Purpose
This study investigates the relationship between pre-linguistic social communication skills and age of cochlear implant for future language outcomes in a large sample of deaf children.

Method
A retrospective cohort study of records from 75 children. Pre-implant data included Age at Implant, pre-linguistic communication (social, symbolic and speech) skills, and non-verbal ability. Receptive and expressive language development data at 1 year, 2 years and 4 years post implant were analysed to investigate the relationships between pre-implant factors and language outcomes, in particular pre-linguistic social communication skills in early and late implanted children.

Results
Age at Implant was the strongest correlate of post implant expressive and receptive language outcomes. The sample was divided into early implanted (<18 month) and late implanted (>18 months) children. In the early implanted group, pre-linguistic social communication skills were the strongest pre-implant correlate of language outcomes four years post-implant. In the late implanted group, there were no significant pre-implant correlates of language outcomes.

Conclusions
Long term language outcomes after cochlear implantation are the product of a set of communicative, cognitive and environmental factors. Early pre-implant social communication skills are an important consideration for clinicians who guide parents as to likely long-term outcomes post cochlear implantation. Social communication skills are particularly important for children who receive implants before the age of 18 months.

Background
Cognitive–communication difficulties are often associated with dementia and can impact a person's ability to participate in meaningful conversations. This can create challenges to families, reflecting the reality that people living with dementia rarely have just one regular conversation partner, but interact with multiple family members. To date, there is limited evidence of the impact of changes in communication patterns in families. A family systems approach, with foundations in psychology, can be used to explore the impact of communication difficulties on multiple different family members, including the person living with dementia and potential coping strategies used by individuals, together with the family as a whole.

Methods & Procedures
A systematic review of primary qualitative research was conducted to identify and examine research exploring communication and interaction within families living with dementia. Studies were identified through a comprehensive search of major databases and the full-text articles were subject to a quality appraisal. We conducted a thematic analysis on the literature identified to consider the role of families in supporting communication for people with dementia.

Outcomes & Results
The searches identified 814 possible articles for screening against the eligibility criteria. Nine articles were included in the final review. Three major themes emerged from the analysis of the included studies: (1) ‘identities changing’ reflected how interactions within the family systems impacted on identities; (2) ‘loss’ reflected the grief experienced by families due to changes in communication; and (3) ‘developing communication strategies’ highlighted strategies and approaches that families affected by dementia may use organically to engage in meaningful interactions and maintain connection. Only one study explicitly used a family systems approach to understand how families manage the changes in interaction resulting from dementia.

Conclusions & Implications
The findings may usefully inform the clinical practice of speech and language therapists in terms of communication strategies and coping mechanisms that may be advised to facilitate connection in families living with dementia. Further research using a family systems approach to exploring communication in dementia may help to support the implementation of family-centred practice as recommended in policy.

Purpose: At one tertiary, academic medical center, two general medicine units averaged 94% and 97% occupancy causing strain on patient throughput. This project was implemented at these two comparable general medicine units, totaling 64 beds. On each of these units, Pareto analyses on causal factors related to discharge order to exit time (DOTE) were performed. DOTE was defined as the period in minutes from when a provider orders a discharge to when the patient actually exits a room. Prime DOTE reduction opportunities were elicited that highlighted the need to address coordination of hospital discharge transportation; that is, arriving family members averaged 120 and 129 min for the two units, and medicars and ambulances averaged 122 and 156 min, which fell above the established 90-min overall strategic DOTE goal. Coordinating efficient discharges decreases the likelihood of hospital bottlenecking and improves patient satisfaction.

Case Management Setting: The health care team is composed of physician and provider services, nursing, and case management, as well as the patient and family. Team-focused interventions aimed at reducing DOTE included leveraging interdisciplinary communication technology and messaging for efficiency and accuracy within the health care team and proactive scheduling of hospital discharge transportation arrival. Process objectives measured included percentage of the health care team educated and utilization of the discharge suite. Outcome objectives measured included median DOTE times, patient satisfaction, and emergency department boarding volume and times. Significantly, admissions for coronavirus disease-2019 (COVID-19) cases were also rapidly increasing early on during program implementation resulting in one of the two general medicine units to be designated for COVID-19 overflow.

Research Methodology: Using Lean methodology, the project design was formed based on the Institute for Healthcare Improvement's work on improving hospital-wide patient flow and the Agency for Healthcare Research and Quality's (AHRQ) IDEAL patient discharge framework to better achieve the well-known, triple aim. In response to COVID-19 demands, the Plan-Do-Study-Act process was warranted to be able to manage acute changes, using iterative processing.

Results and Implications: This program evaluation study assessed whether a communication training program that taught an interdisciplinary team of case managers, nurses, physicians, and related staff how to reduce DOTE was useful. The program had a material impact on the DOTE metric knowing that the hospital's ultimate strategic goal is to reduce DOTE to 90 min or less. A reduction in discharge time was documented when using weekly data from the hospital's discharge dashboard powered by the Maestro database. More specifically, nurses fully trained in the interdisciplinary communications program aimed to reduce DOTE had significantly lower DOTE outcomes on their discharges compared with untrained staff (i.e., average untrained = 127 min, average trained = 93 min). In addition, the fully trained nurses had 14% more of their discharges fall at or below the 90-min goal compared with untrained staff (i.e., untrained = 40%, trained = 54%). Supplemental research also suggested that the content of the communication training program was very relevant (e.g., empowering families to pick up the patients and using scheduling vs. will-call transportation strategies with patients lowered the DOTE metric). Corollary analyses showed that readmissions were also lowered, and patient satisfaction ratings increased. In addition, the interdisciplinary communications training program can benefit from being updated to include content on how COVID-19 issues adversely impact discharge times since significant relationships between various COVID-19 measures and higher discharge exit times were documented.

Les technologies de l’information et de la communication (TIC) ont pris de l’ampleur depuis les dernières années. En contexte de séparation parentale, ces technologies représentent des moyens privilégiés pour que les coparents communiquent entre eux pour l’organisation de la vie familiale en garde partagée, mais aussi pour que les parents gardent contact avec leurs enfants et maintiennent une relation avec eux malgré leur absence. Cet article propose une recension des écrits s’intéressant à l’utilisation des TIC pour communiquer en contexte de séparation parentale. Les constats des recherches sont présentés par l’entremise de quatre dimensions : 1) les différents types de technologies utilisées; 2) l’influence de la qualité de la relation coparentale sur la communication; 3) les avantages perçus des TIC et 4) les inconvénients perçus par les parents, les enfants et les professionnels concernés. Les conclusions sont ambivalentes quant à l’utilisation de TIC au sein des familles séparées, puisque la qualité des liens entre le parent et l’enfant peut être influencée positivement et négativement par ce type de communication. Le peu d’écrits scientifiques sur ce sujet présente une limite importante. Des pistes de recherches futures et des recommandations pour l’intervention sont suggérées.

To inform interpersonal models of intimate partner violence (IPV), the present study examines patterns of vocally encoded emotional arousal during the conversations of mixed-gender couples who reported on the extent of physical and psychological IPV and degree of relationship satisfaction (N = 149). All couples completed two problem-solving discussions. Emotional arousal was measured continuously during each conversation using vocal fundamental frequency. Contrary to expectations, results demonstrated that trajectories of arousal differed based on gender, IPV, and relationship satisfaction. Within conversations, men demonstrated linear increases in arousal at higher levels of IPV, suggesting that men may either struggle to contain their emotions or use heightened emotional expression as a conflict strategy in relationships with more extensive IPV. Conversely, women exhibited different trajectories of arousal depending on the combinations of relationship satisfaction and couple IPV, except at higher levels of their own satisfaction. Specifically, when women reported being highly satisfied in their relationships, they demonstrated similarly shaped trajectories across all levels of IPV and men's satisfaction. Together, this suggests that women's higher relationship satisfaction may buffer their emotional expression, although this may not always be adaptive within the context of relationships with extensive IPV. Overall, this study offers insight into the dynamic interpersonal processes linked with relationship distress and IPV and implies the need for a more nuanced, interpersonal research agenda for IPV research.

Background
Differences in face processing in individuals with ASD is hypothesized to impact the development of social communication skills. This study aimed to characterize the neural correlates of face processing in 12-month-old infants at familial risk of developing ASD by (1) comparing face-sensitive event-related potentials (ERP) (Nc, N290, P400) between high-familial-risk infants who develop ASD (HR-ASD), high-familial-risk infants without ASD (HR-NoASD), and low-familial-risk infants (LR), and (2) evaluating how face-sensitive ERP components are associated with development of social communication skills.

Methods
12-month-old infants participated in a study in which they were presented with alternating images of their mother’s face and the face of a stranger (LR = 45, HR-NoASD = 41, HR-ASD = 24) as EEG data were collected. Parent-reported and laboratory-observed social communication measures were obtained at 12 and 18 months. Group differences in ERP responses were evaluated using ANOVA, and multiple linear regressions were conducted with maternal education and outcome groups as covariates to assess relationships between ERP and behavioral measures.

Results
For each of the ERP components (Nc [negative-central], N290, and P400), the amplitude difference between mother and stranger (Mother-Stranger) trials was not statistically different between the three outcome groups (Nc p = 0.72, N290 p = 0.88, P400 p = 0.91). Marginal effects analyses found that within the LR group, a greater Nc Mother-Stranger response was associated with better expressive language skills on the Mullen Scales of Early Learning, controlling for maternal education and outcome group effects (marginal effects dy/dx = 1.15; p < 0.01). No significant associations were observed between the Nc and language or social measures in HR-NoASD or HR-ASD groups. In contrast, specific to the HR-ASD group, amplitude difference between the Mother versus Stranger P400 response was positively associated with expressive (dy/dx = 2.1, p < 0.001) and receptive language skills at 12 months (dy/dx = 1.68, p < 0.005), and negatively associated with social affect scores on the Autism Diagnostic Observation Schedule (dy/dx = − 1.22, p < 0.001) at 18 months.

Conclusions
In 12-month-old infant siblings with subsequent ASD, increased P400 response to Mother over Stranger faces is positively associated with concurrent language and future social skills.

Background: Family-centered care is a philosophy and healthcare delivery model adopted by many neonatal intensive care units (NICUs) worldwide, yet practice varies widely.

Purpose: The aim of this study was to synthesize recommendations from frontline NICU healthcare professionals regarding family-centered care.

Methods: Data were obtained from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care (baseline) with mobile-enhanced family integrated care (intervention). Members of the NICU clinical care team completed a family-centered care survey and provided free-text comments regarding practice of family-centered care in their NICU and recommendations for improvement. The comments were analyzed using a directed content analysis approach by a research team that included NICU nurses and parents.

Results: Of the 382 NICU healthcare providers from 6 NICUs who completed the survey, 68 (18%) provided 89 free-text comments/recommendations about family-centered care. Almost all comments were provided by nurses (91%). Six main themes were identified: language translation; communication between staff and families; staffing and workflow; team culture and leadership; education; and NICU environment. The need for greater resources for staffing, education, and environmental supports was prominent among the comments, as was team culture and staff-parent communications.

Implications for Practice: The NICU healthcare professionals identified a range of issues that support or impede delivery of family-centered care and provided actionable recommendations for improvement.

Implications for Research: Future research should include economic analyses that will enable determination of the return on investment so that NICUs can better justify the human and capital resources needed to implement high-quality family-centered care.

Background and aims
Play-based interventions are used ubiquitously with children with social, communication, and language needs but the impact of these interventions on the mental health of this group of children is unknown. Despite their pre-existing challenges, the mental health of children with developmental language disorder (DLD) and autism spectrum disorder (ASD) should be given equal consideration to the other more salient features of their condition. To this aim, a systematic literature review with meta-analysis was undertaken to assess the impact of play-based interventions on mental health outcomes from studies of children with DLD and ASD, as well as to identify the characteristics of research in this field.

Methods
The study used full systematic review design reported to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (PRISMA prisma-statement.org) with pre-specified inclusion criteria and explicit, transparent and replicable methods at each stage of the review. The study selection process involved a rigorous systematic search of seven academic databases, double screening of abstracts, and full-text screening to identify studies using randomised controlled trial (RCT) and quasi-experimental (QE) designs to assess mental health outcomes from interventions supporting children with DLD and ASD. For reliability, data extraction of included studies, as well as risk of bias assessments were conducted by two study authors. Qualitative data were synthesised narratively and quantified data were used in the metaanalytic calculation.

Main contribution
A total of 2,882 papers were identified from the literature search which were double screened at the abstract (n  =  1,785) and full-text (n  =  366) levels resulting in 10 papers meeting the criteria for inclusion in the review. There were 8 RCTs and 2 QEs using 7 named play-based interventions with ASD participants only. Meta-analysis of 5 studies addressing positive mental health outcomes (e.g. positive affect and emotional functioning) found a significant overall intervention effect (Cohen's d = 1.60 (95% CI [0.37, 2.82], p = 0.01); meta-analysis of 6 studies addressing negative mental health outcomes (e.g., negative affect, internalising and externalising problems) found a non-significant overall intervention effect (Cohen's d = 0.04 -0.17 (95% CI [-0.04, 0.51], p = 0.88).

Conclusions
A key observation is the diversity of study characteristics relating to study sample size, duration of interventions, study settings, background of interventionists, and variability of specific mental health outcomes. Play-based interventions appear to have a beneficial effect on positive, but not negative, mental health in children with ASD. There are no high quality studies investigating the efficacy of such interventions in children with DLD.

Implications
This review provides good evidence of the need for further research into how commonly used play-based interventions designed to support the social, communication, and language needs of young people may impact the mental health of children with ASD or DLD.

Les personnes présentant une déficience intellectuelle (PPDI) hospitalisées font fréquemment l’expérience d’une communication difficile avec les soignants. La communication centrée sur le patient (CCP) améliore la qualité de la relation patient-soignant et les résultats de santé. Méthode : Étude descriptive corrélationnelle qui avait pour but de mesurer la CCP perçue par ces personnes durant leur hospitalisation. Un questionnaire a été rempli par 32 personnes, comprenant des PPDI auto-représentées et hétéro-représentées. Les données ont été analysées de manière descriptive; des associations et des corrélations ont été recherchées. Résultats : La CCP était perçue comme satisfaisante par 62 % des participants. Le score de perception de la CCP était associé négativement à la dimension « Perte/Dommage » de l’appréciation cognitive de l’hospitalisation.

Comme toutes les activités stratégiques, la communication nécessite d'être évaluée. S'il est possible de se fixer des objectifs pour guider les actions, il est complexe de mesurer réellement leurs effets. Les mesures existantes posent problème, car elles varient en fonction des besoins, des contextes ou encore des outils utilisés. S'il n'y a pas de recette miracle, il existe cependant des questionnements pertinents et des méthodes éprouvées afin d'accompagner au mieux les praticiens actuels et futurs dans l'évaluation de leurs pratiques.
L'ouvrage Evaluer la communication des organisations est destiné aux praticiens, aux étudiants et à leurs enseignants. Il a pour visée de les guider dans l'évaluation de stratégies de communication. Pour cela, cet ouvrage court, didactique, et fondé sur les dernières avancées de la recherche, est construit autour de sept concepts fondamentaux. Chacun des concepts fait l'objet d'un chapitre long rédigé par un universitaire et d'un chapitre court, rédigé par un praticien, abordant leurs aspects numériques.
Evaluer la communication des organisations participe ainsi à la formation de professionnels réflexifs, aptes à s'adapter aux contextes pour évaluer les stratégies qu'ils déploient.

Objectives: The aim of this study was to compare Theory of Mind (ToM) acquisition in typically-hearing preschool-age children (TH), and deaf children of hearing parents (DCHP) who received a cochlear implant by 18 months of age, to determine if early access to spoken language via a cochlear implant affected ToM acquisition.

Methods: Participants included 25 children with cochlear implants ages 3.0 to 6.5 years and 25 age-matched children with TH all of whom were enrolled in preschools with typical peer models. The test battery included measures of expressive and receptive language and ToM.

Results: There were no differences between DCHP and TH peers on language or ToM performance. Hearing age was significantly different; DCHP had been exposed to spoken language for less time than their hearing counterparts by approximately 12 months. Language skills were correlated with ToM after controlling for chronological age.

Discussion: Early cochlear implantation may ameliorate some of the deleterious effects of congenital, profound deafness on oral language development; this could positively influence the development of social cognition.

Conclusions: Children who are deaf who receive a cochlear implant early and who have good oral language skills are more likely to acquire ToM in a typical time frame.

Articles:
Pages 11 à 22: Parler de la mort d'un proche avec un enfant.
Pages 23 à 34: Comment te dire?... Parler de la mort avec les touts-petits.
Pages 35 à 43: Deuil périnatal: un deuil aussi pour la fratrie?
Pages 45 à 52: Pourquoi ne faudrait-il pas parler de la mort aux enfants?
Pages 53 à 62: Orphelins: des enfants en relation avec un parent défunt.
Pages 63 à 73: Accompagner un enfant endeuillé: quel rôle pour les enseignants?
Pages 75 à 78: Dans une école, un compagnonnage après le décès d'un enfant.
Pages 79 à 87: Comment parler à l'enfant de la mort d'un proche?
Pages 89 à 93: Parole d'enfant: entendre les maux de corps.
Pages 95 à 98: D'un haïku à l'autre ou le chemin du deuil.
Pages 99 à 100: Un bout de chemin avec Alban