Simulation of other-initiated repair using AAC

This simulation study assessed the ability of Speech-Output Technologies (SOTs) to keep in-time during conversational repair. Fifty-eight Other Initiated Repair (OIR) initiators were collected from transcripts of repair interaction sequences collected from past research. A range of selection latencies were then used to calculate simulated utterance composition delays for the OIR initiators using two popular SOT software apps, with and without the use of word prediction. To determine whether OIR utterances could be produced within a socially sensitive temporal gap, composition delay was compared to a conservative temporal limit obtained for oral communicators (Kendrick, 2015). Even at the fastest 0.5 s selection latency level, utterance-level composition delays for both SOTs were substantially greater than the OIR limit set for this study. Next, AAC production rate data spanning a variety of technologies, access methods, tasks and user profiles was obtained from the literature. Communication performance for these groups was then evaluated against the identified temporal OIR limit. None of the user groups were found to be capable of producing full OIR utterances within the temporal limits of oral-speech conversation, with most unable to type even a single selection within these bounds. Because of the frequency and importance of repair in conversation, these results have important implications for designing devices to enable their users to successfully engage in such important conversational activities.

Evaluating Camera Mouse as a computer access system for augmentative and alternative communication in cerebral palsy: A case study

Camera Mouse is a freely available software program that visually tracks the movement of facial features to allow individuals with motor impairments to control a computer mouse. The goal of this case study was to provide an evaluation of Camera Mouse as a computer access method as part of a multiple modality communication system for an individual with cerebral palsy. The participant was asked to reproduce sentences and respond to ethical dilemmas for language sampling. Tasks were completed using natural speech and an AAC solution consisting of Camera Mouse paired with an orthographic selection interface and speech synthesis. The participant completed a questionnaire for satisfaction with the introduced assistive technology. Camera Mouse resulted in higher intelligibility than natural speech, while natural speech had a higher rate. She used more complex language with her natural speech. The participant rated Camera Mouse as at least 3/5 on all measures, including 5/5 on weight and safety. The results of this case study suggest Camera Mouse is a promising computer access system for communication supported by the participant's satisfaction rating, expressive language, and synthesized speech production capabilities.

Possibilities of intelligent textiles in AAC - perspectives of speech and language therapists

PURPOSE

The growth of new high-technology devices in the field of augmentative and alternative communication (AAC) has been rapid. However, a vast number of individuals with complex communication needs are left without functional means to communicate in their lives. Intelligent textiles are one of the growing industries in health technologies yet to be explored for the possibility of implementation as an AAC solution. This study aimed to investigate the potential of intelligent textiles and their functions in daily life perceived by experienced speech and language therapists and to obtain data, which will offer direction on how to proceed with prototype development.

MATERIALS AND METHODS

Focus group discussions were conducted remotely within two groups of experienced speech and language therapists (n = 12). The data obtained from the discussions were analysed thematically.

RESULTS AND CONCLUSION

According to the stakeholders in question, intelligent textiles were perceived most useful for individuals with motor disabilities and those with severe intellectual disabilities. The most prominent themes for the purpose of using the intelligent textiles were social interaction and accessing meaningful activities independently. The participants also described how this technology could be used in terms of the textile, the input needed and the output the technology provides. The versatile results are discussed along with directions for future research.

"They aren't waiting for an SLP, they think 'what can I as a parent do now?'" course leaders' perceptions of AAC interventions targeting parents

Parental interventions can help parents use strategies to support their child's language and communication development. The ComAlong courses are parental interventions that focus on responsive communication, enhanced milieu teaching, and augmentative and alternative communication. This interview study aimed to investigate the course leaders' perceptions of the three ComAlong courses, ComAlong Habilitation, ComAlong Developmental Language Disorder, and ComAlong Toddler, and to evaluate their experiences of the implementation of the courses. Qualitative content analysis was used to analyze the interview data. Thereafter, three categories resulted from the findings: Impact on the Family, A Great Course Concept, and Accessibility of the Courses. The results indicate that participants perceived that the courses had positive effects on both parents and themself. Furthermore, it was described that parents gained knowledge about communication and strategies in how to develop their child's communication; however, the courses were not accessible to all parents. The collaboration between the parents and course leaders improved, and course leaders viewed the courses as an important part of their work. The following factors had an impact on the implementation: several course leaders in the same workplace, support from colleagues and management, and recruitment of parents to the courses.

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.

Nurse perspectives on supporting children and youth who use augmentative and alternative communication (AAC) in the pediatric intensive care unit

Many children who require hospitalization in the pediatric intensive care unit (ICU) are unable to or have difficulty communicating through speech, whether because of preexisting or acute conditions. Children who are unable to be heard and understood using only speech benefit from aided augmentative and alternative communication (AAC), including in hospital settings. This qualitative interview study sought to understand the perspectives of nurses on care and support for children who use or would benefit from aided AAC in the pediatric ICU. Participants were six nurses who worked in pediatric intensive care at a tertiary care unit of a children's hospital in the United States. Three main themes were identified related to nurses' views about supporting children's communication: (a) Caring for the Whole Child, (b) Needing Support from Others and Moving between Roles, and (c) Working with Available Resources and Demands. Nurses emphasized the importance of a holistic approach to care, the impact of others' support and knowledge, and a desire for building greater capacity for promoting children's access to effective communication. Findings offer insight that could improve patient-centered care for children with complex communication needs and support for nurses themselves, particularly within the broader context of ICU liberation.

Reading intervention for students with intellectual disabilities without functional speech who require augmentative and alternative communication: a multiple single-case design with four randomized baselines

BACKGROUND

Literacy is one of the most important skills a students can achieve, as it provides access to information and communication. Unfortunately, literacy skills are not easily acquired, especially for students with intellectual disabilities who require augmentative and alternative communication (AAC). There are many barriers to literacy acquisition, some due to low expectations from parents and teachers and lack of evidence-based reading programs and reading materials adapted for AAC. Barriers as a result of extensive support needs is also a real factor. This trial aims to deliver reading instructions to 40 students with intellectual disabilities who require AAC and contribute in the debate on how to best support this population through reading instructions to maximizes their reading skills.

METHODOLOGY

Forty non-verbal or minimally verbal students (age 6-14) with intellectual disabilities who require AAC will be part of a reading intervention with a multiple single-case design with four randomized baselines. The intervention period will last for 18 months and will commence in March 2023. The students will receive the intervention in a one-to-one format, working systematically with a reading material that contains phonological awareness and decoding tasks based on the Accessible Literacy Learning (ALL) developed by Janice Light and David McNaughton. All the teachers will be trained to deliver the reading intervention.

DISCUSSION

The reading material "Lesing for alle" (Reading for all) is based on and follow the strategies behind the research of ALL. The current trial will through a reading intervention contribute to move beyond only teaching sight words and combine several reading components such as sound blending, letter-sound correspondence, phoneme segmentation, shared reading, recognition of sight words, and decoding. The strategies and methods in use is built on the existing science of reading, especially what has been effective in teaching reading for students with intellectual disabilities who require AAC. There is limited generalizability of prior findings in reading-related phonological processing interventions to different populations of them who use AAC specially outside of the USA. More research is needed to understand how programs designed to improve reading skills across other settings understand the program's long-term effects and to study the effectiveness when delivered by educators who are not speech language therapists or researchers.

TRIAL REGISTRATION

NCT05709405 . Registered 23 January 2023.

Teletherapy, AAC & COVID-19: the experiences of speech language pathologists providing teletherapy during a global pandemic

The COVID-19 pandemic required many speech-language pathologists (SLPs) to transition to teletherapy service delivery. This study was designed to explore the experiences and perceptions of SLPs who made this transition with children with disabilities who used aided augmentative and alternative communication (AAC). Semi-structured interviews were conducted virtually with 10 SLPs who provided regular teletherapy services to children who used AAC during but not before the pandemic. Interview transcripts were analyzed thematically using immersion, reduction, and constant comparison to understand SLP experiences and perceptions individually and across the group. Results reveal that despite the challenges faced transitioning to teletherapy, there were benefits. Furthermore, many of the participating SLPs developed successful strategies and solutions for the challenges they faced. Participants in this study highlighted the unique and important role that caregivers and parents played in the success of the teletherapy they provided. This study suggests that SLPs, caregivers, and children demonstrated resilience in the face of a large-scale, unforeseen change. SLPs consistently reported the ability to maintain continuity of care during a stressful transition period, while meeting the unique needs of the children who used AAC they served.

Dynamic Assessment of AAC Action Verb Symbols for Children with ASD

Objectives

The purpose of this study was to determine whether children with autism spectrum disorder (ASD) make progress in learning to use action verb symbols on augmentative and alternative communication (AAC) applications across different communicative functions (requesting, labeling) and instructional formats (embedded instruction, discrete trial teaching).

Methods

Four preschool-aged children completed graduated prompting dynamic assessment sessions in which they were provided with varying levels of support (e.g., models, gestures) across three instructional conditions: (a) requesting actions embedded in play, (b) labeling actions embedded in play, and (c) labeling actions presented via video during discrete trial teaching. An adapted multielement single-case design was used to compare participants' abilities to use symbols with different levels of support across the instructional conditions and a control.

Results

Differences between instructional and control conditions were established for three participants. Three participants also reduced the levels of support they needed to use symbols in at least two instructional conditions. Although participants initially required lower levels of support (i.e., less restrictive prompts) in the requesting condition compared to labeling conditions, these differences only maintained for one participant. Across participants, differences between labeling conditions were minimal.

Conclusions

Although children with ASD can use verb symbols with low levels of support during DA, additional intervention may be needed to increase independent responding. Individual characteristics may influence success across communicative functions.

Using key-word signing to support learners in South African schools: a study of teachers' perceptions

Key-word-signing (KWS), an unaided augmentative and alternative communication (AAC) strategy, has an important role to play in the education system. To date, limited research exists regarding the use of unaided AAC strategies in the school environment, especially in low- and middle-income countries. To address this research gap, the current study aimed to explore the perceptions of South African teachers toward the use of KWS strategies in the educational context. The study used a descriptive paper-based survey comprised of both closed and open-ended questions that was completed by 101 special education teachers. The sample was drawn from 10 public and independent schools for learners with special education needs in five urban school districts within South Africa's Gauteng province. These schools accommodate students with a broad spectrum of disabilities and are likely to include learners with complex communication needs. The participants identified various factors and challenges that influenced the use of KWS within the education system (e.g., school culture, parents and other team members, community awareness, learner-related considerations, and training needs). These factors and challenges are assessed and discussed in relation to both local and international norms. Recommendations are made regarding expanding both an understanding and acceptance of unaided AAC strategies as a further means to support learning in the educational context.

A survey of school-age children with highly unintelligible speech

Prevalence studies in the AAC discipline are fundamental to establishing funding, instructional, and research priorities. These data inform policy-makers on the allocation of clinical and educational services, help prioritize AAC pre-service and in-service trainings, and support AAC research grant applications. A survey study was designed to (a) provide prevalence estimates of school-age students who have highly unintelligible speech, (b) describe the demographic makeup of these students, and (c) describe their access to AAC. Rigorous web-based survey development and distribution procedures were followed. Special education administrators in New Mexico, USA were recruited to distribute the surveys to speech-language pathologists (SLPs) in their respective school districts. The majority of school districts in the state participated, and the overall SLP response rate for participating districts was high (65%). Based on the results, the best estimate indicates that approximately 1 in 89 school-age students in New Mexico has severely unintelligible speech. SLPs averaged 5.4 students per caseload with severely unintelligible speech, with 86% of SLPs providing services to at least one of these students. Only 22% of students with highly unintelligible speech had been seen by an AAC specialist. The findings highlight the substantial number of school-age students with highly unintelligible speech and the ongoing need for high quality AAC service provision for these students.

Using the ImPAACT program with preschoolers with Down syndrome: a hybrid service-delivery model

Three parents of preschool-aged children with Down syndrome using mobile augmentative and alternative communication (AAC) technologies to communicate participated indirect, systematic communication-partner instruction. Intervention featured an adaptation of the ImPAACT Program (Improving Partner Applications of Augmentative Communication Techniques; Kent-Walsh, Binger, & Malani, 2010) that included six face-to-face and three telepractice sessions. Parents learned to use the evidence-based Read-Ask-Answer (RAA) instructional strategy (Kent-Walsh, Binger, & Hasham, 2010) during shared storybook reading with their children. A single-case, multiple-probe across participants design was used to assess parents' accurate implementation of the instructional strategy and children's multimodal communicative turns. All three parents increased their use of the RAA strategy and maintained strategy use over time, and all three children increased their frequency of communicative turns taken and maintained higher turn-taking rates. Results support the use of the ImPAACT Program with parents of children with complex communication needs, including the integration of hybrid learning as part of the instructional approach.

An early Spanish vocabulary for children who use AAC: developmental and linguistic considerations

For children with complex communication needs in the early stages of language development, access to appropriate vocabulary provides a means for social interaction and participation, and the foundation for the acquisition of grammar and other language related skills. While numerous resources are available to support decision making for speakers of English, there is a pressing need to rapidly expand such resources for other languages. Spanish is the official language in 20 countries, and in other countries (e.g., United States) Spanish-speaking communities represent a substantial proportion of the population. The aim of this study was to produce a developmentally-relevant word list for use by Spanish-speaking children in the early stages of language development. The list was developed from an analysis of overlap between published and validated lists of words produced by young Spanish speaking children with typical development. The list includes a wide range of word classes and semantic categories and is proposed as a tool to assist professionals, families and software developers in the process of selecting an initial lexicon for children who require AAC and are learning Spanish. Implications of our findings for vocabulary selection and future research directions are discussed.

A survey on the awareness, accessibility and funding for augmentative and alternative communication services and devices in Saudi Arabia

PURPOSE

To develop and distribute a survey to obtain information on the awareness, accessibility and funding for augmentative and alternative communication (AAC) services and devices within the Kingdom of Saudi Arabia (KSA).

METHOD

The survey targeted three groups of people which included individuals with disabilities and their families, healthcare providers such as medical doctors and nurses and the third group included community members. Survey preparation and administration were performed online via a survey website in order to access a wide range of participants across KSA.

RESULTS

Results revealed different awareness levels for AAC among the three groups (χ² = 45.053, p < .001) with healthcare providers showing a higher degree of awareness compared to the remaining two groups. Moreover, AAC services and devices were found to be accessible within KSA, with no differences in obtaining AAC services and devices among different regions (χ² = 14.204, p = .164).

CONCLUSION

Although numerous AAC users were able to obtain AAC devices, they identified barriers including a lack of sufficient awareness of the importance, associated expenses, funding constraints and a lack of Arabization of AAC devices. Implications for RehabilitationAugmentative and alternative communication (AAC) methods allow individuals with communication difficulties to interact and socialize with those around them.The general authority of statistics in Saudi Arabia has shown that Saudi Arabia has an increased number of individuals suffering from severe to extreme communication disorders compared to other countries around the world. Consequently, the need for AAC in Saudi Arabia cannot be underestimated.This study demonstrates the importance of the awareness of AAC among different stakeholders in Saudi Arabia including AAC users, healthcare providers and community members so that individuals with communication problems can receive maximum benefit from AAC.Given that most healthcare providers in Saudi Arabia are prescribing non-tech and low-tech AAC methods indicates the importance of training on AAC for healthcare providers serving patients with communication disorders.

Core vocabulary lists for young children and considerations for early language development: a narrative review

For early symbolic communicators, acquisition of an initial vocabulary is a critically important achievement that sets the stage for future language development. Children who require augmentative and alternative communication (AAC) rely on others to select and provide these important first words for them. One resource to help guide this process includes published lists of words that may contribute to a core vocabulary for individuals who require AAC. Although some clinicians report that they consider or prioritize core words during the vocabulary selection process, it is not known whether an emphasis on core words will best meet the expressive vocabulary needs of early symbolic communicators. The purposes of this narrative review were to (a) review studies that have developed word lists to inform selection of a core vocabulary for young children who require AAC, (b) compare the words on these lists to the early words used by children with typical development, and (c) consider the implications for vocabulary selection and language development for early symbolic communicators who require AAC. Results suggest that core word lists may under-emphasize many of the types of words that predominate in early expressive vocabulary; these lists may not be the most appropriate resources to guide AAC system design and instruction for early symbolic communicators.

"Now I am a techie too" - parental perceptions of using mobile technology for communication by children with complex communication needs in the Global South

Purpose: Parental perceptions are key to the uptake of augmentative and alternative communication (AAC) devices for their children with complex communication needs. This study aimed to explore the perceptions of parents in a resource poor Global South country on the use of mobile technology as AAC devices.Materials and methods: Sixteen participants (11 female; 5 male) were included in the study. Focus group discussions, face-to-face interviews and telephone interviews were conducted with the aid of an interview guide. The interview data were analysed using the key principles of Framework analysis and through the lens of critical disability studies.Results: Six broad themes emerged. Most participants indicated a penchant for mobile technology, though its current use with their children was mainly as a teaching tool rather than a communication device. Concerns were raised about the cost of mobile technology, which if used within communication, was only as a temporary stop-gap measure with limited knowledge. The power of mainstream technology to challenge prevalent notions of disability was also highlighted by the participants.Conclusions: There is an openness to using mainstream mobile technology by parents with their children with complex communication needs. This use is currently reserved mainly for educational purposes while its power to challenge disability-related stereotypes is acknowledged. More parent training is required to encourage the use of mobile technology as AAC devices for communication.Implications for rehabilitationCurrent parent perspectives on mobile technology as AAC devices must be explored, given its potential impact on the uptake of these devices to support communication in their children with complex communication needs.Mainstream mobile technology could challenge perceptions of disability and therefore, be more acceptable to parents for their children with complex communication needs.Parental training is required to increase knowledge on the use of mobile technology as AAC devices for communication to enable informed choice-making.

An online community of practice to improve intervention for individuals with complex communication needs

Collaboration and information sharing are essential in the fast moving world of augmentative and alternative communication (AAC). This paper describes communities of practice, justifies their need in AAC, and introduces the Communication Matrix Community of Practice (CMCoP)-an online community of practice for professionals and family members supporting individuals at the earliest stages of communication development. Stakeholders share the goal of advancing language and communication intervention for individuals with complex communication needs. Features of the CMCoP include a community forum for discussing and sharing information; collections of posts by professionals and nonprofessionals on various topics; an events calendar of AAC-related activities relevant to stakeholders; and a shared science section offering portraits of the communication skills of various populations with severe communication disorders. The utility of these and other CMCoP features in supporting the implementation of AAC assessment and intervention strategies is discussed.

Error patterns and revisions in the graphic symbol utterances of 3- and 4-year-old children who need augmentative and alternative communication

The purpose of this study was to explore the errors and revisions (i.e., repairs) that 3- and 4-year-old children who require augmentative and alternative communication (AAC) make as they construct 2-3-word utterances using graphic symbols. The current study involves supplemental analyses from a previously published manuscript. Various types of errors and revisions for four different semantic-syntactic structures-agent-action-object, entity-attribute, entity-locative, and possessor-entity-were analysed to explore patterns and differences across utterance types. Results indicated that the majority of errors were made during the baseline phase, and that error types varied depending on the utterance type. For example, inversions were common for agent-action-object utterances, but omissions were common for entity-attribute utterances. When the participants revised their utterances, the resulting messages were more accurate the majority of the time, regardless of utterance type. Past research has highlighted frequent word order errors within graphic symbol messages, but the current results indicate that error types are dependent upon utterance type. A more refined approach, then, is required to better our understanding of how children approach the task of learning to produce graphic symbol utterances.

A systematic review of the barriers and facilitators to the provision and use of low-tech and unaided AAC systems for people with complex communication needs and their families

PURPOSE

Speech-language pathologists may introduce augmentative or alternative communication (AAC) systems to people who are unable to use speech for everyday communication. Despite the benefits of AAC systems, they are significantly underutilized by the people with complex communication needs. The current review aimed to synthesize the barriers and facilitators to the provision and use of low-tech and unaided AAC systems.  Materials and methods: Relevant literature was identified via a systematic search strategy. Included articles (n = 43) were evaluated using the Critical Appraisal Skills Programme. Qualitative framework analysis was then completed with reference to the International Classification of Functioning, Disability, and Health (ICF).  Results and conclusion: Most barriers and facilitators were coded as contextual factors within the ICF. Of most prominence were environmental factors, including attitudes of and supports provided by professionals, family members, and the society at large. Themes were also identified which related to the personal factors, including the user's own attitude, socioeconomic status, and culture. Beyond these contextual factors, the remaining codes related to body functions such as cognition and movement. There are numerous barriers to the provision and use of low-tech and unaided AAC systems, which may contribute to the inadequate use of these systems by people with complex communication needs. Suggestions for reducing these barriers are presented with regards to the person with complex communication needs, their family, and the professionals involved in their care. Implications for Rehabilitation AAC systems can reduce participation restrictions for people with complex communication needs. The provision and use of AAC systems is influenced by environmental factors, personal factors, and features of a person's body function. SLPs may need to collaborate with a large multidisciplinary team to successfully introduce AAC systems. SLP, teaching, and nursing students require theoretical and practical experience in AAC throughout their training to enable the provision and use of these systems.

Assessing cognitive functioning in females with Rett syndrome by eye-tracking methodology

BACKGROUND

While many individuals with severe developmental impairments learn to communicate with augmentative and alternative communication (AAC) devices, a significant number of individuals show major difficulties in the effective use of AAC. Recent technological innovations, i.e., eye-tracking technology (ETT), aim to improve the transparency of communication and may also enable a more valid cognitive assessment.

OBJECTIVES

To investigate whether ETT in forced-choice tasks can enable children with very severe motor and speech impairments to respond consistently, allowing a more reliable evaluation of their language comprehension.

METHODS

Participants were 17 girls with Rett syndrome (M = 6:06 years). Their ability to respond by eye gaze was first practiced with computer games using ETT. Afterwards, their receptive vocabulary was assessed using the Peabody Picture Vocabulary Test-4 (PPVT-4). Target words were orally presented and participants responded by focusing their eyes on the preferred picture.

RESULTS

Remarkable differences between the participants in receptive vocabulary were demonstrated using ETT. The verbal comprehension abilities of 32% of the participants ranged from low-average to mild cognitive impairment, and the other 68% of the participants showed moderate to severe impairment. Young age at the time of assessment was positively correlated with higher receptive vocabulary.

CONCLUSIONS

The use of ETT seems to make the communicational signals of children with severe motor and communication impairments more easily understood. Early practice of ETT may improve the quality of communication and enable more reliable conclusions in learning and assessment sessions.

Supporting a child with multiple disabilities to participate in social interaction: The case of asking a question

Asking a question can be a highly challenging task for a person with multiple disabilities, but questions have not received much attention in research on augmentative and alternative communication (AAC). Conversation analysis is employed to examine an instance of multiparty interaction where a speech and language therapist supports a child with multiple disabilities to ask a question with a communication board. The question is accomplished through a practice where the action is built as a trajectory of interactional steps. Each step is built using ways of involvement that establish different participation spaces designed to deal with different aspects of asking a question: agreeing on the action type, the speaker and recipient, the content of the question, and then asking the question. The segmentation of a question into discrete steps and participation spaces can be used in intervention to model the construction of a question for AAC users and significant others.

Eye Gaze Technology as a Form of Augmentative and Alternative Communication for Individuals with Rett Syndrome: Experiences of Families in The Netherlands

This paper provides a brief report on families' experiences of eye gaze technology as one form of augmentative and alternative communication (AAC) for individuals with Rett syndrome (RTT), and the advice, training and support they receive in relation to this. An online survey exploring communication and AAC was circulated to 190 Dutch families; of the 67 questionnaires that were returned, 63 had answered questions relating to eye gaze technology. These 63 were analysed according to parameters including: experiences during trial periods and longer-term use; expert knowledge, advice and support; funding; communicative progress; and family satisfaction. 20 respondents were using or had previous experience of using an eye gaze system at the time of the survey, 28 of those with no prior experience wanted to try a system in the future. Following a trial period, 11 systems had been funded through health insurance for long-term use and two families had decided a system was not appropriate for them. Levels of support during trials and following long-term provision varied. Despite frustrations with the technology, satisfaction with the systems was higher than satisfaction with the support. The majority of families reported progress in their child's skills with longer term use. These findings suggest that although eye gaze technologies offer potential to individuals with RTT and their families, greater input from suppliers and knowledgeable AAC professionals is essential for individuals and families to benefit maximally. Higher levels of training and support should be part of the 'package' when an eye gaze system is provided.

Alternative service delivery models for families with a new speech generating device: Perspectives of parents and therapists

PURPOSE

Research has revealed limitations in the provision of in-person services to families with a new speech generating device (SGD), both in Australia and overseas. Alternative service models such as parent training, peer support and telepractice may offer a solution, but their use with this population has not been researched to date.

METHOD

Using interviews and focus groups, this study explored the experiences and opinions of 13 speech-language pathologists and seven parents regarding alternatives to in-person support and training for families with a new SGD. Data were analysed using grounded theory. Themes explored in this paper include the benefits and drawbacks of alternative service models as well as participants' suggestions for the optimal implementation of these approaches.

RESULT

Participants confirmed the utility of alternative service models, particularly for rural/remote and underserviced clients. Benefits of these models included reduced travel time for families and therapists, as well as enhanced information access, support and advocacy for parents.

CONCLUSION

Participants viewed the provision of ongoing professional support to families as critical, regardless of service modality. Additional issues arising from this study include the need for development of organizational policies, resources and training infrastructure to support the implementation of these alternative service models.

Influence of message error type on Korean adults' attitudes toward an individual who uses augmentative and alternative communication

The aim of this study was to investigate the influence of types of message errors on the attitudes of Korean adults toward a person who uses AAC. The attitudes of 72 adults who speak native Korean were examined through attitude questionnaires completed after viewing videotaped conversations between a boy with cerebral palsy and an adult without disabilities. Each interaction video involved a message with one of six error types, including various types of syntactic, semantic, and pragmatic errors. The participants provided information on their attitude towards the person who used AAC, and ranked their preferences among the six messages. The results provide evidence that attitudes towards the individual using AAC were most positive (in comparison with other conditions) when a pragmatic error was observed. Messages containing a syntactic error were ranked most favorably. Spearman's correlation analyses revealed some relationship between attitudes rating and preferences ranking. Our results provide evidence that specific language and cultural contexts may play an important role in shaping attitudes toward those who use AAC.

Huffman and linear scanning methods with statistical language models

Current scanning access methods for text generation in AAC devices are limited to relatively few options, most notably row/column variations within a matrix. We present Huffman scanning, a new method for applying statistical language models to binary-switch, static-grid typing AAC interfaces, and compare it to other scanning options under a variety of conditions. We present results for 16 adults without disabilities and one 36-year-old man with locked-in syndrome who presents with complex communication needs and uses AAC scanning devices for writing. Huffman scanning with a statistical language model yielded significant typing speedups for the 16 participants without disabilities versus any of the other methods tested, including two row/column scanning methods. A similar pattern of results was found with the individual with locked-in syndrome. Interestingly, faster typing speeds were obtained with Huffman scanning using a more leisurely scan rate than relatively fast individually calibrated scan rates. Overall, the results reported here demonstrate great promise for the usability of Huffman scanning as a faster alternative to row/column scanning.

Using dynamic assessment to evaluate the expressive syntax of children who use augmentative and alternative communication

The developmental readiness of four 5-year-old children to produce basic sentences using graphic symbols on an augmentative and alternative communication (AAC) device during a dynamic assessment (DA) task was examined. Additionally, the ability of the DA task to predict performance on a subsequent experimental task was evaluated. A graduated prompting framework was used during DA. Measures included amount of support required to produce the targets, modifiability (change in participant performance) within a DA session, and predictive validity of DA. Participants accurately produced target structures with varying amounts of support. Modifiability within DA sessions was evident for some participants, and partial support was provided for the measures of predictive validity. These initial results indicate that DA may be a viable way to measure young children's developmental readiness to learn how to sequence simple, rule-based messages via aided AAC.

A comparison of two approaches for representing AAC vocabulary for young children

PURPOSE

Young children with complex communication needs often experience difficulty in using currently available graphic symbol systems as a method of augmentative and alternative communication (AAC). Information on young children's performance with graphic representations based on this population's conceptualizations of these vocabulary items may assist in the development of more effective AAC systems.

METHOD

This study developed Developmentally Appropriate Symbols (DAS) for 10 early emerging vocabulary concepts using procedures designed to address both conceptual and appeal issues for graphic representations for young children. Using a post-test only, between-subjects comparison group design, 40 typically-developing 2.5-3.5-year-old children were randomly assigned to receive a brief training in either of two different types of graphic symbol sets: (a) DAS or (b) Picture Communication Symbols (PCS), a, commercially available graphic symbol system.

RESULT

Results of a two sample independent t-test provide evidence that children in the DAS condition correctly identified more symbols than children trained with the PCS symbols. There was no evidence of a preference between the symbol sets.

CONCLUSION

The results provide support for careful consideration of children's use and understanding of language in developing AAC systems for young children.

Adults' preferences between Picture Communication Symbols (PCSs) and Gus Communication Symbols (GCSs) used in AAC

The purpose of the study was to determine whether significantly different preference exists in typical adults between Picture Communication Symbols (PCSs) and Gus Communication Symbols (GCSs) frequently displayed on their AAC. A total of 56 participants participated in the study, including 15 participants in ages 20-35; 14 participants in ages 36-50; 13 participants in ages 51-60; and 14 participants in ages 66-80. Two tasks, an identification task and a preference task, were administered sequentially and individually. The results of this study suggest: (1) typical adults' preference between PCSs and GCSs did not show any significant difference; (2) the effect of age groups of typical adults did not have any significant effect on their preference between PCSs and GCSs. However, except the group of ages 51-65, the other three groups did consciously show their preferences for PCSs. Limitations and clinical implications of the current study have been concluded.