Need For Communication Support Research Articles

A Narrative Review of the Sociotechnical Landscape and Potential of Computer-Assisted Dynamic Assessment for Children with Communication Support Needs

This paper presents a narrative review of the current practices in assessing learners’ cognitive abilities and the limitations of traditional intelligence tests in capturing a comprehensive understanding of a child’s learning potential. Referencing prior research, it explores the concept of dynamic assessment (DA) as a promising yet underutilised alternative that focuses on a child’s responsiveness to learning opportunities. The paper highlights the potential of novel technologies, in particular tangible user interfaces (TUIs), in integrating computational science with DA to improve the access and accuracy of assessment results, especially for children with communication support needs (CSN), as a catalyst for abetting critical communicative competencies. However, existing research in this area has mainly focused on the automated mediation of DA, neglecting the human element that is crucial for effective solutions in special education. A framework is proposed to address these issues, combining pedagogical and sociocultural elements alongside adaptive information technology solutions in an assessment system informed by user-centred design principles to fully support teachers/facilitators and learners with CSN within the special education ecosystem.

Memory clinic clinicians’ preferences and needs for communication with patients: A multi‐national survey study from EU‐FINGERS & LETHE projects

AbstractBackgroundIncreased attention to pre‐dementia stages of Alzheimer’s disease (AD) creates new challenges for clinician‐patient communication. To assist clinicians in these challenges, we aimed to: 1) identify their perspectives on communicating about diagnostic testing, biomarker test results, dementia risk, and prevention, and 2) inventory their need for communication support.MethodBetween June and November 2021, 160 memory clinic clinicians from 21 European countries (56% 31‐50yrs; 59% female, 14±10yrs of experience) completed a digital survey in which they provided their opinions based on five hypothetical patient cases: 1) AD dementia, 2) Mild Cognitive Impairment (MCI) with positive (+) AD biomarkers, 3) Subjective Cognitive Decline (SCD) with positive AD biomarkers, 4) MCI with negative (‐) AD biomarkers, and 5) SCD with negative AD biomarkers. Additionally, we asked which amount and what type of support (online tools and/or skills training) would be appreciated for 10 listed communication skills. Descriptive statistics were used to report characteristics and survey responses.ResultMost clinicians indicated they would communicate syndrome diagnosis (66‐88% of clinicians) and biomarker results (97‐100%) to all five hypothetical patients. In case of positive biomarkers, clinicians were more hesitant to explicitly mention the presence of AD in the SCD+ case (29%) than in the MCI+ case (68%). Clinicians rather emphasized that it is not yet known what biomarker positivity means for the patient (68% in SCD+ vs. 32% in MCI+). Almost all clinicians reported discussing prognosis/dementia risk (79‐98%) and prevention (90‐99%), often tailored to patient characteristics and preferences. Of note, more than half of clinicians indicated that they preferred ‘(very) much’ support regarding 9 out of 10 listed communication skills (Figure 1), via online tools (34%), training (13%), or both (32%).ConclusionEuropean clinicians have a positive attitude towards communicating about early diagnosis of AD, dementia risk, and prevention. Clinicians differ in whether and how they explain the meaning of positive AD biomarkers to patients with SCD or MCI, reflecting the current debate in the field. Moreover, we identified a need for communication support on these topics. Fulfilling clinicians’ needs might help to attune memory clinic care even better to individual patients.

Communication Support Needs in Adults with Intellectual Disabilities and Its Relation to Quality of Life.

Research suggests that individuals with intellectual disabilities (ID) experience difficulties in communication, ranging from intelligibility issues to more severe problems in the use and comprehension of spoken, written or sign language. Despite the negative effects that the inability to communicate have on quality of life (QoL), not much research has explored the relationship between communicative competence and QoL in the adult population with ID. The aim of this study was to describe the global communication profile of a sample of 281 adults with ID recruited from Grupo AMÁS Social Foundation, who differed in their level of communication support needs (CSN). The relationships between communicative competence and CSN with QoL were further examined. The results showed lower QoL indices for those participants characterized by their limited use of discourse and inability to exhibit certain communicative purposes, with the largest differences in the dimensions of self-determination, social inclusion, interpersonal relationships, emotional wellbeing and personal development. Overall, low levels of QoL were found for all participants, with even lower scores for the group identified as having CSN. A multiple regression model revealed that having speech/discourse competence is a powerful predictor of QoL, along with the level of disability and having the communicative competences to express likes and preferences or to establish new relationships. This clear relationship between communication and QoL is an important argument for disability support services when it comes to setting communication supports as a priority and as an important preventive step towards the protection of those at risk of exclusion.

Development of a new tool for the early identification of communication-support needs in people living with dementia: An Australian face-validation study.

Language and communication difficulties are common in dementia but limited tools are available for a timely assessment of those individuals who experience these difficulties. The Communication-Support Needs Assessment Tool in Dementia (CoSNAT-D) was developed to assist in (a) the early identification of communication difficulties among people with dementia in the community context; and (b) determining the level of their communication support needs to guide appropriate service access. The CoSNAT-D was developed based on a literature review. The face validity was tested with end-users (people with dementia and support persons of people with dementia) regarding relevance, wording, syntax, appropriateness and comprehensiveness of the items of the tool. Data were collected using semi-structured phone interviews. Seven people with dementia and 15 carers participated in the study. Feedback regarding items' appropriateness was largely positive and minor changes were made to improve comprehensiveness. A new item was added to the original item pool. The interviews highlighted the importance of including people with dementia in the assessment processes and person-centered approaches in this context. The CoSNAT-D presents a first step for the early identification of individual support needs of people living with dementia and communication difficulties who live in the community. Items of the CoSNAT-D have been determined face-valid by end-users. The face-validated version of the tool is currently undergoing further testing to determine additional relevant psychometric properties.

Communication access: is there some common ground between the experiences of people with aphasia and speakers of English as an additional language?

ABSTRACTBackground: Creating communication accessible environments is an essential component to facilitating the social inclusion and well-being of people with communication support needs (CSN). However, in Australia, this has yet to translate into legislation, which may be partly due to the relatively small numbers of people if CSN only considers people with a communication disability. Including people from a culturally and linguistically diverse background, significantly increases the size of the cohort that may benefit from communication access legislation.Aims: This study explores whether the face to face experiences of service encounters of people with aphasia (PWA) were similar to speakers of English as an additional language (EAL) in an attempt to highlight the need for government policy to address the needs of a larger cohort of people with a wide range of CSN.Methods & Procedures: Using a qualitative description approach, semi-structured, in-depth interviews were conducted with five PWA and five EAL speakers about their experiences within service interactions. Using this approach, the study explored the key features which were perceived as enabling or constraining communication access. Results are explored against the backdrop of a sociological theoretical conceptual model, drawing from the theories of Pierre Bourdieu and Erving Goffman, to consider a deeper nuanced understanding of the connections between communication access, social capital and social inclusion.Outcome and results: This study suggests that there are shared experiences for PWA and speakers of EAL within service interactions. Although both groups describe many positive experiences, findings indicate that even subtle negative reactions by service providers, in particular non-verbal behaviours, are conceptualised as having a considerable impact on their negotiation of social capital and ultimately social inclusion. This study highlights that a sociological framework, underpinned by the theories of Bourdieu and Goffman appears to be a useful template for researchers to consider when studying the interactions of people with CSN.Conclusion: A wider cohort of people could benefit significantly from policy development which promotes communication access in everyday service encounters. People with disability are being encouraged to have a voice and people from different cultures are being encouraged to settle into Australian society, so it is essential to understand the everyday experience of communication access. This study has facilitated a more in–depth theoretical understanding of the multidimensional concept of communication access and the significant implications for well-being, social integration and social inclusion currently under recognised within government legislation.

How Practitioners’ Understanding of Dialogical Theory Can Enhance Co- Construction of Meaning and Support the Choice and Control of People Who Have Complex Communication Support Needs


 
 
 People who have complex communication support do not have active choice and control in the process of defining how their lives are organised and the support that they receive, despite there being laws and recommendations in place from many bodies such as the United Nations or national governments. The tendency is that the expression of the needs and expectations originate in the opinion of the people closest to the person who has complex communication support needs, rather than from the person themselves. This problem is related to the fact that the dominant model of communication used in this context is based on information transfer and decoding, causing practitioners to regard the need to interpret and negotiate meaning as problematic and somehow differing from other communicative episodes.
 This challenge can be met by using a dialogical approach where communication is seen as a process of negotiation where meaning is co-constructed through a sequence of interactions. In situations where practitioners are supported to apply dialogical theory in communication partnerships with people who have complex communication support needs, practitioners’ confidence in co-constructing meaning can grow and communication can be richer, supporting direct consultation.
 This article seeks to explore and bring together relevant literature on these topics, highlighting the role of the dialogical approach within the context of the international human rights framework. 
 https://doi.org/10.21827/jdbsc.4.31375
 
 

Developing Communication Access Standards to Maximize Community Inclusion for People With Communication Support Needs

People with communication support needs experience barriers that limit their social inclusion in society. A community approach such as communication access that targets changing attitudes, skills, and resources may assist in facilitating community participation. The authors describe the development of communication access from 2008 in Victoria, Australia. We present the rationale underpinning the need for communication access and the identification of a communication access symbol. A collaborative partnership between people with communication support needs, speech–language pathologists, and community members established a rigorous approach for devising the communication access standards and supporting checklists. The process for awarding a communication access license includes 4 phases: engagement, preparation, assessment, and review. Currently, 200 customer service points in businesses and organizations have been licensed as communication accessible. Further research is needed to establish replicability and sustainability of the communication access initiative and outcomes for a range of people with communication support needs.

The behavioural process underlying augmentative and alternative communication usage in direct support staff

ABSTRACTBackground Research findings suggest that direct support staff use augmentative and alternative communication (AAC) inconsistently. Various staff-related factors have been identified, and researchers agree that these factors somehow interrelate. Therefore, we approached AAC use as a behavioural process and examined the synergy between staff-related factors.Method Fifteen direct support staff and 10 speech-language/occupational therapists who work with adults who have an intellectual disability and use AAC were individually interviewed. Transcripts were studied using thematic analysis.Results Three main themes were discerned: consistent versus inconsistent AAC usage in direct support staff; time as a real and virtual barrier; friction in the peer–expert relationship.Conclusions Direct support staff primarily used AAC when there was an acute need for communication support. In contrast, both direct support staff and speech-language therapists felt that direct support staff should consistently provide augmented input. This discrepancy was driven by team dynamics as well as actual and perceived lack of time.

Design and Implementation of Decision Support Systems in the Public Sector

This article examines the implications of utilizing decision support systems (DSS) in the public sector based on a DSS developed and implemented for a community mental health system. The DSS includes a multiple objective (goal programming) allocation model and encompasses a multiple party decision process. The experiences and insights acquired during the development and implementation of this DSS are relevant to public sector decision support in general. The importance of a DSS as a process-support aid rather than a product-oriented aid (i.e., simply providing answers) and the interaction of system architecture and the chosen design strategy are key insights. In particular, the distinction between model-oriented and data-oriented DSS does not appear to be appropriate. The public sector decision maker's concern with issues of equity requires the ability to operate in a higher dimensional framework than the typical spreadsheet model and there is a critical need for communication support.