Preference between Indian Picture Symbols for Communication (IPSC) and Picture Communication Symbols (PCS) in neurotypical adults and adults with aphasia

ABSTRACT An SLP-preferred symbol set may not always be accepted by the AAC user which makes it essential to investigate how preferences for symbols vary in different population. The primary purpose of the current study was to investigate the preferences between two AAC symbol sets of different cultural origins among neurotypical adults who were natives of Kerala, India. The study also aimed to explore the trend in preferences among adults with aphasia. A total of 240 neurotypical adults and ten adults with aphasia participated in the study. The neurotypical adults encompassed 120 lay-persons from four age groups (i.e., 18–35, 36–50, 51–65, and 66–80), and 120 professionals from three professional categories (i.e., medical and allied health professionals, speech-language pathologists, and special educators). A preference task using IPSC and PCS for the same set of 30 target referents inclusive of nouns, verbs, adjectives, and prepositions was utilized. Both groups of neurotypical adults showed a significant preference for IPSC over PCS for most of the stimuli included in the study. A similar trend was found in adults with aphasia. IPSC was preferred for target referents representing verbs, adjectives, and prepositions, and PCS was preferred for nouns. Analysis of preferences within participant groups revealed that age and profession did not influence symbol preferences in neurotypical adults. The study emphasizes the need to explore preferences among different AAC stakeholders. It also points out that the symbols considered universally iconic may be perceived differently in different cultures and can influence their preferences.