Communication between rehabilitation staff and people with traumatic brain injury: A systematic review.

This systematic review aimed to synthesize barriers and facilitators in communicative interactions between staff and people with traumatic brain injury (TBI) in the rehabilitation context. Searches captured published evidence up to November 2022 in MEDLINE, Embase, SCOPUS, Web of Science, CINAHL, AMED, and PsycINFO. Eligible studies reported on the communicative interaction between rehabilitation staff and adults with TBI. In total, 31 studies were included in the review; including quantitative, qualitative, and mixed-methods designs. Quality assessment was carried out using standard checklists. Quantitative studies and quantitative components of mixed-method studies were synthesized descriptively according to reported communication barriers and facilitators. Qualitative studies and qualitative components of mixed-method studies were analysed through an inductive thematic meta-synthesis; generating six main themes with four subthemes. Themes were categorized as barriers or facilitators to communicative interaction. Findings demonstrated that cognitive-communication disorders of people with TBI challenge the communicative interaction between rehabilitation staff and people with TBI. However, the extent to which these disorders create a communicative barrier is closely related to staff's communicative approach. While staff holding a collaborative and acknowledging approach and using supportive strategies may facilitate successful communicative interactions, staff using the opposite approach may exacerbate communication barriers.

You may point, but do not touch: Impact of gesture-types and cognition on language in typical and atypical development.

BACKGROUND: Evidence shows that the relation with the referent (object manipulation, contact/no contact pointing) and the different hand features (index finger/open palm) when pointing indicate different levels of cognitive and linguistic attainment in typical development (TD). This evidences the close link between pointing, cognition and language in TD, but this relation is understudied in autism. Moreover, the longitudinal pathway these abilities follow remains unexplored and it is unclear what specific role (predictor or mediator) pointing and cognition have in both typical and atypical language development. AIMS: The first aim was to investigate whether pointing hand features (index finger/open palm) and relation with the referent (manipulation, contact and no contact pointing) similarly predict language in children with and without autism. The second aim was to explore whether cognition mediates the longitudinal relationship between pointing and language development. METHODS & PROCEDURES: Sixteen children with autism, 13 children at high risk (HR) for autism and 18 TD children participated in an interactive gesture-elicitation task and were tested on standardised cognitive and expressive language batteries in a longitudinal design. A two-step analysis consisted of a stepwise linear regression and mediation analyses. First, the linear regression identified which hand features and types of relation with the referent predicted expressive language in all groups. Second, three mediation analyses (one per group) assessed the predictor/mediator role of the variables that met significance in the regression analysis. OUTCOMES & RESULTS: Both cognition and index finger pointing were direct longitudinal predictors of further expressive language skills in the autism group. In TD and HR groups this relation was mediated by age. CONCLUSIONS & IMPLICATIONS: Findings highlight the role of age in communicative development, but suggest a key role of cognition and index finger use in the longitudinal relationship between pointing gestures and expressive language development in children with autism. This has important clinical implications and supports the view that index finger pointing production might be a useful tool in the intervention for communicative and language abilities in autism. WHAT THIS PAPER ADDS: What is already known on the subject There is evidence that no contact pointing is associated with complex socio-cognitive abilities that underpin communication in TD. Similarly, studies in TD show that index finger pointing is closely linked with language acquisition. However, it is unclear whether these associations are present in autism. In addition, the mediating (or predictive) role of cognition in the pointing-language relation has not yet been explored neither in typical nor in atypical development. What this paper adds to existing knowledge This paper shows that index finger pointing and cognition are direct longitudinal predictors of expressive language in the autism group. In the other groups this relation is mediated by age. This suggests that there is a window of opportunity for pointing to predict expressive language whereas the predictive value of cognition expands in development. Based on this, children with autism would share the same language predictors as TD children, but with delays. What are the potential or actual clinical implications of this work? This study reveals that index finger, age and cognition reliably predict spoken language in autism, which may indicate that early prelinguistic intervention based on pointing production and the improvement of cognitive skills might have a positive impact on spoken language in this population.

Communicative Interaction with and without Eye-Gaze Technology between Children and Youths with Complex Needs and Their Communication Partners.

Use of eye-gaze assistive technology (EGAT) provides children/youths with severe motor and speech impairments communication opportunities by using eyes to control a communication interface on a computer. However, knowledge about how using EGAT contributes to communication and influences dyadic interaction remains limited. AIM: By video-coding dyadic interaction sequences, this study investigates the impacts of employing EGAT, compared to the Non-EGAT condition on the dyadic communicative interaction. METHOD: Participants were six dyads with children/youths aged 4-19 years having severe physical disabilities and complex communication needs. A total of 12 film clips of dyadic communication activities with and without EGAT in natural contexts were included. Based on a systematic coding scheme, dyadic communication behaviors were coded to determine the interactional structure and communicative functions. Data were analyzed using a three-tiered method combining group and individual analysis. RESULTS: When using EGAT, children/youths increased initiations in communicative interactions and tended to provide more information, while communication partners made fewer communicative turns, initiations, and requests compared to the Non-EGAT condition. Communication activities, eye-control skills, and communication abilities could influence dyadic interaction. CONCLUSION: Use of EGAT shows potential to support communicative interaction by increasing children's initiations and intelligibility, and facilitating symmetrical communication between dyads.

Interacción comunicativa en salud. Comprensión de conceptos mínimos en pacientes oncológicos que asisten al Centro Asistencial Barros Luco (CAB / Communicative interaction in health. Compression of minimal concepts in cancer patients attending the Barros Luco Healthcare Center (CABL)

El presente estudio se centra en la importancia que tiene la interacción comunicativa entre médico y paciente durante el tratamiento del cáncer. El peso de la interacción recae en la comunicación efectiva desarrollada en las prácticas lingüísticas dentro de la medicina clínica. Aquí se aborda la comunicación en salud y se explica el grado de comprensión que el paciente oncológico tiene en torno a cuatro conceptos elementales: cáncer, metástasis, tipos de tumores y tipos de terapia, los que se expresaron para ellos en tres tipos de definiciones: técnica, acomodada y coloquial. Para esto se aplicó una encuesta sociolingüística mixta a 50 pacientes en el Hospital Barros Luco, en donde se observó que más del 50% de los pacientes comprende toda la información cuando esta se explica de manera técnica y, más del 70% incluso 80% comprende toda la información cuando se explica de una manera acomodada a la valoración del contexto, situación e interlocutores. Los resultados también indican que los médicos, según los pacientes entrevistados, explican con un lenguaje de código cerrado y, en ocasiones, simplemente no entregan la información. Según los resultados se puede concluir que la información previa junto con la experiencia comunicativa, entendida como una práctica social, ayudan a construir y representar una nueva realidad sociolingüística que coopera para que los pacientes oncológicos logren entender la información verbal, así como también el nuevo contexto social en el que se encuentran.

The present study focuses on the importance of the communicative interaction between doctor and patient during cancer treat-ment. The weight of the interaction falls on the effective communication developed in linguistic practices within clinical medicine. Here, health communication is addressed, and the degree of understanding that the cancer patient has around four elementary concepts been explained: cancer, metastasis, types of tumors, and types of therapy, which were expressed for them in three types of definitions: technical, well-off and colloquial. For this, a mixed sociolinguistic survey was applied to 50 patients at the Barros Luco Hospital, where it was observed that more than 50% of patients understand all the information when it is explained tech-nically, and more than 70% even 80% understand all the information when it is explained in a way adapted to the assessment of the context, situation, and interlocutors. The results also indicate that the doctors, according to the patients interviewed, explain with a closed code language and sometimes, simply do not provide the information. According to the results, it can be concluded that the previous information together with the communicative experience, understood as a social practice, help to build and represent a new sociolinguistic reality that cooperates so that cancer patients can understand verbal information, as well as the new context social where they are.

Stakeholder framing, communicative interaction, and policy legitimacy: anti-smoking policy in South Korea.

Since the emergence of the argumentative turn in critical policy studies, increasing attention has been paid to the crucial role played by language, context, and communicative practices in the policy process. This study aims to investigate communicative interaction between state elites and societal stakeholders in South Korea with a focus on the anti-smoking policies of two different administrations: the Roh administration (2003-2008) and the Park administration (2013-2017). As a theoretical base, this paper proposes a stakeholder-oriented approach to legitimacy, which incorporates a policy frame analysis with the concept of a three-tier policy structure (i.e., policy goals, policy tools, and tool settings). In assessing policy legitimacy, the stakeholder-oriented approach examines whether there is congruence between the three-tier policy structure and the corresponding stakeholder framing. In the Roh administration, the policy frames among the three tiers of policy structure were centered on public health promotion, whereas in the Park administration, they expanded to the domain of tax policy. The empirical findings underscore the importance of two-way communication between the government and societal stakeholders, which can be evidenced using policy frame analysis. Ultimately, the results show that policy legitimacy is more likely to be guaranteed if there is no hidden or predetermined policy intention that can be detected by stakeholder framing analysis.

Communicative interactions in point-light displays: Choosing among multiple response alternatives.

Vision scientists are increasingly relying on the point-light technique as a way to investigate the perception of human motion. Unfortunately, the lack of standardized stimulus sets has so far limited the use of this technique for studying social interaction. Here, we describe a new tool to study the interaction between two agents starting from point-light displays: the Communicative Interaction Database - 5AFC format (CID-5). The CID-5 consists of 14 communicative and seven non-communicative individual actions performed by two agents. Stimuli were constructed by combining motion capture techniques and 3-D animation software to provide precise control over the computer-generated actions. For each action stimulus, we provide coordinate files and movie files depicting the action as seen from four different perspectives. Furthermore, the archive contains a text file with a list of five alternative action descriptions to construct forced-choice paradigms. In order to validate the CID-5 format, we provide normative data collected to assess action identification within a 5AFC tasks. The CID-5 archive is freely downloadable from http://bsb-lab.org/research/ and from the supplementary materials of this article.

Paternal Retrieval Behavior Regulated by Brain Estrogen Synthetase (Aromatase) in Mouse Sires that Engage in Communicative Interactions with Pairmates.

Parental behaviors involve complex social recognition and memory processes and interactive behavior with children that can greatly facilitate healthy human family life. Fathers play a substantial role in child care in a small but significant number of mammals, including humans. However, the brain mechanism that controls male parental behavior is much less understood than that controlling female parental behavior. Fathers of non-monogamous laboratory ICR mice are an interesting model for examining the factors that influence paternal responsiveness because sires can exhibit maternal-like parental care (retrieval of pups) when separated from their pups along with their pairmates because of olfactory and auditory signals from the dams. Here we tested whether paternal behavior is related to femininity by the aromatization of testosterone. For this purpose, we measured the immunoreactivity of aromatase [cytochrome P450 family 19 (CYP19)], which synthesizes estrogen from androgen, in nine brain regions of the sire. We observed higher levels of aromatase expression in these areas of the sire brain when they engaged in communicative interactions with dams in separate cages. Interestingly, the number of nuclei with aromatase immunoreactivity in sires left together with maternal mates in the home cage after pup-removing was significantly larger than that in sires housed with a whole family. The capacity of sires to retrieve pups was increased following a period of 5 days spent with the pups as a whole family after parturition, whereas the acquisition of this ability was suppressed in sires treated daily with an aromatase inhibitor. The results demonstrate that the dam significantly stimulates aromatase in the male brain and that the presence of the pups has an inhibitory effect on this increase. These results also suggest that brain aromatization regulates the initiation, development, and maintenance of paternal behavior in the ICR male mice.

The Multilingual CID-5: A New Tool to Study the Perception of Communicative Interactions in Different Languages.

The investigation of the ability to perceive, recognize, and judge upon social intentions, such as communicative intentions, on the basis of body motion is a growing research area. Cross-cultural differences in ability to perceive and interpret biological motion, however, have been poorly investigated so far. Progress in this domain strongly depends on the availability of suitable stimulus material. In the present method paper, we describe the multilingual CID-5, an extension of the CID-5 database, allowing for the investigation of how non-conventional communicative gestures are classified and identified by speakers of different languages. The CID-5 database contains 14 communicative interactions and 7 non-communicative actions performed by couples of agents and presented as point-light displays. For each action, the database provides movie files with the point-light animation, text files with the 3-D spatial coordinates of the point-lights, and five different response alternatives. In the multilingual CID-5 the alternatives were translated into seven languages (Chinese, Dutch, English, French, German, Italian, and Polish). Preliminary data collected to assess the recognizability of the actions in the different languages suggest that, for most of the action stimuli, information presented in point-light displays is sufficient for the distinctive classification of the action as communicative vs. individual, as well as for identification of the specific communicative gesture performed by the actor in all the available languages.

Interação comunicativa em contexto lúdico de duas crianças com Síndrome de Down, comportamentos autísticos e privação de estímulos / Communicative interaction in a playful context of two children with Down Syndrome, autistic behavior and deprivation of stimuli

Esta pesquisa qualitativa teve como objetivo analisar o processo de interação comunicativa entre duas crianças que apresentam comportamentos autísticos associados à síndrome de Down e entre estas e a terapeuta, enfocando modalidades de comunicação verbal e não-verbal estabelecidas durante brincadeiras de faz-de-conta. As duas crianças têm histórias de vida com privação de estímulos. Os dados foram coletados em sessões fonoaudiológicas semanais durante 6 meses. Após a transcrição dos episódios, a partir da vídeo-gravação das sessões realizadas, as análises evidenciaram desenvolvimento qualitativo na interação comunicativa entre as crianças e a terapeuta, possibilitando o compartilhamento de significados e inserção destes sujeitos nas situações sociais apresentadas.(AU)

The objective of this qualitative research was to analyze the communicative interaction process between two children who show autistic behavior associated with Down syndrome, as well as the process between them and their therapist. Different modalities of verbal and non-verbal communication demonstrated during make-believe activities were also observed. Both children have life history of deprivation of stimuli. Data were collected during weekly sessions with a speech therapist over 6 months. The sessions were video-taped and then the episodes were transcribed. The analyses displayed a qualitative development in the communicative interaction between the children and the therapist which favored the subjects to share meanings and insert themselves in the social situations presented.(AU)

Interação comunicativa em contexto lúdico de duas crianças com Síndrome de Down, comportamentos autísticos e privação de estímulos / Communicative interaction in a playful context of two children with Down Syndrome, autistic behavior and deprivation of stimuli

Esta pesquisa qualitativa teve como objetivo analisar o processo de interação comunicativa entre duas crianças que apresentam comportamentos autísticos associados à síndrome de Down e entre estas e a terapeuta, enfocando modalidades de comunicação verbal e não-verbal estabelecidas durante brincadeiras de faz-de-conta. As duas crianças têm histórias de vida com privação de estímulos. Os dados foram coletados em sessões fonoaudiológicas semanais durante 6 meses. Após a transcrição dos episódios, a partir da vídeo-gravação das sessões realizadas, as análises evidenciaram desenvolvimento qualitativo na interação comunicativa entre as crianças e a terapeuta, possibilitando o compartilhamento de significados e inserção destes sujeitos nas situações sociais apresentadas.

The objective of this qualitative research was to analyze the communicative interaction process between two children who show autistic behavior associated with Down syndrome, as well as the process between them and their therapist. Different modalities of verbal and non-verbal communication demonstrated during make-believe activities were also observed. Both children have life history of deprivation of stimuli. Data were collected during weekly sessions with a speech therapist over 6 months. The sessions were video-taped and then the episodes were transcribed. The analyses displayed a qualitative development in the communicative interaction between the children and the therapist which favored the subjects to share meanings and insert themselves in the social situations presented.

El aprendizaje de los usos expositivos del lenguaje / The acquisition of expository uses of language / A aprendizagem dos usos expositivos da linguagem

Objetivo: Este estudio presenta una descripción del tipo de ayuda lingüística que los adultos les ofrecen a los niños mientras dan explicaciones sobre diversas cuestiones. Metodología: Se analizó una muestra de once minutos de interacción entre un niño pequeño y sus abuelos maternos, pues en el transcurso de estas conversaciones los niños tienen muchas oportunidades para aprender no sólo de los objetos y eventos del mundo sino también del lenguaje que se utiliza para referirse a ellos, para aprender cómo se nombran las realidades y, en algunos casos, cómo se participa en ellas. Resultados: Los adultos ofrecen al niño diferentes recursos discursivos con los que promueven que éste utilice términos que especifiquen las características que diferencian los objetos a los que se está refiriendo, adicione información, organice y clarifique lo que está diciendo. Conclusiones: La descripción de la ayuda que le ofrecen los adultos al niño permitió identificar diferentes recursos discursivos (elicitaciones y reformulaciones) que promueven el desarrollo de explicaciones cada vez más complejas.

Objective: This study offers a description of the kinds of linguistic aids offered by adults while giving explanations to young children about different issues. During the midst of these conversations children have several opportunities to learn, not only from objects and events, but also from the utterances used to refer to them, learning how realities are named after, and in many cases, how to participate in them. Methodology: Through the analysis of eleven minutes of inte-raction between young child and his maternal grandparents. Results: Adults offers young child different discursive ways for helping him to add information, organize and clarify the topic that he is talking about. Conclusions: The results allow to identify different ways that the adults use for helping young child to improve his explanations.

Objetivo: Este estudo apresenta uma descrição do tipo de ajuda lingüística que os adultos lhes oferecem às crianças enquanto dão explicações sobre diversas questões. Metodologia: Se analisou uma amostra de onze minutos de interação entre uma pequena criança e seus avôs maternos, pois no transcurso destas conversações, as crianças têm muitas oportunidades de aprender não só dos objetos e eventos do mundo senão também da linguagem que é utilizado para se referir a eles, para aprender como se nomeiam as realidades, e em alguns casos como se participa delas. Resultados: Os adultos oferecem à criança diferentes recursos discursivos com os que promovem que este utilize termos que especifiquem as características que diferenciam os objetos aos que se esta referindo, adicione informação, organize e clarifique o que esta dizendo. Conclusões: a descrição da ajuda que lhe oferecem os adultos à criança permitiu identificar diferentes recursos discursivos (incitamento e reformulações), que promovem o desenvolvimento de explicações cada vez mais complexas.