Attributes of communication aids as described by those supporting children and young people with AAC

Background Those supporting children and young people who use augmentative and alternative communication (AAC) contribute to ongoing complex decision-making about communication aid selection and support. Little is known about how these decisions are made in practice and how attributes of the communication aid are described or considered. Aims To understand how communication aid attributes were described by those involved in AAC recommendations and support for children and young people, and how these attributes were described as impacting on AAC use. Methods & Procedures A secondary qualitative analysis was completed of interview and focus group data from 91 participants involved in the support of 22 children and young people. Attributes of communication aids described by participants were extracted as themes and this paper reports a descriptive summary of the identified software (non-hardware) attributes. Main Contribution Decisions were described in terms of comparisons between commercially available pre-existing vocabulary packages. Attributes related to vocabulary, graphic representation, consistency and intuitiveness of design, and ease of editing were identified. Developmental staging of vocabularies, core and fringe vocabulary, and vocabulary personalization were attributes that were described as being explicitly considered in decisions. The potential impact of graphic symbol choice did not seem to be considered strongly. The physical and social environment was described as the predominant factor driving the choice of a number of attributes. Conclusions & Implications Specific attributes that appear to be established in decision-making in these data have limited empirical research literature. Terms used in the literature to describe communication aid attributes were not observed in these data. Practice-based evidence does not appear to be supported by the available research literature and these findings highlight several areas where empirical research is needed in order to provide a robust basis for practice. What This Paper Adds What is already known on the subject Communication aid attributes are viewed as a key consideration by practitioners and family members in AAC decision-making; however, there are few empirical studies investigating language and communication attributes of communication aids. It is important to understand how those involved in AAC recommendations and support view communication aid attributes and the impact different attributes have. What this paper adds to existing knowledge This study provides a picture of how communication aids are described by practitioners and family members involved in AAC support of children and young people. A range of attributes is identified from the analysis of these qualitative data as well as information about how participants perceive these attributes as informing decisions. What are the potential or actual clinical implications of this work? This study provides a basis on which practitioners and others involved in AAC support for children and young people can review and reflect on their own practice and so improve the outcomes of AAC decisions. The study provides a list of attributes that appear to be considered in practice and so also provides a resource for researchers looking to ensure there is a strong empirical basis for AAC decisions

Advanced Augmentative and Alternative Communication System Based in Physiological Control

Dyskinetic Cerebral Palsy (DCP) is mainly characterized by alterations in muscle tone and involuntary movements. Therefore, these people present with difficulties in coordination and movement control, which makes walking difficult and affects their posture when seated. Additionally, their cognitive performance varies between being completely normal and severe mental retardation. People with DCP were selected as the objective of this thesis due to their multiple and complex limitations (speech problems and motor control) and because their capabilities have a great margin for improvement thanks to physiological control systems. Given their communication difficulties, some people with DCP have good motor con-trol and can communicate with written language. However, most have difficulty using Augmentative and Alternative Communication (AAC) systems. People with DCP gen-erally use concept boards to indicate the idea they want to communicate. However, most communication solutions available today are based on proprietary software that makes it difficult to customize the concept board and this type of control system. This is the motivation behind this thesis, with the aim of creating an interface with characteristics, able to be adapted to the user needs and limitations. Thus, this thesis proposes an Augmentative and Alternative Communication System for people with DCP based on physiological control. In addition, an innovative system for direct con-trol of concept boards with EMG is proposed. This control system is based on a physi-cal model that reproduces the muscular mechanical response (stiffness, inertia and viscosity). It allows for a selection of elements thanks to small pulses of EMG signal with sensors on a muscle with motor control. Its main advantage is the possibility of correcting errors during selection associated with uncontrolled muscle impulses, avoid-ing sustained muscle effort and thus reduced fatigue.La Parálisis Cerebral de tipo Discinésica (DCP) se caracteriza principalmente por las alteraciones del tono muscular y los movimientos involuntarios. Por ello, estos pacientes presentan dificultades en la coordinación y en el control de movimientos, lo cual les dificulta el caminar y afecta su postura cuando están sentados. Cabe resaltar que la capacidad cognitiva de las personas con DCP puede variar desde completamente normal, hasta un retraso mental severo. Las personas con DCP han sido seleccionadas como objetivo de esta tesis ya el margen de mejora de sus capacidades es amplio gracias a sistemas de control fisiológico, debido a sus múltiples y complejas limitaciones (problemas de habla y control motor). Debido a sus dificultades de comunicación, algunas personas con DCP se pueden comunicar con lenguaje escrito, siempre y cuando tenga un buen control motor. Sin embargo, la mayoría tienen dificultades para usar sistemas de Comunicación Aumentativos y Alternativos (AAC). De hecho, las personas con DCP utilizan generalmente tableros de conceptos para indicar la idea que quieren transmitir. Sin embargo, la mayoría las soluciones de comunicación disponibles en la actualidad están basadas en software propietario que hacen difícil la personalización del tablero de conceptos y el tipo de sistema de control. Es aquí donde surge esta tesis, con el objetivo de crear una interfaz con esas características, capaz de adaptarse a las necesidades y limitaciones del usuario. De esta forma, esta tesis propone un sistema de comunicación aumentativo y alternativo para personas con DCP basado en control fisiológico. Además, se propone un Sistema innovador de control directo sobre tableros de conceptos basado en EMG. Este Sistema de control se basa en un modelo físico que reproduce la respuesta mecánica muscular (basado en parámetros como Rigidez, Inercia y Viscosidad), permitiendo la selección de elementos gracias a pequeños pulsos de señal EMG con sensores sobre un músculo con control motor. Sus principales ventajas son la posibilidad de corregir errores durante la selección asociado a los impulsos musculares no controlados, evitar el esfuerzo muscular mantenido para alcanzar un nivel y reducir la fatiga.La Paràlisi Cerebral de tipus Discinèsica (DCP) es caracteritza principalment per les alteracions del to muscular i els moviments involuntaris. Per açò, aquests pacients presenten dificultats en la coordinació i en el control de moviments, la qual cosa els dificulta el caminar i afecta la seua postura quan estan asseguts. Cal ressaltar que la capacitat cognitiva de les persones amb DCP pot variar des de completament normal, fins a un retard mental sever. Les persones amb DCP han sigut seleccionades com a objectiu d'aquesta tesi ja el marge de millora de les seues capacitats és ampli gràcies a sistemes de control fisiològic, a causa dels seus múltiples i complexes limitacions (problemes de parla i control motor). A causa de les seues dificultats de comunicació, algunes persones amb DCP es poden comunicar amb llenguatge escrit, sempre que tinga un bon control motor. No obstant açò, la majoria tenen dificultats per a usar sistemes de Comunicació Augmentatius i Alternatius (AAC). De fet, les persones amb DCP utilitzen generalment taulers de conceptes per a indicar la idea que volen transmetre. No obstant açò, la majoria les solucions de comunicació disponibles en l'actualitat estan basades en programari propietari que fan difícil la personalització del tauler de conceptes i el tipus de sistema de control. És ací on sorgeix aquesta tesi, amb l'objectiu de crear una interfície amb aqueixes característiques, capaç d'adaptar-se a les necessitats i limitacions de l'usuari. D'aquesta forma, aquesta tesi proposa un sistema de comunicació augmentatiu i alternatiu per a persones amb DCP basat en control fisiològic. A més, es proposa un sistema innovador de control directe sobre taulers de conceptes basat en EMG. Aquest sistema de control es basa en un model físic que reprodueix la resposta mecànica muscular (basat en paràmetres com a Rigidesa, Inèrcia i Viscositat), permetent la selecció d'elements gràcies a xicotets polsos de senyal EMG amb sensors sobre un múscul amb control motor. Els seus principals avantatges són la possibilitat de corregir errors durant la selecció associat als impulsos musculars no controlats, evitar l'esforç muscular mantingut per a aconseguir un nivell i reduir la fatiga.Díaz Pineda, JA. (2017). Advanced Augmentative and Alternative Communication System Based in Physiological Control [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/90418TESI

Afluentia: suporte à comunicação para afasia fluente

Aphasia is a language disorder caused by brain damage (eg, stroke) that affects a person’s ability to communicate. Involves different degrees of impairment and it can manifest by difficulties in speaking fluently or difficulty finding words (anomia), but can also entail impairment in spoken language comprehension, inability to repeat words or phrases, impairments in written expression (agraphia), in reading comprehension (alexia) or a combination of any of these difficulties. It can thus result in limitations in the way the person with aphasia interacts with others, for instance, to express how they are feeling as well as their needs, making it hard for them to have a more independent life or have their difficulties addressed. Additionally, this condition also has a strong impact in the life of those around them (e.g., family, carers) as the difficulties of communication, should anything happen, can lead to fear of leaving these patients unattended. Several challenges arise when addressing the communication needs of people with aphasia deriving from the diverse and idiosyncratic nature of their condition and although assisted communication tools have been proposed in the literature (e.g. using pictograms), the characteristics of aphasia often render them as partial solutions. In this sense, this project focuses on understanding the characteristics and needs of aphasic patients and also on the proposal of technology-mediated communication tools that address them in their daily lives. This work adopts a user-centered design and development approach to explore how people with aphasia can be supported in their day-today communication resorting to technology mediation. It was thus achieving an iterative design with the development and evaluation of a proof-of-concept solution for communication aspects, which was progressively implemented and refined having in consideration the identified requirements and the continuous evaluation of the proposed solutions, carried out with a focus group composed by a Speech and Language Therapist (SLT) and a Human Computer Interaction (HCI) Expert. After a first version of the system was achieved, an evaluation phase with Speech and Language Therapists with a strong experience with patients with aphasia took place in order to understand and validate the achieved application, which led to more refinement phases. At its current stage of development, evaluation results show a good level of usability and satisfaction and establish Afluentia as promising ground for further evolving the research on communication mediated by technology to support people with aphasia.A afasia é um distúrbio da linguagem provocada por danos cerebrais (por exemplo, acidente vascular cerebral) e que afeta a capacidade de comunicação de uma pessoa. Envolve diferentes graus de deficiência e pode-se manifestar por dificuldades em falar fluentemente ou dificuldade em encontrar palavras (anomia), mas também pode acarretar prejuízo na compreensão da linguagem falada, incapacidade de repetir palavras ou frases, deficiências na expressão escrita (agrafia), na compreensão da leitura (alexia) ou numa combinação de qualquer uma dessas dificuldades. Pode assim resultar em limitações na forma como a pessoa com afasia interage com outras para, por exemplo, exprimir como se está a sentir assim como as suas necessidades, impossibilitando que tenha uma vida mais independente ou tenha as suas dificuldades abordadas. Além disso, a afasia também tem um forte impacto na vida das pessoas ao redor do afásico (por exemplo, familiares, cuidadores), pois as dificuldades de comunicação da pessoa com afasia podem levar ao medo de deixála desacompanhada por aqueles que a rodeiam. Vários desafios surgem ao abordar as necessidades de comunicação de pessoas com afasia decorrentes da natureza diversa e idiossincrática da sua condição e embora ferramentas de comunicação assistida tenham sido propostas na literatura (por exemplo, usando pictogramas), as características da afasia geralmente tornam essas soluções parciais. Nesse sentido, este projeto foca-se na compreensão das características e necessidades dos pacientes afásicos e também na proposta de ferramentas de comunicação mediada por tecnologia que os abordem, no seu cotidiano. Este trabalho adota uma abordagem de design e desenvolvimento centrada no utilizador de modo explorar como as pessoas com afasia podem ser apoiadas na sua comunicação quotidiana recorrendo à mediação tecnológica. Foi assim conseguindo um design iterativo com desenvolvimento e avaliação de uma solução de prova de conceito para aspectos de comunicação, que foi progressivamente implementada e aperfeiçoada tendo em consideração os requisitos identificados e a avaliação contínua das soluções propostas, realizada com um grupo de foco composto por uma Terapeuta da Fala e um Especialista em Interacção Humano Computador. Após a obtenção de uma primeira versão do sistema, uma fase de avaliação com Terapeutas da Fala com forte experiência com pacientes com afasia também ocorreu de modo a entender e validar a aplicação alcançada, o que levou a mais fases de refinamento. Na sua atual fase de desenvolvimento, os resultados da avaliação mostram um bom nível de usabilidade e satisfação e definem o Afluentia como um terreno promissor para evoluir ainda mais a pesquisa em comunicação mediada por tecnologia de suporte a pessoas com afasia.Mestrado em Engenharia de Computadores e Telemátic

Contributos para o desenvolvimento de aplicações para crianças com problemas de comunicação e integração

Communication, to express our needs and ideas, is a fundamental piece of our daily lives, enabling our interaction with others and contributing to establish social bonds. When this ability is affected, whether by contextual issues (e.g., noisy environment) or intrinsic conditions (e.g., speech articulation difficulties) it creates a challenging scenario for both the individuals and those surrounding them. Children diagnosed with Austism Spectrum Disorders (ASD) are a notable example of an audience facing these challenges given their frequent difficulties to communicate and socially interact with others. In this context, their challenges not only affect their ability to integrate with family and friends, but can also influence how they perform at school, an important environment for their development. In recent years, efforts have been made to propose technological solutions that contribute to support these children in their communication, but most of the work in the literature mainly focuses on the child entailing a support that does not truly addresses integration. Considering this context, we argue that these challenges need to be addressed considering the needs and motivations of children with ASD, but also keeping in mind the motivations of those around them, helping parents, teachers and friends to take part in the integration. Profiting from previous work on the characterization of the needs and motivations of children with ASD, their families, and teachers, the work carried out explores different communication-related scenarios, at school and at home, and proposes a set of requirements that should be considered to serve them. Considering these requirements, and adopting an iterative user-centered design approach, a first proof-of-concept application is proposed. AMICA, Adaptive Multimodal Integrated Communication for All, is a multi-platform, multiuser and multimodal application that aims to illustrate how some issues that affect children with ASD and those surrounding them can be addressed in order to their lives easier. At its current stage, AMICA already encompasses support for several communication features adapted to serve the child, family, friends, and teachers providing them a space for interaction. The modular multi-platform nature of the work carried out enables AMICA as a testbed for further research on different multimodal ways of communication for children with ASD (e.g., gaze or pictograms), but, also, by allowing the participation of different users, it fosters first studies on the dynamic nature of such communication.A comunicação, para expressar as nossas necessidades e ideias, é uma peça fundamental do nosso dia a dia, permitindo a nossa interação com os outros e contribuindo para estabelecer laços sociais. Quando essa capacidade é afetada, seja por questões contextuais (por exemplo, ambiente ruidoso) ou condições intrínsecas (por exemplo, dificuldades de articulação de fala), ela cria um cenário desafiante tanto para os indivíduos como para os que os rodeiam. As crianças diagnosticadas com Perturbação do Espetro do Autismo (PEA) são um exemplo notável de uma audiência que enfrenta esses desafios, devido às suas frequentes dificuldades para comunicar e interagir socialmente com os outros. Neste contexto, os seus desafios não afetam apenas a sua capacidade de integração com a família e os amigos, podendo, também, influenciar o seu desempenho na escola, um ambiente importante para o seu desenvolvimento. Nos últimos anos, têm sido feitos esforços para propor soluções tecnológicas que contribuam para apoiar essas crianças na sua comunicação, mas a maior parte do trabalho na literatura concentra-se principalmente no uso, pela criança, de apoios que não abordam verdadeiramente a integração. Considerando esse contexto, argumentamos que esses desafios precisam de ser abordados considerando as necessidades e motivações das crianças com PEA, mas também tendo em mente as motivações das pessoas ao seu redor, ajudando pais, professores e amigos a participarem na integração. Aproveitando os trabalhos anteriores sobre a caracterização das necessidades e motivações das crianças com PEA, as suas famílias e professores, o trabalho realizado explora diferentes cenários relacionados à comunicação, na escola e em casa, e propõe um conjunto de requisitos que devem ser considerados para os servir. Considerando esses requisitos e adotando uma abordagem de projeto iterativa, centrada no utilizador, uma primeira aplicação de prova de conceito é proposta. AMICA, Adaptive Multimodal Integrated Communication for All, é uma aplicação multi-plataforma, multi-utilizador e multimodal que visa ilustrar como algumas questões que afetam as crianças com PEA e aqueles que as rodeiam podem ser abordadas para tentar facilitar as suas vidas. No estado atual, a AMICA já engloba o suporte a vários recursos de comunicação adaptados para atender a criança, a família, os amigos e os professores, proporcionando-lhes um espaço de interação. A natureza modular multi-plataforma do trabalho realizado permite que AMICA seja uma base para mais pesquisas sobre diferentes formas multimodais de comunicação para crianças com PEA (por exemplo, olhar ou pictogramas), mas, também, permitindo a participação de diferentes utilizadores, promove primeiros estudos sobre a natureza dinâmica de tal comunicação.Mestrado em Engenharia de Computadores e Telemátic

Investigating the effects of corpus and configuration on assistive input methods

Assistive technologies aim to provide assistance to those who are unable to perform various tasks in their day-to-day lives without tremendous difficulty. This includes — amongst other things — communicating with others. Augmentative and adaptive communication (AAC) is a branch of assistive technologies which aims to make communicating easier for people with disabilities which would otherwise prevent them from communicating efficiently (or, in some cases, at all). The input rate of these communication aids, however, is often constrained by the limited number of inputs found on the devices and the speed at which the user can toggle these inputs. A similar restriction is also often found on smaller devices such as mobile phones: these devices also often require the user to input text with a smaller input set, which often results in slower typing speeds. Several technologies exist with the purpose of improving the text input rates of these devices. These technologies include ambiguous keyboards, which allow users to input text using a single keypress for each character and trying to predict the desired word; word prediction systems, which attempt to predict the word the user is attempting to input before he or she has completed it; and word auto-completion systems, which complete the entry of predicted words before all the corresponding inputs have been pressed. This thesis discusses the design and implementation of a system incorporating the three aforementioned assistive input methods, and presents several questions regarding the nature of these technologies. The designed system is found to outperform a standard computer keyboard in many situations, which is a vast improvement over many other AAC technologies. A set of experiments was designed and performed to answer the proposed questions, and the results of the experiments determine that the corpus used to train the system — along with other tuning parameters — have a great impact on the performance of the system. Finally, the thesis also discusses the impact that corpus size has on the memory usage and response time of the system

Some problems of designing for augmentative and alternative communication users: an enquiry through practical design activity

The submission is concerned with, and addresses, problems of designing for people with disabilities, with specific reference to people who are illiterate and cannot speak. People with such disabilities often depend on electronic AAC (Augmentative and Alternative Communication) devices for interpersonal communication. A central theme of the thesis, however, is that such products, and products intended for people with disabilities more generally, have characteristics that inadequately attend to users' needs. Through a combination of practical product development and literature reviews, the thesis demonstrates how improvements to AAC devices 'can be made through user-participatory, usercentred and more sensitive and perceptive design. Literature reviews in the following subjects are reported: AAC; the operational knowledge base for design and disability; user participatory design; and wearable computing. At the core of the thesis is the presentation and discussion of an empirical case study, carried out by the researcher, to design and develop the Portland Communication Aid (PCA). The PCA was conceived as an AAC product that would attempt to redress the inadequacies of predecessor devices. The design activity for the PCA is traced in the thesis, from initial concepts and development models through to a working prototype. Key ideas and essential principles of the design are illustrated. Throughout the work on the PCA, many problems associated with designing for people with severe communication disabilities were encountered. These problems, as with their resolutions, comprised matters of both designing (as an activity) and design (as product specification). The thesis contains comprehensive exposure and analysis of these problems and resolutions. In particular, the value of shaping meaning, metaphor, and other product semantics into devices intended for use by people with disabilities is explored. The study provides two substantive conclusions. First, that both the activity and the outcomes of Industrial Design have a valuable role in the empowerment and rehabilitation of AAC users. And second, that key principles have been identified that will enable designers to better identify, articulate and respond to the needs of people with communication disabilities (and the needs of people with disabilities more generally

Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data

Conceptual design and development model of assistive courseware for young low vision learners (AC4LV)

The focus of this study relates to technology (hardware and software) that is purposely designed for people with disabilities (PWDs), which is called Assistive Technology (AT). Previous findings reveal that studies related to educational content in courseware is highly lacking, particularly for low vision learners. Also, many existing conceptual design models of courseware lack of specific requirements and empirical evidences to cater the needs of low vision learners. Preliminary studies have proven that available content applications fail to cater the needs of low vision learners in terms of information accessibility, navigationability, and pleasurability. Hence, this study proposes a conceptual design model of courseware for low vision learners, named as Assistive Courseware for Low Vision (AC4LV). Four (4) specific objectives are formulated. The Design Science Research Methodology has been adopted. Eight (8) components of Conceptual Design Model of AC4LV have been constructed and integrated: structural, content composition, AC4LV element, learning theories, learning approaches, development process, instructional design model, and technology. The proposed model has been reviewed by 12 experts and validated through prototyping. It was found that the proposed model has been well-accepted by local and international experts. Prototyping has implicated that the model is useful to follow by novice and non-technical developers. On top of that, the findings of user experience testing indicate that the AC4LV is able to fulfill the needs of the low vision learners in terms of information accessibility, navigationability, and pleasurability. All these findings demonstrate that the Conceptual Design Model of AC4LV exhibits useful development for content application as well as providing theoretical and practical contributions of the study.This study provides guidelines for developing educational content in courseware that caters the need of low vision learners so that this particular group of PWDs may gain equal opportunities of learning