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Background: Evidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia--ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA-1). Before the current study (ROMA-2), agreement had not been reached on OMIs for the constructs of communication or patient-reported satisfaction/impact of treatment. Aim: To establish consensus on a communication OMI for inclusion in the ROMA COS. Methods & Procedures: Research methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short-listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by [greater than or equal to] 70% of participants. Outcomes & Results: In total, 40 researchers from nine countries participated in ROMA-2 (including four facilitators and three-panel members who participated in pre-meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short-listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting (n = 33) who did not have conflicts of interest (n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living--3 (CADL-3). TST received 72% (n = 21) of 'yes' votes and the CADL-3 received 28% (n = 8) of 'yes' votes. Conclusions & Implications: Consensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient-reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research.

Poor comprehenders are a significant subgroup of poor readers who, due to their ability to read aloud accurately, are often difficult to identify. This study aimed to determine whether assessment using two oral language tasks, mapped onto the two components of the Simple View of Reading, would provide an efficient approach to identification. Children (N = 218) from School Years 3 to 6 (ages 7; 8-12; 1) attending two schools in Australia were assessed, and 45 identified as potential poor comprehenders, based on a profile of average phonological awareness but poor listening comprehension. Subsequent assessment of decoding and text reading comprehension confirmed 24 of these children to be poor comprehenders, consistent with reported prevalence rates. Five of these children were judged to be weak readers by their classroom teacher. The oral tasks alone overidentified this group; however, the findings suggest that using the tasks as an initial phase, followed up with a reading assessment, could be effective in identifying poor comprehenders, and reduce time spent in testing as this would only involve at-risk children.

In contrast to the large body of research investigating intervention for poor decoding skills, far fewer studies have evaluated interventions for reading comprehension. There is even less research on children with more specific difficulties with reading comprehension, often referred to as "poor comprehenders". Levels of effectiveness have varied for interventions targeting lower- and higher-level language, including inference making, on trained measures, with little transfer to generalised reading comprehension measures in both skilled and less-skilled readers. Outcomes have been more positive for poor comprehenders, however findings have been inconsistent as to which programme components have led to gains in reading comprehension. This pilot study utilised a case series design to explore whether a novel intervention targeting oral inference making and comprehension monitoring was effective in improving the targeted skills and reading comprehension of 11 children, aged 9;2-12;3 years, with average-for-age phonological and lower-level language skills but weak inferencing. All participants improved on the primary inference subtest post-intervention and continued to score higher at maintenance than at pre-intervention. Results on the remaining higher-level language tasks were more varied, as were the results for reading comprehension, with fewer participants demonstrating generalisation to these tasks, particularly the nonfiction texts. While the results are preliminary and descriptive, they suggest that improvements can be made in higher-level language in a 10-session intervention, and provide directions for future research.

This study aimed to profile the sublexical, lexical, and text level language skills, and cognitive processes of a sub-group of children with poor reading comprehension known as poor comprehenders. An assessment protocol was developed to assess each of the components from Perfetti and Stafura's Reading Systems Framework. A comprehensive profile was obtained for 17 poor comprehenders in School Years 3-6 (aged 8-11 years), each assessed individually. Consistent with previous research, and irrespective of age, the poor comprehenders in this study did not have difficulty with sublexical and word reading skills overall. Unexpectedly, only two children had difficulty with the lower-level language tasks at the Lexicon and sentence sub-level of the Reading Systems Framework. In contrast, 15 poor comprehenders had difficulty with higher-level comprehension processes. All children had weak verbal working memory, supporting previous research findings. The study provides direction for clinical assessment tasks for use with this population.

AbstractPurposeMethodResultConclusionAlthough discourse assessment is recommended, few tools exist for adolescent acquired brain injury (ABI) and few theories describe the contribution of cognition to discourse impairment. This study explored whether a novel discourse protocol can identify difficulties following ABI and whether a discourse processing model provides a useful account of impairment.Using a case-control design, two adolescent males with moderate ABI (12 and 14 years) were compared to a neurotypical sample on a range of language and cognitive assessments. Patterns in performance were interpreted using a theoretical model. Participants completed a standardised omnibus language assessment, discourse assessment, and battery of cognitive tasks.Analyses revealed significant differences in discourse and cognition between adolescents with and without ABI. No impairment was detected on a standardised language assessment. Patterns in discourse and cognition aligned with a contemporary model of discourse processing.Participants with ABI demonstrated discourse deficits relative to the neurotypical reference sample. The findings demonstrate the value of discourse sampling across multiple genres and analysis of microlinguistic to superstructural features. A structure-building framework (SBF) model, originating in schizophrenia, provides a promising theory with which to interpret discourse impairment and has the potential to inform intervention for discourse in ABI. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment, particularly of executive functioning, has been implicated in deficits in spoken discourse production following acquired brain injury (ABI). However, due to variation in the methodologies and heterogeneity of findings across studies, the nature and extent of this association is not well understood. Aims: This review aims to synthesize the literature investigating associations between cognitive deficits and discourse impairment after ABI. It is reported in accordance with guidelines of The Preferred Reporting Items of Systematic Reviews and Meta-Analyses. Data sources: Searches were conducted of a variety of databases including Medline, PsycINFO, EMBASE, CINAHL, ProQuest, Cochrane and ERIC. Additional studies were identified via reference harvesting. Eligibility criteria: Studies were included if they reported data on participants with ABI, assessed spoken discourse production and cognitive function, and performed statistical analyses to determine the association between discourse and cognitive variables. This review excluded non-English sources and those not published in peer-reviewed journals. Meta-analyses were not conducted due to variability across tools and terminology used to describe participant injury- and non-injury-related characteristics and outcomes. Results: Twenty-five observational studies were included in the review. Findings revealed significant associations between multiple cognitive functions and discourse across micro-linguistic to super-structural measures. Methodological and terminological inconsistencies were identified across studies, which limited systematic comparison of the results. Conclusions: This review revealed present, yet heterogeneous, relationships between cognitive and discourse deficits in speakers with ABI. Associations were interpreted in light of a well-established model of discourse processing. Greater comparison across studies would have been facilitated by a standard nomenclature in relation to cognitive constructs and standardized discourse assessment. Future research should explore the influence of injury- and participant-related factors on discourse-cognitive relationships. The lack of information on conversational discourse and paediatric ABI limits the generalizability of this review to daily interaction following ABI. While applicable across the lifespan, in-depth investigation of discourse following ABI in childhood and adolescence is a priority due to complex changes in language and cognition, and the potential for impairments profoundly impact social, emotional and academic progression into adulthood. Given the centrality of remediating cognitive-communication difficulties in ABI, the interrelationships between discourse and cognition should retain a critical focus of research. This will inform clinical management and future research with this population. Findings have implications for our theoretical understanding of discourse and the nature of its breakdown in ABI.

Background: Given the integral role that verbs play in sentence production, understanding verb deficits is critical to clinical practice. Difficulties in sentence production are often directly related to an inability to retrieve argument structure information which, according to most theoretical accounts, is specified at a lexical level as part of the semantic representation of the verb. The presence of an argument complexity effect when retrieving verbs in isolation, i.e. increased difficulty with increasing number of arguments required by the verb, is considered evidence of the integral link between verbs and the ensuing structure. Recent reports, however, of relatively intact verb retrieval and impaired argument structure suggest that difficulties with verbs and argument structure may not always co-occur. One explanation for this is that lexical--syntactic information may be stored separately to lexical-semantic information at the lemma level and then differentially impaired. Aims: To determine whether the presence of difficulties creating argument structure in a group of people with aphasia with verb-retrieval deficits consistently aligned with the underlying nature of their impairment, where semantic involvement resulted in argument structure difficulties and post-semantic impairment resulted in intact argument structure. This would provide evidence either to support or to challenge the view that argument structure is lexically specified. The presence of an argument complexity effect within the participants' single verb naming was also investigated to examine the relationship between verb argument information and any subsequent difficulties creating argument structure for sentence production. Methods & Procedures: Verb retrieval and argument structure production were investigated in 12 people with aphasia with verb-retrieval deficits on single-word and sentence-production measures. Outcomes & Results: Eight of the 12 participants presented with a semantic verb deficit (five semantic and three mixed semantic and phonological) and had difficulties in creating argument structure. Four participants presented with a phonological verb deficit. Of these, two had intact argument structure while two had impaired argument structure. An argument complexity effect in verb naming was seen in both groups. Conclusions & Implications: Semantic verb-retrieval deficits consistently resulted in argument structure production difficulties, supporting the view that syntactic information is stored within the lemma. The presence of argument structure difficulties in two participants with phonological deficits; however, lends support for the separate coding of lexical--syntactic from lexical-semantic information at the lemma level, a factor that has both theoretical and clinical implications with respect to diagnosis and management.

Background: Despite recognition of the need for increased long-term support for people with aphasia following stroke, there remains limited evidence for effective service-level interventions. Aims: To evaluate the outcomes and experiences of people participating in the Communication Hub for Aphasia in North Tyneside (CHANT), a 2-year partnership project between health, local authority and third-sector services, shaped by people with aphasia, which provided a coordinated programme of support and interventions for people with long-term aphasia following stroke. Methods & Procedures: Quantitative and qualitative methods were used in the evaluation. Thirty-nine participants with aphasia were recruited to the 12-month study as they became part of CHANT, with 20 completing all measures at the end of the study. Participants had no other speech and language therapy during the study. Quantitative measures (before and after intervention) were used for quality of life, self-report outcomes and goal attainment. Three of the participants with aphasia and three further people involved in the service (carer, volunteer, public sector worker) each agreed to a series of five semi-structured interviews over a 9-month period. A total of 28 interviews were collected using neutral interviewers; these were transcribed and analysed by a team within NVivo8 software, based on interpretive principles from grounded theory. Thematic analysis of the narratives explored the experience of engaging with CHANT, and the barriers and facilitators affecting quality of life. Outcomes & Results: People with aphasia made significant gains in quality of life (in particular, in communication and psychosocial adjustment to stroke) and self-report measures of change. A total of 82% of real-life goals set as part of intervention were fully or partially achieved at follow-up. Five core themes emerged from the narratives: "Quality of life", "Barriers", "Facilitators", "Types of CHANT activity" and "Effectiveness". The intervention was evaluated through the theme of "Effectiveness" in relation to the other themes, encapsulating emerging participant views (including the type and timeliness of activity, expectations of outcomes, resources and perceived value). The impact of the intervention was also analysed in terms of identifying barriers and providing facilitators. Conclusions & Implications: The quantitative and qualitative (narrative) findings were complementary in demonstrating the effectiveness of the CHANT service delivery model. Moreover, the narratives, through a longitudinal perspective, provided evidence about people's experience of intervention for long-term aphasia. The findings provide foundations for further work into long-term recovery, intervention and adjustment to aphasia post-stroke. (Contains 5 tables and 6 figures.)

Jarosite and related subgroup minerals are of high importance in mineral processing, as sources and sinks for metals and acidity in the environment, and they have the potential to preserve elemental and isotopic biomarkers relevant to the search for life in the solar system. The crystal structures and chemistry of jarosite minerals affect their stability and reactivity and thus the roles they play in natural and engineered systems. Rhombohedral symmetry has been documented in natural and synthetic jarosites, whereas monoclinic symmetry has only been documented in synthetic jarosites. This research reports the occurrence of monoclinic symmetry in a natural natrojarosite sample investigated using synchrotron powder X-ray diffraction (PXRD), thermogravimetric analysis (TGA), and electron backscatter diffraction (EBSD). Splitting of several rhombohedral PXRD peaks (e.g., 012, 027, and 033) into pairs of peaks was observed, with the magnitude of the splitting and the relative intensities of the pairs of peaks being almost identical to those reported for synthetic monoclinic jarosite. Rietveld refinement with room-temperature PXRD data shows an ordering of iron-site vacancies on the Fe1 site consistent with monoclinic symmetry, space group C2/m. Conversion of monoclinic unit-cell parameters into pseudo-hexagonal unit-cell parameters, specifically β′, also supports the use of a monoclinic model to describe the natrojarosite structure. Structural analysis with increasing temperature is supportive of the thermal evolution previously described for synthetic monoclinic jarosite samples, with some indications of subtle differences between synthetic and natural materials including slower rates of thermal expansion and absence of FeOHSO4 peaks for natural monoclinic jarosite. EBSD provides insight into the spatial–structural variation within the hand specimen from which the natrojarosite was sampled, demonstrating that there are areas of unambiguous monoclinic symmetry, but others where both monoclinic and rhombohedral natrojarosite coexist. The results of this study suggest that monoclinic symmetry in natural jarosites may be more prevalent than previous studies suggest. Monoclinic symmetry in jarosites is identifiable by an ordering of iron-site vacancies on the Fe1 site, splitting of specific rhombohedral XRD peaks into pairs of peaks, and an increase in jarosite symmetry (i.e., from monoclinic to rhombohedral) during heating. The splitting of peaks in monoclinic jarosites can be subtle so it is recommended that high-resolution XRD data are collected when studying the crystal structure of jarosites. [ABSTRACT FROM AUTHOR]

This study aimed to profile the sublexical, lexical, and text level language skills, and cognitive processes of a sub-group of children with poor reading comprehension known as poor comprehenders. An assessment protocol was developed to assess each of the components from Perfetti and Stafura's Reading Systems Framework. A comprehensive profile was obtained for 17 poor comprehenders in School Years 3–6 (aged 8–11 years), each assessed individually. Consistent with previous research, and irrespective of age, the poor comprehenders in this study did not have difficulty with sublexical and word reading skills overall. Unexpectedly, only two children had difficulty with the lower-level language tasks at the Lexicon and sentence sub-level of the Reading Systems Framework. In contrast, 15 poor comprehenders had difficulty with higher-level comprehension processes. All children had weak verbal working memory, supporting previous research findings. The study provides direction for clinical assessment tasks for use with this population. [ABSTRACT FROM AUTHOR]

Poor comprehenders are a significant subgroup of poor readers who, due to their ability to read aloud accurately, are often difficult to identify. This study aimed to determine whether assessment using two oral language tasks, mapped onto the two components of the Simple View of Reading, would provide an efficient approach to identification. Children (N = 218) from School Years 3 to 6 (ages 7; 8–12; 1) attending two schools in Australia were assessed, and 45 identified as potential poor comprehenders, based on a profile of average phonological awareness but poor listening comprehension. Subsequent assessment of decoding and text reading comprehension confirmed 24 of these children to be poor comprehenders, consistent with reported prevalence rates. Five of these children were judged to be weak readers by their classroom teacher. The oral tasks alone overidentified this group; however, the findings suggest that using the tasks as an initial phase, followed up with a reading assessment, could be effective in identifying poor comprehenders, and reduce time spent in testing as this would only involve at-risk children. [ABSTRACT FROM AUTHOR]

The article emphasizes the importance of understanding the factors influencing the quality of life for residents living with dementia and the need for innovative approaches. It highlights the Montessori method as a possible solution, demonstrating the positive outcomes it can achieve. It also provides a blueprint for implementing the Montessori model of care, emphasizing the need for a clear vision, specific goals, training, prepared environments.