Evaluating staff use of crisis prevention intervention techniques: a pilot study.

The purpose of this pilot study was to evaluate staff use of crisis prevention intervention (CPI) techniques in averting crisis episodes at the various levels (anxiety, defensive, and acting out) of a crisis (resulting in reduction of seclusion and restraint episodes and patient/staff injuries). A descriptive correlational research design was used. Data were collected by nurse observers trained in CPI techniques through observation of patient incidents and staff interventions. A 51-item CPI instrument based on the CPI training program techniques was developed and used for data collection. Data were analyzed using descriptive statistics, Pearson correlation, t tests, ANOVA, and the Scheffe test. One hundred forty-six observations of patient incidents were completed on both day and evening shifts. The results of the study indicate that staff use of CPI training program techniques was effective in resolving crises in 84.2% of the episodes observed and over a wide variety of diagnostic and functional levels.

The Communication Analysis System.

The Communication Analysis System (CAS) was developed to facilitate efficient, effective treatment of conversational performance for persons with aphasia. The CAS provides frequent, objective, accurate, ratio-quality measures of ten classes of communicative behaviors for the patient and 11 for the clinician. The clinician using the CAS records the time of occurrence of communicative behaviors by a single keystroke on a keypad attached to an inexpensive microcomputer. The CAS software permits the analysis of data before the next clinical session and includes a method for assessing accuracy and reliability. Sample between-session data show the progress of one patient over several months, whereas within-session data illustrate a use of the CAS to measure a patient's performance under different communicative conditions. Simultaneously, measures of the clinician's communicative performance provide an accurate record of the treatment. This, in turn, allows observation of changes in the patient's behavior as a function of changes in the clinician's behavior. Clinical treatment can thereby be tailored precisely to the individual, optimizing the patient's rehabilitation.

Modification of breath patterning to increase naturalness of a mildly dysarthric speaker.

The case of a 20-year-old, closed head injured male with mild dysarthria is presented. The decreased naturalness of speech was related to short, uniform breath groups, inhalation during every pause, and restricted fundamental frequency. Data related to patterns of breathing and pausing during samples of connected speech along with measures of respiratory control are presented in order to illustrate techniques for assessing and training speech naturalness.