Naturalistic Communication Research Articles

In-home conversations of couples with advanced cancer: Support has its costs.

The goal of this study was to describe the quality of naturalistic communication between patients with advanced cancer and their spouse caregivers using observational methods. We also assessed the association between patient and caregiver communication behaviors and psychological and physical health using the actor-partner interdependence model. Data on 81 dyads were gathered as part of a prospective observational study. Patients with advanced cancer and their spouse caregivers completed demographic, physical health, and emotional well-being questionnaires. Cancer and relationship communication captured in "day-in-the-life" audio recordings were coded using Gottman's Turning System to assess the quality of bids for attention and responses. Bids for attention were most often informational (Low Bids) and responses were mostly positive and effortful (Turn Towards); patients and caregivers did not significantly differ in communication behavior. More effortful bids for attention (High Bids) were associated with more positive and effortful responses. Patient communication behaviors were significantly associated with caregiver emotional well-being, whereas caregiver communication behaviors were significantly associated with their own emotional well-being and patient physical health. While patients may benefit from caregivers' more positive and engaged communication at home, the emotional labor of focusing on and engaging the patient may take a toll on caregivers' own well-being. This work contributes to the understanding of what everyday communication looks like for patients with advanced cancer and their spouse caregivers and how this communication may impact physical and psychological health. Our findings provide a foundation to develop guidelines for psychosocial couple-based interventions.

Meeting the communication needs of students on the autism spectrum in Australian classrooms: Adjustments reported by educators and specialists

Purpose The purpose of this study was to examine educators’ and specialists’ provision of communication adjustments for students on the autism spectrum in mainstream and supported education settings. Method Secondary analysis of data collected from educators and specialists in the Australian Autism Educational Needs Analysis was undertaken. Thematic analysis of adjustment descriptions identified 11 categories. The use of the 11 specific adjustment categories with reference to (a) participant group (educator versus specialists), and (b) setting (mainstream versus supported) were described and associations investigated using Chi-square analyses. Result Only 32% of the 381 educators and specialists reported using adjustments. Of the adjustments reported, those categorised as “Multimodal Communication”, “Structured Teaching”, and “Assistive Technology” were frequently included by both groups. Significant associations were apparent between groups and the use of specific adjustments including naturalistic communication strategies. Significant differences were evident in the proportion of specific adjustments used by participants in supported as opposed to mainstream settings. Conclusion Possible reasons for the differences in the adjustments reported by educators and specialists and the role that setting may play in these are discussed. These include resourcing, the choice of adjustment being driven by school setting rather than student need, and possible differences between professionals in describing the adjustments made.

Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate

Purpose: The purpose of this study was to investigate the extent to which a naturalistic communication intervention, Enhanced Milieu Teaching with Phonological Emphasis (EMT + PE) improved the speech outcomes of toddlers with cleft palate with or without cleft lip (CP ± L)Method: This study was a stratified randomised controlled trial.Setting: Treatment was delivered in a university clinic by a trained speech-language pathologist.Thirty children aged between 15 and 36 months (M = 25) with nonsyndromic CP ± CL and typical cognitive development were randomly assigned to a treatment (EMT + PE) or business as usual comparison condition.Participants in the EMT + PE treatment group received 48, 30-min sessions, over a 6-month period. Fidelity of treatment was high across participants.The primary outcome measures were percent consonants correct (PCC), consonant inventory, compensatory articulation errors, and nasal emission.Result: Regression analyses controlling for pre-intervention child characteristics were conducted for PCC and consonant inventory. Intervention was not a significant predictor of post-intervention outcome. Words per minute differentiated the children who benefitted from the intervention from those who did not. Reduction in compensatory errors and nasal emission occurred in both groups but to a greater degree in the EMT + PE group.Conclusion: EMT + PE is a promising early speech intervention for young children with CP ± L, especially for children with higher rates of word use.

Embedding Naturalistic Communication Teaching Strategies During Shared Interactive Book Reading for Preschoolers with Developmental Delays: A Guide for Caregivers

Shared interactive book reading (SIBR) is a broad term used to describe the act of adults reading aloud to children, while encouraging interaction by asking questions and engaging in a discussion about the book. SIBR can be used to embed naturalistic communication teaching strategies, creating learning opportunities to promote a child’s language and communication skills. This article presents practical information on how caregivers can use naturalistic communication teaching strategies during SIBR with their child with developmental delays or disabilities (DD). The intended audiences are caregivers (e.g., parents, grandparents) and practitioners (e.g., classroom teachers, speech-language pathologists, reading specialists) who work with caregivers of children with DD. We explain the importance of early communication skills, naturalistic communication teaching strategies, and SIBR, and describe how to embed naturalistic communication teaching strategies within SIBR. Through a vignette we illustrate how caregivers can implement the techniques and strategies and how practitioners can support caregivers’ implementation.

Parent-Implemented Communication Strategies During Storybook Reading

Children with developmental disabilities (DD) may experience delays in their ability to speak and communicate with their parents, peers, and others. These children often benefit from evidence-based, parent-implemented communication interventions. In the current study, two mothers were trained and coached to use storybook reading techniques and evidence-based naturalistic communication teaching strategies (i.e., modeling, mand-model, and time delay) while reading books with their children with DD. Using a multiple-baseline design across naturalistic teaching strategies, the following three components were examined: (a) mothers’ use of book reading techniques, (b) mothers’ rate and fidelity in using the three naturalistic teaching strategies, and (c) children’s communication outcomes. After training and coaching, the mothers used the modeling, mand-model, and time delay strategies with higher rates and higher fidelity. The children initiated more communicative acts upon their mothers’ use of time delay. The mothers reported that the training and coaching helped them implement the strategies and led to improvements in their children’s communication skills.

Behind closed doors: How advanced cancer couples communicate at home

Objective: Describe communication between patients with advanced cancer and their spouse/partner caregivers. Design: Prospective observational study. Sample: 83 advanced cancer patient–spouse caregiver couples.Methods: Couples completed surveys and recorded naturalistic communication for one day. Descriptive analysis was performed on self-report and observational communication data.Findings: Both patients and caregivers self-reported high likelihood of engaging in positive interactions. The majority of observed communication was logistical or social small-talk. Cancer and relationship talk was highly skewed; many couples had no talk in these domains.Conclusion: This study is one of the first to assess continuous naturalistic observation of communication in the homes of couples coping with advanced cancer. We found that routine aspects of daily life continue even when couples are facing important challenges.Implications for Psychosocial Providers: There appear to be few naturalistic cues encouraging couples to discuss potentially difficult topics. More work is needed to determine appropriate levels of communication.

Understanding Performance and Verbal-Communication of Children with ASD in a Collaborative Virtual Environment.

Collaborative virtual environments (CVEs), which allow naturalistic communication between two or more individuals in a shared virtual environment, hold promise as a tool for measuring and promoting social communication between peers. In this work, a CVE platform and a set of CVE-based collaborative games are designed for children with autism spectrum disorder (ASD). Two groups (7 ASD/TD pairs; 7 TD/TD pairs) participated in a pilot study to establish system feasibility and tolerability. We also designed a methodology for capturing meaningful metrics of social communication. Based on these metrics, we found improved game performance and trends in communication of these participants over time. Although preliminary, these results provide important insights on CVE-based interaction for ASD intervention.

Bug-in-Ear eCoaching: Impacts on Novice Early Childhood Special Education Teachers

A multiple-probe, single-case design was used to determine the effects of bug-in-ear eCoaching on teachers’ use of two targeted naturalistic communication strategies and focus children’s responses to these strategies. Results indicated that bug-in-ear eCoaching enhanced teachers’ use of communication strategies and the appropriate responses of children with communication difficulties. Moreover, novice teachers reported that bug-in-ear eCoaching was a socially valid intervention.

The Effects of Enhanced Milieu Teaching With Phonological Emphasis on the Speech and Language Skills of Young Children With Cleft Palate: A Pilot Study.

The purpose of this pilot study was to investigate the extent to which a naturalistic communication intervention, enhanced milieu teaching with phonological emphasis (EMT+ PE), improved the language and speech outcomes of toddlers with cleft lip and/or palate (CL/P). Nineteen children between 15 and 36 months (M = 25 months) with nonsyndromic CL/P and typical cognitive development were randomly assigned to a treatment (EMT+PE) or nontreatment, business-as-usual (BAU), experimental condition. Participants in the treatment group received forty-eight 30-min sessions, biweekly during a 6-month period. Treatment was delivered in a university clinic by trained speech language pathologists; fidelity of treatment was high across participants. Children in the treatment group had significantly better receptive language scores and a larger percentage of consonants correct than children in the BAU group at the end of intervention. Children in the treatment group made greater gains than children in the BAU group on most language measures; however, only receptive language, expressive vocabulary (per parent report), and consonants correct were significant. The results of this preliminary study indicate that EMT+PE is a promising early intervention for young children with CL/P. Replication with a larger sample and long-term follow-up measures are needed.

Neurolinguistic and machine-learning perspectives on direct speech BCIs for restoration of naturalistic communication

The ultimate goal of brain-computer-interface (BCI) research on speech restoration is to develop devices which will be able to reconstruct spontaneous, naturally spoken language from the underlying neuronal signals. From this it follows that thorough understanding of brain activity and its functional dynamics during real-world speech will be required. Here, we review current developments in intracranial neurolinguistic and BCI research on speech production under increasingly naturalistic conditions. With an example of neurolinguistic data from our ongoing research, we illustrate the plausibility of neurolinguistic investigations in non-experimental, out-of-the-lab conditions of speech production. We argue that interdisciplinary endeavors at the interface of neuroscience and linguistics can provide valuable insight into the functional significance of speech-related neuronal data. Finally, we anticipate that work with neurolinguistic corpora composed of real-world language samples and simultaneous neuronal recordings, together with machine-learning methodology accounting for the specifics of the neurolinguistic material, will improve the functionality of speech BCIs.

Intercultural communication in online social networking discourse

ABSTRACTThis article presents a case study that examines how an online social networking community is constituted through intercultural discourse on the part of one learner sojourning in the US. Using Byram’s model of intercultural communicative competence, this study examines the learner’s naturalistic communication in a social networking site (SNS). The qualitative analysis indicates that the learner acted upon the affordances of SNSs to reflect on her intercultural experiences and displayed evidence of intercultural understanding during her study abroad years. The learner’s intercultural knowledge, attitudes, and discovery are shown to be co-constructed by her and other members in the online discourse. This study indicates that computer-mediated communities like SNSs provide the learner with a space in which she documented her cultural experience and reflected on those experiences in real-time exchanges with multilingual, multicultural users. Pedagogical implications are discussed.

Teaching Parents Enhanced Milieu Teaching With Words and Signs Using the Teach-Model-Coach-Review Model

Measuring treatment fidelity is an essential step in research designed to increase the use of evidence-based practices. For parent-implemented communication interventions, measuring the implementation of the teaching and coaching provided to the parents is as critical as measuring the parents’ delivery of the intervention to the child. Both levels of measurement are important in translating research into effective practice. In a single-case multiple-baseline design, the effectiveness of the teach-model-coach-review model for teaching Enhanced Milieu Teaching (EMT) Words and Signs to parents of young children with Down syndrome was evaluated. Implementation of parent training was completed with high fidelity. In addition, there was a functional relation between the implementation of the parent training and parents’ use of the specific EMT intervention strategies. The findings of this study replicate and extend previous studies suggesting systematic teaching and coaching can be effective in improving parent use of naturalistic communication strategies.

AAC Modeling Intervention Research Review

A systematic review of research on the effects of interventions that include communication partner modeling of aided augmentative and alternative communication (AAC) on the language acquisition of individuals with complex communication needs was conducted. Included studies incorporated AAC modeling as a primary component of the intervention, defined as the communication partners (a) modeling aided AAC as they speak and (b) participating in the context of a naturalistic communication interaction. This review used a best-evidence approach, including nine single-case studies, with 31 participants, and 70 replications, and one quasi-experimental randomized group design study, including 63 participants. The results of the review indicated that AAC modeling intervention packages led to meaningful linguistic gains across four areas including (a) pragmatics, marked by increases in communication turns; (b) semantics, marked by receptive and expressive vocabulary increases; (c) syntax, marked by multi-symbol turn increases; and (d) morphology, marked by increases in target morphology structures.

Internet-Based Parent-Implemented Intervention for Young Children With Autism

Both naturalistic communication and parent-implemented interventions are evidence-based practices for young children with disabilities, but demonstrations of effective methods for teaching parents to implement naturalistic interventions successfully with their children are still warranted. The purpose of this study was to examine the effects of a training and coaching program on parent implementation of naturalistic teaching strategies and on concomitant child communication skills using a telepractice service-delivery model (i.e., Internet-Based Parent-Implemented Communication Strategies [i-PiCS]). We found that parents learned to implement the targeted naturalistic teaching strategies with fidelity when, and only when, they were provided with training and coaching over the Internet. The parents’ implementation of these strategies also corresponded with positive changes in their children’s communication skills. The limitations and implications of this investigation are discussed.

Prefrontal Cortical Activity During Discourse Processing

Discourse is a commonly occurring and cognitively demanding form of naturalistic communication (e.g., conversation, event narration, personal and fictional narratives, text reading/generation). Because of the prevalence of these communication acts in daily routines (e.g., educational, vocational, and social), disrupted discourse is an important target for treatment of persons with cognitive-communication (CC) disorders (American Speech-Language Hearing Association, 2005). However, there is a paucity of information with regard to the underlying cognitive architecture and processing demands associated with the various forms of discourse in non-brain-injured adults. This is, in part, due to a number of methodological constraints of functional neuroimaging technologies such as functional magnetic resonance imaging that severely limit ecologically typical communication acts such as listening and speaking during scanning. To circumvent these issues, this pilot investigation used functional near infrared spectroscopy (fNIRS) to monitor hemodynamic activity in the prefrontal cortex (PFC) during natural discourse-processing tasks in 13 neurologically healthy adult participants. Task demands were manipulated across a variety of discourse types to elucidate the associated neural and cognitive resources. Results indicate that the comprehension of well-organized discourse text is minimally demanding on the PFC. However, discourse production places a significant burden on the PFC and these processing demands generally reflect the relative complexity of the discourse task. These findings are discussed in terms of potential clinically relevant implications with regard to the elicitation, assessment, and remediation of CC impairments in clinical populations.

Coaching Teachers to Support Child Communication Across Daily Routines in Early Head Start Classrooms

This study investigates the use of a situated coaching protocol in Early Head Start (EHS) classrooms to increase teachers' use of communication facilitation strategies with children identified with delays during typical play and caregiving routines. A single-case, multiple baseline design across 3 EHS teachers and children with communication delays was used to examine the effectiveness of coaching on teacher strategy use and child outcomes. A situated coaching approach that included directly teaching naturalistic communication strategies, demonstrating, observing, offering feedback, and facilitating teacher reflection, was implemented with fidelity in the classroom. The teachers increased their use of the communication facilitation strategies in both types of routines, although rates of implementation were higher in play than in caregiving activities. The child participants increased their rates of communication during the 6-week intervention. Teachers maintained strategy use in a follow-up 3 months after the study.

The Religion of “I Don’t Know”

The goal of this pilot study was to identify naturally occurring, spiritually relevant conversations and elucidate challenges for nurses in home hospice. We examined naturalistic communication data collected during nurse hospice visits with cancer patients and their family caregivers. Using deductive content analysis, guided by Consensus Conference spiritual categories and definition, categorical themes were identified. Thirty-three visits to seven families were recorded by five nurses. Although most spiritual dialogue was brief, analysis revealed five themes: Spiritual Beliefs and Rituals, Connection, Spiritual Comfort, Closure and Acceptance, and Spiritual Distress. Findings demonstrate the range of spiritual issues raised in hospice and challenges nurses face in maintaining boundaries while remaining genuine and family-centered in providing care. This work serves as a foundation for future research and education to help clinicians to engage in more intentional spiritual conversations in the support of families at end of life.

A Randomized Trial Comparison of the Effects of Verbal and Pictorial Naturalistic Communication Strategies on Spoken Language for Young Children with Autism

Presently there is no consensus on the specific behavioral treatment of choice for targeting language in young nonverbal children with autism. This randomized clinical trial compared the effectiveness of a verbally-based intervention, Pivotal Response Training (PRT) to a pictorially-based behavioral intervention, the Picture Exchange Communication System (PECS) on the acquisition of spoken language by young (2-4years), nonverbal or minimally verbal (≤9 words) children with autism. Thirty-nine children were randomly assigned to either the PRT or PECS condition. Participants received on average 247h of intervention across 23weeks. Dependent measures included overall communication, expressive vocabulary, pictorial communication and parent satisfaction. Children in both intervention groups demonstrated increases in spoken language skills, with no significant difference between the two conditions. Seventy-eight percent of all children exited the program with more than 10 functional words. Parents were very satisfied with both programs but indicated PECS was more difficult to implement.

Introducing Emotions to the Modelingof Intra- and Inter-Personal Influencesin Parent-Adolescent Conversations

An understanding of the dynamics underlying emotional interactions between speakers is essential to the design of effective conversational strategies for interviews, mental health therapies, teaching and counseling, as well as the design of naturalistic human-machine communication systems. The present study introduces a new approach to the modeling of emotional influences during parent-adolescent conversations. The proposed dynamic influence model (DIM) estimates the joint conditional probabilities of speaker's states as a linear combination of simpler inter- and intra-speaker conditional probabilities. Contrary to the previously existing influence models (IMs), the DIM's coefficients are given not as static, constant values but as dynamically changing functions of the time delay between the current and the previous state. The speaker's states were annotated using four labels (speech with positive emotion, speech with negative emotion, emotionally neutral speech and silence with undefined emotion). Experimental results based on the audio recordings of 63 different naturalistic (not acted) parent-adolescent conversations showed that the proposed method leads to psychologically plausible observations. It was also demonstrated that the proposed DIM can achieve up to 20 percent higher accuracy of discriminating between emotional influence patterns of parents and adolescents when compared to the previously used static IM.

Training teachers to use a naturalistic communication intervention may increase communicative interactions in young children with ASD

Harjusola-Webb, S., & Robbins, S. H. (2012). The effects of teacher-implemented naturalistic intervention on the communication of preschoolers with autism. Topics in Early Childhood Special Education, 32(2), 99–110. Source of funding and disclosure of interest: The authors stated that no financial support was received for this study. Original authors reported that there were no conflicts of interest.