Seminars in Speech and Language最新文献

For half a century, Dr. Audrey Holland investigated, developed, and implemented ways to extend the assessment of adult language and cognitive-communication disorders beyond traditional impairment-based approaches. This article summarizes Dr. Holland's many groundbreaking contributions to assessment practices by describing and exemplifying major conceptual and measurement innovations that have emerged from her research of both formal and informal assessment techniques. Dr. Holland's assessment contributions encompass the development of many widely used measures of functional communication, discourse, and cognitive-communication abilities. She also contributed to the development of assessment principles that have become part of best-practice standards of care. Some of her most significant contributions include: Drawing attention to assessment within authentic functional contexts; highlighting connections between language, communication, related cognitive abilities, and broader aspects of health including quality of life; raising psychometric standards; and emphasizing the value of implementing multiple person-centered measurement techniques spanning formal and informal as well as quantitative and qualitative approaches. Dr. Holland's career-long commitment and contributions to developing more meaningful and authentic assessment practices have transformed our field and substantively elevated the quality of care and services that we are able to provide to all persons who are impacted by language and cognitive-communication disorders.

Audrey Holland (1982) compared test scores to observers' ratings of conversational communicative success in people with aphasia (PWA). This springboarded a body of evidence employing observers to rate discourse. We review the utility of those ratings for assessing PWA's communication success. A traditional literature review identified 16 articles involving naive or trained raters assessing PWAs' communicative success across discourse genres. Another 10 articles reported ratings over time. Collectively, these studies evaluated 349 PWAs. Four studies utilized observers to rate the success of PWA's conversations. Eight studies that reported observers' ratings on other discourse genres found that multimodal communication and facilitative contexts improved success, and ratings of informativeness and comfort related to objective discourse analysis measures. Nine of 10 studies examining treatment effects found that communicative success ratings captured improvements. Observers' ratings provide social validity by reliably assessing the discourse-level communicative success of PWA. Ratings correlated with standardized diagnostic and objective discourse metrics but provided a window into factors that affect communicative success, including the degree to which communication is interactive, multimodal, and contextual. Integrating observers' ratings of discourse success at pretreatment may help identify supports or barriers to successful communication, facilitate individualization of treatments, and offer social validity of change.

This article acknowledges Audrey Holland's influence on aphasiology as it specifically relates to the emergence of a strengths-based perspective on the everyday communication of people with aphasia. We explore a historical perspective, as well as current ways in which everyday communicative events are approached in both clinical and research practice. The term "functional communication" is synonymous with Audrey's work, with linguistically-based discourse analysis and therapy both viewed as natural companions and extensions of the concept within aphasiology. Audrey's focus on the interactional side of communication and psychosocial impacts of aphasia, as well as her expertise in analysis and measurement, contributed to the coalescing of impairment-based and social communication approaches, encompassing a true sense of humanity and connectedness. Her application of these in international contexts was also noteworthy. In this article, we hope to capture principles of aphasia management that underpin current clinical practice, and also move beyond the traditional clinic context to consider aphasia groups that have had such a key role in promoting successful social communication by and with people with aphasia. We suggest future directions to further promote the principles advocated by Audrey Holland in assisting people with aphasia to move forward with confidence with their conversation partners, friends, and communities.

Audrey Holland was a leading innovator and speech-language pathologist (SLP) in adult neurological communication disabilities for over five decades. She was a pioneer in the involvement of SLPs with people with dementia, inspiring both knowledge development and clinical practice regarding language, functional communication, and quality of life in persons living with dementia. Dr. Holland was also an extraordinary mentor who has impacted many generations of researchers and clinicians. Here, four researchers in the area of dementia and communication discuss the lessons they learned from Dr. Holland that fundamentally shaped their careers and the field of dementia and speech-language pathology. Lessons learned include the following: (1) do not be afraid to stand out when you have a novel idea that will help people; (2) look for strengths to support functional communication; (3) use communication strategies to support identity, quality of life, and self-determination in adults with acquired communication disabilities, including those with dementia; (4) shift from pathologizing to coaching; and (5) challenge the status quo. This article concludes by discussing Dr. Holland's lasting legacy.

Throughout her career, Audrey Holland advocated for persons with aphasia, urging clinicians and others to view each person in the context of their needs and desires in navigating daily life. In this article, we acknowledge her ideas about functional treatment, and consider their influence on contemporary, activity-focused aphasia treatment. Three criteria define activity-focused treatment: (1) activity-specific goals, (2) personally relevant targets, and (3) near-real-life practice settings. Elements of treatment design, activities, and outcome measurement described here exemplify Audrey's beliefs in person-centered clinical aphasiology. Operationalizing treatment elements and designing a context as close to real life as possible are clinical actions that support these beliefs. Activity-focused treatment and other life participation approaches have often been relegated to the last phase of treatment; following Audrey's example, we advocate beginning with activity-focused treatment based on a client's communication needs and desires. Activity-focused treatment benefits persons with aphasia, their families, clinicians, and other stakeholders by presenting outcomes that reflect communication change in a real-life context and that are individually relevant. Such outcomes foster an individual's inclusion in their communication environments, respect the WHO platform of functional treatment, and prepare a clinician to present outcome data relevant to that individual.

Audrey Holland's core beliefs of respect for people and the quality of their lives informed her life's work. This examination of the ways she managed the academic, research, and clinical parts of her illustrious career shows how Audrey leaves a rich legacy and serves as a model for navigating an impactful career path and enhancing clinical interactions. First, she mentored more than 30 doctoral students who then mentored further generations of students, ran clinics, or shaped policy. She also regularly taught classes, supervised student clinicians, and traveled the world doing lectures and workshops. Second, her scholarship spanned more than 50 years and a range of subjects, such as assessment and treatment, self-determination and self-advocacy, pragmatics, counseling, coaching, and communication strategies. Third, her collaborations with many colleagues within the field and in related fields extended her impact even further. Finally, a close analysis of her clinical communication style shows how Audrey's simple, nonverbal behaviors (e.g., eye contact, body position) brought out the best in the people with whom she worked. On all these levels-mentorship, scholarship, collaboration, and communication style-Audrey's legacy leaves a vast array of powerful lessons that can be studied, emulated, and appreciated for years to come.

Dr. Audrey Holland was a friend to people with aphasia and related disorders, care partners, community advocates, students, clinicians, educators, researchers, and more. Her profound impact extended across these diverse communities within aphasiology and speech-language pathology. Through her words and deeds, Audrey established a rich legacy that continues to guide and inspire countless individuals. A careful examination of her contributions reveals a roadmap for those seeking to embark on a similar journey of compassion and influence. To pay tribute to our mentor and friend, we conducted a thematic analysis of her solo works to identify enduring themes, laugh-out-loud anecdotes, and poignant insights to share with her friends, colleagues, mentees, and even strangers who, after reading this article, will be touched and changed by her wisdom.

Professor Audrey Holland is best known for her extraordinary contributions to the field of aphasia rehabilitation; however, for those working in the field of cognitive-communication disorders (CCDs) following traumatic brain injury (TBI), Audrey made seminal contributions to the conceptualization of language disturbances following TBI, setting the scene for a new era of investigation and discovery. This article describes Audrey's contributions which redefined communication disorders following TBI as being different from aphasia, leading to discourse and everyday communication being the gold standard for CCD assessment. Incorporating Professor Holland's influences, this article describes the advances made during the past two decades including the theoretical development of frameworks to inform clinical assessment; expert consensus guidelines that support the assessment of the individual in activities relating to their family life, their friends, their work, and their relationships; the policy from an International Classification of Functioning, Disability and Health (ICF) perspective; advances in technology including the use of automated discourse measures; TBIBank; and main concept analysis. Professor Holland's profound impacts include the recognition that communication skills play a central role in maximizing all aspects of one's life.

Aphasia negatively impacts mental health, disrupting social connections and meaningful life activities. Gratitude interventions for healthy adults positively impact well-being, physical health, and mental health. A systematic review of gratitude interventions for people living with chronic health conditions was conducted to identify current practices and existing gaps and to map the literature for incorporating gratitude interventions into aphasia rehabilitation. A scoping review of the literature published prior to March 2023 was conducted using CINAHL, Google Scholar, PubMed, and ERIC to identify gratitude interventions for adults with chronic health conditions. The search identified 414 studies. Five met the inclusion criteria. Interventions targeting chronic health conditions included alcohol use disorder, chronic heart failure, cancer, and asthma. No empirical studies were identified that used gratitude interventions with people who have aphasia or have had a stroke. Four studies used journaling as the intervention and one used gratitude letters. All interventions used written or verbal expressions of gratitude. Gratitude interventions have been used in limited ways with chronic health conditions. As gratitude interventions are language-based and rely on writing, people with aphasia may need modifications to support accessibility to these interventions which can positively impact mental health and well-being.

Individuals with Parkinson's disease (PD) exhibit a variety of impairments in nonmotor symptoms including emotional processing and cognitive control that have implications for speech production. The present study sought to investigate whether impairments in cognitive processing in individuals with PD impact emotional sentence production as indicated by changes in speech rate. Thirty-six individuals (20 individuals with PD, 16 healthy controls) completed subtests 8A and 8B of the Florida Emotional Expressive Battery (FEEB) to elicit speech samples in five different emotional tones (happy, sad, angry, fear, and neutral). Sentences contained either semantically emotional or neutral information, resulting in conditions of congruency (same semantics-tone) and incongruency (different semantics-tone). Speech rate was impacted by the emotional tone of all participants. Individuals with PD demonstrated faster speech rates under conditions of conflicting semantic information than healthy older adults. Changes in speech rate under emotional conditions were not influenced by global measures of cognition or depression. The results of this study indicate that individuals with PD struggle to manage irrelevant information present during emotional speech production. Speech rate is a simple, easy-to-measure metric that may reflect cognitive processing impairments in PD.