Circumstances and outcomes of falls in hospital for adults with communication disability secondary to stroke: A qualitative synthesis

BACKGROUND: Falls are a significant patient safety concern in hospital. Adult patients with stroke, and those with communication disability, are at an increased risk of falls during their hospital admission compared to patients without stroke or communication disability. OBJECTIVE: The aim of this review is to determine the circumstances and outcomes of falls in hospitalised patients with communication disability following stroke. METHOD: A qualitative synthesis of 16 papers according to the Generic Reference Model of patient safety. This is a secondary analysis of studies in a systematic review of the association between communication disability after stroke and falls in hospitalised patients. RESULTS: In studies including participants with communication disability, falls commonly occurred at the patient bedside, during the day, and in transfers. However, no studies provided individual or group specifically detailing the circumstances and outcomes of falls of the included participants with communication disability. CONCLUSION: Research to date provides scant evidence on the circumstances and outcomes of falls in hospital patients with communication disability after stroke. This review performs a useful function in highlighting a glaring gap in the literature and the urgent need to enrich hospital falls prevention research that includes patients with communication disability following stroke. Findings of this review are discussed in relation to providing a framework for analysis of for future research.

Review of Giving Voice: Mobile Communication, Disability, and Inequality by Meryl Alper

No abstract available.

Clinical and Translational Implications of an Emerging Developmental Substructure for Autism

A vast share of the population-attributable risk for autism relates to inherited polygenic risk. A growing number of studies in the past five years have indicated that inherited susceptibility may operate through a finite number of early developmental liabilities that, in various permutations and combinations, jointly predict familial recurrence of the convergent syndrome of social communication disability that defines the condition. Here, we synthesize this body of research to derive evidence for a novel developmental substructure for autism, which has profound implications for ongoing discovery efforts to elucidate its neurobiological causes, and to inform future clinical and biomarker studies, early interventions, and personalized approaches to therapy. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 17 is May 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Speech language pathologists’ practice with children of parents with an acquired communication disability: A preliminary study

Background: Parental acquired communication disability has long-lasting impacts on children, including increased child stress and behavioural problems. However, speech-language pathologists’ (SLPs) current practice in providing information, education and counselling support to these children is unknown. Therefore, we explored SLPs’ perceived needs, current practices and barriers and facilitators to working with children of people with acquired communication disability (PwCD). Methods: An online survey sought information on Australian SLPs’ current practices in providing education and counselling to children of PwCD. Perceived barriers and facilitators were mapped to the COM-B, a model that considers Capability, Opportunity and Motivation as domains that influence behaviour. Results: 75% of participants (n = 76) perceived a need to provide both information and counselling, but ‘never’ or ‘rarely’ provided either aspect of care. Barriers relating to ‘Opportunity’ were most frequently identified, such as not having access to children in therapy and lack of parental support/engagement. Capability (e.g., knowledge and skills) and Motivation (e.g., confidence) barriers were also identified. Conclusions: There is potential for SLPs to provide services to children of PwCD either directly through information and/or counselling-type interactions or indirectly through referral to other services. This study highlights the need for more research into these areas of practice.