IMPACT, Fall 2013

https://scholarworks.sjsu.edu/impact/1002/thumbnail.jp

Augmentative-Alternative Communication Access for Individuals with Communication Disorders in Medical Settings

This study surveyed speech-language pathologists (SLPs) working in medical settings in the state of Florida in order to: (a) assess the availability of AAC devices, related materials, and services in acute, sub-acute, long-term care, and outpatient medical facilities, (b) examine barriers and supports in providing AAC services to patients with complex communication needs (CCN) in the aforementioned settings, and (c) determine perceived levels of AAC knowledge of health care practitioners. One of the study\u27s major findings was that 97.59% of SLPs served at least one patient they identified as having CCNs, and 94.1% of respondents indicated that their patients could benefit from increased access to AAC devices and service delivery. A notable finding relating to the need for increased AAC-related communication partner instruction (CPI) is as follows: 97% and 100% of respondents indicated that increased CPI for medical practitioners/staff and family members, respectively, were important elements in order to ensure functional communication for individuals with AAC needs in the medical setting. Major barriers to providing AAC services related to device access (i.e., lack of AAC supports / devices, lack of funding for equipment, length of time of device funding). Other barriers were related to the nature of medical settings (i.e., frequently changing caseloads, limited time with patients) and demands of the job (i.e., lack of time to prepare AAC materials / devices). Supports to providing AAC services included low-tech AAC options and mobile technologies. In terms of practitioner knowledge, 57.6% of respondents rated themselves not at all or somewhat knowledgeable regarding AAC. Physicians, nurses, and other rehabilitation professionals were rated as less than knowledgeable by 95%, 97%, and 84.3% of participants, respectively. Overall, the findings of this study suggests there is a high prevalence of patients in medical settings with AAC needs, and some face unmet communication needs resulting from barriers related to the setting itself, lack of access to AAC devices and materials, and limited time spent on AAC service delivery

Developing Augmentative and Alternative Communication Systems in Languages Other Than English: A Scoping Review

Introduction: Access to augmentative and alternative communication (AAC) systems in languages other than English and multilingual AAC systems remains limited for many people with complex communication needs, despite a growing interest in this field, and an acknowledged need for culturally responsive AAC practice. Purpose: The purpose of this scoping review was to identify published research that has reported on the development of components or whole AAC systems in languages other than English, and the linguistic and cultural factors that influenced research methods and AAC system development. Method: Nine databases were systematically searched for published research that presented development of components or whole AAC systems in languages other than English. The Mixed Methods Appraisal Tool was used to assess the quality of studies. Charted data from studies included journal and publication date, research team, language of AAC system, aims of the study, study methodologies, study participants, and type of AAC systems developed. An analytical framework was developed to identify the cultural and linguistic factors that influenced research methods and or AAC system outcomes. Results: A total of 22 studies were included (13 qualitative, one quantitative nonrandomized, six quantitative descriptive, and two mixed-methods studies). Overall quality of studies was high. Some qualitative studies were of lower quality due to limited analysis or interpretation of results. Linguistic factors were extensively reported in the existing literature, whereas cultural factors were rarely explicitly reported. Conclusion: Factors contributing to lack of reporting of cultural considerations are posited with suggestions for future research

Communication aid requirements of intensive care unit patients with transient speech loss

Alert and transiently nonvocal intensive care unit (ICU) patients are dependent on augmentative and alternative communication (AAC). Unfortunately, the literature demonstrates that existent AAC devices have not been widely adopted, and unaided methods are often the primary modalities used despite being insufficient, and frustrating. We present the results of a qualitative semi-structured interview study with 8 ex-ICU patients, 4 ICU patient relatives, and 6 ICU staff, exploring their AAC needs and requirements. Participants identified important AAC hardware, software, and content requirements. Salient factors impacting on AAC adoption in the ICU setting were also highlighted and included the need for staff training and bedside patient assessment. Based on the study results, we propose a series of recommendations regarding the design and implementation of future AAC tools specifically targeted at this group

Effect of Auditory Training and Aided Language Stimulation on Speech Perception of Children with Hearing loss in Ibadan, Oyo State, Nigeria

Children fitted with hearing aid, without appropriate placement on aural rehabilitation always find it difficult to benefit maximally from the use of such assistive listening device as well as experiencing difficulty in producing intelligible speech sounds. Therefore, most of them become discouraged and not interested to undergo aural rehabilitation. Thus, this study examined the effect of auditory training (AT) and aided language stimulation (ALS), moderated on onset and degrees of hearing loss on the speech perception (detection, recognition and discrimination,) of children fitted with hearing aid in Ibadan, Oyo state, Nigeria. A pretest-posttest control group quasi-experimental research design, using a 3x2x2 factorial matrix, was adopted for the study. A purposive sampling technique was used to select 24 children (age ranged between 4 and 7 years) with hearing loss. The participants were randomly assigned to two treatment groups (AT and ALS) with a twelve-week intervention plan and a non-treatment control group. A standardised auditory trainer, and the Peabody Picture Vocabulary Test - 4th Edition (PPVT-4, r=.80 - .84), were the instruments used for the training. The five hypotheses formulated were tested at 0.05 level of significance, and data collected were analysed using Descriptive Analysis, Multivariate Analysis of Co-Variance (MANCOVA) and   Scheffe Post Hoc Analysis. The findings revealed a significant main effect of treatments on the speech perception of the participants; Recognition (F 71.45, η = 94) Discrimination, (F = 88.11, η = .95) and Detection, (F = 32.06, η = 87), with ALS being a more significant treatment (Recognition (F = 3.37, p<.05); Discrimination (F= 5.25, p<.05) and Detection (F = 3.38, p<.05). The onset of hearing loss on the speech perception of the participants was significant in Recognition, (F = 9.37η=51), Discrimination, (F = 12.40η=57), and Detection, (F = 4.72η=39). The degrees of hearing loss had a significant effect on Recognition, (F = .020η=.002), Discrimination, (F = .032η=004), and  Detection, (F = 4.31η=33),  Treatments and onset of hearing loss interacted on Recognition (F = 4.24,  η = .34);  Discrimination, (F = 4.86, η = .39) and Detection, (F = 8.51, η = 65.);but no interaction between treatment and degree of hearing loss on Discrimination,(F= .73, p>.05); Recognition, (F = .83, p>.05), and Detection, (F = .96, p>.05) Onset of hearing loss interacted with the degrees of hearing loss on Detection, (F = 4.69, η = .39) but not on Recognition (F =.67, p>.05); and Discrimination, (F = .53, p>.05).Treatments, onset of hearing loss and degree of hearing loss interacted on Recognition (F =4.31, df = (1, 23), p<.05, η = .47; and Detection, F = 4.95, df = (1, 23), p<.05, η = .52. but not on Discrimination, F = .14, df = (1,23), p>.05). Based on the above findings, it is recommended that children with hearing loss should be rehabilitated using auditory training and aided language stimulation as part of the aural rehabilitative strategies meant to maximize the use of the assistive listening device. Keywords: Auditory training, aided language stimulation, speech perception, children with hearing impairmen

But I’d rather have raisins! Exploring a hybridized approach to multimodal interaction in the case of a minimally verbal child with autism

This article explores a 'hybridized approach' to multimodal research drawing on video data of classroom communication involving children diagnosed with Autism Spectrum Disorder. The focus is a short video of 'Luke', aged six, who at snack time declines to request an available food item (carrot, tomato or apple) with the available Picture Exchange Communication System (PECS); instead deploying embodied, idiosyncratic communication including gaze, vocalisation and object manipulation to request raisins. The article explores the potential of a hybridized approach for understanding Luke's communicative competencies which draws upon the theoretical perspectives of Ethnography of Communication, Conversation Analysis and Multimodal (Inter)Action Analysis; and uses two forms of multimodal transcription (the multimodal matrix and annotated video stills). It is argued that each tradition brings distinct affordances to our understanding of this short interaction and that together they can permit inferences which would not have been possible working with one approach alone

Reducing the risk of being a victim of crime in South Africa : you can tell and be heard!

People who use AAC know that silence is not always golden. Persons with disability, and in particular those with complex communication needs, have a heightened risk of becoming the victim of crime, abuse and neglect. In order to address one of the several problems associated with this, the present study looked at vocabulary needed to disclose or report crime or abuse in South Africa. Furthermore, it also focussed on the development of communication boards in four of the 11 official South African languages (Afrikaans, English, Sepedi and isiZulu). Thirty-six participants were involved in 4 language-based focus groups (English, Afrikaans, Sepedi and isiZulu). Participants were asked to generate a list of possible words they deemed important when wanting to disclose a crime, abuse or neglect. Participants then prioritized the top 55 words. When the lists from the four language groups were compared, a total of 56 words appeared on two or more of the lists. An electronic mail survey indicated that Picture Communication Symbols (PCS™) were the most frequently used symbol set in South Africa, and hence the board was developed using PCS™. A discrepancy analysis revealed that these 56 words could be represented by a staggering 219 symbols, of which 2 words (swear, threaten) did not have any existing PCS™ symbols. Consequently, they were developed. It is hoped that the process of developing the communication boards described in this paper might also be useful to the AAC community in other countries. Futhmore, the communicaton boards developed in this study can serve as a template for other languages.http://www.tandf.co.uk/journals/titles/07434618.as

The Hands with Eyes and Nose in the Palm: As Effective Communication Alternatives for Profoundly Deaf People in Zimbabwe

Drawing from the experiences and testimonies of people with profound deafness, the study qualitatively explored the use of the hands with eyes and nose in the palm as communication alternatives in the field of deafness. The study was prompted by the 27 year old lady, Leah Katz-Hernandez who is deaf who got engaged in March 2015 as the 2016 outgoing President Obama’s new receptionist at the White House in the United States of America (USA). Further prompts were influenced by the July 2015 paper which was presented at the USA Offices at Eastgate in Harare by Professor Thomas K. Holcomb of Ohlone College from California who is profoundly deaf. The paper emphasized on appropriate provisions as instrumental in enhancing academic performance and productiveness of people with profound hearing impairment (HI), a term used interchangeably with deaf. Point of saturation determined the sample size after no-more new data could be obtained from participants who were purposively selected on the criterion of having succeeded in their academic and professional life despite being profoundly deaf and experience in teaching people who are deaf. Semi-structured open-ended interviews were used to explore the communication experiences of people with HI while guided by the ubuntu and person first philosophy; the Symbolic Interaction Theory (SIT) and Cognitive Dissonance Theory (CDT). Patterns and themes emerging from the collected data were sought through the thematic analysis approach. The findings revealed that, the majority of people with profound deafness considered visual cues as central to successful communication despite the level of hearing loss because vision and touch enabled interaction. The study considered the hands with eyes nose in the palm as effective communication alternatives for people with HI since what was smelt, tasted and seen could be interpreted through hand signing. However, use of Sign Language interpreters was proposed for meaningful inclusive practices rather than skill every lecturer in deaf education. Further studies were proposed on policies mandating the use of talking hands and all other alternatives. Keywords: hands with eyes, mouth, nose, palm, communication alternatives, dea