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Describing events may be challenging for any child, but children who use communication aids may face unique linguistic, pragmatic, and strategic challenges in conveying information with the communication means they have available. This study explores strategies used by young, aided communicators when describing the content of a video unknown to their communication partners. The participants of the study were 48 aided communicators (aged 5;3-15;2) from nine countries and seven language groups and their communication partners (parents, professionals, and peers) who used natural speech. Descriptive and statistical analyses were utilized to investigate the relationships between individual characteristics, linguistic and non-linguistic factors, linguistic strategies, and performance in conveying the content of the video event. Analyses of the 48 videotaped interactions revealed the use of a variety of linguistic elements and multimodal strategies, demonstrating both creativity and challenges. Success in relaying messages was significantly related to age, mode of communication, and individual profiles, such as everyday communication functioning and comprehension of grammar. Measures of receptive vocabulary and non-verbal reasoning were not significantly related to communicative success. The use of shared context and negotiation of meaning of potentially ambiguous utterances demonstrate the shared responsibility of disambiguation and meaning construction in interactions involving aided and naturally speaking communicators.

Background & aims: Difficulties understanding spoken language are associated with several social and academic risks in school-age children and adolescents with developmental language disorder (DLD). Still, interventions for this group have received little attention, and there are no reviews focusing on oral language comprehension interventions in school-age children and adolescents. The objective of this systematic scoping review was to identify interventions targeting oral language comprehension in school-age children and adolescents with DLD. Further, the aim was to examine the focus of intervention, efficacy, and level of evidence of the identified interventions. The present review is the second part of a larger search on oral language comprehension interventions. The first review examined the same factors in children 8 years and younger. Methods: A systematic scoping review of eight databases was conducted. Of the 2399 sourced articles, 12 met the inclusion criteria. Another 8 articles were identified through reference lists of sourced articles. In these 20 articles, containing 21 studies, 1661 children aged 5-16 years participated. The data were extracted and analysed, and the intervention focus, efficacy, and level of evidence were examined. Main contribution: In the interventions intended for school-age children and adolescents with DLD, three intervention foci were identified that targeted aspects of language and language processing, as well as modifying the communicative environment. Of the included studies, 57% reported positive results, 14% reported mixed results, and 29% reported no effects on oral language comprehension. The level of evidence varied. One can have high confidence in the results of 19%, moderate in 38%, and indicative confidence in 43% of the included studies. Conclusions: Results of the present review suggest that there are a few interventions providing high confidence on the efficacy of improving oral language comprehension difficulties in school-age children and adolescents with DLD. Most interventions indicating efficacy provide moderate or indicative confidence in the results. More research with a high level of evidence is urgently needed. Most of the interventions indicating efficacy focused directly on language skills or modified the communicative environment. The results suggest that the therapy techniques focusing on improving language processing skills indicate efficacy only when they aim at compensating current language processing skills, not trying to improve them. Implications: The findings on different therapy techniques, their focus of intervention, efficacy, and level of evidence provide information for clinical practice and direct future investigations in this sparsely researched topic.

Aided communicators often have an opportunity to express themselves with speech-generating devices (SGDs) that produce symbol by symbol (SBS) and/or pre-stored (PS) utterances. Studies on the usage of PS utterances report that these utterances affect conversations positively, but it appears that aided communicators and professionals may have divergent views on their benefits. The aim of this study is to analyse how school-aged aided communicators, their mothers, peers, and speech and language therapists (SLTs) co-construct the social actions of PS utterances during their everyday interactions. The theoretical framework of this study is conversation analysis. This approach to analysing the data enhances our understanding of the linguistic and temporal resources of PS utterances and how they are used to reinforce various rich social actions that promote the progress of aided conversations to resemble natural spoken conversations. The results of this study will help SLTs and teachers in their planning content for SGDs as well as in teaching, and guiding aided communicators and their partners to utilize PS utterances in combination with SBS utterances during their conversations.

Co- constructing meaning is a common feature of all conversations but may have a more specific role in interactions where one of the participants uses aided communication. The present study applies qualitative descriptive analysis supported by quantitative measures in exploring meaning- negotiation strategies of speaking communication partners in task- related aided conversations. The study focuses on identifying and exploring strategies that the communication partners utilise when attempting to interpret the meaning and resolve potential ambiguities of aided utterances in the context of event descriptions. The participants of the study were three aided communicators (age 8 to 11 years), who used graphic communication systems as their main means of communication, and familiar adult communication partners. The results demonstrate that the communication partners employed several strategies in attempting to comprehend, interpret and co- construct the meaning of aided utterances at various phases of interaction. The primary strategy involved clarifying the lexical properties of the aided constructions, reflecting the multidimensional and polysemous nature of graphic communication systems. Structural and referential complexities affected how the elements produced were understood as part of the ongoing context. The study highlights the participants´ shared responsibility in developing and utilising effective meaning- negotiation and repair strategies to support successful communication. [ABSTRACT FROM AUTHOR]

Specific language impairment (SLI) is a condition that affects children's emerging language skills. Many different language skills can be affected in SLI, but not all individuals with SLI have the same set of difficulties. As a result, SLI is a highly heterogeneous condition. The ability to read and understand written text is a higher function of language, which has its base on the language skills that may be affected by SLI. Previous studies suggest that children with SLI are at risk of developing literacy difficulties at school age. To test this hypothesis a longitudinal follow-up study of SLI was performed in an urban city in Finland. Forty-three children diagnosed with SLI completed tests for lexical and rapid automatized naming (RAN) and reading ability (technical reading and reading comprehension). Children were tested in schools in years one to three, at the end of each school year. At the age of 10 (year 3) children with SLI had relatively weak technical reading abilities with somewhat stronger reading comprehension abilities and concomitant lexical retrieval impairments, but age-appropriate RAN abilities. These findings lend further support to the view that SLI imposes a considerable risk in learning to read. Even in an orthographically highly transparent language, such as Finnish, technical reading skills often seem to remain poor. In this study, the findings on the development of lexical retrieval abilities support the Matthew-effect model in reading development (Stanovich, 1986), while the results of the development of RAN abilities support the developmental lag theory (Stanovich et al., 1988). All in all, these children with SLI had great difficulties in learning to read, which places them at a serious risk of developing concomitant learning problems.

Background: Speech and language therapists (SLTs) working with adults who have multiple learning disabilities and complex communication needs often deliver their care via indirect therapy where SLTs train carers to communicate with their clients. Yet, very little is known about how SLTs assess the carers' communication skills prior to the training even though the assessment should be the basis of this indirect therapy. Aims: To explore the level of agreement between Finnish SLTs' assessments of carers as skilful communication partners for adults who have multiple learning disabilities and complex communication needs. To investigate which interaction strategies affect the SLTs' assessments. Methods & Procedures: Six SLTs with more than 15 years of experience in working with individuals with complex communication needs saw together ten video clips of interaction situations between a carer and an adult who had multiple learning disabilities (aged 17-50 years). The SLTs assessed the carers on a scale from one to ten. The SLTs discussed their selections before giving their final ratings. The data were analysed both quantitatively and qualitatively. The unanimity of SLTs' assessment was analysed with a test of Kendall's "W". Furthermore, the frequencies of the carers' different communication acts were counted and these counts were compared with the mean of the carers' assessments. These results were further explored with the SLTs' justifications about their assessments. Outcomes & Results: SLTs did not fully agree on which of the carers were the most skilful interaction partners. Furthermore, the six SLTs were not unanimous about which carers' interaction strategies resulted in skilful communication. However, SLTs assessed those carers higher who used facilitative verbal acts. The carers used these verbal acts to involve themselves in the interests of the client. Conclusions & Implications: This case study showed that Finnish SLTs seem to have different criteria about what is considered skilful communication between carers and clients who have multiple learning disabilities. Even though there might not be a single way of being a skilful interaction partner, this variable can be confusing to carers if they work with several SLTs and each of them offers different professional advice. Therefore, the results suggest a need for an assessment tool for evaluating the carers' interaction skills. In addition to this tool, it appears that SLTs also need further training to be able to perform this multifaceted task. (Contains 6 tables.)

Background: Often communication training has been directed at the communication practices of staff members working with people with multiple learning disabilities. To date, the thinking habits of staff members, which also influence interactions, have not been addressed. We identified the issues staff members perceived as important for their development as communication partners after participating in a communication training program. Method: Six key staff members participated in semistructured interviews that explored the insights they had gained during participation in the Finnish communication training program OIVA. Results: Participating staff members identified issues relating to the communication practices and thinking habits they had acquired during the training. Both communication practices and thinking habits were important for the staff members' development as communication partners. Conclusions: The findings of this study suggest that it is important to give staff members the opportunity to learn new practices and to explore the thinking that underpins the actions they perform during communication training. (Contains 1 figure and 2 tables.)

Background: The increasing prevalence of specific language impairment (SLI) is a matter of current debate. Aims: Speech and language therapists and other authorities in Finland have discussed the prevalence of SLI since the 1990s. This discussion has been based on international studies because of the lack of national studies. This paper presents the first Finnish prevalence study of SLI in primary healthcare and, thus, participates in the international discussion on the prevalence of SLI. Furthermore, two samples of delayed language development (DLD) were studied. Methods & Procedures: This is a retrospective study from 1989-1999. It was conducted on the population of one of the biggest towns in Finland, and was collected from the statistical records of speech and language therapists. Outcomes & Results: The prevalence of SLI increased, and this increase was statistically significant. The prevalence of SLI was less than 1% in age group 0-6 years and, thus, presents a much lower prevalence than international discussion has suggested. SLI seems to be present particularly in boys though it was also increasing in girls. Furthermore, children with SLI seem to be more affected by receptive difficulties over the period studied. Particularly important is the observation that the prevalence of DLD was also increasing, and together with SLI they suggest a prevalence rate of 2.5% in Finland. Conclusions: The low prevalence of SLI in this study might be a consequence of the path of intervention that effectively separates SLI from delayed language development. Furthermore, the questions of language specific features needs to be emphasized. The findings of this study suggest that the prevalence of SLI increased as did the prevalence of DLD. The range of prevalence estimates of SLI in different studies raises the need for national and international epidemiological studies of SLI with equal criteria of assessment in each language. (Contains 2 figures and 9 tables.)

This paper focuses on the aspects of the lexicon in 66 prematurely born very-low-birth-weight and 87 full-term Finnish children at 2;0, studied using the Finnish version of the "MacArthur Communicative Developmental Inventory". The groups did not differ in vocabulary size. Furthermore, the female advantage in vocabulary size was not seen in preterm children. The overall shapes of the trajectories for the main lexical categories as a function of vocabulary size were highly similar in both groups and followed those described in the literature. However, there were significant differences in the percentage of nouns and grammatical function words between the two groups. The results suggest that prematurity "cuts off" the female advantage in vocabulary development. Furthermore, it also seems that there are differences between prematurely born and full-term children in the composition of the lexicon at 2;0. The findings support the universal sequence in the development of lexical categories. [This study was authored in part by the Pipari Study Group. This study was supported by grants from the Emil Aaltonen Foundation, the Friends of Paediatric Clinics in University Hospitals in Finland Fund and the Neonatal Research in Southwestern Finland Fund.]

The androgen receptor (AR) plays a central role in the development and maintenance of the male phenotype. The binding of androgens to the receptor induces interactions between the carboxyterminal ligand-binding domain and the highly conserved 23FQNLF27 motif in the aminoterminal domain. The role of these so-called N/C interactions in AR functioning is debated. In vitro assays show that mutating the AR in the 23FQNLF27 motif (called ARNoC) attenuates the AR transactivation of reporter genes, has no effect on ligand binding, but does affect protein-protein interactions with several AR coregulators. To test the in vivo relevance of the N/C interaction, we analyzed the consequences of the genomic introduction of the ARNoC mutation in mice. Surprisingly, the ARNoC/Y mice show a normal male development, with unaffected male anogenital distance and normal accessory sex glands, male circulating androgen levels, body composition, and fertility. The responsiveness of androgen target genes in kidney, prostate, and testes was also unaffected. We thus conclude that the N/C interactions in the AR are not essential for the development of a male phenotype under normal physiological conditions. [ABSTRACT FROM AUTHOR]

Active engagement in interactions is crucial for the development of identity, social competence, and cognitive abilities. For children with severe speech impairment (SSI) who have little or no intelligible speech, active participation in conversations is challenging and can be critical for their social inclusion and participation. The present study investigated the conversational patterns emerging from interactions between children with SSI who use aided communication and typically speaking conversation partners (CPs) and explored whether active participation was different in interactions with different numbers of partners (dyadic versus multi-person interactions). An unusually large multilingual dataset was used (N  =   85 conversations). This allowed us to systematically investigate discourse analysis measures indicating participation: the distribution of conversational control (initiations versus responses versus recodes) and summoning power (obliges versus comments). The findings suggest that (i) conversations were characterized by asymmetrical conversational patterns with CPs assuming most of the conversational control and (ii) multi-person interactions were noticeably more symmetric compared to dyadic, as children's active participation in multi-person interactions was significantly increased. Clinical implications and best practice recommendations are discussed. [ABSTRACT FROM AUTHOR]

Background: Reaching mutual understanding can sometimes be challenging in interactions involving communicators using aided communication. This explorative qualitative study offers insights into some of the features of utterance interpretation and meaning negotiation in interactions using graphic communication systems. Method: Relevance theory was applied as a framework for analysis of conversations between a non-speaking child using a communication aid and her communication partners using natural speech. Results: Through analysis of a series of videotaped conversations, several assumptions and contextual implications affecting the interpretation processes were identified. A tendency to organize interpretations according to contextual expectations and scripts emerged as a central explanatory factor in co-constructing meanings from available graphic utterances. Conclusion: This study highlights the importance of understanding factors that may affect the interpretation processes of all participants in interactions involving aided communication. [ABSTRACT FROM AUTHOR]

This study describes the multiple coconstruction process of aided utterances that occur when non-speaking people use a communication book in their everyday conversations. Previous studies have reported that coconstruction is present both in the progress of pointing-voicing pairs and in the negotiation of meanings. Adopting the concepts and the tools of multimodal conversation analysis, this study demonstrates how two non-speaking boys and their speech and language therapists utilized simultaneously six interactional resources that were interwoven in different multimodal practices during their coconstruction of aided utterances. The observations elicited by microanalysis provide an insight into the temporal, co-operative and progressive nature of conversations that are constructed with a communication book. The findings of this study are helpful for professionals in assessing and scaffolding aided communicators during their conversations with their significant communicative partners. [ABSTRACT FROM AUTHOR]