"I don't think you can really understand it until you put it to action": school-based SLPs' reflections on graduate and continuing education in AAC.

Graduate programs have made strides to improve augmentative and alternative communication (AAC) learning opportunities for pre-service speech-language pathologists (SLPs). In addition, a number of continuing education opportunities are available to practicing SLPs; however, many still report feeling underprepared to serve clients with AAC needs. The purpose of this study was to describe school-based SLPs' perspectives regarding their graduate training, on-the-job experience, and ongoing professional development needs related to AAC. Semi-structured interviews were completed with 17 school-based SLPs. Interviews were recorded and transcribed verbatim. Using a phenomenological approach, key themes emerged related to AAC knowledge and skills including a need for SLPs to rely on a framework for decision making, the importance of interprofessional training, and difficulties with staying abreast of new technology. The researchers present recommendations of principles and concepts for instructors to include in graduate AAC courses, as well as professional development considerations.

Clinical and Research Perspectives on Visual Scene Displays.

Purpose The purposes of this study were to measure the perceptions of speech-language pathologists (SLPs) and researchers regarding the design of visual scene displays (VSDs) and to investigate the perceived difficulties of SLPs in regard to the acquisition and programming of VSDs. Method We recruited 270 SLPs and nine researchers who focus on VSDs to complete an online survey. The SLP survey addressed both perception of VSD design and difficulties associated with implementing these images as communication supports in the clinical realm. The researcher group was surveyed solely regarding their opinions associated with VSD design. Results SLPs and researchers both ranked high-context VSDs as more effective at supporting communication than low-context VSDs. In addition, both groups ranked VSDs with task-engaged people as more effective at supporting communication than VSDs with camera-engaged people or no people. SLPs reported difficulties with acquiring high-quality VSDs from online sources as well as difficulties with maintenance and upkeep of VSDs. In addition, a large portion of SLPs reported challenges with representing complex concepts through VSDs. Conclusions Results from this study provide evidence of general agreement between SLPs and researchers regarding perception of VSD design. SLPs continue to report challenges with the acquisition and programming of VSDs. Further research is needed to develop evidence-based guidelines to support clinical endeavors in these areas.

Effectiveness and Utility of Visual Scene Displays as Communication Supports for Adults and Children With Complex Communication Needs: Perspectives of Clinicians and Researchers.

Purpose The aims of this research study were to describe the perspectives of clinicians and researchers regarding the effectiveness of visual scene displays (VSDs) as communication supports in order to inform the translation of research to clinical practice. Method An online survey was completed by 298 clinicians and nine VSD researchers. Participants rated the effectiveness of VSDs in supporting a variety of communication functions and their strength of agreement regarding statements of VSD utility. Results Regardless of population served, clinicians and researchers rated VSDs as effective at supporting a range of communication functions. Participants also tended to agree with statements of VSD utility. Conclusions The current study highlights the perceptions of clinicians and researchers regarding the uses and benefits of VSDs for adults and children with complex communication needs and provides an initial measure of the current translation of research to clinical practice. Results indicate that VSDs can be used to support a variety of communication functions and utilities; however, further work is necessary to explore additional communication functions and delineate similarities and differences of VSD uses for differing populations. Supplemental Material https://doi.org/10.23641/asha.14551344.

Speech-Language pathologists' decisions when designing an aided AAC display for a compilation case study of a beginning communicator.

PURPOSE: The current study sought to identify decisions speech-language pathologists (SLPs) make and their rationale for those decisions when designing an AAC display for a hypothetical school-aged child who was a beginning communicator. Augmentative and alternative communication (AAC) displays support communicative interactions for children who are unable to use spoken language to meet their communication needs. Children who are at the early stages of learning language, often termed beginning or emerging communicators, may rely heavily on the AAC display to support comprehension and expression. Thus, it is important for speech-language pathologists (SLPs) to design a display that facilitates beginning communicators' communication development. METHODS: This paper reports on the answers related to a specific case study presented in an online survey completed by 77 SLPs with experience in AAC. RESULTS: Data illustrated design decisions driven by child-specific characteristics and informed by research regarding type of layout, representation, and the importance of various design features. CONCLUSIONS: Suggestions for future research are provided, including identifying goals and communicative functions best supported by different types of displays, clinicians' challenges/successes growing a system with the child, and determining the importance of symbol arrangement and organisation in communicative tasks by AAC users.Implications for RehabilitationIdentification of current practices reported by speech-language pathologists given a case study to develop and implement future research.A gap between research and practice suggests the need for better dissemination and application of research supporting the inclusion of people engaged in the event depicted in a visual scene display.Foundations for future research to provide guidance regarding best design of and communication goals supported by visual scene displays and grid-based displays.

An exploration of motor learning concepts relevant to use of speech-generating devices.

For individuals who rely on speech-generating devices (SGDs) to complement and substitute for spoken language, speed, and accuracy of access to the device are paramount for effective communication. There is some evidence that application of motor memory principles may improve effectiveness of SGD-based communication. This article reviews motor learning models and principles, including learning stages, types of practice, and environmental factors that affect learning, and highlights the potential applications of these principles in dynamic display SGD design, intervention, and research.

Consistent Symbol Location Affects Motor Learning in Preschoolers Without Disabilities: Implications for Designing Augmentative and Alternative Communication Displays.

Purpose: Designing augmentative and alternative communication (AAC) displays that minimize operational demands is an important aspect of AAC intervention. The current study compared the effect of 2 display designs on the speed of locating target words by preschoolers without disabilities. Method: Across 5 sessions, participants in the consistent condition (n = 12) were asked to locate symbols on arrays that did not change, whereas participants in the variable condition (n = 12) utilized arrays where the symbols changed locations each session. Results: No difference in response time across conditions was noted during the 1st session; however, by the 5th session, participants in the consistent condition demonstrated significantly faster response times than participants in the variable condition. Conclusions: The current study illustrated an advantage of consistent symbol location for preschoolers without disabilities. Clinical applications for incorporating consistent symbol location into AAC display design are discussed; however, replication with children who use AAC is critical.

Effects of background color and symbol arrangement cues on construction of multi-symbol messages by young children without disabilities: implications for aided AAC design.

Children whose speech does not meet their communication needs often benefit from augmentative and alternative communication (AAC). The design of an AAC display may influence the child's ability to communicate effectively. The current study examined how symbol background color cues and symbol arrangement affected construction of multi-symbol messages using line-drawing symbols, by young children with typical development. Participants (N = 52) heard a spoken phrase matching a photograph and selected line drawings within a 4 × 4 array. Friedman two-way ANOVAs evaluated speed and accuracy of multi-symbol message construction under four conditions in which the background color and arrangement of symbols was manipulated. Participants demonstrated significantly faster response times when symbols were arranged by word-class category compared to no symbol arrangement. The majority of children responded faster when symbols had white backgrounds, but this effect failed to reach statistical significance. This study provides preliminary evidence suggesting the importance of symbol arrangement for young children. The findings highlight the need for caution when incorporating background color on displays for young children. Future research is needed to examine the effect of visual cues on children who use AAC and consider additional factors that could influence efficacy of symbol arrangement and background color use.

Building Evidence-based Practice in AAC Display Design for Young Children: Current Practices and Future Directions.

Each time a practitioner creates or modifies an augmentative and alternative communication (AAC) display for a client, that practitioner must make a series of decisions about which vocabulary concepts to include, as well as physical and organizational features of the display. Yet, little is known about what factors influence the actual decisions and their outcomes. This research examined the design factors identified as priorities by speech-language pathologists (SLPs) when creating AAC displays for young children (age 10 years and under), and their rationale for the selection of these priorities. An online survey gathered ratings and comments from 112 SLPs with experience in AAC concerning the importance of a variety of factors related to designing an aided AAC display. Results indicated that some decisions were supported by existing research evidence, such as choosing vocabulary, collaborating with key stakeholders, and supporting partner modeling. Other decisions highlight areas for future research, including use of visual scene display layouts, symbol background color, and supports for motor planning.

Teaching active listening skills to pre-service speech-language pathologists: a first step in supporting collaboration with parents of young children who require AAC.

PURPOSE: This study examined the effect of instruction in an active listening strategy on the communication skills of pre-service speech-language pathologists (SLPs). METHOD: Twenty-three pre-service SLPs in their 2nd year of graduate study received a brief strategy instruction in active listening skills. Participants were videotaped during a simulated parent meeting before and after the strategy instruction. Simulated parent meetings addressed issues that parents of children who use augmentative and alternative communication (AAC) may face. Social validity measures were gathered from the participants and from parents of children who use AAC. RESULTS: Pre- and postinstruction use of the active listening strategy was scored and compared using a Wilcoxon signed-ranks test, with statistically significant results. Postinstruction scores were significantly higher than preinstruction scores, providing evidence of the effectiveness of the instruction. Furthermore, participants and parents of children who use AAC described the postinstruction interactions more positively than the preinstruction interactions, suggesting that the pre-service SLPs benefited from the instruction. CONCLUSION: The current study provides evidence of the effectiveness of strategy instruction in active listening skills that may be incorporated into SLP preparation programs.

Working memory demands of aided augmentative and alternative communication for individuals with developmental disabilities.

When speech is not functional to meet some or all of an individual's communication needs, aided augmentative and alternative communication (AAC) systems are often implemented. Although aided AAC systems offer some advantages over speech, they also impose some unique demands, especially on working memory, which is commonly defined as the cognitive system by which individuals maintain and manipulate information while completing tasks. For instance, the presence of an external aided AAC device containing arrays of symbols, not all of which are visible simultaneously, presents multiple working memory demands: individuals must maintain the target concepts in mind, all the while (a) navigating through multiple pages, (b) remembering the appropriate or most efficient navigation path, (c) locating the target symbols within the array once the host page has been located, and (d) inhibiting responses to potentially interesting distracters throughout the process. Each of these task demands involves one or more working memory operations that have been identified and studied extensively in research in the cognitive sciences. Failure to acknowledge or understand how working memory might interact with AAC use may place unintentional barriers to effective AAC interventions. This paper explores current information about working memory operations and highlights some of the most relevant issues that warrant further direct study.

The effects of color cues on typically developing preschoolers' speed of locating a target line drawing: implications for augmentative and alternative communication display design.

PURPOSE: This research examined how the presence of color in relation to a target within an augmentative and alternative communication array influenced the speed with which typically developing preschoolers located a target line drawing. METHOD: Fifteen children over the age of 4 years (from 4;2 [years;months] to 5;4) and 15 children under the age of 4 years (2;10-3;11) participated. Participants were asked to find a target line drawing of foods (e.g., banana and tomato) among an array of 12. The reaction time of locating the target was measured across 4 conditions in which the foreground color and the background color of the line drawing were manipulated. RESULTS: For all participants, line drawings featuring foreground color provided greater advantages in the speed of locating the target compared with drawings featuring only background color. Younger participants demonstrated faster reaction times when color was limited to the foreground. CONCLUSION: Clinicians should consider incorporating color in the foreground of the line drawing when constructing visual displays. Targets that contain only background color but no foreground color appear to have a negative effect on the speed with which younger children can locate a target. Further research is needed to determine the effects in children with disabilities.

The role of color cues in facilitating accurate and rapid location of aided symbols by children with and without down syndrome.

PURPOSE: This research examined how the color distribution of symbols within a visual aided augmentative and alternative communication array influenced the speed and accuracy with which participants with and without Down syndrome located a target picture symbol. METHOD: Eight typically developing children below the age of 4 years, 8 typically developing children over the age of 4 years, and 10 children with Down syndrome participated. Participants were asked to find a target line drawing among an array of 12. Line drawings represented either foods (e.g., grapes, cherries), clothing (e.g., a red shirt, a yellow shirt), or activities (e.g., soccer, swimming). In one condition, symbols that shared a color were clustered together, creating a subgroup within which to search. In another condition, symbols that shared a color were distributed across the display, allowing each to appear individually. Dependent measures were accuracy and speed of finding the target symbol. RESULTS: Clustering same-color symbols facilitated the speed of locating the target for all participants, and facilitated search accuracy in the younger preschool children and participants with Down syndrome. These effects held when targets were foods, clothing, or activities. CONCLUSION: Clinicians should consider the internal color of visual symbols when constructing aided symbol displays, at least for children with Down syndrome. Further research is needed on a number of dimensions, however, including visual processing in other etiological categories, the role of background color, and the relation of color to other stimulus dimensions.