Forming a therapeutic alliance with older adults

Speech-language pathologists and audiologists are well aware that older people con- stitute our fastest growing patient population. Adults over 85 are appearing more frequently in clinician caseloads. This increase reflects demographic changes, with the typical older patient being female and widowed, living alone with multiple health problems, taking an average of seven prescription medications, and needing health and social services. According to the 1983 Current Population Survey, older men are three times more likely to be married than older women, and older women spend twice as long living alone in widowhood as older men. These data affect caregiving when health problems occur: who gives care, how much family help is needed, and what forms that help may take

The effect of the presence of a peer adolescent mediator and the amount of verbal praising on the sorting behavior of preschool retarded children

Four preschool children were asked to perform a black-white square sorting task under conditions in which an adolescent mediator was absent, present but nonverbal, present and verbally prompting and praising the child, and present but nonverbal with the experimenter increasing his normal output of praise and prompts by the mean frequency of adolescent verbalizations. The experimenter was present and verbal in all conditions. None of the experimental conditions produced significantly superior square sorting behavior than the others. However, the highest number of squares sorted over all subjects occurred when the adolescent was present and verbal along with the experimenter. The second highest number of squares sorted overall occurred when the same amount of prompts and praises, given previously by both the mediators and experimenter, were given only by the experimenter with mediators present but nonverbal. The results point out the importance of overall rates of prompts and praises, independent of whether they are given by an adolescent mediator or by the experimenter. The need for further research concerning the details of mediator and student interactions was noted

Doctor, lawyer, Indian chief: care of the noncelebrity professional speaker

Abstract: For the past 12 years I have had the opportunity of working in two excellent intensive voice therapy programs, one in a large community hearing and speech center and one in a smaller university clinic. I have observed in such non-hospital-based clinics that the majority of voice clients are an interesting and special group of people—what I term the noncelebrity professional speaker. The purpose of this article is to describe one useful, successful protocol for management of these clients by the speech-language pathologist. The article begins with an introduction to the characteristics of this special population and then describes the referral process and the voice evaluation. Therapy structuring is then considered, including client education, direct voice manipulation, counseling, and frequent voice re-evaluation. The client examples used for illustration are real clients seen by student clinicians with supervision. A secondary purpose of this article is to dispel the myth among some student clinicians that voice therapy is somehow vague, frightening, or magic. Perhaps this myth exists because voice disorders, like other communication disorders, sit at the intersect of so many biological and behavioral sciences (Siegel & Ingham, 1987). I recommend that we take what we need from all the sciences for a rational, exciting clinical experience in voice therapy

Connaissance de Pe´guy a` travers ses oeuvres sur Jeanne d'Arc

Joan of Arc's name appears in several of Charles Péguy's works. She is the main topic in five of these. The purpose of this thesis was to try to know Péguy by studying those five works, to discover his personality, his aesthetics, and his talent as a polemicist. Péguy appears as an original writer who belonged to no philosophical or literary school. Prom the human point of view, he proudly linked himself with his fellow countrymen, the common people, and a certain group of men of his generation who tried to discover and to defend essential values: Christianity, culture and truth. He proclaimed the primacy of spiritual values, the strong basic qualities of the common people, the worthiness of work and poverty. Except for a few friends who collaborated with him in his literary career, he stood alone, and his life was essentially devoted to his work as a writer and publisher. He made many enemies among orthodox Catholics and among the intellectuals associated with the Sorbonne. He was extremely confident in his own opinions and in his talent as a writer. For that reason, and because he had a deep sense of mission regarding the propagation of the values he associated with Joan of Arc, he was an implacable, punctilious, merciless polemicist who at times lacked fairness, and who wrote some lengthy arguments containing digressions

APPENDIX: Review of "In Pursuit of Quality: Evaluating Clinical Outcomes"

A review of the article ?In pursuit of quality: Evaluating Clinical outcomes,? by Dr. Frattali

Effects of Vowel Height and Vocal Intensity on Anticipatory Nasal Airflow in Individuals With Normal Speech

The purpose of this study was to determine the effects of vowel height and vocal intensity on the magnitude of anticipatory nasal airflow in normal speakers when producing vowel-nasal-vowel (VNV) sequences. Measurements of nasal and oral airflow were obtained from 15 men and 12 women with normal speech during production of the VNV sequences /ini/ and /ana/ at low, medium, and high intensity levels. Ratios of nasal to oral-plus-nasal airflow were calculated for the initial vowel of both utterances at each of the intensity levels. Analysis of variance (ANOVA) procedures indicated a significant main effect of intensity level and a significant vowel-by-sex interaction effect (p < .05) on the airflow ratios. Overall, the airflow ratio was reduced at high as compared to low intensity levels, regardless of sex of the speaker or vowel type. Female speakers exhibited greater airflow ratios during production of /ini/ than during productions of /ana/. Their airflow ratios were also greater during production of / ini/ than were those of male speakers. The results suggest that vocal intensity may affect velopharyngeal (VP) function in an assimilative nasal phonetic context. The results further suggest that anticipatory nasal airflow may be determined by the configuration of the oral cavity to a greater extent in women than in men. Theoretical and clinical implications are discussed

Treatment of Voice Disorders in Children

Children with voice disorders do respond to treatment, with vocal hyperfunction being the predominant disorder on the caseload of the pediatric voice clinician. This article reviews the literature in describing what is known about these children and typical disorders, prevention of voice disorders, the need for treatment, the referral patterns of teachers and others, and typical management programs and their settings. Good online resources are offered and brief highlights about voice therapy with children are reviewed

Visual analogue mood scales to measure internal mood state in neurologically impaired patients : description and initial validity evidence

This report describes the development of seven visual analogue mood scales (VAMS), using vertical 100 mm lines and simple, schematic faces representing the following mood states : sad, afraid, angry, tired, energetic, happy, and confused. Two studies are described in which 311 normal volunteers completed the VAMS, as well as the Profile of Mood States (in both studies) and the Beck Depression Inventory (in one study). Using the multitrait-multimethod technique, the VAMS were found to have excellent discriminant and convergent validity. In one study a separate set of VAMS, in which all words were removed from the scales, was also used. Participants' ratings on these No- Word VAMS were highly correlated with their ratings on the VAMS with corresponding words, indicating that the VAMS have content validity and would be accurately completed by patients with impaired language comprehension. These brief mood scales may prove useful in both clinical and research settings in which valid assessment of internal mood states in aphasic patients is required

Classroom tasks and student ability effects on motivation goal orientation in early adolescence : a cognitive-developmental study

Motivation goal orientation declines across school years from learning to master tasks to learning for grades, to please others, avoid negative evaluations, or to do the task as quickly as possible. This research assessed the relationship between different types of language arts tasks, student ability levels, and motivation goal orientation in sixth grade. Six high, six average, and six low achievers (nine girls and nine boys) comprised the sample. Motivation goal orientations are defined as learning to master tasks and increase competence (task-mastery), learning for a grade, to please others, or avoid a negative evaluation of ability (ego-social), or to do the task as quickly as possible (work-avoidant). Tasks are written products that demonstrate student proficiency. Classroom tasks were collected for eight days and quantitatively analyzed by cognitive level and the type of written response required (literacy response). Tasks below application cognitive levels and below sentences literacy response are simple tasks; tasks application and above, and sentences and above are complex tasks. Each student was interviewed on at least two simple and two complex tasks. Interviews were analyzed for motivation goal orientation

The relationship between beginning teachers' engagement with induction program components and student achievement

The purpose of this study was to examine induction programs in North Carolina during the 2010-2011 school year to determine beginning teachers received the support as recommended by State Board of Education policy. Participants were second-year high school teachers participating in district level beginning teacher induction programs and were teaching courses that required state-mandated standardized tests. Research questions were developed to gather data relative to the components of induction: orientation, mentor support, administrator support, and professional development. Data gathered from the researcher-designed Beginning Teacher Induction Program Survey (BTIPS) were used to answer research questions. A correlational research design was used. Predictor variables were engagement level scores and perceived impact on teaching. The criterion variable was change in student achievement as measured by performance on state standardized tests. Using the Rasch Rating Scale Model, engagement scores were calculated. Pearson r (p < .05) found no significant correlations between engagement with induction components and student achievement. A multiple regression analysis further shows that engagement scores did not significantly contribute to predicting student achievement. The relationship between perceived impact on teaching and student achievement was also examined. Several important findings emerged. The data revealed that teachers in this study had access to and participated in the four induction program components recommended by the State School Board. However for many beginning teachers, support was lacking. Results showed that responding teachers were significantly low engaged in the support provided by administrators as opposed to orientation, mentor support and professional development and were high engaged with the support provided by mentors. Schools and school systems are facing challenging times. The current climate of high stakes testing and uncertain economic conditions magnify the importance of having data to inform educators as they make decisions about their teaching force. Important questions about induction must be answered to best guide future policy. More research is needed that will distinguish the relationship between specific program components and student achievement