Communication
AAC technologies with visual scene displays and "just in time" programming and symbolic communication turns expressed by students with severe disability.
Why do this research?
Augmentative and alternative communication (AAC) provides ways to communicate for people with little or no speech, or speech that is hard to understand. This might include photos or symbols, Key Word Signs and gestures.
This paper looks at ways AAC technology can help children and adolescents to communicate. The students were aged between 8-21 years. They were “beginning communicators” who used less than fifty words to communicate. The nine students were from schools in the USA. Three children participated who had an intellectual disability or developmental delay. The children communicated with some Key Word Signs, symbols and/or objects. Only one child was using any AAC technology.
What did they do?
The study was a three single subject multiple probe design across students. This design means ongoing measurements were taken before and during the study activity. The authors took a baseline of how many communicative turns each child took. They then taught the children to communicate with photos of games, songs and activities on a tablet computer. Each photo was paired with voice to identify the photo. For instance one of the songs was “we will rock you” and on being pressed, it played the first line of the song. The children had five sessions of 15 minutes with 10 opportunities to communicate. Each session was videotaped. All attempts by the child to communicate were recorded.
What did they find?
All children increased the number of communicative turns. The results support the use of a voice output AAC app to help children who are beginning communicators. The authors suggest the success was due to making sure the activities were fun. Also, activities need to be age appropriate, in natural settings and provide many opportunities to take turns. The authors do not know if these skills were maintained after the study finished. They point out that all children could use symbols before the intervention. So, this intervention might not be useful for children who cannot use symbols or signs. They also point out that the intervention was given by a skilled practitioner and individualised to each child’s interests. So, this intervention needs specialised help.
Drager, K., Light, J., Currall, J., Muttiah, N., Smith, V., Kreis, D., . . . Wiscount, J. (2019). AAC technologies with visual scene displays and “just in time” programming and symbolic communication turns expressed by students with severe disability. Journal of Intellectual & Developmental Disability, 44(3), 321-336.
Parents’ perspectives of an Australian augmentative and alternative communication service: “I clapped for my child”.
Why do this research?
Many children with communication disabilities need augmentative and alternative communication (AAC) services. Services are usually provided in the home or at school. The speech pathologist shows the parent how to use AAC to help the child communicate. Best practice suggests that family centred practice helps support the whole family. When the child goes to school, AAC services are often provided at school. Some parents report not knowing what happens at school.
In Australia, parents have expressed a need for high quality, individualised services. There is hope for this in the development of a new funding system, the National Disability Insurance Scheme (NDIS). The NDIS promotes the concepts of improved choice and control. In this context a Kids Chat 2 service was set up. The service aimed to help families transition to a new funding model and provide expert help in AAC. The service gave workshops in AAC and individual sessions for children and parents.
What did they do?
Parent interviews took place to find out how the parents felt about the service. Interviews were with 9 parents between 11-22 months after receiving the AAC service. The first author asked the parents how they felt about the service and if it had been helpful. Interviews lasted between 25-45 minutes. The transcribed interviews were coded in themes.
What did they find?
There were three main themes.
- Accessing information Parents reported difficulties finding appropriate information and services. They appreciated workshop information as well as that targeted to their child.
- Unrelenting responsibility. Parents spoke of the struggle to get their child’s needs met. They felt a persistent need to advocate for their child in every aspect of their life. They recognised the value of AAC and worked with teachers to help their child use it at school.
- Looking to the future. Parents were uncertain about ongoing services in the NDIS future. They wanted continuity. They hoped that being in charge of their funding would give them more control.
These Australian findings were similar to other international studies. Parents still have to struggle to find appropriate services both in early intervention and at school. The NDIS offers opportunities for more individualised support. Yet, there is little funding to build the capacity of the community to understand and accept AAC. Developing communication skills in the child and their partners is long term. Further interventions are necessary as the child matures. There is a need for long term funding to build AAC skills in families, in schools and in the community.
Johnson, H., Van Nierop, M., & Iacono, T. (2021). Parents’ perspectives of an Australian augmentative and alternative communication service: “I clapped for my child”. Research and Practice in Intellectual and Developmental Disabilities, 8(1), 46-59. doi:10.1080/23297018.2020.1861552
The behavioural process underlying augmentative and alternative communication usage in direct support staff.
Why do this research?
Augmentative and alternative communication (AAC) provides ways to communicate for people with little or no speech, or speech that is hard to understand. These ways might include photos or symbols, Key Word Signs and gestures. Being able to communicate and to be listened to is essential to foster well-being and inclusion. People who use AAC benefit from seeing others use AAC and their form of communication being modelled every day.
Many people with intellectual disabilities have limited communication. They live in group homes and/or attend day services. Researchers say that the use of AAC is limited in these services and that support staff may not know how to help residents use their AAC.
What did they do?
The researchers used a framework called the reasoned action approach. This approach describes people’s characteristics as behavioural, normative or control beliefs. The research looked at how behavioural, normative and control beliefs affect support workers and AAC use in group homes Behavioural beliefs are those based on their views and background – such as believing AAC is useful or not. Normative beliefs are those that colleagues and friends reinforce – so if all support workers value the use of AAC then AAC is more likely to be used. Control beliefs relate most often to the time available and skill level of the staff which may limit AAC use.
Researchers interviewed 10 speech pathologists /occupational therapists and 15 direct support staff from 10 residential or day services in Belgium. Each face–to–face interview lasted between 30-60 minutes. Interview transcripts were analysed to find themes.
What did they find?
The authors found three main themes.
- Inconsistent and consistent AAC use. If people with intellectual disability did not use AAC staff were less likely to model its use. Also, if staff knew the person well, they felt they did not need AAC. This meant that the person with intellectual disability had few AAC learning opportunities.
- Actual and perceptual time constraints. Staff felt using AAC took time they did not have as an interaction could take a long time. Some felt they didn’t have time to practice Key Word Signs while others did and could see the long-term benefit.
- Peer versus expert relationship. The speech pathologists were frustrated that support workers did not use AAC in everyday activities. There could be a staff culture that did not support the use of AAC. Some support workers felt they knew the resident’s needs and could understand them without AAC.
The researchers found many factors contribute to the successful use of AAC in services for people with an intellectual disability. These are
- Behavioural beliefs. Staff mainly used AAC when there was critical information they needed from the person with disability and could not get any other way.
- Normative beliefs. The guidance provided by the speech pathologists to the support workers could be upset by an unsupportive team. The speech pathologists found the role between expert and peer difficult to navigate.
- Control and Control beliefs. Time restraints were an issue. Some staff were more focussed on doing tasks rather than helping someone to communicate.
The beliefs of speech pathologists and support workers differed about what was important. This has implications for the delivery of AAC services. The authors suggest the following;
- pre-service staff training on aided language stimulation
- train speech pathologists in managerial skills
- base speech pathologists in group homes
- put in place train-the-trainer models or coaches
- give staff time to provide AAC in everyday activities.
Rombouts, E., Maes, B., & Zink, I. (2017). The behavioural process underlying augmentative and alternative communication usage in direct support staff. Journal of Intellectual & Developmental Disability, 42(2), 101-113. doi:10.3109/13668250.2016.1219023