Creating a response space in multiparty classroom settings for students using eye-gaze accessed speech-generating devices.

Conversation Analysis was used to explore how teachers, personal care assistants, and students organized inclusive multiparty classroom interaction when one of the students in the classroom used an eye-gaze accessed speech-generating device (SGD). Scaffolding and collaborative practices that created a response space for the construction of the eye-gaze accessed SGD-mediated turn were identified and analyzed. The participants were two adolescent students with severe cerebral palsy and intellectual disability who relied on eye-gaze accessed SGDs, and their teachers, personal care assistants, and classmates with intellectual disabilities. The data consisted of 2 hr and 40 min of video recordings collected in the participants' classrooms. Three practices were identified (a) the practice of explicit turn allocation organization and the use of display questions, (b) the practice of locally contingent on-screen scaffolding activities, and (c) the practice of dealing with turn competition by classmates. Teacher and assistant practices differed with regard to the student's access to the vocabulary relevant to answering the teacher's question. The practices were found to create a response space for students using SGDs accessed via eye gaze, thereby ensuring their educational inclusion in the classroom.

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.

Participants' dynamic orientation to folder navigation when using a VOCA with a touch screen in talk-in-interaction.

This paper reports on a conversation-analysis case study of interaction between a child with cerebral palsy and an adult using a computer-based voice output communication aid (VOCA) device with a touch-sensitive screen-input system. Data was collected from video recordings of everyday activities at school. The public nature of the VOCA-mediated turn construction process (hand movements towards the screen, on-screen folder navigation, synthetic speech) displays the projection of the turn under way and its possible continuations. The adult interlocutor orients to such projections when contributing to the topic of the ongoing turn and when initiating repair on its topical development. Contributing may activate the AAC user's further involvement in the ongoing turn, while repair may restrict the AAC user's influence on the topical progression. The findings are relevant for clinical assessment and intervention.

Reporting patterns indicative of adverse drug interactions: a systematic evaluation in VigiBase.

BACKGROUND: Adverse drug interaction surveillance in collections of Individual Case Safety Reports (ICSRs) remains underdeveloped. Most efforts to date have focused on disproportionality analysis, but the empirical support for its value is based on isolated examples. Additionally, too little attention has been given to the potential value of the detailed content of ICSRs for improved adverse drug interaction surveillance. OBJECTIVE: The aim of the study was to identify reporting patterns indicative of suspected adverse drug interactions before the drug interactions are generally established. METHODS: A reference set of known adverse drug interactions and drug pairs not known to interact was constructed from information added to Stockley's Drug Interactions Alerts between the first quarter of 2007 and the third quarter of 2009. The reference set was used to systematically study differences in reporting patterns between adverse drug interactions before they are generally established and adverse drug reactions (ADRs) to drug pairs that are not known to interact, in the WHO Global ICSR Database, VigiBase. The scope of the study included pharmacological properties such as common cytochrome P450 metabolism, explicit suspicions of drug interactions as noted by the reporter, clinical details such as dose and treatment overlap, and the lower limit of the 95% credibility interval of a three-way measure of disproportionality, Omega(025) (Ω(025)), based on the total number of reports on two drugs and one ADR together. Analyses were carried out including and excluding concomitant medicines. RESULTS: Five reporting patterns were highlighted as particularly strong indicators of adverse drug interactions before they are known: suspicion of interactions as noted by the reporter in a case narrative, the assignment of the two drugs as interacting or through an ADR term; co-reporting of effect increased with the drug pair; and, finally, an excess total number of reports on the ADR together with the two drugs, as measured by Ω(025). Overall, the inclusion of concomitant medicines led to a larger number of true adverse drug interactions being highlighted, but at a substantial decrease in the strength of most indicators. Notably, the inclusion of concomitant medicines completely eliminated the value of Ω(025) as an indicator of adverse drug interactions, in this systematic evaluation. CONCLUSIONS: Reported suspicion of interactions as noted by the reporter in a case narrative, the assignment of the two drugs as interacting or through an ADR term; co-reporting of effect increased with the drug pair and by the Ω(025) each provide unique information to highlight adverse drug interactions before they become known in the literature. To our knowledge, this is the first systematic analysis demonstrating the value of disproportionality analysis for adverse drug interactions using a comprehensive reference set, and the first study to consider a broader basis including clinical information for systematic drug interaction surveillance.