Electronic Communication Aids Research Articles

The decision-making process in recommending electronic communication aids for children and young people who are non-speaking: the I-ASC mixed-methods study

Background This project [Identifying Appropriate Symbol Communication (I-ASC)] explored UK decision-making practices related to communication aid recommendations for children and young people who are non-speaking. Research evidence related to communication aid decision-making is limited. The research aims were to increase understanding of influencers on the decision-making process in recommending electronic communication aids, and to develop guidance tools to support decision-making. An additional, post hoc aim was to evaluate the public involvement contribution to the I-ASC project. The research focused on the identification of attributes and characteristics that professionals, family members and those who use communication aids considered important in the recommendation process. Findings informed the development of guidance resources. The evaluation of public involvement focused on what could be learned from a nationally funded project with involvement from public contributors typically regarded as hard to include. Methodology For the clinical decision-making component, the methodological investigation adopted a three-tier approach with three systematic reviews, a qualitative exploration of stakeholder perspectives through focus groups and interviews, and a quantitative investigation surveying professionals’ perspectives. The public involvement evaluation adopted a mixed-methods approach. A total of 354 participants contributed to the decision-making data set, including professionals, family members, and children, young people and adults who use communication aids; 22 participants contributed to the public involvement evaluation. The literature review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thematic analysis and framework approach supported the analysis of qualitative data. Two stated preference surveys, a best–worst scaling and a discrete choice experiment, allowed the relative importance of factors in decision-making to be determined. Analysis was grounded in random utility theory. Public involvement Two public involvement co-researchers, an adult using a symbol communication aid and a parent of a communication aid user, were core members of the research team. The I-ASC public involvement resulted in an additional award to evaluate the impact of public involvement across the project. Results Factors influencing decision-making are not always under the control of the decision-makers, for example professional knowledge, referral criteria and service structure. Findings suggest that real clinical decisions contrast with hypothetical decisions. Survey responses indicated that children’s physical characteristics are less important than their language, communication and learning abilities; however, during real-time decision-making, the opposite appeared to be true, with access needs featuring most prominently. In contrast to professionals’ decisions, users and family members prioritise differing aesthetic attributes of communication aids. Time allocated to system learning remains underspecified. The research informed the development of decision-making guidance tools (https://iasc.mmu.ac.uk/; accessed 8 June 2020). A public involvement evaluation suggests that successful public involvement of individuals with disabilities requires significant resources that include staff time, training and personal support (https://iasc.mmu.ac.uk/publicinvolvement; accessed 8 June 2020). Future work Further research is needed in the areas of language assessment, communication aid attributes, types of decision-making episodes and service user perspectives. These data highlight the need for mechanisms that enable public involvement co-researchers to be paid for their contributions to research bid preparation. Limitations Individuals who benefit from communication aids are a heterogeneous group. We cannot guarantee that this study has captured all relevant components of decision-making. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 45. See the NIHR Journals Library website for further project information.

Augmentative, Alternative, and Assistive: Reimagining the History of Mobile Computing and Disability

This article explores the linked histories and sociocultural implications of the Texas Instruments Vocaid and the Apple iPad, two technologies produced by consumer electronics companies and used as assistive devices by nonspeaking individuals. Through this brief case study, the author argues that developments in mobile computing and advancements in electronic communication aids are inherently intertwined through the history of their research, development, commercialization, use, and reuse. Although disability is often underrepresented in the history of computing, it has played, and continues to play, a significant role in how computers augment and provide alternatives to human communication and expression.

Narrative construction by an aided speaker: a pilot study

Purpose – Story‐telling is recognised as important to child language development. However, children who use electronic communication aids have limited opportunities to develop their story‐telling compared to their natural speaking (NS) peers. The “Telling Stories”' project aims to explore narrative construction in teaching staff‐aided communicator dyads.Design/methodology/approach – A pilot study was conducted to examine the feasibility of research methods. Video data were captured during a fictional story‐telling task. Two measures were investigated: communicative modality; and linguistic move type. Momentary time sampling (MTS) was applied to the video to determine range and proportions of communicative modalities in use. A coding framework was applied to determine the distribution of linguistic move‐types across the interlocutors.Findings – The findings revealed multimodal contributions from both interlocutors. The linguistic move‐type coding indicates the NS assumed a more dominant, initiating role. M...

Factors associated with the participation of children with complex communication needs

The aim of this study was to conduct a preliminary analysis of relations between child and environmental variables, including factors related to communication aid provision, and participation in informal everyday activities in a sample of children with complex communication needs.Ninety-seven caregivers of children provided with communication aids responded to a questionnaire survey. Child variables assessed were level of ability, trait emotional self-efficacy, and competence in communication aid use. Environmental variables assessed were the impact of childhood disability on the family, family socio-economic category, perceived reliability of electronic communication aids provided to children, and ease of use of the aid. The outcome measure was the intensity of child participation in informal activities.Significant correlations were observed between participation scores and the following variables: child age, level of ability, trait emotional self-efficacy, and family impact of childhood disability. Regression analyses highlighted trait emotional self-efficacy and, to a lesser degree, family impact of childhood disability as the strongest potential predictors of participation.While aspects of child personality may be difficult to disentangle from behaviours related to disability type or developmental age, this research highlights a clinical requirement to assess systematically child behaviours relating to their general emotional functioning.

Non-electronic communication aids for people with complex communication needs

Non-electronic communication aids provide one form of augmentative and alternative communication (AAC) for people with complex communication needs. The aim here was to explore non-electronic communication aids as one AAC option and research challenges. This aim was addressed by reviewing funding for the provision of AAC systems, data from an Australian pilot project providing non-electronic communication aids, an audit of aided AAC published studies (2000–2009), and discussion of the review literature. Combined, these sources indicate that although there is great demand for non-electronic communication aids, funding schemes, both in Australia and internationally, have focused on electronic communication aids. Such funding has usually failed to meet the total device costs and has not provided for adequate speech-language pathology support. Data from the pilot indicated the demand for non-electronic communication aids, and patterns suggest potential factors that govern the types selected. Despite the high demand for non-electronic aids, the research literature has tended to focus on electronic communication aids, including within intervention studies and addressing design features and long-term outcomes. Concerns about ensuring that AAC systems are chosen according to the assessed needs of individuals are discussed within the context of limitations in outcomes research and appropriate outcome measures.

Silence Is Not Golden

Silence Is Not Golden

Electronic voice-output communication aids for temporarily nonspeaking patients in a medical intensive care unit: a feasibility study

Background The inability to speak during mechanical ventilation is recognized as a terrifying and isolating experience that is related to feelings of panic, insecurity, anger, worry, fear, sleep disturbances, and stress among critically ill patients. Alternative methods of communicating with temporarily nonspeaking patients in the intensive care unit (ICU) have received little study. Although electronic voice output communication aids (VOCAs) are available for disabled children and adults, the effectiveness of VOCA systems with adult medical ICU patients who may have multisystem illness, prolonged intubation, and longer ICU stays has not been explored. Objectives The purpose of this pilot study was to describe (1) the characteristics of intubated MICU patients who use VOCAs, (2) the usage patterns (message categories, frequency, assistance required), (3) communication quality (ease, user satisfaction), and (4) barriers to communication with VOCAs. Methods This pilot study used participant observation, semi-structured interviews, questionnaires, and clinical record review in a complementary design to obtain data on communication events and VOCA use with 11 critically ill adults. Results Study participants, 45.5 ± 16.0 years of age with 13 ± 1.9 years of education and moderately severe illness (APACHE III = 27.5 ± 16.1), used the VOCA for 5.7 ± 4.6 days. Ease of Communication Scale measurements showed significantly less difficulty with communication after device use (t > 2.62; P = .047). Almost half ( n = 5) of the participants demonstrated some independent use of the device. VOCAS were used in one quarter of observed communication events. Patients used VOCAs most often to communicate with family visitors and initiated communication interactions more often when VOCAs were used than when communicating by other nonvocal methods. Poor device positioning, deterioration in patient condition, staff time constraints, staff unfamiliarity with device, and complex message screens were primary barriers to VOCA use. Conclusions This study showed that use of VOCAs is possible with selected critically ill adults and may contribute to greater ease of communication during respiratory tract intubation particularly with family members. Further clinical research using control or comparison groups is needed.

Effects of discourse context on the intelligibility of synthesized speech for young adult and older adult listeners: applications for AAC.

The use of speech synthesis in electronic communication aids allows individuals who use augmentative and alternative communication (AAC) devices to communicate with a variety of partners. However, communication will only be effective if the speech signal is readily understood by the listener. The intelligibility of synthesized speech is influenced by a variety of factors, including the provision of context. Although the facilitative effects of context have been demonstrated extensively in studies with young adults, there are few investigations into older adults' ability to decode the synthesized speech signal. The present study investigated whether discourse context affected the intelligibility of synthesized sentences for young adult and older adult listeners. Listeners were asked to repeat 15-word sentences that were either presented in isolation or preceded by a story that set the context for the sentence. Participants correctly repeated significantly more words in the sentences when they were preceded by related sentences than when the sentences were presented in isolation. This research shows a facilitating effect of context in discourse, wherein previous words and sentences are related to later sentences, for both younger and older adult listeners. These results have direct implications for AAC system message transmission.

Case Study on Application of Electronic Communication Aids Equipments for The Severely Physically Disabled (II)

Case Study on Application of Electronic Communication Aids Equipments for The Severely Physically Disabled (II)

Teaching Children with Severe Disabilities to Utilize Nonobligatory Conversational Opportunities: An Application of High-Probability Requests

Two children with severe disabilities who used electronic communication aids were taught to extend conversations as a result of implementation of an intervention strategy based on high-probability request sequences. Both participants had been selected as a result of the discrepancy between their propensity to respond to obligatory conversational bids (e.g., a question such as “What did you do at recess?”) and their propensity to refrain from responding to nonobligatory conversational bids (e.g., comments such as “I played kickball at recess”). Both learners' conversational maintenance skills improved as a result of the procedure. Educational implications are discussed.

Case Study on Application of Electronic Communication Aids Equipments for The Severely Physically Disabled

Case Study on Application of Electronic Communication Aids Equipments for The Severely Physically Disabled

Electronic Augmentative Communication Aids for the Nonreading Student: Selection Criteria

A discussion of augmentative communication aids for non-reading severely physically handicapped children is presented. Three specific topics are discussed: factors in movement to electronic communication aids, basic components of electronic aids, criteria for selection of aids, and specific training suggestions. The importance of maintaining flexibility is stressed. Augmentative communication aids for this population should reflect a dynamic rather than static philosophy. They must meet the needs and abilities of the student in present and future environments.

Case study of a user-oriented conferencing system (abstract only)

This session described how CONFER, a computer-based conferencing system at the University of Michigan, was developed with participation of users, and what impact the system has on communities of users. At this conference it may be especially interesting to discuss various ways in which help provided to new users has evolved. Some extrapolations may be made for other than electronic communication aids: orientation and training, on-line reference information, on-line consultation, etc.

Standardized Racking for Aircraft Electronic Equipment

THE need to reduce the size and weight of airborne equipment has always been of paramount importance and becomes more pressing with each successive generation of aircraft. The demands made in this respect on electronics manufacturers arc, and always have been, particularly exacting, and this is due to the fact that, in addition to the essential flight control system on which a modern aircraft relies, there is an ever‐increasing number of electronic communication, navigation and other aids to safe flight, many of which are mandatory, to be installed.