This pilot study aimed to explore Spanish-speaking caregivers' attitudes and perceptions toward their preschool child's augmentative and alternative communication (AAC) system. It also examined caregivers' use of language strategies before and after a coaching program provided in their primary language, Spanish. Six Latinx Spanish-speaking caregivers completed a Likert scale pre- and postsurvey regarding their attitudes and perspectives on using AAC. Using a single-case research design, caregiver–child dyads received four, 30-min coaching sessions following the Teach–Model–Coach–Review protocol targeting use of language facilitation strategies (i.e., modeling, wait time, and asking questions) to promote communication while using AAC. Before the AAC coaching, most caregivers reported positive attitudes and perceptions toward using AAC, but none demonstrated use of the language facilitation strategies. After coaching, all caregivers reported positive attitudes and perceptions toward AAC and demonstrated increased use of modeling and wait time from baseline to intervention. The strategy of asking questions while using AAC posed challenges. This study supports the benefits of providing family- and person-centered AAC coaching and education to parents/caregivers in their native language and the scaling up of research to improve communication outcomes for multilingual learners using AAC.

This case report focuses on what patients and family members may experience when a neurological trauma transpires and resultant intensive care (ICU) delirium occurs. It is the personal account of the patient (A.B.) and spouse’s (R.G.B.) perspectives when the patient (A.B) suffered a vertebral artery aneurysm and hemorrhage and experienced intensive care unit (ICU) delirium after being in the ICU for 22 days. This case report provides the patient’s and spouse’s perspectives regarding delirium, i.e., A.B.’s inability to discern reality, loss of memory, paranoia and hallucinations, agency and recovery, post-ICU syndrome, and post-traumatic stress disorder (PTSD). Clinical diagnosis by the neurosurgeon indicated delirium, with treatment consisting of sleep sedation and uninterrupted sleep. A.B. was able to regain consciousness yet experienced post-traumatic stress disorder up to one year afterward. Consistent family participation in the patient’s delirium care is crucial. Family member care and family-centered strategies are provided with implications for future research and health care.

The study investigated word recognition during neural activation in monolinguals and bilinguals. We specifically examined word retrieval and blood-oxygenation changes in the prefrontal cortex during a code-mixed word recognition task. Participants completed a gating task incorporating monolingual sentences and Spanish-English code-mixed sentences while using functional near-infrared spectroscopy (fNIRS) to measure blood-oxygenation changes. Word recognition contained four phonotactic conditions: (1) voiceless initial consonants, (2) voiced initial consonants, (3) CV-tense words, and (4) CV-lax words. Bilingual speakers had word-recognition capabilities similar to monolingual speakers even when identifying English words. Word recognition outcomes suggested that prefrontal cortex functioning is similar for early age of acquisition (AOA) bilinguals and monolinguals when identifying words in both code-mixed and monolingual sentences. Monolingual speakers experienced difficulty with English-voiced consonant sounds; while bilingual speakers experienced difficulties with English-lax vowels. Results suggest that localization of speech perception may be similar for both monolingual and bilingual populations, yet levels of activation differed. Our findings suggest that this parity is due to early age of acquisition (AoA) bilinguals finding a balance of language capabilities (i.e., native-like proficiency) and that in some instances the bilingual speakers processed language in the same areas dedicated to first language processing.

This chapter will illustrate the intertwined concepts of cultural and language proficiency, acculturation, and resilience among marginalized populations and implications for higher education. When students make the transition to tertiary education, they are met with challenges of how to reconcile or integrate what they know and ways of doing things to different standards, rules, beliefs, and norms of higher education culture. Rather than an all or nothing approach, recognizing that preservation of the native culture may coexist with openness to a new culture may have long-term positive implications for families and their children. Strategies to reduce marginalization and achieve high levels of resilience in higher education for students will be provided for teachers, higher education administration, and other school professionals.

This study examined word identification among Spanish-English bilingual and English monolingual individuals, i.e., speech perception using a gated word task examining phonetic category formation. Participants included 25 English-speaking monolingual and 10 fluent Spanish-English speaking bilingual adults. The experiment included a gating task incorporating Spanish sentences, English sentences, code-mixed Spanish-English sentences, and code-mixed English-Spanish sentences. The gated words at the end of the sentences consisted of voiceless initial consonants, voiced initial consonants, CV-tense words, or CV-lax words. There was a significant main effect for consonant voicing features and for language group. In addition, there was a significant interaction between consonant voicing features and language group. A significant main effect for vowel tenseness was also found along with a significant interaction between vowel tenseness and language group. Results suggest that bilinguals are capable of ultimate attainment, with phonotactic capabilities similar to that of monolingual speakers when identifying English words. Bilingual speakers may also be more sensitive to voicing features for both Spanish and English words. Este estudio examinó la identificación de las palabras entre los individuos bilingües español-inglés y monolingües de habla inglesa, es decir, la percepción del lenguaje utilizando un sistema de palabras cerradas que examina la formación de la categoría fonética. Los participantes incluyeron 25 adultos monolingües de habla inglesa y 10 adultos bilingües español-inglés. El experimento incluyó un sistema cerrado que incorporaba frases en español, frases en inglés, frases español-inglés de código mixto y frases inglés-español de código mixto. Las palabras cerradas al final de las frases consistían en consonantes iniciales sordas, consonantes iniciales sonoras, palabras tensas con CV o palabras laxas con CV. Se produjo un efecto principal significativo para las características de entonación de las consonantes y para el grupo de lenguaje. Además, se produjo una interacción entre las características de entonación de las consonantes y el grupo de lenguaje. También se encontró un efecto principal significativo de la tensión de las vocales, y una interacción significativa entre la tensión de las vocales y el grupo de lenguaje. Los resultados sugieren que las personas bilingües son capaces de alcanzar un logro máximo, con capacidades fonotácticas similares a las de los hablantes monolingües, al identificar las palabras en inglés. Los hablantes bilingües pueden ser más sensibles también a las características de entonación de las palabras españolas e inglesas.

Hearing loss is very common in the United States and the most widespread disability in the U.S. Hearing loss is the third most chronic health condition in the U.S. Noise induced hearing loss (NIHL) results from damaging external noise. This injury leads to temporarily or permanently affecting sensitive inner ear structures (e.g., cochlea, organ of Corti, and hair cells). NIHL can result from a single high-level noise exposure or repeated exposures to excessively loud noises [i.e., typically 85 dBA or greater, (A weighted decibel)]. Damage to the inner ear can also result from aging (i.e., presbycusis). This case study documents the hearing loss of an otherwise healthy 21-year-old, male individual and his progressive moderate-to-severe sensorineural hearing loss over a period of 41 years. His history will be reported along with his perspective as a speech-language pathologist and speech scientist. The individual with hearing loss has adapted to wearing hearing aids over the last five years. Issues that have occurred affecting comprehension along with compensatory strategies that assisted listening and comprehension will be discussed.

Researcher-initiated research often has little or no input from the groups who will be affected by the results of the research. The aim of this project was to describe practices of embracing patient-partners (i.e., individuals with aphasia and spouses/family members) in research. Six webinars were developed for both researchers and patient-partners that were required prior to participating in a joint conference that focused on collaborative research teams. The conference was designed based on an appreciative inquiry approach. Including patient-partners into research priorities and planning has been accomplished across various health domains in the United States, but this was the first organized national effort, in the United States, to support the inclusion of people with aphasia and their families as active partners in the research process. Consequently, it is hoped that future aphasia researchers also include patient-partner teams into their research process for more ecologically valid outcomes.

This second article of a two-part case study focuses on the experiences of a patient and his spouse (caregiver) when a neurological trauma occurs. It is the personal account when A.B. survived a vertebral artery aneurysm and hemorrhage resulting in a subarachnoid hemorrhage. It is also an in-depth post-trauma account from two speech-language pathologists' viewpoints (i.e., patient and spouse/caregiver). Present-day persistent difficulties, 5 years post-trauma, are also presented. Therapeutic strategies for managing working memory difficulties, attention issues, and word retrieval issues are given. The spouse's perspective on managing emotional and caregiver stressors and recommendations based on these personal experiences and the Caregiver Empowerment Scale are provided. Suggestions for patients with neurological trauma returning home are suggested to improve home and social integration. In addition, strategies for caregivers are suggested to reduce stress and improve quality of life.

Subarachnoid hemorrhages (SAHs) are grave medical emergencies, whereas 30–50% of all SAHs may ultimately result in death. Subarachnoid hemorrhages share many resemblances with other neurological traumas such as a cerebral vascular accident, meningitis, and/or traumatic brain injury. Autoimmune encephalopathies (AE) occur when human antibodies assault the body's cell surfaces and/or synaptic proteins. Consequently, widespread nervous system and diffuse brain involvement may occur. With subarachnoid hemorrhages and autoimmune encephalopathies, multiple areas of cognition and language can be impaired. Case studies in communication sciences and disorders are underutilized, yet are important in evidenced‐based practice. Speech‐language pathologists in medical settings have worked with patients and families with similar types of disorders. Therefore, speech‐language pathologists should be well equipped to provide therapy with these types of injuries. This chapter presents two case studies and cognitive language rehabilitation strategies following diffuse brain injuries.

Subarachnoid hemorrhages (SAHs) are a serious medical emergency, as 30% to 50% of all SAHs can result in death. Personal accounts and case studies are an important aspect of evidence-based practice. This first article of two presents a review of AB's (patient) condition immediately following an SAH in the intensive care and immediately post discharge, that is, Days 1 through 22. An SAH shares many similarities with other neurological traumas such as a cerebral vascular accident, meningitis, and/or traumatic brain injury. Speech-language pathologists (SLPs) in medical settings have worked with patients and families with these types of disorders. Therefore, SLPs should be well equipped to assist with SAH issues from their existing knowledge and experiences.

You have accessThe ASHA LeaderOn the Pulse1 Sep 2016Are Your Clients Ready to Vote?Even people who’ve lost their ability to read can vote—if they’re given the right preparation and technologies. Jacqueline Hinckley, andPhD, CCC-SLP Alejandro BricePhD, CCC-SLP Jacqueline Hinckley Google Scholar More articles by this author , PhD, CCC-SLP and Alejandro Brice Google Scholar More articles by this author , PhD, CCC-SLP https://doi.org/10.1044/leader.OTP.21092016.38 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In If you have trouble reading, voting might seem impossible. But it needn’t be. Mike Caputo has aphasia from a stroke and uses text-to-speech technology apps on his smartphone and tablet to help read the newspaper and emails. The 54-year-old businessman hasn’t voted in the five years since his stroke, though, because no one ever told him that the same kind of technology he uses for newspapers and email could help him read the ballot and vote confidently—and privately—in the polls. “I never knew about it,” Caputo says. “And all these years since my stroke, I never voted until now.” Any communication or sensory disability that affects reading is likely to hinder the ability to vote. Helping people to return to social roles—including the role of citizen—is the goal of rehabilitation in general. It also fits squarely in ASHA’s 2016 Scope of Practice in Speech-Language Pathology, which describes the overall objective of speech-language pathology services: “to optimize individuals’ abilities to communicate … thereby improving quality of life”. Speech-language pathologists, therefore, play a critical role in helping people with communication difficulties return to voting independently and by secret ballot. There are many people and organizations out there that can help. Speech-language pathologists play a critical role in helping people with communication difficulties return to voting independently and by secret ballot. Life participation In the life participation approach to aphasia (LPAA), the life goals of the person living with aphasia, and of those around them, are primary targets for intervention efforts. For many people, fulfilling the role of active citizen through voting is one aspect of their former lives. As a fundamental right and responsibility in a democratic society, voting goes to the core of people’s identities as citizens. The LPAA uses the World Health Organization (WHO) definition of disability: It is not just a personal health problem, but also encompasses the interaction between the person and society. WHO also states that people with disabilities are one of the most marginalized groups in the world; one example of marginalization is the inability to vote. Aphasia is not the only condition that affects participation in civic activities. Hearing impairment, developmental language disabilities or acquired language disability due to neurological conditions or trauma can all restrict participation in society through voting and related activities. Physical disabilities can also hinder a person’s ability to mark a ballot. Fortunately, voting technologies are available that can make going to the polls an accessible and independent experience for people with a variety of disabilities. Treatment options The first thing that SLPs can do is to target the language skills required to understand the ballot and ballot issues. Using a printed version of the sample ballot or printed versions of candidates’ or position summaries, the SLP can target reading comprehension in the following ways: Underline key words. Target comprehension of paragraphs by asking comprehension questions. Practice using text-to-speech technology, if appropriate, for understanding written material. Clinicians can also use the voting and candidate information to target auditory listening comprehension. To target writing, ask the client to write words, phrases or sentences related to information that they read, or to explain their position if they choose. Voting technologies are available that can make going to the polls an accessible and independent experience for people with a variety of disabilities. Environmental options In the LPAA, targeting the environment is a relevant and important way to improve a person’s functioning. Technologies are available that can make the confidential and independent U.S. voting experience accessible to many individuals with aphasia. For example, the AutoMark is a special voting machine that provides text-to-speech output with adjustable speech rate, magnified visual displays, touch-screen input, paddle-switch input, and sip-and-puff input. The Pinellas County (Florida) board of elections created a voter education video that introduces AutoMark to prospective voters. Depending on a state’s voting method, some standalone technologies—text-to-speech apps or devices—may be equally useful in helping someone vote independently. Voters in some states—Oregon, for example—are limited to mail-in ballots only. Polls may also allow a helper to accompany a person with a disability if desired. Although mail-in ballots provide the opportunity to have someone else assist with the ballot, it is the right of every U.S. citizen to vote secretly, an act which reinforces the person’s autonomy and value. Local voting information Your local state supervisor or board of elections can demonstrate the technologies that are available in your state to your aphasia group, support group or clinic. We recently organized an open voter registration event at a local community center for people with communication and other disabilities. You can find your local state election office on the website of the Federal Election Commission. Election boards offer a variety of adapted information; Pinellas County, for example, also has an audio version of its Voter’s Guide on YouTube. It takes just a few minutes to contact your local elections office. But those minutes could make a huge difference to your clients’ sense of self, autonomy and participation in a full life. Author Notes Jacqueline Hinckley, PhD, CCC-SLP, is executive director of Voices of Hope for Aphasia, Inc., in St. Petersburg, Florida. She is an affiliate of ASHA Special Interest Groups 2, Neurophysiology and Neurogenic Speech and Language Disorders; and 15, Gerontology. [email protected] Alejandro Brice, PhD, CCC-SLP, is a professor in the College of Education at the University of South Florida-St. Petersburg. He is an affiliate of ASHA Special Interest Group 14, Cultural and Linguistic Diversity. 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Video created as part of a Faculty Research Lightning Talk, Nelson Poynter Memorial Library, April 7, 2016. 5 minutes 16 seconds in duration.

Introduction Bilingualism is the norm worldwide. Despite the fact that nearly one in five individuals (17.9%; U.S. Census Bureau, 2007) speaks another language other than English in the home, knowledge regarding the nature of bilingualism and school performance, particularly vocabulary skills in bilingual children, is still needed. Purpose This study investigated vocabulary skills of bilingual, Spanish-English speaking students enrolled in 3rd, 4th, and 5th grades. Methods Fifteen Spanish-English speaking students were administered English and Spanish receptive and expressive vocabulary measures. Total conceptual vocabulary scores were also obtained for both the English and Spanish measures. Results Results indicated significant differences for 3rd and 5th grade groups on the Spanish expressive vocabulary measure and also on the expressive total conceptual vocabulary measure. Conclusions The bilingual students, although the majority had been mainstreamed and exited from ESOL classes and services, appeared to be still acquiring English vocabulary skills and may have not attained complete cognitive academic English language proficiencies. Therefore, it is possible that incomplete vocabulary skills may affect overall academic language skills and overall academic performance. Speech-language pathologists (SLPs) must strive to maintain native language skills that facilitate reading comprehension and English academic success.

Typical language development has far too long been predicated on monolingual development. It is estimated that approximately more than half of the world's population speaks more than one language. Multilingual or multilanguage acquisition differs from monolingual development. It involves more layers that affect ultimate acquisition including second and/or multiple language acquisition factors, environmental factors, individual factors, developmental factors, and, if the child has disabilities, then disabilities are also confounding factors. In addition, the following factors influencing multilingual language acquisition will be discussed: (1) second and/or multiple language acquisition; (2) language dominance and proficiency; (3) language maintenance; (4) language model; (5) language deceleration; (6) cross-linguistic influence, that is, language transference; (7) cross-linguistic influence, that is, language interference; (8) cross-linguistic influence, that is, code switching and code mixing; (9) ultimate attainment; (10) language loss (attrition); (11) language fossilization; (12) environmental factors; (13) individual and developmental factors; (14) biological, neurological aspects of multilingualism; (15) disability factors; and (16) strategies for promoting multilingualism. This article will briefly present these overlaying components and provide suggestions for language professionals in promoting multilingualism.

Children's names reflect their gender, culture, religion, language, and family history. Use of students' personal names has the power to positively affirm identity and signal belonging within the classroom and school community. However, naming practices also have the power to exclude, stereotype, or disadvantage students. For many students from diverse cultural and linguistic backgrounds, their names can be a source of cultural conflict and a watershed for issues of identity and belonging within the school setting. Through multicultural explorations of students' names, educators can affirm students' cultures and identities, and draw upon these as resources to support learning and development from early childhood through the adolescent years. The purpose of this article is to (a) discuss the importance of a person's name to cultural identity, (b) describe strategies to build multicultural communities in K-8 classrooms through exploration of students' names, and (c) suggest multicultural children's literature and curricular activities to teach about the importance of personal names, and develop cross-cultural understandings.

Alejandro's StoryI was born with the name “Alejandro.” My parents shortened this to “Ale” (ah-leh) when calling me. However, upon becoming a naturalized U.S. citizen at age 7, my name was changed t...