Augmentative Communication Research Articles

Intervention and Sampling Trends in Literacy Research for Young Augmentative and Alternative Communication Users: A Scoping Review.

This scoping review aims to characterize the body of literature addressing literacy interventions involving young children (ages 2-8 years) who use or would benefit from aided augmentative and alternative communication (AAC). A systematic search was conducted in six databases. The search yielded 33 intervention studies. Participant characteristics (i.e., age, gender, communication profile) were charted along with intervention characteristics (i.e., focus, outcome variables, settings, interventionists, aided AAC materials). Findings provide insight into intervention and sampling trends. Specifically, studies predominantly investigated shared reading interventions to support expressive communication with children who were already symbolic communicators. There was a noticeable lack of studies involving children with multiple disabilities including intellectual disabilities. The review highlights the necessity for more inclusive research that represents the diverse communication and disability profiles of young children who use or would benefit from aided AAC. Future studies should aim to include participants with varying abilities and access methods. Additionally, the emphasis on emergent literacy, particularly shared reading, should be expanded to include comprehensive emergent literacy skills such as generative writing, phonological awareness, and language comprehension. This broader focus will better support the literacy development of young children who use or would benefit from aided AAC.

Soundboard-trained dogs produce non-accidental, non-random and non-imitative two-button combinations

Early studies attempting interspecies communication with great apes trained to use sign language and Augmented Interspecies Communication (AIC) devices were limited by methodological and technological constraints, as well as restrictive sample sizes. Evidence for animals’ intentional production of symbols was met with considerable criticisms which could not be easily deflected with existing data. More recently, thousands of pet dogs have been trained with AIC devices comprising soundboards of buttons that can be pressed to produce prerecorded human words or phrases. However, the nature of pets’ button presses remains an open question: are presses deliberate, and potentially meaningful? Using a large dataset of button presses by family dogs and their owners, we investigate whether dogs’ button presses are (i) non-accidental, (ii) non-random, and (iii) not mere repetitions of their owners’ presses. Our analyses reveal that, at the population level, soundboard use by dogs cannot be explained by random pressing, and that certain two-button concept combinations appear more often than expected by chance at the population level. We also find that dogs’ presses are not perfectly predicted by their owners’, suggesting that dogs’ presses are not merely repetitions of human presses, therefore suggesting that dog soundboard use is deliberate.

Utilizing Augmentative and Alternative Communication and a Mixed Therapy Approach to Address the Complex Communication Needs for a Patient With Cleft Palate, Velopharyngeal Insufficiency, Spina Bifida, and 16p11.2 Deletion Syndrome

Utilizing Augmentative and Alternative Communication and a Mixed Therapy Approach to Address the Complex Communication Needs for a Patient With Cleft Palate, Velopharyngeal Insufficiency, Spina Bifida, and 16p11.2 Deletion Syndrome

Bridging the Gap: Insights From Telepractice Augmentative and Alternative Communication Services in the Digital Age

Purpose: The United States Society for Augmentative and Alternative Communication and the Patient-Provider Communication Network sought to quantify the impact of utilization of and access to telepractice for the provision of augmentative and alternative communication (AAC) services. The purpose of this article is to summarize findings from two surveys that explored the kinds of AAC services delivered remotely, barriers to AAC addressed through telepractice, and impact of the availability of remote AAC services on people with communication disabilities and their caregivers. Method: The study team developed two online surveys: (a) for speech-language pathologists (SLPs) and (b) for individual AAC clients (or family members in the case of pediatric clients). Results: Survey responses were obtained from 66 SLPs and 90 AAC clients/family members. Access to telepractice allowed clients/family members to overcome both access and financial barriers. Respondents indicated that the availability of AAC telepractice services reduced transportation barriers, increased access to services by appropriately trained clinicians, and improved the outcomes for individuals needing AAC. Conclusions: Telepractice has made it possible for individuals with significant medical challenges, as well as those residing in areas lacking qualified providers, to receive services. Given that both clinicians and clients/families indicated that travel to receive services posed a significant barrier to access medically necessary treatment, the anticipated December 2024 end of Centers for Medicaid and Medicare Services' authorization of reimbursement for telepractice services will be detrimental to many needing AAC services. Supplemental Material: https://doi.org/10.23641/asha.27885447

School staff perspectives on using augmentative and alternative communication with students with severe or profound intellectual and multiple disabilities

AbstractThis mixed methods survey study aims to investigate school staff's perspectives on using augmentative and alternative communication (AAC) with students with the most severe disabilities in Swedish school settings. The study employed a convergent mixed methods design, where both quantitative and qualitative data were collected and analysed in parallel and then integrated and compared in the discussion and conclusion section of the paper. The study's respondents consisted of school staff who worked with students with severe or profound intellectual and multiple disabilities (S/PIMD) in Swedish schools. Results showed that almost all staff reported using AAC with students at least half of the time. The frequency of AAC use did not seem to differ between staff with different educational backgrounds, apart from teachers/special educators appearing slightly more inclined to use AAC in planned classroom activities when compared to staff with other educational backgrounds. The results also corroborate previous research stating that collaboration between stakeholders (such as school, family and the habilitation services) is fundamental to successful AAC implementation but that there are challenges when establishing efficient collaborations between stakeholders.

Intention to Adopt Digitalized Augmentative and Alternative Communication by Applying the UTAUT Model

ABSTRACT The purpose of this study was to identify the factors that influence teachers’ behavioural intention to adopt digitalised augmentative and alternative communication (AAC) using the unified theory of acceptance and use of technology (UTAUT) model. Using survey data collected from 337 special education teachers in Korea, this study identified social influence, and facilitating conditions as the factors that positively affect behavioural intention to use high-tech AAC devices. The results also indicated that teachers’ efforts for teaching expectancy had no effect on behavioural intention to use them. However, the result suggested that teachers were rather willing to use high-tech AAC devices with performance expectancy of them, social influence and facilitating conditions even though teachers recognised that using the AAC tools relative to students’ abilities required too much effort.

Automated error detection and correction in Augmentative and Alternative Communication (AAC) Systems Using NLP

Automated error detection and correction in Augmentative and Alternative Communication (AAC) Systems Using NLP

Alternative and Augmentative Communication (AAC) in Remote and Rural Settings in India: Challenges and Solutions

Alternative and Augmentative Communication (AAC) in Remote and Rural Settings in India: Challenges and Solutions

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.

Parental expectations and perceptions of augmentative and alternative communication: A Sri Lankan perspective.

Everybody has a right to communicate in any way they can, which includes augmentative and alternative communication. The uptake of augmentative and alternative communication in everyday life may be influenced by awareness, perceptions and acceptance of augmentative and alternative communication by caregivers, family members and the wider society. This study aimed to uncover what parents thought about augmentative and alternative communication in a Global South context. Eleven mothers and five fathers (16 participants) of children with complex communication needs were included. Data were collected using an interview guide from a focus-group discussion and semi-structured interviews. The data were analysed using Framework Analysis and from a gender and critical disability theory viewpoint. The key theme found was fear of augmentative and alternative communication stopping the child from learning to speak. The parents wondered if siblings might also use the alternative communication method and stop talking. They worried whether the communication device will negatively highlight their child in society. As parents' views on augmentative and alternative communication influence whether they use it with their child, informing and preparing parents before introducing augmentative and alternative communication to a child and on-going parent training should be considered.

Exploring core competencies for language facilitation in parent training programs in AAC

The relationship between children and their caregivers is essential for the development of social, emotional, cognitive, and linguistic skills. This is especially critical for children with complex communication needs who use augmentative and alternative communication (AAC), as parents play a crucial role in supporting AAC integration within the home. However, communicating with a child who uses AAC does not come naturally and requires the learning of several specific skills. Various training programs have shown that, with appropriate training, parents and caregivers can develop the skills necessary to become effective communication partners and support the use of AAC at home. This paper analyzes the overlap between existing parent training programs in AAC to identify the core competencies essential for parents and caregivers to become effective communication partners. By extracting these fundamental skills, this paper aims to guide practitioners in the design of effective parent training sessions. Key strategies include responsivity, environmental arrangements, wait time, aided modeling, prompting, and appropriate feedback.

Making my voice and owning its future

This article explores disabled experience and the future of technologies relating to augmentative and alternative communication (AAC). This field includes people’s use of AAC devices, typically in combination with other...

Communication Prototype for Post-Stroke Patients Using Electrooculography (EOG)

Background this prototype is intended for post-stroke patients experiencing disabilities in their daily activities, particularly in communication with others. The challenge they face is difficulty in communication, leading to a diminished quality of life for post-stroke patients. The purpose of innovating this communication aid prototype is to facilitate communication between post-stroke patients and caregivers. The method employed in the post-stroke communication aid prototype utilizes Electrooculography (EOG) signals generated from eye muscle movements during eye gazes, captured by the MaM Sense sensor. The variation in Analog-to-Digital Converter (ADC) values in the MaM Sense sensor is exploited to produce various forms of EOG signals. The resultant command signals from this method are processed by a microcontroller and displayed on a 20 x 4 Character LCD. Testing was conducted on 9 healthy individuals, comprising 5 males and 4 females. To ensure the prototype's functionality, testing was also performed on 1 post-stroke patient. The success rate of MaM Sense sensor readings was 80.5% for the 4 communication modes employed, involving 4 eye gaze movements: right gaze, left gaze, upward gaze, and downward gaze. Thus, the post-stroke communication aid prototype proves effective in assisting communication for post-stroke patients and aiding caregivers in understanding the patients' desires. In the future, a wireless system may be implemented for the acquisition of EOG signals attached to the face to minimize the use of cables.

Use of Augmentative and Alternative Communication Technology to Retrain Attention and Enhance Functional Communication Following Severe Traumatic Brain Injury: A Clinical Case Report

Purpose: This case report outlines the use of high-tech assistive technology in the form of an augmentative and alternative communication device to assess and treat a veteran with severe speech, language, and cognitive impairments status post severe blast injury. Method: The patient is a right-handed male Veteran of the United States Marine Corps who sustained catastrophic injury after stepping on a dismounted improvised explosive device. He presented to the outpatient clinic 4 years status post injury for continued speech, language, and cognitive interventions. Based on assessments and observations, the patient was diagnosed with spastic anarthria, probable apraxia of speech, aphasia, and attentional impairments. His functional communication was restricted to limited facial expression and eye movements interpreted by those who knew him well. This case reviews the detailed informal and novel assessment techniques and training methods used to implement high-tech assistive technologies as part of the rehabilitation plan designed to enhance functional communication. Results: Through systematic instruction and retraining visual and sustained attention, the patient was able to engage meaningfully with a high-tech device to increase functional personal choice when supported by a partner. Conclusion: This case demonstrates the role high-tech assistive technologies can play in the rehabilitation and functional communication efforts for persons with severe traumatic brain injury and cerebrovascular accidents.

Brain-computer interface applications in the aging population with Alzheimers and Parkinsons disease

Abstract. The rapidly aging population faces increasing prevalence of neurodegenerative conditions like Alzheimer's Disease (AD) and Parkinson's Disease (PD), which significantly impair cognitive and motor functions. There is an urgent need for increased research, awareness, and development of effective treatments to mitigate their impact on the affected individuals and their families. This paper delves into the history, mechanisms, and applications of brain-computer interfaces (BCIs) as innovative solutions to mitigate these impacts. BCIs enable direct brain-to-device communication, circumventing conventional neuromuscular routes. We highlight how neurofeedback and neuroplasticity facilitated by BCIs not only restore motor skills and cognitive functions but also enhance the overall quality of life for sufferers. Through applications in cognitive training, motor assistance, and advanced communication aids, BCIs present a significant promise despite the ethical and practical challenges they pose. The continual advancement of this technology promises to a future when its incorporation into treatment plans will be widely used and provide significant advantages for those with PD and AD.

Socio-Communicative Behaviors Involving Minimally Speaking Autistic Preschoolers and Their Typically Developing Peers: Effects of an Augmentative and Alternative Communication Intervention Package.

The purpose of this study was to examine the effectiveness of an augmentative and alternative communication (AAC) intervention package consisting of systematic instruction and aided AAC modeling with speech-output technology on the acquisition, maintenance, and generalization of socio-communicative behaviors in four minimally speaking, preschool-aged, autistic children. A multiple-probe design across behaviors (i.e., initiating a request for a turn, answering questions, and commenting) replicated across participants was implemented to evaluate the effects of the intervention package on socio-communicative behaviors. Furthermore, a pretreatment and posttreatment multiple-generalization-probe design was used to assess generalization across typically developing peers who were not a part of the intervention. Maintenance data were collected 3 weeks post intervention. Visual analysis, corroborated by nonoverlapping of all pairs statistics, established a strong functional relationship between the AAC intervention package and all targeted socio-communicative outcomes for two participants. For the other two participants, inconsistent intervention effects were observed. In terms of generalization from interacting with the researcher to typically developing peers, a functional relationship between the intervention and generalization outcomes for all targeted behaviors was established for only one participant (i.e., Aiden). The outcomes of this study suggest that aided AAC modeling and systematic instruction using a speech-output technology may lead to gains in socio-communicative behaviors in some minimally speaking, preschool-aged, autistic children. https://doi.org/10.23641/asha.27091879.

Using large language models to accelerate communication for eye gaze typing users with ALS

Accelerating text input in augmentative and alternative communication (AAC) is a long-standing area of research with bearings on the quality of life in individuals with profound motor impairments. Recent advances in large language models (LLMs) pose opportunities for re-thinking strategies for enhanced text entry in AAC. In this paper, we present SpeakFaster, consisting of an LLM-powered user interface for text entry in a highly-abbreviated form, saving 57% more motor actions than traditional predictive keyboards in offline simulation. A pilot study on a mobile device with 19 non-AAC participants demonstrated motor savings in line with simulation and relatively small changes in typing speed. Lab and field testing on two eye-gaze AAC users with amyotrophic lateral sclerosis demonstrated text-entry rates 29–60% above baselines, due to significant saving of expensive keystrokes based on LLM predictions. These findings form a foundation for further exploration of LLM-assisted text entry in AAC and other user interfaces.

Imagining alternative futures with augmentative and alternative communication: a manifesto.

This manifesto seeks to challenge dominant narratives about the future of augmentative and alternative communication (AAC). Current predictions are mainly driven by technological developments-technologies usually being developed for different markets-and are often based on ableist assumptions. In online conversations and a discussion panel at the 2023 International Society for Augmentative and Alternative Communication conference, we explored alternative futures by adopting different starting positions. Our case is presented under five headings: questioning the dominance of predictions that artificial intelligence and brain-computer interfaces will define the future of AAC; resisting disability being framed medically, as a problem to be solved, yet acknowledging both the pleasures and pains of being disabled; declaring that people who use AAC-as cyborgs of necessity rather than choice-should have choice and ownership of our technologies; challenging notions of independence as the necessary end goal for disabled bodies and considering interdependence as a human right; imagining alternative futures in which all people who use AAC are accepted and embraced for our communication and self-expression. This manifesto is an invitation for further discussion, and we welcome responses. While our focus is AAC, and three of the authors use AAC, we believe that our stance could be relevant to other disability communities in turn. This paper is about who gets to imagine disability futures and whose voices are left out. It is about how uncritical these futures can be, often presuming values that disabled people, in all their diversity, may not share.

An Audit of General Surgery Clinical Records (2021) in Ribat University Hospital, Sudan.

Documentation is critical for effective patient management in hospitals, serving essential roles in improving patient care continuity, supporting clinical decisions, and fulfilling legal requirements. Comprehensive documentation not only aids in communication among healthcare providers but also serves as a vital record of patient history, facilitating accurate diagnosis and treatment. Clinical audits are systematic evaluations that compare current patient care practices against established criteria, helping identify deficiencies and promote adherence to quality standards. By increasing awareness of documentation practices, such audits can elevate the overall standard of clinical records, leading to improved patient care and safety. This is particularly important for healthcare professionals, as accurate records are essential for licensing and certification, as well as for demonstrating the delivery of quality care. This study aimed to conduct a medical audit of inpatient medical records in the General Surgery Department atRibat University Hospital to assess the documentation quality and improve patient outcomes. A cross-sectional study was performed on 518 long-stay medical records from Ribat University Hospital in 2021. A quantitative approach was used, employing a structured checklist of 26 points as the audit tool. Documentation was largely incomplete, with significant deficiencies identified: patient full name (17.6%), admission policy (21%), admission time (2%), treatment plan approval (2%), and discharge summary (4.4%). Better documentation was found for admission dates (86.3%), medical histories (81.5%), and diagnoses (87%). Accurate and comprehensive medical record documentation is essential for quality care. This audit revealed major areas needing improvement in the General Surgery Department, emphasizing the need for initiatives to enhance documentation practices.

Ability to Select AAC Graphic Symbols by Severity of Alzheimer’s Disease and Number of Symbols

Purpose: This study aimed to examine the graphic-symbol selection ability of patients with dementia of Alzheimer's type (DAT) based on the severity of dementia by conducting symbol identification and symbol discrimination tasks with increasing numbers of symbols. These tasks were performed with both normal elderly individuals and DAT patients to explore how cognitive load affects them differently.Methods: A total of 21 normal elderly individuals, 17 mild DAT patients, and 20 moderate to severe DAT patients were assessed. They performed symbol identification and symbol discrimination tasks using the Augmentative and Alternative Communication Symbol Assessment Tool. The number of symbols increased in six steps, from 4 to 72. Accuracy and response time were measured for statistical analysis.Results: In the symbol identification task, there was no significant difference in accuracy among the three groups. However, normal group showed significantly faster responses compared to moderate to severe DAT group. In the symbol discrimination task, normal group showed higher accuracy and significantly faster responses than moderate to severe DAT group. As the number of symbols increased, response times increased across all groups, with more time required for the symbol discrimination task.Conclusion: It was confirmed that the greater the severity of DAT, the more cognitive load and impaired information processing were reflected in symbol selection. Findings suggest that response time is a more sensitive indicator of cognitive decline in DAT patients and highlight the need to adjust the number of symbols and presentation methods according to the severity of the patient’s condition in dementia interventions.