Adult Skills Research Articles

Combining low-technology augmentative and alternative communication with regular aphasia treatment: interim findings of a hospital-based RCT in post-stroke patients

ABSTRACT Background Previous research indicates that low-technology (low-tech) augmentative and alternative communication interventions (AACT) can enhance communication skills in individuals with post-stroke aphasia in China. However, there is limited evidence for low-tech AACT in inpatient settings. Aim This study aims to evaluate the impact of low-tech AACT combined with speech-language therapy (SLT) on communication skills related to basic needs, quality of life, and spoken language function among individuals with post-stroke aphasia in an inpatient setting. Methods & Procedures Twelve participants with aphasia having difficulty in daily communication were randomly assigned to an experimental group, receiving 30 minutes of SLT and 30 minutes of low-tech AACT per session (AACT + SLT), or a control group, receiving 60 minutes of SLT per session (SLT), over ten sessions in two weeks. Primary outcomes were measured using the basic needs (CBN) domain of the functional assessment of communication skills for adults (FACS). Secondary outcomes included scores from the Chinese version of the stroke-specific quality of life scale (SS-QOL) and subtests of spoken language production and comprehension from the aphasia battery of Chinese (ABC). The study was registered in the Chinese clinical trial registry (ChiCTR2000028870). Results The results indicated a significant improvement in the CBN domain of FACS in the AACT + SLT group, with larger clinically significant changes compared to the SLT group. The AACT+ SLT group also showed significantly higher overall scores on the SS-QOL and more significant improvements in the content of spontaneous speech than the SLT group after intervention. Comparable improvements were observed in other subtests of the ABC between the two groups. Conclusions Incorporating low-tech AACT into regular SLT in inpatient settings can improve communication for basic needs in an in-patient setting, facilitate language recovery, and potentially support the overall quality of life, compared to SLT alone, for people with post-stroke aphasia. This combined approach demonstrates preliminary feasibility in hospital settings, suggesting the value of low-tech AACT in aphasia rehabilitation.

Pulsed lighting for adults with Dyslexia: very limited impact, confined to individuals with severe reading deficits

The goal of this study is to evaluate the impact of pulsed lighting on the reading performance of young adults with dyslexia. A total of 42 participants were recruited, including individuals diagnosed with developmental dyslexia and adults without reported reading difficulties. The severity of each participant’s reading deficit was assessed on a continuous scale using a reading impairment score, derived from four reading tests: an isolated-word reading test, a pseudoword reading test, and two reading fluency tests. The impairment score ranged from 0 (no impairment) to 4 (severe impairment across all tests). To examine the potential effect of pulsed lighting, we measured (1) sentence reading speed, expressed as a reading accessibility index (ACC), and (2) text comprehension, expressed as a comprehension score. These measures were taken under three lighting conditions: standard lighting, pulsed lighting, and a combination of the two. Linear mixed-effects models were applied to assess the effects of lighting on ACC and comprehension, controlling for the reading impairment score. We found no effect of lighting conditions on either ACC or comprehension, except in the most impaired readers, who showed a small but significant increase of 7% in ACC. However, even with pulsed lighting, impaired readers did not reach the performance level of skilled adult readers. In conclusion, the study did not demonstrate a clear positive impact of pulsed lighting on the reading skills of adults with dyslexia.

Effects of a combined neuropsychological and cognitive behavioral group therapy on young adults with Fragile X Syndrome: An explorative study

BackgroundFragile X Syndrome (FXS) is an X-linked neurodevelopmental disorder that leads to intellectual disability (ID) along with cognitive-behavioral difficulties. Research on psychosocial treatments in individuals FXS and ID is still lacking. This study aimed to investigate the effectiveness of a combined neuropsychological and cognitive behavioral group therapy (nCBT) among young adults with FXS. MethodTen young adults diagnosed with FXS took part in the second stage intervention of "Corp-osa-Mente" (CoM II), a group nCBT program previously outlined by Montanaro and colleagues in an earlier study, with the participants being the same as in the previous research. This report details the outcomes of an additional twelve-month group sections aimed at enhancing the ability to manage emotions and the socio-communicative skills of these young adults. Caregivers completed measures of adaptive functioning, emotional and behavior problems, executive function, communication skills and family quality of life at pre-treatment (T0) and post-treatment (T1). ResultsCoM II showed a decrease in depressive and anxiety symptoms from T0 to T1, along with increased socio-pragmatic and communication skills from pre-test to post-test intervention. Additionally, our analysis revealed improvements in the adapative behavior of participants and in the family quality of life. ConclusionsThese preliminary findings suggest that young adults with FXS and ID experienced positive outcomes through participation in CoM II, a group nCBT. However, it is recommended to undertake additional methodologically rigorous studies, such as randomized controlled trials (RCTs), to substantiate these initially promising findings.

Hippotherapy Used in Medical Recovery

Hippotherapy, also known as equine-assisted therapy, falls into the category of alternative therapies that involve human-horse interaction for therapeutic purposes. Horse therapies are especially used for children with various physical, cognitive, and emotional disorders. They can also be successfully used with adults and the elderly. The horse's movement is what stimulates the development of motor skills, balance, and coordination. Direct interaction with the horse, including caring for it, riding, and other related activities, is effective in developing social, emotional, and cognitive skills in both children and adults, as well as in the elderly. Hippotherapy encourages self-confidence, concentration, and motor coordination, making it suitable for people who are anxious, antisocial, depressed, have language difficulties, or low self-esteem. Studies highlight that the presence of horses changes the frequency of the human brain, with subjects becoming more aware and focused when around horses. Horses help therapy beneficiaries stay connected to the present, becoming more aware of their experiences. Additionally, patients learn to pay more attention to the feelings and nonverbal language transmitted by the being they come into contact with. Numerous studies show that horseback riding improves balance, coordination, and reflexes, induces muscle relaxation, reduces spasticity, increases joint mobility, and improves respiratory function and blood circulation. The main objective of the paper is to identify therapies that use horses for patients diagnosed with various conditions, the benefits of these therapies on patients' motor skills, and their effects on patients' mental state. Additionally, we aim to identify horse-related activities that enhance concentration, help address behavioral issues, and facilitate patients' integration into social groups.

The Immediate Effects of a Single 20-Minute Session of Transcranial Direct Current Stimulation (tDCS) on Muscle Strength in Older Adults

The older population often experiences a gradual age-related decline in the primary motor cortex, leading to muscle weakness that can harm their physical performances. Exercise could improve physical performance and prevent falling in older adults. However, the decrease in motor function and motor skills in older adults reduces the efficiency of fall prevention. Transcranial Direct Current Stimulation (tDCS) is a non-invasive intervention aimed at improving muscle strength in various conditions by utilizing transcranial direct current stimulation applied to the primary motor cortex (M1). Pre- and post-studies were conducted to demonstrate the effects of a single 20-minute session of tDCS alone, as well as to assess any potential side effects. Sixteen older individuals, both male and female, aged 65 years or older, with or without underlying diseases, were assessed for leg and hand grip strength, followed by physical performance tests. Subsequently, they underwent stimulation of the primary motor cortex through the placement of anodal tDCS (a-tDCS) over the left M1 for 20 min. Immediate effects were evaluated within 24 h, and side effects were recorded for up to 2 weeks after the stimulation. The results demonstrated that a single session of tDCS led to a significant increase in leg strength by 13 kg (5.9 to 20.1 kg, p < 0.01). There was also a significant correlation observed with hand grip strength (r = 0.68, p < 0.01). All physical performance tests, except the fastest speed in the 10-meter walk test, showed statistically significant improvements (p < 0.01). Participants reported no serious side effects, and the intervention will now be incorporated into prospective clinical studies involving older populations to compare its effectiveness with other treatments. HIGHLIGHTS A single session of tDCS led to a significant increase in leg strength. A single session of tDCS, with a significant correlation observed with hand grip strength. Physical performance tests showed statistically significant improvements after a single session of tDCS. Participants reported no serious side effects. This intervention will now be incorporated into prospective clinical studies involving older populations to compare its effectiveness with other treatments. GRAPHICAL ABSTRACT

Influencing factors of self-management ability among dry eye patients in west China.

To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China. A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University. All participants completed the rating scale of health self-management skill for adults (AHSMSRS), Huaxi Emotional-Distress Index (HEI), e-health literacy scale (e-HEALS) and Brief Illness Perception Questionnaire (Brief-IPQ). A generalized linear model was employed to establish a multivariate linear model with demographic data, psychological state, e-HEALS, and illness perception as independent variables and health self-management skill score as the dependent variable. The mean score for health self-management skill was 165.58±15.79. Multivariate analysis revealed that advanced age, better illness perception and improved psychological state were associated with better health self-management ability among dry eye patients. Furthermore, the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y. The health self-management ability of dry eye patients in west China is relatively high. Age, duration of disease, illness perception and psychological state are the influencing factors on the health self-management ability of dry eye patients.

Can Virtual Reality Cognitive Remediation in Bipolar Disorder Enhance Specific Skills in Young Adults through Mirror Neuron Activity?—A Secondary Analysis of a Randomized Controlled Trial

Introduction: Impairments in social cognition and cognitive deficits in bipolar disorder (BD) offer insights into the disorder’s progression. Understanding how interventions impact both cognitive and emotional aspects of social cognition is essential. This study examines the effects of virtual reality (VR) cognitive remediation on cognitive skills, stratified by age, in the early stages of the disorder. Methods: A secondary analysis of a randomized controlled trial (RCT) compared the efficacy of VR cognitive remediation on cognitive skills between young adults (≤58 years) and older adults (≥59 years) in the experimental group with BD. Results: The experimental group included 39 participants: 24 ≤ 58 years and 15 ≥ 59 years. Young adults showed greater improvement in the Digit Span Backward (0.37 ± 0.35 vs. 0.07 ± 0.26, F = 9.882, p = 0.020) and Digit Symbol tests (3.84 ± 3.05 vs. 1.16 ± 3.8, F = 5.895, p = 0.020). Older adults improved more in the Frontal Assessment Battery (1.00 ± 0.95 vs. 0.54 ± 0.21, F = 5.295, p = 0.027), Matrix test (0.58 ± 0.35 vs. 0.37 ± 0.26, F = 4.606, p = 0.038), and Test of Tale (0.81 ± 0.36 vs. 0.42 ± 0.38, F = 10.115, p = 0.003). Conclusions: Young adults improved more in complex cognitive tasks, while older adults showed better results in simpler tasks. The effectiveness of VR may be due to hyperstimulation of mirror neurons. Further studies are needed to confirm these findings.

Low literacy skills in adults can be largely explained by basic linguistic and domain-general predictors.

Despite having sufficient formal education, a large group of people cannot complete everyday tasks like reading, writing, or making basic calculations. Regarding reading, millions of people are not able to understand more complex texts despite the ability to read simple words or sentences; they have low literacy skills. Even though this problem has been known for decades, the causes and predictors of their poor reading comprehension skills are not fully explored. Socioeconomic, sociodemographic, and reading-related (i.e., linguistic) factors, especially of English-speaking participants and thus users of an opaque orthography, were often assessed. The goal of this study was to examine which linguistic, domain-general, or numerical factors predict substandard complex text reading as the core symptom of low literacy skills in adulthood. To this end, we assessed a group of German-speaking participants-users of a transparent orthography-who are at risk for complex text reading deficits. The results indicated that linguistic variables (reduced word/pseudoword reading, weaker oral semantic and grammatical comprehension), working memory, and age predicted lower performance in text comprehension. This model explained 73% of the total variance, indicating that most of the deficits in complex text reading can be explained by a group of basic underlying linguistic and domain-general factors. We conclude that interventions for adults with low literacy skills and others at risk for complex text reading deficits should address word/pseudoword reading and focus on both written and oral comprehension.

Barriers to Early Progress in Adult Cochlear Implant Outcomes.

Adult cochlear implant (CI) recipients obtain varying levels of speech perception from their device. Adult CI users adapt quickly to their CI if they have no peripheral "bottom-up" or neurocognitive "top-down" limiting factors. Our objective here was to understand the influence of limiting factors on the progression of sentence understanding in quiet and in noise, initially and over time. We hypothesized that the presence of limiting factors, detected using a short test battery, would predictably influence sentence recognition with practical consequences. We aimed to validate the test battery by comparing the presence of limiting factors and the success criteria of >90% sentence understanding in quiet 1 month after activation. The study was a single-clinic, cross-sectional, retrospective design incorporating 32 adult unilateral Nucleus CI users aged 27 to 90 years (mean = 70, SD = 13.5). Postoperative outcome was assessed through sentence recognition scores in quiet and in varying signal to noise ratios at 1 day, 1 to 2 months, and up to 2 years. Our clinic's standard test battery comprises physiological and neurocognitive measures. Physiological measures included electrically evoked compound action potentials for recovery function, spread of excitation, and polarity effect. To evaluate general cognitive function, inhibition, and phonological awareness, the Montreal Cognitive Assessment screening test, the Stroop Color-Word Test, and tests 3 and 4 of the French Assessment of Reading Skills in Adults over 16 years of age, respectively were performed. Physiological scores were considered abnormal, and therefore limiting, when total neural recovery periods and polarity effects, for both apical and basal electrode positions, were >1.65 SDs from the population mean. A spread of excitation of >6 electrode units was also considered limiting. For the neurocognitive tests, scores poorer than 1.65 SDs from published normal population means were considered limiting. At 1 month, 13 out of 32 CI users scored ≥90% sentence recognition in quiet with no significant dependence on age. Subjects with no limiting peripheral or neurocognitive factors were 8.5 times more likely to achieve ≥90% score in quiet at 1 month after CI switch-on (p = 0.010). In our sample, we detected 4 out of 32 cases with peripheral limiting factors that related to neural health or poor electrode-neural interface at both apical and basal positions. In contrast, neurocognitive limiting factors were identified in 14 out of 32 subjects. Early sentence recognition scores were predictive of long-term sentence recognition thresholds in noise such that limiting factors appeared to be of continuous influence. Both peripheral and neurocognitive processing factors affect early sentence recognition after CI activation. Peripheral limiting factors may have been detected less often than neurocognitive limiting factors because they were defined using sample-based criteria versus normal population-based criteria. Early performance was generally predictive of long-term performance. Understanding the measurable covariables that limit CI performance may inform follow-up and improve counseling. A score of ≥90% for sentence recognition in quiet at 1 month may be used to define successful progress; whereas, lower scores indicate the need for diagnostic testing and ongoing rehabilitation. Our findings suggest that sentence test scores as early as 1 day after activation can provide vital information for the new CI user and indicate the need for rehabilitation follow-up.

Digital Inclusion among Community Older Adults in the Republic of Korea: Measuring Digital Skills and Health Consequences.

Many older adults are increasingly embracing digital technology in the Republic of Korea. This study investigated the relationship between the digital skills of Korean older adults and their perceived health status and digital technology application for health promotion. This mixed-method study comprised a community survey of 434 older adults aged ≥65 in two cities in South Korea, followed by focus group interviews. Five types of digital skills, 'operational internet skills', 'information navigation skills', 'social skills', 'creative skills', and 'mobile skills', were measured using the LSE digital skill measurement instrument. Multivariable analysis identified the influence of digital skills on health-related outcomes. Among them, 'social skills' associated positively with self-rated health (β 0.37, 95%CI 0.08, 0.65). 'Information navigation skills' contributed positively to the use of digital technology and the internet for a healthy lifestyle in terms of improving eating habits (β 0.43, 95%CI 0.09, 0.77), accessing healthcare (β 0.53, 95%CI 0.21, 0.85), and accessing long-term care services (β 0.45, 95%CI 0.11, 0.79). Thematic analysis revealed that the study participants use Korean language-based resources such as Naver and Kakao Talk for social connection to promote a healthy lifestyle. This study concludes that encouraging initial and sustained use of the internet and enhancing digital skills among Korean older adults can promote active and healthy aging.

The effectiveness of different attentional foci on the acquisition of sport-specific motor skills in healthy adults: a systematic review with network meta-analysis.

The acquisition of motor skills is a key element in many sports. A motor learning principle, which is frequently used to support skill acquisition is the application of different attentional foci. The effectiveness of different attentional foci on performance and the learning of motor skills has been investigated in various sports using randomised controlled trials. The aim of the present study was to investigate the effectiveness of different attentional foci (such as external (EFA) and internal attentional foci (IFA), but also holistic and switching foci) on the performance and learning of a sport-specific motor task in healthy individuals. This study was a systematic review with network meta-analysis. We followed the Prisma reporting guideline and the Cochrane handbook for systematic reviews. Cinahl, Embase, Medline and Cochrane Central were searched for eligible studies. Network meta-analyses were performed for the post-acquisition, retention and transfer test endpoints. Twelve studies were included in the review. At post-acquisition an EFA was the most effective intervention compared to the control intervention (SMD: 0.9855; 95% CI [0.4-1.57]; p: 0.001). At the retention and transfer test endpoints, a holistic focus of attention had the highest effectiveness compared to an IFA (SMD 0.75; 95% CI [-0.1 to 1.6]; p: 0.09) and (SMD 1.16; 95% CI [0.47-1.86]; p: 0.001). For all three endpoints, we analysed a greater effectiveness of an EFA and holistic focus compared to an IFA. Several promising different attentional focus interventions were identified. The largest effects were analysed for a holistic focus. However, only one study used this intervention and therefore there remains uncertainty about the effectiveness. With regard to the inconsistency observed, the analysis at post-acquisition should be interpreted with caution. Modified versions of the EFA were the imagined and the dynamic EFA. Both were only explored in single studies and should therefore be investigated in further follow-up studies that directly compare them.

Five key actions for redesigning adult skills assessments from learners, employees, and educators

Summative assessments provide data to evaluate the effectiveness of schools, teachers, and educational policies, contributing to a robust accountability system worldwide. However, educators and scholars argue that summative assessments do not effectively promote ongoing learning, enhance teaching practices, or align with the skills required in the workplace. Furthermore, traditional summative testing approaches lack culturally responsive practices and overlook the diverse needs of adult learners. This article summarizes research conducted through focus groups, interviews, and listening sessions to gain insight into learners’, employees’, and educators’ perceptions of assessment needs in adult education and workforce development in the United States. We conducted six focus groups, four interviews with diverse learners and employees, and two listening sessions with educators and administrators. In-person and online formats were used in Spanish and English. The results indicate that the backgrounds and needs of learners, employees, and educators in this study are diverse, but all agree there is a strong need for open assessment resources for mid- and lower-skilled and culturally diverse learners that provide them with useful information to help them achieve their personal and occupational goals. Educators in this study needed assessment information connected to the standards and curriculum that guide their instruction, and employees and their employers needed tools to identify and train adult learners for in-demand skills within industries and occupations. Assessing adult skills requires addressing these needs by designing tests that focus on learners’ characteristics and goals and are integrated with educators’ and employers’ needs and goals. The research findings suggest that assessments should be personalized to learners, integrated with instruction or job training, and embrace the cultural diversity of the adult learner population better to serve learners, employees, and educators.

Investigating prison factors related to literacy and numeracy skills of incarcerated adults

Incarcerated adults in the United States are a vulnerable group with substantially low skills and educational attainment. However, the extent to which various, malleable prison factors are related to the skills of adults from diverse backgrounds remains scarcely explored. Therefore, the purpose of the present study was to explore such factors in order to examine which prison programs and activities are associated with higher skills for incarcerated adults in the United States. The sample included 1247 inmates who participated in the Program for the International Assessment of Adult Competencies survey. Regression analysis results revealed that completing more than high school education in prison was linked to higher performance in literacy and numeracy. Also, higher performance was associated with more time in prison, suggesting that program benefits for inmates with shorter time in prison might go unnoticed. Lastly, the most notable differences in performance were related to participation in prison job training. Even though many incarcerated adults partake in various prison programs and activities, participation in these programs was not consistently associated with higher literacy or numeracy skills. Potentially, prison programs might not be providing sufficient applied opportunities for enhancing skills. Findings from this study suggest a need for a closer evaluation of the malleable prison factors and programs relating to the literacy and numeracy skills of incarcerated adults in the United States.

Associations of cerebral amyloid beta and tau with cognition from midlife.

Understanding early neuropathological changes and their associations with cognition may aid dementia prevention. This study investigated associations of cerebral amyloid and tau positron emission tomography (PET) retention with cognition in a predominately middle-aged community-based cohort and examined factors that may modify these relationships. 11C-Pittsburgh compound B amyloid and 18F-flortaucipir tau PET imaging were performed. Associations of amyloid and tau PET with cognition were evaluated using linear regression. Interactions with age, apolipoprotein E (APOE) ε4 status, and education were examined. Amyloid and tau PET were not associated with cognition in the overall sample (N=423; mean: 57±10 years; 50% female). However, younger age (<55 years) and APOE ε4 were significant effect modifiers, worsening cognition in the presence of higher amyloid and tau. Higher levels of Aβ and tau may have a pernicious effect on cognition among APOE ε4 carriers and younger adults, suggesting a potential role for targeted early interventions. Risk and resilience factors influenced cognitive vulnerability due to Aβ and tau. Higher fusiform tau associated with poorer visuospatial skills in younger adults. APOE ε4 interacted with Aβ and tau to worsen cognition across multiple domains.

Tablet-based Rey–Osterrieth Complex Figure copy task: a novel application to assess spatial, procedural, and kinematic aspects of drawing in children

The paper-and-pencil Rey–Osterrieth Complex Figure (ROCF) copy task has been extensively used to assess visuo-constructional skills in children and adults. The scoring systems utilized in clinical practice provide an integrated evaluation of the drawing process, without differentiating between its visuo-constructional, organizational, and motor components. Here, a tablet-based ROCF copy task capable of providing a quantitative assessment of the drawing process, differentiating between visuo-constructional, organizational, and motor skills, is trialed in 94 healthy children, between 7 and 11 years of age. Through previously validated algorithms, 12 indices of performance in the ROCF copy task were obtained for each child. Principal component analysis of the 12 indices identified spatial, procedural, and kinematic components as distinct dimensions of the drawing process. A composite score for each dimension was determined, and correlation analysis between composite scores and conventional paper-and-pencil measures of visuo-constructional, procedural, and motor skills performed. The results obtained confirmed that the constructional, organizational, and motor dimensions underlie complex figure drawing in children; and that each dimension can be measured by a unique composite score. In addition, the composite scores here obtained from children were compared with previsions results from adults, offering a novel insight into how the interplay between the three dimensions of drawing evolves with age.

Quantifying the productivity effects of education-job mismatch: a cross-country analysis

ABSTRACT This study addresses the relationship between education-job mismatch and aggregate labor market performance in a cross-country setting. We examine the effect of education-job mismatch on aggregate productivity across 15 countries using data from the OECD Survey of Adult Skills (PIAAC). We measure mismatch levels and compute their incidence across countries. Next, the paper develops a model linking mismatch to aggregate productivity. In the model the allocation of labor across the types of mismatch is derived from the endogenous process. The findings show that reducing mismatch results in increases in output per capita. This provides evidence for an important role of the allocation of workers according to jobs that match their fields of study and qualification levels not only for individual earnings but also for aggregate outcomes.

Effects of a Virtual Reality Reaction Training Protocol on Physical and Cognitive Skills of Young Adults and Their Neural Correlates: A Randomized Controlled Trial Study.

Increasing evidence shows that virtual reality (VR) training is highly effective in cognitive and motor rehabilitation. Another modern form of training is cognitive-motor dual-task training (CMDT), which has been demonstrated to rapidly improve physical and cognitive functions in real environments. This study aims to test whether a VR-based CMDT protocol can be used for motor and cognitive skill enhancement in young, healthy subjects. For this aim, 24 university students participated in a randomized control trial. The experimental group participated in a 5-week virtual reality reaction training (VRRT), performing 30 min sessions once a week. The control group did not receive any training but was tested twice with the same measures and temporal distance as the experimental group. Before and after the intervention, motor, cognitive, and electrophysiological measures were assessed. The results showed that following VRRT, the response time for both physical and cognitive tests was improved by about 14% and 12%, respectively, while the control group did not show significant changes. Moreover, electrophysiological data revealed a significant increase in anticipatory motor readiness in premotor brain areas in the experimental group only; however, cognitive top-down control tended to be increased in prefrontal areas after VRRT. This training protocol in a VR modality seems to be as effective as other CMDT methodologies carried out in a real modality. Still, it has the advantages of being more flexible and more user-friendly compared to standard training. The VRRT's efficacy on physical and cognitive functions indicates that virtual reality applications can be used by the young population, not only for entertainment purposes but also in the form of cognitive-motor training.

Comparison of the Effects of Mobile Learning and Traditional Self-care Education on Loneliness and Social Isolation in Community-dwelling Older Adults: Study Protocol of a Three-Arm Randomized Controlled Trial

Introduction: Loneliness and social isolation are common problems in older adults, which has negative effects on health. Increasing self-care ability seems to help. Therefore, the present study will be conducted with the aim of comparing the effects of mobile learning and traditional self-care education on loneliness and social isolation in community-dwelling older adults. Methods: This three-arm randomized controlled trial will be conducted in Tehran-Iran 2024. The qualified older adults from health centers in Tehran city will be consecutively selected and randomly allocated into three groups: mobile learning (n = 40), traditional education (n = 40), and control (n = 40). The loneliness inventory for older adults, Lubben social network scale, and demographic characteristics will be used to collect information, and completed before, immediately, and 12 weeks after the intervention. The data will be analyzed using descriptive and inferential statistics by SPSS software version 16 at a significance level of p &lt; 0.05. Conclusion: This clinical trial will determine the most successful and cost-effective approach in reducing loneliness and social isolation in older adults. The results are expected to improve the self-care skills of the older adults, thereby reducing the negative consequences of loneliness and social isolation, including various health issues and mortality rates, in the long run.

Impact of repetitive home-based galvanic vestibular stimulation on cognitive skills in healthy older adults

The human vestibular system is adversely affected by the aging process. Recent evidence indicates that vestibular information and cognitive functions are related, suggesting that age-related vestibular loss may contribute to cognitive impairment. In this study, we aimed to investigate the effects of repetitive, home-based galvanic vestibular stimulation (GVS) on cognitive functions in healthy older adults. Twenty-one participants (age = 64.66 ± 2.97 years, 12 females) were randomly allocated to either a home-based GVS or an active control group. The GVS intervention lasted 20 min per session, five times a week, for two weeks (10 sessions). Cognitive functions were assessed before and after the intervention using the Stroop Test, Trail Making Test A&B, and Dual-Task (digit recall and paper-pencil tracking test). Our findings revealed a significant group-by-time interaction effect for the tracking accuracy (F(1,18) = 7.713, p = 0.012, η p2 = 0.30), with only the home-based GVS group showing significant improvement (t = −2.544, p = 0.029). The proposed home-based GVS protocol offers a promising non-pharmacological avenue for enhancing visuospatial ability in healthy older adults. Further research is needed to investigate the effects of different GVS protocols on various cognitive functions, particularly in older individuals with different health conditions.

Peer-Mediated Interventions to Enhance Conversation Skills of Young Adults with Intellectual and Developmental Disabilities on a University Campus

Young adults with intellectual and developmental disabilities (IDD) on college campuses are vulnerable to exclusion and a lack of social participation. However, peers can provide meaningful supports to young adults with IDD in the area of social/communication skills. The purpose of this study was to enhance the conversation skills of four young adults with IDD (ages 22–23) during their regular lunch breaks on a university campus. The dependent variable was percent of conversational engagement during 10-min audio recorded sessions as measured using partial interval recording procedures. Typically developing peers served as peer coaches and provided structured or natural supports. Experiment 1 used an alternating treatments design to compare the effects of peer coaching alone vs. peer coaching + goal setting with two adjacent baseline conditions and a final student-choice condition. Results for Experiment 1 indicated peer coaching alone and the additive effects of goal setting was more effective than natural supports only. Experiment 2 used a withdrawal design to compare the effects of young adults with IDD speaking with fellow classmates with disabilities vs. peers without disabilities. Participants in Experiment 2 demonstrated higher levels of conversational engagement when speaking with peers without disabilities in a natural manner. Social validity of the different peer-mediated interventions was overall high for all participant types as reported on questionnaires and exit interviews. We provide implications for practice and suggestions for future research related to peer-mediated interventions for young adults with IDD on college and university campuses.