Improve Communication Outcomes Research Articles

Expanding the scope: multimodal dimensions in aphasia discourse analysis-preliminary findings.

Aphasia, resulting from acquired brain injury, disrupts language processing and usage, significantly impacting individuals' social communication and life participation. Given the limitations of traditional assessments in capturing the nuanced challenges faced by individuals with aphasia, this study seeks to explore the potential benefits of integrating multimodal communication elements into discourse analysis to better capture narrative proficiency in this population. This study examined how incorporating multimodal communication elements (e.g., physical gestures, writing, drawing) into discourse analysis may affect the narrative outcomes of persons with aphasia compared to those observed using methods that exclude multimodal considerations. Participants included individuals with chronic aphasia and age-and education-matched healthy controls who completed a storytelling task-the Bear and the Fly story. Macrolinguistic scores were obtained using verbal-only and multimodal scoring approaches. Additionally, the frequency and type of multimodal communication use during storytelling were examined in relation to aphasia characteristics. Statistical analyses included both within-group and between-group comparisons as well as correlational analyses. Individuals with aphasia scored significantly higher in terms of their macrolinguistic abilities when multimodal scoring was considered compared to verbal-only scoring. Within the aphasia group, there were prominent differences noted in macrolinguistic scores for both fluent and nonfluent aphasia. Specifically, both groups scored higher on Main Concepts when multimodal scoring was considered, with the nonfluent group demonstrating significantly higher Main Concept and total macrolinguistic rubric scores in multimodal scoring compared to verbal scoring on the storytelling task. Additionally, aphasia severity showed moderate positive correlations with total macrolinguistic scores, indicating that individuals with less severe aphasia tended to produce higher quality narratives. Lastly, although persons with aphasia used different types of nonverbal modalities (i.e., drawing, writing), the use of meaning-laden gestures was most predominant during storytelling, emphasizing the importance of multimodal elements in communication for individuals with aphasia. Our preliminary study findings underscore the importance of considering multimodal communication in assessing discourse performance among individuals with aphasia. Tailoring assessment approaches based on aphasia subtypes can provide valuable insights into linguistic abilities and inform targeted intervention strategies for improving communication outcomes.

The coproduction of a multilevel personal narrative intervention for people with aphasia in a community communication support group—A pilot study

IntroductionPeople with aphasia (PWA) face challenges in sharing personal stories due to communication difficulties. Discourse treatment in aphasia focusing on personal narrative macrostructure has yet to receive the attention this warrants of researchers and clinicians. Emerging person-centered approaches involve coproduction and codesign with PWA for meaningful discourse treatments. Few studies explore discourse treatment's impact on functional communication. This pilot study aims to explore whether the use of the coproduction approach in the development of a multilevel personal narrative intervention at the group level increased the production of macrostructure elements in trained and untrained narrative discourse contexts, improved aphasia severity and functional communication skills, and advanced quality of life of the participants with aphasia.MethodsAn ABA design was followed featuring a pre-treatment baseline assessment phase, a treatment phase, and a post-treatment assessment phase immediately after treatment was completed. Three people with chronic stroke-induced aphasia, three communication partners, and a moderator took part in the study. All participants were members of a university-led community aphasia communication group. The research protocol consisted of eleven, two-hour, weekly sessions over an 11-week block. Nine treatment sessions were carried out following codesign and coproduction methods that focused on participants with aphasia producing words, sentences, and total communication strategies to express macrostructure elements in their personal stories. Assessment measures were collected at baseline and post-treatment to evaluate improvements in trained and untrained narrative abilities, aphasia severity, functional communication, and the impact of aphasia on quality of life.ResultsMultilevel personal narrative therapy improved the narrative skills of the participants with aphasia at the macrostructural level of narrative discourse. Improvements were also observed in functional communication and quality of life post-treatment.DiscussionThe involvement of participants with aphasia in the codesign and coproduction of the treatment content for the group intervention facilitated improvement in narrative skills, functional communication, and overall quality of life with aphasia. It is recommended that researchers and clinicians consider using content from the personal narratives of clients with aphasia to build discourse treatment and adopt codesign and coproduction approaches, when designing interventions for people with chronic aphasia, to improve communication outcomes in everyday life.

Logical Argumentation and Persuasion in Interpersonal Communication

Logical argumentation and persuasion are pivotal components of effective interpersonal communication. This paper examines the principles and methods of logical argumentation, the role of persuasion in communication, and how these elements intertwine to enhance understanding and influence within personal and professional interactions. By analyzing theoretical frameworks and practical applications, this paper elucidates the mechanisms through which logical argumentation and persuasive techniques can be employed to improve communication outcomes. The integration of logical, emotional, and ethical appeals is explored, highlighting their combined impact on fostering better relationships, decision-making, and influence.

Effect of subsequent context on the real-time interpretation of ambiguous target words in spectrally degraded speech

Subsequent context in a sentence can be used to revise the interpretation of a word that was not clearly heard, a frequent occurrence in degraded speech. One strategy for avoiding the cognitive cost associated with revising an initial interpretation is to delay commitment to an interpretation until the end of the sentence, sometimes called a “wait-and-see” strategy. Listening with a significant hearing loss (i.e., constantly hearing degraded speech), may prompt a listener to use this strategy even in relatively easy listening conditions. This study used an eye-tracker to record gaze patterns during a phoneme classification task of ambiguous target words in two levels of background noise ( + 5 and −5 dB SNR). Participants either used cochlear implants (CIs) or were presented 8-channel noise vocoded speech. The target words were at the beginning of sentences; the subsequent context cued one target word interpretation (based on phoneme classification) or the other. We hypothesized that listeners who use CIs will demonstrate a delaying strategy at both levels of background noise, while listeners who have acoustic hearing will only demonstrate a delaying strategy at the highest level of background noise. These findings have implications for rehabilitative strategies to improve communication outcomes in adults with CIs.

The Integration of Social Media in Integrated Marketing Communication: A Systematic Review and Theorical Framework

This study examines the impact and significance of integrating social media into integrated marketing communication (IMC) strategies. By analyzing the literature and synthesizing existing research, this study aims to evaluate the role of social media in enhancing communication effectiveness, consumer engagement, and brand promotion. The research objective is to assess the level of coherence and consensus among scholars regarding marketing communication strategies and explore emerging trends in social media integration within IMC. This study employs a systematic review methodology to collect and analyze relevant articles from prominent literature databases. Findings underscore the importance of IMC as a holistic approach to marketing communication and demonstrate how social media platforms facilitate two-way interaction between companies and consumers. Additionally, the analysis delves into the influence of social media on consumer perception and engagement, examines the connection between social media integration and the marketing mix, and identifies emerging trends for future research (Bry?a et al., 2022). Overall, this study provides valuable insights into the significance of social media integration within IMC strategies and offers implications for marketers to effectively leverage these platforms for improved communication outcomes.
 
 Received: 23 May 2023 / Accepted: 12 October 2023 / Published: 5 November 2023

Intergenerational choral singing to improve communication outcomes in Parkinson’s disease: Development of a theoretical framework and an integrated measurement tool

Purpose: This study presented an initial step towards developing the evidence base for intergenerational choral singing as a communication-focussed rehabilitative approach for Parkinson’s disease (PD). Method: A theoretical framework was established to conceptualise the rehabilitative effect of intergenerational choral singing on four domains of communication impairments – motor drive, timing mechanism, sensorimotor integration, higher-level cognitive and affective functions – as well as activity/participation, and quality of life. A computer-assisted multidimensional acoustic analysis was developed to objectively assess the targeted domains of communication impairments. Voice Handicap Index and the World Health Organization’s Quality of Life assessment-abbreviated version were used to obtain patient-reported outcomes at the activity/participation and quality of life levels. As a proof of concept, a single subject with PD was recruited to participate in 9 weekly 1-h intergenerational choir rehearsals. The subject was assessed before, 1 week post, and 8 weeks post-choir. Result: Notable trends of improvement were observed in multiple domains of communication impairments at 1 week post-choir. Some improvements were maintained at 8 weeks post-choir. Patient-reported outcomes exhibited limited pre-post changes. Conclusion: This study provided the theoretical groundwork and an empirical measurement tool for future validation of intergenerational choral singing as a novel rehabilitation for PD.

Close spatial distance and direct gaze bring better communication outcomes and more intertwined neural networks

Non-verbal cues tone our communication. Previous studies found that non-verbal factors, such as spatial distance and gaze direction, significantly impact interpersonal communication. However, little is known about the behind multi-brain neural correlates and whether it could affect high-level creative group communication. Here, we provided a new, scalable, and neuro-based approach to explore the effects of non-verbal factors on different communication tasks, and revealed the underlying multi-brain neural correlates using fNIRS-based hyperscanning technique. Across two experiments, we found that closer spatial distance and more direct gaze angle could promote collaborative behaviors, improve both creative and non-creative communication outcomes, and enhance inter-brain neural synchronization. Moreover, compared to the non-creative communication task, participants’ inter-brain network was more intertwined when performing the creative communication task. These findings suggest that close spatial distance and direct gaze serve as positive social cues, bringing interacting brains into alignment and optimizing inter-brain information transfer, thus improving communication outcomes.

Video Relay Interpretation and Overcoming Barriers in Health Care for Deaf Users: Scoping Review.

BackgroundPersons who are deaf are more likely to avoid health care providers than those who can hear, partially because of the lack of means of communication with these providers and the dearth of available interpreters. The use of video remote interpretation, namely the video camera on an electronic device, to connect deaf patients and health providers has rapidly expanded owing to its flexibility and advantageous cost compared with in-person sign language interpretation. Thus, we need to learn more about how this technology could effectively engage with and respond to the priorities of its users.ObjectiveWe aimed to identify existing evidence regarding the use of video remote interpretation (VRI) in health care settings and to assess whether VRI technology can enable deaf users to overcome barriers to interpretation and improve communication outcomes between them and health care personnel.MethodsWe conducted a search in 7 medical research databases (including MEDLINE, Web of Science, Embase, and Google Scholar) from 2006 including bibliographies and citations of relevant papers. The searches included articles in English, Spanish, and French. The eligibility criteria for study selection included original articles on the use of VRI for deaf or hard of hearing (DHH) sign language users for, or within, health care.ResultsFrom the original 176 articles identified, 120 were eliminated after reading the article title and abstract, and 41 articles were excluded after they were fully read. In total, 15 articles were included in this study: 4 studies were literature reviews, 4 were surveys, 3 were qualitative studies, and 1 was a mixed methods study that combined qualitative and quantitative data, 1 brief communication, 1 quality improvement report, and 1 secondary analysis. In this scoping review, we identified a knowledge gap regarding the quality of interpretation and training in sign language interpretation for health care. It also shows that this area is underresearched, and evidence is scant. All evidence came from high-income countries, which is particularly problematic given that most DHH persons live in low- and middle-income countries.ConclusionsFurthering our understanding of the use of VRI technology is pertinent and relevant. The available literature shows that VRI may enable deaf users to overcome interpretation barriers and can potentially improve communication outcomes between them and health personnel within health care services. For VRI to be acceptable, sign language users require a VRI system supported by devices with large screens and a reliable internet connection, as well as qualified interpreters trained on medical interpretation.

Toward improved measurement of infant bone conduction auditory brainstem responses

Newborn hearing screening has led to improved detection and treatment of hearing loss (HL) in infants and young children, supporting improved communication outcomes in early childhood and beyond. However, current screening protocols are not equally sensitive to all forms of HL, limiting diagnostic accuracy and, ultimately, identification of appropriate treatment options. Correspondingly, treatment outcomes in children with HL remain quite variable. One fundamental and persistent challenge is the assessment of bone conduction hearing, which is essential to differentiate conductive versus sensorineural pathology. Whereas hearing via air conduction can be effectively assessed using the auditory brainstem response (ABR), a noninvasive electrophysiologic measure, bone conduction ABR measurements suffer from comparatively poor signal quality (including significant stimulus artifact), transducer acoustic output limitations, and generally lower test-retest reliability. Here we evaluated the prospective benefits of measuring infant bone conduction ABRs using a modified bone conduction transducer designed to reduce stimulus artifact and thereby improve measurement quality. Measurements obtained using a standard bone conduction transducer were compared on several dimensions to measurements obtained using the modified transducer. Improved bone conduction measurement tools are expected to support improved detection and classification of conductive and mixed HL, leading to improved treatment outcomes for this important patient population.

Strengthening Professional Networks to Serve Students With Autism Who Have Communication Needs

Many students with autism have complex communication needs and benefit from the use of aided augmentative and alternative communication (AAC), which can include picture symbols, communication boards or books, or speech-generating devices. However, many of the challenges to high-quality AAC intervention are amplified by inadequate collaboration. Effective collaboration is critical, including between teachers and speech-language pathologists (SLPs), with students’ parents and other family members, and with other related service providers or specialists. This article draws from social network theory and special education research to offer practical guidelines for special education teachers and SLPs to develop and strengthen their own professional networks and more effectively serve students with autism who have communication needs. Guidance is also offered for school and district leaders. Strong professional networks can improve communication outcomes for students with complex communication needs by fostering educators’ knowledge, skills, confidence, and collective action toward effective and integrated AAC intervention.

Self-Care Efficacy-Mediated Associations Between Healthcare Provider-Patient Communication and Psychological Distress Among Patients With Gastrointestinal Cancers.

Both healthcare provider-patient communication and self-care efficacy affect psychological distress, which is prevalent among patients with gastrointestinal (GI) cancers. It is essential to explore the underlying mechanism among them to relieve psychological distress. The aim of this study was to examine whether self-care efficacy mediated the association between healthcare provider-patient communication and psychological distress among patients with GI cancers. A cross-sectional study was conducted between March 2018 and May 2019 in China. In total, 219 patients with GI cancers were recruited before discharge from chemotherapy. Healthcare provider-patient communication was assessed by the revised Physician-Patient Communication Scale; patient self-care efficacy was assessed by the Strategies Used by People to Promote Health; and psychological distress was assessed by the Distress Thermometer and the Hospital Anxiety and Depression Scale. Mediation analyses were conducted to examine the mediating effect of self-care efficacy on the association between healthcare provider-patient communication and psychological distress. A total of 54.34% of patients experienced psychological distress. Patients reported a mean score of 89.93 (SD, 13.81) for healthcare provider-patient communication and 93.91 (SD, 23.39) for self-care efficacy. Self-care efficacy completely mediated the association between healthcare provider-patient communication and psychological distress, and communication outcome was the only domain that significantly influenced self-care efficacy. Psychological distress is prevalent among patients with GI cancers. Healthcare provider-patient communication, especially communication outcome, promoted patients' self-care efficacy to reduce psychological distress. Healthcare providers should design interventions to improve communication outcomes and eventually increase self-care efficacy to relieve psychological distress among patients with GI cancers.

Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis.

Interventions to address core symptoms for young children on the autism spectrum have a strong and growing evidence base. Adapting and delivering evidence-based interventions to infants and toddlers with a high likelihood for autism is a logical next step. This systematic review and meta-analysis summarize the association between infant and toddler interventions and developmental and family outcomes. Results indicate that these early interventions are effective for improving parent implementation of core strategies, yet the effects do not readily translate to child outcomes. However, key studies demonstrate conditional results that indicate that parent implementation is associated with child outcome. Implications for research and practice toward building adaptive interventions that respond to parent implementation and changing child characteristics are discussed.

Aphasia and Friendship: The Role and Perspectives of Speech-Language Pathologists.

Purpose Speech-language pathologists (SLPs) who work with people with aphasia focus on assessment and intervention to support improved communication outcomes for their clients. Friendship, a key component of quality of life, often depends on communicative interaction, and many people with aphasia report having reduced social circles. The purpose of this study was to explore the perceptions of SLPs working with clients with aphasia on their role in supporting friendship development and maintenance. Method An online survey composed of questions addressing SLP perspectives and goal setting, assessment, and treatment practices related to aphasia and friendship was distributed to SLPs across the United States. Survey data were analyzed using both quantitative and qualitative methods. Results Forty-seven SLPs completed the survey. While many SLPs reported that the friendships of their clients with aphasia were impacted by aphasia and that it was within their scope of practice to support friendship development and maintenance, many did not specifically assess or target friendship and friendship outcomes in the treatment plan. SLPs identified barriers and facilitators to focusing on friendship within the context of speech and language therapy. Conclusions Findings suggest the majority of participating SLPs were interested in addressing friendship with clients with aphasia; however, they experienced barriers in practice. Further examination of SLP perspectives and clinical practice regarding friendship and aphasia is warranted. Additionally, research investigating effective assessment and therapeutic methods that target friendship in aphasia is needed to support clinical practice and the well-being of clients with aphasia. Supplemental Material https://doi.org/10.23641/asha.15032217.

Cognitive communication and the law: a model for systemic risks and systemic interventions.

Legal contexts frequently impose steep communication barriers, but because the law’s ontological framework of communication views it as an atomized, transaction phenomenon, the law lacks the ability to conceptualize and describe the way in which it itself imposes systemic communication burden. To overcome this shortcoming, this article presents a model for a systemic analysis of communication within the law. Part One operationalizes a set of cognitive-communication resources necessary to navigate communication in legal contexts. Part Two uses the operational model to illustrate how systemic elements of the law pressure the cognitive resources that underlie communication. Finally, Part Three uses the model to predict how possible systemic interventions might improve communication outcomes by alleviating or reducing systemic communication burdens. Not only does this article provide a conceptual tool to articulate the law’s systemic impacts on communication, the subsequent analysis offers a framework for exploring interventions that could ultimately lead to better outcomes for persons, particularly vulnerable or at-risk persons, who must navigate legal contexts. By changing how it conceptualizes communication and working to modify the communication dynamics that it itself perpetuates, the law can reduce the weight of the communication burdens that it imposes on the people within it.

Communication between native and non-native speakers

For decades, research in speech communication has ask how an individual perceives and produces speech. However, most prior research has used an idealized, monolingual speaker-listener as its model, which is not the norm in our globalizing world. Real-world situation of communication between native and non-native speakers can result in challenges for successful communication. However, the sources of those miscommunications are not well-understood. While many studies have directly examined how a learner acquires a second language, only in the last decade has research expanded rapidly on how a native listener might improve their ability to understand non-native speech. An understanding of the communication between native and non-native speakers is required to truly understand the processes that underlying speech communication, broadly. In this talk, I address issues of communication between native and non-native speakers in their capacities as speakers and listeners. Specifically, I describe the current state of knowledge about how non-native speakers understand and produce speech in their second (or third) language, how native speakers understand non-native speech, and how both parties can improve their abilities at these tasks. This line of inquiry has implications for both practical goals of improving communication outcomes and theoretical understanding of speech perception and production.For decades, research in speech communication has ask how an individual perceives and produces speech. However, most prior research has used an idealized, monolingual speaker-listener as its model, which is not the norm in our globalizing world. Real-world situation of communication between native and non-native speakers can result in challenges for successful communication. However, the sources of those miscommunications are not well-understood. While many studies have directly examined how a learner acquires a second language, only in the last decade has research expanded rapidly on how a native listener might improve their ability to understand non-native speech. An understanding of the communication between native and non-native speakers is required to truly understand the processes that underlying speech communication, broadly. In this talk, I address issues of communication between native and non-native speakers in their capacities as speakers and listeners. Specifically, I describe the current stat...

Lies and consequences

I study a strategic-communication game between an informed sender and an uninformed receiver with partially aligned preferences. The receiver is endowed with the ability to probabilistically detect if the sender is lying. Specifically, if the sender is making a false claim about her type, with some commonly known probability p the receiver additionally observes a private signal indicating that the sender is lying. The main result is that the receiver’s stochastic lie-detection ability makes fully revealing equilibria—the best outcome for the receiver—possible, even for small p (less than $$\frac{1}{2}$$ ). Additionally, if the language consists of precise messages, fully revealing equilibria exist only for $$p=1$$ and for a set of intermediate values of p that is bounded away from 0 and 1, making the maximal ex-ante expected equilibrium utility of the receiver non-monotone in p. If vague messages are allowed, full revelation can be supported for all large enough p, overturning the non-monotonicity and improving communication outcomes relative to the precise-language case.

Randomised controlled feasibility trial of the Active Communication Education programme plus hearing aid provision versus hearing aid provision alone (ACE to HEAR): a study protocol

IntroductionUp to 30% of hearing aids fitted to new adult clients are reported to be of low benefit and used intermittently or not at all. Evidence suggests that additional interventions...

Preliminary study of a communication intervention for family caregivers and spouses with dementia.

This study was to designed to examine the feasibility and preliminary outcomes of CARE: Caring About Relationships and Emotions, a 10-week, home-based, intervention to support married couples affected by dementia. Fifteen older couples participated in a single group repeated measures feasibility study. Weekly, video-recorded conversations over 10weeks were used to rate communication using the Verbal/Nonverbal Interaction Scale for caregivers and care receivers. Accounting for mental status of care recipients, the ratio of social to unsocial communication showed a significant improvement across sessions-an average of 4.46 points per session [β=4.46, t(10)=1.96, p=.039]. Spouse caregiver (CG) communication showed a significant decrease in the number of disabling communications with approximately .65 decreased comments per session [β=0.654, t(11)=-2.61, p=.024]. At home dyadic, relationship-focused psychoeducational intervention to improve communication in spouses affected by dementia has the potential to improve communication outcomes. Creative ways of working with couples are needed to help them sustain their relationships and maintain their health.

Role of the speech-language pathologist: augmentative and alternative communication for acute care patients with severe communication impairments.

Severe communication deficits occur frequently in acute care. Augmentative and alternative communication (AAC) may improve patient-nurse communication, yet it remains underutilized. The objective of this study was to assess the impact of training student nurses (SNs) in acute and critical care on the use of AAC with regard to confidence levels and likelihood of implementation of AAC by SNs in acute care. Training in AAC techniques was provided to SNs. A pretraining and posttraining assessment was completed along with follow-up surveys conducted after the SNs had an opportunity to use AAC. A 6-fold increase in confidence (P < .01) was reported by the SNs after AAC training, as was an approximately 3-fold increase in likelihood of use (P < .01). The reliable yes/no was the most reported AAC technique (34.7% of the students). Providing SNs with AAC tools accompanied by brief training increases their confidence in the use of AAC and the likelihood that they will use them. Inclusion of AAC education in nursing curricula and nursing orientations could be an important step in risk reduction among patients with severe communication disorders. Further study is needed of the relationship between training student nurses in the use of AAC as a way to change practice and improve communication outcomes.

Is conversation partner training effective in assisting individuals with a traumatic brain injury to display improved communication outcomes

Background : People who experience Traumatic Brain Injury (TBI) often exhibit a range of communication difficulties following their injury. Conversation is a vital component of communication that can have wide-ranging effects on social and vocational roles. Conversation ability is often negatively affected by a brain injury. It has been suggested that training the conversation partners of people with TBI can be effective in improving communication outcomes, therefore, positively affecting quality of life. This is the first systematic review investigating the efficacy and effectiveness of conversation partner training with this population. Method : After appropriate search terms were chosen, Medline, Psychinfo, CINAHL and Speechbite databases were searched to find appropriate articles for inclusion in the review. Papers underwent a three step screening process (title, abstract and full text) to be included in the study. Data were extracted and summarised. Results : Although only four studies were included in the final review, all showed positive effects of training in relation to a range of conversation partners for people with TBI, including family, carers and shop assistants. Training programs varied in method and outcome measures, but all provided support for the inclusion of communication partner training in TBI rehabilitation. Conclusion : Conversation partner training can be an effective intervention for people with TBI. More studies with larger sample sizes would add strength to conclusions and provide more informed basis for clinical practice. Recommendations for future research and practice are provided. Keywords : Traumatic brain injury, conversation partner training, rehabilitation, measurement tool