The effect of age and hearing loss on partner-directed gaze in a communicative task

The study examined the partner-directed gaze patterns of old and young talkers in a task (DiapixUK) that involved two people (a lead talker and a follower) engaging in a spontaneous dialogue. The aim was (1) to determine whether older adults engage less in partner-directed gaze than younger adults by measuring mean gaze frequency and mean total gaze duration; and (2) examine the effect that mild hearing loss may have on older adult’s partner-directed gaze. These were tested in various communication conditions: a no barrier condition; BAB2 condition in which the lead talker and the follower spoke and heard each other in multitalker babble noise; and two barrier conditions in which the lead talker could hear clearly their follower but the follower could not hear the lead talker very clearly (i.e., the lead talker’s voice was degraded by babble (BAB1) or by a Hearing Loss simulation (HLS). 57 single-sex pairs (19 older adults with mild Hearing Loss, 17 older adults with Normal Hearing and 21 younger adults) participated in the study. We found that older adults with normal hearing produced fewer partner-directed gazes (and gazed less overall) than either the older adults with hearing loss or younger adults for the BAB1 and HLS conditions. We propose that this may be due to a decline in older adult’s attention to cues signaling how well a conversation is progressing. Older adults with hearing loss, however, may attend more to visual cues because they give greater weighting to these for understanding speech

Targeting the expressive language of children with Down syndrome who are minimally verbal : bridging research and practice

textChildren with Down syndrome present with an array of physical and cognitive sequelae that can hinder speech and language development. These individuals can constitute a considerable portion of a speech-language pathologist’s caseload. Based on the principles of best evidence, clinicians are ethically responsible for providing the most effective treatment for their clients. The available literature focuses mainly on describing the linguistic characteristics in this population, while relatively less focus is placed on effective intervention programs. This paper investigates the available evidence regarding speech and language interventions for children with Down syndrome who are in the mild to moderate range of linguistic functioning, and provides an outlook for future research based on best evidence.Communication Sciences and Disorder

Eye-to-face Gaze in Stuttered Versus Fluent Speech

The present study investigated the effects of viewing audio-visual presentations of stuttered relative to fluent speech samples on the ocular reactions of participants. Ten adults, 5 males and 5 females, aged 18-55 who had a negative history of any speech, language and hearing disorders participated in the study. Participants were shown three 30 second audio-visual recordings of stuttered speech, and three 30 second audio-visual recordings of fluent speech, with a three second break (black screen) between the presentation of each video. All three individuals who stutter were rated as ‘severe’ (SSI-3, Riley, 1994), exhibiting high levels of struggle filled with overt stuttering behaviors such as repetitions, prolongations and silent postural fixations on speech sounds, in addition to tension-filled secondary behaviors such as head jerks, lip protrusion, and facial grimaces. During stuttered and fluent conditions, ocular behaviors of the viewers including pupillary movement, fixation time, eye-blink, and relative changes in pupil diameter were recorded using the Arrington ViewPoint Eye-Tracker infrared camera and the system’s data analysis software (e.g., Wong & Cronin-Colomb & Neargarder, 2005) via a 2.8GHz Dell Optiplex GX270 computer. For all ocular measures except fixation time, there were significant (p\u3c.05) differences for stuttered relative to fluent speech. There was an increase in the number of pupillary movements, blinks, and relative change in pupil diameter and a decrease in time fixated when viewing stuttered relative to fluent speech samples. While not significant, participants fixated or directed their attention for less time during stuttered than fluent conditions, indicating decreased attention overall during stuttered speech samples. Increases in eye-blink data and pupil-dilation data were also significant. Because both eye-blink, as a measure of the startle reflex, and pupil-dilation are resistant to voluntary control or are completely under the control of the autonomic nervous system, significant increases in both for stuttered relative to fluent speech indicate a visceral reaction to stuttering

The development of conversational and communication skills

This thesis investigates the development of children's conversational and communication skills. This is done by investigating both communicative process and outcome in two communication media: face-to-face interaction and audio-only interaction. Communicative outcome is objectively measured by assessing accuracy of performance of communication tasks. A multi-level approach to the assessment of communicative process is taken. Non-verbal aspects of process which are investigated are gaze and gesture. Verbal aspects of process range from global linguistic assessments such as length of conversational turn, to a detailed coding of utterance function according to Conversational Games analysis. The results show that children of 6 years and less do not adapt to the loss of visual signals in audio-only communication, and their performance suffers. Both the structure of children's dialogues and their use of visual signals were found to differ from that of adults. It is concluded that both verbal and non-verbal communication strategies develop into adulthood. Successful integration of these different aspects of communication is central to being an effective communicator

Development of social functioning in children with congenital visual impairment

Effects of significant visual impairment (VI) in childhood are profound and far-reaching, impacting on most developmental areas. In recent years, there has been a particular emphasis on the effects of VI on social communication and social cognition, with a focus on a potential link with autism. However, the mechanisms underlying specific socio-developmental difficulties and the 'autistic-like' presentation shown by some children with VI, as well as the mechanism by which many children with VI are able to overcome such developmental vulnerabilities, remain poorly understood and require further clarification. The goal of the research reported in the present thesis was to elicit further understanding of the developmental patterns of social functioning in children with VI, and gain a better appreciation of the role that language may play in these processes. The thesis focused on children with severe and profound degrees of congenital vision loss without additional impairments, as learning difficulties have been identified as a confounding factor. Their developmental outcomes were compared to those of a group of typically developing sighted children of similar age and ability. The children were assessed using parental/teacher questionnaires and a battery of developmental and experimental tasks targeting language, social communication, mental state understanding and discourse, and executive functioning. An important finding was a discrepancy between the structural language skills and pragmatic language use in children with VI. Additionally, a substantial proportion of children with VI showed socio-communicative profiles that were consistent with a broader autism phenotype. An investigation of the children's mental state language use, which was also reported, provided a useful context within which socio-pragmatic difficulties seen in children with VI in this research could be considered. A similar contribution was provided by a study of mother-child mentalistic language exchange, which emphasised specific strengths of socio-interactive environment of children with VI that future interventions can capitalise on. Furthermore, the developmental vulnerabilities imposed by VI were found to extend to a broader behavioural presentation in children with VI, including weaknesses in specific executive function domains. Such weaknesses, notably in cognitive shifting, were considered in the context of attentional mechanisms that may be particularly affected by vision loss in early development. A retrospective examination of attentional behaviours in pre-school development of children with VI helped to clarify these issues further, by shedding light on the potential precursors to the vulnerabilities in achieving social competence and adjustment in children with VI at school age. The findings are believed to offer original contribution to understanding the development of social functioning in children with congenital VI, and are hoped to contribute towards the diagnostic considerations and intervention strategies aiming to boost such children's developmental potential

Development of the Communication Complexity Scale

Accurate description of an individual's communication status is critical in both research and practice. Describing the communication status of individuals with severe intellectual and developmental disabilities is difficult because these individuals often communicate with presymbolic means that may not be readily recognized. Our goal was to design a communication scale and summary score for interpretation that could be applied across populations of children and adults with limited (often presymbolic) communication forms

An evaluation of a communicative intervention programme for hearing caregivers and their deaf children in a developing context

Includes bibliographical references (p. 398-428).This study set out to evaluate the effectiveness of an intervention programme, in a developing context within an ecological framework that involves parents througp parent training adopting a parent-child interaction approach to intervention. This short-term, group intervention programme was developed specifically for hearing primary caregivers of profo,undly deaf signing children from low socio-economic backgrounds. A naturalistic approach to .intervention that followed a conversational model was applied. The programme was deSigned to enhance dyadic communicative interaction and to empower the caregivers as effective change agents, primarily through the programme components of communication skills and sign language, information and knowledge, educational advocacy and support. A broader perspective was adopted through addressing socio-economic factors and adapting to cultural differences. A team of people was involved in programme development, implementation and evaluation and included professionals from a range of disciplines, Deaf signing adults, and an English-isiXhosa interpreter. A shortterm longitudinal, before-and-after group design was used in programme implementation and evaluation. This design encompassed constructivist-interpretive and positivist/post-positivist research paradigms. The group of sixteen caregiver-child dyads reported on in this study was its own control, constituting a quasi-experimental design. An estimate of the effect of the programme was determined by analysing pre-post-intervention comparisons of videotaped dyadic interactions during play and storytelling, and the post-intervention evaluation questionnaire and focus group interview data. A coding system was compiled for the investigation of communication and sign language parameters that were not part of an occurrence of communication breakdown. Investigation of breakdown and repair as well as aspects of caregiver sign production constituted a separate analysis. Both quantitative and qualitative analyses were Icarried out in the evaluation process and certain procedures were adopted to enhance the reliability and validity of the findings. It is believed that the aims I of this study and the specific goals/objectives of the programme were met. The analyses carried out indicated positive change and that this change was most likely due to the programme. In particular, it is believed that the style of caregiver-child interaction changed over the course of the intervention and so the programme was effective to the degree that it improved caregiver-child communicative interaction. More so, it is believed that the programme resulted in empowerment of the caregivers. Numerous aspects are believed to contribute towards the uniqueness of this study and of the communicative intervention programme. The numerous clinical and theoretical implications and implications for future research arising from this study are discussed in detail

The role of children, social partners and objects triad in children's environment and learning

It is well established that children’s learning is shaped by social partners and by non-social aspects of their environment. However, most work in this field has been based on relatively constrained settings where the experimenter controls the order and duration of children’s experiences. Therefore, the current thesis aimed to explore how children’s learning environments are affected by different features in controlled but relatively unconstrained settings through the triad of child, object and social partner. The first study examined how two-year-old children’s attention to, and exploration of objects were affected by the presence or absence of labels. Between conditions, objects were either handled by children or by their social partner. Within each condition the objects were either labelled or non-labelled. Children looked longer at the objects and at their social partner’s face when the objects were handled by the social partner. Looking at labelled or non-labelled objects did not differ. Lower vocabulary predicted longer looking at the social partner’s face and more eye-gaze switches and fewer eye-gaze switches, and lower vocabulary predicted better label retention when the experimenter handled the objects. Thus, social partner’s actions affect children’s experiences when actively involved during play. The second study examined caregivers’ actions and language while playing with familiar and novel objects with their nine- or 18-month-old child. Overall, the results suggested that object novelty affected caregivers’ interactive and non-interactive actions and infant directed speech (IDS) characteristics (number of words, pitch range, first utterance duration) while playing with their children. Children’s age also affected caregivers’ actions: caregivers of 18-month-old children used more interactive actions compared to caregivers of the younger age group. Children’s receptive vocabularies and caregivers’ educational levels predicted caregivers’ actions and IDS characteristics. Hence, object types, children’s age and individual differences influence caregivers’ actions and language characteristics and consequently children’s experiences and learning input. In the third study caregivers and their two-year-old children played with 3D novel objects in which the perceptual distances between objects were controlled. Caregivers generated sequences in which they handed objects to their child. Caregivers’ object choices were not the same as their children’s preferences (indicated by child’s longer looking time). Agreement between infant’s and caregiver’s object choice was higher for less securely attached children. While caregivers showed a tendency to generate higher to intermediate novelty sequences (i.e. perceptual distances between successive objects) of objects, this result was not systematic. Caregivers of shyer children generated sequences of higher novelty between the objects. Overall, caregivers’ object sequences were not systematic, and they did not choose the objects their children preferred; however, children’s individual characteristics influenced caregivers’ behaviours during play. Overall, children, social partners and objects, as well as individual characteristics, play an important role in the construction of children’s experiences. The manipulation of these features provided evidence regarding the influence these features have on each other and consequently their effect on children’s experiences, which in turn influences children’s learning and development. Exploring these influences provides a deeper understanding of children’s early learning and development throughout their everyday experiences

Communication in young people with intellectual impairments: the influence of partnership

Adults with intellectual impairments experience frequent communication breakdown in their everyday interactions. This can result from impairment of the linguistic skills required for effective communication and/or difficulties dealing with non-verbal information. Problems also exist, however, in the way that some non-impaired speakers, such as care providers, approach these communicative episodes. This thesis investigates communication in young adults with intellectual impairments with three different communication partners. These were a care provider, a student and a peer with intellectual impairments. Student partners were previously unknown to the main participants and not experienced in communicating with people with intellectual impairments. Communication structure and process are investigated according to the number of words and turns used to complete a co-operative problem-solving task and the types of conversational acts used by speakers and listeners. Non-verbal communication is investigated through the use of one non-verbal signal, gaze, during the task dialogues. An interactionist approach is taken to communication, where outcome or success is viewed as a product of the collaborative efforts of speakers and listeners. Communication is seen as multi-modal and involving the exchange of information via the verbal and non-verbal channels. The results show that when both parties were intellectually impaired performance was poorest. More surprisingly, dyads including a student partner communicated more effectively and efficiently than where the partner was a carer. One reason for this may be that carers used more complex, open questions to introduce new information into the task, and these were distracting rather than useful. Overusing open questions may be problematic for this population and less effective at establishing shared understanding than where listeners check their own interpretation of previous messages, a strategy preferred by student partners. Non-verbal signals can help to ease constraints on communication by providing interlocutors with feedback information on the levels of mutual understanding

Communication: How do females with Rett syndrome perform this activity and what factors influence performance?

Background Rett syndrome is a neurodevelopmental disorder primarily caused by mutations in the X-linked methyl-Cp2G-binding protein 2 (MECP2) gene. The disorder affects approximately 1 in 9000 females and is usually associated with language, physical and intellectual impairments, each of which contributes to difficulties with communication. In Rett syndrome, eye gaze is considered a common form of communication and conventional methods, such as talking and gestures, less common. Females appear to use these forms of communication to serve a number of functions including choice making, requesting, social convention, bringing attention to themselves, and to reject, comment and answer. However, the literature is limited due to poorly described case inclusion criteria, the inclusion of cases without a diagnosis of Rett syndrome and small sample sizes. Furthermore, there is a paucity of research on the numerous barriers and facilitators to successful communication. Therefore the aim of this research was to describe the performance of communication tasks in girls and women with Rett syndrome and to investigate factors that are positively and negatively associated with performance. Methods Qualitative and quantitative methods were used to understand the communication performance of girls and women with Rett syndrome and the impairments of body function and structure, activity limitations and contextual factors that influence these. The International Classification of Functioning Disability and Health - Child and Youth Version (ICF-CY) and The Communication Matrix were used as the theoretical framework throughout the research. This thesis includes four studies of which the first employed interviews with caregivers, the second and third used caregiver questionnaire data and the final utilised video data of girls and women engaged in a communicative interaction. Data were used to describe the use of specific communication modalities such as eye gaze, gestures and speech, and communicative functions including the ability to make requests and choices. Relationships between the performance of these communication tasks and factors including MECP2 mutation type, age and level of motor abilities were investigated. Results During interviews all parents reported their daughters were able to express discomfort and pleasure, and make requests and choices using a variety of modalities including body movements and eye gaze. They also reported level of functional abilities and environmental factors influenced communication performance. Questionnaire data on speech-language abilities showed 89% (685/766) acquired speech-language abilities in the form of babble or words at some point in time. Of those who acquired babble or words, 85% (581/685) experienced a regression in these abilities. Those with a p.Arg133Cys mutation were the most likely to use one or more words, prior to (RRR=3.45; 95% CI 1.15-10.41) and after (RRR=5.99; 95% CI 2.00-17.92) speech-language regression. Australian questionnaire data (n=151) found women aged 19 years or older had the lowest scores for eye gaze. Females with better gross motor abilities had higher scores for the use of eye gaze and gestures. The use of eye gaze did not vary across mutation groups, but those with a C-terminal deletion had the highest scores for use of gestures. The video study found 82.8% (53/64) of the sample made a choice, most using eye gaze. Of those who made a choice, 50% did so within 8 seconds. Conclusions In using qualitative and quantitative methods, and the ICF-CY and The Communication Matrix as the theoretical framework, this thesis was able to provide new insight into the way in which females with Rett syndrome communicate while considering the influence of impairments of body function and structure, activity limitations and contextual factors. We found that females with Rett syndrome share communicative strengths including the use of eye gaze and the ability to make choices. Multidisciplinary assessment of communication abilities, considering the range of factors identified to impact communication, and using multiple sources of information, will likely result in a more accurate assessment of the communication abilities of girls and women with Rett syndrome. Interventions should target communicative strengths, such as the use of eye gaze, and factors shown to impact communication, including the skills of communication partners. Reporting and accounting for genetic information in future research would help improve our understanding of the relationship between MECP2 and communication abilities, which may in turn improve our knowledge of the role MECP2 plays in neurodevelopment