The Assessment and Intervention of Communication Repair Strategies in Primary School Children with Autism Spectrum Disorder Who Are Minimally Verbal

<p>Autism Spectrum Disorder (ASD) is characterized by marked deficits in communication and social skills in addition to restricted interests and repetitive behaviour. Children with ASD have also been reported to have significant deficits with respect to their ability to repair communication breakdowns. To date, assessments targeting communication repair strategies in children with ASD have been limited in number and lack consistency of implementation. For the current research, both an indirect and direct assessment have been developed to investigate the repair repertoires of primary school-aged children who were minimally verbal. Indirect assessments were conducted with each of the participant’s teachers, and the direct assessments were conducted by creating breakdown scenarios during a requesting routine and recording if and how the children attempted to repair the communication breakdown. Results show that children tended to rely on a singular repair strategy involving the repetition of their initial request. An intervention program was then developed and evaluated with two of the children. These children were taught to use an iPad®-based speech generating device to repair communication breakdowns that occurred when the children’s initial request was followed by receipt of the wrong item. The intervention was evaluated using a nonconcurrent multiple baseline experimental design. Each of the participants showed an increase in responding under specific communication breakdown conditions. While this research is quite preliminary, the data suggests that repair repertoires of children with ASD can be assessed via a structured, direct asses and improved with interventions based on the assessment results.</p>

Communication Breakdown: Differing Relationship Wellbeing Effects of Positive and Negative Spin in Communication Behaviour

<p>Romantic couples must regularly navigate interactions to maintain satisfying relationships, but it is unclear how people’s variability in communication behaviour is linked to relationship wellbeing. Varying communication behaviours may display responsiveness to a partner’s needs by adjusting behaviour appropriately. Or else, inconsistent behaviour may undermine partner trust by fuelling uncertainties about commitment. Across two studies, we investigated how a person’s variability of communication behaviour was associated with their own wellbeing and their partner’s wellbeing. Specifically, we assessed spin, a measure of how often a person switches between communication behaviours. We predicted that switching between positive behaviours would be linked with higher relationship wellbeing but, conversely, switching between negative communication behaviours would be linked with lower wellbeing. We assessed spin in positive and negative forms of relationship behaviour over three weeks (Study 1; 78 couples) and over a single interaction (Study 2; 112 couples). Effects for spin in positivity emerged only in Study 1. For women, switching daily positive behaviour over three weeks was associated with higher partner relationship wellbeing but unexpectedly lower wellbeing for women (controlling for mean-level positivity). This suggests that, for women, being responsive to partners in diverse ways is beneficial for the partner but comes at a personal cost. Effects for spin in negativity emerged in both studies. Switching negative behaviour was linked with lower partner wellbeing in both studies, indicating that use of different negative behaviours is more dysfunctional than the sum of individual relationship behaviours. Across both studies, additional tests illustrated that these effects were independent and not due to variability in the magnitude of behaviours. Our findings show variable behaviour may benefit partner wellbeing when behaviour is positive, but inconsistent negativity interrupts intimacy processes to undermine wellbeing. Our research highlights the importance of considering behavioural variability when studying relationship maintenance processes over time.</p>

Communication Breakdown: Differing Relationship Wellbeing Effects of Positive and Negative Spin in Communication Behaviour

<p>Romantic couples must regularly navigate interactions to maintain satisfying relationships, but it is unclear how people’s variability in communication behaviour is linked to relationship wellbeing. Varying communication behaviours may display responsiveness to a partner’s needs by adjusting behaviour appropriately. Or else, inconsistent behaviour may undermine partner trust by fuelling uncertainties about commitment. Across two studies, we investigated how a person’s variability of communication behaviour was associated with their own wellbeing and their partner’s wellbeing. Specifically, we assessed spin, a measure of how often a person switches between communication behaviours. We predicted that switching between positive behaviours would be linked with higher relationship wellbeing but, conversely, switching between negative communication behaviours would be linked with lower wellbeing. We assessed spin in positive and negative forms of relationship behaviour over three weeks (Study 1; 78 couples) and over a single interaction (Study 2; 112 couples). Effects for spin in positivity emerged only in Study 1. For women, switching daily positive behaviour over three weeks was associated with higher partner relationship wellbeing but unexpectedly lower wellbeing for women (controlling for mean-level positivity). This suggests that, for women, being responsive to partners in diverse ways is beneficial for the partner but comes at a personal cost. Effects for spin in negativity emerged in both studies. Switching negative behaviour was linked with lower partner wellbeing in both studies, indicating that use of different negative behaviours is more dysfunctional than the sum of individual relationship behaviours. Across both studies, additional tests illustrated that these effects were independent and not due to variability in the magnitude of behaviours. Our findings show variable behaviour may benefit partner wellbeing when behaviour is positive, but inconsistent negativity interrupts intimacy processes to undermine wellbeing. Our research highlights the importance of considering behavioural variability when studying relationship maintenance processes over time.</p>

The Assessment and Intervention of Communication Repair Strategies in Primary School Children with Autism Spectrum Disorder Who Are Minimally Verbal

<p>Autism Spectrum Disorder (ASD) is characterized by marked deficits in communication and social skills in addition to restricted interests and repetitive behaviour. Children with ASD have also been reported to have significant deficits with respect to their ability to repair communication breakdowns. To date, assessments targeting communication repair strategies in children with ASD have been limited in number and lack consistency of implementation. For the current research, both an indirect and direct assessment have been developed to investigate the repair repertoires of primary school-aged children who were minimally verbal. Indirect assessments were conducted with each of the participant’s teachers, and the direct assessments were conducted by creating breakdown scenarios during a requesting routine and recording if and how the children attempted to repair the communication breakdown. Results show that children tended to rely on a singular repair strategy involving the repetition of their initial request. An intervention program was then developed and evaluated with two of the children. These children were taught to use an iPad®-based speech generating device to repair communication breakdowns that occurred when the children’s initial request was followed by receipt of the wrong item. The intervention was evaluated using a nonconcurrent multiple baseline experimental design. Each of the participants showed an increase in responding under specific communication breakdown conditions. While this research is quite preliminary, the data suggests that repair repertoires of children with ASD can be assessed via a structured, direct asses and improved with interventions based on the assessment results.</p>

Developing Behavioral Coding to Understand Family Communication Breakdown in Dementia Care

Communication breakdown is a challenge for family caregivers of persons living with dementia. We adapted established theory and scales for computer-assisted behavioral coding to characterize caregiver communication for a secondary analysis. We developed verbal, nonverbal, and breakdown coding schemes and established reliability (κ > .85). Within the 221 family caregiving videos analyzed, 55% of exchanges were interactive, 30% were silence, 4% consisted of talking to self or others, and 8% included a breakdown. An average of 2.4 ( SD = 1.9) breakdowns occurred per observation and were successfully resolved 85% of the time, with 31% being resolved most successfully following only one flag and repair strategy. Caregivers were the primary speakers (67%); their communication preceded most breakdown (65%), and they primarily initiated the repairs after a breakdown (70%). Common repair strategies included clarifications (31%), asking questions (24%), and repeating information (24%). Associations between communication strategies and repair success will provide evidence for caregiver training.

Implementation of Return to Learn Protocols for Student Athletes with Sport and Recreation Related Concussion: An Integrative Review of Perceptions, Challenges and Successes

Concussion or mild traumatic brain injury (mTBI) is a common phenomenon in the United States, with up to 3.6 million sport-related mTBIs diagnosed annually. Return to learn protocols have been developed to facilitate the reintegration of students into school after mTBI, however, the implementation of return to learn protocols varies significantly across geographic regions and school districts. An integrative review of the literature was performed using Whittemore and Knalf's methodology. A search of published literature was conducted using the PRISMA checklist. Database searches were conducted from March 2,019 to October 2,021 using the terms “mild traumatic brain injury” and “return to learn.” Twenty-eight publications were included. Three themes were derived from this review: lack of policy, poor staff education on concussion symptoms and stakeholder communication breakdown. The development of communication patterns and use of a return to learn protocol could facilitate a gradual return to full academic workload after concussion.

Fillers as Communication Strategies Among English Second Language Speakers in Job Interviews

Good mastery of English in job interviews does not only give an added value to the second language (L2) interview candidates but also increases the chances to be employed. However, not all English as Second Language (ESL) speakers are competent in using the language. In this regard, communication strategies (CS) are useful for L2 speakers in overcoming the difficulties in communicating their intended messages. The objective of this study is to examine the use of fillers as CS by interviewing candidates of academic staff recruitment at Universiti Teknologi MARA Machang, Kelantan, in Malaysia. The data of this qualitative study were obtained from observations through video-recorded oral interactions between candidates and panellists during interview sessions. The NVivo software (version 12) was used to help the researcher in analysing the oral data. The results revealed that the use of fillers stipulated in D&ouml;rnyei and Scott&rsquo;s (1997) taxonomy of CS was extensively used by ESL speakers in real job interviews as a processing time pressure-related strategy when the speaker was trying to fill in the gaps between their limited resources and message conveyance in L2. In conclusion, fillers are useful to L2 speakers by helping them to maintain conversations and prevent communication breakdown.

Devising a method to control the operational quality and reliability of fiber-optical communication lines

The lack of recommendations in the normative and technical documentation related to fiber-optic communication lines (FOCL) for assessing their technical condition necessitated devising a method to control the lines' quality and reliability of operation. The method creates the basis for calculating the quality and reliability indicators of FOCL operation and suggests measures to improve them. It determines the methods of control, as well as the acquisition, accounting, and analysis of damage statistics with and without interruption of communication. The graphic sequence of implementation of the stages of the method demonstrates that resolving the task to control these indicators should involve: – managing the acquisition and actual acquisition of operational data on damages (the causes, nature, quantity, the duration of communication breakdown and complete elimination of damage); – determining the quality and reliability indicators of FOCL operation annually; – analysis of the obtained results and the development (correction) of measures to comply with the norms of these indicators; – the implementation of measures to comply with the norms of quality and reliability of FOCL operation (if necessary). Based on the operational data from a line operator acquired over three years in the specified climatic zone (a cable of the type OKLBg-3 DA12-3×4E-0.4F3.5/0.22N18-12/0), the methodical component of the method was examined. The obtained results on the operational quality (damage density, average damage duration, break (downtime) of communication) and reliability indicators (FOCL readiness factor) of a subscriber access network without reservation showed that the line had low efficiency. The communication breakdown over three years amounted to K=12,569.8 stream∙hours. The downtime at this volume of digital stream∙hours has led to significant economic losses. Line operators have been given recommendations for the proper FOCL operation and ensuring a normalized value of the line readiness coefficient. To this end, it is necessary to reduce the time to re-link and prolong the line's failure-free operation

Enhancing Interprofessional Collaboration in Perioperative Setting from the Qualitative Perspectives of Physicians and Nurses

Communication failures were a leading cause of sentinel events in the operation room due to frequently the communication breakdown occurs between physicians and nurses. This study explored the perspectives of surgical teams (nurses, physicians, and anaesthesiologists) on interprofessional collaboration and improvement strategies. A surgical team comprising eight perioperative nurses, four surgeons, and four anaesthesiologists from a university-affiliated hospital participated in this qualitative and phenomenological research from December 2018 to April 2019. Data were collected in in-depth interviews and were used in a thematic analysis according to Colaizzi to extract themes and categorised codes with the ATLAS.ti software. The result is presented in three generic categories: Barrier-like disruptive behaviours and lack of coordination of care; consequences by safety threats to the patient; overcoming barriers by shared decision making among professionals, flattened hierarchies, and teamwork/communication training. The conclusion is that different teams’ perspectives can facilitate genuine reflection, discussion, and implementation of targeted interventions to improve operating room interprofessional collaboration and overcome barriers and their consequences. Currently, there is a need to change towards interprofessional collaboration for optimal patient outcomes and to ensure all professionals’ expectations are met.

Patient complaints in the postoperative period following spine surgery

OBJECTIVE Patient complaints are associated with a number of surgical and medical outcomes. Despite high rates of patient complaints regarding spine surgeons and efforts to study patient complaints across medicine and surgery, few studies have analyzed the complaints of patients undergoing spinal surgery. The authors present a retrospective analysis that, to their knowledge, is the first study to directly investigate the complaints of spine surgery patients in the postoperative period. METHODS Institutional records were reviewed over a 5-year period (2015–2019) to identify patients who underwent spine surgery and submitted a complaint to the institution’s ombudsman’s office within 1 year of their surgery. A control group, comprising patients who underwent spine surgery without filing a complaint, was matched to the group that filed complaints by admission diagnosis and procedure codes through propensity score matching. Patient demographic and clinical data were obtained by medical record review and compared between the two groups. Patient complaints were reviewed and categorized using a previously established taxonomy. RESULTS A total of 52 patients were identified who submitted a complaint after their spine surgery. There were 56 total complaints identified (4 patients submitted 2 each) that reported on 82 specific issues. Patient complaints were most often related to the quality of care received and communication breakdown between the healthcare team and the patient. Patients who submitted complaints were more likely to be Black or African American, have worse baseline health status, and have had prior spine surgery. After their surgery, these patients were also more likely to have longer hospital stays, experience postoperative complications, and require reoperation. CONCLUSIONS Complaints were most often related to the quality of care received and communication breakdown. A number of patient-level demographic and clinical characteristics were associated with an increased likelihood of a complaint being filed after spine surgery, and patients who filed complaints were more likely to experience postoperative complications. Improving communication with patients could play a key role in working to address and reduce postoperative complaints. Further study is needed to better understand patient complaints after spine surgery and investigate ways to optimize the care of patients with risks for postoperative complaints.