Severe Speech And Physical Impairments Research Articles

But was it Trustworthy? Methodological Experiences From a Study of a Hard-to-Reach Group of Students in Need of a Flexible Research Approach

Pedagogical research on experiences of learning among students with severe speech and physical impairment (SSPI) is sparse. This may be due to a lack of research-on-research methodology literature about students with SSPI, as they are difficult to find and there are barriers to their participation in mainstream research. Hence, method development is especially important regarding these students, who cannot participate when traditional inquiry methods are used. This article’s objective is therefore to advance method development by means of a retrospective investigation. The empirical findings consist of documented experiences from a previous study of students with SSPI (henceforth, “literacy study”). A computer-assisted email dialogue technique was developed in the literacy study’s pilot study and eventually used in the main study, to investigate the students’ experiences of their literacy development. The aim of this study is to retrospectively and critically examine the scientific trustworthiness of a methodological research approach based on an email dialogue technique used exploratively in the literacy study, to investigate the literacy development among the students grounded in their own experiences, and to contribute methodological experiences gained from that study regarding the relationship between the use of verification strategies and checking techniques. The computer-assisted email dialogue approach was necessary because the few participants were spread over great geographical distances. The approach was developed as an explorative and flexible inclusive research design and was used within the tradition of participatory research. The students in both the pilot and main studies (8–16 years of age) were treated as collaborators rather than research subjects. Both the verification strategies and techniques regarding trustworthiness criteria were found to be important for trustworthiness. The main conclusion, based on our experiences in this retrospective investigation, is that it is necessary to continuously and thoroughly focus on trustworthiness issues throughout the research process to obtain trustworthy findings.

Soliciting BCI user experience feedback from people with severe speech and physical impairments

Brain–computer interface (BCI) researchers have shown increasing interest in soliciting user experience (UX) feedback, but the severe speech and physical impairments (SSPI) of potential users create barriers to effective implementation with existing feedback instruments. This article describes augmentative and alternative communication (AAC)-based techniques for obtaining feedback from this population, and presents results from administration of a modified questionnaire to 12 individuals with SSPI after trials with a BCI spelling system. The proposed techniques facilitated successful questionnaire completion and provision of narrative feedback for all participants. Questionnaire administration required less than 5 minutes and minimal effort from participants. Results indicated that individual users may have very different reactions to the same system, and that ratings of workload and comfort provide important information not available through objective performance measures. People with SSPI are critical stakeholders in the future development of BCI, and appropriate adaptation of feedback questionnaires and administration techniques allows them to participate in shaping this assistive technology.

Initial constructs for patient-centered outcome measures to evaluate brain–computer interfaces

Purpose: The authors describe preliminary work toward the creation of patient-centered outcome (PCO) measures to evaluate brain–computer interface (BCI) as an assistive technology (AT) for individuals with severe speech and physical impairments (SSPI). Method: In Phase 1, 591 items from 15 existing measures were mapped to the International Classification of Functioning, Disability and Health (ICF). In Phase 2, qualitative interviews were conducted with eight people with SSPI and seven caregivers. Resulting text data were coded in an iterative analysis. Results: Most items (79%) were mapped to the ICF environmental domain; over half (53%) were mapped to more than one domain. The ICF framework was well suited for mapping items related to body functions and structures, but less so for items in other areas, including personal factors. Two constructs emerged from qualitative data: quality of life (QOL) and AT. Component domains and themes were identified for each. Conclusions: Preliminary constructs, domains and themes were generated for future PCO measures relevant to BCI. Existing instruments are sufficient for initial items but do not adequately match the values of people with SSPI and their caregivers. Field methods for interviewing people with SSPI were successful, and support the inclusion of these individuals in PCO research.Implications for RehabilitationAdapted interview methods allow people with severe speech and physical impairments to participate in patient-centered outcomes research.Patient-centered outcome measures are needed to evaluate the clinical implementation of brain–computer interface as an assistive technology.

Teaching mindfulness meditation to adults with severe speech and physical impairments: An exploratory study

People with severe speech and physical impairments may benefit from mindfulness meditation training because it has the potential to enhance their ability to cope with anxiety, depression and pain and improve their attentional capacity to use brain-computer interface systems. Seven adults with severe speech and physical impairments (SSPI) – defined as speech that is understood less than 25% of the time and/or severely reduced hand function for writing/typing – participated in this exploratory, uncontrolled intervention study. The objectives were to describe the development and implementation of a six-week mindfulness meditation intervention and to identify feasible outcome measures in this population. The weekly intervention was delivered by an instructor in the participant's home, and participants were encouraged to practise daily using audio recordings. The objective adherence to home practice was 10.2 minutes per day. Exploratory outcome measures were an n-back working memory task, the Attention Process Training-II Attention Questionnaire, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, the Positive and Negative Affect Schedule, and a qualitative feedback survey. There were no statistically significant pre–post results in this small sample, yet administration of the measures proved feasible, and qualitative reports were overall positive. Obstacles to teaching mindfulness meditation to persons with SSPI are reported, and solutions are proposed.

Creating meaning through the coordination of gaze direction and arm/hand movement

This study is an investigation of the practice of achieving shared understanding in Augmented and Alternative Communication (AAC) using natural modes. The interaction between a girl with severe speech and physical impairment (SSPI) and moderate intellectual disability and her everyday communication partners is explored. The aims are to investigate how the participants create meaning through the girl’s coordination of gaze direction and arm/hand movements and vocalizations, as they occur in natural interaction with everyday communication partners. e principles of conversation analysis (CA) were used to record, transcribe and analyse the interaction. The analysis demonstrates that the participants collaboratively create local meaning in and through the coordination of gaze and arm/hand movement. us, the speaking co-participants ascribe meaning to the girl’s actions of directing gaze and arm/hand movement at the same target. e analysis shows that the ascription of a specific meaning is context-specific. These findings highlight the importance of taking into account all interaction-relevant modalities and the relevance of systematic details in the micro-context of interaction when looking for processes of sensemaking. In addition, the role of the communication partner is emphasized. These findings may have implications for clinical intervention.

Noninvasive brain-computer interfaces for augmentative and alternative communication.

Brain-computer interfaces (BCIs) promise to provide a novel access channel for assistive technologies, including augmentative and alternative communication (AAC) systems, to people with severe speech and physical impairments (SSPI). Research on the subject has been accelerating significantly in the last decade and the research community took great strides toward making BCI-AAC a practical reality to individuals with SSPI. Nevertheless, the end goal has still not been reached and there is much work to be done to produce real-world-worthy systems that can be comfortably, conveniently, and reliably used by individuals with SSPI with help from their families and care givers who will need to maintain, setup, and debug the systems at home. This paper reviews reports in the BCI field that aim at AAC as the application domain with a consideration on both technical and clinical aspects.

Focus groups as a requirements gathering method with adults with severe speech and physical impairments

Technological supports have the potential to greatly improve the quality of life and independence of adults with severe speech and physical impairments (SSPI). In particular, augmentative and alternative communication (AAC) devices can enable people with little or no speech to communicate with others. However, the rate of rejection of AAC devices is estimated to be as high as 53.3%. It is suggested that a major reason for this rejection is a lack of user-centred design in the development of these devices. As part of a wider study looking at involving adults with SSPI in all stages of user-centred design, this paper looks at the use of focus groups in requirements gathering with this user group.

Reading and spelling in children with severe speech and physical impairments: a comparative study

Effective literacy skills are crucial in supporting communication for children with severe speech and physical impairments (SSPI). Reading and spelling difficulties are reported to be over-represented in this group, even where language and cognitive skills are age appropriate. To compare the performance of children with SSPI on a range of language, reading and spelling tasks with that of their typically developing peers matched for receptive vocabulary and mental age. A wide range of tasks was developed as part of a larger study exploring phonological awareness, reading and spelling skills. All tasks were accessible to children with severe physical impairments. Two groups of primary school-aged children were recruited, children with SSPI of average intelligence, and naturally speaking peers, matched for receptive vocabulary. Children were assessed individually on language, non-verbal cognition, phonological awareness, reading and spelling tasks. Sixteen children with SSPI were recruited. Their performance was compared with that of 15 naturally speaking peers, matched for receptive vocabulary scores. The children with SSPI achieved significantly lower scores on reading and spelling measures relative to their naturally speaking peers. However, at least one participant with SSPI scored at ceiling on each task, indicating that SSPI do not preclude the development of reading and spelling, at least in the early stages of literacy development. This study indicates that some children with severe speech impairments can develop phonological awareness, reading and spelling skills. However, the data suggest that phonological awareness may not be as good a predictor of reading and spelling abilities in this group of children as in typically developing children. Further research is needed to track development of reading and spelling, as well as the instructional support needed to scaffold more effective skills in these areas.

Reading and Spelling in Children with Severe Speech and Physical Impairments

The aim of the present paper was to study literacy skills in children with severe speech and physical impairment (SSPI), and compare their performance to typically developing children. The children with SSPI and the comparison group, both groups with 28 children, were matched on receptive vocabulary and assessed on measures of reading, spelling, rhyming, phoneme awareness and memory. The comparison group achieved significantly higher scores on reading, spelling, and rhyme awareness, but no differences were found on phoneme awareness or memory. Regression analyses, with reading and spelling as dependent variables and phoneme awareness, rhyming, and memory as independent variables, revealed that phoneme awareness was the strongest predictor of both reading and spelling in both groups. Rhyming seemed more important to reading and spelling for the children with SSPI than for their speaking peers. The children with SSPI were at an earlier literacy stage and therefore more dependent on rhyming ability than children in the comparison group who drew on their phoneme awareness. Although both groups performed similarly on phoneme awareness, the comparison group showed stronger reading and spelling abilities, suggesting a different relationship between phoneme awareness and reading and spelling in children with SPPI.

Communication Functions, Modalities, and Maternal Responses in Children with Severe Speech and Physical Impairment

Abstract The study aimed at exploring the different kinds of functions and modalities used by children with severe speech and physical impairment (SSPI) and cerebral palsy (CP) during communicative interactions with their mothers; and the choice of modalities to indicate different functions. Furthermore, this study attempted to investigate if mothers displayed identifiable responsive styles during these interactions. An extensive coding system was developed to assess the communication functions and modalities used by children with SSPI and CP, and the maternal responsivity for the same. Four 15-minute maternal interaction sessions with their children were video-recorded for 10 subjects within the age range of 2;1 to 3;11 years. Interaction transcribed by the principal investigator was then coded by trained judges for the functions and modalities employed by the children and for the maternal responses for the same. Mean percentage for the coded communication functions, modalities, and maternal responses we...

Early reading and spelling abilities in children with severe speech and physical impairment: A cross-linguistic comparison

Early reading and spelling abilities in children from Ireland and Sweden with severe speech and physical impairment (SSPI) were studied and compared. The aim was to look for similarities as well as for differences that could be related to the different linguistic environments. Both group consisted of 15 children, and were matched on linguistic age. Reading and spelling as well as phonological awareness and memory were tested. Both groups performed fairly well on the phonological awareness tasks, but the Swedish children did not seem to manage to use this ability successfully for reading and spelling. Overall the Irish children showed a slightly stronger performance, and were significantly better at the reading tasks. There were some signs that children were affected by the structure of their individual languages. The Irish children revealed the greatest problems with pseudoword spelling which is in line with results from speaking children with English as their mother tongue and could be a result of using a strategy based on larger linguistic units. The Swedish children had particular problems with tasks presented without oral support, which may be an effect of memory problems due to their lack of articulatory ability.

The Morphology and Syntax of Individuals who use AAC: Research Review and Implications for Effective Practice

A research review of 31 studies pertaining to the morphology and syntax of individuals who use augmentative and alternative communication (AAC) and who had severe speech and physical impairments (SSPI) was completed. Results suggest that, although many individuals who use AAC exhibit comprehension and expression of a wide range of grammatical structures, these individuals are at risk for experiencing grammar deficits. A wide range of individual differences was noted, both within and across many of the investigations. One of the more robust findings was that individuals tended to produce shorter utterances when they used graphic symbol-based AAC systems than would be expected, based on participant profiles; however, there appeared to be a developmental trend toward using longer utterances. There has been a dearth of research pertaining to the development and evaluation of appropriate assessment tools and intervention techniques to enhance grammar acquisition for individuals who use AAC. Considerations for developing such tools and techniques are discussed.

“Please listen, it's my turn”: Instructional approaches, curricula and contexts for supporting communication and increasing access to inclusion

Background Four elementary (primary) school students with severe speech and physical impairments (SSPI) who used augmentative and alternative communication (AAC) aids were selected to take part in an intensive, 4‐week summer intervention program. The program was designed to explore effective approaches, content and contexts for supporting communication (including oral language, literacy, and technology skills) among young people who require AAC.Method Features of the intervention included (i) using an integrated approach to provide language and literacy opportunities intended to elicit the students' active involvement in meaningful, productive and expressive tasks in everyday contexts; (ii) constant modelling of AAC usage; (iii) requiring family involvement as a criterion for participation in the program; and (iv) follow‐up visits to schools during which effective instructional strategies were shared with staff.Results Formative and summative assessment measures revealed that all four participants made progress during intervention. However two of the students maintained these gains into the follow‐up period, whereas the other two did not. Each pair seemed to share certain characteristics, which are illustrated in this paper by two case study synopses. One relates the story of a child whose successes continued into the follow‐up period, and the other chronicles the experiences of the child whose successes quickly waned.Conclusions This study provides a range of instructional approaches, curricula and contexts to promote communication for children with complex communication needs. These instructional supports are more likely to improve access to inclusion in schools that seek to work in partnership with parents, plan educational transitions, and implement adequate training and awareness‐raising among their staff.

Theory of mind in children with severe speech and physical impairment (SSPI): a longitudinal study

Six children with cerebral palsy and severe speech impairment took part in a two‐phase longitudinal study of development of social cognition. The children ranged in age from 5 to 7 years old at data collection time 1 and from nine to 11 years old at data collection time 2. Using a model of normal development of Theory of Mind (ToM) suggested by Gopnik and Slaughter (1991), the children were tested on a number of tasks requiring (ToM). The findings suggest that the children with speech impairment follow a normal pattern of development, but with a severe delay compared with children without disability. The results are discussed in relation to problems in early social and communicative experience for the group of children with cerebral palsy and severe speech impairment.

Students With Severe Speech and Physical Impairments

This qualitative study examined obstacles to literacy for individuals With severe speech and physical impairments (SSPI). Using a constant comparison approach, the authors addressed attitudinal and opportunity barriers to literacy education from the perspective of parents, teachers, university faculty, and administrators involved in literacy education of students With SSPI. Major themes emerged Within the categories of knoWledge, policy, practice, and attitude relating to funding issues, segregation of students With SSPI, use of a life skills curriculum, lack of certification preparation and training in methods and assistive technology, and attitudes that embraced stigmatization and loWered expectations.

Evaluating the morphological competence of children with severe speech and physical impairments.

Reports present mixed findings on the extent to which the development of receptive language skills in children with severe speech and physical impairments (SSPI) is compromised by their difficulty with speaking (V. W. Berninger & B. M. Gans, 1986; D. V. M. Bishop, B. Byers Brown, & J. Robson, 1990; O. Udwin & W. Yule, 1990). In this study, grammaticality judgments were used to measure the sensitivity of 4 school-age children with SSPI to different morphological errors. These errors included violations of agreement between the subject and auxiliary verbs (e.g., she are falling), the marking of aspect (e.g., she is play the horn), and the marking of past tense on regular and irregular verbs (e.g., he jump, he fall, he falled). Performance of the participants with SSPI was compared to groups of typically developing children and adults. Results indicated that children in the SSPI and control groups made similar judgments. All groups showed high levels of sensitivity to agreement violations, aspect-marking errors, and tense-marking errors involving irregular verbs. Participants with SSPI had greater difficulty detecting tense-marking errors involving regular verbs. Implications for improving clinical assessments within this population are discussed.

Approaching literacy with AAC graphics

This paper examines the possible impact on beginning reading of graphic representational system (GRS) instruction and usage during the emergent literacy years of young children with severe speech and physical impairments (SSPI). The unique development of children who use GRS symbols for communication is discussed within the context of the research literature on the reading process, visual processing, graphic representational processing, and language development. The position taken argues that one should remain open to the possibility of a differential impact upon beginning reading due to use of different types of GRSs. The objectives of this paper are to refine the questions relating to the relationship between the use of a GRS during the preschool years and the child's ultimate reading acquisition.

Classroom literacy instruction for children with severe speech and physical impairments (SSPI)

Classroom literacy instruction for children with severe speech and physical impairments (SSPI)

The role of computers in promoting literacy in children with severe speech and physical impairments (SSPI)

The role of computers in promoting literacy in children with severe speech and physical impairments (SSPI)

Emerging literacy and children with severe speech and physical impairments (SSPI)

Research Assistant Professor Research Associate The Carolina Literacy Center Department of Medical Allied Health Professions The University of North Carolina at Chapel Hill Chapel Hill, North Carolina