Family members, who provide 70% to 80% of all long-term care, have often been perceived by occupational therapists as a barrier to, rather than a partner in, effective care for elderly persons. This perception suggests that in order to build effective partnerships to manage complex issues, occupational therapists working with elderly persons must develop effective strategies for involving family members in the therapeutic process. This article describes a pilot study that examined how occupational therapists engage family caregivers of elderly persons receiving home care services. A qualitative descriptive approach was used to explore the behaviors demonstrated by two occupational therapists when working with family caregivers. The findings point to four primary types of occupational therapist-caregiver interaction, categorized as: caring, partnering, informing, and directing. These interaction styles were compared with current literature describing state-of-the-art occupational therapy practices with older adults and family caregivers. An emphasis was placed on examining how therapeutic interactions can evoke different caregiver responses and influence the development and maintenance of collaborative therapeutic relationships. The results of this pilot study can serve as a framework for further exploration of interactive strategies that promote caregiver empowerment and ultimately influence the ability of families to assume responsibility for the long-term care required by many chronically disabled older adults.

Purpose: The purpose of this study is to characterize the local (utterance-level) temporal regularities of child-directed speech (CDS) that might facilitate phonological development in Spanish, classically termed a syllable-timed language. Method: Eighteen female adults addressed their 4-year-old children versus other adults spontaneously and also read aloud (CDS vs. adult-directed speech [ADS]). We compared CDS and ADS speech productions using a spectrotemporal model (Leong & Goswami, 2015), obtaining three temporal metrics: (a) distribution of modulation energy, (b) temporal regularity of stressed syllables, and (c) syllable rate. Results: CDS was characterized by (a) significantly greater modulation energy in the lower frequencies (0.5–4 Hz), (b) more regular rhythmic occurrence of stressed syllables, and (c) a slower syllable rate than ADS, across both spontaneous and read conditions. Discussion: CDS is characterized by a robust local temporal organization (i.e., within utterances) with amplitude modulation bands aligning with delta and theta electrophysiological frequency bands, respectively, showing greater phase synchronization than in ADS, facilitating parsing of stress units and syllables. These temporal regularities, together with the slower rate of production of CDS, might support the automatic extraction of phonological units in speech and hence support the phonological development of children. Supplemental Material: https://doi.org/10.23641/asha.21210893

Human neurocognitive mechanisms track the acoustic temporal landmarks of the speech signal to enable comprehension. It is also well-known that adults adapt their speech when addressing children to facilitate comprehension. However, the temporal statistics of child-directed speech (CDS) have not been directly contrasted with those of adult-directed speech (ADS) to specify to what extent they can be exploited by the emergent phonological systems of children. In the present study, we analyzed the temporal regularities of spontaneous and read speech productions of 18 Spanish-speaking women addressing adults (ADS) and children (CDS). We focused on three related metrics of the temporal organization of speech: prosodic and syllabic salience (through the modulation spectrum), regularity of stressed syllables (in terms of delta-theta amplitude modulation phase synchronization), and syllable rate (syllables per second). We found that, while CDS and ADS overlap to a big extent in their modulation spectra and both show syllabic salience, CDS is characterized by a higher regularity of stressed syllables and a slower syllable rate than ADS. These temporal regularities of CDS make it highly supportive to the phonological development of children. Together with previous IDS and ADS findings, our CDS results help to delineate developmental changes in the temporal acoustic speech statistics that human neurocognitive systems need to map for efficient language comprehension across the lifespan.

Reading involves mapping combinations of a learned visual code (letters) onto meaning. Previous studies have shown that when visual word recognition is challenged by visual degradation, one way to mitigate these negative effects is to provide "top-down" contextual support through a written congruent sentence context. Crowding is a naturally occurring visual phenomenon that impairs object recognition and also affects the recognition of written stimuli during reading. Thus, access to a supporting semantic context via a written text is vulnerable to the detrimental impact of crowding on letters and words. Here, we suggest that an auditory sentence context may provide an alternative source of semantic information that is not influenced by crowding, thus providing "top-down" support cross-modally. The goal of the current study was to investigate whether adult readers can cross-modally compensate for crowding in visual word recognition using an auditory sentence context. The results show a significant cross-modal interaction between the congruency of the auditory sentence context and visual crowding, suggesting that interactions can occur across multiple levels of processing and across different modalities to support reading processes. These findings highlight the need for reading models to specify in greater detail how top-down, crossmodal and interactive mechanisms may allow readers to compensate for deficiencies at early stages of visual processing.

When a second CI is not a consideration, a contralateral HA should be pursued as the standard of care for prelingually deaf adults despite substantial auditory deprivation in the previously unaided ear, unpleasant sensations at initial HA fit, or lack of dramatic objective test gains. Frequent audiologist contact, repeated HA adjustments, and client journals are valuable in promoting favorable outcomes with bimodal hearing (adaptation, acceptance, and benefit) for this population.

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Aural rehabilitation and speech-language therapy is described for severe-to-profoundly deaf, college-age students. Students in therapy are often cochlear implant users and are quite variable in spoken communication skills. Individual therapy rationale, techniques, materials, and computer resources are illustrated by 2 audiologists and a speech-language pathologist whose work is collaborative. An illustrative case history is provided.