Randomized controlled trial of supplemental augmentative and alternative communication versus voice rest alone after phonomicrosurgery.

OBJECTIVE: This randomized trial investigated voice rest and supplemental text-to-speech communication versus voice rest alone on visual analog scale measures of communication effectiveness and magnitude of voice use. STUDY DESIGN: Randomized clinical trial. SETTING: Multicenter outpatient voice clinics. SUBJECTS: Thirty-seven patients undergoing phonomicrosurgery. METHODS: Patients undergoing phonomicrosurgery were randomized to voice rest and supplemental text-to-speech communication or voice rest alone. The primary outcome measure was the impact of voice rest on ability to communicate effectively over a 7-day period. Pre- and postoperative magnitude of voice use was also measured as an observational outcome. RESULTS: Patients randomized to voice rest and supplemental text-to-speech communication reported higher median communication effectiveness on each postoperative day compared to those randomized to voice rest alone, with significantly higher median communication effectiveness on postoperative days 3 (P=.03) and 5 (P=.01). Magnitude of voice use did not differ on any preoperative (P>.05) or postoperative day (P>.05), nor did patients significantly decrease voice use as the surgery date approached (P>.05). However, there was a significant reduction in median voice use pre- to postoperatively across patients (P<.001) with median voice use ranging from 0 to 3 throughout the postoperative week. CONCLUSION: Supplemental text-to-speech communication increased patient-perceived communication effectiveness on postoperative days 3 and 5 over voice rest alone. With the prevalence of smartphones and the widespread use of text messaging, supplemental text-to-speech communication may provide an accessible and cost-effective communication option for patients on vocal restrictions.

Tele-AAC Resolution.

Approximately 1.3% of all people, or about 4 million Americans, cannot rely on their natural speech to meet their daily communication needs. Telepractice offers a potentially cost-effective service delivery mechanism to provide clinical AAC services at a distance to the benefit of underserved populations in the United States and worldwide. Tele-AAC is a unique cross-disciplinary clinical service delivery model that requires expertise in both telepractice and augmentative and alternative communication (AAC) systems. The Tele-AAC Working Group of the 2012 ISAAC Research Symposium therefore drafted a resolution underscoring the importance of identifying and characterizing the unique opportunities and constraints of Tele-AAC in all aspects of service delivery. These include, but are not limited to: needs assessments; implementation planning; device/system procurement, set-up and training; quality assurance, client progress monitoring, and follow-up service delivery. Tele-AAC, like other telepractice applications, requires adherence to the ASHA Code of Ethics and other policy documents, and state, federal, and international laws, as well as a competent technological infrastructure. The Working Group recommends that institutions of higher education and professional organizations provide training in Tele-AAC service provision. In addition, research and development are needed to create validity measures across Tele-AAC practices (i.e., assessment, implementation, and consultation); determine the communication competence levels achieved by Tele-AAC users; discern stakeholders' perceptions of Tele-AAC services (e.g., acceptability and viability); maximize Tele-AAC's capacity to engage multiple team members in AAC assessment and ongoing service; identify the limitations and barriers of Tele-AAC provision; and develop potential solutions.

Fast mapping semantic features: performance of adults with normal language, history of disorders of spoken and written language, and attention deficit hyperactivity disorder on a word-learning task.

PURPOSE: This study was designed to test the word learning abilities of adults with typical language abilities, those with a history of disorders of spoken or written language (hDSWL), and hDSWL plus attention deficit hyperactivity disorder (+ADHD). METHODS: Sixty-eight adults were required to associate a novel object with a novel label, and then recognize semantic features of the object and phonological features of the label. Participants were tested for overt ability (accuracy) and covert processing (reaction time). RESULTS: The +ADHD group was less accurate at mapping semantic features and slower to respond to lexical labels than both other groups. Different factors correlated with word learning performance for each group. CONCLUSIONS: Adults with language and attention deficits are more impaired at word learning than adults with language deficits only. Despite behavioral profiles like typical peers, adults with hDSWL may use different processing strategies than their peers. LEARNING OUTCOMES: Readers will be able to: (1) recognize the influence of a dual disability (hDSWL and ADHD) on word learning outcomes; (2) identify factors that may contribute to word learning in adults in terms of (a) the nature of the words to be learned and (b) the language processing of the learner.