An application of steady state visual evoked potential brain-computer interface as an augmentative alternative communication system for individuals with severe motor impairments

Thesis (M.S.)--Boston UniversityPURPOSE: Tbis study will look at the feasibility of Steady State Visually Evoked Potential (SSVEP) brain-computer interfaces (BCI) as possible augmentative and alternative communication (AAC) systems for individuals who are severely disabled such as those with Locked-in Syndrome (LIS). The study intended to test whether there is a difference in BCI performance between healthy and impaired individuals and why. Specifically, the study focused on the operational competency, such as ocular motor function, ofthe impaired individuals as it relates to performance. Further, the study also attempted to explore the contributions of environmental distracts to performance. The results oftbis investigation will provide insights valuable for future BCI-AAC development and the potential for their acceptance by the AAC and LIS communities. METHODS: The study consisted of 12 healthy adults and 5 severely disabled adults presenting with 4 different neurological disorders. Tbis study consisted to two parts. The first part was an assessment ofthe communicative abilities ofthe impaired subjects. The assessment was conducted through a video recorded interview, from which communication rates were calculated and behavioral observations of each impaired subject's communicative behaviors were made with a focus on ocular motor behavior. The second part involved testing of the SSVEP BCI. All subjects performed selection tasks from a choice of four directions in the UDLR task. For each trial, the subject was prompted to attend to a specific SSVEP stimulus. Each stimulus was selected at random to flash at one of four frequencies (12, 13, 14, or 15Hz) (Lorenz, 2012). After 4 seconds, the BCI predicted the attended cue direction (Up, Down, Left, Right). If the prediction was correct, a "thumbs-up" feedback signal was shown to the subject; a "thumbs-down" was shown for incorrect predictions. The UDLR data collected for each trial consisted of a table with two columns: one column recorded the ground truth, which was the target direction, and one column recorded the decoded, or classified direction. Two additional columns were added. One column indicated whether the subject had any ocular motor impairment with a 1 or 0. A binary logistic regression was completed to investigate the main effect of age, subject group, and ocular motor impairment with respect to BCI accuracy. Additionally, observations regarding the affect of environmental distractions were also made. [TRUNCATED

Evaluating Camera Mouse as a computer access system for augmentative and alternative communication in cerebral palsy: a case study

PUPRPOSE: Individuals with disabilities, who do not have reliable motor control to manipulate a standard computer mouse, require alternate access methods for complete computer access and for communication as well. The Camera Mouse system visually tracks the movement of selected facial features using a camera to directly control the mouse pointer of a computer. Current research suggests that this system can successfully provide a means of computer access and communication for individuals with motor impairments. However, there are no existing data on the efficacy of the software’s communication output capabilities. The goal of this case study is to provide a comprehensive evaluation of Camera Mouse as a computer access method for Augmentative and Alternative Communication (AAC) for an individual with cerebral palsy, who prefers to use her unintelligible dysarthric speech to communicate her desires and thoughts despite having access to a traditional AAC system. METHOD: The current study compared the Camera Mouse system, the Tobii PCEye Mini (a popular commercially available eye tracking device) paired with speech generating technology, and natural speech using a variety of tasks in a single dysarthric speaker. Tasks consisted of two questionnaires designed to measure psychosocial impact and satisfaction with assistive technology, two sentence intelligibility tasks that were judged by 4 unfamiliar listeners, and two language samples designed to measure expressive language. Each task was completed three times—once for each communication modality in question: natural speech, Camera Mouse-to-speech system, and Tobii eye tracker-to- speech system. Participant responses were recorded and transcribed. RESULTS: Data were analyzed in terms of psychosocial effects, user satisfaction, communication efficiency (using intelligibility and rate), and various measures of expressive output ability, to determine which modality offered the highest communicative aptitude. Measures showed that when paired with an orthographic selection interface and speech-generating device, the Camera Mouse and Tobii eye tracker resulted in greatly increased intelligibility. However, natural speech was superior to assistive technology options in all other measures, including psychosocial impact, satisfaction, communication efficiency, and several expressive language components. Though results indicate that use of the Tobii eye tracker resulted in a slightly higher rate and intelligibility, the participant reported increased satisfaction and psychosocial impact when using the novel Camera Mouse access system. CONCLUSION: This study is the first to provide quantitative information regarding the efficiency, psychosocial impact, user satisfaction, and expressive language capabilities of Camera Mouse as a computer access system for AAC. This study shows promising results for Camera Mouse as a functional access system for individuals with disabilities and for future AAC applications as well.2018-08-28T00:00:00

The Challenges and Perceptions of Raising a Child Who Uses AAC: A Review of the Literature

The purpose of this review was to examine the perceptions of parents and caregivers on raising a child who uses augmentative and alternative communication (AAC). Factors and overarching themes in existing literature affecting parent’s perceptions were examined and condensed in this review. Seven research studies were chosen for analysis. A variety of common perspectives were found in the research and the conclusions relating to caregiver challenges and thoughts on AAC were categorized, including four thematic categories: problems with the AAC system; barriers to learning AAC; societal, family, and professional influences; and differences among individuals who use AAC. Information gained in this review may be used to improve professional development for speech-language pathologists (SLPs) and teaming between parents and SLPs

The Quality of Transdisciplinary Team Assessment Practices for Mobile Technology as Augmentative and Alternative Communication

While research acknowledges the impact the rapid growth in mobile technology is having on the field of augmentative and alternative communication (AAC), little has been done to investigate the impact this development has had on assessment practices for matching an individual with the appropriate technology. The purpose of this descriptive and causal-comparative research study was to gather demographic and descriptive data on mobile technology as AAC and to investigate the quality of transdisciplinary teamwork assessment practices as evaluated by speech-language pathologists (SLPs) for the provision of mobile technologies as AAC devices across SLP practice settings. A random sample of 60 SLPs in each of the three practice settings of education, health care, and private practice completed a survey containing demographic questions and the Team Decision Making Questionnaire (TDMQ). Proposed data analysis consisted of descriptive statistics and an ANOVA. Due to a violation of homogeneity, a Welch’s ANOVA was conducted with post hoc testing. A statistically significant difference between SLP ratings of the quality of transdisciplinary assessment practices for mobile technology as AAC was discovered between education and health care settings as well as between education and private practice settings. This difference was significant across all subscales of the TDMQ as well. There was no statistically significant difference found in quality ratings between health care and private practice settings. Descriptive analysis revealed additional areas of differences across practice settings in the provision of mobile technology as AAC. Limitations of this study were identified and further research recommendations were made

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

Best Practices for Children and Youth with Autism Spectrum Disorder: A Resource Guide for Community Partners

Students with Autism Spectrum Disorder (ASD) present a unique challenge, and learning opportunity for professionals. The purpose of this study was to create a comprehensive and accessible handbook to empower those who work with children and youth with ASD in a community setting. The best practices and effective intervention programs for students with ASD were researched and evaluated. Four individuals from various community agencies voluntarily participated in a Needs Assessment Questionnaire and, based on their information, a Handbook on Best Practices for Children with ASD, including a resource section was created. The theoretical framework examined for this project was based on social-cognitive theory, specifically Bandura's (1986) theory of triadic reciprocity and reciprocal determinism. This theory places emphasis on the fact that behaviour must be evaluated in the course of normal development, and that what may be appropriate for an individual at one age or point in time, may not be at another. Once the handbook was complete, an Evaluative Questionnaire was circulated to determine its effectiveness and overall benefits in practice for community partners in the field. The results of this questionnaire contributed to a final copy of the handbook. Implications for future research were considered and the limitations of this study were examined

BARRIERS TO CHANGE FOR AUGMENTATIVE AND ALTERNATIVE COMMUNICATION

The purpose of this study was to identify the effects of counseling training on speech language pathologists’ (SLPs) perceived competency to address Attitude Barriers within the augmentative and alternative communication (AAC) assessment process as presented by Beukelman and Mirenda (2005). Counseling techniques, such as the use of the Readiness to Change© tool, are within the scope of practice for SLPs. Unfortunately, there is a lack of research on how to apply these tools and techniques with individuals who use AAC . A training seminar was conducted to educate participants in the use of the Readiness to Change© tool. Data was collected using a mixed-methods pre-and post-test survey. The quantitative results indicated a statistically significant change in participants’ perceived competency to use the counseling tools. The qualitative results identified several interesting themes within SLPs responses. Continuation of this research topic is recommended based on the both the outcomes of the data as well as the need for further knowledge on the subject

An Overview of Speech-Language Pathologists’ Current Practices for Bilingual Children with Childhood Apraxia of Speech

Purpose: This study aimed to explore and describe current practices of speech-language pathologists (SLPs) who presently work or have worked with bilingual children with Childhood Apraxia of Speech (CAS) in diverse settings. Exploration of this topic may contribute to the need for more knowledge in the Speech-Language Pathology field regarding evidence-based practices for the target population. The primary aims addressed in this study were: 1) To describe the assessment procedures currently used by speech-language pathologists to diagnose bilingual children with Childhood Apraxia of Speech, 2) To describe the intervention approaches currently used by speech-language pathologists to treat bilingual children with Childhood Apraxia of Speech, 3) to describe diversity training provided to SLPs who treat bilingual children with Speech Sound Disorders (SSDs) across regions. Method: This study followed a qualitative research approach utilizing a descriptive, questionnaire-based survey design. An online survey of speech-language pathologists working with bilingual children with SSDs and CAS was distributed through e-mail and snowball sampling. The survey requested information regarding the clinicians\u27 background and work setting, the composition of caseloads, diversity training, current assessment procedures used in the field, current intervention approaches used in the field, and service delivery challenges. Results: Seven surveys were received and analyzed. Monolingual and bilingual participants from Colorado, Texas, and Virginia participated in the study. Of the total participants, six reported providing services to bilingual children with SSDs, and only four participants indicated currently providing services to bilingual children with Childhood Apraxia of Speech. Between 10-25% of the participants\u27 total caseload comprised bilingual children with SSDs between ages 4-12, and less than 10% of children in their total caseload were identified as bilinguals with CAS between the ages 5-12. All participants reported being competent and comfortable at assessing and treating individuals from a cultural or racial background other than their own, even though 57.1% of SLPs reported that service bilingual children do not speak a second language. In addition, all participants indicated that they do not utilize the services of interpreters/translators when assessing and treating bilingual children aligning with the lack of coursework received on working with an interpreter throughout their carrier and the ongoing challenge faced by these participants on the lack of interpreters who speak the necessary languages to provide services. Speech-language pathologists employ a combination of formal and informal methods to assess bilingual children with Childhood Apraxia of Speech. These methods are modifications of monolingual English assessment and treatment approaches as they have not yet been explored and are not supported by evidence to be employed with the target group. Conclusions: Results confirm the ongoing growth diversity of the population in our country and the lack and limited resources to provide best-practice to bilingual children with SSDs and Childhood Apraxia of Speech. Clinicians are trying to closely follow the American Speech-Language-Hearing Association\u27s (ASHA) recommended guidelines when providing services to bilingual children. However, despite the increase and improvement of training opportunities, a large proportion of SLP professionals still lack confidence in serving the bilingual Hispanic population due to insufficient training in this area. Currently, SLPs rely on various modifications of monolingual English assessment and treatment approaches, which may yield uneven or erroneous outcomes as they may not consider cultural and linguistic variables. Hence, the need for specialized skills and the ability to recognize individual differences, given the child\u27s linguistic background and the nuances of bilingual language development, is highly necessary when serving bilingual children with Childhood Apraxia of Speech. The urgent need for more study in this field has been established, particularly on the best effective evaluation technique and treatment method to utilize with this population. Continued descriptions of developmental norms in culturally and linguistically diverse groups, evidence-based screening and assessment techniques, and research-based intervention methods should be included in future studies. Hence, based on these findings, recommendations are to conduct further studies that contribute to developing evidence-based practice guidelines and ensure the best quality of services to culturally and linguistically diverse children with Childhood Apraxia of Speech

Using Machine Learning Techniques to Model Encoder/Decoder Pair for Non-invasive Electroencephalographic Wireless Signal Transmission

This study investigated the application and enhancement of Non-Invasive Brain-Computer Interfaces (NI-BCIs), focused on enhancing the efficiency and effectiveness of this technology for individuals with severe physical limitations. The core research goal was to improve current limitations associated with wires, noise, and invasive procedures often associated with BCI technology. The key discussed solution involves developing an optimized Encoder/Decoder (E/D) pair using machine learning techniques, particularly those borrowed from Generative Adversarial Networks (GAN) and other Deep Neural Networks, to minimize data transmission and ensure robustness against data degradation. The study highlighted the crucial role of machine learning in self-adjusting and isolating essential data for accurate and efficient classification. The research design involved training this E/D pair to unlock applications of NI EEG BCIs, such as speech synthesis and seamless control of mobile devices. This research successfully trained the E/D pair with a compression ratio of 500 to 75 data points. With parallel processing, this paper successfully processed and transmitted 36 channels of EEG data without data loss at 97% accuracy in 0.0752s. By successfully developing a robust E/D pair, the study aims to revolutionize BCI technology, paving the way for more intuitive interfaces and significantly improving the quality of life for locked-in individuals. This research thus contributes to advancements in NI-BCIs, harnessing machine learning to address current limitations and unlock new possibilities for this critical technology

A Formative Evaluation Of Augmentative And Alternative Communication Approaches To Promote Literacy In Young Children With Severe Speech And Physical Impairments

This thesis describes an educational intervention with three children with severe speech and physical impairments. The intervention focused on storybook reading experiences for early literacy development through the use of Augmentative and Alternative Communication technologies and methods. The review of literature focused on the main aspects relating to children with SSPI, and in particular on the difficulties they experience in developing emergent literacy skills. This review suggests the hypothesis that the use of AAC Techniques in storytelling achievement can provide emergent literacy experiences, which can promote the development of literacy in children with SSPI. In particular the study set out to enquire whether AAC techniques can be used to enhance participation with SSPI in storytelling activities, and whether such activities improve a pupil’s opportunities to become emergent readers. A six-month intervention was designed which included strategies proposed for increasing the children’s participation during storybook reading sessions, like repeated readings of the same story, abundant use of graphic symbols and access to AAC techniques. Qualitative data were gathered from the professionals at the Centre, and from the mothers. Storybook reading sessions with the teacher at school and with the mothers or significant other at home were videotaped, at the beginning and at the end of the intervention. Quantitative data were collected by videotape analysis. Communicative acts of children and adults were divided into communication categories, and their meaning was discussed as to form, use and content. One of the main conclusions of the study was that the use of stories promoting communication and language learning in storybook reading sessions can develop literacy skills if carried out in conjunction with AAC techniques, including graphic symbols and the technology to generate them. A second conclusion is that there is no automatic transfer of the improvement of communicative skills in the classroom to the interaction with the mothers