Susan Balandin

Peer-Mediated Teaching and Augmentative and Alternative Communication for Preschool-Aged Children with Autism.

Abstract Background The aim of this study was to assess the effectiveness of two communication interventions for preschool-aged children with autism. Method Six typically developing peers were taught to implement peer-mediated naturalistic teaching, with and without a speech generating device (SGD), during play sessions with 3 classmates with autism in three preschools. Generalisation probes were conducted during mealtimes at the preschools. A multiple baseline design was used to assess the outcomes of the two intervention conditions. Results All 3 children with autism increased their communicative behaviours immediately following the introduction of the two interventions, and generalised these increases to mealtime interactions with their peers. However, only 1 child maintained these increases in communication. Conclusion These results provide preliminary evidence for the effectiveness of combining peer-mediated naturalistic teaching with the use of SGDs for preschool-aged children with autism. Suggestions for improving the maintenance of intervention effects are provided.

The Kirkpatrick model: A useful tool for evaluating training outcomes.

Abstract Background Services employing staff to support people with disability usually provide training in a range of areas including communication and managing challenging behaviour. Given that such training can be costly and time-consuming, it is important to evaluate the evidence presented in support of such programs. Efficacy in clinical practice is measured using evidence-based practice. However, there is currently no model that is widely used to compare and evaluate training programs despite the large number of training programs reported each year. Method Six studies published in the last decade that reported the outcomes of communication-based training and six that reported on the outcomes of challenging behaviour training were evaluated using the 4-level Kirkpatrick model. Results Comparison of the levels of evidence is made for these 12 studies. Conclusion The Kirkpatrick model provides one technique for appraisal of the evidence for any reported training program and could be used to evaluate whether a training program is likely to meet the needs and requirements of both the organisation implementing the training and the staff who will participate.

Adults with cerebral palsy: What’s happening?

A total of 279 adults with cerebral palsy from across Australia responded to a survey which sought information about their health, modes of communication, access to information and perception of their own ageing process. Results indicated that 77% of the respondents believed that their physical condition was changing and 78% were taking medication. All but 11% indicated that the ageing process was having some effect on their lifestyle. A total of 22% had made retirement plans. Respondents discussed their health concerns with their family or attendants and 57% judged their general practitioner knowledgeable about cerebral palsy. The implications of the results for future service planning and delivery are considered.

Twelve tips for effective international clinical placements

As universities adopt an increasingly international focus, student health professionals are keen to gain clinical experiences in other countries. Such clinical placements provide students with the opportunity to share their knowledge and at the same time acquire new clinical and cultural skills. The experience gained will not only enhance their clinical practice overseas, but will also enhance it in their home country where they are likely to work with people from culturally, linguistically and clinically diverse backgrounds. Careful preparation and adequate supports are critical if students and the host institutions are to gain maximum benefit from cross-cultural clinical placements. The tips below are based on an ongoing collaboration between the Indian Institute of Cerebral Palsy, Kolkata, India and The University of Sydney, as well as recommendations from the burgeoning literature on international clinical placements. The authors are from both the sending and the receiving institutions, and have found that close collaboration between the home and host institutions along with student reflection, evaluation and the opportunity to integrate new knowledge with other clinical experiences are keys to a satisfactory outcome for all concerned.

Crews, Wusses, and Whoppas: Core and Fringe Vocabularies of Australian Meal-Break Conversations in the Workplace

Conversational samples were collected from 34 nondisabled subjects across four worksites. The total sample was analyzed for core vocabulary, and the five most frequently referenced topics were analyzed for core and fringe vocabularies and the commonality of fringe vocabulary across topics. The results indicated that there was a small stable core vocabulary of 347 words containing words unique to this study, which accounted for 78% of the conversational sample. A total of 21 words in the fringe vocabulary was common to all topics. Implications of this study for vocabulary selection for augmented communicators in employment are discussed.

The loneliness experiences of young adults with cerebral palsy who use alternative and augmentative communication.

Young adults with cerebral palsy who use augmentative and alternative communication (AAC) systems may be at increased risk of loneliness due to the additional challenges they experience with communication. Six young adults, aged 24–30 years, who used AAC and had cerebral palsy, participated in in-depth interviews to explore their experiences of loneliness as they made the transition into adulthood. A total of five major themes in the data were identified using the constant comparative method of analysis. Three of these themes were discussed by all participants: (a) Support Networks, (b) AAC System Use, and (c) Technology. The authors concluded that these three themes were most important in understanding the experiences of loneliness of the young adults with cerebral palsy who participated in this study.

Post-parental care: a new generation of sibling-carers

Family, friends and neighbours are typically more important in the lives of most people with developmental disabilities than are service agencies and professionals (Prosser & Moss, 1996). There are approximately 9,000 parents over the age of 65 years in Australia who are still living with an adult son or daughter with a disability. Simply put, their greatest concern for the future is ‘‘Who will look after my ‘child’ and in the way that I have done?’’ (Llewellyn, Gething, Kendig & Cant, 2003). The death or incapacity of the parent who has provided a lifetime of love, care and support, coupled with the associated loss of home and surrounding networks, can have a devastating impact on the person with a disability. Few people with a developmental disability living in the parental home marry or have children, and consequently they lack the traditional family members who would support them as they age. This lack of support poses the dilemma of who will provide the person with a developmental disability with the support they may need when their parents die or become too frail to continue supporting them in the family home. Caring, according to Twigg and Atkin (1994), almost always occurs within a context of kinship obligation with an underlying emotion of love between the carer and the person they are caring for and a sense of responsibility by the carer for the cared-for person. A sibling is likely to be the closest relative of the person with a developmental disability when parents die. The main informal network for the person with a disability may now hinge on their sibling relationship. Parents undoubtedly feel both love and responsibility for their offspring. Do siblings share these feelings for each other? According to Cicirelli (1995), the sibling relationship is potentially the longest standing relationship that a human being will have and, as the role of sibling is ascribed rather than achieved, it remains part of a person’s identity regardless of changes in life fortunes or circumstances. As the saying goes: ‘‘you can choose your friends but you can’t choose

Older disabled workers’ perceptions of volunteering

The activity of volunteering is readily available to, and undertaken by, able‐bodied people in Australia and is recognized as a valuable social pursuit, particularly among citizens of retirement age. Despite the known benefits of volunteering, however, there are few reports of disabled people participating as volunteers and little is understood of their experiences or perceptions of volunteering. The aim of this study was to explore how older workers within supported employment settings perceived the opportunities for and barriers to volunteering. Fourteen people with long‐standing impairments participated in this small qualitative study. Overall the participants were positive about volunteering, but noted they might require support to volunteer successfully. Drawing upon the participants’ views, recommendations are made for developing training. Disabled workers facing retirement need to be supported to have opportunities for active participation in the community as volunteers if so desired.

Without AAC: The stories of unpaid carers of adults with cerebral palsy and complex communication needs in hospital

Many adults with cerebral palsy and complex communication needs rely upon the support of their unpaid carers when they are in hospital. In this paper, the authors present some of the findings of a larger qualitative study of the experiences of unpaid carers of hospitalized adults with cerebral palsy and complex communication needs who did not have access to their usual augmentative and alternative communication (AAC) systems. Drawing upon the stories of unpaid carers, communication issues associated with cerebral palsy and complex communication needs and the absence of AAC are discussed. Such information can be used to assist AAC specialists, hospital staff, and hospital policy developers to improve care provided to not only people with cerebral palsy and complex communication needs, but also to other people who are unable to speak in hospital.

A few well-chosen words

Ten professionals (five speech pathologists, three rehabilitation counsellors, and two teachers) participated in a survey to investigate their ability to predict the topics and vocabulary of meal-break conversations at work. Participants selected two topics that they thought were likely to occur during meal-break conversations between nondisabled employees for each day of the week. They selected five key words appropriate to each chosen topic. The topics and key words were analyzed for frequency and commonality and compared to the topics and vocabulary from actual meal-break conversations in the workplace. The professionals accurately predicted some topics that occurred in the actual conversational sample. However, one-third of the key words (33%) predicted by the participants did not occur in the conversational sample. The implications of these findings for vocabulary selection for augmented communicators are discussed.