Augmentative Communication Devices Research Articles

We All Need at Least One Friend Who Understands What We Do Not Say: A Scoping Review of Friendship and Augmentative and Alternative Communication.

The purpose of this scoping review was to understand what is known about the friendships of individuals who use augmentative and alternative communication (AAC) devices. Because communication is important to friendship, severe communication impairment may impact the establishment or maintenance of friendships in unique and important ways. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews and Covidence software using an established set of operationally defined inclusion criteria supported the identification of the 46 papers included in this review. Included papers presented original data on the friendships of individuals with disabilities (acquired and developmental) who could benefit from AAC across the lifespan. Data were extracted to identify features of the body of literature and to identify themes that could inform future research and clinical practice. Themes identified from the included studies related to how friendship is defined, supports for friendship formation and maintenance, help and care in friendships, positive outcomes, barriers, the impact of AAC, and recommendations for moving clinical practice and research forward. Friendships are chosen relationships that stem from congruences in perspectives between two individuals. People who use AAC, like the broader population, are likely to seek out and maintain friendships with people who are similar to them: people who share personality traits, past experiences (including experiencing disability), interests, and activities. Creative solutions are needed to increase the independence of disabled children and adults to meet and engage with new people with a variety of lived experiences. https://doi.org/10.23641/asha.28119857.

Reimagining AAC designs for children during dynamic social situations by leveraging smart device design.

Social interaction plays a pivotal role in human development, influencing cognitive, emotional, and communicative growth across all stages of life. Integrating augmentative and alternative communication (AAC) devices into social interactions, especially during dynamic activities such as play, introduces cognitive complexity. This forum explores leveraging smart device design and technology to help integrate AAC into dynamic social interactions, focusing specifically on play. Using the framework of interactivity and simplicity, which are important elements for improving usability of smart devices, we provide example applications of how smart device features such as multimodal control, animation, artificial intelligence, contextual awareness, and augmented reality may be applied to AAC to promote dynamic interactions and support communication partners. Our aim is to inspire advancements in AAC that prioritize playfulness, inclusivity, and children's unique needs. We intend to encourage future discussions and research that incorporate AAC users' perspectives and support networks, fostering optimal integration of AAC tools into playful activities to support communication and social development.

Health Challenges in Conscious Intubated Patients-Concept Review

Patients benefit from maintaining consciousness throughout intubation; but, they may experience a variety of adverse physical and mental consequences, such as pain, dyspnea, and fear, and helplessness, loss of control, speech difficulties, and anxiety. The physical and psychological well-being of cognizant intubated patients is adversely affected by communication difficulties. Health care professionals tackle this matter by utilizing a range of available communication instruments in addition to traditional approaches such as assessing through sign languages and gestures. Enhancing communication between healthcare professionals and conscious intubated patients can be achieved through the use of Augmentative and Alternative Communication (AAC) devices, which are readily available. While there are various communication aids at the disposal of clinical caregivers, they should utilize the most patient-centric communication technologies possible, despite the fact that several alternatives exist.

Teleintervention for users of augmentative and alternative communication devices: A systematic review.

https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.15387

How do soundboard-trained dogs respond to human button presses? An investigation into word comprehension.

Past research on interspecies communication has shown that animals can be trained to use Augmentative Interspecies Communication (AIC) devices, such as soundboards, to make simple requests of their caretakers. The recent uptake in AIC devices by hundreds of pet owners around the world offers a novel opportunity to investigate whether AIC is possible with owner-trained family dogs. To answer this question, we carried out two studies to test pet dogs' ability to recognise and respond appropriately to food-related, play-related, and outside-related words on their soundboards. One study was conducted by researchers, and the other by citizen scientists who followed the same procedure. Further, we investigated whether these behaviours depended on the identity of the person presenting the word (unfamiliar person or dog's owner) and the mode of its presentation (spoken or produced by a pressed button). We find that dogs produced contextually appropriate behaviours for both play-related and outside-related words regardless of the identity of the person producing them and the mode in which they were produced. Therefore, pet dogs can be successfully taught by their owners to associate words recorded onto soundboard buttons to their outcomes in the real world, and they respond appropriately to these words even when they are presented in the absence of any other cues, such as the owner's body language.

Smart Predict: adding partner-suggested vocabulary to increase efficiency in a dual tablet AAC typing application

Smart Predict is a novel two-tablet application developed to improve conversational efficiency for people who use augmentative and alternative communication (AAC) devices. The Smart Predict system consists of two distinct applications that were built for use with two Android tablets and/or phones with Bluetooth® capability. One application is referred to as the AAC User app and the second application is called the Partner app. Smart Predict integrates vocabulary supplementation from communication partners in real-time while persons who rely on AAC generate text and maintain full control to choose words within a word prediction line. Using single-case research designs with adapted alternating treatments under two counterbalanced treatment conditions (AAC User app alone versus AAC User app + Partner app), we examined message efficiency with persons who rely on switch scanning for on-screen keyboards. User experience questionnaires were administered to determine satisfaction and workload, and to provide feedback for future development efforts. Three adults with complex communication needs and motor impairments conversed with research staff about fourteen movie trailers. Characters per minute and switch selections per character produced by the person with complex communication needs and motor impairments were measured during 15-minute interviews to represent communication speed and effort. Results indicate that message efficiency increased with the dual-tablet Smart Predict, indicating faster message generation with the vocabulary supplementation system. User satisfaction increased and perceived effort decreased under the Smart Predict conditions. Given these results within a research and development framework, the Smart Predict concept is a viable feature that could be considered within smart AAC technologies.

Dyadic Training of Communication Partners for Autistic Students: A Feasibility Study

Access to communication is a primary challenge affecting the education of Autistic students who use augmentative and alternative communication devices. This is compounded by potential communication partners (e.g., teachers and classroom paraeducators) who have insufficient training and skills to meaningfully engage these students in communication. To address these deficits in skills and training, this feasibility study used a multiple probe across participants design to test the effects of using behavioral skills training on dyads of teachers and paraeducators in increasing teacher-delivered opportunities to respond and student communication responses. The results show that after training, teachers’ opportunities to respond and use student-specific strategies increased. Following the teachers’ implementation of the strategies, students’ prompted and unprompted communication increased. These results provide evidence that supports the use of behavioral skills training to support communication partner skill development and student communication needs. These methods showed positive social validity with participants and demonstrate a professional development method that is more feasible for use by school staff than individual training. The results of this study provide initial evidence of the effectiveness of these methods with dyads of participants as well as with licensed teachers, extending the extant research, which often focuses on the individual training of paraeducators.

Comparing and contrasting barriers in augmentative alternative communication use in nonspeaking autism and complex communication needs: multi-stakeholder perspectives.

Augmentative alternative communication (AAC) devices or systems are often prescribed to minimally verbal or nonspeaking autistic individuals and other individuals with complex communication needs to facilitate communication or as an alternative to spoken language. AAC use can result in communication gains and improved quality of life for minimally verbal or nonspeaking individuals. Despite this, AAC abandonment is high, limiting societal participation of the individual on the autism spectrum with complex communication needs. Our study is a novel exploration of the barriers of AAC use from a multi-stakeholder perspective, and a qualitative analysis of similarities and differences between stakeholders. We conducted semi-structured interviews and focus groups with 30 parent-carers, educators and clinicians currently supporting AAC users in Western Australia and analysed the data using reflexive thematic analysis. Barriers from each stakeholder group were coded, resulting in 17 subthemes forming five main themes common to all stakeholders: Stakeholder Knowledge, Stakeholder Attitudes and Stigma, Resources, AAC User Engagement, and Device Fit. Contrasting perspectives included actual and perceived stigma associated with AAC use (parent-carers vs clinicians); different struggles with resources and knowledge (parent-carers vs clinicians and educators); and a lack of clinician communication in the processes that determined AAC-fit for school environments (educators only). Findings are discussed in the context of improving inter-stakeholder collaboration and capacity building in Australian health service and practice to better support minimally verbal or nonspeaking autistic individuals and individuals with complex communication needs. Suggestions are also offered for communication partner training.

Nonverbal Communication through Expressive Objects

Augmentative and alternative communication (AAC) devices enable speech-based communication, but generating speech is not the only resource needed to have a successful conversation. Being able to signal one wishes to take a turn by raising a hand or providing some other cue is critical in securing a turn to speak. Experienced conversation partners know how to recognize the nonverbal communication an augmented communicator (AC) displays, but these same nonverbal gestures can be hard to interpret by people who meet an AC for the first time. Prior work has identified motion through robots and expressive objects as a modality that can support communication. In this work, we work closely with an AAC user to understand how motion through a physical expressive object can support their communication. We present our process and resulting lessons on the designed object and the co-design process.

Assessing Language and Literacy of Students with Developmental Disabilities and Complex Communication Needs

Students with developmental disabilities and complex communication needs are impacted by assessments that may not show their ability or address their needs. Multiple modes of assessment presentation and response formats, augmentative and alternative communication approaches, and assistive technology may help students engage more equitably in literacy assessment activities. The Nonverbal Literacy Assessment (NVLA) is an example of a tool used to assess the language and literacy skills of students with disabilities in various formats. Augmentative and Alternative Communication (AAC), eye-gazing, and speech-generating device (SGD) technology are also used to make assessment more accessible to students with developmental disabilities and speech difficulties.

A speech-to-symbol app for supporting communication partner to model and improve vocabulary

In order to meet the communication needs of individuals who use Augmentative and Alternative Communication (AAC) devices, communication partners are often responsible for the programming of the AAC devices. However, the prolonged learning time and operational demands of AAC devices are often barriers to an efficient use of time during a therapy session. We developed a prototype app for iPad, called Speech-to-Symbol that decreases the programming time by finding pictures stored in the app using speech-to-text technology. We compared our solution to the TalkTablet app during AAC sessions with children with different communication disabilities. The aims of this study were 1) to compare the time to program both apps, 2) to identify the type of vocabulary used, and 3) to assess the usability of the two apps. Results showed that the reduced operational demands of our Speech-to-Symbols app allow communication partners to expose children to a larger and more diverse vocabulary. In addition, the communication partners gave our Speech-to-Symbols app a higher usability rating. Implications for clinical and educational settings and directions for future research are also discussed.

Language modeling using an augmentative and alternative communication device during virtual schooling: A single case study

Aided augmentative and alternative communication (AAC) modeling is an important approach to facilitating language learning for individuals with complex communication repertoires. This study examines the implementation of this approach during COVID-19 virtual schooling. Key implementation challenges are identified, along with implications for educational practice to facilitate language learning. We conducted a qualitative case study of a 5-year-old child with Rett syndrome, a rare neurological disorder, who used an eye-tracking AAC device. We collected and triangulated data using participant observation of three one-on-one story reading sessions involving the child, her caregiver, and her teacher during virtual schooling as well as a semi-structured interview with the teacher. The study identified key steps for successful language modeling during virtual sessions. These included: ensuring access to the device, promoting attention through gestural and verbal prompts, providing modeling of AAC symbols, confirming responses, providing feedback, using visual supports, a collaborative approach, and positive reinforcement. Our findings suggest these strategies can help facilitate effective language development for children using AAC devices in online schooling contexts. The virtual context presented significant barriers to the practice of aided AAC modeling. Active participation of caregivers and teacher–caregiver collaboration is essential for effective implementation of aided AAC modeling during such schooling.

High-Tech Augmentative and Alternative Communication Devices: Observing Children’s Need for Help and Interaction with Caregivers

There are many children with disabilities who need specialised devices to communicate and to be understood, which poses an added challenge for their caregivers. This study aims to diagnose the training needs of informal caregivers concerning high-tech devices for augmentative and alternative communication (AAC), to enhance the use of these devices in the home setting. The aim is to study children’s performance and their interaction with caregivers, to improve practices and contribute to reducing technology abandonment at home. Participant observation sessions were carried out in three home settings to describe the interaction between children and their caregivers, as well as to assess the former’s need for assistance in using the Grid3 software when combined with eye-gaze-controlled technology. The findings seem to demonstrate the importance of interactions between caregivers and children for carrying out tasks and improving performance. Therefore, it can be inferred that positive reinforcement is important to foster children’s motivation to overcome difficulties in using such devices, along with corrective feedback. The data suggest the need to promote technology-mediated communicative interaction in all life contexts. It is also possible to infer that the lack of regular device use at home compromises skills development. These findings have contributed to the planning and implementation of parental training intervention regarding using assistive technology for augmentative and alternative communication.

Where is Community Involvement in Open Science? A Commentary on "(Why) Are Open Research Practices the Future for the Study of Language Learning?"

Where is Community Involvement in Open Science? A Commentary on "(Why) Are Open Research Practices the Future for the Study of Language Learning?"

Use of Augmentative Interspecies Communication devices in animal language studies: A review.

Countless discussions have been generated by the animal language studies, specifically those utilizing mechanical interfaces, termed here Augmentative Interspecies Communication (AIC) devices (e.g., lexigrams; magnetic chips; keyboards). Overall, three concerns dominate the field: (1) claims that AIC device using animals manifest linguistic skills remain nebulous, and simpler alternative mechanisms have been proposed (e.g., associative learning); (2) such methodology may be unsuitable as some theorize AIC device interfaces are not sufficiently ecologically relevant to foster meaningful use; (3) data may be considered dubious due to potential cueing from experimenters and lack of systematicity in reporting training and performance. Despite such controversy-which eventually led to the field's deterioration around the last quarter of the twentieth century-this research also saw important successes, such as improvements in captive animal welfare, the outcomes of which hold promise for future interspecies communication work. This article is categorized under: Linguistics > Evolution of Language.

Chinese-English speaking family perspectives of augmentative and alternative communication use with their children.

Culturally and linguistically diverse families who have children with complex communication needs (CCN) often have limited access to augmentative and alternative communication (AAC) devices and interventions due to the lack of services that acknowledge their families' cultural and linguistic needs. Despite the increasing need for culturally responsive services, little is known about Chinese-English speaking families' perspectives and experience related to AAC use and services. The objective of this study was to understand the perspectives and experiences of Chinese-English speaking family members of children who use AAC use. This study employs a qualitative descriptive methodology approach. The researchers conducted individual or group semi-structured interviews with 10 adult family members (mother, father, and grandparent) from four Chinese-English speaking families in the U.S. and Canada who have a child who uses AAC (ages 3-8). Chinese-English speaking families have high acceptance and satisfaction with their child's AAC as long as they see the benefits of the AAC system. Mothers and siblings play unique roles in supporting home AAC practice given frequent engagement with and observed influence on the child who uses AAC. Family members indicated goals in building stronger family connections, but noted that the child's speech difficulties interfered with this goal. Chinese-English speaking families felt they can overcome limitations resulting from lower English language proficiency, but still find difficulties in obtaining resources because of the Western expectations of advocacy. Additionally, service providers' lack of responsiveness related to family goals could prevent families in obtaining AAC resources. The findings suggest the need for family-centered services with cultural sensitivity and humility for those serving Chinese-English speaking families with children who use AAC. Additionally, involving family members beyond the mother within services may improve both family functioning and child communication.

A decision support system for selecting augmentative and alternative communication devices

The goal of this research is to improve access to services for patients in need of augmentative and alternative communication (AAC). The specific aim of this paper is to develop a decision-making model that evaluates an exhaustive list of AAC devices and recommends the best alternative(s) for the patient. The model maximises a best-fit function that considers the patient's disability profile and the capabilities of each device. Currently, there are multiple private and government companies that offer a large variety of devices targeting patients in need of AAC. However, the decision-making process of what device to try on the patient is largely based on the health professional's experience and familiarity with specific companies. The proposed decision-model has the capability of improving patient experience of care by reducing the assessment time required to find the best device.

Using the ICF Framework to Assess Communicative Competence in Dyadic Communication among Children and Adolescents Who Use Augmentative and Alternative Communication Devices in Taiwan.

Augmentative and alternative communication (AAC) devices enable children and adolescents (CAD) with communication disorders to communicate competently and develop friendships through communicative competence (CC). Existing assessment tools are unable to indicate whether CAD aged 0 to 18 years would competently use the subsidized AAC devices provided by the Ministry of Health and Welfare in Taiwan. This study, thus, aimed to develop an assessment tool by using the International Classification of Functioning, Disability and Health (ICF) to measure CC in dyadic communication among CAD using AAC devices. Five speech-language pathologists (SLPs), five special education teachers, and four AAC experts (14 in total) selected codes relevant to the four domains of CC via the Delphi method. Next, they categorized the selected codes into one of the four domains of CC through a face-to-face expert panel. A total of 112 codes were listed in the tool and fully classified into the four domains of CC. Among these, seven codes were concurrently placed under two domains of CC. Consequently, this study developed an assessment tool by employing the ICF for children and youth core set using universal qualifiers to measure the relative levels of CC in dyadic communication among CAD who use AAC devices in their daily life.

Writing Blindly in Incomplete Locked-In Syndrome with A Custom-Made Switch-Operated Voice-Scanning Communicator—A Case Report

Locked-In Syndrome (LIS) is a rare neurological condition in which patients' ability to move, interact, and communicate is impaired despite their being conscious and awake. After assessing the patient's needs, we developed a customized device for an LIS patient, as the commercial augmentative and alternative communication (AAC) devices could not be used. A 51-year-old woman with incomplete LIS for 15 years came to our laboratory seeking a communication tool. After excluding the available AAC devices, a careful evaluation led to the creation of a customized device (hardware + software). Two years later, we assessed the patient's satisfaction with the device. A switch-operated voice-scanning communicator, which the patient could control by residual movement of her thumb without seeing the computer screen, was implemented, together with postural strategies. The user and her family were generally satisfied with the customized device, with a top rating for its effectiveness: it fit well the patient's communication needs. Using customized AAC and strategies provides greater opportunities for patients with LIS to resolve their communication problems. Moreover, listening to the patient's and family's needs can help increase the AAC's potential. The presented switch-operated voice-scanning communicator is available for free on request to the authors.

Social Validity, Cost, Acceptability, and Feasibility of Augmentative and Alternative Communication Devices Used for Individuals With Autism Spectrum Disorder and Intellectual Disability: A Systematic Review

Purpose: The authors conducted a systematic review of single-case experimental designs that included individuals with autism spectrum disorder and/or intellectual disability who used speech-generating devices (SGDs) for communication. The purpose of this study was to review subjective and normative pre- and post-intervention social validity data, in addition to the cost, acceptability, and feasibility of the SGDs used in the studies. The authors also studied trends in the reporting of pre- and post-intervention data over time. Method: A systematic review of 7,327 articles resulted in 86 articles that met design quality criteria and included participants who used SGDs. A group of raters completed interrater reliability for all stages of the review. Results: Researchers reported more subjective than normative data. Few studies reported on the price of the SGD or the person who purchased the SGD. More researchers reported using an SGD with more than one use, but few solicited feedback about the SGD used during the intervention. Few researchers reported information about the portability of the device or the operation effort. Conclusions: Reporting on social validity represents a substantial limitation in experimental studies. Future work incorporating less biased/more objective measures is important for the creation of socially valid interventions.