Background: Auditory processing disorder (APD) is a diagnosis that is widely discussed. Children diagnosed with APD have difficulty listening in complex situations, despite a well-functioning peripheral hearing. However, there seems to be no evidence for the validity of a purely auditory deficit. The aim of this study is to examine the differences in performance between children with suspected APD and typically developing children on tests of communication, auditory processing, nonverbal intelligence, working memory, and visual and auditory attention. Methods: In a case-control study we examined 9 children with suspected APD and 21 typically developing children, ages 8;0 to 12;0 years. The parents of all children completed three questionnaires about history, behavioral symptoms of ADHD, and communication skills. The teachers of the children completed the Children’s Auditory Processing Performance Scale (CHAPPS). The children themselves were assessed for auditory processing abilities, nonverbal intelligence, working memory, and auditory and visual attention. Results: No differences were found between groups in age, nonverbal intelligence quotient, and performance on auditory processing tests. Children with suspected APD have significantly poorer communication performance (parent report), poorer listening skills (teacher report), poorer working memory and poorer auditory and visual skills. Conclusion: There is a difference between children with suspected APD and typically developing children. Children with suspected APD perform insufficient on tests of working memory, and have a slower response to auditory and visual attention tasks. Parents of children with suspected APD report difficulties in communication and teachers assess the children of being at risk for listening difficulties.
Objective: To gain insight into how communication vulnerable people and health-care professionals experience the communication in dialogue conversations, and how they adjust their conversation using augmentative and alternative communication (AAC) or other communication strategies. Methods: Communication vulnerable clients and health-care professionals in a long-term care institution were observed during a dialogue conversation (n = 11) and subsequently interviewed (n = 22) about their experiences with the conversation. The clients had various communication difficulties due to different underlying aetiologies, such as acquired brain injury or learning disorder. Results from the observations and interviews were analysed using conventional content analysis. Results: Seven key themes emerged regarding the experiences of clients and professionals: clients blame themselves for miscommunications; the relevance of both parties preparing the conversation; a quiet and familiar environment benefitting communication; giving clients enough time; the importance and complexity of nonverbal communication; the need to tailor communication to the client; prejudices and inexperience regarding AAC. The observations showed that some professionals had difficulties using appropriate communication strategies and all professionals relied mostly on verbal or nonverbal communication strategies. Conclusion: Professionals were aware of the importance of preparation, sufficient time, a suitable environment and considering nonverbal communication in dialogue conversations. However, they struggled with adequate use of communication strategies, such as verbal communication and AAC. There is a lack of knowledge about AAC, and professionals and clients need to be informed about the potential of AAC and how this can help them achieve equal participation in dialogue conversations in addition to other communication strategies.
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.
