Alternative Communication Techniques Research Articles

Are quality of care instruments inclusive of older people living with dementia? A scoping review in long-term care settings.

More than half of older people in long-term care facilities have dementia. Little is currently known about the methods and instruments which can be used to capture the perspectives of older people, including those with dementia, regarding the quality of care provided in such facilities. The main aims of this scoping review were two-fold. Firstly, to identify quality of care instruments that have been applied in long-term care settings. Secondly, to evaluate how these instruments have been developed and validated, particularly in terms of their applicability among older people with dementia. Seven databases (Medline, Web of Science, Scopus, ProQuest, Ageline, CINHAL and google scholar) were searched for relevant literature without any date limit. We used quality criteria adapted from COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) guidelines to assess the psychometric properties of the instruments. The search identified 16 quality of care instruments which had been used in long-term care settings. Of which, two (12.5%) were specifically designed for older people with dementia, and three instruments (18.7%) were modified for use with older people with mild to moderate dementia. A variety of methods were used to develop the identified instruments including literature reviews, qualitative interviews, expert panel reviews, pre-testing and piloting with older people. None of the identified instruments had been subjected to comprehensive psychometric assessment. Most instruments for assessing quality of care in long term care settings lack alternative communication techniques tailored to people with dementia. This review highlights the need for more rigorous psychometric testing of existing instruments for assessing quality of care in long-term care settings. Several existing measures show promise and may be taken forward for further testing and development for widespread application with older people, including those living with dementia, in long term care settings.

Facilitating Communication in Neuromuscular Diseases: An Adaptive Approach with Fuzzy Logic and Machine Learning in Augmentative and Alternative Communication Systems

Augmentative and alternative communication techniques (AAC) are essential to assist individuals facing communication difficulties. (1) Background: It is acknowledged that dynamic solutions that adjust to the changing needs of patients are necessary in the context of neuromuscular diseases. (2) Methods: In order address this concern, a differential approach was suggested that entailed the prior identification of the disease state. This approach employs fuzzy logic to ascertain the disease stage by analyzing intuitive patterns; it is contrasted with two intelligent systems. (3) Results: The results indicate that the AAC system’s adaptability enhances with the progression of the disease’s phases, thereby ensuring its utility throughout the lifespan of the individual. Although the adaptive AAC system exhibits signs of improvement, an expanded assessment involving a greater number of patients is required. (4) Conclusions: Qualitative assessments of comparative studies shed light on the difficulties associated with enhancing accuracy and adaptability. This research highlights the significance of investigating the use of fuzzy logic or artificial intelligence methods in order to solve the issue of symptom variability in disease staging.

Gli esiti dello stroke ischemico del bambino: afasia e talamo

Left thalamic stroke in adults commonly results in thalamic aphasia, which is characterized by defects in lexical and semantic abilities associated with fluency and comprehension disabilities and intact word repetition. Although few cases have been reported, aphasia with similar features can also be present as a consequence of left-brain hemisphere stroke in children, which has usually a poorer prognosis if compared with that of the adult population. The paper reports the case of a 20-month-old female child that developed aphasia after an ischemic stroke that involved the left anteromedial thalamus. In these cases it is necessary to initiate an early rehabilitation treatment, possibly supported by augmentative and alternative communication techniques.

Влияние использования альтернативной и дополнительной коммуникации на смягчение поведенческих трудностей детей и подростков с тяжелыми множественными нарушениями развития

This article is relevant in the framework of the study educational training importance and the ability to communicate with adolescents with severe multiple developmental and behavioral disorders (SMDD) in adults working for inpa- tient social service institution (ISSI). The survey of communication and behavioral skills in adolescents with SMDD living in ISSI presented. The study involved 60 employees, 28 adolescents with SMDD, 20 parents of special children. Methods used: Communication Matrix, cyclogram «Review of the day», evaluation sheet «Table of interests». A spe- cific case of employee training and introduction of Augmentative and Alternative Communication techniques into an individual form of work with the student and the impact of these activities on improving her behavior demonstrated. The experimental data presented in this article can be used for work with ISSI to increase the communication skills available to students with SMDD. Also, the article includes the description of the work on improvement of the qual- ity of life of adolescents with SMDD that are in inpatient institutional care. It has been established that children and adolescents with SMDD living in the ISSI have persistent impairments in mastering skills, identifying their com- munication mechanisms.

Features of Mobile Apps for People with Autism in a Post COVID-19 Scenario: Current Status and Recommendations for Apps Using AI.

The new ‘normal’ defined during the COVID-19 pandemic has forced us to re-assess how people with special needs thrive in these unprecedented conditions, such as those with Autism Spectrum Disorder (ASD). These changing/challenging conditions have instigated us to revisit the usage of telehealth services to improve the quality of life for people with ASD. This study aims to identify mobile applications that suit the needs of such individuals. This work focuses on identifying features of a number of highly-rated mobile applications (apps) that are designed to assist people with ASD, specifically those features that use Artificial Intelligence (AI) technologies. In this study, 250 mobile apps have been retrieved using keywords such as autism, autism AI, and autistic. Among 250 apps, 46 were identified after filtering out irrelevant apps based on defined elimination criteria such as ASD common users, medical staff, and non-medically trained people interacting with people with ASD. In order to review common functionalities and features, 25 apps were downloaded and analysed based on eye tracking, facial expression analysis, use of 3D cartoons, haptic feedback, engaging interface, text-to-speech, use of Applied Behaviour Analysis therapy, Augmentative and Alternative Communication techniques, among others were also deconstructed. As a result, software developers and healthcare professionals can consider the identified features in designing future support tools for autistic people. This study hypothesises that by studying these current features, further recommendations of how existing applications for ASD people could be enhanced using AI for (1) progress tracking, (2) personalised content delivery, (3) automated reasoning, (4) image recognition, and (5) Natural Language Processing (NLP). This paper follows the PRISMA methodology, which involves a set of recommendations for reporting systematic reviews and meta-analyses.

IMPROVING LISTENER RESPONDING SKILL USING BEE-BOT® IN AUTISM SPECTRUM DISORDER: CASE STUDY

Children with autism spectrum disorder may have a variety of communication deficits. Their communication difficulties include language delay, limited vocabulary, inability to speak words, echolalia or repetitive use of phonemes, words, or phrases, absence of eye-contact during communication, and poor non-verbal communication skills. Moreover, some of them are nonverbal so they have to learn how to communicate by using alternative and augmentative communication techniques. Some children on the spectrum in order to improve their receptive and expressive communication skills need to work on a highly structured therapeutic environment and others need to work on a natural environment. Educational robotics can be a successful tool for children on the spectrum in order to improve communicational skills. The main goal of this study is to implement Bee-Bot® robotic toy as a supportive tool for a child with autism in order to improve his listener responding skill across actions. The results showed that during speech and Applied Behavior Analysis intervention, the child improved his receptive skill in a more funny and educational way. Researchers identified that by using Bee-Bot®, the participant communicated intensively and participated to the activity more enthusiastically than using the traditional method of teaching at the table. Nevertheless, researchers should implement generalization and maintenance procedures to ensure that the participant will be able to apply the learned behavior and skill outside of the learning environment and continue to practice the acquired skill over time.
 
 <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0781/a.php" alt="Hit counter" /></p>

Evaluating the perspectives of those with severe physical impairments while learning BCI control of a commercial augmentative and alternative communication paradigm

ABSTRACT Augmentative and alternative communication (AAC) techniques can provide access to communication for individuals with severe physical impairments. Brain–computer interface (BCI) access techniques may serve alongside existing AAC access methods to provide communication device control. However, there is limited information available about how individual perspectives change with motor-based BCI-AAC learning. Four individuals with ALS completed 12 BCI-AAC training sessions in which they made letter selections during an automatic row-column scanning pattern via a motor-based BCI-AAC. Recurring measures were taken before and after each BCI-AAC training session to evaluate changes associated with BCI-AAC performance, and included measures of fatigue, frustration, mental effort, physical effort, device satisfaction, and overall ease of device control. Levels of pre- to post-fatigue were low for use of the BCI-AAC system. However, participants indicated different perceptions of the term fatigue, with three participants discussing fatigue to be generally synonymous with physical effort, and one mental effort. Satisfaction with the BCI-AAC system was related to BCI-AAC performance for two participants, and levels of frustration for two participants. Considering a range of person-centered measures in future clinical BCI-AAC applications is important for optimizing and standardizing BCI-AAC assessment procedures.

Vaccine decision-making among parents of children on Medicaid with and without autism spectrum disorder

BackgroundThe belief that there is a link between the MMR vaccine and autism has led to a decline in childhood-immunization uptake and a resurgence of preventable infectious diseases. This study aimed to understand how the vaccine decision-making process differed between parents with a child diagnosed with autism and parents with a child that did not have autism. MethodsInterviews were conducted in September–December 2018 with 24 racially and demographically diverse parents of children on Medicaid at two Baltimore clinics serving Medicaid patients, one of which only serves families of children with autism. We conducted a semi-structured, qualitative, in-person in-depth interview study to explore parental perceptions of vaccine-decision making. Interviews with participants were transcribed from audio recordings. We then extracted and analyzed the types of barriers each participant experienced. ResultsParent descriptions of their vaccine decision-making process focused on three primary factors: concerns about vaccines, the relationship between the child’s provider and the parent, and risk perception. These findings are in line with existing literature that has articulated key factors in the vaccine decision-making process generally. Parents of a child with autism were more likely to consider the idea that vaccines were linked to autism in their decision-making process, and were less likely to be influenced by personalized recommendations from the child’s health care provider. ConclusionParental concerns about vaccines, the parent-provider relationship, and vaccine risk perception all contribute to vaccine decision-making among parents of children with and without ASD. However, providers may find it especially difficult to manage parental misconceptions about vaccines and developmental disabilities. Future studies can identify alternative communication techniques and determine what mechanisms may be more effective in encouraging vaccine acceptance among parents of children with ASD.

An AAC Mobile-Based Application for People with Intellectual Disability: A Case Study in Brazil

Augmentative and Alternative Communication (AAC) techniques are employed to mediate communication with people who have communication disorders, as in cases of intellectual disability. Although there are various digital solutions that promote alternative communication options for individuals with communication disorders, only a few of them have been specifically designed or targeted to people with intellectual disability (ID). This work is motivated by the lack of AAC solutions contributing to the rehabilitation processes of individuals with intellectual disability in Brazil. The study presents a mobile-based AAC solution conceived as a tool to assist the rehabilitation process of people with ID. The design was based on user-centered design principles and accessibility standards. The System Usability Scale (SUS) questionnaire was used to evaluate the solution. Four specialists and twenty-five students participated in this study. The proposed solution shows the potential educational value for professionals who assist individuals with intellectual disability in Brazil.

Using Rich Pictures to Model the ‘Good Life’ in Indigenous Communities of the Tumucumaque Complex in Brazilian Amazonia

The primary objective of this paper is to examine how socio-ecological modeling efforts can use participatory visual methods to bridge cultural and linguistic differences among research participants and researchers. The growing number of case studies of indigenous communities highlights the need for methods that recognize and represent such communities’ distinctive realities while also establishing alternative communication techniques to enhance the participatory process. Using the Rich Picture method as a first step in a participatory modeling effort in the Tumucumaque Complex, a multicultural indigenous reserve in the Brazilian Amazon, our research specifically investigates how young adults envision the “good life” in Tumucumaque, including their perceptions of the elements most central to indigenous lifeways as well as the perceived roles of traditional cultural materials and modern industrial technologies. Finally, we make a critical assessment of the Rich Picture method, elucidating both its strengths and weaknesses while also addressing the, often underestimated, complexity of modeling culture in socio-ecological research.

Impact of the Sign Language for pediatric patients with a tracheostomy

The lack of verbal communication due to the tracheostomy is a great challenge for nurses because communication is an essential aspect for caring, which also involves parental figures in pediatric patients. Qualitative synthesis of the evidence to support learning and use of sign language in tracheostomised children in order to enhance the therapeutic relationship as well as communication between nurse and pediatric patient. We conducted a narrative review, the following databases were interrogated: PubMed (Medline), Cinahl, Scopus, Cochrane and Google Scholar. Studies related to the research question were included, without temporal limitation. 43 articles were selected and were subsequently grouped in relation to the type of study, description of specific teaching programs and recommendations. The use of alternative communication techniques is a priority for nurses who take care of tracheostomised children. Among these, undoubtedly, the sign language reveals its efficiency.

Os benefícios da oralização e da leitura labial no desempenho de leitura de surdos profundos usuários da Libras

RESUMO O aprendizado da leitura da língua portuguesa por surdos tem atraído estudiosos da área em virtude do fraco desempenho nessa habilidade apresentado pela maioria desses indivíduos. Este trabalho tem como objetivo principal averiguar se o uso da leitura labial e/ou da oralização como complemento à Língua Brasileira de Sinais (Libras) pode auxiliar no processo de aprendizagem da leitura do português. Trinta e sete surdos profundos, da comunidade surda brasileira, cursando do 7º ano do ensino fundamental ao 1º ano do ensino médio e com idade entre 12 e 18 anos, foram submetidos às Matrizes Progressivas de Raven, a uma entrevista semiestruturada e a dois testes de leitura. Todos os participantes são usuários da Libras, e 57% a complementam com meios alternativos de comunicação. Nossos dados sugerem que o desenvolvimento de habilidades como a leitura labial e a oralização facilitam o processo de leitura.

Speech, communication and use of augmentative communication in young people with cerebral palsy: The SH&PE population study

Communication is frequently impaired in young people (YP) with bilateral cerebral palsy (CP). Important factors include motoric speech problems (dysarthria) and intellectual disability. Augmentative and Alternative Communication (AAC) techniques are often employed. The aim was to describe the speech problems in bilateral CP, factors associated with speech problems, current AAC provision and use, and to explore the views of both the parent/carer and young person about communication. A total population of children with bilateral CP (n = 346) from four consecutive years of births (1989-1992 inclusive) with onset of CP before 15 months were reassessed at age 16-18 years. Motor skills and speech were directly assessed and both parent/carer and the young person asked about communication and satisfaction with it. Sixty had died, eight had other conditions, 243 consented and speech was assessed in 224 of whom 141 (63%) had impaired speech. Fifty-two (23% of total YP) were mainly intelligible to unfamiliar people, 22 (10%) were mostly unintelligible to unfamiliar people, 67 (30%) were mostly or wholly unintelligible even to familiar adults. However, 89% of parent/carers said that they could communicate 1:1 with their young person. Of the 128 YP who could independently complete the questions, 107 (83.6%) were happy with their communication, nine (7%) neither happy nor unhappy and 12 (9.4%) unhappy. A total of 72 of 224 (32%) were provided with one or more types of AAC but in a significant number (75% of 52 recorded) AAC was not used at home, only in school. Factors associated with speech impairment were severity of physical impairment, as measured by Gross Motor Function Scale level and manipulation in the best hand, intellectual disability and current epilepsy. In a population representative group of YP, aged 16-18 years, with bilateral CP, 63% had impaired speech of varying severity, most had been provided with AAC but few used it at home for communication.

A home‐based intervention using augmentative and alternative communication (AAC) techniques in rural Kenya: what are the caregivers' experiences?

Caring for a child with complex communication needs associated with a developmental condition frequently adds stress to the caregiver. Furthermore, professional assistance is scarce in low-income rural settings. For such children speech is frequently unachievable. Augmentative and alternative communication provides options for supplementing or replacing speech with other techniques. The current study aimed to examine the experiences of caregivers in Kenya before and after a home-based intervention using augmentative and alternative communication techniques with children with complex communication needs. Caregivers were interviewed pre- and post-intervention. The interviews were digitally recorded, transcribed and translated into English. Content analysis was applied through the stages of text familiarization and topic organization. Emergent themes and their sub-themes were identified and labelled. Connections between themes were established and interpretations made. The procedure was completed by a second researcher independently. Conflicting ideas were jointly discussed until consensus was achieved. Four themes emerged from the data: communication process; struggle; normality; and supernatural power. Before intervention, the caregivers acknowledged their expertise in communications with the child, while also revealing their sense of isolation, burden and pain. Normality was present as a source of comparison and also an aspirational goal. Post-intervention more positive language was used to describe the child. There was an 'opening up' of communication that recognized the child's strengths and some social support systems were re-established. The power of the supernatural was recognized before and after intervention. Caring of a child with complex communication needs presents many challenges. A home-based intervention using augmentative and alternative communication techniques appears to have been a catalyst for some positive transformations in the caregivers' experiences, although it is not possible to attribute this change to any one aspect. The potentials of the home-based intervention would benefit from further investigation on a larger scale.

Autism, communication and use of a speech‐generating device in different environments – a case study

PurposeThis paper aims to examine interaction patterns in two activities at home and one activity at school when a seven‐year‐old boy with autism and learning disabilities was supplied with a speech‐generating device (SGD).Design/methodology/approachActivity‐based communication analysis (ACA) was used as the basis for analysing and discussing of communicative behaviours in video recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn‐taking and communicative form, function and effectiveness. Conversational topics were also analysed.FindingsActivity characteristics seemed important for the outcome. In the two more structured activities (story reading at home and morning circle at school), the child could use the SGD to communicate more effectively within the given frames. During mealtime at home, topic length increased and the instruction to the parents to also use the SGD resulted in positive changes in this activity. ACA highlighted some important issues related to SGD intervention, such as use for expression of communicative needs and access to suitable vocabulary. There also seems to be a need for more guidance to communication partners with respect to the use of communicative strategies to support communication and machine‐mediated interaction.Originality/valueResearch of the effects of augmentative and alternative communication techniques used in natural interaction is almost non‐existent. This case study, therefore, is an important contribution to the field and provides some insights into the challenge of using an electronic device in natural interaction.

The Use of Computers and Augmentative and Alternative Communication Devices by Children and Young With Cerebral Palsy

The purpose of the study was to determine the use of computers and assistive devices amongst children with cerebral palsy (CP) and establish the satisfaction level of both users and educational staff. The study was carried out with 30 children with cerebral palsy. A questionnaire was designed to characterize the use of new technologies and assistive devices. Some of the questions were reserved for the teachers. Even though 29 users show some type of communication difficulty, only 4 users dispose of a computer-aided communication device, with the static symbolic board being the most widely used device (4). More than half of the participants (17) regularly use a computer, 16 of them requiring some type of assistive device. The perception of the teachers with regard to the use of Information and Communications Technologies (ICTs) in the classrooms is positive in 5 out of 6 cases. ICTs only provide assistance if their application is accompanied by the involvement of professionals and the child's social environment. The low use of Augmentative and Alternative Communication techniques along with the absence of communication codes reveal the need to establish training protocols. The inclusion of social, physical, and personal factors is considered essential in order to evaluate the needs for assistive technology.

Children with Autism Spectrum Disorders: Three Case Studies

Children with Autism Spectrum Disorders: Three Case Studies

Introdução da comunicação suplementar e alternativa na terapia com afásicos

Sabe-se que o tratamento fonoaudiológico de pacientes com afasia severa é limitado. A ausência de fala articulada, algumas vezes, impede o diagnóstico da afasia. O paciente "grave" pode não falar devido à inabilidade de articulação, como ocorre na disartria e/ou apraxia. Essa ausência de fala não permite afirmar se a linguagem está comprometida. O uso da comunicação suplementar e alternativa tem sido um método eficaz na reabilitação desses pacientes. Esse estudo visou descrever o uso da comunicação suplementar e alternativa associada a outras modalidades de linguagem (escrita, gestos), a partir do relato de dois casos de afasia. A análise dos dados foi composta por dois blocos: a introdução da comunicação suplementar e alternativa no diálogo; e o uso da leitura e escrita associado aos símbolos. A comunicação suplementar e alternativa foi um apoio para a oralidade, leitura e escrita dos pacientes.

Helpful vibrations: Assistive devices in hearing loss

Hearing loss should not mean the end for communication. Julie Swann explores the specialist devices and alternative communication techniques that can assist in overcoming hearing problems.

Supporting communication in the child with a learning disability

Learning disabilities can result from a range of genetic, social and specific medical conditions. In addition to a restricted ability to learn, children may present with speech, language or communication difficulties of varying degrees. Associated physical, hearing or visual impairments will influence the nature and course of language development. Best practice in this area involves collaborative working between families, education and health professionals directed towards agreed functional communication goals. Augmentative and alternative communication techniques, such as signing, symbols and communication aids, can have a major role in the development of effective social communication, appropriate behaviour and curriculum access.