Environmental factors contributing to using spelling in communication: Perceptions of literate aided communicators.

The aim of this interpretive qualitative study was to explore how environmental factors influence the transition from relying solely on graphic symbols to using spelling in face-to-face communicative interactions, from the perspective of literate adults with speech and motor impairments who use augmentative and alternative communication (AAC). Fourteen adults either chose to submit a written story with weekly email follow-up, took part in interviews conducted via Zoom1, or chose to communicate solely by email. Researchers analyzed data using Charmaz's (2014) constructivist grounded theory approach. The analysis yielded three themes explaining environmental factors relevant to the transition from using graphic symbols to spelling in communication: (a) access to AAC systems and services; (b) knowledgeable and supportive communication partners who have high expectations; and (c) opportunities to learn reading, writing, and spelling. Supportive factors included providing sufficient time for spelling in communicative interactions, structured learning opportunities for practice and independence, opportunities to learn through socially meaningful interactions and having print-rich and language-rich activity settings. Slow speed in navigating graphic symbols and lack of ability to express an exact message were motivational reasons for participants to use spelling in communicative interactions. The interaction among environmental factors and person-related characteristics warrants further investigation.

Communication partner strategies in negotiation for meaning in interactions involving aided communication.

Co-constructing meaning is a common feature of all conversations but may have a more specific role in interactions where one of the participants uses aided communication. The present study applies qualitative descriptive analysis supported by quantitative measures in exploring meaning-negotiation strategies of speaking communication partners in task-related aided conversations. The study focuses on identifying and exploring strategies that the communication partners utilise when attempting to interpret the meaning and resolve potential ambiguities of aided utterances in the context of event descriptions. The participants of the study were three aided communicators (age 8 to 11 years), who used graphic communication systems as their main means of communication, and familiar adult communication partners. The results demonstrate that the communication partners employed several strategies in attempting to comprehend, interpret and co-construct the meaning of aided utterances at various phases of interaction. The primary strategy involved clarifying the lexical properties of the aided constructions, reflecting the multidimensional and polysemous nature of graphic communication systems. Structural and referential complexities affected how the elements produced were understood as part of the ongoing context. The study highlights the participants´ shared responsibility in developing and utilising effective meaning-negotiation and repair strategies to support successful communication.

Aided communication, mind understanding and co-construction of meaning.

Mind understanding allows for the adaptation of expressive language to a listener and is a core element when communicating new information to a communication partner. There is limited knowledge about the relationship between aided language and mind understanding. This study investigates this relationship using a communication task. The participants were 71 aided communicators using graphic symbols or spelling for expression (38/33 girls/boys) and a reference group of 40 speaking children (21/19 girls/boys), aged 5;0-15;11 years. The task was to describe, but not name, drawings to a communication partner. The partner could not see the drawing and had to infer what was depicted from the child's explanation. Dyads with aided communicators solved fewer items than reference dyads (64% vs 93%). The aided spellers presented more precise details than the symbol users (46% vs 38%). In the aided group, number of correct items correlated with verbal comprehension and age.

Expressive and receptive performance with graphic symbol sentences by individuals who use aided communication.

This study explored performance on expressive and receptive graphic symbol tasks and spoken comprehension by individuals who use augmentative and alternative communication (AAC) as well as the relationship of performance with participants' skills and characteristics. Participants were 19 children and youth (aged 5- to 18-years-old) who used aided communication. Four experimental tasks were administered, with either speech or symbols as input (stimuli) and symbols or choice from an array of pictures as output (response). Symbols were not accompanied by written or spoken labels in the tasks. Measures of receptive vocabulary, receptive syntax, memory, and visual cognitive skills as well as information regarding participant characteristics were collected. There were strong relationships among all experimental tasks. Cluster analysis revealed different response patterns that may suggest a progression in expressive and receptive performance with graphic symbol sentences. Individual differences in receptive language, particularly receptive syntax, were related to task performance. The findings suggest that different ways of experiencing symbols, in addition to spoken comprehension of the sentences and receptive spoken language more generally, may contribute to expressive graphic symbol sentences. Performance on receptive symbol tasks may uncover a level of facility with the graphic-symbol modality not observed through expressive symbol use in communicative situations.

Sibling involvement in interventions for children with a disability: a systematic review.

PURPOSE: To conduct a systematic review of the involvement of siblings of individuals with a disability in therapeutic interventions to explore (a) sibling roles, (b) reported outcomes related to participant skills, interactions, or relationships, and (c) participant experiences. METHODS: A search of popular databases and grey literature was completed identifying studies published in English from 1999-2020. In total, 14,815 citations were extracted. Following a review of titles and abstracts, 31 studies met the inclusion criteria and were assessed for study quality. RESULTS: The most common role assigned to siblings was that of a trained playmate (n = 11), followed by an untrained playmate (n = 5). Overall, the interventions reported positive outcomes, although sample sizes were small and variability in outcomes was high. None of the studies included adult participants and most (n = 28, 90.32%) included participants who had a diagnosis of Autism Spectrum Disorder (ASD). Over half of the studies reported participant experiences of the intervention, with most reporting positive experiences. CONCLUSIONS: Notwithstanding the reported positive outcomes of the interventions in this review, further research is needed to better understand the specific impact of involving siblings in interventions, as is research with adult participants and participants with diagnoses other than ASD.Implications for RehabilitationSiblings can fulfil a range of roles, (e.g., trained playmate, instructor, model), when participating in interventions for an individual with a disability. frequently with positive outcomes.While overall involving siblings in interventions seems to lead to positive outcomes, the specific effect of involving a sibling (rather than a peer or parent) in an intervention is not clear.Most of the available research has focused on children with a diagnosis of autism spectrum disorder and so the findings may not apply across all disability groups.It is important to acknowledge sibling opinions about taking part in such interventions to ensure all participants' needs are being met.

Expressive and receptive use of speech and graphic symbols by typically developing children: What skills contribute to performance on structured sentence-level tasks?

PURPOSE: To explore expressive and receptive use of speech and graphic symbols and relationships with linguistic and cognitive skills in children with typical development. METHOD: Participants were 82 children with typical development (4 to 9 years). Measures of memory, visual analysis skills, and receptive language were used, along with five experimental tasks with speech or symbols as input (stimulus) or output (response), using single clause and compound clause stimuli. Cluster analysis grouped participants with similar performances patterns, who were then compared on linguistic and cognitive skill measures. RESULT: The lowest performing group sometimes accurately interpreted graphic symbol utterances that were visible during responding. The mid-performing group was stronger on expressive than receptive symbol utterances when the model did not remain visible. The highest group was comparable on expressive and receptive symbol tasks, but nonetheless stronger with spoken utterances. Relationships of linguistic and cognitive skills with task performance differed across the clusters. CONCLUSION: The findings help clarify the input-output modality asymmetry in graphic symbol communication. Spoken language proficiency does not directly transfer to sentence-level expressive and receptive graphic symbol use. Exploring potentially challenging sentence-level phenomena is important. Research is warranted to explore developmental progressions and potential clinical applications more systematically.

Innovations for Supporting Communication: Opportunities and Challenges for People with Complex Communication Needs.

Individuals with complex communication needs have benefited greatly from technological innovations over the past two decades, as well as from social movements that have shifted focus from disability to functioning and participation in society. Three strands of technological innovation are reviewed in this paper: (1) innovations in the tools that have become available, specifically tablet technologies; (2) innovations in access methods (eye gaze technologies and brain-computer interfaces); and (3) innovations in output, specifically speech technologies. The opportunities these innovations offer are explored, as are some of the challenges that they imply, not only for individuals with complex communication needs, but also for families, professionals, and researchers.

Constructing narratives to describe video events using aided communication.

Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be lacking. This study reports on the analysis of narratives generated in interactions involving aided communication in response to short, silent, video vignettes depicting events with unintended or unexpected consequences. Two measures were applied to the data: the Narrative Scoring Scheme and the Narrative Analysis Profile. A total of 15 participants who used aided communication interacted with three different communication partners (peers, parents, professionals) relaying narratives about three video events. Their narratives were evaluated with reference to narratives of 15 peers with typical development in response to the same short videos and to the narratives that were interpreted by their communication partners. Overall, the narratives generated using aided communication were shorter and less complete than those of the speaking peers, but they incorporated many similar elements. Topic maintenance and inclusion of scene-setting elements were consistent strengths. Communication partners offered rich interpretations of aided narratives. Relative to the aided narratives, these interpreted narratives were typically structurally more complete and cohesive and many incorporated more elaborated semantic content. The data reinforce the robust value of narratives in interaction and their potential for showcasing language and communication achievements in aided communication.

Communicating the unknown: descriptions of pictured scenes and events presented on video by children and adolescents using aided communication and their peers using natural speech.

The facility to describe scenes and events is important in everyday communication, but little is known about the description skills and strategies of young people using aided communication. This article explores how 81 children and adolescents using aided communication and 56 peers using natural speech, aged 5-15 years, described pictured scenes and events presented on video to a partner who had no prior knowledge of the content. The group who used aided communication took longer and included fewer elements in their descriptions than the reference group; however, the groups did not differ in their use of irrelevant or incorrect elements, suggesting that both groups stayed on topic. Measures related to aided message efficiency correlated significantly with measures of spoken language comprehension. There were no significant differences between groups for their descriptions of pictured scenes and video events. Analyses showed both unpredicted group similarities and predictable differences, suggesting key components for future research consideration.

Language Development of Individuals Who Require Aided Communication: Reflections on State of the Science and Future Research Directions.

Language acquisition theories differ in the importance they assign to production as a learning mechanism. This review summarizes some of the theoretical issues linked to this debate and considers their implications for children with severe speech and physical impairments. The unique aspects of the language-learning contexts of these children are explored. Drawing largely on papers published within the journal Augmentative and Alternative Communication, this review summarizes features of language development that have been described over the past 3 decades and considers how these findings might illuminate our understanding of language development across both spoken and aided modalities. Implications for assessment, intervention and for further research are suggested.

Parachute without a ripcord: the skydive of communication interaction.

Identifying and rating the outcomes of an intervention is not a new concept, but has gained impetus and currency with the emergence of evidence-based practice to support clinical decision making. In this paper, we present a metaphor as a unifying framework for the many different goals and outcomes that may come into focus across extended interventions with individuals who use aided communication. The metaphor is that of skydiving. We explore the value of this metaphor in understanding outcome measures for interventions, using analysis of interview data collected with adults who have used high-tech aided communication devices over many years.

Roles of aided communication: perspectives of adults who use AAC.

PURPOSE: The study described here explores the perspectives of adults who use augmentative and alternative communication in relation to their use of aided communication. The aims were to describe the supports available to adults using aided communication, their views on the role(s) they assigned to aided communication within their total communication systems and the factors they identified as affecting their use of aided communication. METHOD: Eighteen adults with cerebral palsy who use aided communication were surveyed using questionnaire-based interviews exploring the range of services available to them and the relevance, importance and meaning they assigned to communication devices. RESULTS: Overall, participants expressed positive views about aided communication. Although all identified many unaided modes of communication as being important, most participants ranked aided communication among their primary modes. Use of aided communication was reported to be influenced by communication partners, but also by device features, with major concerns about reliability emerging. CONCLUSIONS: Factors affecting the integration of aided communication are complex. For many adults, lack of key supports, including availability of communication partners restrict the contexts and extent to which aided communication is used. The comments from the participants highlight the need to develop services for adults who use aided communication.