Assessment of Significant Other's Burden and Their Communication Strategies to Enhance the Treatment Outcome in Aphasia

Post-stroke management of person with aphasia (PWA) needs the crucial involvement of significant others (SOs) or caregivers of PWA. The manners in which SOs perceive the burden and execute their supportive communication strategies (SCS) are highly variable and are influenced by many factors like their motivation, emotional attachment, constraints of time and economy, self-confidence, and the clinical and individualistic attributes of the PWA herself or himself. There are variations regarding motivation, supportive communication strategies (SCS), significance and burden of communication to PWA by SO. These variations lead to a prognosis of a PWA, which needs to be evaluated for a better understanding of the diversity of burden and SCS before incorporating tailor-made treatment planning. These aspects have a significant bearing on the prognosis of aphasia, hence must be evaluated prior to treatment planning.

Subjective Fatigue in Children and Adults

Fatigue is a common yet poorly understood topic. The psychological, physiological, social, emotional, and cognitive wellbeing of a person may be affected due to fatigue. Despite a century of research in understanding the effect of fatigue on human systems, there is no concrete explanation as how fatigue affects the perception of speech. Fatigue impairs auditory cognition and the reduced cognitive abilities further increase mental and physical fatigue. Since cognition is markedly affected in individuals experiencing mental fatigue, its consequences are widespread. According to the top-down approach of auditory processing, there is a direct link between cognition and speech perception. Thus, in the present chapter, the influence of fatigue on perception is reviewed. It is noted that the impact of fatigue on cognition and quality of life is different for children and adults. Training in music, meditation, and exposure to more than one language are some of the measures that help to reduce the effect of fatigue and improve cognitive abilities in both children as well as in adults.

Dysphagia in Persons With Communication Disorders

Dysphagia (swallowing disorders) is any difficulty in swallowing that interferes with safe and adequate intake of nutrition and hydration requirements in an individual. It may present itself as a symptom of another underlying medical condition or as a consequence of surgical and pharmacological treatment. While in few, dysphagia resolves itself as a transient phase; in the rest, dysphagia demands immediate treatment. It may be seen as an associated dysfunction in persons with communication disorders (PsWCD) as speech and swallowing functions share many neuro-musculo-skeletal structures at the oral, pharyngeal, and laryngeal level along with their central control processes. This chapter aims at introducing the readers to the signs and symptoms of dysphagia in PsWCD. This is expected to guide the team of professionals working with PsWCDin identification and making appropriate referrals to the concerned professional for effective intervention. This further can accelerate the progress and prognosis of PsWCD towards improved health, development, and quality of life.

Knowledge, Attitude, and Practices of Primary and Secondary School Teachers on Specific Learning Disorder

Early identification of Specific Learning Disorder (SLD) is essential not only for effective remediation of their problems but would also prevent the problems from aggravating. The role of general education teachers in early identification becomes crucial, as they are the ones who first identify the academic and behavioral issues of school children. The main aims of the study are to assess the knowledge, attitudes, and current practices pertaining to SLD, among pre-primary, primary, and secondary school teachers in public schools from Trivandrum, India, to find whether there exists any relation between years of teaching experience and awareness on SLD and to assess the effect of a short-term training program on the knowledge, attitude, and practices of school teachers. In conclusion, short-term training programs of a multi-disciplinary nature are found to be effective in bringing about improvements with both pre-primary and primary teacher's knowledge factor, but such training is maximally beneficial for improving attitude and practice of teachers in the primary level.

Speech Therapy for Children Who Stutter

This chapter aims to investigate and evaluate the evidence available for stuttering treatment research in children who stutter (CWS) and provide a qualitative review of the same. Studies were considered for review if (1) they were behavioral intervention of stuttering for children, (2) participants were in the age range of 2-18 years, and (3) the outcomes reported assessed stuttering. Twenty-seven studies were obtained through an electronic search of databases covering two approaches and 10 techniques. The analysis of these studies revealed that direct approaches have a stronger evidence base in comparison to the indirect approaches. The most popular approach with maximum studies is the early intervention Lidcombe program. The commonly used outcome measures included the percentage of syllables stuttered, syllables per minute, and severity rating scales. The conclusion drawn from the review suggest that evidence base to support behavioral intervention of CWS exists for a limited number of intervention techniques and among them very few exploring the long-term effects of the intervention.

Discourse Elicitation in Aphasia

Persons with aphasia (PWA) face varying difficulties of communication breakdown through different stages of recovery. With speech-language therapy, significant recovery may be seen at unitary levels, but the ultimate success of therapy is evident when the PWA uses all of the units as a whole and is able to communicate optimally to sustain social identities. An individualized intervention program as the focus, a protocol is proposed with seven semi-structured interviews aimed at eliciting discourse incorporating the philosophies of the social model, LPAA, SCA, AphasiaBank Protocol, and Protocol to Measure Participation of Persons with Aphasia. The interviews with the PWA and their communication partners in individual and joint sessions can help the clinician answer questions regarding the PWA's physical abilities, dietary issues, functional independence, personal traits, relationships at home, different social roles played, and subsequently plan a treatment program, and track the holistic recovery of the PWA.

Behavioral Approach to Speech, Language, Hearing, and Communication Disorders

This chapter seeks to outline the overarching scenario of behavioral approaches to developmental and childhood speech, language, hearing, and communication disorders. By adopting the dichotomy of skill and problem behaviors, the steps or sequence, procedures, and practices of behavioral assessment and interventions are explained. While doing so, the uniquely Indian cultural underpinnings are highlighted with evidence-based empirical supports for the optimal benefits of the affected individuals. Additionally, two separate segments are focused on guidelines for skill training and problem behavior management along with case illustration on the format for their mapping procedures. The concluding section covers a critique of this approach which continues to hold promise for some more explorations in the contemporary circumstances for the optimum habilitation of these affected individuals.

Stress and Anxiety Among Parents of Children With Communication Disorders

Parenting is a wonderful and rewarding experience, but in the case of parents of children with communication disorder, this experience is often accompanied with high levels of stress, due to difficulties, frustrations, and challenges that these parents face in everyday life. This chapter was carried out to find the status of stress in parents of children with communication disorder and also to find the levels of stress among mothers as well as fathers, and the level of support system available. The results revealed that most of the parents experience stress and anxiety in bringing up their child with communication disorder, although the stress being more in the mothers. Gender of the child also played a crucial role in determining the levels of stress. The results highlighted the fact that parents of children with autism spectrum disorder have a higher level of stress followed by parents of children with intellectual disability, multiple disability, and hearing impairment.

Mothers as Advocates of Social Inclusion for Children With Communication Disorders

Social inclusion is based on acceptance and belonging irrespective of any status, disability, or disadvantage. The ability to communicate empowers humans in their quest for social inclusion. However, children challenged by communication disorders struggle to form friendships and make inroads into social groups. Mothers, the primary caregivers in most instances, with their intimate knowledge of their children, are considered the best advocates. This study set out to identify strategies that mothers engage in to pave the way for successful social inclusion of children with communication disorders. An online survey was conducted in different geographical locations. Mothers with children aged 6-13 years who had received speech therapy or are currently receiving speech therapy were invited to participate. Data were analyzed using a mixed methods approach. Outcomes suggest that all mothers believe in social inclusion despite facing a range of inclusion and exclusionary practices. Undeterred by these responses, mothers advocate for social inclusion by engaging in a range of strategies.

Selective Mutism

Selective mutism is a disorder that is characterized by a failure to speak in certain social settings, like the school, while speaking normally in other settings, like home. The settings in which the failure to speak occur are those where speech is expected from the individual. It is a disorder that onsets in childhood, and if left untreated, may go well into adolescence. For a very long time, this disorder has been overlooked and understudied. Though rare, the disorder may pose a potential threat to the social and academic development of a child suffering from it. The DSM-5 has classified selective mutism as an anxiety disorder. The present chapter intends to cover the psychosocial approach to the disorder, the diagnostic criteria, the etiology, the treatment of the disorder, and the management by respective caregivers. An analysis of case studies has also been given in the chapter.