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.

Social Media and Internet Use Patterns by Adolescents With Complex Communication Needs.

Purpose Nearly all students use Internet-based social media to communicate and network. For those with complex communication needs who may benefit from augmentative and alternative communication, social media offer specific opportunities to participate. However, do students make use of them-or do they face new barriers? The aim of the study was to collect data on the types, frequency, and duration of Internet and social media use among students with complex communication needs, along with the barriers to and facilitators of use, and to compare their use with peers without disabilities. Method Twenty-four German secondary school students with complex communication needs and motor difficulties were surveyed by a questionnaire based on an Australian study. Results A majority (75%) of the participants used the Internet, with most using daily and on more than one device. Use for school activities played only a minor role. Instead, the Internet was most often used for recreational activities (e.g., listening to music, watching videos), followed by communication by e-mail or chat, and lastly for seeking information. Greater Internet use was desired by 88% of the participants. The data show technical and social difficulties in Internet access and use and indicate that literacy skills and motor skills influence the Internet use. Conclusion School education should address the desire for greater Internet use. The teaching of media literacy and the provision of appropriate assistive and/or mainstream technology are therefore needed. More research is required on how persons with complex communication needs can potentially and actually benefit from the use of social media and on how teaching how to use social media can lead to further digital and social participation.

[Usability of Input Devices and Aids in the Field of Augmentative and Alternative Communication - An Experimental Study with People with and without Disabilities]. / Usability von Eingabehilfsmitteln und Ansteuerungsmöglichkeiten im Bereich der Unterstützten Kommunikation.

This study explored the usability of 15 different assistive input devices for persons with severe motor disabilities. Fifteen people without disabilities were asked to speak a predefined test-sentence and then to write it using 15 different input aids. Ten persons with severe motor and communication disabilities wrote the same sentence using their own communication aid. The usability was evaluated in 3 dimensions: efficiency (speed as information transfer rate in bit per second), effectiveness (proportion of correct input over all input including errors and error correction), and user's satisfaction with an adapted version of the Quest II questionnaire. Participants without disabilities needed 40 to 140 times more time to write the sentence using the aid compared to speech, participants with disability between 13 to 500 times. The effectiveness was between 80 and 100% for the participants without disabilities and between 73 and 100% for the participants with disabilities. Satisfaction was between 3.4 and 5.0 (max.) for the participants without disability and between 2.8 and 5.0 for the participants with disabilities. Overall the input by standard devices such as keyboard and mouse had better usability than the more complex devices like eye gazing technology. Comparable types of control (head control, eye control) also had similar usability. The usability dimensions of efficiency, effectiveness and satisfaction with input aids as examined in this study could be evaluated in the process of recommending communication and writing aids. The focus should however not only be on the input aids as such, but also include all optimization options such as word prediction and auto text.

Assessment of aided language comprehension and use in children and adolescents with severe speech and motor impairments.

There is limited knowledge about aided language comprehension and use in children who use aided communication and who are considered to have a relatively good comprehension of spoken language. This study's purpose was to assess their aided language skills. The participants were 96 children and adolescents who used communication aids (aided group) and 73 children and adolescents with natural speech (reference group), aged 5 to 15 years. All of the participants who used aided communication were regarded by their teachers or professionals as having age-appropriate language comprehension. All of the participants completed (a) standardized tests of visual perception, non-verbal reasoning, and comprehension of spoken language, and (b) tasks designed for this study that measured comprehension and production of graphic utterances through communicative problem solving. Using their own communication systems, the participants achieved an average of 72% correct on the graphic symbol comprehension task items, and 63% on the expressive tasks. The participants with natural speech achieved an average of 88% correct on comprehension items, and 93-96% accuracy on production items. The differences between groups were significant on all the tasks and standardized tests. There was considerable variation within the group of participants who used aided communication, and the results reveal a need to develop instruments with norms for aided language competence that can inform the implementation of interventions to support aided language development.

Investigating executive functions in children with severe speech and movement disorders using structured tasks.

Executive functions are the basis for goal-directed activity and include planning, monitoring, and inhibition, and language seems to play a role in the development of these functions. There is a tradition of studying executive function in both typical and atypical populations, and the present study investigates executive functions in children with severe speech and motor impairments who are communicating using communication aids with graphic symbols, letters, and/or words. There are few neuropsychological studies of children in this group and little is known about their cognitive functioning, including executive functions. It was hypothesized that aided communication would tax executive functions more than speech. Twenty-nine children using communication aids and 27 naturally speaking children participated. Structured tasks resembling everyday activities, where the action goals had to be reached through communication with a partner, were used to get information about executive functions. The children (a) directed the partner to perform actions like building a Lego tower from a model the partner could not see and (b) gave information about an object without naming it to a person who had to guess what object it was. The executive functions of planning, monitoring, and impulse control were coded from the children's on-task behavior. Both groups solved most of the tasks correctly, indicating that aided communicators are able to use language to direct another person to do a complex set of actions. Planning and lack of impulsivity was positively related to task success in both groups. The aided group completed significantly fewer tasks, spent longer time and showed more variation in performance than the comparison group. The aided communicators scored lower on planning and showed more impulsivity than the comparison group, while both groups showed an equal degree of monitoring of the work progress. The results are consistent with the hypothesis that aided language tax executive functions more than speech. The results may also indicate that aided communicators have less experience with these kinds of play activities. The findings broaden the perspective on executive functions and have implications for interventions for motor-impaired children developing aided communication.

Confirming and denying in co-construction processes: a case study of an adult with cerebral palsy and two familiar partners.

For individuals with complex communication needs, one of the most frequent communicative strategies is the co-construction of meaning with familiar partners. This preliminary single-case study gives insight into a special sequential pattern of co-construction processes - the search sequence - particularly in relation to the processes of confirming and denying meanings proposed by familiar interaction partners. Five different conversations between an adult with cerebral palsy and complex communication needs and two familiar co-participants were videotaped and analyzed using the methodology of conversation analysis (CA). The study revealed that confirmations and denials are not simply two alternative actions, but that several possibilities to realize confirmations and denials exist that differ in their frequency and that have different consequences for the sequential context. This study of confirmations and denials demonstrates that co-construction processes are more complex than have previously been documented.

Face stimuli effectively prevent brain-computer interface inefficiency in patients with neurodegenerative disease.

OBJECTIVES: Recently, we proposed a new stimulation paradigm for brain computer interfaces (BCI) based on event-related potentials (ERP), i.e. flashing characters with superimposed pictures of well-known faces. This new face flashing (FF) paradigm significantly outperformed the commonly used character flashing (CF) approach, i.e. simply highlighting characters. METHODS: In the current study we assessed the impact of face stimuli on BCI inefficiency in patients with neurodegenerative disease, i.e. on their inability to communicate by means of a BCI. Healthy participants (N = 16) and those with neurodegenerative disease (N = 9) performed spelling tasks using CF and FF paradigms. RESULTS: Online performance with FF was significantly increased as compared to CF in both, healthy and impaired users. Importantly, two patients who were classified "highly inefficient" with the classic CF stimulation were able to spell with high accuracy using FF. Our results particularly emphasize great benefit of the FF paradigm for those users displaying low signal-to-noise ratio of the recorded ERPs in the classic stimulation approach. CONCLUSION: In conclusion, we confirm previously reported results now systematically validated in an online setting and display specifically beneficial effects of FF for motor-impaired users. SIGNIFICANCE: The FF paradigm thus constitutes a big step forward against the BCI inefficiency phenomenon.