodal technology (n=1). BASC-3 scales of interest in this study were the developmental social disorders scale (DSD), Autism probability index (AUI), clinical scales, and adaptive scales. BASC-3 scores were standardized using General Combined norms and means were plotted.Results:BASC-3 mean scores on clinical scales were elevated (T&gt;60) on Atypicality (M=71), Hyperactivity (M=63), Withdrawal (M=63), and Attention Problems (M=65) in children with ASD who are DHH in this sample. BASC-3 mean scores on adaptive scales were below threshold (T&lt;40) on Social Skills (M=37), Functional Communication (M=39), and overall Adaptive Skills (M=39). DSD scores were in the at-risk (T&gt;60&lt;70) range for 2 out of 8 cases and clinically significant (T&gt;70) for 5 out of 8 cases.The AUI was clinically significant for 2 out of the 3 cases within the age range for reporting AUI data.Conclusions:In this preliminary sample of DHH children with a confirmed diagnosis of ASD by comprehensive specialized interdisciplinary clinical evaluations, parent ratings on the BASC-3 were consistent with what is known about BASC-3 profiles in hearing children diagnosed with ASD. Our findings suggest it may be helpful to review the DSD, AUI, clinical scales, and adaptive skills scales profiles when assessing DHH children at risk for ASD. Further research, including a larger sample size and assessment of language differences among participants, is necessary.

Employer’s Satisfaction on Accounting Internship in Digital Learning Environment

The accounting profession plays a vital role in organizations’ financial stability and transparency, making it imperative to examine the satisfaction levels of employers regarding the quality and preparedness of accounting interns. Limited knowledge about how employers perceive the value of accounting interns who have engaged in digital learning experiences throughout their undergraduate studies is known. The study aims to examine the impact of digital learning environments on employer satisfaction with accounting interns in three different aspects, namely technical and functional skills, communication skills and organizational management skills. The study surveyed a sample of employers that had hosted accounting internships in 2022. The findings of this study revealed that employers have a high level of satisfaction towards accounting interns in the digital learning environment. This has significant implications for various stakeholders, including educational institutions, employers, accounting interns and the accounting profession as a whole. It offers insights into how academic institutions can better align their curriculum and support systems with the needs and expectations of employers, thus bridging the gap between classroom learning and real-world accounting practice.

Functional approach to teaching a foreign language for specific purposes

The article is devoted to the problem of teaching a foreign language for specific purposes. The paper emphasizes the need to develop functional communication skills in a foreign-language professional environment as well as an intercultural communicative competence. The functional approach to teaching a foreign language is usually associated with a peculiar way of teaching foreign language grammar, but at present it seems appealing to consider functionality in teaching a professional discourse from a cognitive perspective, taking into account such phenomena as functional literacy, functional reading, functional language, which are necessary to create a holistic system for teaching a foreign language. The author describes a cognitive-interactive model of communication, which contributes to students’ understanding of the peculiarities of the functioning of a foreign language and encourages its use as an efficient tool to carry out professional communications.

Design Specifications of Augmentative and Alternative Communication Apps for Individuals with Autism Spectrum Disorder

The literature has emphasized the positive impact of mobile technologies with augmentative and alternative communication (AAC) apps for enhancing the functional communication skills of individuals with autism spectrum disorders (ASD). Although various AAC apps are available, the system design of such apps presents assorted challenges, particularly for those with ASD in different cultures. Designing useful and engaging apps by considering the affordances of mobile technologies and the characteristics of individuals with ASD may contribute to the success of interventions. In this regard, the purpose of this study is to examine the design specifications of AAC apps based on the considerations of subject-matter experts from an instructional system design (ISD) perspective. The current research employed a design-based research framework, including different methods. An AAC app named as EBA was developed by following design specifications as suggested by the field experts to answer the research questions. The results of the study revealed several enhancements in usability, flexibility, and feasibility issues of AAC apps, and highlighted the importance of (a) personalized apps, (b) simple user-interface, (c) hierarchical representation of visuals, (d) responsive apps, (e) help and documentation, and (f) parent control service. Directions for future research are proposed.

A tool to assess functional communication skills and its correspondence with traditional language testing in patients with brain tumors

To identify the relationship between speech impairment as measured by the Russian Aphasia Test (RAT) and functional communication as assessed by the Communicative Effectiveness Index (CETI). RAT and CETI were administered to 87 patients at two time points, before surgery and in 3 months after brain tumor resection surgery. There were significant correlations between CETI and the total scores on RAT subtests for speech comprehension and production before surgery but not in the follow-up period. The present research is the first to present the Russian version of CETI and to confirm the relationship between speech disorders measured by the comprehensive standardized battery for evaluating speech function RAT and functional communication as measured by CETI.

Management of Children with Autism Spectrum Disorder using Picture Exchange Communication System - A Pilot Study

Aim: The aim of the study was to empirically assess the efficacy of Picture Exchange Communication System (PECS) in 5 children with autism spectrum disorder (ASD). This study was also intended to report parental feedback on using PECS with their children.Method: Purposive convenient sampling was used for this quasi-experimental study. Five nonverbal children who were diagnosed with mild to moderate autism spectrum disorder with a median age of 4.1 years were selected for the study. All the five participants who exhibited limited or no functional communication skills were recruited for the study. Exclusion criteria included presence of any syndrome or any significant medical conditions such as seizures. The pre-assessment and the post assessments after 24 sessions of PECS training were done using selected communicative function domains. Post therapy parental feedback was obtained concerning five categories which are communication intent, attention, behavioural issues, vocalization and ease of communication. Also frequency of initiation as observed in home settings was obtained by interview method.Results: Current study shows that all the children were able to use PECS spontaneously and independently without any physical prompts. Children were able to generalize PECS at home with ease and were able to initiate communication on their own using the pictures. The mothers of the children reported that they observed a drastic subsidence in children’s challenging behaviours and also improvement in their attention span. The findings from our study showed that PECS training is effective in improving the socio-communication skills in children with ASD who had restricted communication. On analysing the report, mothers stated that they were able to easily incorporate PECS at home with their child as it implements the use of actual pictures for communicative exchange. As PECS training paves the way for expression of the child’s needs, there was also a significant reduction in the children’s behavioural problems such as tantrums and other self-injurious behaviours.Conclusion: From this study, it can be concluded that PECS training is effective in improving various communicative temptations in socio-communication skills in children with ASD who have restricted communication. It was also noted that obtaining parental feedback periodically would help in generalization and it encourages the parents’ involvement in the child’s learning process.

AAC and Autism: Manual Signs and Pecs, a Comparison.

Autism Spectrum Disorders (ASD) represent a heterogeneous group of disorders, with onset in developmental age, which present a clinical expressiveness that varies from subject to subject and in the same subject over time. The DSM 5 defines Autism Spectrum Disorders according to two main criteria: persistent deficits in social communication and social interaction in multiple contexts and limited and repetitive patterns of behavior, interests or activities. This disorder can manifest itself across a broad spectrum of severity levels. Indeed, ASD includes clinical conditions from low functioning (LF—Low Functioning) to high functioning (HF—High Functioning), taking cognitive and adaptive functioning as a reference. One of the main characteristics of individuals with ASD is a delay in receptive and expressive communication. These deficits have led to the identification of evidence-based practices, particularly for those with severe communication difficulties. Augmentative Alternative Communication (AAC) has been implemented to compensate for deficits in functional communication and language skills in individuals with complex communication deficits. The AAC comprises communication systems including the Manual Signs, speech and image output devices (Communicators), and Image Exchange Systems (PECS); these systems have been shown to actually improve various abilities in autism such as social skills, modify and improve dysfunctional behaviors and, above all, improve learning. Recent meta-analyses have shown how PECS and Manual Sign can have great effects on the communication skills of young people with autism. The aim of this study is to compare these two types of intervention to improve communication in terms of vocalization in subjects with ASD and try to understand which of the two lead to more significant and rapid improvements.

SPED Teachers’ Extent of Implementing Picture Exchange Communication System: It’s Effect on the Functional Communication Skills of Learners with Down Syndrome

People with limited or no communication skills can use the Picture Exchange Communication System, or PECS, to communicate visually. Based on an evaluation of the functional communication skills of students with Down syndrome, this study investigated the profile of the respondents, the respondents' level of implementation of the Picture Exchange Communication System for students with Down Syndrome, the level of effectiveness of using the Picture Exchange Communication System, and the connection between these variables. The descriptive correlational research method was used for the study. The study's respondents were special education teachers from various schools in NCR. The study's respondents were chosen through the use of purposeful sampling. Frequency count, percentage, mean, weighted mean, and the chi-square test were used to tabulate and evaluate the data collected. The respondents are aged 38 on average, with more females than males. The majority of the instructors has bachelor's degrees in early childhood special education. Additionally, it was discovered that these teachers had been working in the field for an average of 7 years. The picture exchange communication system for kids with down syndrome is being used by these teachers to a very high degree, according to the research on its deployment. Based on the evaluation of the functional communication abilities of students with down syndrome, the picture exchange communication system (PECS) is rated as fair or emerging in terms of its effectiveness. Significant relationship was also observed between age and the level of effectiveness, Gender and extent of implementation.

Predictors of functional communication in people with aphasia after stroke.

Aphasia, the most common language disorder secondary to stroke, has been associated with increased mortality, longer hospitalization and rehabilitation times, worse performance in daily activities, increased financial burden, and short- and long-term complications. Aphasia can negatively impact functional communication skills, including social networks, social activities, relationships with other people and social support. To evaluate patients with poststroke aphasia in their respective residences to investigate potential predictors of functional communication. The prospective cohort included patients with poststroke aphasia aged 18 years or older who resided in the city of Salvador, Northeastern Brazil. Following discharge from the Stroke Unit (SU), the individuals themselves, or their guardians, were contacted by telephone to schedule a home visit no less than three months after discharge. At baseline, sociodemographic and clinical data were collected, in addition to the scores on the National Institutes of Health Stroke Scale (NIHSS) and modified Barthel Index (mBI). The American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS) was applied at the patients' homes. Multivariate linear regression was employed using the total score on the ASHA FACS as the outcome of interest. A multivariate analysis of the associated factors identified using the linear regression revealed that only functional capacity (as assessed by the mBI) upon discharge from the SU remained as an independent predictor of functional communication performance (β = 0.042; 95% confidence interval [95%CI] = 0.013-0.071; p = 0.002). The functional capacity to perform daily activities, evaluated upon discharge from a stroke unit, was identified as a potential predictor of functional communication performance, regardless of the time elapsed after the stroke.

Convergent validity of functional communication tools and spoken language comprehension assessment in children with cerebral palsy.

The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Cross-sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months-3;11y (n = 59), 4;0-5;11 years (n = 37) and 6;0-8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities-Dutch Version (CPCHILD-DV) and the Focus on Communication Under Six-34 (FOCUS-34) questionnaire. Spoken language comprehension was assessed with the Computer-Based instrument for Low motor Language Testing (C-BiLLT). Correlations between the functional communication tools, and with the C-BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD-DV and FOCUS-34, and with a lower level of spoken language comprehension (C-BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 atall developmental stages. Correlations between C-BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months-3;11 years, between 0.781 and 0.897 at developmental stage 4;0-5;11 years, and between 0.635 and 0.659 at developmental stage 6;0-8;11 years. The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS-34 or CPCHILD-DV is recommended. What is already known on the subject A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD-DV and FOCUS-34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD-DV and FOCUS-34 include items that pertain to communicative participation. The innovative C-BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD-DV and FOCUS-34. Correlations between these functional communication tools and the C-BiLLT were moderate to strong. What are the potential or actual clinical implications of this work? For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication-AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD-DV and FOCUS-34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication.

Using the Model, Lead, and Test Technique and "GoTalk NOW" App to Teach Children With Intellectual and Developmental Delays to Correctly Request.

Augmentative and alternative communication systems have been successfully used to help pupils with intellectual and developmental disabilities for functional communication skills. Whereas the effects of the GoTalk NOW application (app) available on the iPad have been investigated, no such study has been conducted in Saudi Arabia. This study investigated the effects of the “model, lead, and test” (MLT) technique paired with the GoTalk NOW app, which is used to teach four children with intellectual and developmental delays to correctly request. The participants were four children (three boys and one girl) from 6 to 8 years of age with intellectual and developmental disabilities. A multiple baseline design was implemented across all participants. All four participants made clear progress using the GoTalk NOW app on the iPad, and implementation of the MLT technique was successful in helping the participants request correctly and independently. This study provided a practical, effective, and easy-to-use method for special education teachers to teach children with disabilities. It contributes to expand the range of teaching options for children with intellectual and developmental disabilities.

Impact of Evidence-Based Functional Intervention Approach on an Individual with Wernicke’s Aphasia Based on International Classification of Functioning, Disability and Health Framework: A Case Study

Background Severe comprehension impairments in Wernicke’s aphasia (WA) are often seen to be associated with auditory related impairment and phonological processing, including semantic and executive difficulties. This study investigated whether an intensive functional approach regime underpins the improvement in speech, language and cognitive domains in an individual with WA resulting in a positive impact on functional communication skills and quality of life-based on international classification of functioning (ICF), disability and health framework. Aim To study the impact of evidence-based functional treatment approach on the speech, language, cognitive and quality of life (QoL) domains in a patient diagnosed with WA based on ICF Framework. Objective The purpose of this longitudinal case study was to compare before- and after-scores of speech and language abilities, cognitive abilities and QoL in a patient diagnosed with WA after providing an intensive evidence-based functional communication treatment approach. Material and Methods A case aged 60-years-old male with a one-month history of stroke; was diagnosed as WA. The patient received intensive functional treatment approach focusing on language and cognition for one hour continuously per session, for eight sessions, within 2-months which involved different therapy approaches to improve his communication abilities. The measurement of language, cognitive abilities and QoL was assessed using the English adaptation of the Western Aphasia Battery (WAB), Addenbrooke’s Cognitive Examination-Revised (ACE-R) and World Health Organization Quality of Life Instrument, Short Form ((WHOQoLBREF) respectively. The results obtained were analyzed based upon the scores obtained across the domains of WAB, ACE-R, and QoL in two stages i.e. pre- and post-intensive aphasia functional language intervention program. Results The outcome of the current study revealed improved scores in WAB, ACE-R, and WHOQoL which highlighted the fact that aphasia therapy techniques targeting the language and functional goals must be followed and implemented during the therapeutic sessions based on the client’s type of aphasia. Conclusion The findings of the case study suggests that the impact of functional communication approach targeting the maximum participation of the person with aphasia seems to be one of the most effective and efficient way to rehabilitate aphasics to improve their QoL.