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Objective: Our aim was to evaluate a health education programme (TBIoptions: Promoting Knowledge) designed to increase public awareness and understanding about traumatic brain injury (TBI) through in-person (classroom) and computer-based (electronic) learning environments. Design: We used a pre-post survey design with randomization of participants to classroom (N = 22) or electronic (N = 22) delivery of the programme, in classroom and computer laboratory settings on the campus of Kansas State University, Manhattan, KS. Method: Forty-four participants rated areas of knowledge about TBI prior to and after the programme experience. They also rated health programme quality and instructional strategies (e.g. video vignettes). Written responses provided information for qualitative analysis. Results: Participants reported significantly higher ratings of knowledge after the programme experience. Qualitative analysis of written responses provided further evidence to support quantitative outcomes. There were no significant differences in comparing the two methods of delivery (classroom versus electronic learning format). Participants rated the quality of the programme and various instructional strategies very highly. Conclusion: TBIoptions: Promoting Knowledge offers a health education programme to increase understanding about TBI. Both modes of delivery, classroom and electronic, appeared equally effective in terms of self-report of change.

TBI"options" helps survivors of traumatic brain injury and their families identify, locate, and contact helpful organizations in their local communities to promote successful living. This article discusses the role of county agents in the program and the support offered by community partners. Results of pre- and post-surveys for both groups are reported. The research provides information regarding changes in knowledge and noteworthy outcomes for participating agents and community partners. Through engagement in the issue of traumatic brain injury, Extension is better positioned to meet the needs of survivors, family members, and caregivers within Kansas.

Purpose: This study compared the influence of speaker-implemented iconic hand gestures and alphabet cues on speech intelligibility scores and strategy helpfulness ratings for 3 adults with cerebral palsy and dysarthria who differed from one another in their overall motor abilities. Method: A total of 144 listeners (48 per speaker) orthographically transcribed sentences spoken with alphabet cues (aided), iconic hand gestures (unaided), and a habitual speech control condition; scores were compared within audio-visual and audio-only listening formats. Results: When listeners were presented with simultaneous audio and visual information, both alphabet cues and hand gestures resulted in higher intelligibility scores and higher helpfulness ratings than the no-cues control condition for each of the 3 speakers. When listeners were presented with only the audio signal, alphabet cues and gestures again resulted in higher intelligibility scores than no cues for 2 of the 3 speakers. Temporal acoustic analyses showed that alphabet cues had consistent effects on speech production, including reduced speech rate, reduced articulation rate, and increased frequency and duration of pauses. Findings for gestures were less consistent, with marked differences noted among speakers. Conclusions: Results illustrate that individual differences play an important role in the value of supplemental augmentative and alternative communication strategies and that aided and unaided strategies can have similar positive effects on the communication of speakers with global motor impairment. (Contains 2 figures, 1 footnote, and 4 tables.)

This study surveyed the practice patterns of speech-language pathologists in their use of thickened liquids for patients with swallowing difficulties. A 25-item Internet survey about thickened liquids was posted via an e-mail list to members of the American Speech-Language-Hearing Association Division 13, Swallowing and Swallowing Disorders (Dysphagia). Responses of 145 professionals who primarily manage adult dysphagia are reported. Although the majority affirmed that thickening thin liquids was an effective intervention strategy, opinions about effectiveness were more favorable for nectar-thick versus honey-like and spoon-thick consistencies. Respondents also acknowledged that their patients had little liking for thickened liquids. Results highlight issues related to products and staff training, as well as perceptions concerning the factors that might affect patients' acceptance of and compliance with use of the products.

The role of contextual factors in intelligibility was examined using sentences produced under varying conditions by a speaker with severe flaccid dysarthria. Results indicated that gestures, predictiveness, and context influenced intelligibility. It is argued that when signal fidelity is poor, different combinations of signal-independent information may enhance listener comprehension. (Author/PB)

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2006.04.022 Byline: Ziad Matta, Edgar Chambers, Jane Mertz Garcia, Jennifer McGowan Helverson Abstract: To describe and compare sensory characteristics of six beverages prepared with four commercial thickeners used in dysphagia diets.

Many speakers with dysarthria benefit from the use of strategies that provide additional contextual information to listeners, such as the use of hand gestures (gesticulations) while speaking. Less is known [...]

The effortful swallow is a common intervention strategy recommended for many people with dysphagia. This case report describes the use of effortful swallowing with a young man with a severe [...]

Simple measurement tools that provide objective information about the consistency of thickened liquids have received increasing attention given possible application to clinical practice for dysphagia. The International Dysphagia Diet Standardization Initiative (IDDSI) advocates the use of the IDDSI Flow Test for measuring thickness and verifying a prescribed level of consistency. This study compares gravity flow test measurements taken with two 10‐ml syringes of starch and gum‐thickened samples prepared to a mildly thick consistency using product label information. One of the 10‐ml syringes met IDDSI specification and the other 10‐ml syringe did not. Thickened samples also were measured using the line spread apparatus. The results showed that two syringes yielded significantly different gravity flow test measurements, often resulting in changes to the classification level of thickness. There was no effect of thickening agent. Line spread measurements did not vary from one another. Study findings indicate the importance of continued testing with the IDDSI Flow Test and education/awareness about the use of the IDDSI reference syringe. An essential aspect about the use of thickened liquids in dysphagia management is that beverage preparations represent their prescribed level of modification. The findings of this study indicate the importance of following syringe specifications when conducting gravity flow testing using the IDDSI methodology. The implication is that the wrong 10‐ml syringe could result in errant clinical decisions in determining the accuracy of texture modifications, resulting in care providers who are more likely to over or under thicken modifications to achieve a targeted level of thickness. [ABSTRACT FROM AUTHOR]

A 20-item Piagetian-type sorting task was presented to 12 unilaterally brain-injured adult patients and 12 non-injured controls. The left hemisphere brain-injured subjects and the controls showed preferences for the features of shape and texture. In contrast, the right hemisphere brain-injured subjects preferred the feature of size. (Author)

Purpose: Accurate texture modifications to thin liquids are a critical aspect of patients’ nutritional health and well-being. This study explored the use of 3 tools (2 distance- and 1 time-measuring devices) to characterize texture-modified liquids. The objectives were to use the tools to measure modified liquids, to determine if measurements differentiated nectar and honey levels of modification, and to compare measurements with other published reports. Method: We measured the flow distance of 33 prethickened water samples in centimeters (cm) using a line spread apparatus and a Bostwick Consistometer (Christison Particle Technologies). We selected a Zahn viscosity cup to measure the stream time of each prethickened liquid in seconds. Results: The 2 distance-measuring devices (line spread and Bostwick Consistometer) showed that thinner (nectar-thick) modifications spread or flowed a farther distance in comparison to thicker (honey-like) modifications. Testing with the line spread indicated that an average spread distance of 4.5 cm differentiated nectar-thick and honey-like consistencies. A flow distance of greater than 15 cm differentiated nectar from honey consistency measured with a Bostwick Consistometer. We were not successful in using the Zahn viscosity cup to determine the stream time of modified liquids. Conclusions: Two of the tools provided objective information about levels of liquid modification, which has implications for day-to-day preparation. Measurement tools that are accurate and easy to use have the potential to provide quick and dependable feedback to verify a prescribed level of liquid modification. Further efforts are needed to standardize the application of simple measurement tools in the management of patients who consume thickened liquids. [ABSTRACT FROM AUTHOR]

This study examined changes in the sentence intelligibility scores of speakers with dysarthria in association with different signal-independent factors (contextual influences). This investigation focused on the presence or absence of iconic gestures while speaking sentences with low or high semantic predictiveness. The speakers were 4 individuals with dysarthria, who varied from one another in terms of their level of speech intelligibility impairment, gestural abilities, and overall level of motor functioning. Ninety-six inexperienced listeners (24 assigned to each speaker) orthographically transcribed 16 test sentences presented in an audio + video or audio-only format. The sentences had either low or high semantic predictiveness and were spoken by each speaker with and without the corresponding gestures. The effects of signal-independent factors (presence or absence of iconic gestures, low or high semantic predictiveness, and audio + video or audio-only presentation formats) were analyzed for individual speakers. Not all signal-independent information benefited speakers similarly. Results indicated that use of gestures and high semantic predictiveness improved sentence intelligibility for 2 speakers. The other 2 speakers benefited from high predictive messages. The audio + video presentation mode enhanced listener understanding for all speakers, although there were interactions related to specific speaking situations. Overall, the contributions of relevant signal-independent information were greater for the speakers with more severely impaired intelligibility. The results are discussed in terms of understanding the contribution of signal-independent factors to the communicative process. KEY WORDS: dysarthria, intelligibility, gestures, context, predictiveness