The study shows that the executors' gaze at the director accompanies important dynamic shifts in the dialogue. The association with requests for clarification indicates that gaze at the director can be used to monitor the response with two modalities. Furthermore, the significantly higher association with requests for previously unmentioned information indicates that gaze may be used to emphasize the verbal content. The results will be used as a reference for studies of gaze behaviour in clinical populations with hearing and language impairments.
Assessment of bilingual children in only one language fails to acknowledge their distributed linguistic competence and has been shown to overidentify language disorder in bilingual populations. However, other factors, sometimes associated with bilingualism, may also contribute to low results in language assessments. Our aim was to examine the impact of these factors on language abilities. We used the Clinical Evaluation of Language Fundamentals – Fourth Edition, Swedish (CELF-4) to investigate core language abilities of 224 7- to 8-year-old children. Results showed 30 and 80% of monolinguals and bilinguals, respectively, performing more than 1 SD below the normative sample mean, calling into question the clinical utility of the test. However, participant and school characteristics provided a deeper understanding of the skewed results. In isolation, bilingualism predicted 38% of the variance in the CELF-4 Core scores. With level of parental education entered the variance explained by the model increased to 52%, but the unique contribution of bilingualism was reduced to 20%. Finally, with information added on school characteristics and enrollment in the school’s recreation center the model explained an additional two percent, with the unique contribution of bilingualism further reduced to 9%. The results indicate an increased risk for low results on the CELF-4 Core when children present with multiple risk factors. This highlights the need to look beyond bilingualism in language assessment of bilingual children and adolescents and to consider other explanations to academic struggle. Available interventions must be considered and applied proportionately to their respective impact on the individual’s development.
Background: This study investigates responses to requests for clarification in conversations between children/adolescents with cochlear implant (CI) and normally hearing peers. Earlier studies have interpreted a more frequent use of requests of confirmation (yes/no interrogatives) in the CI group as a conversational strategy used to prevent communication breakdowns and control the development of the conversation. This study provides a continuation of this line of research, now focusing on responses to requests for clarification. Aims: The aim was to examine the type and distribution of responses to requests for clarification in a referential communication task. In addition, we analysed the compliance between the type of response and the type of request as a measure of mutual adaptation. Methods & Procedures: Twenty‐six conversational pairs aged 10–19 years participated: 13 pairs consisting of a child/adolescent with CI (CI) and a conversational partner (CIP); and 13 pairs consisting of a normally hearing control (NH) and a conversational partner (NHP). The pairs performed a referential communication task requiring the description of faces. All occurrences of requests for clarification and their responses in the dialogues were identified and categorized. We also analysed how the different types of requests and responses were combined and the type‐conformity of the responses to requests for confirmation. Outcomes & Results: The results showed no significant group differences regarding type, distribution or type‐conformity of responses. In all four groups (CI, CIP, NH and NHP), a discrepancy between the request and the response was found, indicating that the response provided information that was not explicitly requested. Requests for confirmation constituted 78–90% of the requests, whereas only 54–61% of responses were confirmations. Conversely, the proportion of requests for elaboration was 6–15%, whereas the proportion of elaborated responses was 34–40%. Conclusions & Implications: The children/adolescents with CI contribute equally to the conversation regarding type and distribution of responses to requests for clarification. The frequent use of elaborated responses indicates common ground for the conversational partners and a shared understanding of the objective of the task. The context creates facilitative conditions, with positive interactional consequences. The results have implications for the design of intervention, where tasks such as this can be used to make children with CI more aware of the role of questioning strategies in interaction.
BackgroundOutcome- or competency-based education is well established in medical and health sciences education. Curricula are based on courses where students develop their competences and assessment is also usually course-based. Clinical reasoning is an important competence, and the aim of this study was to monitor and describe students’ progression in professional clinical reasoning skills during health sciences education using observations of group discussions following the case method.MethodsIn this qualitative study students from three different health education programmes were observed while discussing clinical cases in a modified Harvard case method session. A rubric with four dimensions – problem-solving process, disciplinary knowledge, character of discussion and communication – was used as an observational tool to identify clinical reasoning. A deductive content analysis was performed.ResultsThe results revealed the students’ transition over time from reasoning based strictly on theoretical knowledge to reasoning ability characterized by clinical considerations and experiences. Students who were approaching the end of their education immediately identified the most important problem and then focused on this in their discussion. Practice knowledge increased over time, which was seen as progression in the use of professional language, concepts, terms and the use of prior clinical experience. The character of the discussion evolved from theoretical considerations early in the education to clinical reasoning in later years. Communication within the groups was supportive and conducted with a professional tone.ConclusionsOur observations revealed progression in several aspects of students’ clinical reasoning skills on a group level in their discussions of clinical cases. We suggest that the case method can be a useful tool in assessing quality in health sciences education.
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