Anthony John Angwin

Purpose: The aim of this study was to reach consensus among researchers, clinicians, and service managers on the most important outcomes of cognitive-communication treatments for children and adolescents (ages 5–18 years) with traumatic brain injury, in the postacute stage of rehabilitation and beyond. Method: This is an international three-round e-Delphi study. In Round 1, participants answered three open-ended questions, generating important treatment outcomes at three stages of development (5–11, 12–15, and > 15–18 years). Results were analyzed using qualitative content analysis and combined with outcomes from a previous scoping review. In Rounds 2–3, outcome importance was ranked on a 9-point scale. Consensus was defined a priori with outcomes rated as being “essential” (7–9) by at least 70% of respondents and rated 1–3 by less than 15% of respondents. Consensus outcomes were linked to the International Classification of Functioning, Disability and Health (ICF). Results: A total of 360 outcomes met consensus for all age groups. For 5- to 11-year-old children, important outcomes linked almost equally to the Body Functions ( n = 52, 13.1%) and Activity/Participation ( n = 50, 12.6%) components of the ICF. Outcomes of “successful start to school,” “return to school,” and “school functioning” were uniquely important. For older children and adolescents, outcomes linked to the Activity/Participation component of the ICF most frequently (12–15 years: n = 62, 15.6%; > 15–18 years: n = 73, 18.4%). For older cohorts, unique outcomes of “emotional safety,” “employment,” and “life skill development” met consensus. Conclusions: Participants consider many outcomes, spanning most of the ICF, to be important for children and adolescents with cognitive-communication disorders (CCDs). As children and adolescents age, the importance of ICF components shifts, and distinct outcomes emerge, highlighting the necessity of developmentally relevant rehabilitation. The broad range of outcomes reaching consensus reflects pediatric CCD complexity and the need for holistic, person-centered care. Future research should explore the priorities of children and adolescents with CCDs and their families.

Background: Experience-based co-design (EBCD) is a well-established method to engage patients, family members and healthcare professionals in the co-design of interventions. A key principle of EBCD is equal partnership. For adults with acquired communication disabilities, additional measures are required to ensure authentic, rather than tokenistic, engagement. The aim of this study was to evaluate the co-design process from the perspectives of co-designers (individuals with aphasia (impaired language/communication), family members, speech pathologists), and researchers (speech pathologists and technology developer) participating in EBCD workshops, with respect to co-designer involvement, engagement, experiences and personal outcomes. Workshops represented the co-design phase in the EBCD of a novel technology for self-management of post-stroke aphasia. Methods: Mixed methods process evaluation within a convergent-parallel research design was conducted. Twelve co-designers participated in 15 EBCD workshops. Co-designers completed personal outcome surveys and semi-structured interviews pre- and post-workshops, with a pulse survey midway. Researcher reflections were recorded during a debriefing session. Survey data were analysed using descriptive statistics and Wilcoxon signed-rank tests for pre-post comparisons. Semi-structured interviews and researcher reflections were analysed using the Framework Method and qualitative content analysis. Results: Overall, findings indicated co-designers had positive experiences during EBCD and believed their ideas were integrated into the interface design. Suggestions to improve communication accessibility were provided. Conclusions: With appropriate support, persons with aphasia can meaningfully participate in EBCD.

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This study investigated the effect of overnight sleep on associative novel word learning and examined whether the effects of sleep on word learning are modulated by the provision of semantic information. Seventy-five healthy young adults attended an initial word-learning session followed by a delayed testing session. An interval of overnight sleep (sleep group) or daytime wakefulness (wake group) separated the two sessions. At the initial learning session, participants learned three-word names of 20 novel objects, where half the names comprised a novel word and two semantic attributes (semantic condition), and half comprised a novel word and two meaningless proper names (name condition). Novel word cued-recall was measured at both the initial and the delayed session. Although both groups demonstrated similar cued-recall accuracy at the first session, by the delayed session the sleep group demonstrated superior cued-recall accuracy compared to the wake group. There was no influence of semantics on the sleep-dependent consolidation of the novel words. Overall, these findings suggest that novel words encoded with or without the provision of semantic information can benefit from an overnight sleep period for consolidation.

People living with Parkinson’s disease (PD) with poor verbal fluency have an increased risk of developing dementia. This study examines the neural mechanisms underpinning semantic fluency deficits in patients with PD with mild cognitive impairment (PD-MCI) compared to those without MCI (PD-NC) and control participants without PD (non-PD). Thirty-seven (37) participants with PD completed a cognitive assessment battery to identify MCI (13 PD-MCI). Twenty sex- and age-matched non-PD patients also participated. Participants were scanned (3T Siemens PRISMA) while performing semantic fluency, semantic switching, and automatic speech tasks. The number of responses and fMRI data for semantic generation and semantic switching were analyzed. Participants also completed a series of verbal fluency tests outside the scanner, including letter fluency. Participants with PD-MCI performed significantly worse than PD-NC and non-PD participants during semantic fluency and semantic switching tasks. PD-MCI patients showed greater activity in the right angular gyrus than PD-NC and non-PD patients during semantic switching. Increased right angular activity correlated with worse verbal fluency performance outside the scanner. Our study showed that the PD-MCI group performed worse on semantic fluency than either the PD-NC or non-PD groups. Increased right angular gyrus activity in participants with PD-MCI during semantic switching suggests early compensatory mechanisms, predicting the risk of future dementia in PD.

Decline in language and cognitive functioning often deprives people living with moderate-to-severe dementia of self-reporting their quality of life (QoL) on the written and verbal formats of questi...

There exists a substantial body of research to suggest that children with cochlear implants (and hearing loss more generally) experience difficulties when learning to read and write. These difficulties are posited to stem partly from limitations in phonological processing ability, which is considered fundamental to typical literacy development. This paper comprises a narrative review of the current literature on (1) literacy development in children with hearing loss and cochlear implants; (2) relationships between literacy sub-skills in children with hearing loss and cochlear implants; and (3) factors that influence learning and contribute to the heterogeneity of the population of children with hearing loss.