Meeting in the middle: Improving communication in primary health care consultations with people with an intellectual disability

The increased presence and participation in Australian society of people with an intellectual disability provides challenges for the provision of primary health care. General practitioners (GPs) identify themselves as ill equipped to provide for this heterogeneous population. A major obstacle to the provision of appropriate health care is seen as inadequate communication between the GP and the person with an intellectual disability, who may or may not be accompanied by a carer or advocate. This qualitative study in which five GPs, three people with intellectual disability, seven carers and two advocates (parent and friend) were interviewed was conducted in Brisbane, Australia. The aim was to better understand the factors that have an impact upon the success of communication in a medical consultation. Findings suggested that GPs were concerned with the aspects of communication difficulties which influenced their ability to adequately diagnose, manage and inform patients. Implications for practice management were also identified. People with intellectual disability reported frustration when they felt that they could not communicate adequately with the GP and annoyance when they were not included in the communication exchange. Carers were strong advocates for the person with intellectual disability, but indicated insufficient skill and knowledge to provide the level of assistance required in the consultation. The outcome was a model of cooperation that outlined the responsibilities of all players in the medical encounter, prior to, during and after the event.

Facilitating communication in children with multiple disabilities: three case studies of girls with Rett syndrome

Purpose: To investigate the effect of cueing on communicative responses of children with multiple disabilities in an educational setting. It was hypothesized that differences would exist in teacher interactional styles and the use of orienting cues would increase the communicative responses of the participants. Method: A naturalistic observation research method was employed in order to examine the interaction of three student-teacher dyads in three special schools. Three different activity types were videotaped from which interactions were coded and analysed. Results: Multi-modal cueing facilitated communicative responses of children with Rett syndrome. However, increased communication opportunities provided by caregivers did not elicit increased responses from the girls. Conclusion: There is a difference in cueing by teachers in their interactions with children with multiple disabilities. Also, more frequent communicative interactions did not necessarily lead to increased student responses. It is suggested that amount and type of cueing may need to be considered to be effective in generating student responses. The small number of participants, however, means findings should be viewed cautiously and that more research is indicated.

Impact of social group processes and functional diversity on communication in networked organizations

This study examines the role of social group processes in perceptions of effective communication in Australian Cooperative Research Centres (CRCs). Communication professionals in 25 CRCs discussed the barriers and opportunities for communication in their diverse networked organizations. Thematic analysis of the transcripts highlighted the contribution of social group processes to both barriers and opportunities. Communication challenges implicated the social identity of organizational members, many of which were associated with distinct structural aspects of these organizations. Opportunities for communication frequently involved features that implicated social identity, including taking advantage of existing organizational or industry identities, preventing conflicting identities from becoming salient, and promoting a collective CRC identity.

Business communication in interactions between mainland Chinese and western firms through Hong Kong Chinese intermediaries

Purpose-The paper aims to analyse the nature of business communication and its influence on relationships development between Hong Kong Chinese intermediaries sourcing from Mainland Chinese sellers involved in manufacturing for sale to Western buyer firms. Design/methodology/approach-A case study-driven methodology with purposeful sampling is applied to yield maximum variation in the sampling to elicit underlying tendencies and generative mechanisms that exist within and across the multiple cases of relationships. Findings-The paper finds that Mainland Chinese sellers and Hong Kong Chinese intermediaries tend not to have the close ties that might be expected. Mainland Chinese sellers constrained their use of social information, requiring Hong Kong Chinese intermediaries to use commercial information transfers to evaluate the trustworthiness of their Mainland Chinese partners. An ingroup/outgroup bias exacerbates the modesty bias of the Mainland Chinese and also hinders learning through the transfer of technical information within these Chinese interactions. On the other hand, Western buyers tend not to prefer social information interactions with their Hong Kong Chinese intermediaries, requiring these intermediaries to emphasise commercial information interactions to evaluate the trustworthiness of their Western buyers. Research limitations/implications-This research uses a restricted sample of case study respondents. Representative sampling across multiple contexts will assist in testing the generality of the findings. Practical implications-For the West to source increasingly attractive manufactures from Mainland China, Hong Kong intermediaries will remain fundamentally important even though this creates further interactions. The aggregate of these multiple exchange arrangements is less problematic than would be the case if Western business were to deal directly with the Mainland Chinese. Originality/value-This article sheds light on the nature of business communication interactions in a group of relationships between Hong Kong Chinese intermediaries and Mainland sellers, and buyers from the West. Implications for relationships development among the Chinese and Western actors are identified with propositions framed to guide further investigation.

Highlighting hybridity: A critical discourse analysis of teacher talk in science classrooms

There is evidence that alienation from science is linked to the dominant discourse practices of science classrooms (cf. Lemke, J. L. (1990). Talking Science: Language, Learning, and Values. Norwood, NJ: Ablex). Yet, in secondary science education it is particularly hard to find evidence of curriculum reform that includes explicit changes in pedagogic discourses to accommodate the needs of students from a wide range of backgrounds. However, such evidence does exist and needs to be highlighted wherever it is found to help address social justice concerns in science education. In this article, I show how critical discourse analysis can be used to explore a way of challenging the dominant discourse in teacher-student interactions in science classrooms. My findings suggest a new way of moving toward more socially just science curricula in middle years and secondary classrooms by using hybrid discourses that can serve emancipatory purposes. © 2005 Wiley Periodicals. Inc.

Social communication in older age: Lessons from people with aphasia

Lessons on social communication in older age are drawn from the stories and qualitative case reports of three older people who have aphasia following stroke. Descriptive accounts of participant responses to qualitative interviews and stimulated recall of natural conversations, together with information from a social network diary, provide evidence of aspects of social communication relevant to the older person with aphasia. The perspectives of individuals and common themes relating to social communication with family and friends, the experience of aphasia, and living with aphasia in older age are presented. The prominence of conversations and the role of storytelling and of humor within the daily social communication of older people are illuminated. Key words: aphasia, older people, social communication

Intergroup processes in intragroup contexts: The roles of group status, group identification and communication in diverse work teams

The present research examines employee identification and communication in organisations. In Study 1, 2229 soldiers from a military organisation completed measures of perceived status and strength of identification with their unit, employment category and their brigade. As predicted, the status of a key organisational group influenced reactions to different organisational groups: full-time soldiers evaluated their work unit and the organisation as being lower in status and identified less strongly with both of these groups than part-time soldiers. The second study extended these findings to a different research context: a large psychiatric hospital undergoing downsizing and restructuring. Surprisingly, there were no differences in survivors' and victims' levels of identification with organisational groups. Instead, and consistent with Study 1, there was evidence to suggest that employees adjusted their patterns of identification and perceptions of group status through a compensatory mechanism that maximised opportunities for selfenhancement and positive distinctiveness. In the third study, employees from a public hospital (N = 142) rated communication from double ingroup members (same work unit/same occupational group) more favourably than communication from partial group members (same work unit/different occupational group). These results are considered in terms of their practical implications for identity management in organisations.