Integrating familiar listeners and speech recognition technologies into augmentative and alternative communication intervention for adults with down syndrome: Descriptive exploration

Effects of an AAC feature on decoding and encoding skills of adults with Down syndrome

Literacy skills can assist in the navigation and enjoyment of adult life. For individuals who have reached adulthood without strong literacy skills, opportunities for continued literacy learning are few. Redesigning AAC technologies to support literacy skill development could extend literacy learning opportunities for adults with developmental disabilities who have limited speech. The current preliminary study evaluated an AAC technology feature designed to support literacy development. The study used a multiple probe across participants design. Three adults with Down syndrome who had limited speech and only basic decoding skills participated. Results suggest the participants made modest gains in decoding accuracy after interacting using the AAC app with the literacy supportive feature, though performance was highly variable. Results also offer emerging evidence that, for two participants, some generalization to encoding performance may have also been achieved. Results showed that, for all the participants, interacting using the literacy supportive feature increased their reading confidence. Altogether, the study's results show preliminary evidence that the feature can support adults with Down syndrome in their ongoing literacy learning, though access to formal instruction is still critical. Future research is needed to continue to explore this and other AAC technology redesigns to increase learning opportunities for the people who use the technology every day to communicate.

Developing accessible speech technology with users with dysarthric speech

The Voiceitt app is designed for people with dysarthric speech, to support vocal communication and access to voice-driven technologies. Sixty-six participants were recruited to test the Voiceitt app and share feedback with developers. Most had physical, sensory, or cognitive impairments in addition to atypical speech. The project team liaised with individuals, their families and local support teams to provide access to the app and associated equipment. Testing was user-led, with participants asked to identify and test use cases most relevant to their daily lives over three months or more. Ongoing technical support and training were provided remotely and in-person throughout their testing. Semi-structured interviews were used to collect feedback on users' experiences, with delivery adapted to individuals' needs and preferences. Informal feedback was collected through ongoing contact between participants, their families and support teams and the project team. User feedback has led to improvements to the user interface and functionality, including faster voice training, simplified navigation, the introduction of game-style features and of switch access as an alternative to touchscreen access. This work offers a case-study in meaningful engagement with diverse disabled users of assistive technology in commercial software development.

Ultrasonic vocalization phenotypes in the Ts65Dn and Dp(16)1Yey mouse models of Down syndrome

Down syndrome (DS) is a developmental disorder associated with a high incidence of challenges in vocal communication. DS can involve medical co-morbidities and structural social factors that may impact communication outcomes, which can present difficulties for the study of vocal communication challenges. Mouse models of DS may be used to study vocal communication differences associated with this syndrome and allow for greater control and consistency of environmental factors. Prior work has demonstrated differences in ultrasonic vocalization (USV) of the Ts65Dn mouse model of DS at a young adult age, however it is not known how USV characteristics are manifested at mature ages. Given that the aging process and age-related co-morbidities may also impact communication in DS, addressing this gap in knowledge may be of value for efforts to understand communication difficulties in DS across the lifespan. The current study hypothesized that the Ts65Dn and Dp(16)1Yey mouse models of DS would demonstrate differences in multiple measures of USV communication at a mature adult age of 5 months.

METHODS

Ts65Dn mice (n = 16) and euploid controls (n = 19), as well as Dp(16)1Yey mice (n = 20) and wild-type controls (n = 22), were evaluated at 5 months of age for USV production using a mating paradigm. Video footage of USV sessions were analyzed to quantify social behaviors of male mice during USV testing sessions. USV recordings were analyzed using Deepsqueak software to identify 10 vocalization types, which were quantified for 11 acoustic measures.

RESULTS

Ts65Dn, but not Dp(16)1Yey, showed significantly lower proportions of USVs classified as Step Up, Short, and Frequency Steps, and significantly higher proportions of USVs classified as Inverted U, than euploid controls. Both Ts65Dn and Dp(16)1Yey groups had significantly greater values for power and tonality for USVs than respective control groups. While Ts65Dn showed lower frequencies than controls, Dp(16)1Yey showed higher frequencies than controls. Finally, Ts65Dn showed reductions in a measure of complexity for some call types. No significant differences between genotype groups were identified in analysis of behaviors during testing sessions.

CONCLUSION

While both Ts65Dn and Dp(16)1Yey show significant differences in USV measures at 5 months of age, of the two models, Ts65Dn shows a relatively greater numbers of differences. Characterization of communication phenotypes in mouse models of DS may be helpful in laying the foundation for future translational advances in the area of communication difficulties associated with DS.

Interaction between people with dysarthria and speech recognition systems: A review

In recent years, rapid advancements have taken place for automatic speech recognition (ASR) systems and devices. Though ASR technologies have increased, the accessibility of these novel interaction systems is underreported and may present difficulties for people with speech impediments. In this article, we attempt to identify gaps in current research on the interaction between people with dysarthria and ASR systems and devices. We cover the period from 2011, when Siri (the first and the leading commercial voice assistant) was launched, to 2020. The review employs an interaction framework in which each element (user, input, system, and output) contributes to the interaction process. To select the articles for review, we conducted a search of scientific databases and academic journals. A total of 36 studies met the inclusion criteria, which included use of the word error rate (WER) as a measurement for evaluating ASR systems. This review determines that challenges in interacting with ASR systems persist even in light of the most recent commercial technologies. Further, understanding of the entire interaction process remains limited; thus, to improve this interaction, the recent progress of ASR systems must be elucidated.

A qualitative study exploring the effect of communicating with partially intelligible speech

Few studies have investigated how individuals with partially intelligible speech choose to communicate, including how, when, and why they might use a speech-generating device (SGD). This study aimed to add to the literature by exploring how this group of individuals use different communication strategies. Qualitative interviews were carried out with 10 participants with partially intelligible speech with the aim of investigating participants' perceptions of modes of communication and communication strategies. Transcripts were analyzed using Framework Analysis to investigate the role of SGDs alongside other communication strategies. Factors that influence why, when, and how a person chooses to communicate were identified and these were interpreted as an explanatory model of communication with partially intelligible speech. Participants described how they made the decision whether to attempt to communicate at all and then which communication method to use. Decision-making was influenced by the importance of the message, how much time is available, past experience, and the communication partner. Each communication attempt adds to an individuals' experience of communicating and influences subsequent decisions. This study suggests that individuals with partially intelligible speech are at risk of reduced communication environments and networks and that current SGDs may not be designed in a way that recognizes their particular needs.

Quality of life in adults with Down syndrome: A mixed methods systematic review

BACKGROUND

As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life.

OBJECTIVE

Using Schalock and Verdugo's multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting.

METHODS

Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered.

CONCLUSION

This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome.

INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER

CRD42019140056.

It's Never Too Late: Debunking Myths About Communication and Adults With Severe Disabilities

Communication infuses all dimensions and stages of life, influencing one's self-determination and quality of life. A number of empirical studies have demonstrated that people with severe disabilities continue to develop communication and language skills well into their adult years and make measurable gains when provided with appropriate communication services and supports. Several myths about age, ability, and experiences limit opportunities for persons with severe disabilities. In this paper, we confront and address these myths.