Strategies in conveying information about unshared events using aided communication

Describing events may be challenging for any child, but children who use communication aids may face unique linguistic, pragmatic, and strategic challenges in conveying information with the communication means they have available. This study explores strategies used by young, aided communicators when describing the content of a video unknown to their communication partners. The participants of the study were 48 aided communicators (aged 5;3-15;2) from nine countries and seven language groups and their communication partners (parents, professionals, and peers) who used natural speech. Descriptive and statistical analyses were utilized to investigate the relationships between individual characteristics, linguistic and non-linguistic factors, linguistic strategies, and performance in conveying the content of the video event. Analyses of the 48 videotaped interactions revealed the use of a variety of linguistic elements and multimodal strategies, demonstrating both creativity and challenges. Success in relaying messages was significantly related to age, mode of communication, and individual profiles, such as everyday communication functioning and comprehension of grammar. Measures of receptive vocabulary and non-verbal reasoning were not significantly related to communicative success. The use of shared context and negotiation of meaning of potentially ambiguous utterances demonstrate the shared responsibility of disambiguation and meaning construction in interactions involving aided and naturally speaking communicators.Peer reviewe

Conversation Patterns between Children with Severe Speech Impairment and their Conversation Partners in Dyadic and Multi-person Interactions

Active engagement in interactions is crucial for the development of identity, social competence, and cognitive abilities. For children with severe speech impairment (SSI) who have little or no intelligible speech, active participation in conversations is challenging and can be critical for their social inclusion and participation. The present study investigated the conversational patterns emerging from interactions between children with SSI who use aided communication and typically speaking conversation partners (CPs) and explored whether active participation was different in interactions with different numbers of partners (dyadic versus multi-person interactions). An unusually large multilingual dataset was used (N= 85 conversations). This allowed us to systematically investigate discourse analysis measures indicating participation: the distribution of conversational control (initiations versus responses versus recodes) and summoning power (obliges versus comments). The findings suggest that (i) conversations were characterized by asymmetrical conversational patterns with CPs assuming most of the conversational control and (ii) multi-person interactions were noticeably more symmetric compared to dyadic, as children's active participation in multi-person interactions was significantly increased. Clinical implications and best practice recommendations are discussed.Peer reviewe

Constructing narratives to describe video events using aided communication

Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be lacking. This study reports on the analysis of narratives generated in interactions involving aided communication in response to short, silent, video vignettes depicting events with unintended or unexpected consequences. Two measures were applied to the data: the Narrative Scoring Scheme and the Narrative Analysis Profile. A total of 15 participants who used aided communication interacted with three different communication partners (peers, parents, professionals) relaying narratives about three video events. Their narratives were evaluated with reference to narratives of 15 peers with typical development in response to the same short videos and to the narratives that were interpreted by their communication partners. Overall, the narratives generated using aided communication were shorter and less complete than those of the speaking peers, but they incorporated many similar elements. Topic maintenance and inclusion of scene-setting elements were consistent strengths. Communication partners offered rich interpretations of aided narratives. Relative to the aided narratives, these interpreted narratives were typically structurally more complete and cohesive and many incorporated more elaborated semantic content. The data reinforce the robust value of narratives in interaction and their potential for showcasing language and communication achievements in aided communication.Peer reviewe

Metastatic state of parent cells influences the uptake and functionality of prostate cancer cell-derived extracellular vesicles

Peer reviewe

Aided communication, mind understanding and co-construction of meaning

Mind understanding allows for the adaptation of expressive language to a listener and is a core element when communicating new information to a communication partner. There is limited knowledge about the relationship between aided language and mind understanding. This study investigates this relationship using a communication task. The participants were 71 aided communicators using graphic symbols or spelling for expression (38/33 girls/boys) and a reference group of 40 speaking children (21/19 girls/boys), aged 5;0-15;11 years. The task was to describe, but not name, drawings to a communication partner. The partner could not see the drawing and had to infer what was depicted from the child's explanation. Dyads with aided communicators solved fewer items than reference dyads (64% vs 93%). The aided spellers presented more precise details than the symbol users (46% vs 38%). In the aided group, number of correct items correlated with verbal comprehension and age.Peer reviewe

Co-constructing negotiated meanings in interactions using aided communication : an exploration in the framework of relevance theory

Individuals with significant speech impairments may face unique challenges in becoming understood in everyday life. This doctoral dissertation explores, within the framework of relevance theory, communicative interactions between children and adolescents who use augmentative and alternative communication (AAC) and their communication partners who use natural speech. The participating nonspeaking children and adolescents had severe motor and speech impairments and used aided communication – a form of external communication (e.g., spelling or graphic symbols displayed in communication books or speech-generating devices) – as their primary mode of communication. This study aimed to identify and describe strategies of the aided communicators and their speaking communication partners in co-constructing, negotiating, and interpreting meaning in interactions using aided communication. Through the framework of relevance theory, the focus was on extending understanding of the meaning construction and utterance interpretation of multidimensional and potentially ambiguous aided utterances. The data was drawn from a large international study project, Becoming an Aided Communicator (BAC). The data for the current study comprised transcribed video event descriptions from 48 participating aided communicators (aged 5–15) and their speaking communication partners. The context of the interactions was a task where the aided communicators conveyed information about video events to the communication partners who had not seen the event and had no prior clues regarding the context. The study applied qualitative analyses supported by quantitative measures. Each of the three original studies of this dissertation focused on different perspectives, varying regarding the number of dyads and the focus of the investigation. First, the study explored how the aided communicators construct messages with the communication means, how they attempt to overcome potential limitations in the available vocabulary, and what factors could affect their performance in conveying meaningful information. Second, the focus was on identifying and exploring strategies of the speaking communication partners in co-constructing, negotiating, and interpreting aided utterances. The findings of this study illustrate achievements and complexities in achieving an agreed-upon understanding within the multidimensional and multimodal aided interactions. The aided communicators used a range of linguistic and multimodal strategies in describing events unknown to their communication partners. These communicators portrayed creative and generative strategies in expressing meaning and overcoming potential limitations in their communication aids. The speaking communication partners utilized various strategies in negotiating and interpreting the meaning of aided utterances. Most strategies in negotiating for meaning were targeted at solving lexical and structural ambiguities. The speaking communication partners experienced challenges, particularly when the produced utterances were deemed imprecise, and the contextual information was sparse. The visual-graphic mode of communication and the potential for the ambiguity of graphic symbols decisively impacted the comprehensibility of messages. Relevance theory provided a framework to identify and explain how specific patterns in communicative interactions involving aided communication may (or may not) contribute to the understandability of aided utterances. Many of the communicative disruptions reflected the speaking communication partners’ challenges in constructing the gap between the aided communicators’ intended meaning and the explicit utterance meaning. In these instances, they appeared to balance the accuracy of resolutions and the efforts involved in processing potential interpretations. The study demonstrates that participants in aided interactions benefit from efficient strategies in negotiating for meaning and repairing communicative disruptions to achieve mutual understanding. The findings imply that the awareness of features of aided language, the comprehension of the potential for ambiguity, and the loose use of aided language can support successful meaning-making in aided conversations. The findings also led to implications for practice in supporting the communicative competence of aided communicators and their communication partners in various interaction contexts in everyday life.Jos ihmisellä on merkittäviä puheen tuottamisen vaikeuksia, hän saattaa kohdata moninaisia haasteita tullakseen ymmärretyksi arjen erilaisissa vuorovaikutustilanteissa. Tämä väitöskirjatutkimus tarkastelee relevanssiteorian viitekehyksessä puhetta tukevaa ja korvaavaa viestintää käyttävien lasten ja nuorten sekä heidän puhuvien viestintäkumppaneidensa välisiä keskusteluja. Tutkimuksen tavoitteena oli tunnistaa ja kuvailla keinoja, joilla viestinnän apuvälinettä käyttävät lapset ja nuoret sekä heidän puhuvat viestintäkumppaninsa rakentavat ja neuvottelevat viestien merkityksistä yhdessä. Tavoitteena oli myös tunnistaa niitä tekijöitä, jotka saattavat vaikuttaa monimerkityksisten avusteisten viestien ymmärrettävyyteen ja avusteisten viestijöiden ymmärretyksi tulemiseen. Tämän väitöskirjatutkimuksen tutkimusaineisto on osa laajaa kansainvälistä tutkimushanketta Becoming an Aided Communicator (BAC). Tutkimusaineisto koostui 48:n 5–15-vuotiaan avusteista viestintää käyttävän lapsen ja nuoren sekä heidän puhuvien keskustelukumppaniensa videoiduista ja litteroiduista keskusteluista. Tutkimusaineistossa tutkittavat kertoivat näkemistään lyhyistä videoista keskustelukumppaneilleen, jotka eivät olleet nähneet videoita ja joilla ei ollut ennalta tietoa videoiden asiayhteydestä. Aineistoa analysoitiin pääosin laadullisin keinoin, mitä tuettiin määrällisillä analyyseilla. Tulokset ilmentävät niitä saavutuksia ja haasteita, joita keskustelukumppanit saattavat kohdata rakentaessaan viestien merkitystä avusteisissa keskusteluissa. Avusteiset viestijät käyttivät monenlaisia, kielellisiä, multimodaalisia ja ajoittain luoviakin keinoja tullakseen ymmärretyksi keskustelukumppaneilleen ja kompensoidakseen viestinnän apuvälineen puutteita. Puhuvat viestintäkumppanit käyttivät erilaisia keinoja rakentaessaan ja tulkitessaan avusteisten viestien merkityksiä. Suurin osa puhuvien viestintäkumppanien merkitysneuvotteluista keskittyi selvittämään sanaston ja lauserakenteiden monimerkityksisyyttä. Kumppanien oli toisinaan vaikea tulkita avusteisia viestejä tilanteissa, joissa tuotetut viestit olivat epätarkkoja ja asiayhteyteen liittyvä tieto oli niukkaa. Viestinnän visuaalinen muoto ja graafisten merkkien monimerkityksisyys vaikuttivat merkittävästi siihen, kuinka avusteiset viestijät tulivat ymmärretyksi puhuville viestintäkumppaneilleen. Tutkimus osoittaa, että avusteisissa keskusteluissa molemmat osapuolet tarvitsevat tietoisia keinoja, joiden avulla he voivat keskustella merkityksistä ja korjata viestinnän katkoksia, jotta yhteisen ymmärryksen saavuttaminen mahdollistuu. Havainnot viittaavat siihen, että onnistunutta merkityksen rakentamista voidaan tukea vahvistamalla ymmärrystä erityisesti luovan avusteisen kielen käytön piirteistä sekä tunnistamalla avusteisen kielen monimerkityksisyyttä. Havainnot tuottavat tietoa kliiniseen kuntoutukseen ja vahvistavat käsitystä siitä, että kuntoutuksella tulee pyrkiä tukemaan avusteisten viestijöiden ja heidän puhuvien kumppaniensa viestinnän taitojen kehittymistä arjen moninaisissa viestintätilanteissa

Kliinisten hoitotyön taitojen kehittäminen etä- ja hybridiopetuksessa Kajaanin ammattikorkeakoulussa ja Diakonia-ammattikorkeakoulussa : DIGIHOI - ÄLÄ JÄTÄ -hankkeen kokoomajulkaisu

Covid-19-pandemia on aiheuttanut haasteita hoitotyön kliinisten taitojen opettamiselle ja oh-jaamiselle ammattikorkeakouluissa. Tutkinnon saavuttamiseksi kliinisten taitojen harjoittelutun-neille osallistuminen on usein pakollista ja nämä tunnit toteutetaan perinteisesti lähiopetuk-sena. Mikäli lähiopetukseen osallistuminen ei ole mahdollista, tämä vaikeuttaa opintojen etene-mistä. Joitakin lähityöskentelyä vaativia asioita on kuitenkin mahdollista opettaa, ohjata ja opis-kella myös etä- ja hybridiopetuksena (kuva 1.) hyödyntäen digitaalisia menetelmiä. (DIGIHOI –ÄLÄ JÄTÄ -hankkeen hankesuunnitelma, 2022.) Tutkimusten mukaan digitaalisten menetelmien mukaan ottaminen opettamiseen on myös johtanut parempiin oppimistuloksiin ja siten lisännyt opiskelijoiden motivaatiota opiskeluun (Coyne ym., 2020; Martinengo ym., 2020; McDonald ym., 2018; Rouke, 2020). Viitteitä löytyy myös siitä, että hybridiopetus koetaan parempana ope-tusmetodina oppimisen näkökulmasta kuin perinteinen lähiopetus (Martinengo ym., 2020; McDonald ym., 2018)