Preetie Shetty Akkunje

Aspiration in individuals with dysphagia is associated with serious health complications, including aspiration pneumonia and increased mortality. Despite its clinical significance, awareness of aspiration-related signs among the general public remains limited, leading to delayed recognition and intervention. This study aimed to develop and validate a multimedia educational resource to promote awareness of observable aspiration related signs during oral feeding among non-healthcare college students. A multi-phase developmental design was employed to appraise the aim. Key indicators of aspiration were identified through expert consensus using the nominal group technique, followed by structured script development. Content validity was established using the Educational Content Validation Instrument in Health, with a scale-level content validity index ≥ 0.90. The validated script was used to develop a 19.40-min multimedia educational video incorporating narration and visual content. The developed material was evaluated for overall suitability of information using the Suitability Assessment of Materials. Further validation of communication effectiveness was conducted using the Patient Education Materials Assessment Tool for Audiovisual Materials and the Centers for Disease Control and Prevention Clear Communication Index. A total of 44 participants, including healthcare professionals and non-healthcare college students, contributed across development and validation phases. The finalized multimedia educational resource demonstrated good suitability, with a mean Suitability Assessment of Materials score of 75%. The material achieved understandability scores exceeding 70% and actionability scores of 100% on the Patient Education Materials Assessment Tool. Communication clarity scores exceeded 90% on the Centers for Disease Control and Prevention Clear Communication Index, indicating high clarity and effectiveness. The present study developed and validated a multimedia educational resource which has high content validity, suitability, understandability, actionability, and communication clarity. Evaluation of its educational effectiveness must be undertaken in the subsequent phase of the research.

The implementation of Augmentative and Alternative Communication (AAC) systems for individuals with nonverbal Autism Spectrum Disorder (nvASD) remains highly debated, especially in a multilingual and multicultural country like India. Existing AAC guidelines are largely Western-based and may not be fully applicable in the Indian context. This study explored the perspectives of Indian Speech-Language Pathologists (SLPs) on AAC implementation in individuals with nvASD. A cross-sectional study was conducted in two phases. Phase 1 involved developing and validating a questionnaire assessing SLP’s practices and attitudes towards AAC. In phase 2, the validated questionnaire was administered online to 93 Indian SLPs (29.23 years of mean age, 71% female) represented diverse clinical, educational, and academic settings. The survey explored key parameters, including AAC candidacy, cultural and linguistic adaptation, AAC selection and customization, interdisciplinary collaboration and caregiver involvement, outcome based evaluation practices, speech-AAC integration, and barriers to AAC implementation. Most SLPs emphasized working on communication prerequisites before introducing AAC. Vocabulary selection was prioritized over partner training. AAC was primarily used for both intervention and communication, employing goal-oriented approaches alongside other speech and language strategies. Challenges included lack of resources, inadequate training, and limited interdisciplinary collaboration. Parental involvement and caregiver feedback were identified as critical to success. SLPs in India broadly recognize AAC as a valuable tool for individuals with nvASD but report facing multiple systemic and practical challenges to its implementation. The findings underscore the need for culturally and contextually relevant AAC guidelines, targeted clinician training, and supportive policy measures to improve access and long-term communication outcomes in Indian settings.

Music‐based interventions (MBIs) offer promising strategies for addressing speech‐language impairments in individuals with nonfluent aphasia. This systematic review summarizes the current literature of MBIs for nonfluent aphasia recovery by types of MBIs to determine the efficacy of MBIs and assesses the risk of bias to identify common methodological limitations. A systematic search was conducted of MEDLINE, PubMed, and APA PsycInfo for the 20 years preceding July 2024. Risk of bias assessment was performed using the revised Joanna Briggs Institute critical appraisal tool for randomized controlled trials (RCTs). Ten RCTs met the inclusion criteria, featuring MBIs such as Melodic Intonation Therapy, Modified Melodic Intonation Therapy, and singing‐based approaches. The results highlighted the potential of MBIs in various domains, particularly in enhancing repetition and naming abilities, even when compared to speech therapy. The reviewed studies exhibited a moderate to high risk of bias. Outcome measures varied widely, and functional communication, a critical rehabilitation goal, was examined in just two RCTs. Furthermore, heterogeneous control conditions and statistical methods hindered meaningful comparisons across studies. Future research should prioritize functional communication outcomes and refine intervention protocols to strengthen the evidence base. Addressing these gaps is essential for advancing the potential benefits of these clinical tools for nonfluent aphasia recovery.

Background: The dual‐cyclical relationship between language and cognition, encapsulated in linguistic relativity, underscores the reciprocal influence of thoughts on communication and vice‐versa. This study explores the intricate changes in pragmatics, a fundamental aspect of human communication, during the aging process, considering changes in sensory abilities, cognition, and language.Method: Sixty participants, aged ≥50 years with a minimum of five years of formal education, were included, excluding those with neurological or psychological illnesses. Participants were categorized based on Montreal Cognitive Assessment (<25 & ≥25 MOCA scores), and their demographic details, language use, and educational and occupational history were recorded. Pragmatic evaluations included 1) functional communication profile analysis (sensory, receptive language, expressive language, pragmatic language and non‐oral communication), 2) pragmatic language evaluation (verbal aspects, paralinguistic aspects, nonverbal aspects), 3) spontaneous speech evaluation using Western Aphasia Battery, 4) discourse production assessment (macrostructures–main concept analysis, correct information units, global coherence and microstructures–T unit), and 5) hearing evaluation (pure tone audiometry, speech audiometry). Statistical analysis employed SPSS version 29.0.10, utilizing descriptive statistics and Likelihood ratio or Chi‐square tests.Results: Participants had a mean age of 66.5±9.9 years, with 58.3% females and 41.7% males. Educational distribution included 31.7% with ≤10th standard, 13.3% with 12th standard, 46.7% with a Bachelor’s degree, 6.7% with a Master’s degree, and 1.7% with a Ph.D. Regarding language proficiency, 41.7% were proficient in one language, 53.3% in two languages, and 5% in three languages. Significant relationships between pragmatic characteristics were identified among participant groups, supporting existing literature linking cognitive‐linguistic decline to aging. Higher MOCA scores correlated with superior speech discrimination and communication, while lower scores were associated with hearing loss. Likelihood Ratio Tests indicated significant associations between higher MOCA scores (≥25) and clear, specific, stimulus‐related pragmatic communication, while scores below 25 were linked to pragmatic difficulties.Conclusion: The study highlights the robust connection between pragmatics, cognitive function, and hearing abilities in the elderly. It offers insights into communication disorders, advocating for integrated rehabilitation programs for individuals with cognitive decline and hearing loss. Additionally, it reveals the intricate relationship between education, cognitive abilities, and pragmatic skills, guiding clinical practice and intervention strategies.

Background: Verbal fluency (VF) is crucial for language processing and cognitive flexibility, involving selective attention, inhibition, set shifting, response generation, and self‐monitoring. VF assessment includes two distinct tasks, i.e., phonemic and semantic VF. It assesses long‐term verbal semantic memory, phonological awareness, lexical–semantic access, and executive function. Semantic VF is mainly based on generating semantic associations, whereas phonemic VF is based majorly on executive functions instead of lexicon–semantic networks. Even though the VF involves several neural substrates majorly is coordinated by superior frontal lobe and temporal lobe for phonemic and semantic VF, respectively. This study aims to assess VF in linguistically diverse young adults of bilingual and multilingual individuals and its contributing insights into language‐cognition interplay.Method: A prospective cross‐sectional research study recruited 120 participants, divided into two groups: bilinguals (proficient in at least two languages;n = 60) and multilinguals (proficient in at least three languages;n = 60), identified through the Language Experience and Proficiency Questionnaire. Inclusion criteria encompassed participants aged 20‐50, of both genders, with standard education up to graduation. Participants with neurological or psychiatric language disorders and those scoring ≤25 on the Montreal Cognitive Assessment were excluded from the study. Research‐specific assessments, including Spontaneous speech of Western Aphasia Battery, Addenbrooke’s Cognitive Examination‐III for cognitive functions and VF tests (phonemic & semantic VF, phonemic & semantic switching tasks, alternating language task, controlled semantic association task), were conducted in L1, L2 for bilinguals and L1, L2, and L3 for multilinguals. Statistical evaluation was done using SPSS‐version‐29.0.10, utilizing descriptive statistics, Likelihood ratio, Chi‐square, and Independent sample t’‐tests.Results: Participants recruited showed no significant difference between groups for age, gender and education highlighting linguistic‐diversity of participants which is essential for comprehending potential variations in research findings and their general applicability. The results revealed that bilinguals outperformed multilinguals in semantic VF tasks while multilinguals outperformed bilinguals in phonemic verbal VF tasks.Conclusion: The adaptability in switching between semantic fields and linguistic‐dimensions of temporal lobe, particularly evident in bilinguals, underscores the cognitive advantages of bilingualism. These findings are crucial for formulating targeted interventions tailored to the unique needs of linguistically‐diverse dementia patients, to strengthen neural‐networks which can account for the principles of neuroplasticity.

The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.