AAC: bonding the uncertain mosaic

Key Word Signing Usage of Adults With Intellectual Disabilities: Influence of Communication Partners' Sign Usage and Responsivity

PURPOSE

In services for adults with intellectual disabilities, various staff members may have different key word signing (KWS) skills and conversational style. Little is known about how these clients use KWS with different staff members. Therefore, we observed staff-client conversations and examined how clients' KWS usage was shaped by staff members' KWS usage and conversational style.

METHOD

Three 10-min dyadic conversations between an adult with moderate or severe intellectual disabilities (N = 15) and three familiar staff members were filmed and transcribed. The KWS usage and conversational responsivity in the transcriptions was analyzed at group (using generalized estimating equations), subgroup, and individual levels.

RESULTS

Clients appeared to produce significantly more KWS as partners imitated more signs and as partners were more responsive. There was a negative interaction between these two factors. Subgroup analyses showed that spontaneity of clients' KWS usage was a continuum.

CONCLUSION

Findings suggest that staff can encourage clients' KWS usage by imitating manual signs but that clients' response efficiency should also be taken into account.

Beliefs and habits: staff experiences with key word signing in special schools and group residential homes

Even though use of aided augmentative and alternative communication (AAC) by staff has been extensively researched, few studies relate to unaided AAC strategies such as key word signing (KWS). We explored the KWS views of two groups: direct support staff in group residential homes and teachers from special education secondary schools. We examined transcripts from individual semi-structured interviews with five direct support staff and five teachers using thematic analysis. Participants discussed consistency of KWS use and reasons for implementing KWS. Compared to direct support staff, teachers described more use of KWS throughout the day with more individuals with intellectual disability. Teachers discussed use of KWS to facilitate students' present and future interactions, while direct support staff primarily discussed immediate effects. Participants experienced KWS implementation as a learning process and aimed to turn the use of manual signs into a routine habit. This required considerable self-monitoring, and the effort that this continuous self-feedback required, combined with environmental factors, could hinder KWS implementation. These preliminary findings suggest that preservice KWS training and on-site KWS assistance may need to be enhanced.

Literacy before and after Inclusion in General Education Settings: A Case Study

This 7 year case study describes a young woman with moderate to severe disabilities and her use of literacy (i.e., reading, writing, listening, and speaking) during various stages of her educational career. Her use of literacy is described (a) when she was 15-years-old, after having received special education and related services in self-contained special education classes for 10 years and (b) during the proceeding 7 years, after the location in which she received services was changed to general education settings with nondisabled classmates, first in middle school, then high school, and finally in college. This change in location of services resulted in changes both in her instructional content and in the manner in which instruction and assessment occurred. Concomitantly, observable changes occurred in her social and learning behaviors. Significant changes resulted in the student's reading, writing, listening, and speaking across settings, people, content, and activities. In addition, the student's prior inappropriate social behaviors and refusals to participate in learning activities were replaced with appropriate behaviors in both instructional and social situations. Finally, the implications of the findings from this case study are discussed and recommendations are made for providing effective educational programs for students with moderate to severe disabilities, including literacy development.

What We Write about When We Write About AAC: The Past 30 Years of Research and Future Directions

For the past 30 years, the Augmentative and Alternative Communication (AAC) journal has both documented and instigated change in the field of AAC. We reviewed the papers published in the AAC journal from 1985-2014 in order to identify trends in research and publication activities. Intervention research made up the largest proportion of the four types of research (i.e., intervention, descriptive, experimental, and instrument and measurement development) reported in the journal. Intervention research has most commonly focused on the individual with complex communication needs, and most frequently on younger individuals (aged 17 and younger) with developmental disabilities. While much has been learned in the past 30 years, there continues to be a need for high quality research in a large number of areas. There is a special need for reports of interventions with older individuals with complex communication needs as a result of acquired disabilities, and for information on effective interventions for the communication partners of persons with complex communication needs.

Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication?

In 1989, Light defined communicative competence for individuals with complex communication needs who require augmentative and alternative communication (AAC) as a dynamic interpersonal construct based on functionality of communication; adequacy of communication; and sufficiency of knowledge, judgment, and skills. Specifically, Light argued that, in order to demonstrate communicative competence, individuals who required AAC had to develop and integrate knowledge, judgment, and skills in four interrelated domains: linguistic, operational, social, and strategic. In 2003, Light expanded this definition and argued that the attainment of communicative competence is influenced by not just linguistic, operational, social, and strategic competencies but also a variety of psychosocial factors (e.g., motivation, attitude, confidence, resilience) as well as barriers and supports in the environment. In the 25 years since this definition of communicative competence for individuals who use AAC was originally proposed, there have been significant changes in the AAC field. In this paper, we review the preliminary definition of communicative competence, consider the changes in the field, and then revisit the proposed definition to determine if it is still relevant and valid for this new era of communication.

Long-term outcomes for individuals who use augmentative and alternative communication: Part III--contributing factors

In order to improve outcomes for individuals who use augmentative and alternative communication (AAC), it is important to understand what factors contribute to or detract from positive outcomes. Seven young men who had used AAC systems for at least 15 years, their family members, and professionals who had worked with them, participated in the study. Qualitative interviews were used to identify contextual factors that may have contributed (both positively and negatively) to the young men's outcomes. Factors that impeded positive outcomes included: attitude barriers, cultural differences, technological barriers, and service delivery limitations. Contributions to positive outcomes included: community support, parent and family support, personal characteristics, and appropriate and high-quality AAC services. The results are discussed with implications for clinical practice and directions for future research.

Long-term outcomes for individuals who use augmentative and alternative communication: Part II – communicative interaction

This study evaluated the communicative interaction skills of seven young men (ages 19-23 years) who had used AAC systems for at least 15 years. Turn-taking patterns, use of communicative functions, and linguistic complexity were analyzed. Current performance was compared to the participants' skills when they were preschoolers and participated in another study of interaction skills (Light, 1985; Light, Collier, & Parnes, 1985a,b,c). Results indicated that the turn distribution between partners was more equitable than it had been when the participants were preschoolers; five of the participants approached reciprocity in turn taking during at least two of the interactions observed. During interactions with their caregivers, the participants fulfilled most of their obligatory turns and more than half of their non-obligatory turns. The communicative functions used most frequently by the participants were confirmations/denials and provisions of information. Three of the participants demonstrated the ability to use complete and complex syntax and committed few errors in grammar, while the other four participants demonstrated many syntactic errors. The results are discussed with implications for clinical practice and directions for future research.

A Framework for Managing Controversial Practices

Every day, speech-language pathologists working in schools make difficult, life-impacting decisions regarding which assessment and intervention approaches to use with their clients. These decisions can become even more difficult when the approaches being considered for use are controversial. The risks involved in making choices about controversial practices are likely to have increased significance simply because the approach being considered is not widely accepted. The increased professional risk may cause decisions to be made based on risk avoidance rather than on a careful consideration of the pros and cons of the approach itself. This article offers a clinical practice framework for gathering information about controversial approaches and for implementing and monitoring their use. The framework will be illustrated using facilitated communication as an example of a controversial practice.