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A network is constructed by nodes and links, thus the node degree and the link strength appear as underlying quantities in network analysis. While the power-law distribution of node degrees is verified as a basic feature of numerous real networks, we investigate whether the link strengths follow the power-law distribution in weighted networks. After testing 12 different paper cocitation networks with 2 methods, fitting in double-log scales and the Kolmogorov-Smirnov test ( K- S test), we observe that, in most cases, the link strengths also follow the approximate power-law distribution. The results suggest that the power-law type distribution could emerge not only in nodes and informational entities, but also in links and informational connections. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to analyse Iranian scientific publications in the neuroscience subfields by librarians and neuroscientists, using Science Citation Index Expanded (SCIE) via Web of Science data over the period, 2002-2008. Methods: Data were retrieved from the SCIE. Data were collected from the 'subject area' of the database and classified by neuroscience experts into 14 subfields. To identify the citation patterns, we applied the 'impact factor' and the 'number of publication'. Data were also analysed using HISTCITE, Excel 2007 and SPSS. Results: Seven hundred and thirty-four papers have been published by Iranian between 2002 and 2008. Findings showed a growing trend of neuroscience papers in the last 3 years with most papers (264) classified in the neuropharmacology subfield. There were fewer papers in neurohistory, psychopharmacology and artificial intelligence. International contributions of authors were mostly in the neurology subfield, and 'Collaboration Coefficient' for the neuroscience subfields in Iran was 0.686 which is acceptable. Most international collaboration between Iranians and developed countries was from USA. Eighty-seven percent of the published papers were in journals with the impact factor between 0 and 4; 25% of papers were published by the researchers affiliated to Tehran University of Medical Sciences. Conclusion: Progress of neuroscience in Iran is mostly seen in the neuropharmacology and the neurology subfields. Other subfields should also be considered as a research priority by health policymakers. As this study was carried out by the collaboration of librarians and neuroscientists, it has been proved valuable for both librarians and policymakers. This study may be encouraging for librarians from other developing countries. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the scientific research ability of Chinese specialist nurses (SNs) in the Guangxi Zhuang Autonomous Region and its influencing factors. Design: A cross‐sectional design. Methods: A total of 652 SNs in the Guangxi Zhuang Autonomous Region were investigated from March to October 2021. The nursing scientific research ability level was measured using the Nursing Research Competence of Nurses Self‐evaluation Scale. Descriptive statistics, univariate analysis and ordinal logistic regression analysis were used to evaluate factors affecting the scientific research ability of SNs. Results: The median score of scientific research ability of SNs was 31 (interquartile range: 19–41). Approximately 74.8% of clinical speciality nurses had low scientific research ability. Educational background, working hospital level, being the first author of a published paper and successful application for scientific research projects were identified as factors influencing scientific research ability score. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Understanding the impact of health information technology on doctor-patient interaction is vital to designing better electronic health records ( EHRs). This article quantitatively examines and compares clinically experienced physicians' interactions with patients using paper or EHRs in ambulatory primary care settings. Methods Clinical encounters using paper or EHRs were recorded with high-resolution video cameras to capture physicians' interactions with the health records and patients. All videos were coded using quantified video coding methodology to understand how physicians interacted with EHRs and patients through measuring eye gaze durations. Statistical analysis was conducted to compare the results of the paper and EHR visits. Results Eight experienced family medicine physicians and 80 patients participated in the study. A total of 80 visits, 40 with paper and 40 with EHRs were recorded. The proportion of time physicians spent gazing at medical records during EHR visits was significantly more than in paper chart visits (35.2 versus 22.1%, P = 0.001). A significantly smaller proportion of physician time was spent gazing at the patient when using an EHR compared with when using a paper chart (52.6 versus 45.6%, P = 0.041). Conclusions For this group of family medicine physicians, more time was spent looking at the EHR screen than paper records and a little less time looking at the patient. These findings may negatively affect the patient perception of the visit with the physician and have implications for the design of future EHRs. [ABSTRACT FROM AUTHOR]

In this article, we build models to predict the existence of citations among papers by formulating link prediction for 5 large-scale datasets of citation networks. The supervised machine-learning model is applied with 11 features. As a result, our learner performs very well, with the F1 values of between 0.74 and 0.82. Three features in particular, link-based Jaccard coefficient difference in betweenness centrality, and cosine similarity of term frequency-inverse document frequency vectors, largely affect the predictions of citations. The results also indicate that different models are required for different types of research areas-research fields with a single issue or research fields with multiple issues. In the case of research fields with multiple issues, there are barriers among research fields because our results indicate that papers tend to be cited in each research field locally. Therefore, one must consider the typology of targeted research areas when building models for link prediction in citation networks. [ABSTRACT FROM AUTHOR]

Background: Augmented reality (AR) is receiving increasing interest as a tool to create an interactive and motivating learning environment. Yet, it is unclear how instructional support affects performance in AR. Objectives: This study sought to explore how varying the instructional support in AR can affect performance‐related behaviours of students with low cognitive abilities during assembly work. Methods: A total of 90 Belgian secondary school students repeatedly executed four different realistic assembly tasks. Three levels of instructional support (low, medium, and high) in AR as well as a control condition with paper instructions with a high level of detail were systematically varied across tasks and participants. Results and Conclusions: Multilevel regression analyses showed that AR instructions yielded lower assembly times and a lower perceived physical effort than paper instructions. Additionally, participants perceived tasks as less complex when given AR instructions with a high or a medium level of detail than when given a low level of detail. No effects of instructional support were established for other performance‐related behaviours, namely necessary assistance, error‐making, cognitive load, competence frustration, and stress. Effect sizes were small, at least among the instructional support conditions studied, yielding a limited base for adaptivity. Presumably, tailoring the instructional support in AR is only beneficial for highly complex tasks. The results might be useful for the design and implementation of AR in educational settings. Lay Description: What is currently known about the subject matter: Augmented reality is knowing increased use in education.Little is known about how to design effective instructional support in augmented reality. What this paper adds: This study represents an initial insight into how to personalize instructional support.The impact of instructional support on augmented reality performance of students with low cognitive abilities was investigated.The study suggests that varying instructional support may lead to differences in performance outcomes. Implications for practitioners: How instructional support is constructed may affect augmented reality learning.The results may inform the design of effective augmented reality learning environments for students with special needs.How individual, contextual, and task‐specific characteristics moderate the effectiveness of instructional support should be further investigated. [ABSTRACT FROM AUTHOR]

Background: People with an acquired brain injury (ABI) find it challenging to use social media due to changes in their cognition and communication skills. Using social media can provide opportunities for positive connection, but there is a lack of interventions specifically designed to support safe and successful social media use after ABI. Aims: To investigate the outcomes of completing a social media skills intervention and identify barriers and facilitators for future implementation. Methods & Procedures: The study used a mixed‐methods, pre‐post‐intervention design. A total of 17 adults with an ABI were recruited. Participants completed an intervention that included a short self‐guided course about social media skills (social‐ABI‐lity course), and then participated in a private, moderated Facebook group over a 12‐week period (social‐ABI‐lity Facebook group). Data were collected over this period through observation of group activity and weekly surveys. They were also collected on social media use and quality of life at pre‐intervention, post‐intervention and after 3 months. Participants provided feedback on the experience of participating in the programme via a post‐intervention interview. Outcomes & Results: At post‐intervention, there were significant improvements in confidence in using Facebook (p = 0.002) and enjoyment of using Facebook to connect with others (p = 0.013). There was no significant change in reported quality of life, although participants described the multiple benefits of connection they perceived from involvement in the group. Observational data and feedback interviews were informative about the feasibility and acceptability of the intervention. Conclusions & Implications: This pilot study provided preliminary evidence that an intervention comprising a short, self‐guided training course and a private, moderated Facebook group improved outcomes for people with ABI. Key recommendations for future implementation include embedding active peer moderators within groups and taking an individualized approach to delivery of the intervention. WHAT THIS PAPER ADDS: What is already known on the subject: Research has documented the challenges that people with ABI experience in using social media, and the difficulty for rehabilitation clinicians in providing appropriate support in this field. What this paper adds to existing knowledge: This pilot study reports the outcomes of people with ABI completing a short, self‐guided social media skills course and participating in a private, moderated Facebook group. After the intervention, participants reported significantly increased confidence and enjoyment in using Facebook, described the benefits of connection found in the groups, and suggested potential improvements for future implementation. What are the potential or actual clinical implications of this work?: With the growing use of social media for connection and participation, there is a professional obligation to address social media communication skills in cognitive–communication rehabilitation for people with ABI. The findings of this study will inform interventions and future research to assist people with ABI to build their social media skills for communication, social support and a sense of connection. [ABSTRACT FROM AUTHOR]

Purpose Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. Methods We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Findings Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. Conclusions Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. [ABSTRACT FROM AUTHOR]

Women veterans (WV) are the fastest growing veteran subpopulation and recognized to be at increased risk for suicide compared with civilians. Improving engagement (e.g., response rates) of WV in survey research is critical to ensuring valid and generalizable findings, which can inform suicide prevention programs tailored for this population. Many factors are known to influence response rates, yet little is known about ways to optimize survey response rates among WV. Three recruitment cohorts (Waves 1 [W1], 2a [W2a], and 2b [W2b]) of WV were invited to participate in an online survey for a national, mixed‐methods study examining suicide risk among WV using reproductive health care services paid for or provided by the Veterans Health Administration. To examine the effects of enhanced recruitment efforts, standard recruitment materials were mailed to all three cohorts, with the additions of: a study flyer aiming to build trust between participants and researchers (W2a, W2b) and a paper survey (W2b). Characteristics of responders and non‐responders were compared by wave and across survey modalities. Response rates were significantly higher for groups receiving enhanced (W2a = 17.1%; W2b = 24.6%) versus standard (W1 = 12.2%) recruitment materials. WV residing in rural areas were significantly more likely to respond by paper (37.1%) than online (19.8%). Non‐respondents were disproportionately racial and ethnic minorities. Disclosure of sensitive information (e.g., military sexual trauma) did not differ by survey modality. Findings suggest that enhanced recruitment materials improve survey response rates among WV, an important consideration for future research with this population. [ABSTRACT FROM AUTHOR]

Background: Maintaining cohesion is critical for teams to achieve shared goals and performance outcomes within a work‐integrated learning (WIL) environment. Cohesion is an emergent state that develops over time, representing the synchrony of different behavioural interactions. Cohesive teams will exhibit such phenomena by their temporal coordination of micro‐level relations. Objectives: The primary aim of this study is to examine the cohesion of teams in learning environments using a learning analytics approach. Method: This study examines teams from higher education who participate in a WIL environment platform working in teams to develop their collaborative problem‐solving skills. Here we show that temporal network motifs can be used as a proxy to measure cohesion. Results and Conclusions: We illustrate three clusters represented by team learning behaviours and found that each cluster has distinctive interactions with learning resources, performance outcomes, temporal network motif group characteristics and emergence over time using learning analytics. Implications: Applying temporal motifs as an analytics‐based measure of cohesion is a starting point for understanding how cohesion develops over time without relying on surveys. We anticipate that the same approaches can be applied in most learning management systems containing trace data of teams and their interactions with learning resources to understand cohesion. Lay Description: What is already known about this topic?: The development of team cohesion has been widely studied for decades in face‐to‐face educational contexts but remains underexplored in online environmentsObtrusive tools, such as questionnaire instruments are still the primary method used to examine team cohesionTeam cohesion is an emergent state that changes over time, representing the synchrony of different behavioural interactionsResearch that explores and examines the temporality of cohesion as it unfolds in team learning is limited What this paper adds?: Underlines how emerging team behaviours are characterised by their engagement, performance and cohesion development using temporal network motifsPresents an analytics‐based measure to examine cohesion using temporal network motifs as a proxyProvides a learning analytics approach for researchers and instructors to evaluate cohesion in online learning environments through online learner trace data The implications of study findings for practitioners: The paper provides insights into distinct teams with emerging learning behaviours, performance associations and cohesion in an online learning platform.The paper provides instructors with a way to monitor and support a team's cohesion over time by examining the way temporal motifs occur.The paper offers a new avenue to understanding learner engagement beyond summarisations [ABSTRACT FROM AUTHOR]

Background: Continued professional development (CPD) is required for updated skills and knowledge. This study evaluates the efficacy of a CPD programme for mainstream school teachers. Aims: In an 11‐week intervention programme, speech–language therapists (SLTs) presented the participating teachers with whole‐class teaching techniques aimed at creating a language and communication‐supporting classroom environment. The effects of the intervention on the language development of the students in the teachers' classes were assessed. Methods & Procedures: A total of 211 first‐ and second‐year students (Mage = 7;6, range = 6;5–8;9) underwent standardized language assessments of receptive and expressive language abilities before and after their teachers' participation in the CPD. The students were divided into intervention and delayed intervention groups to enable randomized intervention allocation. Linear mixed modelling was used to estimate the individual and interaction effects of group, time and demographic factors. Outcomes & Results: Significant effects of time, group and school, respectively, but no interaction between time and group indicates that while all students advanced between assessments, the progress was not attributable to the teachers' participation in the CPD. Conclusions & Implications: Results are discussed in light of those of recent studies of universal services to support optimal language development. WHAT THIS PAPER ADDS: What is already known on this subject: Although inconclusive, previous research indicates that intervention delivered to teachers by SLTs has the potential to improve the language abilities of the students in the teachers' classrooms. What this paper adds to existing knowledge: This study explored the language development of first‐ and second‐year mainstream school students whose teachers took part in a CPD programme aimed at establishing language and communication‐supporting teaching techniques. Results indicate that the development of the students' language abilities could not be attributed to the teachers' participation in the CPD. What are the potential or actual implications of the work?: SLTs are often asked to guide teachers and teaching staff rather than themselves conduct individual assessments and interventions. The results of this trial can be used to inform the discussion on how to prioritize between tasks. [ABSTRACT FROM AUTHOR]

Background: Early and effective treatment for children with developmental language disorder (DLD) is important. Although a growing body of research shows the effects of interventions at the group level, clinicians observe large individual differences in language growth, and differences in outcomes across language domains. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking. Aims: To assess changes in the language domains: expressive morphosyntax; receptive and expressive vocabulary; and comprehension, in children in special needs education for DLD. To explore if differences in language gains between children are related to child characteristics: language profile; severity of the disorder; being raised mono‐ or multilingually; and cognitive ability. Methods & Procedures: We extracted data from school records of 154 children (4–6 years old) in special needs education offering a language and communication‐stimulating educational environment, including speech and language therapy. Changes in language were measured by comparing the scores on standardized language tests at the beginning and the end of a school year. Next, we related language change to language profile (receptive–expressive versus expressive‐only disorders), severity (initial scores), growing up mono‐ and multilingually, and children's reported non‐verbal IQ scores. Outcomes & Results: Overall, the children showed significant improvements in expressive morphosyntax, expressive vocabulary and language comprehension. Baseline scores and gains were lowest for expressive morphosyntax. Differences in language gains between children with receptive–expressive disorders and expressive‐only disorders were not significant. There was more improvement in children with lower initial scores. There were no differences between mono‐ and multilingual children, except for expressive vocabulary. There was no evidence of a relation between non‐verbal IQ scores and language growth. Conclusions & Implications: Children with DLD in special needs education showed gains in language performance during one school year. There was, however, little change in morphosyntactic scores, which supports previous studies concluding that poor morphosyntax is a persistent characteristic of DLD. Our results indicate that it is important to include all children with DLD in intervention: children with receptive–expressive and expressive disorders; mono‐ and multilingual children, and children with high, average and low non‐verbal IQ scores. We did not find negative relations between these child factors and changes in language skills. WHAT THIS PAPER ADDS: What is already known on the subject: Intervention studies indicate that intervention can be effective, but not for all children with DLD, and not in all language domains. Longitudinal studies on language development show stable growth patterns in children with DLD at the group level. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking. What this paper adds to existing knowledge: In this study, we report on the language gains of a cohort of 154 children with DLD (4–6 years old), in a special education setting for children with language disorders. Our sample includes children with receptive–expressive disorders and expressive‐only disorders, and monolingual as well as multilingual children. Our results show that children's language skills improved. The co‐normed tests we used revealed that the children had much lower growth in morphosyntax than in the other language domains. Language gains between children with receptive–expressive and expressive‐only language disorders did not differ, children with lower initial test scores showed more improvement than children with higher initial scores, multilingual children showed more gains in expressive vocabulary than monolingual children, and there was no effect of non‐verbal IQ on change in language scores. What are the potential or actual clinical implications of this work?: The results suggest that catching up on language is possible for children with DLD. It is important to include all children with DLD in intervention: mono‐ and multilingual children; children with receptive–expressive and expressive disorders; and children with high, average and low non‐verbal IQ scores. We did not find negative relations between these child factors and changes in language skills. The limited growth in morphosyntax compared with other linguistic areas warrants the attention of both practitioners and researchers, with a particular focus on the implementation of research findings in clinical practice. [ABSTRACT FROM AUTHOR]

Recent research has stated that early oral language acquisition difficulties are related to reading and writing difficulties. Children with developmental language disorder (DLD) experience difficulties with several dimensions of language. In this study we focus on the specific difficulties of children with DLD in spelling. We examine the impact of lexicality and length in written production of Spanish‐speaking children with DLD. A total of 18 children with language difficulties (Mage = 8;4) were compared with age‐matched children (Mage = 8;2). Participants completed a spelling‐to‐dictation task of words and pseudo‐words, where length was manipulated. A digital tablet was used to collect data and obtain measures of accuracy, latencies and total writing durations. Results showed that children with DLD produced more errors, longer latencies and longer writing durations than age‐matched children. Regarding accuracy, analysis of the errors shows that children in the control group produce few errors, most being substitutions, while children with DLD made more errors and of more varied categories. Moreover, they were more affected by length on writing accuracy than the control group. WHAT THIS PAPER ADDS: What is already known on this subject: Children with language difficulties are more likely to present reading difficulties. There are fewer studies analysing the impact of oral language difficulties in writing skills. What this paper adds to existing knowledge: The study suggests that children with oral language difficulties also have impairments in spelling, impacting on accuracy, duration and reaction time, possibly related to poor phonological working memory. What are the potential or actual clinical implications of this work?: This study highlights the need to emphasize early oral intervention and language‐related processing skills to help prevent written language difficulties. [ABSTRACT FROM AUTHOR]

Background: Communication difficulties are common in people with dementia, and often present from an early stage. However, direct treatment options for people with dementia that positively influence their daily communication are scarce. Aims: To evaluate the potential impact and feasibility of a personalized logopaedic intervention. Methods & Procedures: A total of 40 community‐dwelling persons with dementia and their caregivers were recruited. Five experienced speech and language therapists (SLTs) delivered the six‐session Com‐mens intervention at home. Com‐mens aims to improve positive communication between people with dementia and their primary caregivers and comprises five elements: interactive history‐taking, dynamic observational assessment, education about the consequences of dementia on communication, development and use of personalized communication tools, use motivational, and person‐centred strategies by the SLT. We conducted a single‐group mixed‐methods pilot study with five measurements: baseline, directly after intervention, and at 3, 6 and 9 months follow‐up. Semi‐structured interviews and questionnaires for Experienced Communication in Dementia, quality of life, psychological well‐being and caregiver burden were conducted. Process evaluation was performed by interviewing participants, drop‐outs, SLTs and other stakeholders. Outcomes & Results: A total of 32 dyads completed the intervention. Repeated measures analyses revealed no significant changes over time. In the interviews, participants reported a positive impact on their feelings, increased communication skills and better coping with the diagnosis. Participants would recommend the intervention to others. Facilitators were timely delivery, personalized content and adequate reimbursement. Barriers were unfamiliarity with Com‐mens among referrers, an overburdened caregiver or disrupted family relationships. Conclusions & Implications: This newly developed logopaedic intervention is feasible and has a perceived positive impact on both people with dementia and their caregivers, which is confirmed by a stable pattern over a period of 1 year. Future comparative studies are needed to test the effectiveness of personalized interventions in this patient population. What this paper adds: What is already known on the subject?: SLTs are experts in the field of communication, but even though communication problems are common between people with dementia and their caregivers, there is a lack of logopaedic guidelines and materials for the direct treatment for this population. Interventions that are available either focus on (professional) caregivers only or aim to enhance cognitive functioning and do not target on joined communication. What this paper adds to the existing knowledge?: A newly developed intervention called Com‐mens can be provided by trained SLTs and takes an average of six 1‐h sessions. The intervention is perceived to be valuable and feasible for people with dementia and their caregivers, by the participants themselves, as well as by healthcare professionals and other stakeholders. What are the potential or actual clinical implications of this work?: Dissemination of this intervention will give SLTs skills, tools and materials to provide meaningful care to home‐dwelling persons with dementia and their caregivers. Also, persons with dementia and their caregivers will receive education and materials that can help them increase their understanding of communication problems, enhance their communication skills and better cope with the communication problems that result from dementia. We consider the Com‐mens intervention to be a valuable addition to the field of speech language therapy and dementia. [ABSTRACT FROM AUTHOR]

Purpose: Communicative participation poses a challenge in meetings between healthcare professionals (HCPs) and people with aphasia (PwA). How communication is affected by aphasia in group meetings, where several healthcare professionals participate together with the patient, is largely unexplored. The aim of this study was to investigate self‐rated communicative participation during goal‐setting meetings among PwA compared to patients without aphasia and to investigate whether communicative participation among PwA was associated with self‐rated knowledge about aphasia among HCPs. A further aim was to investigate if there was a difference in the use of communication strategies among HCPs in the respective situations. Methods: Nine PwA and nine control patients without aphasia rated their experience of communication during a goal‐setting meeting. Thirty‐eight HCPs rated their knowledge about aphasia and communication, and their use of communication strategies during goal‐setting meetings. Results: The PwA reported being listened to by the HCPs as well as being able to comprehend the meeting. PwA with more severe language impairment did not report a lower level of communicative participation compared to PwA with milder impairment. Half of the patients from both groups indicated some difficulty asking questions during the meeting. Patients' ratings of communication were not correlated to HCPs' knowledge of communication strategies. There was a significant difference in self‐rated use of communication strategies among HCPs for the two conditions, although the individual variation was large. Conclusion: Results from both PwA and controls imply that patients may need more support to be able to ask questions in meetings with HCPs. Although self‐ratings increase the ecological validity of the study of participation, further studies could benefit from using video observations in combination with self‐reported experience, since awareness might influence results. What this paper ads: What is already known on this subject: Aphasia is an acquired language disorder that affects patient–provider communication. In stroke rehabilitation, person‐centred goal setting is a key component. If healthcare professionals (HCPs) are not able to use adequate communication strategies, a lack of accessible communication can become a barrier to person‐centredness. There are evidence‐based communication strategies which can be used to overcome this barrier. What this paper adds to existing knowledge: This study aimed to investigate communicative participation during goal‐setting meetings from the perspective of patients with aphasia and HCPs. To our knowledge, this is the first study where persons with aphasia are asked to rate communicative participation in goal‐setting meetings. To broaden the perspective on communication and goal setting, ratings of patients with aphasia are compared to ratings by patients with stroke but no aphasia. The results of this study indicate that there is room for improvement regarding communication during goal‐setting meetings. However, asking direct questions on communicative participation to persons with severe aphasia may not be feasible. What are the potential or actual clinical implications of this work?: The results of this study imply that both patients with and without aphasia may need more support to be able to express themselves during goal‐setting meetings. There also seems to be a need for further education on aphasia and communication strategies among rehabilitation professionals. [ABSTRACT FROM AUTHOR]

Background Proper scientific reporting is necessary to ensure the correct interpretation of study results by readers. The main objective of this study was to assess the quality of reporting in abstracts of systematic reviews ( SRs) with meta-analyses in periodontology and implant dentistry. Differences in reporting of abstracts in Cochrane and paper-based reviews were also assessed. Methods The Pub Med electronic database and the Cochrane database for SRs were searched on November 11, 2012, independently and in duplicate, for SRs with meta-analyses related to interventions in periodontology and implant dentistry. Assessment of the quality of reporting was performed independently and in duplicate, taking into account items related to the effect direction, numerical estimates of effect size, measures of precision, probability and consistency. Results We initially screened 433 papers and included 146 (127 paper-based and 19 Cochrane reviews, respectively). The direction of evidence was reported in two-thirds of the abstracts while strength of evidence and measure of precision (i.e., confidence interval) were reported in less than half the selected abstracts. Measures of consistency such as I2 statistics were reported in only 5% of the selected sample of abstracts. Cochrane abstracts reported the limitations of evidence and precision better than paper-based ones. Two items ('meta-analysis' in title and abstract, respectively), were nevertheless better reported in paper-based abstracts. Conclusion Abstracts of SRs with meta-analyses in periodontology and implant dentistry currently have no uniform standard of reporting, which may hinder readers' understanding of study outcomes. [ABSTRACT FROM AUTHOR]

Background: Writing is an important and complex skill, which could be enhanced by teaching students effective writing strategies such as outlining. Electronic outlining ‐ integrated feature in Microsoft® Word – has been shown to enhance students' writing performance. However, little is known about the optimal didactic approach for electronic outlining. Objective: This study examined the effects of learning to use electronic outlining either via observational learning or via learning‐by‐doing on students' argumentative writing performance. Methods: Students (N = 129, 10th‐grade) were assigned with their complete class to one of three conditions: a control (traditional pen and paper outlines via learning‐by‐doing), outline (electronic outlines via learning‐by‐doing) or observation (electronic outlines via observational learning) condition. Students followed an argumentative writing lesson‐series that differed across conditions in terms of planning strategies and didactic approaches used. To examine the influence of the different conditions on students' writing, argumentative texts were used as pre‐ and post‐tests, and the quality was evaluated with an analytic assessment protocol. In addition, data regarding students' perceived mental effort and the organisation of the writing process were collected. Finally, students' attitudes towards electronic outlining were assessed. Results and Conclusion: Although the overall text structure had improved after the lesson series, no significant differences were found between conditions. Electronic outlining increased the total amount of time dedicated to the texts as well as the revision ratio. Students in the observation condition showed a higher pause ratio and a lower fluency on the post‐test as compared to students who learned by doing (both control and outline conditions). With regard to perceived mental effort, students in the outline and control conditions perceived significant decreases over tasks, as opposed to those in the observation condition. In conclusion, the self‐reports indicate that students in the outline condition appropriated electronic outlining significantly better than those in the observation condition, suggesting that practice enhanced students' appropriation of electronic outlining. Lay Description: What is already known about this topic: Planning as a writing strategy helps students organise their writing and reduce mental effort.Electronic outlining is an effective and efficient tool to support a planning strategy.Observational learning is an effective didactic approach in writing education. What this paper adds: Traditional planning and electronic outlining via either observational learning or learning‐by‐doing affect writing products equally.Tool appropriation is greater for students who learned‐by‐doing. Implications for practice: Importance of elaborated and explicit (strategy) instruction.Advantage of video‐based modelling for teacher efficiency. [ABSTRACT FROM AUTHOR]

Background: Aims: To investigate the developmental trajectory of the rate and perceptual assessment of oral diadochokinesis (DDK) in typically developing children compared with adults. Also to examine the characteristics of DDK productions in children with speech sound disorders (SSD) and the relationship between DDK production and percentage of consonants correct (PCC). Methods & Procedures: Participants were 316 typically developing children and 90 children with SSD from 3 to 9 years old, as well as 20 adults with normal speech. The mono‐, bi‐ and trisyllabic nonsense strings containing Korean tense consonants and the vowel [a] were used for DDK tasks. The number of iterations per s was measured as the DDK rate for each stimulus. The perceptual assessment of DDK productions was also performed for regularity, accuracy and rate. Outcomes & Results: The DDK rates increased throughout childhood, but the oldest children, 9‐year‐olds in the current study, did not achieve adult‐like rates for all mono‐ and trisyllabic strings. Children with SSD also did not show significant differences from typically developing children when the DDK productions were analysed using only accurate tokens. The PCC of children with SSD showed higher correlations with regularity, accuracy and rate of perceptual ratings than the timed DDK rate. Conclusions & Implications: This study highlighted the fact that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills. WHAT THIS PAPER ADDS: What is already known on the subject: Rates of DDK reflect the motor skills of the articulatory systems independently of phonological skills; therefore, the tasks are widely used in the diagnostic evaluations of speech disorders in both children and adult populations. However, a substantial number of studies have questioned the validity and usefulness of DDK rates for evaluating speech abilities. Also, the literature suggested that the measure of DDK rate alone does not provide a clear and useful indication of children's oral motor skills. DDK tasks should be analysed in terms of accuracy and consistency as well as rate. What this paper adds to the existing knowledge: The literature reporting normative DDK performance has mainly been based on English speakers. As different consonants have different temporal characteristics, the linguistic and segmental features of DDK tasks can impact the DDK rate. This study established a norm for DDK rate for Korean‐speaking children and investigated the developmental trajectory of DDK performance in typically developing children compared with adults. This study suggested that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills by examining the characteristics of DDK productions in children with SSD. What are the potential or actual clinical implications of this work?: This study provided normative data of young Korean‐speaking children aged 3–9 years. Normative data in children under 5 years of age are valuable given that the majority of children referred for speech difficulty assessments are between 3 and 5 years of age, but only a few studies have provided the normative data in young children. This study showed that many children could not complete DDK tasks correctly and provided additional support for the notion that other aspects of DDK performance, including accuracy and regularity, may yield more useful diagnostic indications than timed DDK rates alone. [ABSTRACT FROM AUTHOR]

Background: Reading comprehension is frequently impaired in persons with aphasia (PWA). For goal‐setting and outcome measurement, speech and language therapists (SLTs) need to determine an individual's perspective of their reading difficulties and everyday reading activities. The Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire provides a person‐centred tool to find out the individual perception of reading functions, reading‐related emotions and reading activities in PWA. It was developed and evaluated in English. So far, there is no equivalent instrument in German. Aims: To translate and adapt the CARA reading questionnaire into German language and culture, to evaluate its practicability and acceptance, and to provide the first psychometric properties of the German version. Methods & Procedures: Based on translation and adaptation guidelines, we conducted two forward translations that were merged and then adapted. A back translation was prepared and compared with the original version. It was found to be semantically equivalent by one of the authors of the original version. We performed pilot testing with 12 PWA, and the pilot version was adapted according to the comments of these participants. We then collected data on self‐reported perception of reading and on psychometric properties of the translated and adapted German version. A total of 22 German‐speaking PWA completed the questionnaire at least five times during an intervention study. We analysed retest reliability with Spearman correlation, internal consistency with Cronbach's alpha, internal responsiveness with the standardized response mean, as well as the relationship between outcomes of the questionnaire and text comprehension measures using repeated measures correlations. Outcomes & Results: Our data suggest good practicability and acceptance of the German version of the CARA reading questionnaire as well as appropriate validity, reliability and sensitivity to measure therapy‐induced change. We found moderate correlations between outcomes of the questionnaire and text‐level reading speed. Conclusions & Implications: The German version of the CARA reading questionnaire could be helpful in intervention planning and goal‐setting with German‐speaking PWA. By using the questionnaire, SLTs can find out about a person's individual perception of reading difficulties as well as individually relevant reading activities. The questionnaire provides a tool to measure change and is therefore valuable to demonstrate self‐reported individual progress. As reading speed seems to be an indicator of personal perception of reading difficulty, it is important to consider reading speed in reading interventions and in reading comprehension assessments. WHAT THIS PAPER ADDS: What is already known on the subject: Reading comprehension is frequently impaired in PWA. Reading preferences, the perception of difficulties and the impact on everyday life reading activities are specific to the individual and thus need to be known for goal‐setting, intervention planning and monitoring of change. As part of a comprehensive assessment of reading, Morris et al. developed a person‐centred English language questionnaire for this purpose. So far, there is no equivalent tool in German. What this paper adds to the existing knowledge: In this study, we translated and adapted the questionnaire to German language and culture, and analysed its validity and reliability with German‐speaking PWA. We demonstrated that the German version is accessible for German‐speaking PWA, and that it has appropriate validity, reliability and sensitivity to measure self‐reported change. Outcomes of the questionnaire correlate with text level reading speed. What are the potential or actual clinical implications of this work?: The German version of the questionnaire could be a valuable self‐reported outcome measure to assess individual perceptions of reading and to measure progress (as perceived by an individual) as a consequence of recovery or intervention in either clinical or research settings. As reading speed might be an indicator of everyday life reading as perceived by an individual, it should be considered in reading assessments and interventions. [ABSTRACT FROM AUTHOR]

Background: The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. Aims: To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Methods & Procedures: Cross‐sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months–3;11y (n = 59), 4;0–5;11 years (n = 37) and 6;0–8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities—Dutch Version (CPCHILD‐DV) and the Focus on Communication Under Six‐34 (FOCUS‐34) questionnaire. Spoken language comprehension was assessed with the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT). Correlations between the functional communication tools, and with the C‐BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. Outcomes & Results: At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD‐DV and FOCUS‐34, and with a lower level of spoken language comprehension (C‐BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 at all developmental stages. Correlations between C‐BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months–3;11 years, between 0.781 and 0.897 at developmental stage 4;0–5;11 years, and between 0.635 and 0.659 at developmental stage 6;0–8;11 years. Conclusions & Implications: The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS‐34 or CPCHILD‐DV is recommended. What this paper adds: What is already known on the subject: A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD‐DV and FOCUS‐34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD‐DV and FOCUS‐34 include items that pertain to communicative participation. The innovative C‐BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge: In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD‐DV and FOCUS‐34. Correlations between these functional communication tools and the C‐BiLLT were moderate to strong. What are the potential or actual clinical implications of this work?: For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication—AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD‐DV and FOCUS‐34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication. [ABSTRACT FROM AUTHOR]

Background: Research in word‐finding difficulties is sparse, especially in languages other than English. As a result, the factors associated with the frequency of word‐finding behaviours are poorly understood, particularly in discourse. Aims: This exploratory study is the first to collect data relative to the expected frequency of word‐finding behaviours in narration for French speakers aged 7–12 years old with typical development; and (2) to identify the factors associated with the frequency of word‐finding behaviours in narration. We hypothesized that sociodemographic characteristics, language abilities and characteristics of the spoken productions could be linked to word‐finding behaviours. Methods & Procedures: The participants consisted of 61 French‐speaking children aged 7–12 years old (M = 9;09 years, SD = 1;06 years) with typical development. Children were asked to complete a receptive vocabulary task, a non‐word‐repetition task and two narrative tasks. The children's narrative samples were coded using a discourse analysis of word‐finding behaviours, as described by Diane J. German. Outcomes & Results: Participants produced 39% of T‐units with least one word‐finding behaviour, which included relatively frequent use of repetitions and word reformulations. Regression analyses revealed that the participants' gender was the only significant variable associated with the frequency of word‐finding behaviours in narration. Boys produced a higher percentage of T‐units with at least one word‐finding behaviour. Post‐hoc analyses suggested that gender differences reflected differences in repetitions and word reformulations. Boys and girls did not differ on any other language measures collected. Conclusions & Implications: Speech–language pathologists may want to take into account a child's gender when assessing word‐finding difficulties in narration. Additional studies are needed to understand whether this finding extends to other word‐finding tasks and to children with word‐finding difficulties. WHAT THIS PAPER ADDS: What is already known on the subject: Studies in English have identified that analyses of word‐finding behaviours in discourse can be used to correctly identify children with word‐finding difficulties. Studies are needed in other languages to determine if this observation holds true across languages. Moreover, the factors associated with the frequency of word‐finding behaviours in discourse are poorly understood. What this paper adds to existing knowledge: The frequency of word‐finding difficulties in narration was higher in our study of French‐speaking children than in previous studies of English. Gender was the only factor associated with the frequency of word‐finding difficulties. What are the potential or actual clinical implications of this work?: The language and task used to assess word‐finding skills as well as the child's gender may be important to take into account when assessing word‐finding difficulties based on word‐finding behaviours. [ABSTRACT FROM AUTHOR]

Background: Despite increasing knowledge of social communication skills of autistic peole, the interrelatedness of different skills such as non‐linguistic comprehension, social inference and empathizing skills is not much known about. A better understanding of the complex interplay between different domains of social communication helps us to develop assessment protocols for individuals with social communication difficulties. Aims: To compare the performances of autistic young adults, young adults with autistic traits identified in childhood and control young adults in social communication tasks measuring non‐linguistic comprehension, social inference and empathizing skills. In addition, to examine associations between the different social communication measures. Methods & Procedures: Autistic young adults (n = 34), young adults with autistic traits (n = 19) and control young adults (n = 36) completed the extra‐ and paralinguistic scales of the Assessment Battery for Communication (ABaCo), the Faux Pas Recognition Test, Social–Pragmatic Questions (SoPra) and the Empathy Quotient (EQ). Outcomes & Results: Group differences were found in the performance in the ABaCo, SoPra and EQ scores. Compared with the control young adults, autistic young adults scored lower. The performance of the young adults in the autistic traits group fell in between the other two groups. There were no group differences in the Faux Pas Recognition Test. The variability within the groups was large in all measurements. In the control group, there was a significant correlation between EQ and SoPra scores and between the Faux Pas and SoPra scores. In the autistic group, a significant correlation was found between Faux Pas and SoPra scores. Also, other patterns were observed but these were not statistically significant. Conclusions & Implications: The young adults with autistic traits fell in between the control and autistic young adults, highlighting the presence of the continuum in the terms of features of social communication. The results support other current research that suggests that theory of mind and other social communication skills may not be universally or widely impaired in all autistic individuals without cognitive deficits. Although all tasks examined social communication skills, only a small number of significant correlations were found between test scores. This highlights that clinical conclusions about a person's social communication should be based on the outcomes of different types of methods measuring different aspects of social communication. It is clear that the interrelatedness of different social communication skills needs further research. What This Paper Adds: What is already known on this subject: For successful communication, the ability to infer others' emotions, intentions and mental states is crucial. Autistic people have difficulty with many aspects of social communication. However, the associations between different aspects of social communication need to be better understood. What this paper adds to existing knowledge: The unique contribution of this study is to compare the performance of autistic people not only with that of a control group but also with people with childhood autistic traits. This provides an understanding of the interrelatedness of different social communication skills in people with varying degrees of autistic traits. This study used four assessment methods focusing on three different social communication elements (non‐linguistic comprehension, social inference and empathizing skills). These elements have complex relationships to one another, some being closely overlapping, some more distally related and some reflect more complex multifactorial elements. This study shows that although groups differ from each other in most of the assessments, the performance of different groups overlapped showing that many autistic young adults can perform well in non‐linguistic and social inference tasks in structured assessment contexts. What are the potential or actual clinical implications of this work?: Our findings suggest that in the assessment of social communication, self‐reports and clinical assessments can be used effectively together. They can complement each other, pointing out the strengths and weaknesses of a person, leading to more personalized therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background: Teachers often rely on the use of open‐ended questions to assess students' conceptual understanding of assigned content. Particularly in the context of mathematics; teachers use these types of questions to gain insight into the processes and strategies adopted by students in solving mathematical problems beyond what is possible through more close‐ended problem types. While these types of problems are valuable to teachers, the variation in student responses to these questions makes it difficult, and time‐consuming, to evaluate and provide directed feedback. It is a well‐studied concept that feedback, both in terms of a numeric score but more importantly in the form of teacher‐authored comments, can help guide students as to how to improve, leading to increased learning. It is for this reason that teachers need better support not only for assessing students' work but also in providing meaningful and directed feedback to students. Objectives: In this paper, we seek to develop, evaluate, and examine machine learning models that support automated open response assessment and feedback. Methods: We build upon the prior research in the automatic assessment of student responses to open‐ended problems and introduce a novel approach that leverages student log data combined with machine learning and natural language processing methods. Utilizing sentence‐level semantic representations of student responses to open‐ended questions, we propose a collaborative filtering‐based approach to both predict student scores as well as recommend appropriate feedback messages for teachers to send to their students. Results and Conclusion: We find that our method outperforms previously published benchmarks across three different metrics for the task of predicting student performance. Through an error analysis, we identify several areas where future works may be able to improve upon our approach. Lay Description: What is already known about this topic: Open‐ended questions are used by teachers in the domain of mathematics to assess their students understanding but automated support for these types of questions are limited in online learning platforms. Recent advancements in areas of machine learning and natural language processing have led to promising results in a range of domains and applications. What this paper adds: Emulating how teachers identify similar student answers can be used to build tools that support teachers in assessing and providing feedback to student open‐ended work. Implications for practice: Developing better automated supports can increase the amount of direct feedback students receive to guide their learning. [ABSTRACT FROM AUTHOR]

Background: Verbal fluency tasks are routinely used in clinical assessment and research studies of aphasia. People with aphasia produce fewer items in verbal fluency tasks. It remains unclear if their output is limited solely by their lexical difficulties and/or has a basis in their executive control abilities. Recent research has illustrated that detailed characterization of verbal fluency performance using temporal characteristics of words retrieved, clustering and switching, and pause durations, along with separate measures of executive control stands to inform our understanding of the lexical and cognitive underpinnings of verbal fluency in aphasia. Aims: To determine the locus of the verbal fluency difficulties in aphasia, we compared semantic and letter fluency trials between people with aphasia and healthy control participants using a wide range of variables to capture the performance between the two groups. The groups were also tested on separate measures of executive control to determine the relationship amongst these tasks and fluency performance. Methods & Procedures: Semantic (animal) and letter (F, A, S) fluency data for 60s trials were collected from 14 people with aphasia (PWA) and 24 healthy adult controls (HC). Variables, such as number of correct responses, clustering and switching analyses, were performed along with temporal measures of the retrieved words (response latencies) and pause durations. Participants performed executive control tasks to measure inhibitory control, mental‐set shifting and memory span. Outcomes & Results: Compared with HC, PWA produced fewer correct responses, showed greater difficulty with the letter fluency condition, were slower in getting started with the trials, showed slower retrieval times as noted in within‐ and between‐cluster pause durations, and switched less often. Despite these retrieval difficulties, PWA showed a similar decline in the rate of recall to HC, and had similar cluster size. Executive control measures correlated primarily with the letter fluency variables: mostly for PWA and in one instance for HC. Conclusions & Implications: Poorer performance for PWA is a combination of difficulties in both the lexical and executive components of the verbal fluency task. Our findings highlight the importance of detailed characterization of fluency performance in deciphering the underlying mechanism of retrieval difficulties in aphasia, and illustrate the importance of using letter fluency trials to tap into executive control processes. WHAT THIS PAPER ADDS: What is already known on the subject: PWA typically show impaired performance in verbal fluency tasks. It is debated whether this impaired performance is a result of their lexical difficulties or executive control difficulties, or a combination of both. This debate continues because previous studies have mostly used semantic fluency condition without including letter fluency condition; used a limited range of variables (e.g., number of correct responses); and not included separate executive control measures to explain the performance pattern in aphasia. This research addresses these outstanding issues to determine the specific contribution of lexical and executive control processes in verbal fluency in aphasia by including: both semantic and letter fluency conditions; a wide range of variables to identify the relative contribution of lexical and executive control mechanisms; and independent measures of executive control. What this paper adds to existing knowledge: Using the multidimensional analysis approach for verbal fluency performance from both semantic and letter fluency conditions, this is the first study to systematically demonstrate that PWA had difficulties in both lexical and executive control components of the task. At the individual level, PWA had greater difficulty on the letter fluency condition compared with semantic fluency. We observed significant correlations between the executive control measures and verbal fluency measures primarily for the letter fluency condition. This research makes a significant contribution to our understanding of lexical and executive control aspects in word production in aphasia. What are the potential or actual clinical implications of this work?: From a clinical perspective, this research highlights the importance of using a full range of verbal fluency and executive control measures to tap into the lexical as well as executive control abilities of PWA, and also the utility of using letter fluency to tap into the executive control processes in PWA. [ABSTRACT FROM AUTHOR]

Background: Intervention studies aimed to improve the written production of single words by persons with aphasia have yielded promising results and there is growing interest in interventions targeting text writing. The development of technical writing aids offers opportunities for persons with aphasia, and studies have shown that using them can have a positive impact on written output. Aims: The aim was to investigate what impact training to use a computerised spell checker had on text writing in persons with aphasia. Methods & Procedures: The study had a multiple‐baseline single‐case experimental design replicated across six male Swedish participants with mild‐to‐moderate post‐stroke aphasia. The participants received training twice a week during 8 weeks, learning how to use the spell checker. At baseline and before every session, the participants wrote two texts which were logged in a keystroke‐logging tool. Dependent variables were continuously measured in the texts, and the participants performed tests of language function and answered questionnaires on reading and writing habits and health‐related quality of life before and after the intervention. The participants were also interviewed about how they had experienced the training. The results were evaluated on individual and group level. Results: The study showed that systematic individual training involving a spell checker was experienced as positive by the participants and that they all described their writing ability in more positive terms after the intervention. Evaluation showed statistically significant improvements on group level for the dependent variables of spelling accuracy, rated syntax, writing speed and proportion of unedited text during text writing when using the spell checker. The intervention also had a generalising effect on writing speed and editing during text writing without the spell checker and on spelling accuracy in a dictation test. The participants who had the greatest spelling problems were the ones who showed the most progress, but participants with only minor writing difficulties at baseline also improved. Conclusions & Implications: The study shows that a digital spelling aid constitutes effective support for people with aphasia and may also affect levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. Although writing difficulties is a persisting symptom in aphasia, it can be supported and improved through use of digital spelling aids. Hence, treatment of writing ability should always be included in the rehabilitation of people with aphasia. WHAT THIS PAPER ADDS: What is already known on this subject: Use of a technical writing aid can have a positive impact on the written output of persons with aphasia. Using a digital spell checker may improve spelling as well as other levels of writing, but it has not been investigated using a keystroke‐logging tool in combination with language‐test scores and results from questionnaires. What this paper adds to existing knowledge: Through analyses on both individual and group level, this study shows that a digital spelling aid constitutes effective support for people with aphasia and also affects levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. What are the potential or actual clinical implications of this work?: Digital spelling support, which is a relatively simple and inexpensive technology, can support and improve text writing in persons with post‐stroke aphasia. [ABSTRACT FROM AUTHOR]

Background: Aims: To describe typical phonological development of Brazilian Portuguese (BP)‐speaking children, considering the following parameters: age of customary production, acquisition and mastery. Methods & Procedures: Data were collected from 857 children aged between 3 years and 8 years 11 months with typical language and speech development. The sample was grouped into 6‐month age bands. The data were analysed using one‐way analysis of variance (ANOVA) followed by Games–Howell post‐hoc tests. Outcomes & Results: Stops (/p, b, t, d, k, g/), nasals (/m, n, ɲ/) and some fricatives (/f, v, s, z/) were mastered before the age of 3 years (age of mastery). The age of acquisition for phonemes /ʃ, ʒ/ was 3;6, though both were only mastered at 4;0 years. The liquid /l/ was acquired at 3;0 and mastered at age 3;6, while /x/ was acquired and mastered at age 3;6. The phoneme /ʎ/ was acquired at 7;0 and mastered at age 8;6. The tap /ɾ/ was acquired between the ages of 4;0 and 4;6, and mastered at 4;6. In coda position, /n, l/ were acquired at 3;0, while /s/ was mastered at 4;6 and /ɾ/ between 4;6 and 5;0 years. Clusters involving /ɾ/ were acquired at 6;0, while those with /l/ were acquired between the ages of 6;6 and 7;0. Conclusions & Implications: This study presented acquisition for consonants in BP and can be used as a reference for the assessment of developmental speech disorders. In this study, stops and nasals were acquired first, followed by fricatives and, lastly, liquids. This finding is corroborated by previous studies in BP and other languages. What this paper adds: What is already known on the subject: What this paper adds to existing knowledge: What are the potential or actual clinical implications of this work?: [ABSTRACT FROM AUTHOR]

Background: Difficulties in language development are related to social and emotional problems, lower academic outcomes, and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. The introduction of systematic screening for language delay (LD) in 3‐year‐old children in Hungary was based on the recent adaptation of the MacArthur–Bates CDI‐III (HCDI‐III). Aims: To explore the relevant psychometric properties of the HCDI‐III; to identify factors characteristic of the families and children influencing language development at the age group under investigation; and to evaluate the adequacy of the tool for the purpose of screening LD in kindergarten at the age of 3 years. Methods & Procedures: The norming study of the HCDI‐III was conducted in a collaborative research project with the Metropolitan Pedagogical Services in Budapest. HCDI‐III parent report forms along with a demographic survey form were distributed to parents of all Hungarian‐speaking children between the ages of 2;0 and 4;2 without special education needs. The normative sample comprised data from 1424 children aged 2;0–4;2 with 51.1% boys and 48.9% girls. The data set contained information including language skills, basic demographics, birth conditions, health issues and socio‐economic status (SES). Outcomes & Results: In the HCDI‐III form, six outcome variables were created to cover the domains of expressive vocabulary, morphosyntax and language use. Statistical analyses revealed appropriate psychometric properties of five outcome variables that showed a normal distribution and were strongly correlated to age. Outcomes of girls were slightly (but significantly) higher on scales corresponding to vocabulary, syntax, language use and productivity. Most variables were highly correlated with one another even with age partialled out. Multiple regression analyses revealed significant effect of age, gender and parental education on all main outcome variables. Neither one of the other eight predictors, including familial and birth‐related factors, affected linguistic outcomes in our sample. Conclusions & Implications: The results are consistent with the majority of Communicative Development Inventory (CDI) studies, and support the psychometric eligibility of the instrument for screening purposes between 30 and 50 months. As certain regions of Hungary are characterised by a high prevalence of low‐SES families, more research is needed to adapt the screening procedure and subsequent measures to their needs. What this paper adds: What is already known on the subject: Difficulties in language development are related to lower social and academic outcomes and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. Structured parent report forms such as the MacArthur–Bates CDI are widely accepted methods for screening children with LD. What this paper adds to existing knowledge: This study reports the Hungarian adaptation and norming of the CDI‐III form. Statistical analyses revealed appropriate psychometric properties of most of its sections. Language outcomes were affected by age, gender and parental education on all main outcome variables in children between 2 and 4 years of age. What are the potential or actual clinical implications of this work?: The results support the psychometric eligibility of the HCDI‐III instrument for screening purposes. The introduction of the screening procedure in clinical practice is expected to improve early support of children with language difficulties and reduce risks of developmental problems related to language disorders. [ABSTRACT FROM AUTHOR]

Objectives: This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites. Materials and Methods: Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi‐peak LED curing unit (VALO—Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one‐step (1S) (OneGloss), two‐step (2S) (EVE Diacomp Twist Basic CA), or 3‐step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two–way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre‐set alpha of 0.05. Results: The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations. Conclusions: The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification. Clinical Significance: The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite. [ABSTRACT FROM AUTHOR]

This paper examined relationships between area‐level deprivation, local authorities' social care expenditure and the rates of children entering care proceedings in England using a novel data linkage of de‐identified records provided by the Children and Family Court Advisory Service (Cafcass). Using structural equation modelling, the authors found strong positive relationships between socioeconomic area deprivation and high rates of children undergoing care proceedings in England between 2015 and 2019. Preventative social care expenditure is associated with lower child rates when adjusting for deprivation. Our findings suggest that deprived and underfunded local authorities respond to an increased need by prioritizing care arrangements. [ABSTRACT FROM AUTHOR]

Purpose: Housing is essential to health. Governmental rental assistance is one way to increase access to affordable housing, but little is known about how it varies by rural/urban location. This paper seeks to address that gap by examining rural/urban and within‐rural differences in receipt of rental assistance, with particular attention differences by health and disability. Methods: We used data from the 2021 National Health Interview Survey (n = 28,254) to conduct bivariate analyses to identify significant differences in receipt of rental assistance by rural/urban location. We then conducted logistic regression analyses to generate odds ratios of receiving rental assistance, adjusting for self‐rated health, disability, sociodemographic characteristics, and the US Census region. Findings: When limiting the sample to those who rent (20.6% of rural residents and 29.6% of urban residents), rural residents were nearly 5 percentage points more likely to receive rental assistance (13.1% vs 8.2%, P<.001). Rural recipients of rental assistance were more likely to have a disability than urban residents (27.9% vs 20.3%, P<.05) and were more likely to report fair/poor health (41.6% vs 31.4%, P<.05). Conclusions: Rural residents are less likely to rent their homes, but, among those who rent, they are more likely to receive governmental rental assistance. This may be reflective of the greater need for rental assistance among rural residents, who were in poorer health and of lower socioeconomic status than urban renters. As housing is essential to good health, policy attention must prioritize addressing a persistent and growing need for affordable housing in rural and urban areas alike. [ABSTRACT FROM AUTHOR]

Background: The Communicative Participation Item Bank (CPIB) is a patient‐reported outcome measure (PROM) designed to measure the extent of interference, or difficulty, experienced by adults with communication disorders participating in their day‐to‐day communication activities. To date, there is limited evidence regarding sensitivity of the CPIB for capturing change with intervention in people with Parkinson's disease (PwPD). Aims: The purpose of this study was to examine the following measurement properties of the CPIB in PwPD who received community‐based, standard care, speech‐language therapy focusing on motor speech concerns: Change over time between treatment and observation groups, comparison to patient‐defined ideal and satisfactory targets, comparison of static short form to computerised adaptive testing (CAT), comparison of self to proxy‐rated scores, and comparison to other common PROMs. Methods and Procedures: Forty‐six PwPD (20 treatment/26 observation) completed data collection upon enrolment (pre‐treatment) and 6 months later. In addition to the CPIB, PROMs included the Voice Handicap Index 10‐item short form (VHI‐10), PROMIS Global Health‐Related Quality of Life, Levels of Speech Usage, self‐rated speech severity, and Patient Health Questionnaire‐9 (PHQ‐9). Participants also engaged in qualitative interviews. Forty‐four family members completed proxy CPIB ratings. Outcomes and Results: There were no significant differences between treatment and observation groups on the CPIB pre‐treatment, but there were significant differences post‐treatment. The differences appeared to be largely due to significant gains in the treatment group. No participants reached their ideal CPIB target, and few reached their satisfactory target. Static CPIB short form and CAT scores were not significantly different, with an average of five CAT items administered per participant. Overall group similarities between patient and proxy scores may have obscured wide variability across individual patient‐proxy pairs. Associations between CPIB and VHI‐10, health‐related quality of life, self‐reported speech severity, and depression ranged from weak to moderate. Conclusions and Implications: The CPIB appears to be sensitive to capturing change with intervention, and similar results are obtained with the static short form and CAT formats. One clinical caution is that even with gains observed in the treatment group, no participants obtained their ideal communicative participation goals, and few obtained a satisfactory level of communicative participation. Thus, while current interventions are beneficial, they may not meet the full range of clients' communication needs. While responding to the CPIB through a proxy rater may be feasible, caution is warranted due to concerns about maintaining the autonomy of PwPD. What this paper adds: What is already known on this subject: The communication disorders associated with Parkinson's disease (PD) can have a negative impact on quality of life and life participation as measured by patient (or person)‐reported outcome measures (PROMs). The Communicative Participation Item Bank (CPIB) is one PROM available to use with adults with communication disorders. However, little is known about whether the CPIB captures changes in communicative participation as a result of standard care treatment for people with Parkinson's disease (PwPD). Use of computerised adaptive testing (CAT), proxy report and comparison to targeted participation outcomes have not been explored. What this study adds to existing knowledge: As a result of this study, we know that the CPIB captured differences between treatment and observation groups after community‐based, standard care speech therapy intervention focusing on motor speech production in PwPD. Static short form and CAT scores did not differ significantly, so the CAT option provides better efficiency requiring, on average, five items to administer compared to the 10‐item short form. Proxy and PwPD scores did not differ as a group, but wide variability was noted. What are the potential or actual clinical implications of this work?: The CPIB may be a clinically sensitive instrument for capturing changes in communicative participation after treatment. No participants met their ideal CPIB target, and few reached their satisfactory target, suggesting that while current interventions contribute to gains in communicative participation, there are still unmet needs that may call for support and interventions addressing the more complex array of factors affecting communicative participation outcomes for PwPD. [ABSTRACT FROM AUTHOR]

Safety concerns for women are prevalent and influence their likelihood to exercise outside. While some women modify their exercise behaviour due to safety concerns, others exercise outside more freely. In this paper, two experiments are reported with women runners to examine whether making their identity as a runner or a woman salient changed their self‐reported likelihood of exercising outside, sense of safety and personal safety anxiety. While study 1 (n = 153) found no significant experimental effect, it revealed a trend: women whose runner identity was made salient were more likely to self‐report their willingness to exercise outside than those in the gender identity condition. Study 2 (n = 236) was conducted to examine this trend further. The second study employed a larger sample size and a more robust manipulation of social identity salience. A significant effect of the experimental condition on women's sense of safety was observed. Specifically, women in the runner identity salience condition had significantly greater feelings of safety than women in the gender identity salience condition. A similar trend emerged for self‐reported likelihood to exercise outside. These findings corroborate prior research on the impact of identity salience on intention to engage in health behaviours. They contribute to the existing body of literature on the intricate interplay between women's physical activity intentions and safety concerns. Furthermore, these findings could aid in the development of interventions to increase women's physical activity levels. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) is considered a promising approach to support learning. An instructional design is essential to optimize cognitive processes. Studies show that VR has unique instructional and pedagogical requirements. Objectives: To evaluate the effectiveness and applicability of the modality principle, which was previously validated in 2D classic multimedia, for learning with VR. The modality principle states that multimedia information presented as spoken narration is superior to on‐screen text. Methods: A prospective experimental study with two compared conditions of instruction: VR‐based learning guided by on‐screen text (n = 34) versus spoken narration (n = 28). Students' cognitive learning experiences were captured by eye‐tracking and electrodermal activity (EDA). In addition, students' knowledge was evaluated using a pre–post knowledge test. Results and Conclusions: Overall, there was no significant difference in knowledge retention between the participants who learned with on‐screen text compared to spoken narration. However, results from the eye‐tracking analysis showed that students who learned with the on‐screen text devoted longer visual attention toward important learning activity areas of interest, suggesting a better ability to discern between relevant and irrelevant information. Conversely, students who learned with the spoken narration expressed significantly more EDA peak responses, proposing a higher cognitive load. Implications: This study outlines that while learning with VR was effective, the modality principle might not apply to learning with VR. Moreover, the analysis of the learning process suggests even an inverse effect, favouring the provision of instructional scaffolds as on‐screen text. Future research should evaluate this effect on long‐term knowledge retention. Lay Description: What is already known about this topic?: VR can increase learners' engagement and impact their cognitive processing.VR has different instructional requirements than classic multimedia learning material.The modality principle states that audio‐visual is superior to visual‐only information. What this paper adds?: This study evaluated the impact of the modality design principle to scaffolded learning with VR.In terms of achievements learning with textual and audio instruction was comparable.Eye‐tracking analysis showed that learning with on‐screen text was characterized by longer visual attention to the important learning objects.Learning with the auditory narration was associated with a higher cognitive load as measured by EDA and more performance errors.In both study conditions, students tended to focus more on the less important information in the learning activity. Implications of the study's findings for practitioners: VR‐based simulations are effective to support learning and knowledge gaining.The modality principle is not fully applicable to support learning in VR‐based learning environments.Instructional design should take into consideration that novices often notice the non‐salient information in VR. [ABSTRACT FROM AUTHOR]

Background: Augmented reality has been widely applied in various fields, and its benefits in language learning have been increasingly recognized. However, the investigation of effective learning behaviours and processes in augmented reality learning environments, taking into account temporality and analysis of differences in learning behaviours between learning achievements from the perspective of learning strategies, is still a topic that requires further research. Objectives: The goal of this research is to explore effective learning processes in AR language learning environments and learning behavioural patterns of learners with different performance levels via LA taking into account temporality. Methods: We used the learning application designed and developed in previous studies to understand the learning process and behavioural patterns of acquiring Japanese compound verbs with augmented reality. Lag sequential analyses were conducted to analyse the learning behavioural transitions using learning data. Additionally, frequent sequences were analysed using frequent sequence mining to compare the learning behavioural patterns of learners with different learning performances. Results and Conclusions: We investigated the learning process and behavioural patterns and discussed the language learning strategies employed in the augmented reality learning environment. The results indicated that learners primarily performed strategies of performed expressions, recombining, and structured reviewing in AR compound verb learning activities. Furthermore, the results revealed the different types of strategies applied by different learning performance learners, whereby the low group learners used the least variety of strategies, and the middle and high group learners employed repeating and deductive reasoning strategies that were not followed by the low group. Lay Description: What is already known about this topic: The development of information and communication technologies have made augmented reality (AR) technology gradually known and applied.The use of AR is increasingly gaining attention in language learning owing to advantages of increasing motivation and satisfaction, learning performance of language skills and improving interaction among materials, learners and teachers.Learning Analytics (LA) plays a key role in analysing learning data.LA studies in language learning are almost always used to monitor data such as attendance and amount of learned vocabulary. What this paper adds: Employing temporal LA techniques of lag sequential analysis and frequent sequence mining to investigate learners' behavioural patterns and processes.Learning behavioural patterns in AR learning environments were discussed from the perspective of language learning strategies.The three main learning behavioural patterns of analysing expressions, recombining, and structured reviewing in the learning process were confirmed.High performance level learners used the greatest variety of learning strategies. Implications: A new category of language learning strategies under technology‐enhanced language learning is required.Different learning strategies should be instructed for the learner's performance in the AR learning environment.Based on a full understanding of the role of AR system features, it is crucial to conduct instructional designs for language learning using language learning strategies. [ABSTRACT FROM AUTHOR]

Summary Occlusal indicators are widely used in dental treatment to measure tooth contacts that occur during occlusion. However, the presence of an indicator may affect the mechanics of occlusion and lead to invalid tooth contact data. The objective of this study was to determine the effect of four indicators (Parkell, silk, T-Scan® sensor and paper) on surface electromyography (SEMG) activity during occlusion. Twenty-three subjects performed strong bites and maximum clenches onto the four indicators and natural dentition. Surface electromyography recordings of anterior temporalis and superficial masseter activity and the subjects' perception of each indicator were measured. SEMG activity with the T-Scan® sensor and paper was significantly different (higher masseter activity; P < 0·05) compared to that for natural dentition. The Parkell and silk gave no significant differences to natural dentition. Similarly, subjects perceived that T-Scan® sensor and paper had the greatest effect on occlusion and were the least comfortable ( P < 0·05). Thus, the very plastic T-Scan® sensor and very thick articulating paper both affected SEMG activity during occlusion and, therefore, may not provide valid tooth contact information for dental treatment. In conclusion, occlusal indicators can change SEMG activity during occlusion which may affect the validity of the measurements they provide. [ABSTRACT FROM AUTHOR]

Background: Despite emerging evidence of validity and reliability, speech and language therapists' (SLT) uptake of telehealth has been limited and barriers remain to the effective and confident use of this service model. The COVID‐19 pandemic has caused significant disruption to essential health services, including speech and language therapy assessment and intervention, meaning that telehealth must now be considered as part of the suite of service delivery options for all clinicians. Aims: To explore the perceived barriers and facilitators of telehealth among community paediatric SLTs before and after their use of a telehealth platform with an embedded standardised assessment tool. Methods & Procedures: Mixed‐methods questionnaires were developed for this study and completed by SLTs before and after the 3‐month trial of the telehealth platform. A total of 38 SLTs completed the pre‐trial questionnaire and training in the use of telehealth platform (Coviu), including instruction in using a standardised, norm referenced language test as an integrated tool within the Coviu platform. A total of 27 SLTs went on to use the telehealth platform, and 25 of these completed the post‐trial questionnaire on which subsequent qualitative and quantitative analysis was completed. Outcomes & Results: Prior to using the platform, perceived barriers included technology issues, limited clinician experience and concerns around parent acceptance of the service. Potential facilitators included access to appropriate platforms, tools and resources as well as increased clinician confidence with telehealth. Following the trial, barriers to telehealth use continued to include technology barriers, particularly internet stability, and client issues, including suitability for telehealth services. Facilitators for future telehealth use included access to appropriate platforms for telehealth, stable and appropriate internet connectivity, and more extensive telehealth resources for both assessment and intervention for this mode of service delivery. Conclusions & Implications: This study provides insights into the perceptions of the barriers and facilitating factors for telehealth use among community‐based SLTs. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery beyond the pandemic. What this paper adds: What is already known on the subject: Research about telehealth has shown that it is a reliable and valid way of delivering speech pathology services, yet many clinicians have been wary of its use and uptake of telehealth prior to COVID‐19 had been limited. We wanted to know what SLTs thought about using telehealth before and after participating in a 3‐month trial of a telehealth platform with an embedded formal language assessment. What this study adds to existing knowledge: This study indicates that technology issues including internet stability are a barrier to effective telehealth services, but that appropriate telehealth platforms, resources and experience are facilitators of uptake and successful use of telehealth. What are the potential or actual clinical implications of this work?: This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery for children during and beyond the pandemic, including those isolated by geographical or transport barriers. [ABSTRACT FROM AUTHOR]

Background We examined differences in response to self-reported alcohol use items by survey mode, whether self-report differences were the result of modality effects or self-selection, and whether these differences varied across the treatment and control arms of a preventative intervention trial. Methods Data from an existing alcohol prevention trial were used to estimate the effect of survey modality on adolescent's self-reported alcohol use at ages 17 to 18. Estimates were derived from regression models controlling for self-reported alcohol use during 8th grade, measured using a single survey modality, as well as time invariant selection factors. Results No statistically significant survey modality effects were found. No differential effects of survey modality were observed by assigned intervention group. Conclusions We provide initial evidence that adolescent alcohol prevention trials may use multiple survey modalities when necessary to increase response rates without harming interpretation of intervention effects. [ABSTRACT FROM AUTHOR]

This study investigates scholars' citation behaviors from a fine‐grained perspective. Specifically, each scholarly citation is considered multidimensional rather than logically unidimensional (i.e., present or absent). Thirty million articles from PubMed were accessed for use in empirical research, in which a total of 15 interpretable features of scholarly citations were constructed and grouped into three main categories. Each category corresponds to one aspect of the reasons and motivations behind scholars' citation decision‐making during academic writing. Using about 500,000 pairs of actual and randomly generated scholarly citations, a series of Random Forest‐based classification experiments were conducted to quantitatively evaluate the correlation between each constructed citation feature and citation decisions made by scholars. Our experimental results indicate that citation proximity is the category most relevant to scholars' citation decision‐making, followed by citation authority and citation inertia. However, big‐name scholars whose h‐indexes rank among the top 1% exhibit a unique pattern of citation behaviors—their citation decision‐making correlates most closely with citation inertia, with the correlation nearly three times as strong as that of their ordinary counterparts. Hopefully, the empirical findings presented in this paper can bring us closer to characterizing and understanding the complex process of generating scholarly citations in academia. [ABSTRACT FROM AUTHOR]

Background: The Successful Aging after Elective Surgery (SAGES) II study was designed to increase knowledge of the pathophysiology and linkages between delirium and dementia. We examine novel biomarkers potentially associated with delirium, including inflammation, Alzheimer's disease (AD) pathology and neurodegeneration, neuroimaging markers, and neurophysiologic markers. The goal of this paper is to describe the study design and methods for the SAGES II study. Methods: The SAGES II study is a 5‐year prospective observational study of 400–420 community dwelling persons, aged 65 years and older, assessed prior to scheduled surgery and followed daily throughout hospitalization to observe for development of delirium and other clinical outcomes. Delirium is measured with the Confusion Assessment Method (CAM), long form, after cognitive testing. Cognitive function is measured with a detailed neuropsychologic test battery, summarized as a weighted composite, the General Cognitive Performance (GCP) score. Other key measures include magnetic resonance imaging (MRI), transcranial magnetic stimulation (TMS)/electroencephalography (EEG), and Amyloid positron emission tomography (PET) imaging. We describe the eligibility criteria, enrollment flow, timing of assessments, and variables collected at baseline and during repeated assessments at 1, 2, 6, 12, and 18 months. Results: This study describes the hospital and surgery‐related variables, delirium, long‐term cognitive decline, clinical outcomes, and novel biomarkers. In inter‐rater reliability assessments, the CAM ratings (weighted kappa = 0.91, 95% confidence interval, CI = 0.74–1.0) in 50 paired assessments and GCP ratings (weighted kappa = 0.99, 95% CI 0.94–1.0) in 25 paired assessments. We describe procedures for data quality assurance and Covid‐19 adaptations. Conclusions: This complex study presents an innovative effort to advance our understanding of the inter‐relationship between delirium and dementia via novel biomarkers, collected in the context of major surgery in older adults. Strengths include the integration of MRI, TMS/EEG, PET modalities, and high‐quality longitudinal data. [ABSTRACT FROM AUTHOR]

BACKGROUND: Return to learn (RTL) after mild traumatic brain injury (mTBI) presents unique challenges for school professionals. A multidisciplinary team approach is necessary yet training school professionals is logistically difficult. This paper describes an innovative pilot RTL program and its evaluation. METHODS: Utilizing the telehealth/telementoring program Project ECHO® (Extension for Community Healthcare Outcomes), this study utilized a multidisciplinary team of subject matter experts to deliver five 1‐hour sessions across 5 cohorts of school‐based professionals (total of 133 participants). The evaluation used a mixed‐methods approach of post‐session and post‐program participant surveys and post‐program participant focus groups. RESULTS: Participants who completed a post‐program survey reported statistically significant improvements in essential aspects of RTL knowledge and self‐efficacy. This included improvements in how to manage a student with an mTBI (44.8% to 86.9%), benefits of early return to school for students following mTBI (31.8% to 86.9%), and the importance of written RTL policies/procedures (55.1% to 97.1%). CONCLUSIONS: This study demonstrates that RTL training via a telementoring approach may be a positive and effective way to train school‐based professionals and improve knowledge and self‐efficacy, especially when attending face‐to‐face trainings are difficult. This model has the potential to produce programmatic and systematic improvements for RTL education. [ABSTRACT FROM AUTHOR]

Background: This study aims to establish the mechanism by which virtual reality (VR) media characteristics affect learning transfer in a VR‐based job‐training environment. The two main determinants of learning transfer are the technology and the learner, but not many studies have considered both factors simultaneously. Objectives: This study aims to ascertain the mechanism by which VR media characteristics affect learning transfer with flow as a mediator, and to explore whether presence moderates the effect of VR media characteristics on flow. Methods: A survey of semiconductor facilities engineers who received VR‐based job training was conducted. A total of 106 responses were used in the statistical analysis. A path analysis was conducted to determine the promotional mechanism that connects VR media characteristics, flow, and learning transfer. Results and Conclusions: The results were as follows. First, VR media characteristics had a positive impact on learning transfer. Second, flow acted as a mediator in the relationship between VR media characteristics and learning transfer. Third, presence played a moderating role in the relationship between VR media characteristics and flow. Key takeaways: This study is significant as it identifies elements to consider in relation to both the technological and learner aspects of VR while designing a VR‐based job‐training programme. A corporation should consider VR media characteristics from a technological perspective, and flow and presence from a learner's perspective. Lay Description: What is already known about this topic: Corporations provide virtual reality (VR)‐based job training because of its positive impact.Interactions between the VR environment and learners impact flow.Presence is important as learner's subjective awareness affects efficacy. What this paper adds: VR media characteristics influence learning transfer in VR‐based job training.VR media characteristics affect flow, which, in turn, affects learning transfer.Presence moderates the relationship between VR media characteristics and flow. Implications for practice and/or policy: VR media characteristics influence learning transfer in VR‐based job training.VR media characteristics affect flow, which, in turn, affects learning transfer.Presence moderates the relationship between VR media characteristics and flow. [ABSTRACT FROM AUTHOR]

Child malnutrition is an enormous public health problem in low‐ and middle‐income countries (LMICs). In this paper, we study the relationship between non‐maternal adult female household members (AFHMs) and under‐5 child nutritional outcomes using nationally representative Ethiopian Demographic and Health Survey data, 2016. Because most of the primary inputs that go into the production of child health are intensive in maternal time, having additional AFHMs may ease the time constraints of the child's mother. We use anthropometric measures such as height‐for‐age z‐scores (HAZ) and weight‐for‐age z‐scores (WAZ) to measure stunting and underweight, respectively, as objective indicators of child nutritional status. Among our sampled households, we find that 40% of the children are stunted, 18% severely stunted, 27% underweight and 8% severely underweight. Furthermore, about 20% of the sampled children live with at least one extra non‐maternal AFHM. The multivariate regression results suggest that an additional AFHM is associated with significantly higher HAZ and WAZ scores and less likelihood of severe stunting compared with children living with fewer AFHMs. Finally, the paper discusses the potential pathways through which non‐maternal AFHMs can influence child nutritional status. [ABSTRACT FROM AUTHOR]

Background: Intelligibility can be defined as the speakers' ability to convey a message to the listener and it is considered the key functional measure of speech. The Intelligibility in Context Scale (ICS) is a parent rating scale used to assess intelligibility in children. Aims: To describe normative and validation data on the ICS in Swedish and to investigate how these are related to age, gender and multilingualism. Methods & Procedures: Two studies were included. Study 1 included ICS forms from 319 Swedish‐speaking children (3:2–9:2 years:months). Study 2 included video recordings and ICS forms from 14 children with speech sound disorder (SSD) and two with typical speech. The video recordings were transcribed in the validation process, resulting in intelligibility reference scores to which ICS scores were correlated. Outcomes & Results: Study 1: The mean value of the ICS for the 319 children was 4.73. There were no differences in ICS score related to age or gender. The children in the multilingual group were significantly older than the monolingual group and had significantly lower ICS scores than the group of monolinguals. Study 2: There was a moderate correlation between the ICS score and the transcription‐based intelligibility score, with the two children with typical speech excluded; however, this correlation was not significant. Conclusions & Implications: We contribute mean scores and percentiles on the ICS for Swedish‐speaking children. The finding that the ICS does not provide valid measures of intelligibility for the included children with SSD suggests that the instrument measures a different construct. What this paper adds: What is already known on the subject: The ICS has been translated to numerous languages and validated against articulation measures in several previous studies. The validity of the Swedish version has been investigated against intelligibility based on transcription of single words. What this paper adds to existing knowledge: The study provides normative values of the Swedish version of the ICS for children aged 3–9 years. This is the first study to use a gold standard measure of intelligibility in continuous speech to validate the ICS. The results show a somewhat dubious validity regarding ICS for the group of children with SSD included in the study. What are the potential or actual clinical implications of this work?: The ICS's suitability as a measure of intelligibility is questionable; however, it might be of use for speech and language pathologists to give an overview of the parents' view of their child's ability to communicate, in order to make a decision on possible further assessment and intervention. The normative values of the Swedish version of the ICS could be of use in this decision process. [ABSTRACT FROM AUTHOR]

Background: The status of the velopharyngeal mechanism can be inferred from perceptual ratings of specified speech parameters. Several studies have proposed the measure of an overall velopharyngeal composite score based on these perceptual ratings and have reported good validity. The Cleft Audit Protocol for Speech—Augmented (CAPS‐A) is a validated and reliable perceptual framework for the assessment of cleft speech and velopharyngeal function used by all Regional Cleft Services in the UK and Ireland. An overall velopharyngeal composite summary score based on the CAPS‐A would serve as an important surgical outcome measure of speech. Aims: To develop and validate a velopharyngeal composite summary score based on perceptual ratings made on the CAPS‐A (CAPS‐A VPC‐Sum) using data from a maxillary osteotomy (MO) study. Methods & Procedures: There were two surgical groups: a cleft lip and palate (CLP) (N = 20) group and a non‐CLP group (N = 10), and a normal control group (N = 20). Participants in groups 1 and 2 were seen for perceptual and instrumental assessments of speech and velopharyngeal function preoperatively (T1), 3 months (T2) and 12 months (T3) postoperatively. Perceptual speech data were collected and rated by independent listeners using CAPS‐A. Outcomes & Results: Moderate to strong interrater reliability for perceptual data (rs = 0.503–1.000, all p < 0.01) and strong to very strong reliability for videofluoroscopic measurements (rs = 0.746–0.947) were found. Construct validity of the CAPS‐A VPC‐Sum was shown by an increase in postoperative scores for the CLP group only ϰ2(2) = 9.769, p = 0.008 and significant differences between the CLP and the other two groups at T2 and T3 using independent t‐tests. Convergent and divergent validity was indicated by a positive moderate correlation with related parameters (e.g., hypernasality rs = 0.869, p < 0.01) and a weak correlation with unrelated parameters (e.g., amount of forward advancement rs = 0.160, p = 0.526). Criterion validity was found by a moderate correlation between closure ratio rs = –0.541, p = 0.020 and CAPS‐A VPC‐Sum. Conclusions & Implications: A velopharyngeal composite score based on perceptually rated parameters serves as an important surgical speech outcome measure. The CAPS‐A VPC‐Sum is a useful, reliable and valid outcome measure of velopharyngeal function. There are added positive implications for other clinicians using geographically and language‐specific adapted versions of the CAPS‐A internationally. What this paper adds: What is already known on this subject: Velopharyngeal composite scores based on perceptually rated speech parameters have been shown to have both clinical and research utility, serving as a useful surgical outcome measure. However, such a composite score must be specifically validated on the perceptual speech framework upon which it is based, as there are differences in measurement methods and terminology across cleft speech perceptual frameworks internationally. What this paper adds to existing knowledge: The CAPS‐A is a nationally used tool in the UK and Ireland for audit and research purposes with validated and adapted international versions. This paper reports on the validation of the derived velopharyngeal composite score measure based on the CAPS‐A and an English‐speaking sample, providing evidence of its validity through a speech osteotomy study. What are the potential or actual clinical implications of this work?: This work provides CLP teams who use CAPS‐A with a validated surgical speech outcome measure of velopharyngeal function. It has positive implications also for adapted versions of the CAPS‐A internationally. [ABSTRACT FROM AUTHOR]

Background: Collaborative learning can effectively promote the development of higher‐order competencies, where learners collaborate via social interactions to explore and solve complex problems. It has been found that the effective occurrence of collaborative learning requires appropriate external guidance and support. In particular, collaborative interactions in open learning environments are more complex and difficult, which makes it important to provide dynamic interventions for learners according to different collaborative situations. However, the role of facilitators and the characteristics and mechanisms of their interventions have yet to be thoroughly investigated. Objectives: The study aims to uncover the characteristics and patterns of interaction among groups with different collaborative performance and facilitator performance in an open learning environment, and to explore the differentiated role of facilitators in this process. Method: Groups are categorised as high or low based on their collaborative performance and facilitator performance. This study used lag sequential analysis (LSA) and content analysis to explore the interaction patterns of groups with different collaborative performance and facilitator performance. Also, the different roles of facilitators were analysed by comparing the differences in interaction patterns of different collaborative performance groups. Results: The study found that groups with different collaborative performances and facilitator performances showed significant differences in interaction patterns, and the two had crossover effects. There is also variability in the role of facilitators in groups with different collaborative performance profiles. Patterns of transition between different layers of interaction can indicate the level of groups' collaborative engagement. Specific interaction patterns exist that are conducive to enhancing collaborative learning. Conclusions: The results of the study pointed out that groups with different collaborative performance and facilitator performance showed different characteristics of interaction patterns. The role of the facilitator in online collaborative learning is characterised by compensatory and merit‐promoting. High‐quality online collaboration is the result of multiple factors, including learners and facilitators working together. This study has practical implications for the design of instructional interventions for group collaboration in online learning communities. Lay Description: What is already known about this topic: Deep instructional interactions help stimulate group intelligence and promote knowledge creation and deep connections.The facilitation strategies of the instructional implementer in online collaborative learning contexts play an important role in guiding students to engage in interactions and promoting efficient learning.Facilitators need to adopt different intervention strategies for different learners and learning stages to advance collaborative task completion. What this paper adds: Group collaborative performance is closely related to the strength of the connection and the depth of interaction of group members.Roles of facilitator in online collaborative learning can be characterised by strong support, compensation, and merit promotion.High‐quality online collaboration is the result of multifactor interaction between learners and facilitators. Implications for practice and/or policy: Course organisers' rating scale proposed in this study can help screen and train facilitators with excellent attributes.Examining different roles of facilitators can help curriculum designers rationalise the design and organisation of collaborative instruction.When group collaboration is active, learners should be guided through activities for deeper interaction and exploration.When group collaboration is low‐spirited, learners should be encouraged to focus on the stage tasks and explore the tasks step by step. [ABSTRACT FROM AUTHOR]

Background: Students' tendencies to seek feedback are associated with improved learning. Yet, how soon this association becomes robust enough to make predictions about learning is not fully understood. Such knowledge has strong implications for early identification of students at‐risk for underachievement via digital learning platforms. Objectives: We sought to understand how early in the academic year students' end‐of‐year learning outcomes could be predicted by their performance and feedback‐seeking behaviours within a digital learning platform. We analysed data collected at different time points in the academic year and across different cohorts of students within the context of high school advanced placement (AP) Statistics courses. Methods: High school students enrolled in AP Statistics spanning three academic years between 2017 and 2020 (N = 726; Mage = 16.72 years) completed 3 or 4 homework assignments, each 2 and 3 months apart. Results and conclusions: Across the three cohorts, and even as early as the first assignment, a model consisting of demographic variables (gender, race/ethnicity, parental education), assignment performance, and interaction with the digital score report explained significant variation in students' final course grades (R2 = 0.314–0.412) and AP exam scores (κ = 0.583–0.689). Students' assignment performance was positively associated with end‐of‐year learning outcomes. Students who more frequently checked their digital score reports tended to receive better learning outcomes, though not consistently across cohorts. Implications: These findings further an understanding of how students' early performance and feedback‐seeking behaviours within a digital learning platform predict end‐of‐year learning outcomes. Lay Description: What is already known about this topic: Students' early academic performance predicts end‐of‐year success.Students' self‐regulated learning behaviours are another predictor of academic success.Clickstream data have been used as an indicator of the application of self‐regulated learning strategies, particularly behaviours associated with seeking feedback.Indicators of feedback‐seeking behaviours reflected via clickstream data have been shown to predict student learning.Yet, how soon associations between early performance and such indicators of self‐regulated learning as feedback‐seeking are robust across different groups of learners, different learning circumstances, and different types of learning outcomes has yet to be more fully understood. What this paper adds: We investigated whether performance and feedback‐seeking behaviours predict end‐of‐year learning outcomes at different points during the academic year across multiple cohorts of learners (2017–2018, 2018–2019, and 2019–2020) and using two different learning outcomes (class grades, AP exam scores).One cohort was affected by COVID‐19 during the 2019–2020 academic year, allowing us to examine whether differences emerge amidst unprecedented circumstances.We used assignment scores and online feedback‐seeking to predict end‐of‐year learning outcomes.Assignment scores were positively associated with end‐of‐year grades.First assignment performance predicted AP exam scores.Use of feedback (an indication of self‐regulated learning behaviours) tended to predict learning outcomes, though not consistently across cohorts. Implications for practice and/or policy: The findings from this study could improve understanding of how digital learning platform measurements predict end‐of‐year learning outcomes though also highlight the importance of context differences.Such findings hold implications for early identification of at‐risk students and appreciation for differences between learners and contexts.These findings also contribute to a growing understanding of the impact of the COVID‐19 pandemic on student engagement and learning. [ABSTRACT FROM AUTHOR]

Background: Leaderboards are a highly popular gamification component used in student learning to enhance motivation, attentional engagement, and learning performance. However, few studies have examined the effects of individual leaderboard elements on English vocabulary learning through video lectures. Objectives: The present study aimed to examine how different leaderboard elements (i.e., points and rank) may affect students' English vocabulary learning through video lectures. Methods: A total of 34 students were assigned to groups using different leaderboard elements in a counterbalanced order. Participants' motivation, eye movements, and learning performance were measured and analysed. Results and Conclusions: Students' leaderboard rank was shown to increase their motivation regardless of whether other elements were present. Eye movement tracking revealed that the presence of the leaderboard increased students' saccades between the questions and the options, and lengthened their dwell time on the learning materials while reducing their dwell time on the non‐learning‐related screen areas. Presenting students' rank alone also improved their learning performance. Implications: Our findings strongly support the use of video lectures for English vocabulary learning, with the following recommendations: (1) Instructors should present students' rank on the leaderboard to enhance students' motivation and engagement; (2) Instructors should present only the students' rank on the leaderboard to also enhance students' learning performance. Lay Description: What is already known about this topic: While learning English vocabulary from video lectures, students might experience low levels of motivation and engagement, and pay less attention to the lectures.Leaderboards are a highly popular gamification component used in student learning to enhance motivation, attentional engagement, and learning performance.It remains unclear which leaderboard elements (i.e., points or rank) contribute most significantly to the effectiveness of the leaderboards. What this paper adds: Leaderboard elements have different effects on English vocabulary learning.The rank on the leaderboard benefited students' motivation and engagement.The rank also enhances students' confidence and learning performance. Implications for practice and/or policy: Instructors should present students' rank on the leaderboard to enhance students' motivation and engagement.Instructors should present only the students' rank on the leaderboard to also enhance students' learning performance. [ABSTRACT FROM AUTHOR]

Background: Prelinguistic communication complexity refers to the use of different communication forms such as eye gaze, gestures and vocalisations and the degree to which these forms are coordinated and how directed to a communication partner. To date, little is known about the relationship between prelinguistic communication complexity and expressive language in minimally verbal autistic children. Aims: To test the hypothesis that prelinguistic communication complexity predicts expressive language 12 months later in autistic children and explore whether there are any differences in specific prelinguistic intentional communicative behaviours that are related to later expressive language levels. Methods & Procedures: This longitudinal study examined 37 minimally verbal autistic children (29–71 months old). The Communication Complexity Scale (CCS) was used to measure participants' prelinguistic communication behaviours, which were extracted from a semi‐structured play interaction at Time 1. The Chinese Communicative Development Inventory (CCDI) was used to examine participants' expressive language at Time 1 and Time 2 (12 months later). According to Time 2 vocabulary size, participants were divided into two groups: Low CCDI, between 0 and 62 words, and High CCDI, more than 100 words. Linear regression was used to examine the relationship between early prelinguistic communication complexity and later expressive language. Binary logistic regression was used to determine which of the early communication behaviours were uniquely significantly related to later expressive language levels. Outcomes & Results: There was a significant positive relationship between prelinguistic communication complexity and expressive language 12 months later, even after controlling for age and concurrent language. Findings revealed a group difference in the frequency of gesture and vocalisation combinations between the Low and High CCDI groups at Time 1. Gesture‐vocalisation combinations also predicted better expressive language levels at Time 2. Conclusions & Implications: Our findings suggest that it may be beneficial to incorporate different complex communication behaviours into prelinguistic intervention targets for minimally verbal autistic children. The CCS hierarchies can be used as a reference for the intervention goals of minimally verbal autistic children. These findings highlight the importance of targeting gesture and vocalisation combinations when autistic children transition from single prelinguistic communication behaviours to multimodal behaviours. What this paper adds: What is already known on this subject: Children use eye gaze, gestures and vocalisations to communicate with others before they learn spoken language. There is strong evidence suggest that the frequency of prelinguistic communication predicts later linguistic achievements in autistic children. However, less is known about whether prelinguistic communication complexity also predicts later language and which specific behaviours are most predictive of language outcomes. What this study adds: Minimally verbal autistic children who exhibit more complex prelinguistic communication behaviours have better expressive language 12 months later. Gestures combined with vocalisations predict better expressive language in minimally verbal autistic children. What are the clinical implications of this work?: When identifying intervention targets for minimally verbal autistic children, the clinicians may reference the prelinguistic communication behaviours from the CCS. The gesture and vocalisation combinations are the key behaviours when targets transit from single form to two‐form behaviours. [ABSTRACT FROM AUTHOR]

Background: Treatment fidelity refers to the degree to which an intervention is implemented as intended. Promoting treatment fidelity is important to achieve a valid comparison in intervention research. However, it is often underreported: few studies detail the use and development of fidelity measures. This study aims to promote the treatment fidelity of a modified version of the Derbyshire Language Scheme (M‐DLS), a manualised intervention for children with language difficulties, by exploring participants' opinions on training and intervention delivery. Results inform development of a checklist and scoring system to monitor and promote treatment fidelity in a comparison trial. Method: Ten student speech and language therapists (SLTs) and two research assistants (RAs) participated in the study. All received training on the M‐DLS, and 10 were video‐recorded completing role‐plays of an M‐DLS session in small groups. Feedback was gathered after training and role‐plays in focus groups and interviews. Feedback was interpreted using the constructs of the Theoretical Domains Framework (TDF). A treatment fidelity checklist was then developed using the feedback. The first author and two RAs rated role‐play videos using the checklist to trial it to inform amendments and to promote interrater reliability. Interrater agreement was calculated using Spearman's test of correlation. Results: Participants discussed the importance of having clear materials and time to practise sessions. They suggested amendments to the materials and training to promote treatment fidelity. The checklist and scoring system accounted for participants' suggestions, with amendments detailed in a log. Spearman's correlation results suggested agreement between the raters was strong. Conclusions: Results emphasise the importance of training quality, practice and reflective opportunities and clear materials to promote treatment fidelity. The construction of the checklist and scoring system was described in detail, informing the development of future checklists. After further trialling, the checklist can be used to ensure the M‐DLS is delivered with high treatment fidelity in the comparison trial. What this paper adds: What is already known on this subject: Treatment fidelity is an essential component of intervention effectiveness and efficacy studies, ensuring the intervention is delivered as intended. It is also an essential component of evidence-based clinical practice. However, few research studies report the treatment fidelity process or publish the checklists used, depriving clinicians of useful information for implementation. What this study adds: This study describes in detail the iterative process of treatment fidelity checklist development, engaging those implementing the intervention in development. This ensured clarity and interrater reliability of the checklist. Furthermore, a novel scoring system was developed so that accuracy of implementation can be easily compared across users and across practice attempts. What are the clinical implications of this work?: The importance of treatment fidelity when implementing effective and efficacious interventions cannot be overstated. The treatment fidelity checklist developed for research can be easily adopted to support accurate implementation in clinical practice through an audit process. [ABSTRACT FROM AUTHOR]

Background: The impact of hearing impairment is typically studied in terms of its effects on speech perception, yet this fails to account for the interactive nature of communication. Recently, there has been a move towards studying the effects of age‐related hearing impairment on interaction, often using referential communication tasks; however, little is known about how interaction in these tasks compares to everyday communication. Aims: To investigate utterances and requests for clarification used in one‐to‐one conversations between older adults with hearing impairment and younger adults without hearing impairment, and between two younger adults without hearing impairment. Methods & Procedures: A total of 42 participants were recruited to the study and split into 21 pairs, 10 with two younger adults without hearing impairment and 11 with one younger adult without hearing impairment and one older participant with age‐related hearing impairment (hard of hearing). Results from three tasks—spontaneous conversation and two trials of a referential communication task—were compared. A total of 5 min of interaction in each of the three tasks was transcribed, and the frequency of requests for clarification, mean length of utterance and total utterances were calculated for individual participants and pairs. Outcomes & Results: When engaging in spontaneous conversation, participants made fewer requests for clarification than in the referential communication, regardless of hearing status/age (p ≤ 0.012). Participants who were hard of hearing made significantly more requests for clarification than their partners without hearing impairment in only the second trial of the referential communication task (U = 25, p = 0.019). Mean length of utterance was longer in spontaneous conversation than in the referential communication task in the pairs without hearing impairment (p ≤ 0.021), but not in the pairs including a person who was hard of hearing. However, participants who were hard of hearing used significantly longer utterances than their partners without hearing impairment in the spontaneous conversation (U = 8, p < 0.001) but not in the referential communication tasks. Conclusions & Implications: The findings suggest that patterns of interaction observed in referential communication tasks differ to those observed in spontaneous conversation. The results also suggest that fatigue may be an important consideration when planning studies of interaction that use multiple conditions of a communication task, particularly when participants are older or hard of hearing. WHAT THIS PAPER ADDS: What is already known on this subject: Age‐related hearing impairment is known to affect communication; however, the majority of studies have focused on its impact on speech perception in controlled conditions. This indicates little about the impact on everyday, interactive, communication. What this study adds to the existing knowledge: We investigated utterance length and requests for clarification in one‐to‐one conversations between pairs consisting of one older adult who is hard of hearing and one younger adult without hearing impairment, or two younger adults without hearing impairment. Results from three tasks (two trials of a referential communication task and spontaneous conversation) were compared. The findings demonstrated a significant effect of task type on requests for clarification in both groups. Furthermore, in spontaneous conversation, older adults who were hard of hearing used significantly longer utterances than their partners without hearing impairment. This pattern was not observed in the referential communication task. What are the potential or actual clinical implications of this work?: These findings have important implications for generalizing results from controlled communication tasks to more everyday conversation. Specifically, they suggest that the previously observed strategy of monopolizing conversation, possibly as an attempt to control it, may be more frequently used by older adults who are hard of hearing in natural conversation than in a more contrived communication task. [ABSTRACT FROM AUTHOR]