Augmentative and Alternative Communication最新文献

Access to speech-language therapies that promote optimal communication outcomes is a fundamental right outlined by the United Nation's Article 19 of the Convention on the Rights of Persons with Disabilities as well as the Communication Bill of Rights of the National Joint Committee on the Communication Needs of Persons with Severe Disabilities. For many individuals, augmentative and alternative communication (AAC) offers an important set of supports for realizing this critical human right. Yet despite a strong evidence base, many AAC systems are not tailored to the support needs of individuals with visual and/or motor impairments. In this paper we explore the potential for artificial intelligence to interpret body-based communicative movements (including gestures) into speech output. The team, which includes individuals with motor impairments, developed and tested a prototype application that shifts the burden of access off the AAC user and onto the application, through the use of body-based sensors. The effort demonstrated proof of concept that the prototype could learn meaningful idiosyncratic gestures and ignore unintentional ones. Movement sensors interpreted the gestures regardless of the user's or communication device's position, reducing constraints on its usability, potentially increasing the flexibility of AAC access. Dedicated research is needed to confirm this possibility.

Individuals with communication disabilities often use augmentative and alternative communication technologies (AAC-T) to facilitate in-person conversations. However, social interactions using AAC-T are complex and frequently characterized by delays and miscommunications. Microanalysis involving detailed video-based transcription is a valuable method for studying these interactions, providing insights into how participants use AAC-T to achieve mutual understanding and manage conversational flow. Microanalytic transcription's iterative and interpretive nature requires thoughtful decision-making about what is transcribed and how this information is represented. This article describes an approach to conducting microanalytic transcription of interactions mediated by AAC-T. This includes decision making about the level of transcription detail to include, approaches to training transcribers, and maintaining accuracy of transcription conventions. Relevant considerations will be presented in both developing this approach and training student transcribers to translate theoretical knowledge of transcription to operational skills. Implications and considerations for future research adopting similar approaches to microanalysis are discussed.

Development in children is sometimes described as a series of isolated milestones, e.g., first smile, first word, sitting, crawling, first step, and so on, even though that is not actually how human development unfolds. Rather, many of the skills that emerge during childhood are better understood using neuroplasticity, dynamic systems theory, and embodied cognition. Based on these findings and theories, we explore the potential impact that upright, hands-free, self-initiated mobility can have on children with severe physical and communication disabilities who use augmentative and alternative communication, specifically focusing on their growth in communicative competence. We discuss research that demonstrates the benefits to children with different physical abilities when they engage in upright, hands-free, self-initiated mobility. This article reflects the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth by considering the importance of identifying functional communication needs and goals, taking into account participation barriers, communication limitations, and personal and environmental factors. We advocate for adopting family-centered, interprofessional collaborative service delivery models that more directly align with current theories of human development. Finally, we call for the adoption of implementation science to help bridge the existing gaps between theory and evidence-based practices.

This introduction to the special forum on basic/foundational research in AAC offers a brief rationale for the importance of the three pillars of evidence-based practice, including scientific evidence, clinical expertise, and client/family insights, and underscores that each pillar can and should offer something and also benefit from the other pillars. It briefly overviews several areas in which basic science has been instrumental in promoting clinical advances and then introduces the articles in the current forum, which each in its own way relates to access. The hope is to promote constructive dialog between scientists, clinicians, and individuals who use AAC to move these ideas forward.

The integration of Brain-Computer Interface (BCI) technology into Augmentative and Alternative Communication (AAC) systems introduces new complexities in training, particularly for children with diverse cognitive, sensory, motor, and linguistic abilities. Effective AAC training is crucial for enabling individuals to achieve personal goals and enhance social participation. This study aimed to explore potential training strategies for children using P300 based BCI-AAC systems through focus group discussions with experts in AAC and BCI technologies. Participants identified six key themes for effective training: (1) Scaffolding-developing adaptive systems tailored to each child's developmental level, including preteaching, visual display adaptations, and gamification; (2) Verbal Instructions-emphasizing the use of clear, simple language and spoken prompts; (3) Feedback-incorporating immediate feedback and biofeedback methods to reinforce learning; (4) Positioning-ensuring proper trunk stability and addressing electrode placement; (5) Modeling and Physical Supports-using physical cues and demonstrating BCI-AAC use; and (6) Considerations for Visual Impairment-accommodating cortical visual impairment (CVI) with suitable stimuli and environmental adjustments. These insights offer an initial foundation for identifying P300 BCI-AAC training strategies for children. Further systematic research with end users, support networks, and professionals is needed to validate, refine, and expand interventions that support diverse communication needs.

Although current best practices of augmentative and alternative communication (AAC) implementation have been established, some studies indicate that there is poor AAC implementation in schools. This qualitative study investigated the barriers to school participation and learning for students who use AAC in Ontario, Canada from the point of view of six parents. After semi-structured interviews were used to gather stories, inductive thematic analysis was used to develop five themes: potential to learn, growth mindset, knowing the student, collaboration, and AAC knowledgeable professionals. This study reinforces the existence of opportunity barriers in schools and extends previous research by identifying the predominance of attitude barriers.

Most individuals with disabilities live in low-and middle-income countries (LMICs) where healthcare services such as speech-language therapy are limited. The challenge of accessing services was compounded by the COVID-19 global pandemic, leaving many people who use augmentative and alternative communication (AAC) vulnerable. The aim of this study was to investigate the nature of tele-AAC across three LMICs as described by speech-language therapists (SLTs). Although studies have been published about speech-language therapy services provided via telepractice, some specifically on AAC services, none of these have examined the impact of having to rapidly pivot to tele-AAC in LMICs. Semi-structured interviews were conducted with 15 SLTs from three LMICs to explore their experiences. SLTs shared the impact that tele-AAC had on their work, their experiences, benefits and challenges including broader challenges of service provision in LMIC contexts.

Augmentative and alternative communication (AAC) can be used effectively by persons with speech or speech-related disabilities to accomplish a variety of communicative functions. However, the majority of AAC interventions reported in the literature focused on requesting. While it is important to initially teach requesting skills, commenting should not be neglected. As AAC emerges, commenting is essential for social engagement, social closeness and information transfer. The purpose of this systematic review (INPLASY protocol 3160) was to describe and critically appraise the existing research on AAC interventions for commenting. A systematic search and application of inclusion criteria yielded 14 single case design studies that examined the effect of an AAC intervention on commenting of children with communication disabilities. A quality appraisal indicated that the rigor of most studies was acceptable. However, there are areas in which research can be improved, especially around the number of points per phase, blinding of personnel, and clear reporting of procedures. Interventions fell into three types of teaching procedures, including prompt hierarchies, aided modeling and direct prompting. Likewise, three teaching contexts (i.e., book reading, play/toys/preferred activities, intensive teaching) and four types of commenting behaviors (i.e., one-symbol utterances, two-symbol utterances, sentences frames and grammatically correct utterances) were identified. Findings suggest the strongest evidence exists to support the use of least-to-most prompt hierarchies that include aided modeling in the context of book reading. However, there are too few studies to recommend their use with certainty.

Time use and timing are of particular relevance for people who use communication aids because of the role time plays in communication. However, the use of time in real-life communicative interactions of aided communicators has not been much researched. The present study explores time use in goal-oriented and activity-based communicative interactions involving 72 children who used aided communication and 56 children who used natural speech, aged 5-15 years, and their communication partners. The children using aided communication took significantly longer time than their naturally speaking peers to complete the tasks using language. Access method, whether direct or scanning, did impact aided communicators' time use, with children using direct access being faster than children using scanning. Time use was not statistically related to age or verbal comprehension but was related to non-verbal reasoning: to communicate with their partners, children with higher non-verbal reasoning scores used less time than children with lower reasoning scores. Regardless of access method, aided communicators who used less time to communicate had more success in solving the tasks. The results suggest that to tackle the issue of time, aided language interventions with children could focus on communicative problem-solving with partners in real-life situations.

The objective of this replication study was to compare the perspectives of Hebrew-speaking speech-language pathologists (SLPs) on augmentative and alternative communication (AAC) assessment and intervention in each of the five language domains (semantics, pragmatics, phonology, morphology, and syntax) with those previously reported for English-speaking SLPs. Specifically, the comparison aimed to understand AAC service delivery patterns in different linguistic contexts. Using an anonymous online survey, the study collected responses from 167 Hebrew-speaking SLPs regarding preprofessional training, clinical practices, resource adequacy and continuing education interests related to AAC assessment and intervention in each language domain. Global agreement was found among Hebrew-speaking and those previously reported for English-speaking SLPs on the importance of all language domains for people who use AAC (PWUAAC) and their interest in professional development. In ratings of preprofessional training, clinical practice, and resource adequacy, pragmatics and semantics had consistently higher percentages of positive responses in both groups, followed by syntax, while morphology and phonology received fewest. Fewer Hebrew-speaking as compared to English-speaking SLPs rated morphology/phonology skills as important for PWUAAC and reported providing clinical services in each language domain. However, more Hebrew-speaking SLPs rated their resources and preprofessional training as adequate in semantics, pragmatics, syntax, and phonology. These findings suggest that while shared AAC service delivery patterns exist in different linguistic contexts (e.g., Hebrew, English) across language domains, there is a need for development and validation of language-specific (e.g., Hebrew) resources, particularly in morphology and phonology. Factors influencing clinical decision-making, including client age, preferences, disabilities, and resource availability, are also discussed.