Gesture production and comprehension in children with specific language impairment

Children with specific language impairment (SLI) have difficulties with spoken language. However, some recent research suggests that these impairments reflect underlying cognitive limitations. Studying gesture may inform us clinically and theoretically about the nature of the association between language and cognition. A total of 20 children with SLI and 19 typically developing (TD) peers were assessed on a novel measure of gesture production. Children were also assessed for sentence comprehension errors in a speech-gesture integration task. Children with SLI performed equally to peers on gesture production but performed less well when comprehending integrated speech and gesture. Error patterns revealed a significant group interaction: children with SLI made more gesture-based errors, whilst TD children made semantically based ones. Children with SLI accessed and produced lexically encoded gestures despite having impaired spoken vocabulary and this group also showed stronger associations between gesture and language than TD children. When SLI comprehension breaks down, gesture may be relied on over speech, whilst TD children have a preference for spoken cues. The findings suggest that for children with SLI, gesture scaffolds are still more related to language development than for TD peers who have out-grown earlier reliance on gestures. Future clinical implications may include standardized assessment of symbolic gesture and classroom based gesture support for clinical groups

The acquisition of Sign Language: The impact of phonetic complexity on phonology

Research into the effect of phonetic complexity on phonological acquisition has a long history in spoken languages. This paper considers the effect of phonetics on phonological development in a signed language. We report on an experiment in which nonword-repetition methodology was adapted so as to examine in a systematic way how phonetic complexity in two phonological parameters of signed languages — handshape and movement — affects the perception and articulation of signs. Ninety-one Deaf children aged 3–11 acquiring British Sign Language (BSL) and 46 hearing nonsigners aged 6–11 repeated a set of 40 nonsense signs. For Deaf children, repetition accuracy improved with age, correlated with wider BSL abilities, and was lowest for signs that were phonetically complex. Repetition accuracy was correlated with fine motor skills for the youngest children. Despite their lower repetition accuracy, the hearing group were similarly affected by phonetic complexity, suggesting that common visual and motoric factors are at play when processing linguistic information in the visuo-gestural modality

Transitioning to a safeguarding children clinical network during a time of major NHS reform: an exploratory study about the experiences of Designated professionals

Background: Safeguarding children is a priority area, yet the experiences of those statutorily charged with offering strategic direction and clinical leadership in health organisations has received little research attention. This study focuses on the experiences of Designated nurses and doctors as they transition from working as an organisation’s sole expert to sharing tasks and responsibilities across many organisations as part of a countywide clinically-led Network. Method: This qualitative study used a participatory action research methodology that allowed the author – a participant Designated nurse – together with colleagues to address concerns and ensure improvements during the course of the study. Data was collected at two points: during the consultation on the Network’s form; and 12-18 months after its implementation. Results: The first data, gathered when Designates were working as sole practitioners, illustrated their isolation, difficulties in accessing knowledge and anxieties about their capacity to respond to changing demands. Further analysis demonstrated that participants’ experiences were shaped by local circumstances and the concerns raised by the newly announced NHS reforms. The second data set, gathered a year after the Network’s launch and contemporaneous with the implementation of the NHS reforms, showed that team working had addressed most of their earlier concerns. The Network had legitimised sharing tasks, combatted isolation, improved access to new knowledge, and benefitted the professionals’ authority through the reputation the Network had achieved for innovation in safeguarding. However, professionals raised concerns regarding collective responsibilities and individuals’ accountability to the team. Conclusion: The study’s inability to completely separate the effects of this change in working practice from the NHS reforms limits its generalisability. The research offers insights into whether small groups of practitioners endeavouring to deliver scarce expertise to multiple organisations would benefit from a team approach, and whether voluntary participation and shared objectives are enough to sustain such teams

Building an Assessment Use Argument for sign language: the BSL Nonsense Sign Repetition Test

In this article, we adapt a concept designed to structure language testing more effectively, the Assessment Use Argument (AUA), as a framework for the development and/or use of sign language assessments for deaf children who are taught in a sign bilingual education setting. By drawing on data from a recent investigation of deaf children's nonsense sign repetition skills in British Sign Language, we demonstrate the steps of implementing the AUA in practical test design, development and use. This approach provides us with a framework which clearly states the competing values and which stakeholders hold these values. As such, it offers a useful foundation for test-designers, as well as for practitioners in sign bilingual education, for the interpretation of test scores and the consequences of their use

Very Late–Onset Schizophrenia-Like Psychosis: A Clinical Update

Psychosis symptoms (delusions and hallucinations) are multifactorial in origin and, in later life, occur in the context of schizophrenia, delirium, dementia, delusional and schizophrenia-like disorders, mood disorders, and alcohol or substance abuse. The current article provides a clinical overview of very late–onset (after age 60) schizophrenia-like psychosis (VLOSLP), summarizing the literature on treatment options and reflecting on the role of psychiatric–mental health nurses (PMHNs). Increased awareness of the clinical presentation, key features, and evidence-based treatment options will assist PMHNs to confidently recognize this often under-diagnosed disorder and adopt a more assertive role in terms of engagement and follow up. Pragmatic research involving individuals with VLOSLP is required to increase the evidence base for treatment and improve outcomes of care. [Journal of Psychosocial Nursing and Mental Health Services, 56(1), 37–47.] It has long been acknowledged that psychotic illness can lead to alienation, discrimination, and isolation (Burke & Shome, 1998), and older adults with psychosis represent one of the most disenfranchised groups in relation to health care (Mitford, Reay, McCabe, Paxton, & Turkington, 2010). In the older adult mental health setting, nurses encounter two main groups with a schizophrenia diagnosis: (a) individuals with early-onset schizophrenia (EOS) who have grown old, and (b) those who experience the onset of psychosis in later life, either as late-onset (after age 40) schizophrenia (LOS) or very late–onset (after age 60) schizophrenia-like psychosis (VLOSLP). Older adults with schizophrenia have been somewhat neglected historically by the scientific research community (Cohen et al., 2008; Folsom et al., 2006), and there is a significant gap between the high prevalence of psychotic disorders in older adults and the availability of evidence-based treatments (Reinhardt & Cohen, 2015). This gap leaves health care systems ill-prepared to manage the predicted substantial growth in the older adult population (Cohen, Meesters, & Zhao, 2015). Drawing on the published literature and the current authors' clinical and research experience, the current article reflects on VLOSLP from a person-centered, biopsychopharmacosocial mental nursing perspective (Clarke & Clarke, 2014), describing clinical presentation and treatment interventions. A search of PubMed and CINAHL using “very late-onset schizophrenia-like psychosis” and a range of related terms combined with (mental health/psychiatric) nursing revealed very little attention specifically relating to mental health nursing care of this patient group, although information is available in relation to generically supporting older adults experiencing psychosis, schizophrenia, or both

Selective Visual Attention in ADHD: A Narrative Review

Purpose of Review Attention-deficit/hyperactivity disorder is a common neurodevelopmental disorder characterized by impairing levels of inattention, hyperactivity and impulsivity that adversely impact functioning across social, academic/occupational and home settings. While the name of the disorder implies obvious difficulties in attention, research has struggled to consistently identify a precise neurocognitive marker. This article aims to characterize the functioning of selective visual attention in ADHD by reviewing previous studies that compare individuals with ADHD and healthy controls at the behavioral and neural levels using single-frame visual search tasks. Recent Findings Past research indicates both bottom-up (stimulus-driven) and top-down (goal-driven) attention across both time and space are likely affected in ADHD. However, more research is needed to illuminate the specific mechanisms involved. Summary Ultimately, this narrative review aims to highlight the importance of studying selective visual attention in ADHD to explain the heterogeneous symptoms and impairments of this complex disorder, as well as to build a stronger bridge between the high-level behaviors of ADHD and their underlying neurobiological mechanisms

Developing a co‐produced practice framework to support personalised safety planning for adults experiencing suicidality

Introduction: Suicide safety plans are widely used internationally in health and social care settings. This study aimed to co‐produce a framework for supporting personalised safety planning, sensitive to the needs, preferences and values of people experiencing suicidality. Methods: Phase 1 conducted semi‐structured interviews to explore the views and preferences of adults with lived experience of suicidality on the content and implementation of personalised suicide safety planning. In Phase 2, interactive practitioner workshops reviewed and refined a draft framework for personalised suicide safety planning. Data analysis was conducted in two steps: an inductive thematic analysis of interview data, followed by a deductive–inductive approach to develop the themes using data from two workshops with practitioners. Results: n = 11 adults with current or previous lived experience of suicidality participated in semi‐structured interviews, and n = 16 practitioners from primary care, secondary care, third sector and emergency services involved in providing suicide prevention were recruited to two workshops. Two overarching themes and six sub‐themes were identified: (1) the personalisation of safety planning (sub‐themes—co‐production, involving family and friends, true personalisation) and (2) the process of safety planning (sub‐themes—implementation, format and purpose) were used to inform the structure of a prototype personalised suicide safety planning framework. Conclusions: Personalised suicide safety planning requires early intervention and a person‐centred approach. Pivotal to this is the need to move away from standardised tools towards the development of a workforce with the skills and confidence to work flexibly and collaboratively with the people they are supporting. Future research is needed to test the utility of the framework in a range of settings, including primary care, urgent care and the third sector. Patient or Public Contribution: This study was co‐produced from the outset by people with personal experience of suicidality. Pre‐study public engagement helped inform the study design, and peer researchers on the study team collaborated in all stages of the process from design through to dissemination, including development of this manuscript. PPI involvement was included in practitioner workshops and in producing accessible dissemination materials

An audit of Supplementary Prescribing within South West Yorkshire Mental Health Trust

Results are presented from an audit of mental health nurses (MHNs) who have undertaken training in order to practise as supplementary prescribers as part of an evaluation of the development of non-medical prescribing (NMP) across South West Yorkshire Mental Health Trust (SWYMHT). Quantitative (demographics) and qualitative (open-ended statements) results derived from a questionnaire survey are analysed and compared to the national picture. Implications for the governance arrangements which need to be in place for the further development of non-medical prescribing in mental health care, both for the Trust and nationally, are suggested