Comparing treatment intensities of tactile-thermal application.

The purpose of this study was to investigate the relationships of four intensities of tactile-thermal application (TTA) to changes in duration of stage transition (DST) and performance on a newly designed scale of penetration and aspiration by groups of patients made dysphagic by stroke. Patients were randomly assigned to receive 150, 300, 450, or 600 trials of TTA during each of 2 weeks. Data on the time required to provide such treatment, the actual number of trials clinicians were able to provide, and on the influence of the four intensities are provided. No single intensity emerged as the most therapeutic. It is suggested that subsequent studies with larger groups include intensities between 300 and 550.

Discourse topic management in senile dementia of the Alzheimer's type.

The purpose of the study was to provide a detailed evaluation of the topic management abilities of a group of subjects with senile dementia of the Alzheimer's type (SDAT) and to compare their patterns of topic management to that of a normal elderly (NE) subject group. Twenty-four subjects participated in the study: 12 SDAT subjects and 12 NE subjects matched along the variables of age, sex, and education. The evaluation of topic management was based on a 20-minute casual conversational interaction between the subject and a speech-language pathologist that was videotaped and later transcribed orthographically. Topic management was analyzed in terms of a modified version of the multidimensional topic coherence analysis developed by Mentis and Prutting (1991). The results indicated significant differences between the SDAT and NE subjects along a number of parameters of topic introduction and maintenance. The topic management profiles of the SDAT subjects were characterized by a reduced ability to change topics while preserving the discourse flow, difficulty in actively contributing to the propositional development of the topic, and a failure to consistently maintain topic in a clear and coherent manner. These problems appeared to be related to underlying problems across the discourse-pragmatic, linguistic, and cognitive domains; they highlight the need to more fully explore the interactions among deficits in SDAT and their effects on conversational discourse.