The Impact of Contextualization and Personal Relevance on Communicative Performance by People with Severe Aphasia

The purpose of this research is to determine how best to represent information in AAC systems for people with moderate/severe/profound chronic aphasia. The researcher hypothesized that people with moderate/severe/profound chronic aphasia will use AAC systems more efficiently and effectively when information is represented through personally-relevant highly contextualized pictures rather than iconic symbols or non-personally relevant contextualized pictures. Data was collected from eight participants with moderate/severe/profound chronic aphasia. Results from eight participants indicated, that people with moderate/severe/profound chronic aphasia prefer and identify personally relevant highly contextualized pictures with greater accuracy than iconic symbols or non-personally relevant contextualized pictures

The perspectives of augmentative and alternative communication experts on the clinical integration of non-invasive brain-computer interfaces

As brain-computer interface for augmentative and alternative communication access (BCI-AAC) development continues to consider avenues for translation into the clinical setting, the perspectives of clinician experts in AAC should be considered. Therefore, 11 USA-based speech-language pathologists who are experts in AAC completed a semistructured interview along with Likert scale measures to assess their perspectives on BCI-AAC. The interviews and scales explored the potential impact of BCI-AAC, along with barriers and solutions to BCI-AAC implementation. Speech-language pathologists estimated that 1.5% to 50% of their caseload may benefit from BCI-AAC across various settings. Further, identified barriers and solutions included (a) BCI-AAC implementation and support, (b) funding and access, (c) applicability and literacy skills, (d) assessment and training in supporting outcomes, and (e) motivation and customization. Results reinforce and extend existing directions for BCI-AAC translation such as user-centered assessment, stakeholder support, and populations who may benefit from intervention, such as children

Moderate-severe, chronic aphasia: An exploration of the changes in social roles

This study explored the changes in social roles following a stroke from the perspective of three people living with moderate-severe, chronic aphasia. The researchers conducted semi-structured interviews with two family members/friends of the people with aphasia. Next, the researchers transcribed the interviews and analyzed them for emergent themes. The researchers used these themes to develop questions and conduct semi-structured interviews with the participants with aphasia—using augmented communication strategies as necessary—to validate, or negate the findings. Although results confirm that a change in social roles is present, some discrepancies exist between family/friends and the people with aphasia

Personalizing AAC for People with Aphasia: The Role of Text and Pictures

Over time, and with intensive instruction, people with aphasia (PWAs) can learn to use grid-based, categorically organized, high-technology AAC layouts during structured tasks (e.g., Hough & Johnson, 2009). In an effort to reduce the training intensity required to teach PWAs to use AAC; researchers developed visual scene displays (VSDs), designed to complement the residual cognitive and linguistic abilities of PWAs by tapping their intact episodic memory. VSD interfaces incorporate personally relevant (PR) photos, text, and speech output (Dietz, McKelvey, & Beukelman, 2006; Weissling & Beukelman, 2006). VSDs appear to facilitate improved communication success (e.g., McKelvey, Dietz, Hux, Weissling, & Beukelman, 2007) as well as relatively efficient learning of system navigation with less instruction than reported for traditional grid layouts (McKelvey et al., 2007; Wallace & Hux, 2012). Figure 1 contrasts VSD and grid interfaces. The success of VSDs is frequently attributed to the PR photographs; however, investigators have not examined the impact of the various VSD elements on communication behaviors. Therefore, the purpose of this study was to examine the influence of PR photographs and the presence of text on a VSD interface on the communication behaviors of PWAs during a narrative retell task

Personalizing AAC for People with Aphasia: The Role of Text and Pictures

Over time, and with intensive instruction, people with aphasia (PWAs) can learn to use grid-based, categorically organized, high-technology AAC layouts during structured tasks (e.g., Hough & Johnson, 2009). In an effort to reduce the training intensity required to teach PWAs to use AAC; researchers developed visual scene displays (VSDs), designed to complement the residual cognitive and linguistic abilities of PWAs by tapping their intact episodic memory. VSD interfaces incorporate personally relevant (PR) photos, text, and speech output (Dietz, McKelvey, & Beukelman, 2006; Weissling & Beukelman, 2006). VSDs appear to facilitate improved communication success (e.g., McKelvey, Dietz, Hux, Weissling, & Beukelman, 2007) as well as relatively efficient learning of system navigation with less instruction than reported for traditional grid layouts (McKelvey et al., 2007; Wallace & Hux, 2012). Figure 1 contrasts VSD and grid interfaces. The success of VSDs is frequently attributed to the PR photographs; however, investigators have not examined the impact of the various VSD elements on communication behaviors. Therefore, the purpose of this study was to examine the influence of PR photographs and the presence of text on a VSD interface on the communication behaviors of PWAs during a narrative retell task

Revisiting the Rainbow: Culturally Responsive Updates to a Standard Clinical Resource

Purpose Cultural responsivity is essential for efficacious and affirming clinical relationships. This may be especially important with historically marginalized clients, such as transgender and gender-diverse (TGD) people seeking behaviorally based affirming communication services. We recommend modifications to standard tools for diagnostics and training that otherwise might undermine our efforts to create an inclusive and affirming environment. Method Modifications to the Rainbow Passage, a standardized paragraph utilized for eliciting speech samples in clinical settings, focused on nongendered terminology and the elimination of content with religious connotations. Results The recommended edits to the Rainbow Passage maintain similar length, cadence, and phonetic balance while considering cultural and health care context for TGD people and other clients. Conclusion Simple linguistic changes to a standardized paragraph maintain clinical benefits and facilitate SLP efforts toward cultural responsivity, client engagement, and good clinical outcomes

Reading comprehension by people with chronic aphasia: A comparison of three levels of visuographic contextual support

This repeated measures investigation evaluated the impact of three levels of visuographic context—(a) photos of high-context scenes, (b) photos of low-context scenes, and (c) no-context—on the reading comprehension of narratives by people with chronic aphasia. Participants included 10 medically-stable adults with chronic aphasia and concomitant reading comprehension deficits. Analysis of individual accuracy scores revealed a subgroup of participants who appeared to benefit from visuographic context. Analysis also yielded significant differences for response time across the conditions. Findings suggest that contextually-rich visuographic information is supportive to at least some individuals with chronic aphasia when they perform reading comprehension tasks

The Impact of Interface Design During an Initial High-Technology AAC Experience: A Collective Case Study of People with Aphasia

The purpose of this collective case study was to describe the communication behaviors of five people with chronic aphasia when they retold personal narratives to an unfamiliar communication partner using four variants of a visual scene display (VSD) interface. The results revealed that spoken language comprised roughly 70% of expressive modality units; variable patterns of use for other modalities emerged. Although inconsistent across participants, several people with aphasia experienced no trouble sources during the retells using VSDs with personally relevant photographs and text boxes. Overall, participants perceived the personally relevant photographs and the text as helpful during the retells. These patterns may serve as a springboard for future experimental investigations regarding how interface design influences the communicative and linguistic performance of people with aphasia. Includes supplementary files

Assessment with children who need augmentative and alternative communication (AAC): Clinical decisions of AAC specialists.

Purpose The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits? Method This study used a phenomenological qualitative design. The researchers conducted 2 in-depth, semistructured interviews with 8 SLPs who specialized in AAC and self-identified as primarily working with children. Results Four major themes emerged from the data: area of assessment, method of assessment, evaluation preparation, and parent education. Each major theme contained multiple subthemes and categories within those subthemes. Conclusions Participants discussed similar areas of assessment for both cases, indicating that some aspects of AAC assessment are universal. However, the specific aspects of what they were assessing and how they went about assessing them differed between the 2 cases. The results of the current study provide an outline of an assessment protocol for children with complex communication needs

Assessment with children who need augmentative and alternative communication (AAC): Clinical decisions of AAC specialists.

Purpose The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits? Method This study used a phenomenological qualitative design. The researchers conducted 2 in-depth, semistructured interviews with 8 SLPs who specialized in AAC and self-identified as primarily working with children. Results Four major themes emerged from the data: area of assessment, method of assessment, evaluation preparation, and parent education. Each major theme contained multiple subthemes and categories within those subthemes. Conclusions Participants discussed similar areas of assessment for both cases, indicating that some aspects of AAC assessment are universal. However, the specific aspects of what they were assessing and how they went about assessing them differed between the 2 cases. The results of the current study provide an outline of an assessment protocol for children with complex communication needs