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

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

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

Using Visual Scene Displays as Communication Support Options for People with Chronic, Severe Aphasia: A Summary of AAC Research and Future Research Directions

Research about the effectiveness of communicative supports and advances in photographic technology has prompted changes in the way speech-language pathologists design and implement interventions for people with aphasia. The purpose of this paper is to describe the use of photographic images as a basis for developing communication supports for people with chronic aphasia secondary to sudden-onset events due to cerebrovascular accidents (strokes). Topics include the evolution of AAC-based supports as they relate to people with aphasia, the development and key features of visual scene displays (VSDs), and future directions concerning the incorporation of photographs into communication supports for people with chronic and severe aphasia

Using Visual Scene Displays as Communication Support Options for People with Chronic, Severe Aphasia: A Summary of AAC Research and Future Research Directions

Research about the effectiveness of communicative supports and advances in photographic technology has prompted changes in the way speech-language pathologists design and implement interventions for people with aphasia. The purpose of this paper is to describe the use of photographic images as a basis for developing communication supports for people with chronic aphasia secondary to sudden-onset events due to cerebrovascular accidents (strokes). Topics include the evolution of AAC-based supports as they relate to people with aphasia, the development and key features of visual scene displays (VSDs), and future directions concerning the incorporation of photographs into communication supports for people with chronic and severe aphasia

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