Effects of a Conversation-Based Intervention on the Linguistic Skills of Children With Motor Speech Disorders Who Use Augmentative and Alternative Communication

What relationships exist between nouns and verbs and the use of prepositions, adverbs, and adjectives in children and adolescents who use speech generating devices?

The relationships between the use of nouns and verbs, and other word classes have been well established in the typical language development literature. However, questions remain as to whether the same relationships are seen in the language use of individuals who use graphic symbol-based augmentative and alternative communication (AAC). The aim of the study was to examine relationships between the use of verbs and nouns, and the use of prepositions, adverbs, and adjectives through a secondary analysis of language transcripts taken from 12 children and adolescents who used aided AAC in conversation with an adult. A series of multiple linear mixed-effect regression analyses showed a positive predictive association between the use of verbs and the use of prepositions and adverbs, as well as a positive predictive relationship between the use of nouns and the use of adjectives. The theoretical and practical implications of these findings are discussed.

Using PAALSS for the manual analysis of language samples of individuals who use aided AAC in Spanish: A pilot study

This pilot study describes the application of the Protocol for the Analysis of Aided Language Samples in Spanish (PAALSS), specifically designed for the manual analysis of language samples from individuals in the early stages of Spanish aided language development. Data were collected from 22 language samples from 16 individuals who use aided AAC and are at the earlier stages of Spanish language development. The primary objective of this study was to explore the feasibility of using PAALSS as an analytical tool to describe various aspects of the language samples, including lexical productivity, lexical diversity, morphology, grammatical complexity, and syntax. Results are presented according to four different groupings, based on the language samples' grammatical complexity scores. The study provides preliminary evidence of the potential of PAALSS as a useful tool for the manual analysis of language samples from users of AAC in Spanish. However, future studies are needed to establish its formal psychometric and measurement properties.

Stakeholder validation of a Sepedi core vocabulary list as a resource for augmentative and alternative communication

PURPOSE

The development of culturally and linguistically appropriate resources to support communication interventions for underserved communities is an urgent necessity. The purpose of the study was to obtain stakeholder feedback on vocabulary items from a Sepedi core vocabulary list developed as a resource for vocabulary selection for augmentative and alternative communication (AAC) systems, and to expand the list based on stakeholders' vocabulary recommendations.

METHOD

A questionnaire was used to obtain the ratings of 57 stakeholders regarding the importance of including 155 Sepedi words from the Sepedi core vocabulary list on an AAC system for a child with receptive language skills at the level of a 4-year-old or higher. Stakeholders also suggested additional words to include on the system.

RESULT

All words were rated as important or very important. However, there was a statistically significant inverse relationship between the average frequency of occurrence of words belonging to a specific category and the average importance rating that stakeholders assigned to words in that category. A total of 48 words were additionally suggested by three or more stakeholders.

CONCLUSION

Stakeholder ratings validated the list as relevant to consult in vocabulary selection for Sepedi AAC systems for children. Stakeholder-suggested words may be a useful supplement to this list.

Is there a 'universal' core? Using semantic primes to select vocabulary across languages in AAC

Core vocabulary lists and vocabulary inventories vary according to language. Lists from one language cannot and should not be assumed to be translatable, as words represent language-specific concepts and grammar. In this manuscript, we (a) present the results of a vocabulary overlap analysis between different published core vocabulary lists in English, Korean, Spanish, and Sepedi; (b) discuss the concept of universal semantic primes as a set of universal concepts that are posited to be language-independent; and (c) provide a list of common words shared across all four languages as exemplars of their semantic primes. The resulting common core words and their corresponding semantic primes can assist families and professionals in thinking about the initial steps in the development of AAC systems for their bilingual/multilingual clients.

Relationship between lexicon and grammar in children and youth who use augmentative and alternative communication

The present study investigated the relationship between lexicon and grammar in individuals who use graphic symbol-based aided augmentative and alternative communication (AAC). Data came from 60 transcripts of generalization sessions that were part of two previous intervention studies, aimed at improving the expressive vocabulary and grammar of 12 children and youth who used graphic symbol-based AAC. The specific aims of the current study were to (a) describe vocabulary composition across different levels of expressive vocabulary and (b) analyze the relationship between global measures of expressive vocabulary and the use of grammar in individuals who use aided AAC. A series of multiple linear mixed effect regression analyses showed a positive predictive association between overall vocabulary size and the use of closed-class words, and a positive relationship between the use of verbs and the use of closed-class words. Additionally, the use of verbs had a significant positive association with the use of inflectional morphology, while the use of nouns did not. Theoretical and practical implications of these findings are discussed.

Dyadic Conversation between Mandarin-Chinese-Speaking Healthy Older Adults: From Analyses of Conversation Turns and Speaking Roles

Older adults' daily conversations with other older adults enable them to connect to their surrounding communities and improve their friendships. However, typical aging processes and fluctuations in family caring might cause conversation changes. The purpose of this study was to explore the quantitative contributions of conversation turns (CTs) and speaking roles (SRs) in Mandarin-Chinese-speaking conversation dyads between mutually familiar healthy older adults (HOAs). A total of 20 HOAs aged 65 or over were recruited. Each dyad conversed for ten minutes once a week for five weeks, five sessions per dyad, for a total of 50 sessions. The frequency and percentages of the coded CTs and SRs contributed by each HOA were individually tallied and calculated. Quantitatively symmetrical contributions of CTs and SRs occurred in Mandarin-Chinese-speaking conversation dyads between mutually familiar HOAs. Although typical aging processes might change conversations, both Mandarin-Chinese-speaking HOAs serve as active interlocutors to each other in taking CTs and SRs to co-construct their conversation processes and content in their dyadic conversation. Sufficient knowledge of conversation co-constructions might lead them to have more supportive environments to connect to surrounding communities and improve their friendships.

Prompting for repair as a language teaching strategy for augmentative and alternative communication

Conversational repair has been found to play a fundamental role in the acquisition of language. This paper describes existing research on conversational repair and its relationship to language learning, whether a first language or a second language, as well as its relevance to augmentative and alternative communication (AAC). A case is made for incorporating prompts to repair in conversation-based language interventions with children learning to use AAC. We argue that interventions targeting linguistic complexity should encourage self-repair in conversation in order to develop linguistic and operational competency as well as increase automaticity when using AAC. Clinical implications and directions for future research are discussed.

Comparison of Preschooler Verbal and Graphic Symbol Production Across Different Syntactic Structures

The present study focuses on the impact of graphic symbols used in Augmentative and Alternative Communication (AAC) on clause construction. It is not yet well-understood to what extent communication produced via graphic symbols differs from verbal production. This study attempts shed light on the impact of the graphic symbol modality on message construction beyond individual differences, language knowledge, and language-specific patterns by providing a direct comparison between children's verbal and graphic symbol production. Nineteen typically developing Hebrew-speaking children aged 4-5 years were presented with 16 short videos of actions and were asked to express what they saw verbally and by choosing among graphic symbols displayed on an iPad communication board. The 570 clauses produced by the children were coded and analyzed. A significant difference was found in favor of verbal speech across different syntactic structures in terms of utilization of the target lexicon, syntactic complexity, and expected target word order. These results are consistent with the existing literature for English. Implications for AAC practices are discussed, highlighting the notion that using graphic symbols to represent spoken language may not reflect actual linguistic knowledge and that adequate, explicit instruction is necessary for graphic representation of more complex linguistic structures.

Sensitivity to Communication Partners During Naturalistic AAC Conversations in Cantonese Chinese

Previous studies have shown that graphic-based augmentative and alternative communication (AAC) output tend to be short and simple in structure with non-canonical word order, and that AAC users may show differences when communicating with peers compared to professionals such as speech therapists (STs). However, there was a lack of report for graphic-based AAC in the Chinese context, and the effect of communication partners had not been investigated systematically. In this study with 34 AAC users and 10 STs, we reported common and distinct features of free conversations in Cantonese graphic-based AAC, relative to AAC in other languages. We also found that AAC users were sensitive to different types of communication partners. In particular, when conversing with peers, AAC users produced long messages with equal proportion of questions and responses, which suggested active and bi-directional exchanges. In conversations with STs, AAC users showed high diversity in expressive vocabulary, indicating access to more semantic concepts. Results suggested that the base language and the communication partner are both influential factors that should be considered in studies of graphic-based AAC. The mobile AAC system facilitated free conversations in users with complex communication needs, affording an additional channel for social participation.

Caregivers', teachers', and assistants' use and learning of partner strategies in communication using high-tech speech-generating devices with children with severe cerebral palsy

Communication with speech generating devices (SGDs) with children with severe physical, communicative and cognitive impairments, such as children with cerebral palsy (CP), can be difficult. Use of partner strategies facilitates the communication and instructional approaches such as feedback and role play facilitate communication partners' learning in how to use partner strategies. To describe communication partners' use and learning about partner strategies in SGD-mediated communication with children with severe CP. Questionnaires (n = 65) were sent to caregivers (n = 30), teachers (n = 17), and teaching or personal assistants (n = 18) of children with severe CP. Response rate was 80%. To ask open-ended questions was the most frequently used partner strategy and aided augmented input the least frequently used partner strategy. Most commonly, participants learned partner strategies from speech and language pathologists (SLPs) who used verbal instructions when teaching partner strategies but seldom or never feedback, role play or video examples. Communication partners' learning about partner strategies in SGD-mediated communication is inadequate and needs to be improved. SLPs, who are the main prescribers of SGDs and responsible for training and support in using them, should consider using instructional approaches when teaching communication partners about partner strategies in communication with an SGD.

A map of assistive technology educative instruments in neurodevelopmental disorders

PURPOSE

The use of assistive technology in mental health has gained an increased interest over the last decades. A growing number of studies have investigated diverse applications of technological interventions for rehabilitation of children with neurodevelopmental disorders. This article presents a map of the technological devises applied as therapeutic instruments.

METHODS

The research question of this review was which technological applications could be referred as an educational instrument for the management of children with autism spectrum disorders (ASDs), intellectual disability and attention deficit disorder. The articles included in this review were collected after a structured literature search in electronic databases using keywords such as "Assistive Technology", "technology devices", "robots", "Autism Disorder", "Intellectual Disabilities" and "Mental Retardation".

RESULTS

Assistive technology with the most up-to-date devices and applications helps children with intellectual disability and ASDs enhance cognitive skills and improve challenging behaviour, social communication and academic performance. Different technological tools are used to foster attention span and improve time management skills in children with attention deficit syndrome.

CONCLUSION

It is important that therapists choose the instrument that will offer the best approach towards the goal that is set. Future research could provide evidence based data, evaluating each specific methodology and tailoring each therapeutic approach specifically to a case.IMPLICATIONS FOR REHABILITATIONTechnology creates environments in which children could practice and learn in a safer, more predictable and pleasant manner.Assistive Technologies provide the opportunity for better acquisition of selfhelp skills and the power of social interaction for individuals with disabilities.By mapping out the wide array of Assistive Technology that is available today, future applications for rehabilitation of children with neurodevelopmental disorders could help extend therapeutic strategies out of the clinical and school settings and into the home, thereby incorporating the family and emphasizing personalization.Future studies could develop a model for the choice and use of each tool, tailoring each therapeutic approach specifically to each case.

Preliminary Investigation of the Perspectives of Parents of Children With Cerebral Palsy on the Supports, Challenges, and Realities of Integrating Augmentative and Alternative Communication Into Everyday Life

Purpose To ensure long-term adoption and use of augmentative and alternative communication (AAC) technologies, they must be designed to support children to participate within everyday activities and routines that are prioritized by families. The aim of this study was to gain parent perspectives on how AAC technologies were integrated into everyday life. Method Nine parents of children with cerebral palsy who used AAC technologies participated in semistructured interviews to provide their perspectives on how AAC technologies were integrated into the functional contexts of everyday life. Results Five major themes emerged from the discussions: (a) integrating AAC into life, (b) AAC technologies, (c) child needs and skills, (d) parent responsibilities and priorities, and (e) AAC process and decision making. Children were able to use AAC technologies within a variety of everyday contexts with various partners; however, challenges included access to technologies within care routines and outdoor activities as well as partners who lacked knowledge regarding operational competencies and effective interaction strategies. To integrate AAC technologies into life, parents prioritized technology features including ease of programming, improved physical design, features to enhance efficiency and ease of access, and availability of multiple functions and features (e.g., games and leisure activities, environmental controls). Conclusion AAC manufacturers and mainstream technology developers should work to ensure that technologies are responsive to the supports, limitations, and ideal features identified by parents. Future research should seek input from a larger group of stakeholders and use longitudinal methods to examine perceptions of AAC technologies over time. Supplemental Material https://doi.org/10.23641/asha.11625543.

Recast type, repair, and acquisition in AAC mediated interaction

The present study investigated the effects of different types of recasts and prompts on the rate of repair and spontaneous use of novel vocabulary by eight children with severe motor speech disabilities who used speech-generating technologies to communicate. Data came from 60 transcripts of clinical sessions that were part of a conversation-based intervention designed to teach them pronouns, verbs, and verb inflections. The results showed that, when presented alone, interrogative choice and declarative recasts led to the highest rates of child repair. The results also showed that when children were presented with recasts and prompts to repair, the rate of repair increased. Spontaneous use of linguistic targets was significantly and positively related to conversational sequences where the adult recast was followed by child repair. These findings suggest that using different recast types and prompts to repair may be beneficial for spontaneous use of linguistic targets in this population.

The emergence of clause construction in children who use speech generating devices

This study aimed to detect patterns in clause construction structural changes produced by four participants aged 9;5-13;7 (years;months) with motor speech disorders who used speech-generating devices. Sequences of adult-child interactions, drawn from the data of a larger study focused on enhancing vocabulary and grammar skills, were examined. This current study comprises a secondary analysis of a corpus of 29 conversations totalling 808.36 min, analysing clause structures by type, linguistic complexity, and intensity of adult prompts (number of turns). Results show that, over time, the participants' clause structure complexity increased through addition of phrase-internal elements such as inflections, articles, and prepositions. Use of specific grammatical elements followed the developmental stages observed in children with typical development. For all participants, the personal pronoun I (first-person singular) emerged before she, he (third-person singular), and we or they (plural). Participants with the highest number of adult-child co-constructed clauses also had the highest number of well-formed clauses. The intensity of adult prompts increased as clause structures became more complex and as participants needed more support. Implications for practice and theory are discussed.

Introducing the Beatalk technique: using beatbox sounds and rhythms to improve speech characteristics of adults with intellectual disability

BACKGROUND

Individuals with intellectual disability (ID) often demonstrate speech impairments and reduced intelligibility. However, traditional treatment methods, which involve using repetitive verbal and non-verbal exercises, may not be fully suitable for this population. As adults with ID tend to lose interest and motivation facing the demands of a typical speech therapy session, other intervention methods are needed. The current study tested a novel intervention technique, Beatalk, based on practising vocally produced sounds and rhythms, imitating the sounds produced by rhythm machines in an a cappella musical context (i.e., human beatboxing). Human beatboxing may be a particularly effective tool since it involves intense production of speech sounds (phonemes) that can be misarticulated in the presence of speech disorders; it is relatively easy to learn and practice, and is also considered 'fun'.

AIMS

As many of the features of beatboxing make it a promising method for speech therapy, this pioneering study aimed to examine its effectiveness in comparison with a traditional speech therapy.

METHODS & PROCEDURES

Twelve adults with moderate ID and low speech intelligibility (age 24-48 years) participated in a speech therapy group for 6 weeks. Six participants were assigned to the Beatalk (study) group and six to a traditional (control) therapy group. Pre- to post-treatment changes in speech intelligibility and voice measures were assessed.

OUTCOMES & RESULTS

The preliminary data demonstrate that both types of therapy groups resulted in improved performance in articulation accuracy and voice measures, yet the Beatalk technique yielded larger gains.

CONCLUSIONS & IMPLICATIONS

The results present initial evidence for the beneficial effect of the Beatalk technique as an intervention tool for adults with ID. It is an easy-to-use technique in the context of speech therapy, and may enhance verbal communication skills in this population.

Early verbal categories and inflections in children who use speech-generating devices

The use of early verbal categories, their event types, and the emergence of verbal inflections (-ing, -s, and -ed) were analyzed in data from four participants with motor speech disorders aged 9;5-13;9 (years;months) who used speech-generating devices to converse with a familiar adult. The study was conducted through a secondary analysis of a corpus of data collected as part of another study. It documents the production of verbs and the emergence of verb inflections in natural conversations between each of the participants and a member of their educational team over a period of up to 10 months. All participants used both action and state verbs, although action verbs were dominant. The emergence of the inflections -ing, -s, and -ed varied and were distributed selectively with different verb categories and event types. The results are discussed in terms of language development and are considered in terms of the findings from research with children without disabilities, which suggest that action verbs precede state verbs, and inflections are primarily acquired based on their correspondence to the verbal category (action-state). Implications for theory, practice, and further research are discussed.

Conversation-based intervention for adolescents using augmentative and alternative communication

This study evaluated the effects of a conversation-based intervention on the use of verbs, personal pronouns, bound morphemes and spontaneous clauses in adolescents with cerebral palsy who use augmentative and alternative communication (AAC). Four teenage girls aged from 14 to 18 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant in the context of a personal collage-building activity. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT™) . While the results are mixed, all four participants increased their use of at least one linguistic target, three increased their use of verbs and grammatically correct spontaneous clauses, two increased their use of personal pronouns, and one produced more bound morphemes during intervention than in baseline. These findings, and future research needs, are discussed.

Augmentative and alternative communication in children with Down's syndrome: a systematic review

BACKGROUND

The use of technology to assist in the communication, socialization, language, and motor skills of children with Down's syndrome (DS) is required. The aim of this study was to analyse research findings regarding the different instruments of 'augmentative and alternative communication' used in children with Down's syndrome.

METHODS

This is a systematic review of published articles available on PubMed, Web of Science, PsycInfo, and BVS using the following descriptors: assistive technology AND syndrome, assistive technology AND down syndrome, down syndrome AND augmentative and alternative communication. Studies published in English were selected if they met the following inclusion criteria: (1) study of children with a diagnosis of DS, and (2) assistive technology and/or augmentative and alternative communication analysis in this population.

RESULTS

A total of 1087 articles were identified. Thirteen articles met the inclusion criteria. The instruments most used by the studies were speech-generating devices (SGDs) and the Picture Exchange Communication System (PECS).

CONCLUSION

Twelve instruments that provided significant aid to the process of communication and socialization of children with DS were identified. These instruments increase the interaction between individuals among this population and their peers, contributing to their quality of life and self-esteem.