Augmentative Communication Research Articles

Is There a Place for Pseudostuttering Assignments in Speech-Language Pathology Training Within the Neurodiverse Paradigm?

Purpose: The continued use of pseudostuttering assignments, a disability simulation for speech-language pathology students, needs to be reexamined to align with neurodiversity and students' reluctance to participate in these studies. Stuttering, from a neurodiverse perspective, is regarded as a normal speech variation, rather than a disorder. The purpose of this research was for people who stutter, speech-language therapy students, and faculty members to respond to a survey to determine the future of these assignments, in terms of developing empathy and clinical skills of pseudostuttering. Method: A descriptive design electronic survey using typical case sampling was disseminated globally. A total of 134 participants, divided into three participant groups, completed the survey. The survey consisted of 84 closed- and open-ended questions. Percentages and thematic analysis were used to determine the results. Results: Quantitative and qualitative analyses indicated that 83% of speech-language pathology faculty members supported these assignments. Forty-eight percent of people who stutter and 58% of speech-language pathology students felt negatively toward pseudostuttering assignments. Students reported being more comfortable performing augmentative and alternative communication simulations than pseudostuttering or aphasia simulations. Students were concerned that pseudostuttering assignments were offensive and stigmatizing for people who stutter. Conclusions: The results reflect the benefits of partnering with all the constituent groups. Adaptations to pseudostuttering assignments, such as speaking with people who stutter and adopting a neurodiverse, inclusive approach to student education, are recommended.

AAC in AACtion: Collaborative Strategies for Special Education Teachers and Speech-Language Pathologists

Augmentative and alternative communication (AAC) refers to a wide variety of communication devices, systems, tools, and strategies that support or replace spoken language. Augmentative and alternative communication users represent a range of ages, abilities, and communication needs. Support for AAC often begins in the public school setting. Although the Individuals with Disabilities Education Act (IDEA) mandates public schools to provide adequate assistive technology for communication and training to support implementation, researchers estimate that fewer than 40% of students with communication impairments using AAC are proficient communicators. Barriers to implementation include a lack of training opportunities, limited preparation time, unfamiliarity with AAC systems, and difficulty finding evidence-based strategies for AAC. To address these, we present evidence-based strategies that speech-language pathologists (SLPs) and special education teachers may use in collaboration to support students using AAC and practical tips for implementation. Strategies described include aided language modeling, core vocabulary, and communication partner support behaviors. Planning considerations for collaboration are discussed.

The confidence and competence of speech language pathologists in augmentative and alternative communication: a scoping review

Augmentative and alternative communication (AAC) is a core component of speech pathology practice. However, international literature has highlighted that speech language pathologists (SLPs) may not feel confident or competent in this area. Confidence and competence are critical factors in therapy as they can impact the quality-of-service provision. The purpose of this scoping review was to investigate the confidence/competence of SLPs in AAC. A systematic scoping search was conducted using four databases to identify relevant literature. The first two authors reviewed 30% of abstracts and the remaining 70% were reviewed by the first author. Full-text screening applied the same review approach. Data was then extracted and organized according to the research questions. Thirteen studies were included in the review. All thirteen used self-assessment to measure confidence or competence with one study also using an objective evaluation. Overall, confidence and competence levels varied based on the specific clinical task and etiology of the client in addition to being influenced by prior training, clinician age, workplace and AAC caseload. While current research provides a snapshot of the SLP workforce, it is limited in that the research predominantly uses self-assessment measures, is cross-sectional and is quantitative in nature. Further research into the confidence and competence of SLPs in AAC is required, specifically how confidence and competence can be defined and developed.

The prevalence of relational basic concepts on core vocabulary lists for AAC: is frequency enough?

The selection of appropriate vocabulary is a crucial and challenging aspect of augmentative and alternative communication (AAC) intervention. Core vocabulary lists are frequently used to support vocabulary selection for children who require AAC. A vocabulary domain that has garnered limited attention within the AAC literature is relational basic concepts (RBCs). RBCs describe relationships between objects, persons, or situations, and play a pivotal role in language development, communication, and academic success. For the present study, we created a list of 156 RBCs, drawing primarily from assessments that measure basic concept knowledge in preschool and early elementary school students. We examined the overlap of these words on nine core vocabulary lists. We found that most concepts were not represented on any core lists. Additionally, there was relatively little overlap of RBCs between the core lists. These findings suggest that vocabulary selection resources created using exclusively a core vocabulary approach may have limited utility for identifying many concepts that preschool and early elementary students are expected to know and use. Implications for AAC research and practice are discussed with emphasis on the need for further consideration of RBCs within vocabulary selection practice and the field of AAC at large.

Multilingualism and Augmentative and Alternative Communication: A Review of the Literature

Purpose: Individuals from culturally and linguistically diverse backgrounds who use augmentative and alternative communication (AAC) are often offered English-only AAC systems that do not meet their language needs. The aim of this review article was to describe the research published on multilingual AAC, define any emerging best practices, and highlight gaps in the literature that exist to ensure equal language access for all learners. Method: The authors reviewed the literature by searching relevant databases using a variety of search terms. Following our inclusionary and exclusionary criteria, 15 articles were yielded for coding and then patterns were reported. Results: The authors found that more than half of the included articles were expert opinion papers on AAC delivery, barriers to AAC and multilingualism, and code-switching using AAC. The included qualitative studies aimed to summarize the perceptions on AAC services—their impact, facilitating and limiting factors in communication, and the importance or relevance of using an AAC device. Only two quantitative studies were included. Conclusions: Practitioners have an obligation to support multilingual clients who use AAC across all languages they speak at school, at home, and in the community. Much of the literature supports encouraging multiple languages, but limited access to multilingual AAC systems are available. There is also a dire need for empirically based studies and more perspectives by way of interviews or surveys.

British Sign Language and its Role in Dentistry

Hearing impairments affect up to 1.57 billion individuals globally, and 11 million people within the UK. Worldwide, 60% of hearing loss in children is due to preventable causes. Types of hearing loss vary in their aetiology and severity; however, all can negatively affect an individual's quality of life. The general health of those within the deaf population has been shown to be poorer than that of the general population, with under-diagnosis and under-treatment of chronic conditions putting individuals at risk of preventable ill-health. Deaf individuals experience greater problems in accessing healthcare, with a lack of British Sign Language (BSL), deafness awareness training and other communication aids being identified as barriers in such settings. With respect to dental health, deafness can result in poorer oral hygiene and greater dental caries. Communication issues faced at the dentist include being called from the waiting room, communicating with the dental team, mask wearing and background noise in the surgery. British Sign Language is a visual and spatial language, using movements of the hands, body, face and head. With its own grammar, syntax, idioms and regional variations, it is recognized as an official language in England, Wales and Scotland. This article provides a general background on hearing loss, its influence on general and dental health, an introduction to BSL, and hopes to encourage the general dental practitioner to seek further training in BSL. CPD/Clinical Relevance: To aid in effective communication with patients who have hearing loss, a knowledge of BSL would be helpful.

The importance of the team in small animal CPR

This review draws on evidence from human medicine to assess the team factors most relevant to small animal cardiopulmonary resuscitation (CPR). It is increasingly being recognised that leadership, team building, communication and situational awareness all impact both the team's experience and clinical outcomes. Leadership training, nurse-led teams, debriefing, closed-loop communication and cognitive aids have all been shown to improve CPR performance and thus deserve consideration alongside the practical elements of arrest and resuscitation. There is limited primary evidence to support this claim in veterinary medicine. However, the mental models underpinning clinical human factors are largely seen as transferable, with veterinary governing bodies supporting their inclusion in practice culture and training.

The Perceptions of Speech-language Pathologists toward Augmentative and Alternative Communication in China

The purpose of this study is to investigate the awareness and use of Augmentative and Alternative Communication (AAC) systems, as well as the related training received by speech therapists in China. A questionnaire survey was designed and distribute to speech therapists in hospitals, rehabilitation organizations and universities in China. A total of 50 valid questionnaires were returned. The results showed that 94% of the speech therapists had heard of various AAC tools. However, only 10% of the speech therapists considered themselves proficient in providing AAC assessment and intervention services. 30% of them had never received AAC training, 48% had attended seminars or lectures related to AAC but had not received systematic training, and 20% had only received less than 1 day of training. 80% of the speech therapists expressed a strong interest in participating in AAC training, and most of the speech therapists believed that the AAC tools helped improve their patients’ communication skills. This research provided insights into how Chinese speech therapists perceived AAC devices. However, the research also revealed a lack of training and experience with AAC in China.

Technology osmosis in augmentative and alternative communication: Opportunity, trend, and upshot

Abstract Technology has made a revolution in the realm of augmentative and alternative communication (AAC) possible. This paper presents fresh concepts and solid duties for creating a locally produced assistive technology. The study will also reverse and combine the fundamental specifications for AAC for people with communication problems. The study aimed to examine parents’ perceptions of AAC devices and how cutting-edge technology can meet their needs. Several significant issues are covered in this article, including (a) the difficulties associated with product repair, maintenance, and servicing; (b) familiarizing and educating stakeholders about the AAC devices; (c) product customization; (d) the integration of AAC into traditional educational systems; and (e) future research directions.

Primitive way country come look inside

Abstract A disabled poet with Rett syndrome and a disabled performing artist with type 1 diabetes document their 12-month artistic collaboration to illuminate ground-time: the nonverbal, expressive dynamics of embodied communication. Five “communication moments” between the artists (documented in writing, video, and photo) are described. Potentials and limitations of augmentative and alternative communication (AAC) technologies, specifically Tobii Dynavox eye-tracking technology and Communicator 5, are discussed. Additionally, the authors question the clinical diagnostic category of “intellectual disability” on the grounds of disability justice, decolonial science, and philosophy. Communication-assistive technology platform developers are challenged to consider relational embodiment as the foundation of communication in design decisions regarding platform function. Technologies should facilitate improvisation and nonlinear expression—verbal and nonverbal— while maintaining freedom of nondisclosure. The right to opacity in communication is also discussed.

Distant suffering and digital knowledge politics: New trajectories for critical geography

AbstractThis paper engages theoretical principles from critical human geography, media and communication studies, and development literature to present a research trajectory that unpacks the influence of digital platforms in representing and mediating distant suffering. Critiques of aid and development communication have long focused on concerns around the representation of the Global South as an ‘Othered’ space; powerful and deeply problematic geographical imaginaries become embedded within contemporary dominant discourses of aid and development. As significant sources of aid and development imaginaries, how civil society has mediated distant suffering has been subject to much critique. However, the rapid transition towards engagement with digital platforms necessitates an extension of critical considerations about representation and mediation. For example: what impact do digital platforms, their knowledge politics and representational capabilities have on imaginaries of distant suffering? Digital platforms (such as websites and other social media platforms) are situated within and constituted by (and through) a ‘digital knowledge politics’. These platforms and their mediations still exist within broader social practices and processes, and therefore remain entrenched within the power relations between Global North and Global South. This poses significant questions regarding the role digital platforms (and their representational capabilities) play in producing and mediating representations of distant strangers and their places. Moreover, further gaps within existing research emerge regarding how digital platforms can inform how (and indeed if) the public respond to such discourses. Through identifying key interdisciplinary intersections between critical human geographies and media and communication studies, this paper considers research trajectories that extend critical examinations of the role that digital platforms play in producing and representing aid and development imaginaries.

Study to assess the effectiveness of behavioural change communication aid for the anger management in adolescents: A Quasi experimental study in the selected juvenile aid center, New Delhi

Background and purposeRising anger issues among young individuals are becoming increasingly prevalent in contemporary society. Comprehensive examinations and literary investigations have illuminated the detrimental consequences of unregulated anger in adolescents. Consequently, it is imperative to investigate the efficacy of various anger management interventions in curbing the anger of adolescents. Behavioral change communication aids represent an effective and accessible method for anger management in juveniles. The researcher identified juvenile aid centers as optimal locations for conducting such intervention studies. Materials and methodsIn this study, we conducted research within a Juvenile Aid Center and evaluated the anger levels of the participants using a clinical anger scale. Following the initial assessment, only the experimental group received the Behavior Change Communication aid, and after a four-week period, we reevaluated the juveniles using the same measurement tool. ResultsThe total sample size for this study comprised 73 adolescents. The experimental group received the Behavior Change Communication aid, and their anger levels were assessed using the Clinical Anger Scale, which showed improvements in all participants. ConclusionThe findings of this study indicated a significant effectiveness of the Behavior Change Communication aid in managing anger among adolescents residing in juvenile aid centers.

Bridging Communication Gaps: A Literature Survey on Assistive Technologies for Individuals with Disabilities in India

Communication barriers faced by individuals with disabilities, particularly in India, pose significant challenges to social inclusion and interaction. This paper presents a comprehensive literature survey on existing research and developments in assistive technologies aimed at overcoming these barriers. Focusing on communication aids for the blind, deaf, and mute populations, this survey explores innovative solutions, evaluates their effectiveness, and identifies areas for future research

Project Building Bridges: A Framework for Preparing Highly Qualified Speech-Language Pathologists to Serve Culturally and Linguistically Diverse Students With Augmentative and Alternative Communication Needs.

Project Building Bridges was funded by the U.S. Department of Education Office of Special Education Programs to address the shortage of speech-language pathologists qualified to serve students with complex communication needs who benefit from augmentative and alternative communication (AAC) and are culturally and linguistically diverse. The purpose was to train future speech-language pathologists in culturally responsive AAC practices through coursework and fieldwork in AAC integrated into the Master of Science degree in Speech, Language and Hearing Sciences. Fifty-seven graduate students completed the project. The scholars' curriculum consisted of two AAC courses, both on-campus and externship AAC clinical practicum experiences to provide services to multicultural and linguistically diverse students, a U.S. or international service-learning opportunity, and cumulative portfolio presentations. Mixed-methods outcome measures consisted of four sets of pre- and postsurveys and qualitative feedback from exit interviews to assess changes in graduate student competencies. Significant differences were demonstrated between scholars' pre- and post-assessments of confidence ratings. Significant differences were also demonstrated in both scholars' and school mentors' pre- and post-assessments of competency ratings. No significant differences were found between evaluations of AAC preparation by Clinical Fellowship (CF) candidates and their CF mentors at 1 year postgraduation. Project Building Bridges provides a framework for preparing highly qualified speech-language pathologists to serve culturally and linguistically diverse students who benefit from AAC as evidenced by pre- and postsurvey results. The project can serve as a model for other university programs in the development of preservice preparation programs focusing on culturally and linguistically diverse students with AAC needs.

Increasing Reciprocal Social Interactions Between Children Who Use Augmentative and Alternative Communication and Peers Using a Collaborative Learning Framework.

Children with complex communication needs who rely on augmentative and alternative communication (AAC) strategies to express themselves face significant difficulties interaction with peers. This study sought to design, implement, and evaluate a collaborative photography intervention designed to increase reciprocal social interaction between children who use AAC and their same-age peers. A single-subject, withdrawal design (ABAB) was used to explore the functional relationship between engagement in a collaborative photography intervention and the frequency of reciprocal social interactions between children who use AAC and their same-age peers. Partial-interval time sampling was used to code the number of reciprocal social interactions across four dyads. Increased frequencies of reciprocal social interactions were observed in intervention phases across all four dyads. Very large levels of effect and 100% nonoverlapping data were noted for Dyads 1 and 4. Moderate levels of effect and 70% of nonoverlapping data were noted for Dyads 2 and 3. Collaborative learning frameworks may be used to increase reciprocal social interactions between children who use AAC and their peers. Speech-language pathologists should consider utilizing collaborative learning elements in activities with children who use AAC. Future research is needed to further explore collaborative learning frameworks for interventions for children who use AAC. https://doi.org/10.23641/asha.25464064.

Staff-Facilitated Telemedicine Care Delivery for Treatment of Hepatitis C Infection among People Who Inject Drugs.

Telemedicine offers the opportunity to provide clinical services remotely, thereby bridging geographic distances for people engaged in the medical system. Following the COVID-19 pandemic, the widespread adoption of telemedicine in clinical practices has persisted, highlighting its continued relevance for post-pandemic healthcare. Little is known about telemedicine use among people from socially marginalized groups. The No One Waits (NOW) Study is a single-arm clinical trial measuring the acceptability, feasibility, and safety of an urban point-of-diagnosis hepatitis C (HCV) treatment initiation model delivered in a non-clinical community setting. Participants enrolled in the NOW Study are recruited via street outreach targeting people experiencing homelessness and injecting drugs. Throughout the NOW Study, clinical care is delivered through a novel staff-facilitated telemedicine model that not only addresses geographic and transportation barriers, but also technology and medical mistrust, barriers often unique to this population. While clinicians provide high-quality specialty practice-based care via telemedicine, on-site staff provide technical support, aid in communication and rapport, and review the clinicians' instructions and next steps with participants following the visits. Research questionnaires collect information on participants' experience with and perceptions of telemedicine (a) prior to treatment initiation and (b) at treatment completion. For people from socially marginalized groups with HCV infection, creative person-centered care approaches are necessary to diagnose, treat, and cure HCV. Although non-clinical, community-based staff-facilitated telemedicine requires additional resources compared to standard-of-care telemedicine, it could expand the reach and offer a valuable entrance into technology-delivered care for socially marginalized groups. NCT03987503.

Deep learning in the classification and recognition of cardiac activity patterns

Electrocardiography is an examination performed frequently in patients experiencing symptoms of heart disease. Upon a detailed analysis, it has shown potential to detect and identify various activities. In this article, we present a deep learning approach that can be used to analyze ECG signals. Our research shows promising results in recognizing activity and disease patterns with nearly 90% accuracy. In this paper, we present the early results of our analysis, indicating the potential of using deep learning algorithms in the analysis of both onedimensional and two–dimensional data. The methodology we present can be utilized for ECG data classification and can be extended to wearable devices. Conclusions of our study pave the way for exploring live data analysis through wearable devices in order to not only predict specific cardiac conditions, but also a possibility of using them in alternative and augmented communication frameworks.

How Toddlers Use Core and Fringe Vocabulary: What's in an Utterance?

Selecting vocabulary for preliterate individuals who use augmentative and alternative communication presents multiple challenges, as the number of symbols provided must be balanced with cognitive, motoric, and other needs. Prioritizing certain types of vocabulary thus becomes a necessity. For example, prioritizing core vocabulary-that is, words that are commonly used across a group of people and contexts-is a common practice that attempts to address some of these issues. However, most core vocabulary research to date has narrowly focused on individual word counts, ignoring other critical aspects of language development such as how vocabulary aligns with typical development and how children use core and fringe vocabulary within their utterances. Descriptive and inferential statistics were used to analyze 112 transcripts to describe how typically developing toddlers (aged 2.5 years) use core and fringe vocabulary within their utterances, in reference to a range of commonly used core vocabulary lists. Results indicated that the proportion of the toddlers' utterances that consisted of only core, only fringe, or core + fringe vocabulary varied dramatically depending on the size of the core vocabulary list used, with smaller core lists yielding few "core-only" utterances. Furthermore, utterances containing both core and fringe vocabulary were both grammatically and semantically superior to utterances containing only core or only fringe vocabulary, as evidenced by measures such as mean length of utterance and total number of words. Thus, relying on word frequency counts is an insufficient basis for selecting vocabulary for aided preliterate communicators.

A Randomized Controlled Trial Comparing Face-to-Face Versus Remote Delivery of Low-Tech Augmentative and Alternative Communication in Nonspeaking Children With Autism Spectrum Disorder.

Thirty percent of children diagnosed with autism spectrum disorder (ASD) do not develop spoken language. To provide a means of communication for this subset of the population, augmentative and alternative communication (AAC) systems are often utilized. Low-tech options have traditionally been delivered through the in-person modality. However, due to the COVID-19 pandemic, changes to service delivery models have been required. This randomized controlled trial was conducted in order to assess the efficacy of low-tech AAC delivered face-to-face versus remotely on communication outcomes in nonspeaking children with ASD. Both participant groups demonstrated similar gains in AAC proficiency, number and type of nonspeaking acts, and number of spoken communication acts. Remote delivery of low-tech AAC treatment is a viable alternative to face-to-face instruction.

Still having his say: David Yoder’s legacy in AAC

On February 2 2023, one of the guiding lights in the field of augmentative and alternative communication (AAC) for more than four decades, David E. Yoder, passed away at the age of 90. A voracious reader and gifted storyteller, David was particularly fond of a quote from George Bernard Shaw’s Back to Methuselah, “You see things; and you say ‘Why?’ but I dream things that never were; and I say ‘Why not?’” That vision led him to take on multiple leadership roles and influence the field of AAC in multiple ways. He played a pivotal role in establishing both the International Society for Augmentative and Alternative Communication (ISAAC) and the United States Society for Augmentative and Alternative Communication (USSAAC). Additionally, he chaired the panel for the National Institute on Disability and Rehabilitation Research (NIDRR)’s inaugural Consensus Validation Conference on AAC, advocated for the American Speech-Language-Hearing Association to recognize AAC within the profession’s scope of practice, and served as the first editor for the Augmentative and Alternative Communication journal. In this tribute, we describe David’s diverse and unique contributions to improving the lives of people with communication challenges with a focus on some of his central insights and actions.