Imprecise consonant articulation is common in speakers with Parkinson’s disease and can affect intelligibility. The research on the relationship between acoustic speech measures and intelligibility in Parkinson’s disease is limited, and most of the research has been conducted on English. This pilot study investigated aspects of consonant articulation acoustics in eleven Swedish speakers with Parkinson’s disease and six neurologically healthy persons. The focus of the study was on consonant cluster production, articulatory motion rate and variation, and voice onset time, and how these acoustic features correlate with speech intelligibility. Among the measures in the present study, typicality ratings of heterorganic consonant clusters /spr/ and /skr/ had the strongest correlations with intelligibility. Measures based on syllable repetition, such as repetition rate and voice onset time, showed varying results with weak to moderate correlations with intelligibility. One conclusion is that some acoustic measures may be more sensitive than others to the impact of the underlying sensory-motor impairment and dysarthria on speech production and intelligibility in speakers with Parkinson’s disease. Some aspects of articulation appear to be equally demanding in terms of acoustic realization for elderly healthy speakers and for speakers with Parkinson’s disease, such as sequential motion rate measures. Clinically, this would imply that for the purpose of detecting signs of disordered speech motor control, choosing measures with less variation among older speakers without articulation impairment would lead to more robust results. 

Purpose: Speech-language pathologists (SLPs) are a new but rapidly growing addition to the Swedish school work force. This study sought to inventory the employment and work task characteristics of school-based SLPs to assess equitable access to SLP services.

Method: We collected questionnaires from 111 SLPs currently practicing in Swedish schools. The respondents were asked for details regarding their employment.

Results: Roughly equal proportions of respondents reported to work with intervention and consultation to teaching staff. Almost all reported that the preservice training provided insufficient preparation for school-based practices. The work assignments of school-based SLPs were more similar than 10 years ago, likely a consequence of agreements between the parties caring for students with language disorder, and the vast majority of SLPs now being employed within student health teams. However, differences in workload and assigned tasks affect the nature of the work performed, to the point that current best practice cannot always be upheld.

Conclusions: The results indicate that the services provided by Swedish school-based SLPs can be expected to vary because of qualitative and quantitative differences in employment and work task characteristics. The results are discussed in light of reviews of language interventions for children and young people.

Purpose: In primary progressive aphasia (PPA), multimodal means may gradually become more important in conversations. In this study, the aim was to investigate the functions of hand movements of a man with PPA.Method: Peter and Karen participated in this study. Peter was diagnosed with nonfluent PPA two years prior to data collection. Casual conversation and cognitive and linguistic testing were audio- and video-recorded. Analyses were informed by multimodal interaction analytical approaches.Results: The results showed that Peters opportunities to engage in conversations were enabled within a co-operative framework, where Peter would contribute within a predetermined slot using a variety of multimodal resources to, for example, organize turn-taking or repair difficulties relating to verbal output.Discussion and conclusions: Studying multimodal resources across tasks may reveal important features of the ways in which persons with communicative impairment adjust to different contexts. In clinical settings, multimodal resources need to be viewed as multi-layered actions rather than as isolated contributions.

Purpose: This study challenges the notion that people living with dementia are unable to achieve novel learning without focussed intervention techniques. The purpose of this study is to explore how a woman living with dementia (Alzheimer’s disease) learns to use a tablet computer with support from communicative partners.

Method: The study is based on video recordings and the theoretical framework of learning as changing participation in joint activities. Quantitative and qualitative focus is on changes in the interactional organization

over the course of six weeks in the activity of using an augmentative and alternative communication application.

Results: Over time, the participant living with dementia, relies less on the expertise and explicit instructions of her communicative partners when navigating the application, and more on the immediate feedback provided by the tablet computer.

Conclusions: The findings suggest that novel learning still is possible for people living with dementia, even without the implementation of focussed interventions. This study further emphasizes the procedural nature of learning for people living with dementia as the woman’s embodied actions were carried out in an increasingly more direct fashion.

Aim: To investigate how conceptualizations of cognition and aging are displayed through evaluations and accounts after cognitive testing with elders who do not have dementia.

Method: 14 persons >65 years of age without clinical memory loss were tested with the MMSE and interviewed about their experiences. The audio-recordings were transcribed according to Conversation Analytic conventions. Examples of evaluations and accounts related to cognitive competence were collected, categorized, and analyzed by topic.

Results: The results show how the interviewer and participant being tested evaluate and account for face threats related to the cognitive and communicative competence of the person being tested. Examples of evaluations include downplaying one's own competence, while accounts include attributing difficulties with test tasks to personal circumstances, such as participants' lived experiences or to expected (as opposed to pathological) cognitive change in aging.

Conclusions: Inviting participants to share their experiences of cognitive testing can reveal valuable information on how they conceptualize cognition and aging, as well as the testing process itself. Reflections may also reveal potential dementia worry. Evaluations and accounts are closely related to face-saving acts.

Background: In dementia with Lewy bodies (DLB), limitations in linguistic and cognitive abilities may lead to difficulties in participating in conversations. The conversational outcome is also dependent on how the conversation partner adjusts to potential communicative challenges.

Aims: This study explored resources and barriers in communication in DLB.

Methods & procedures: Linguistic and cognitive function was explored through standard clinical testing. The dyad's perception of function in daily life was explored through semi-structured interviews analysed with content analysis. Interactional patterns and participation in casual conversation was analysed with conversation analysis.

Outcome & results: The results show how the husband diagnosed with DLB performed with high scores across most cognitive and linguistic test tasks. The interview data, however, revealed how both he and his wife experienced significant challenges regarding, for example, conversational tempo, as well as negative feelings relating to adjusting to these conversational changes. The interactional data from the casual conversation revealed, among other patterns, how the wife engaged in most of the storytelling in the conversation. The husband contributed details when his wife asked for help, or he acknowledged a faulty or missing detail in his wife's storyline. Thus, they both oriented to the husband's competence in monitoring and keeping track of the conversational content, despite challenges in taking the floor.

Conclusions & implications: A holistic picture of communication in DLB necessitates the use of different evaluation approaches. Both monological (e.g., test tasks revealing cognitive and linguistic resources) and dialogical information sources (e.g., observations of conversations revealing adjustments in conversations), as well as the perceptions of those engaging in everyday conversations (i.e., people with DLB and their conversation partner(s)), need to be evaluated when assessing resources and barriers in communication.

What this paper adds: What is already known on the subject It is well-known that dementia with Lewy bodies (DLB) affects language and cognition. In conversations, persons with DLB experience difficulties in turn-taking, topic initiation, entering conversations and keeping up with the conversational tempo. What this study adds This study sheds light on conversations in one dyad where the husband has been diagnosed with DLB. The results from three different information sources (testing of language and cognition, interviews and a video-recorded conversation) reveal patterns of resources and barriers that at first appear to contradict each other. However, the contradictions can be resolved when these discrepancies are examined in light of the differences in task structure, in terms of, for example, predetermined topics and how turn-taking is managed. What are the potential or actual clinical implications of this work? In order to gather a holistic picture of a person's conversational abilities, clinicians need to include information from both monological tasks (e.g., linguistic testing) as well as dialogical tasks (e.g., video recordings from conversation). The results also need to be evaluated in light of all conversation partners' perspectives on function in daily life. Furthermore, it is important to consider the nature of assessment tasks (particularly their interactional structure) when interpreting assessment results.

Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impacton users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment, thisrequires evaluation that can accommodate diferent levels of cognitive impairment, alongside input from family and formalcaregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions forthe Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six nationalpilot sites to examine a number of variables including impact on the users, user acceptance of the individual services andthe overall platform, plus the economic case for the IN LIFE platform. The results confrmed the interest and need amongolder adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT).Relative to the baseline, quality of life improved and cognition stabilised; however, there was an overall reluctance to payfor the platform. The fndings provide insights into existing barriers and challenges for adoption of ICT for older peopleliving with cognitive impairment.

Recent research has stressed the collaborative competences of people living with dementia, showing how they are capable of participating in a multitude of everyday activities when supported by cognitively healthy individuals. However, little is known about the collaborative work between different people living with dementia. Accordingly, this study aims to explore how people living with dementia, without the support of a cognitively healthy interlocutor, collaborate with other people living with dementia in an unfamiliar activity. The study is based on video recordings of three dyads, each comprising two individuals living with dementia, as they are using tablet computers with reminiscence and communication aiding applications. Drawing on multimodal interaction analysis, we show how the participants living with dementia treat the activities as joint endeavors and, when needed, engage in problem-solving sequences where they make their knowledge about how to progress within the activities publicly visible to their interlocutor. Our findings suggest that people living with dementia do collaborate with each other, and that the interactional labor between different people living with dementia is more symmetrical than what has been described in joint activities involving people living with dementia and cognitively healthy individuals.Previous article in issue

Introduction: Assessment of intelligibility in dysarthria tends to rely on oral reading of sentences or words. However, self-generated utterances are closer to a clients’ natural speech. This study investigated how transcription of utterances elicited by picture description can be used in the assessment of intelligibility in speakers with Parkinson’s disease.

Methods: Speech samples from eleven speakers with Parkinson’s disease and six neurologically healthy persons were audio-recorded. Forty-two naive listeners completed transcriptions of self-generated sentences from a picture description task and orally read sentences from the Swedish Test of Intelligibility, as well as scaled ratings of narrative speech samples.

Results:  Intelligibility was higher in orally read than self-generated sentences and higher for content words than for the whole sentence in self-generated sentences for most of the speakers, although these within-group differences were not statistically significant at group level. Adding contextual leads for the listeners increased intelligibility in self-generated utterances significantly, but with individual variation. Although correlations between the intelligibility measures were at least moderate or strong, there was a considerable inter- and intra-speaker variability in intelligibility scores between tasks for the speakers with Parkinson’s disease, indicating individual variation of factors that impact intelligibility. Intelligibility scores from neurologically healthy speakers were generally high across tasks with no significant differences between the conditions.

Conclusion: Within-speaker variability supports literature recommendations to use multiple methods and tasks when assessing intelligibility. The inclusion of transcription of self-generated utterances elicited by picture description to the intelligibility assessment has the potential to provide additional information to assessment methods based on oral reading of pre-scripted sentences and to inform the planning of interventions.

Objectives In the present paper we aim to contribute to the understanding of how people with dementia experience using a web-based communication support application on a tablet computer in a group activity. The specific focus of the present paper is on perception of social inclusion among people with dementia in a group activity using digital communication support. Methods The study is based on interviews with participants in a communication group for people with dementia where the application CIRCA, specifically designed to support interaction involving people with dementia, was used. Five individuals with dementia were recruited from a residential care home where they lived in different wards. Seven group interviews with the participating persons with dementia following directly after each session were carried out. Results The views of the participants were generally very positive, regarding many aspects of the activity. In the present study, the group activity seemed more important and beneficial for the participants, than the specific use of the application in itself. Conclusions Taking part in a group activity targeting communication made participants with dementia feel that they were part of a social group, that they had learnt things, and that they had been able to contribute with their expertise to others. Clinical Implications Group activities targeting communication give people with dementia the opportunity to exercise their social inclusion practices. Group activities may render a feeling of social community and a sense of belonging to the participants. The use of digital communication support may enhance such activities.