Effects of speech and print feedback on spelling performance of a child with cerebral palsy using a speech generating device

Purpose. The aim of the study was to investigate the effectiveness of three feedback conditions, using a speech-generating device, on spelling performance of Tom, an 11-year-old boy with cerebral palsy and complex communication needs.

Method. Tom was taught to spell 12 words under three feedback conditions. In the SPEECH condition, he received only speech feedback from the device and in the PRINT condition he received only the orthographic feedback on the display of the device. In the SPEECH – PRINT condition, Tom received both speech output and orthographic feedback. An adapted alternating treatment design was used to investigate the effects of the three-feedback conditions. To strengthen the reliability and increase the internal validity of the findings, an intrasubject direct replication was carried out using the same procedure, but teaching 12 different spelling words to Tom.

Results. Tom reached criterion with the PRINT feedback condition first, followed by SPEECH and SPEECH – PRINT conditions simultaneously for the first 12 words, and the same order for the second set of 12 words.

Conclusions. Overall, the PRINT condition was most efficient for Tom. The results are discussed in terms of evidence for learning style preferences within spelling instruction for a child with complex communication needs. Furthermore, the implications for targeting intervention to optimise spelling achievement amongst this group are considered.     

A comparison of two approaches for representing AAC vocabulary for young children

Abstract

Purpose: Young children with complex communication needs often experience difficulty in using currently available graphic symbol systems as a method of augmentative and alternative communication (AAC). Information on young children's performance with graphic representations based on this population's conceptualizations of these vocabulary items may assist in the development of more effective AAC systems.

Method: This study developed Developmentally Appropriate Symbols (DAS) for 10 early emerging vocabulary concepts using procedures designed to address both conceptual and appeal issues for graphic representations for young children. Using a post-test only, between-subjects comparison group design, 40 typically-developing 2.5–3.5-year-old children were randomly assigned to receive a brief training in either of two different types of graphic symbol sets: (a) DAS or (b) Picture Communication Symbols (PCS), a, commercially available graphic symbol system.

Result: Results of a two sample independent t-test provide evidence that children in the DAS condition correctly identified more symbols than children trained with the PCS symbols. There was no evidence of a preference between the symbol sets.

Conclusion: The results provide support for careful consideration of children's use and understanding of language in developing AAC systems for young children.     

The effect of phonological awareness intervention on non-word spelling ability in school-aged children: An analysis of qualitative change

The purpose of this pre-experimental, retrospective study was to examine the effect of a phonological awareness intervention program on qualitative changes in the non-word spelling skills of children with spelling difficulties. Additionally, this pilot study set out to determine the reliability and effectiveness of a newly developed spelling analysis tool. This tool, the Feature Analysis of Non-word Spelling (FANS) was devised to qualitatively describe children's non-word spelling performance. Participants were 16 school-aged children, ranging in age from 8 years 6 months to 10 years 1 month, who were selected for this study on the basis of their below average non-word spelling ability prior to intervention. All children in the study had received phonological awareness training based on the University of Queensland Phonological Awareness for Literacy (UQPAL) program. Pre- and post-intervention non-word spelling responses of participants were analysed using the FANS. Results revealed a significant overall improvement in non-word spelling skills following phonological awareness training. Specifically, participants displayed significant improvements in their ability to represent vowels post intervention. The FANS was found to be a highly reliable qualitative measure of non-word spelling. Results highlight the merit of using a qualitative analysis of spelling to best elucidate the effectiveness of intervention or developmental change.     

对脑瘫患儿监护人实施心理护理的效果观察

[目的]探讨心理护理干预对脑瘫患儿监护人心理状态、生活质量、社会支持及依从性的影响。[方法]将80名脑瘫患儿家长随机分为对照组和观察组各40名。对照组给予常规护理干预,观察组在对照组的基础上给予心理护理干预。对两组监护人心理状态、生活质量、社会支持及依从性进行对比。[结果]观察组症状自评量表总分低于对照组,生活质量评分、社会支持评分和依从性方面高于对照组,差异有统计学意义(P0.05)。[结论]对脑瘫患儿家长进行心理护理干预能有效地改善家长心理状态、生活质量、社会支持及依从性,有利于患儿得到更好的照顾。     

Effect of two layouts on high technology AAC navigation and content location by people with aphasia

Abstract

Purpose: Navigating high-technology augmentative and alternative communication (AAC) devices with dynamic displays can be challenging for people with aphasia. The purpose of this study was to determine which of two AAC interfaces two people with aphasia could use most efficiently and accurately. Method: The researchers used a BCB′C′ alternating treatment design to provide device-use instruction to two people with severe aphasia regarding two personalised AAC interfaces that had different navigation layouts but identical content. One interface had static buttons for homepage and go-back features, and the other interface had static buttons in a navigation ring layout. Throughout treatment, the researchers monitored participants’ mastery patterns regarding navigation efficiency and accuracy when locating target messages. Results: Participants’ accuracy and efficiency improved with both interfaces given intervention; however, the navigation ring layout appeared more transparent and better facilitated navigation than the homepage layout. Conclusions: People with aphasia can learn to navigate computerised devices; however, interface layout can substantially affect the efficiency and accuracy with which they locate messages.

• Implications for Rehabilitation

• Given intervention incorporating errorless learning principles, people with chronic aphasia can learn to navigate across multiple device levels to locate target sentences.

• Both navigation ring and homepage interfaces may be used by people with aphasia.

• Some people with aphasia may be more consistent and efficient in finding target sentences using the navigation ring interface than the homepage interface. Additionally, the navigation ring interface may be more transparent and easier for people with aphasia to master – that is, they may require fewer intervention sessions to learn to navigate the navigation ring interface.

• Generalisation of learning may result from use of the navigation ring interface. Specifically, people with aphasia may improve navigation with the homepage interface as a result of instruction on the navigation interface, but not vice versa.

     

CT在脑性瘫痪早期诊断中的价值

目的探讨CT在小儿脑性瘫痪(脑瘫)早期诊断中的价值。方法对124例小儿脑瘫的头颅CT进行回顾性研究与分析。结果124例中96例头颅CT检查阳性,CT异常率77.42％,其中脑萎缩是最常见的表现(54.84％)。临床类型中痉挛型最多见(71.77％)。不同年龄组中,年龄越小,CT异常率越高。结论虽然CT不能作为诊断脑瘫的主要依据,但有助于早期发现病变,有助于寻找病因及定位,还可以为判断本病的预后提供依据,在脑瘫的早期诊断中具有重要价值。     

脑性瘫痪患儿智力水平及智力结构的调查与分析

目的了解脑性瘫痪患儿的智力水平及智力结构情况。方法采用修订版韦克斯勒儿童智能量表对60例脑性瘫痪患儿进行测试,并对测试结果进行分析。结果 60例脑性瘫痪患儿总智商(70.01±18.35)分,较正常儿童偏低;言语智商(79.71±18.56)分,操作智商(64.35±18.37)分,轻度脑性瘫痪患儿总智商和言语智商高于中度和重度脑性瘫痪患儿,比较差异有统计学意义,操作智商轻、中、重度脑性瘫痪患儿之间,比较差异无统计学意义;言语智商与操作智商的差值12分;应用因素分析方法研究患儿的智力结构,患儿概念因素得分(19.51±11.21)分,获得因素得分(18.00±9.89)分,空间因素得分(17.02±9.25)分,序列因素得分(14.78±9.22)分。结论脑性瘫痪患儿智力水平低于正常儿童,其智力结构存在不平衡现象。     

Identifying assessment measures and interventions reported for Thai children with cerebral palsy using the ICF-CY framework

Background: Cerebral palsy (CP) is the most common disability in childhood. The International Classification of Functioning, Disability and Health (ICF) provides a standard framework for classifying performance in people with disability, including children with CP. Linking measures actually reported with the ICF classification promotes best practice, especially pertinent in developing countries such as Thailand. This study aimed to explore the charted demographic data, assessment and intervention measures reported for children with CP in Central region of Thailand using the ICF for children and youths (ICF-CY) framework to clarify the scope of actual management practice in this population. Methods: Charts of children admitted to four public hospitals and two schools in 2007–2009 were age stratified, and approximately 48% audited (n?=?269). Results: Contextual information was clearly reported, and measures could be classified across all components of the ICF, being mainly classified in Body Structures and Functions and to a lesser degree, in Activities and Participation. Our ability to compare across cultures was affected by poor recording practices limiting the amount and quality of data available. Conclusions: Classifying measures of children with CP in Thailand in terms of the ICF-CY framework demonstrates their holistic management as well as where gaps need to be addressed, and thus contributes to best practice.

Implications for Rehabilitation

• Assessments and interventions reported for children with CP in Central region, Thailand cover all components of the ICF-CY, and describe the individual roles of the Inter-professional team members.

• Local health practitioners should consistently conform with internationally practice by using Standardized tools assessing all components of the ICF

• Consistent and uniform charting practices should be used to provide accurate interpretation of actual practice, as well as a clear pathway from assessment to intervention.

     

中西医结合的综合疗法对脑瘫患儿的临床疗效及生存质量的影响

目的探讨中西医结合的综合疗法对脑瘫患儿的临床疗效及生存质量的影响。方法将我院收治的70例脑瘫患儿按治疗方式的不同分对照组(35例,西医疗法)和观察组(35例,中西医疗法)。比较两组的临床疗效。结果治疗后,观察组的ACA、MCA、PCA平均血流速度大于对照组,Ashworth、S-S、FMA及CP QOL-Child评分均优于对照组(P<0.05)。结论中西医结合的综合疗法能改善患儿的脑血流量、肌张力、语言及运动功能,提高生存质量。     

脑瘫患儿实施系统化健康教育的康复效果观察

目的探讨脑瘫患儿实施系统化健康教育对康复效果的影响。方法选取2016年1月至6月痉挛性脑瘫住院患儿120例(实验组)与2015年6月至12月痉挛性脑瘫住院患儿118例(对照组)进行比较,对照组采用传统健康教育,实验组采用院前、院内、院外系统化健康教育,两组患儿均于入院时、出院时和出院后6个月进行康复依从性、残疾儿童生活自理能力、粗大运动功能的评价。结果健康教育干预前、干预后、干预后6个月3个时间点两组患儿康复依从性、残疾儿童生活自理能力、粗大运动功能的时间效应差异有统计学意义(P0.05);时间因素存在交互效应(P0.05)。结论系统化健康教育有利于提高脑瘫患儿的康复依从性,持续改善脑瘫患儿生活自理能力和粗大运动功能,比传统健康教育具有更大优势,值得在儿童脑瘫康复中推广应用。     

脑性瘫痪患儿静脉输液的难点分析及改进措施

目的制定符合护理操作规范及脑性瘫痪(以下简称脑瘫)患儿特点的输液流程,理顺静脉输液工作程序,减少差错事故。方法分析脑瘫患儿静脉输液的特点、难点及相关因素,完善各项制度,修改输液流程;改进输液方法;做好输液宣教;制定输液单项考核方案等措施。结果护士责任心增强,业务水平提高,护患配合协调,输液等候时间缩短,无差错发生。结论改进后的输液流程符合脑瘫患儿治疗的需求,调动了护士工作的积极性,患儿家长对输液的满意度提高。     

Cultural adaptation and construct validation of the Arabic version of children’s assessment of participation and enjoyment and preferences for activities of children measures

Purpose: To establish the construct validity and internal consistency of the Arabic Children Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) and to determine the effects of age, gender, and disability status on diversity and intensity of participation.

Methods: The World Health Organization guidelines for translation of measures were applied to translate the CAPE and PAC, 75 children with cerebral palsy (mean age?=?10.7?±?2.9 years) and 75 children with typical development (mean age?=?10.8?±?2.7 years) completed the translated measures. The construct validity of the translated measures was demonstrated by principle component analyses in addition to the known-groups method by examining the effects of age, gender, and presence of disability on diversity and intensity scores. The internal consistencies of the extracted components were examined by Cronbach’s alpha.

Results: Four components emerged: (1) physical activities; (2) home-based activities; (3) self-improvement activities; and (4) social activities. Cronbach’s alpha varied from 0.61 (social activities) to 0.83 (physical activities). Age, gender, and disability were significant determinants of types of activities.

Conclusions: The Arabic CAPE and PAC are culturally valid in measuring participation of children with or without disabilities in Jordan. The child’s age, gender, and disability should be considered to provide participation-based plans of care that are considerate for children and their families.

• Implications for rehabilitation

• The Arabic CAPE and PAC are culturally valid measures for participation of children with or without disabilities in Jordan.

• The Arabic CAPE and PAC measures can guide participation-based plans of care that are meaningful and considerate for children and their families.

• Child age and gender should be considered to provide appropriate activities and to facilitate participation of children with and without disabilities.

• Families and service providers in Jordon are encouraged to provide children opportunities to participate in desired physical, self-improvement, and social activities.

     

应用显微技术选择性脊神经后根切断术治疗儿童痉挛性脑性瘫痪

目的探讨应用显微技术选择性脊神经后根切断术治疗儿童脑性瘫痪的临床效果。方法选择32例4～12岁下肢痉挛性脑瘫儿童,应用电刺激及显微技术,按不同脊神经节段,不同比率选择性切除脊神经后根,观察术后肌张力缓解情况。结果25例儿童术后双下肢痉挛消失,7例好转,排尿费力者明显改善,无严重并发症及死亡病例,19例随访6个月～4年,未见痉挛再现。结论应用显微技术选择性脊神经后根部分切断术是治疗儿童脑性瘫痪的有效方法。     

依托咪酯和氯胺酮对脑瘫患儿心率变异性的影响

目的观察依托咪酯和氯胺酮在脑瘫患儿手术麻醉期间对心血管功能变化的影响。方法将 84例接受下肢矫形手术并采用基础麻醉加硬膜外连续阻滞麻醉的脑瘫患儿随机分为依托咪酯组和氯胺酮组各 42例。连续记录入室后及麻醉诱导后 3 0min心电图 ,监测心率变异性 (HRV)。结果依托咪酯组麻醉诱导后HR、HRV明显降低 (P <0 .0 5— 0 .0 1)。氯胺酮组HR略增快 ,HRV无明显变化 (P >0 .0 5 )。结论依托咪酯对脑瘫患儿手术麻醉期间心血管功能变化的影响显著。     

Intervention and the role of theory, empiricism and experience in children with motor impairment

Purpose. This paper presents a framework for examining the different approaches to intervention in children with motor impairment such that more informed decisions are made by researchers and clinicians in their respective fields.

Method. Studies are examined using a framework employing theoretical, empirical and experiential evidence. A range of interventions are analysed and are applied to the conditions of cerebral palsy and developmental coordination disorder. The theoretical, empirical and experiential evidence is analysed by an examination of such methods as constraint induced therapy, Bobath techniques, bimanual coordination methods, sensory integration therapy and functional task approaches, all set within a development and learning context.

Results. The results show that evidence from the three parts of the framework, namely theoretical, empirical and experiential are often in conflict with each other and it is not surprising that there is confusion in the field about the efficacy of the various methods.

Conclusions. First, it is recommended that more complete information is required on the methods employed from the three areas of our framework. Secondly, researchers, clinicians and other practitioners should examine the evidence from these three areas and align it to the needs of their research or practice before embarking on action.     

脑瘫儿童语言认知训练对肢体功能康复的促进作用

目的：探讨脑瘫儿童语言认知训练对肢体运动康复的促进作用,增加对语言康复的重视。方法：选择30例语言发育迟缓的脑瘫儿童,针对语言发育和肢体情况进行评定。标准组对15例语言发育迟缓的儿童进行语言认知训练、肢体运动疗法和作业疗法的综合训练;对照组对15例语言发育迟缓的儿童只进行肢体运动疗法与作业疗法训练。运动疗法、作业疗法和语言训练每日各1次,每次30min,12周为1疗程,3个月后进行评定。评定方法采用中国康复研究中心研制的汉语版s—s语言发育迟缓评定法和脑瘫儿童粗大运动评估表。结果：15例语言发育迟缓的儿童经过语言认知、肢体的运动疗法和作业疗法相结合的训练,与单独做肢体训练的患儿康复效果相比,差异有统计学意义（P〈0．01）。结论：语言认知训练是影响脑瘫儿童康复的重要因素,对肢体运动康复有促进作用。     

早产脑瘫患儿的临床表现分析

目的探讨脑瘫致病因素与临床表现之间的关系。方法对 185例脑瘫患者的致病因素与临床表现进行分析。结果早产的脑瘫患者与足月产的脑瘫患者相比 ,重度者的比例高 (P <0 .0 1) ,痉挛型发生率高 (P <0 .0 5 )。结论对早产儿早期随访 ,早期干预 ,有利于脑瘫的早期诊断和治疗