Limited Communication Skills Research Articles

Retinoscopes: Past and present.

Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors. Advantages of retinoscopy include its non-invasive nature, ability to assess patients of all ages, and usefulness in patients with limited cooperation or communication skills. To discuss the history of retinoscopes and examine current literature on the subject. A search was conducted on the PubMed and with the reference citation analysis (https://www.referencecitationanalysis.com) database using the term "Retinoscopy," with a range restricted to the last 10 years (2013-2023). The search string algorithm was: "Retinoscopy" (MeSH Terms) OR "Retinoscopy" (All Fields) OR "Retinoscopes" (All Fields) AND [(All Fields) AND 2013: 2023 (pdat)]. This systematic review included a total of 286 records. Publications reviewed iterations of the retinoscope into autorefractors, infrared photo retinoscope, television retinoscopy, and the Wifi enabled digital retinoscope. The retinoscope has evolved significantly since its discovery, with a significant improvement in its diagnostic capabilities. While it has advantages such as non-invasiveness and broad applicability, limitations exist, and the need for skilled interpretation remains. With ongoing research, including the integration of artificial intelligence, retinoscopy is expected to continue advancing and playing a vital role in eye care.

The effect of teacher education supported through consultation on acquisition communication skills in children with autism spectrum disorder

The purpose of this paper is to measure the effects of the consultation method that includes teaching and practicing the mand-modelling technique to teachers and parents to improve the communication skills of children with autism. Multiple probe design, which is one of the single-case research designs, was used in the study. The findings of this research show that families with children with autism can be successful in improving their children’s limited verbal communication skills through receiving training in milieu teaching techniques that parents receive from their children’s teachers and perform in parallel with their teachers. The results showed that using the consultation method to teach the mand-modelling technique to special education teachers by ensuring that the family participates in the education is effective in developing pragmatic language in children with autism.

Crossing horizons: unraveling perspectives on enhancing medical students’ success through at-risk factor exploration

BackgroundMedical universities often face the ongoing challenge of identifying and supporting at-risk students to enhance retention rates and academic success. This study explores a comprehensive analysis of perceived at-risk factors impeding academic and career aspirations and compares the perspectives of students and faculty in a medical school.MethodsWe focused on first and second-year medical (MBBS) students and teaching faculty in an international medical college offering a twinning program in India and Malaysia. Our investigation involved a comprehensive assessment of 25 at-risk factors through Likert-type questionnaires distributed to 250 MBBS students and 50 teaching faculty.ResultsOur findings revealed distinct disparities in perceptions between faculty and students regarding mean scores of classroom engagement (p = 0.017), procrastination (p = 0.001), unrealistic goals (p = 0.026), emotional/behavioral problems (p = 0.008), limited key social skills (p = 0.023), and a non-supportive home environment (p = 0.001). These differences underscore the need for increased communication and understanding between faculty and students to address these risk factors effectively. In contrast, no significant disparities were observed among faculty and students’ perceptions concerning mean scores of various potential at-risk factors, including academic unpreparedness, cultural/language barriers, individual guidance/mentoring, limited communication skills, racism/sexism, self-confidence, self-respect, self-concept, motivation, underprepared for current academic challenges, self-discipline, negative social network, negative peer culture, transportation time, college financial cost, college evaluation culture bias, broken college relationships, teaching methodology, and learning disabilities. However, varying degrees of influence were perceived by faculty and students, suggesting the importance of individualized support.ConclusionThis study contributes to the academic community by shedding light on the multifaceted nature of at-risk factors influencing student success. It underscores the need for proactive measures and tailored interventions to enhance student retention in higher education and academic achievement, fostering a sustainable foundation for lifelong learning and growth.

Evaluating Artificial Intelligence on the Efficacy of Preference Assessments for Preservice Speech-Language Pathologists

AbstractIndividuals with intellectual and developmental disabilities (IDD) face many barriers to meaningful inclusion, including limited language and communication skills. Professionals, such as speech-language pathologists (SLPs), can provide personalized instruction to promote skill development and inclusion. Providing opportunities for individuals to express preferences and choice, such as the multiple stimulus without replacement preference assessment (MSWO; DeLeon & Iwata 1996), within these programs, further increases skill acquisition and social interaction. However, limitations in professionals’ knowledge and skills in performing assessments can be another barrier to meaningful inclusion for individuals with IDD and traditional training methods can be challenging and time consuming. The purpose of the current study was to compare the use of artificial intelligence with traditional pen and paper self-instructional MSWO training methods for five preservice SLPs. Fidelity of implementation and duration of assessment were measured. Results demonstrated a large increase in implementation fidelity for two participants, a moderate increase for two participants and a slight increase for the remaining participant while using artificial intelligence. All participants demonstrated a decrease in scoring errors using artificial intelligence. Regarding duration of implementation, artificial intelligence resulted in a significant reduction for four participants and a moderate reduction for the remaining participant. Results of the follow-up survey suggest that all adult participants and both child participants found that artificial intelligence had a higher treatment acceptability and was more effective at producing socially significant outcomes than traditional methods. Recommendations for clinicians and future research are discussed.

Speakezio Application as an Alternative and Augmentative Communication Media for Cerebral Palsy Students

The obstacle experienced by most children with cerebral palsy is limited communication skills. This is due to disorders of the speech organs or limitations in receptive and expressive language abilities experienced by children with cerebral palsy. So, when communicating, you need alternative augmentative media or communication systems (AAC) that can help you communicate. This research aims to develop the Speakezio application as AAC media. The method used is the RD (Research and Development) research method with a qualitative approach. This research involves one subject (single subject) which is used as a model in developing applications. This research obtained results in the form of the Speakezio application which was developed based on the results of assessments on target subjects and trials of the application as a media for the AAC system. The trial results show that this application can improve children's receptive and expressive language skills. Apart from that, this application can help communication between children and parents so that parents can more easily understand the messages conveyed by children.

Enacting a Global Englishes and Critical Pedagogy Integrated Curriculum in Korean High School English as a Foreign Language Classrooms

AbstractThis study examines the enactment of Global Englishes (GE) curriculum in public high school English as a foreign language classrooms in South Korea. Data collection involved pre‐ and post‐course surveys (N = 217, nine classrooms), students' written responses, and their oral presentations. The findings highlight the necessity of adopting a critical perspective as the initial step to incorporate GE in these classrooms. They also recommend integrating GE curriculum within the existing assessment framework. After curriculum enactment based on critical pedagogy and GE took place over the course of a year, the results from the post‐course survey indicated positive changes in students' receptiveness to GE, their perceptions of Outer Circle varieties, and their confidence in engaging in intercultural communication. Students' written responses also demonstrated an enhanced critical awareness of GE‐related issues. However, there was no significant change in their perceptions regarding the exclusion of GE in listening tests, their low preference for Expanding Circle varieties, and their limited multicultural communication skills. The pedagogical implications of this study are relevant not only for GE educators but also for those who enact locally driven curriculum innovations within test‐oriented contexts.

Promoting Safety While Addressing Dangerous Behavior via Telehealth: A Clinical Case Investigation Serving the Family of an Autistic Adolescent Living in India

When clinicians address dangerous behavior via remote telehealth consultation, it may be especially important to ensure remote implementers can apply behavioral interventions in a manner that keeps recipients and implementers safe while still achieving effective outcomes. We present the case of a 13-year-old autistic adolescent with limited communication skills, living in South India, whose dangerous behavior was escalating and becoming more pervasive during the pandemic quarantine, putting himself and his family at risk. In this study, we evaluated the effects of an enhanced choice model of skill-based treatment—informed by a practical functional assessment of dangerous behavior. We systematically replicated and extended procedures that have been shown to address dangerous behavior while avoiding difficult situations that place the individual and others at risk. The intervention yielded elimination of dangerous and associated non-dangerous behavior and socially valid acquisition of multiple alternative behaviors. We report multiple strategies to overcome barriers unique to remotely addressing dangerous behavior and discuss implications for the safe, telehealth application of behavior analysis in research and practice.

Role of the supervision of the school principal in improving the quality of learning at state elementary school’s post-pandemic COVID-19

This research aims to evaluate the role of principal supervision in improving teacher performance, identify obstacles related to academic supervision analysis, and design strategies to overcome these obstacles. This research was conducted at a public elementary school in Blora Regency. Qualitative data analysis techniques were used in this research. Sampling used purposive sampling technique. Data collection through observation and in-depth interviews. The informants taken included the Principal, Teachers, Supervisors, Chair of the School Committee, and Students. The results of the study show that academic supervision is carried out by the principles of academic supervision by going through the stages of planning, implementing, evaluating, and following up. The techniques and models of academic supervision that are applied vary according to the situation and condition of the school, as well as the principles of academic supervision that are applied. The obstacles found include the role of the principal as a supervisor who is often given additional tasks by the department, teachers as the party being supervised have various activities and competencies, as well as a lack of facilities and infrastructure. Another obstacle is the limited study time and the limited communication skills of students. Efforts have been made, among others, by rearranging schedules, involving teachers in training, allocating budgets for new facilities and infrastructure through the School Operational Assistance program, and building good cooperation with school committees.

Active Learning Barriers in Developing Mathematical Proficiency: Comparing Visual Impairment Students’ and Teachers’ Perspective

Visual impairment (VI) students face various barriers in mathematics learning, which cause low mathematical proficiency (MP). Therefore, active learning (AL) needs to be optimized to develop the MP of VI students in inclusive classes. This research aimed to explore the barriers of AL to developing MP from the perspectives of VI students and teachers. This was qualitative research with a case study design. The subjects were nine VI students and seven mathematics teachers from an inclusive high school in Yogyakarta. They were selected using purposive sampling. Semi-structured interviews were conducted to collect data. Data analysis was done using the Bogdan and Biklen approach. The result explores AL barriers to developing MP from the perspectives of VI students and teachers almost similar. It can be categorized into three themes: 1) human side barriers, mainly barriers are students' lack of confidence in their abilities and novice teachers' lack of confidence in facilitating VI students. This indicates that both of them have low self-efficacy; 2) environmental barriers, mainly related to discrimination and limited communication skills; and 3) technology and learning media barriers, mainly related to limited learning media for VI students' hands-on activities.

Research on the intelligent internet nursing model based on the child respiratory and asthma control test scale for asthma management of preschool children.

Childhood asthma is a common respiratory ailment that significantly affects preschool children. Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver. With the rise of digital healthcare and the need for innovative interventions, Internet-based models can potentially offer relatively more efficient and patient-tailored care, especially in children. To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test (TRACK) on asthma management in preschool children. The study group comprised preschoolers, aged 5 years or younger, that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022. Total of 200 children were evenly and randomly divided into the observation and control groups. The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma. In addition to above treatment, the observation group was introduced to an intelligent internet nursing model, emphasizing the TRACK scale. Key measures monitored over a six-month period included the frequency of asthma attack, emergency visits, pulmonary function parameters (FEV1, FEV1/FVC, and PEF), monthly TRACK scores, and the SF-12 quality of life assessment. Post-intervention asthma control rates were assessed at six-month follow-up. The observation group had fewer asthma attacks and emergency room visits than the control group (P < 0.05). After six months of treatment, the children in both groups had higher FEV1, FEV1/FVC, and PEF (P < 0.05). Statistically significant differences were observed between the two groups (P < 0.05). For six months, children in the observation group had a higher monthly TRACK score than those in the control group (P < 0.05). The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period (P < 0.05). Furthermore, the groups showed statistically significant differences (P < 0.05). The asthma control rate was higher in the observation group than in the control group (P < 0.05). TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children, improve lung function, quality of life, and the TRACK score and asthma control rate. The effect of nursing was significant, allowing for development of an asthma management model.

An Overview of Father Involvement in Parenting Children with Dyslexia

Father involvement in child care is very important for child development. Based on several studies, father involvement can affect child development. The purpose of this study is to provide an overview of how the involvement of working fathers in providing care for children who have dyslexia. The method used is qualitative with a phenomenological approach. The research participants were three fathers. Data obtained through interviews with openended questions via zoom. The result showed that the three participants still took their time to be involved in parenting, then on the other hand, it was also found that the difficulties experiences by fathers in caring for dyslexic children were due to limited interaction communication skills and behavioral issues of dyslexic children.

THE SOCIO-ECONOMIC IMPACTS OF ECOTOURISM IN TAMAN NEGARA PAHANG ON THE LOCAL COMMUNITY GROUPS WITH DIFFERENT ECONOMIC STATUSES

Ecotourism conserves the natural environment and raises the community’s living standards. The socio-economic impacts, however, may vary due to different economic statuses among the local community groups. Hence this study examines the socio-economic impacts of ecotourism in Taman Negara Pahang on the locals and indigenous people with different incomes, education, and occupations. This qualitative research employed semi-structured interviews to understand better the socioeconomic benefits and challenges of tourism development in the national park. It was found that the locals were highly dependent on tourism economic activities, and their living standards improved. Nevertheless, most indigenous people still lived in poverty because they were incompetent with limited communication skills and hospitality knowledge. Besides, tourism seasonality has caused irregular business revenue, low return on investment, and underutilisation of facilities in the off-peak season. Conversely, the tourism operators and locals may gain maximum business revenue and additional income in the peak season. This paper draws the attention of government agencies and local community groups to the importance of educational attainment and appropriate capacity-building programs based on different needs to ensure an equitable distribution of ecotourism socio-economic benefits. Their involvement in such events may also help to overcome the challenges of tourism seasonality through proper planning and implementation in the national park.

Acute Appendicitis in Children: Evaluation of the Diagnostic Efficacy of Ultrasonography and Computed Tomography.

Acute appendicitis (AA), the most common cause of acute abdomen in childhood, can result in significant morbidity and mortality if not diagnosed and treated in a timely manner. Diagnosis of AA is more difficult in children due to the limited communication skills, in comparison to adults. The aim of this study is to evaluate the diagnostic accuracy of abdominal ultrasonography (US) and computed tomography (CT) in the diagnosis of AA in children. Pediatric patients who were operated on with the diagnosis of AA between January 2016 and December 2021 were retrospectively reviewed. Preoperative abdominal US and CT findings of the patients and postoperative pathology results were recorded. A total of 263 patients with a mean age of 11.3 years were included in the study. There were 164 (62.3%) males and 99 (37.7%) females. Histopathology revealed AA in 215 (81.7%) patients. Preoperatively, US and CT were performed in 139 (52.8%) and 137 (54.5%), respectively. Both imaging methods were applied to 13 (5.1%) patients. US had a sensitivity and specificity rate of 77.2% and 52.6%, respectively. Positive predictive value (PPV) was found to be 81.2%, whereas negative predictive value (NPV) was 46.5% for US. The diagnostic accuracy rate of US was found as 70.5%. CT had a sensitivity and specificity rate of 88.1% and 57.1%, respectively.PPV was found to be 88.8%, whereas NPV was 55.1% for CT. The diagnostic accuracy rate of CT was found as 81.8%. In case of suspicion of AA, US may be the first choice because it is inexpensiveand easily accessible. However, considering patient incompatibility and subjective factors in children, US may sometimes be insufficient. We think that CT should be performed as an advanced examination method in cases where US is not compatible with the patient's condition, not clinic.

Biochemical, Genetic and Clinical Diagnostic Approaches to Autism-Associated Inherited Metabolic Disorders

Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disorders characterized by impaired social interaction, limited communication skills, and restrictive and repetitive behaviours. The pathophysiology of ASD is multifactorial and includes genetic, epigenetic, and environmental factors, whereas a causal relationship has been described between ASD and inherited metabolic disorders (IMDs). This review describes biochemical, genetic, and clinical approaches to investigating IMDs associated with ASD. The biochemical work-up includes body fluid analysis to confirm general metabolic and/or lysosomal storage diseases, while the advances and applications of genomic testing technology would assist with identifying molecular defects. An IMD is considered likely underlying pathophysiology in ASD patients with suggestive clinical symptoms and multiorgan involvement, of which early recognition and treatment increase their likelihood of achieving optimal care and a better quality of life.

Case report: Look at my eyes

The comorbidity of migraine and Autism Spectrum Disorder (ASD) still remain unclear. In spite of plausible evidences of such comorbidity, there is a scarcity of populational studies focusing this hypothesis. The diagnosis of migraine in children with ASD is very challenge due to the large clinical heterogeneity and limited communication skills, particularly verbal abilities in young children and those with intellectual disability. ASD and migraine are chronic prevalent disorders sharing some pathophysiological changes (neurotransmission dysregulation, altered immune response, abnormal findings in the cortical minicolumn organization, and dysfunctions in the gut–brain axis), susceptibility genes (including calcium channel mutations and polymorphisms), and atypical sensory processing. Herein, we take advantage of a prototypical case of an adolescent with episodic migraine transformed to chronic, not responsive to preventive treatment, to explore the diagnostic workup and successful personalized clinical and therapeutical management.

Bridging the divide on climate solutions: Development, implementation, and evaluation of an online workshop for climate volunteers

A critical component to addressing climate change is effective communication with the public and legislators about urgency for action. Health professionals have a vital role to play in climate advocacy. However, several key barriers to public advocacy have been identified, including limited communication skills to effectively advocate with others. We describe the development, implementation, and evaluation of a novel online workshop, whose goal is to teach volunteers to communicate more effectively on climate change with those holding differing views regarding potential solutions (e.g., role of government vs. private sector). The development phase included seeking input from multiple stakeholders about the workshop's focus and creating specific examples and prompts. The workshop was then pilot-tested, and refinements were made based on evaluations. Volunteers within a climate organization then took the workshop and evaluations were collected. Evaluations from 312 attendees were analyzed, including 14% in healthcare-related fields. On a 10-point scale (10 being highest), volunteers reporting a median score of 8 in their confidence level for setting a constructive tone in conversations with people holding differing views on climate solutions. Qualitative analysis of participants’ responses “Single most important learning?”, “What was most important to share?”, and “What would you like to see changed?” by two independent observers supported almost perfect agreement (kappa of 0.88) in themes that included Learning New Skills, Developing New Ways of Being, Format, and Additional Training/Suggested Enhancements. Our workshop increased participant confidence in having conversations on climate change solutions, an important part of climate advocacy.

Early Interventionists’ Knowledge of Evidence-Based Practices for Autism

This online survey study examined early intervention providers’ knowledge and training needs surrounding evidence-based practices for autism spectrum disorder (ASD). The researchers analyzed data from 87 early intervention providers (speech-language pathologists and developmental specialists) in a rural Southwestern U.S. state. The survey included both quantitative (i.e., rating and multiple-choice questions) and qualitative (open-ended) components. Survey sections included demographics, self-ratings of knowledge of evidence-based practices/self-reported training needs and barriers to working with children with ASD, and directly assessed knowledge of evidence-based practices. Findings support specific knowledge gaps and training needs (e.g., practices for addressing challenging behaviors, strategies for working with children with limited communication skills) and suggest developmental specialists who provided special instruction services may have greater training needs than speech-language pathologists. Findings have important implications for professional development and training programs for early intervention providers.

‘My partner will think I’m weak or overthinking my pain’: how being superwoman inhibits Black women’s sexual pain disclosure to their partners

Black women experience persistent sexual pain that may often last longer than White women. Despite the value of sexual communication to alleviate sexual pain concerns, many women do not disclose sexual pain to their partners. Limited research explores barriers to disclosing sexual pain to partners among Black women. This study seeks to fill this gap. Relying on an integration of Sexual Script theory and Superwoman Schema, the study explored the barriers that premenopausal, cisgender Black women from the Southern USA perceived when disclosing sexual pain to their primary partners. We identified five common themes from women’s open-ended responses to an online survey: (a) distressing emotions associated with disclosure; (b) limited knowledge and communication skills; (c) protecting partner’s feelings and ego; (d) invading privacy; and (e) taking sole responsibility for managing sexual pain. Findings suggest a combination of intrapsychic, interpersonal and cultural factors influence Black women’s perceived ability to have direct and open dyadic communication about sexual pain with their partners. Implications for Black women’s sexual health and relationship outcomes are discussed.

Assessing and Treating Anxiety in Individuals with Autism.

Anxiety is a cluster of responses that can involve both operant and respondent behavior, which can be both public and/or private in nature, and occurs when an upcoming aversive stimulus is signaled. Despite the reported high comorbidity of autism and anxiety, there has been very limited research on how to directly assess and treat anxiety, especially with individuals who have limited communication skills. In Study 1, anxiety was assessed in five individuals with autism, ranging in age from 10 to 19 years old. Anxiety was assessed by measuring behavior during (1) a baseline (with no putative anxiety-provoking stimuli present), (2) signals for an upcoming aversive event, and (3) exposure to that aversive event. Anxiety presented in several different ways, as both conditioned activation and suppression, and both with and without problem behavior during the aversive event. In Study 2, individualized treatments involving differential reinforcement of alternative responses and stimulus fading were used to successfully reduce anxious responding in all four participants who displayed anxiety. These studies demonstrated a potentially useful means of assessing anxiety in individuals with autism which may not only help to measure anxious behavior and identify anxiety-provoking events, but may also lead to effective treatment.

두 가지 다요소 중재가 자폐스펙트럼 장애 고등학생의 음성상동행동과 과제 수행에 미치는 영향*

This study evaluated the effect of two multi-component interventions in reducing vocal stereotypy and increasing task engagement especially in learning situations among children with developmental disabilities. The participant was a 17-year-old high school student with autism spectrum disorder. He had very limited communication skills and a high level of vocal stereotypy that interfered with learning. Based on an alternating treatment design, a multi-component intervention with a redirection prompt using sound and a multi-component intervention with a redirection prompt using activity engagement were conducted by behavioral therapists during learning activities in a hospital-based behavioral therapy room. According to the results of the study, both multi-component interventions were effective not only in reducing vocal stereotypy but also in increasing task performance in learning situations. There was no significant difference between the two multi-component interventions in reducing vocal stereotypy. Based on these results, practical applications of the vocal stereotypy intervention methods were discussed.