Augmentative and Alternative Communication最新文献

Every individual has a fundamental right to communicate and access equal opportunities to fully participate in society. However, this right may not be fully manifested for individuals with communication access needs especially those from underrepresented groups. This project had two aims, to determine 1) the specific experiences, challenges, and aspirations related to the cultural identities of people of color (POC) who use augmentative and alternative communication (AAC) and 2) how AAC service providers and manufacturers can support POC AAC users in a culturally and linguistically responsive manner. We conducted an online, asynchronous focus group with seven participants over eight weeks. The participants' responses were coded qualitatively. Seven major themes were identified: AAC is a Culture, AAC System Features, Self-Identity as a Person of Color who uses AAC, Experience with Service Providers, Improvements to the Field of AAC, Racial Inequities in AAC Support, and Future Research. Suggestions are provided regarding how service providers and manufacturers can serve as better allies to support POC who use AAC.

Key word signing (KWS) is an unaided form of augmentative and alternative communication (AAC) and is frequently used by children with cognitive impairments and their families. Successful implementation of KWS requires a family environment that provides aided language input by modeling the signs. However, families face challenges implementing the signs in their everyday lives. KWS requires effort and sustained parental commitment. Users may also struggle with finding good learning resources and stimulating and enjoyable shared contexts for communication. Signed videos of popular children's books may help to implement KWS and create a signing environment which exposes children and their families to KWS in meaningful ways. The aim of this study was to create videos of this type and investigate whether and how they might serve as an attractive medium of support for families' KWS experience. Three families tested the videos. A triangulated qualitative study incorporating interviews and participant observation explored the families' experience of using these videos as a context for shared communication. The findings suggest that picture book videos supplemented by KWS may be appropriate resources for the use of KWS in everyday family life. They serve as a child-centered activity involving KWS exposure, in which children and their families can participate joyfully and naturally.

Many autistic¹ children experience communication challenges. Augmentative and alternative communication (AAC) can function as a primary or supportive mode of communication, and interventions incorporating AAC have a positive impact on the communication skills of autistic children. This systematic review investigated intervention studies using speech generating devices to enhance the expressive language of autistic preschoolers. Specifically, research questions addressed the (a) expressive communication skills and functions; (b) instructional strategies; (c) impact of interventions; and (d) ecological validity of the included studies. After an extensive search process, twenty studies from 1998 to 2023 met the inclusion criteria. Study characteristics were extracted, social and ecological validity were evaluated, and results were described using effect sizes and visual analysis. The majority targeted requesting (n=14) and the remaining addressed communication acts across diverse functions (n=6). Eleven of the studies demonstrated moderate to strong effects. Most interventions were multicomponent, including a variety of strategies, with prompting being the most common. Fewer than half of the studies met the full criteria for ecological validity, and only seven measured social validity. Implications for the field are provided including a call to action for researchers to evaluate interventions to support communication across diverse functions.

A socio-neurocognitive approach to augmentative and alternative communication (AAC) shows several underlying domains of communicative competence: Attention, perception, cognition, memory, orientation, socio-emotional development, motor skills, and language. To determine developmental markers of these underlying core domains of communicative competence in children with communication support needs, we developed a new screening instrument. The present article consists of three consecutive studies. In study 1, we constructed the first version of the screening instrument based on a sample of both children without disabilities and children with Down syndrome. In study 2, we confirmed the reliability (i.e., internal consistency) of the screening instrument in a new group of young children with typical development and established concurrent validity with the Early Language Scale. In study 3, we established concurrent validity with the Communication Matrix in a clinical sample of children with communication support needs. The screening instrument can be used in clinical practice as part of AAC assessment to provide comprehensive insights into strengths and weaknesses in the underlying core domains of communicative competence of children with communication support needs.

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.

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.