This dissertation describes a research project about the communication between communication vulnerable people and health care professionals in long-term care settings. Communication vulnerable people experience functional communication difficulties in particular situations, due to medical conditions. They experience difficulties expressing themselves or understanding professionals, and/or professionals experience difficulties understanding these clients. Dialogue conversations between clients and professionals in healthcare, which for example concern health-related goals, activity and participation choices, diagnostics, treatment options, and treatment evaluation, are, however, crucial for successful client-centred care and shared decision making. Dialogue conversations facilitate essential exchanges between clients and healthcare professionals, and both clients and professionals should play a significant role in the conversation. It is unknown how communication vulnerable people and their healthcare professionals experience dialogue conversations and what can be done to support successful communication in these conversations. The aim of this research is to explore how communication vulnerable clients and professionals experience their communication in dialogue conversations in long-term care and how they can best be supported in improving their communication in these conversations.
Inter)nationally there is discussion about whether auditory processing disorders (APD) should be seen as a unique clinical diagnosis and what is the most appropriate diagnosis and referral of children in this target group. In this context, the Dutch Audiological Centres (AC) have different care pathways for children with so-called unexplained listening difficulties. The purpose of the current document is to provide professionals with tools to identify, diagnose and treat children with listening difficulties. The Dutch Position Statement Children with Listening Difficulties has been developed based on current scientific evidence of listening difficulties, and based on meetings held with professionals. Professionals in the Dutch Audiological Centres have reached a consensus with the following 9 statements: Definition: (1) The target group 'Children with listening difficulties' is not a unique and demonstrable clinical entity. (2) The problems of children with listening difficulties are multimodal. (3) The symptoms of children with listening difficulties may also occur in children with other developmental disorders such as AD(H)D, DLD, dyslexia and learning disorders. Detection and referral: (4) After detection of listening difficulties, children can be referred to a multidisciplinary centre. Diagnostics: (5) When diagnosing a child with listening difficulties, an audiologist, a speech language therapist and a behavioral scientist must be involved. (6) Listening difficulties are initially mapped using patient history (with client-centred focus) and, if available, a validated questionnaire. (7) In the case of children with listening difficulties, a speech-in-noise test is always carried out in addition to the pure tone and speech audiometry (8) The diagnostic procedure for listening difficulties starts from a broad perspective on development. Therapy: (9) For children with listening difficulties, intervention is focused on the client’s needs and focuses on action-oriented practice. This document informs professionals in the Netherlands, who are working with children who are referred because of listening difficulties in the absence of hearing loss, about the current evidence available and about the consensus in the Netherlands.
Background: Children with difficulties in listening and understanding speech despite normal peripheral hearing, can be diagnosed with the diagnosis Auditory Processing Disorder (A). However, there are doubts about the validity of this diagnosis. The aim of this study was to examine the relation between the listening difficulties of children between 8 and 12 years with suspected A and the attention, working memory, nonverbal intelligence and communication abilities of these children.Material and methods: In this case-control study we examined 10 children who reported listening difficulties in spite of normal peripheral hearing (3 referred by speech-language pathologist in the Northern Netherlands, 6 by an audiological center in the Southern Netherlands and one by parental concern) and 21 typically developing children (recruitment through word of mouth and by the website Taalexpert.nl), ages 8;0 to 12;0 years. The parents of all children completed three questionnaires about history, behavioral symptoms of ADHD, and communication skills (Children’s Communication Checklist). Teachers of the children completed the Children’s Auditory Processing Performance Scale (CHAPPS). Children were assessed for auditory processing abilities (speech-in-noise, filtered speech, binaural fusion, dichotic listening), nonverbal intelligence (Raven’s Coloured Progressive Matrices), and working memory (Clinical Evaluation of Language Fundamentals). Auditory and visual attention was studied with four behavioral tests of the WAFF battery of the Vienna Test System (Schuhfried).Results: Preliminary analysis shows no differences between groups on the auditory processing tests and nonverbal intelligence quotient. Children in the experimental group have poorer communication performance (parent report), poorer listening skills (teacher report), and poorer working memory and attention skills (behavioral tests).Conclusions: The results of this study showed that there is a difference between children with listening complaints and typically developing children, but that the problems are not specific to the auditory modality. There seems to be no evidence for the validity of an auditory deficit.
“Empowering learners to create a sustainable future” This is the mission of Centre of Expertise Mission-Zero at The Hague University of Applied Sciences (THUAS). The postdoc candidate will expand the existing knowledge on biomimicry, which she teaches and researches, as a strategy to fulfil the mission of Mission-Zero. We know when tackling a design challenge, teams have difficulties sifting through the mass of information they encounter. The candidate aims to recognize the value of systematic biomimicry, leading the way towards the ecosystems services we need tomorrow (Pedersen Zari, 2017). Globally, biomimicry demonstrates strategies contributing to solving global challenges such as Urban Heat Islands (UHI) and human interferences, rethinking how climate and circular challenges are approached. Examples like Eastgate building (Pearce, 2016) have demonstrated successes in the field. While biomimicry offers guidelines and methodology, there is insufficient research on complex problem solving that systems-thinking requires. Our research question: Which factors are needed to help (novice) professionals initiate systems-thinking methods as part of their strategy? A solution should enable them to approach challenges in a systems-thinking manner just like nature does, to regenerate and resume projects. Our focus lies with challenges in two industries with many unsustainable practices and where a sizeable impact is possible: the built environment (Circularity Gap, 2021) and fashion (Joung, 2014). Mission Zero has identified a high demand for Biomimicry in these industries. This critical approach: 1) studies existing biomimetic tools, testing and defining gaps; 2) identifies needs of educators and professionals during and after an inter-disciplinary minor at The Hague University; and, 3) translates findings into shareable best practices through publications of results. Findings will be implemented into tangible engaging tools for educational and professional settings. Knowledge will be inclusive and disseminated to large audiences by focusing on communication through social media and intervention conferences.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
