Alternative Communication Method Research Articles

High performance P300 spellers using GPT2 word prediction with cross-subject training

ABSTRACT Amyotrophic lateral sclerosis (ALS) severely impairs patients’ ability to communicate, often leading to a decline in their quality of life within a few years of diagnosis. The P300 speller brain–computer interface (BCI) offers an alternative communication method by interpreting a subject’s EEG response to flashing characters presented on a grid interface. This paper addresses the common speed limitations encountered in training efficient P300-based multi-subject classifiers by introducing innovative ‘across-subject’ classifiers. We leverage a combination of the second-generation Generative Pre-Trained Transformer (GPT2) and Dijkstra’s algorithm to optimize stimuli and suggest word completion choices based on subjects’ typing history. Additionally, we employ a multi-layered smoothing technique to accommodate out-of-vocabulary (OOV) words. Through extensive simulations employing random sampling of EEG data from multiple subjects, we demonstrate significant speed enhancements in typing passages containing rare and OOV words. These optimizations result in approximately 10 % improvement in character-level typing speed and up to 40 % improvement in multi-word prediction. We demonstrate that augmenting standard row/column highlighting techniques with layered word prediction yields close-to-optimal performance. Furthermore, we explore both ‘within-subject’ and ‘across-subject’ training techniques, showing that speed improvements are consistent across both approaches.

Monocytes and macrophages transmit inflammatory signals to each other via extracellular vesicles

Monocytes and macrophages play an important role in the development of inflammatory diseases, including sepsis, etc. In addition to their role as “scavengers,” macrophages secrete various substances (mainly cytokines and chemokines), which have a systemic effect and modulate the microenvironment of the inflammatory focus. Disruption of their normal function can cause various immune pathologies and changes in tissue homeostasis. Macrophages are able to transmit signals to other cells in the area of inflammation, including various cytokines and other compounds. Usually, they are secreted directly into the extracellular space. However, the lifetime and range of action of these substances may be limited. An alternative method of intercellular communication is the packaging of substances into extracellular vesicles, which can help in signal propagation. Extracellular vesicles are small particles with a bilayer lipid membrane that transport various biologically active substances. There are different types of extracellular vesicles, each of which can have its own specific effect on other cells. Due to the presence of specific receptors on the surface of the vesicles, they can make selective delivery of biological molecules to certain cells. Vesicles can contain various components, such as nucleic acids, proteins, lipids, and even individual cell organelles. Therefore, it is not surprising that vesicles are able to modulate physiological processes in the body and be involved in the pathogenesis of various diseases. Establishing the mechanisms of vesicle participation in the development of inflammatory diseases, including chronic ones, is extremely important. The aim of the present study was to determine whether extracellular vesicles are capable of modulating the immune response. To do this, we assessed cytokine secretion by macrophages treated with vesicles from LPS-stimulated monocytes and macrophages. It was found that cells that received vesicles from LPS-activated monocytes and macrophages secrete more pro-inflammatory signaling molecules: the cytokine IL-6 and the chemokine IL-8. The results demonstrate that intercellular interaction and transmission of the inflammatory signal of monocytic cells also occurs through extracellular vesicles. In the future, additional research is needed to understand the full picture of what substances in the extracellular vesicles of monocytes and macrophages allow them to have an immunomodulatory effect not only on each other, but also on other types of cells.

A Spectrotemporal EEG Mapping Approach for Decoding Imagined Marathi Language Phonemes

Individuals facing verbal communication impairments resulting from brain disorders like paralysis or autism encounter significant challenges when unable to articulate speech. This research proposes the design and development of a wearable system capable of decoding imagined speech using electroencephalogram (EEG) signals obtained during the mental process of speech generation. The system’s main objective is to offer an alternative communication method for individuals who can hear and think but face challenges in articulating their thoughts verbally. The design suggested includes user-friendliness, wearability, and comfort for seamless integration into daily life. A minimal number of electrodes are strategically placed on the scalp to minimize invasiveness. Achieving precise localization of the cortical areas responsible for generating the EEG patterns during imagined speech is vital for accurate decoding. Literature studies are utilized to determine the cortical positions associated with speech processing. Due to the inherent limitations in EEG spatial resolution, meticulous experiments are conducted to map the scalp positions onto their corresponding cortical counterparts. Specifically, we focus on identifying the scalp location over the superior temporal gyrus (T3) using the internationally recognized 10-20 electrode placement system by employing a circular periphery movement with a 2 cm distance increment. Our research involves nine subjects spanning various age groups, with the youngest being 23 and the oldest 65. Each participant undergoes ten iterations, during which they imagine six Marathi syllables. Our work contributes to the development of wearable assistive technology, enabling mute individuals to communicate effectively by translating their imagined speech into actionable commands. This innovation ultimately enhances their social participation and overall well-being.

A aplicação da Comunicação Suplementar e Alternativa para a estimulação da intenção comunicativa e da cognição em pacientes com Transtorno do Espectro Autista

ABSTRACT Purpose: to assess the advancement in communicative intention and cognition in children with autism spectrum disorder after applying a personalized alternative communication method. Methods: patients had their communicative intention and cognition (Vineland-3) assessed before and after the intervention with 10 structured alternative communication sessions. The “Demystifying Alternative Communication” podcast was developed as supplementary material to this study. Student’s t-test was used, setting the significance level at p < 0.05. Results: patients improved their communicative intention, with higher scores after the intervention, and no changes were found in relation to cognition. Conclusion: even though the patients’ equivalent age was inferior to their real age in the communication subdomain assessment, they progressed in expressive communication, language, and writing.

Effects of acoustic nonlinearity on communication performance in soft tissues.

Acoustic communication has been gaining traction as an alternative communication method in nontraditional media, such as underwater or through tissue. Acoustic propagation is known to be a nonlinear phenomenon; nonlinear propagation of acoustic waves in soft tissues at biomedical frequencies and intensities has been widely demonstrated. However, the effects of acoustic nonlinearity on communication performance in biological tissues have not yet been examined. In this work, nonlinear propagation of a communication signal in soft tissues is analyzed. The relationship between communication parameters (signal amplitude, bandwidth, and center frequency) and nonlinear distortion of the communication signal propagating in soft tissues with different acoustic properties is investigated. Simulated experiments revealed that, unlike linear channels, bit error rates increase as signal amplitude and bandwidth increase. Linear and decision feedback equalizers fail to address the increased error rates. When tissue properties and transmission parameters can be estimated, receivers based on maximum likelihood sequence estimation approach the performance of an ideal receiver in an ideal additive white Gaussian noise channel.

Optimization-based designs for communicating through impenetrable barriers with mechanical waves

Piezoelectric-based acoustic energy transmission is an emerging alternative communication method that allows signal transmission across a barrier without wires or physical penetration. A major challenge in the design of an electrical-mechanical coupled communication channel is how to resolve the undesirable signal transformation known as acoustic multipath as the elastic wave propagates through a multi-layered deformable solid. Solutions largely investigated by the communications community are typically based on sophisticated signal processing methods. However, we approach the problem through the lens of computational mechanics and design optimization. Proposed method is to design a piezoelectric stack that mitigates acoustic multipath by optimizing the thickness of various stack layers and the material properties of the epoxy-based backing. We optimize the design parameters of a 3-D coupled electrical-mechanical finite element model using partial differential equation (PDE) constrained optimization. We leverage higher order polynomial elements (P-elements) and high-performance computing to solve the computationally expensive 3-D wave propagation problem in the MHz frequency range. The results demonstrate how finite element modelling and optimization can be used to achieve optimal physical channel designs for mechanical acoustic-based communication. [SNL is managed and operated by NTESS under DOE NNSA contract DE-NA0003525.]

Effectiveness of augmented alternative communication method on physiological parameters among conscious mechanical ventilation patients

Background: Conscious mechanical ventilation patients in intensive care unit experience intense anxiety due to inability to communicate which might also affect their physiological parameters. Aim: to evaluate the effectiveness of augmented alternative communication method on physiological parameters (heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate and SpO2-oxygen saturation) among conscious MV patients in the ICU. Methodology/Design: Quantitative evaluative approach with quasi experimental (pretest, posttest with control group) research design was adopted in the present study.120 conscious mechanical ventilated patients were randomized into two groups, experimental and conventional care group (60 in each group).The experimental group, mechanical ventilation patients who were awake, aware and responsive to verbal communication was served by a simple assistive communication tool ( augmented alternative communication) for continuous three days. In contrast, only routine or usual nursing communication practice or standard care was provided to the control group. The socio-demographic data, clinical profile, communication difficulties self-evaluation questionnaire, patient satisfaction self-evaluation questionnaire, self-rating Face anxiety scale and Physiological parameters was used to measure study parameters.

Perspective: Presuming Autistic Communication Competence and Reframing Facilitated Communication

Debate surrounding the validity of the method of supported typing known as facilitated communication (FC) has been continuous since its inception in the 1990s. Views are polarized on whether FC can be considered an authenticated method for use by people with complex communication needs (CCN) or significant challenges in speech, language, and communication. This perspective article presents an analysis of the research arguing for—and against—the use of FC, combined with the lived experience knowledge of autistic adults who utilize FC, to rehabilitate its current standing as discredited and unevidenced. By considering extant qualitative and quantitative studies, as well as personal accounts of the use of this particular Augmentative and Alternative Communication (AAC) method, the authors argue that the current dismissal of FC is rooted in ableist and outdated approaches. FC research should be reconsidered and reconducted using current best practice autism research approaches, including coproduction and a presumption of autistic communication competence, to assess its validity as a potential AAC method for autistic individuals.

The Arthur App: Designing an Augmentative and Alternative Communication Method for Use With Hospitalized Patients.

An innovative augmentative and alternative communication method consisting of a mobile application (app) on an Apple iPad®, such as the Arthur app, can provide patients with barriers to verbal communication an easy means to express their needs, feelings, and questions. When using this technology, it is important to consider the right patient population at the right time, as well as the proper quantity and quality of information.

Communication during Covid‐19: Use of video conferencing technology by people living with dementia

BackgroundThe use of videoconferencing technology has increased as an alternative communication method for people to retain social and clinical contact during Covid‐19 restrictions. This study investigated the uptake, limitations and benefits of videoconferencing for people living with dementia (PLWD).MethodTwenty‐three PLWD, 87 caregivers (on behalf of PLWD) and 39 healthy control participants anonymously reported their experiences of using videoconferencing technology during the Covid‐19 pandemic (PLWD: 38‐90 years; controls: 32‐100 years). The online survey ran between December 2020 and April 2021. Respondents represented experiences of people living with Alzheimer’s Disease (AD; 27), Frontotemporal Dementia (FTD; 23), Primary Progressive Aphasia (PPA; 24), Posterior Cortical Atrophy (PCA; 22), Lewy Body Dementia (LDB; 7). Mann‐Whitney U tests were used to compare Likert ratings of videoconferencing experiences between PLWD or diagnostic subgroups and controls.ResultThe majority of survey respondents that use videoconferencing technology reported an increased usage during the Covid‐19 pandemic than before (85%). However, 28% of PLWD did not use videoconferencing at all, compared to 3% of healthy controls. Only 53% of PLWD reported they liked using videoconferencing technology compared to 67% of controls, and this was lowest for people with LBD (33%) or PCA (40%). Interestingly, 64% of people with FTD liked videoconferencing and rated it more engaging than traditional telephone calls compared to healthy controls (p=0.045). People with AD, PCA and FTD found online meetings with multiple people more difficult than controls (p=0.036; p<0.001; p=0.030). Qualitative responses to questions on telemedicine were mixed, with PLWD three times more likely to report overall negative consequences (e.g. “communication better face‐to‐face”) than positive benefits (e.g. “less tiring”) for cognitive clinic and dementia‐related GP appointments, compared to face‐to‐face visits.ConclusionThe use of videoconferencing by PLWD and healthy controls has increased during the Covid‐19 pandemic. However, a significant proportion of PLWD surveyed are not able to use these technologies, with different profiles of uptake and enthusiasm across dementia subtypes. Our findings suggest that whilst representing a helpful alternative to face‐to‐face communication during the pandemic, videoconferencing (particularly in clinical settings) may be a significant barrier to communication for some people with cognitive impairment.

An acoustic study of vowels produced by Cantonese alaryngeal speakers using clear speech

Alaryngeal speech is an alternative method of verbal communication following the removal of the larynx. Common alaryngeal speaking methods include esophageal (ES) speech, tracheoesophageal (TE) speech, and speech produced using an electrolarynx (EL). A recent study [Hui et al., in press, Folia Phoniatr Logop] demonstrated better intelligibility in Cantonese alaryngeal speakers while using clear speech (CS) compared to their everyday ‘habitual speech’ (HS). Yet the correlated change in the acoustics associated with CS is still not clear. The purpose of this study was to assess the acoustic characteristics of vowels produced by Cantonese alaryngeal speakers during HS and CS conditions. Thirty-one alaryngeal speakers (9 EL users, 10 ES speakers, and 12 TE speakers) produced sentences from the Cantonese Sentence Intelligibility Test in HS and CS. Acoustic analyses considered formants (measured by reassigned spectrogram), vowel space area (VSA) and vowel duration across alaryngeal speaking methods and styles. We also examined these acoustic differences in relation to duration of alaryngeal speech use and intelligibility. Results suggest that EL users had larger VSAs and larger increases in vowel duration while using CS compared to ES and TE speakers. Future research will examine the effects of refined CS protocols on improving acoustic and perceptual characteristics of Cantonese alaryngeal speech.

ASSESS THE COMMUNICATION PATTERN AMONG CONSCIOUS MECHANICAL VENTILATION PATIENTS AND NURSES IN THE SELECTED INTENSIVE CARE UNIT

Conscious ventilator dependent patients often experience communication difficulties due to intubation. The study aimed to understand the conscious mechanical ventilation (MV) patients and nurses existing communication pattern in the ICU and develop the augment alternative communication method (AAC). In this quasi experimental study (pretest and posttest design), participants were enrolled using purposive sampling method and assigned to experimental (n = 10) and control (n = 10) groups from ICU based on certain determined criteria. Communication pattern assessment observational check list used to collect the data from both groups. Patients were used paper and pen as aided communication device 45 %, head nodding 95 % and hand movement using fingers 75 %. Patients primarily prefer to communicate with nurses 95% .Patients expressed pain associated in the endo tracheal (ET) tube and inability to communicate 100% and 95% respectively. Ninety percent of the patients expressed feeling of anxiety / fear of dying and feeling of afraid. The study further revealed 100% of the patients expressed trouble sleeping and feeling of discomfort, 100% wanted to know about their condition, when will ET tube be removed and when I go home. With regards to patients physical care needs, 100% expressed thirsty feeling, need to be suctioned and hungry feeling, 75% expressed their lip to be moistened. Related to nurses positive communication strategies, 90% makes eye contact, 85�ing kind and spoke slowly. With regards to negative strategies 75% of the nurses spoke too rapidly and selftalk mumbling. Nurses used yes/ no gestures 100%, head nodes 85% and AAC no were not used other than natural methods. Communication pattern assessment helps the nurses to find out and distinguish the sources of discomforts, distressed symptoms especially the domains such as psychological, physiological, spiritual, comfort needs, expectations and preparing appropriate AAC for conscious MV patients.

Remote monitoring of patients with axial spondyloarthritis during the COVID-19 pandemic: results and prospects of using the information technology “Aspine”

During the pandemic of the new coronavirus infection COVID-19, the need for remote communication between doctors and patients has increased around the world. Objective : remote interaction between rheumatologist and patients using “ASpine” technology in the context of the COVID-19 pandemic. Subjects and methods . Within the framework of the scientific project, the information technology “ASpine” was used, which consists of two parts. The first is directly a mobile application for patients with a diagnosis of axial spondyloarthritis and the second is a program for a personal computer that is used by a rheumatologist. In the “ASpine” application, patients fill out BASDAI, ASDAS-CRP, BASFI questionnaires, enter data from various studies, and control the performance of daily exercise therapy. Also, the program has the ability to contact the attending physician via text messages. The paper presents the experience of one rheumatologist with the information technology “ASpine” during the COVID-19 pandemic from April to June 2020. Results . From January 1 to June 6, 2020, the total number of downloads of “ASpine” applications from the AppStore and GooglePlay was 1778, most of all during the COVID-19 pandemic. During this period, a rheumatologist using “ASpine” remotely observed 71 patients with axial spondyloarthritis. 47 (66.1%) of them were attached from April to June 2020. As of June 1, 2020, the average BASDAI in the observed values of patients was 4.7±2.3, BASFI -3.5±2.7, ASDAS-CRP - 3.1±1.1. During a pandemic, messages from patients came in daily from 1 to 16. Their review and preparation of a response by a doctor per call took an average of 5 minutes; usually it took no more than 30 minutes to answer each day. Conclusion . The “ASpine” program for patients with axial spondyloarthritis during a difficult situation in the country caused by restrictive means of preventing COVID-19 provided real help as an alternative method of communication with the attending physician. In turn, the technology allows a rheumatologist to remotely monitor the health status of a large number of time expenditures (no more than 30 minutes per day for 71 patients).

Art Music as Universal Language: Youth Orchestras' Reactions to Social Conflict

This article identifies the role art music plays in orchestra projects that deal with social conflicts of youth populations. I argue that art music serves well in this context because it is a universal language that allows for an alternative method of communication and expression between the young musicians themselves and with others. I apply metaphysical explanations, studies from cognitive neuroscience, and philosophy of language in three specific youth orchestra contexts: the Retiro Youth Orchestra, El Sistema, and the West-Eastern Divan Orchestra. These different lenses help uncover why and how art music positively impacts the development, both socially and personally, of young musicians in a healthier or alternative manner.

Digital Processing of Autistic Children's Drawings to Make Use of them in the Design of Printed Fabrics for Children's Clothin

Saudi Arabia's vision 2020 has placed more emphasis on paying attention to groups with special needs, providing support to them, addressing all their difficulties and considering them as part of human wealth, which makes it necessary to develop, integrate and benefit from them in the society. Autistic children are a wealth that can be invested and benefited from their capabilities and potentials. Researchers point out that these children lack social interaction and communication. Many studies tried to enter their world, to break the barrier of social withdrawal and isolation they live in, and to draw their attention. Therefore, the purpose of this study is to reveal the supporting activities, specifically the art of drawing, which help develop autistic children's sensory perception and use it as an alternative method of communication, to adapt and utilize their drawings to develop digital designs through computer software to produce children's printed fabrics. The major research question is: How can artistic elements and vocabulary of autistic children's drawings be adapted and digitized to develop printed fabrics for children's clothing? The current research aimed to identify the artistic and aesthetic characteristics of autistic children's drawings for the 6-12 age group, to digitize the drawings through computer software to design printed fabrics for children's clothing, and to measure the degree to which specialists and children's mothers accept the designs developed from the autistic children's drawings to be marketed locally. The analytical descriptive approach was used in this study. The results showed statistically significant differences at a significance level of 0.05 between the 20 designs proposed by the researcher, based on the specialists' opinions on the appropriateness of designs in achieving the aesthetic and functional requirements. In addition, the results revealed statistically significant differences at a significance level of 0.01 among the 20 designs proposed by the researcher, based on the mothers' opinions

Pesquisas em recursos de alta tecnologia para comunicação e transtorno do espectro autista

Cerca de um terço dos indivíduos diagnosticados com Transtorno do Espectro Autista (TEA) não conseguem desenvolver a oralidade. Os benefícios da Comunicação Alternativa (CA) para pessoas com TEA são bem reconhecidos e podem ser usados ​​para ampliar a fala limitada ou atuar como o método de comunicação principal (ou seja, alternativo). Os dispositivos de geração de fala referem-se a uma variedade de soluções de alta tecnologia, incluindo dispositivos de comunicação eletrônica dedicados (comunicadores/vocalizadores), processadores de texto com voz sintetizada e dispositivos móveis multifuncionais (ex. iPad, iPod e tablets com sistema Android) carregados com aplicativos de CA, e que são um opções viáveis para indivíduos com autismo. O objetivo deste artigo é verificar os estudos que investigam a alta tecnologia para comunicação e TEA, publicados no Augmentative and Alternative Communication Journal, que é o periodico oficial da Sociedade Internacional de Comunicação Aumentativa e Alternativa (ISAAC), no período de 2011 a 2018. Esta é uma área nova de conhecimento que está em rápido crescimento e com poucos estudos no Brasil. Os resultados dos 15 artigos analisados indicam que pessoas com TEA se beneficiam com o uso da alta tecnologia. Pesquisas futuras em criação de recursos de comunicação, intervenção com usuários e descrição dos repertórios verbais são recomendadas.

Space for Listening: using a library unConference as an alternative method of communication

Space for Listening: using a library unConference as an alternative method of communication

Ideomotor Apraxia in Alzheimer’s Disease: Intervention using an Unaided Augmentative and Alternative Communication System

Objectives: The potential value of gestures needs to be evaluated as an unaided alternative and augmentative communication (AAC) method to improve the naming ability of persons with Alzheimer's disease (AD). Considering the possible effect of ideomotor apraxia (IMA) in AD patients, the current study...

Acquisition, Preference and Follow-up Comparison Across Three AAC Modalities Taught to Two Children with Autism Spectrum Disorder

Identifying an augmentative and alternative communication (AAC) method for children with autism spectrum disorder (ASD) might be informed by comparing their performance with, and preference for, a range of communication modalities. Towards this end, the present study involved two children with ASD who were taught to request the continuation of toy play by: (a) signing MORE, (b) exchanging a picture card representing MORE, and (c) touching a MORE symbol from the screen of a speech-generating device. The children were also given opportunities to choose among the three modalities to identify their preferred method of communication. Both children performed better with picture exchange and the speech-generating device than with manual signing, but had variable performance during follow-up. Both children more often chose the speech-generating device, suggesting a preference for that modality. We conclude that concurrent intervention across several communication methods can generate data to inform the selection of an AAC modality.

The clinical utility curve: a proposal to improve the translation of information provided by prediction models to clinicians.

BackgroundPrediction models are essential to the development of prediction rules that guide decision-making, and comparison of prediction models with and without an additional diagnostic or prognostic risk factor allows assessment of the value of the additional factor in risk prediction. However, the many different measures described to translate the information provided by a prediction model do not readily assist clinicians’ decision-making.ResultsThe clinical utility (CU) curve is proposed as an alternative method of communication of information from a prediction model to the clinician. The CU curve is essentially a derivation of the ROC curve that has sensitivity on the y-axis and the number needed to capture one case (NNCOC) on the x-axis. It provides information about the relationship between sensitivity and false positive rate over the full range of prediction score thresholds, and it also indicates the proportion of the patient population with an absolute risk below the threshold for 100 % sensitivity that can therefore be classified as free of disease.ConclusionsThe CU curve is proposed as a means to assist the translation of model information to the clinician, in the hope that it will stimulate debate and, through refinement, assist the development of prediction rules with optimal clinical utility.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2028-0) contains supplementary material, which is available to authorized users.