Investigating the success factors of expert users to inform device development

Objective: Expert user testing is a well recognised tool within user experience and human computer interaction design. Within the domain of assistive technology device design, however, this technique seems to be little used. It is suggested that studying the success factors of expert assistive technology device users may provide a valuable source of data to inform development of assistive technology devices. This paper presents an example of this technique, within the context of a number of studies carried out by the authors, using the example of preliminary data from a study informing the development of an innovative Augmentative and Alternative Communication (AAC) device. Main Content: The paper presents a qualitative study whose objective was to influence the design and further development of an innovative voice-input voice-output communication aid (Vivoca) which has previously reached proof-of-concept stage. The Vivoca device is designed for people with dysarthria and this dictates a number of specific constraints and considerations. In order to understand how Vivoca could be designed to be used successfully by people with dysarthria, this study aimed to identify the factors associated with expert users' successful use of current AAC devices. In order to allow comparison, the study included users with some understandable speech and also those with no understandable speech. The study procedure was designed to provide a profile of participants' communication methods and to identify the factors that participants felt made their communication successful. Results: Preliminary results from the study (currently underway) are presented, including a qualitative analysis of interview data, and data profiling participants' communication methods and context. Initial data has highlighted the very specific requirements for a communication aid design for people with some understandable speech. Conclusion: Study of expert users may provide an effective tool to help inform assistive technology device development

Factors related to the rejection and/or abandonment of AAC devices

More than 3.5 million Americans have such significant communication disability that they cannot rely on their natural speech to meet their communication needs. As a result, these individuals are severely restricted in their participation in all aspects of life, including their education, employment, family, and community. Augmentative and alternative communication strategies offer great potential to enhance the communication of individuals with complex communication needs, and therefore improve their quality of life. Fifty-two ISAAC members that responded to the online survey utilized a 5 point Likert-type scale (strongly agree to strongly disagree) to rate the importance of factors as they relate to the rejection and/or abandonment. The mean values of ratings were calculated to determine which factors were cited as relevant in predicting AAC device rejection and abandonment. Additionally, an independent T-test was utilized to determine if the factors cited varied depending on the role of the person completing the survey. The results of this investigation indicate that it is imperative to consider a complex interaction of factors pertaining to the individuals who use AAC, their conversational partners, settings in which interactions occur, and devices used to interact, when designing an AAC intervention. The statistical analysis revealed no significance difference in how the respondents rated the factors based on their occupation. Based on the results of the study, a checklist of factors that an AAC practitioner might consider addressing in order to foster acceptance of AAC systems initially and later on was constructed

Use of an agile bridge in the development of assistive technology

Engaging with end users in the development of assistive technologies remains one of the major challenges for researchers and developers in the field of accessibility and HCI. Developing usable software systems for people with complex disabilities is problematic, software developers are wary of using user-centred design, one of the main methods by which usability can be improved, due to concerns about how best to work with adults with complex disabilities, in particular Severe Speech and Physical Impairments (SSPI) and how to involve them in research. This paper reports on how the adoption of an adapted agile approach involving the incorporation of a user advocate on the research team helped in meeting this challenge in one software project and offers suggestions for how this could be used by other development teams

A home-based intervention using augmentative and alternative communication (AAC) techniques in rural Kenya: what are the caregivers’ experiences?

Background Caring for a child with complex communication needs associated with a developmental condition frequently adds stress to the caregiver. Furthermore, professional assistance is scarce in low-income rural settings. For such children speech is frequently unachievable. Augmentative and alternative communication provides options for supplementing or replacing speech with other techniques. The current study aimed to examine the experiences of caregivers in Kenya before and after a home-based intervention using augmentative and alternative communication techniques with children with complex communication needs. Methods Caregivers were interviewed pre- and post-intervention. The interviews were digitally recorded, transcribed and translated into English. Content analysis was applied through the stages of text familiarization and topic organization. Emergent themes and their sub-themes were identified and labelled. Connections between themes were established and interpretations made. The procedure was completed by a second researcher independently. Conflicting ideas were jointly discussed until consensus was achieved. Results Four themes emerged from the data: communication process; struggle; normality; and supernatural power. Before intervention, the caregivers acknowledged their expertise in communications with the child, while also revealing their sense of isolation, burden and pain. Normality was present as a source of comparison and also an aspirational goal. Post-intervention more positive language was used to describe the child. There was an ‘opening up’ of communication that recognized the child’s strengths and some social support systems were re-established. The power of the supernatural was recognized before and after intervention. Conclusion Caring of a child with complex communication needs presents many challenges. A home-based intervention using augmentative and alternative communication techniques appears to have been a catalyst for some positive transformations in the caregivers’ experiences, although it is not possible to attribute this change to any one aspect. The potentials of the home-based intervention would benefit from further investigation on a larger scale

What children on the autism spectrum have to ‘say’ about using high-tech voice output communication aids (VOCAs) in an educational setting

This paper focuses on accessing the experiences of three boys who are on the autism spectrum to identify what using a voice output communication aid (VOCA), within a classroom setting, means to them. The methods used to identify the boys' perspectives are described and evaluated. Establishing these through direct methods of engagement proved problematic but working with parents and school staff as ‘expert guides’ provided a rich insight into what using a VOCA appeared to mean to the boys. The findings suggest that using a computer-based VOCA can be viewed by children with autism as a pleasurable and motivating activity. This technology also seems to offer the potential for a much broader developmental impact for these children than that currently recognised within the research literature

Application-Based Development of Alternative and Augmentative Communication System for Children with Cerebral Palsy

Based on the observation results, children with cerebral palsy were the subjects of the study. They communicate using gestures such as pointing accompanied by meaningless vocalizations. Only some people can immediately understand what the child intends. When they need something, the child will cry and scream. Based on these obstacles, the children need media as an alternative and augmentative communication system that can support them in communicating with their modalities and needs, one of which is using symbolic pictures and voice output. This research aims to design an alternative and augmentative communication program based on the children's assessment results. This research uses a qualitative approach with data collection techniques such as interviews, observations, and documentation. The study results in a program design expected to be implemented as a comprehensive tool to assist children in communication

Expert perspectives on using mainstream mobile technology for school-age children who require augmentative and alternative communcation (AAC): a Policy Delphi study

Despite legislation in the U.S.A requiring the use of assistive technology in special education, there remains an underutilization of technology-based speech intervention for young students who require augmentative and alternative communication (AAC). The purpose of this Policy Delphi study was to address three guiding research questions that relate to the feasibility of using mainstream mobile technology, facilitative actions, and stakeholder roles for implementation and utilization of AAC in elementary school settings. Data were collected in two rounds of questionnaires given to experts in special education, assistive technology and speech and language pathology, with experience in AAC. Round 1 included 19 participants, 14 of whom also completed the Round 2 questionnaire. The results indicated that a very strong case can be made that mainstream mobile devices have several advantages over traditional AAC systems, not only in their affordability, but also transparency and social acceptance by providing an ideal medium for inclusion in mainstream settings. A challenge that confronts AAC innovations is the tendency to focus on the technology instead of pedagogical, social and therapeutic goals. Until a perfect AAC system becomes available for mainstream mobile devices that meet individuals’ communicative, educational and physical needs and personal preferences, it is apparent that multimodality will continue to be the model. The utilization of mainstream mobile technology for AAC necessitates certain facilitative actions and stakeholder responsibilities. Team collaboration is essential in supporting AAC use and, when applicable, facilitating the inclusion and mainstreaming of students who use AAC in the general education setting

Identification of Opportunity Barriers and Supports for Individuals Using Augmentative and Alternative Communication (AAC) and Stakeholders

Individuals using augmentative and alternative communication (AAC) are supported by many AAC stakeholders and communication partners. Clinical decision making and AAC assessment models consider the capabilities and access needs of the individual using AAC, as well as opportunity barriers and supports imposed by communication partners and environments. The purpose of this research was to investigate opportunity barriers and supports identified by two critical AAC stakeholders: speechlanguage pathologists and caregivers. The first study investigated characteristics of AAC service provision reported by post-professional speech-language pathologists. Speech-language pathologists reported lack of perceived knowledge related to AAC service delivery, inconsistent use of AAC modalities, and persistent barriers to AAC service provision. The second study analyzed parent, guardian, and caregiver perceptions of AAC interventions for school-aged children. Caregivers preferred family-centered rather than patient-centered service delivery models to facilitate AAC use by their child. The third study investigated experiences and contributing factors of stress in adult caregivers of children using AAC. Caregivers’ stress was impacted by the multiple enveloping systems. Within the family, caregivers’ experiences of stress were predicted by number of children and the caregivers’ educational level. Stress was mitigated by support systems which meet caregivers’ needs and expectations. This research reveals opportunity barriers and supports are a critical component to AAC service delivery and clinical decision making as perceived by speech-language pathologists and caregivers. Sustainable and adequate AAC service delivery requires AAC stakeholders to recognize opportunity barriers and implement supports to facilitate the long-term participation and communication of individuals using AAC. Augmentative and alternative communication service delivery in the absence of explicit consideration for communication partners and environments does not address opportunity barriers for the individual using AAC

The Relationship Between Recent CSD Graduates\u27 Comfort and Training with AAC and Their Knowledge of AAC

The purpose of this research was to investigate the perspectives of recent Communication Sciences and Disorders (CSD) graduate students regarding their comfort and training around Augmentative and Alternative Communication (AAC) and examine the Dunning-Kruger effect between recent CSD graduates’ knowledge with AAC versus their perceived expertise of AAC. The researcher distributed an online survey via email, social media, American Speech-Language- Hearing Association (ASHA) Special Interest Groups to individuals who graduated from a CAA- accredited Speech-Language Pathology master’s program with a graduation year of 2018-2022 who now currently hold either their Certificate of Clinical Competency (CCC-SLP) or their Clinical Fellowship license (CF-SLP). A total of 42 participants completed the survey to 100% completion or completed the survey up until the knowledge portion (73% complete). Less than half of participants felt prepared by their graduate-level educational experiences. Additionally, while nearly 2/3 of participants feel comfortable providing services, few participants feel comfortable assessing clients with AAC or troubleshooting devices. This research survey found no correlation between knowledge and perceived expertise, likely due to participants feeling unprepared. The results of this study provide pilot data suggesting that graduate programs need to offer more cohesive education and strive for their graduate students to receive high-quality graduate-level clinical experiences