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

Caries experience by socio-behavioural characteristics in HIV-1-infected and uninfected Ugandan mothers – a multilevel analysis

Objectives To assess caries experience in Ugandan mothers according to HIV status, socio-behavioural-characteristics, gingival bleeding status and to examine whether HIV status impacts the association of socio-behavioural characteristics with caries experience. Third, using multilevel analysis, this study assessed to what extent surface-specific caries experience varied between and within individuals. Materials and methods Caries experience was recorded using the World Health Organization’s Decayed, Missed and Filled Teeth/Surfaces indices from a cohort of 164 HIV-1-infected Ugandan mothers and a cross sectional comparison group of 181 negative controls. Mixed-effects logistic regression was conducted with surface-specific caries experience as the outcome variable. Results The prevalence of caries in HIV-1-infected and uninfected mothers was 81% and 71%, respectively. Significant associations occurred between caries experience at surface level and women’s increasing age (odds ratio [OR] = 1.8, 95% confidence interval [CI]: 1.1–2.8) and presence of gingival bleeding (OR = 2.0, 95% CI: 1.2–3.2). Intra-class correlation (ICC) coefficient amounted to 0.54 (95% CI 0.48‒0.59). Conclusions Caries prevalence was higher in HIV-1 infected than in uninfected mothers and increased with age and gingival bleeding. ICC indicated that 54% of the variance was attributable to variation between individuals. Socio-demographic differences in dental caries did not vary by HIV-1 status.publishedVersio

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

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

Assessment of verbal comprehension and non-verbal reasoning when standard response mode is challenging: A comparison of different response modes and an exploration of their clinical usefulness

Objective: Assessment of cognition is important for providing children with developmentally appropriate interventions. Often children with severe speech and motor disorders are not assessed, as standardized assessment is perceived as challenging. This study investigates how assessments of cognition can be conducted using alternative response modes. Method: The study has two parts. The response modes finger pointing (FP), gaze pointing (GP), and partner-assisted scanning (PAS) were compared when assessing verbal comprehension and visuospatial abilities in 27 typically developing (TD) children, aged 5; 10–6; 10 years. Clinical utility was investigated by assessing 69 children with cerebral palsy (CP), using FP or GP as response mode depending on motor functioning. Results: In TD first graders, using alternative response modes did not influence the test results (Wilks’s lambda = 0.871, F (2, 23) = 1.70, p = 0.204). PAS was more time consuming than FP and GP on some of the tasks. In the CP group, considerable individual variation was found both when using FP (standard scores 40–138) and GP (37–120). Conclusions: Type of response mode did not impact test results in typically developing children. Assessment of cognition is possible even when children have severe speech and movement impairments

Gaining Super Control: Psychoeducational group intervention for adolescents with mild intellectual disability and their parents

Adolescents with intellectual disability experience psychological and social challenges in their transition to adulthood. Knowledge about the diagnosis and insight into own strengths and difficulties can help them manage the limitations and barriers they face, but suitable interventions with this purpose are scarce. The present paper presents a psychoeducational group intervention, The Super Control Project, for adolescents (15–17 years old) with mild intellectual disability (n = 23) and their parents. In a pre-post design, adolescent outcome data was obtained through teacher and parent questionnaires, and interviews with the adolescents. Parents and adolescents also evaluated the interventions’ usefulness. Results indicated positive impact on participants’ understanding of the diagnosis, managing of everyday challenges, and social networking. The intervention seemed to fit the participants’ needs and abilities. The study encourages further implementation and rigorous evaluation

Cognitive assessments among children with cerebral palsy in Sweden and the use of augmentative and alternative communication and interpreters : a cross-sectional registry study

PURPOSE: Children with cerebral palsy (CP) have an increased risk of cognitive difficulties and should be offered cognitive assessments. In Sweden, the CP Cog protocol recommends children with CP undergo cognitive assessments at the start of primary and secondary school. To assess children with CP can be challenging, in particular when children are non-vocal or do not speak the local language. In such instances, augmentative and alternative communication (AAC) and qualified medical interpreters should be considered. The purpose of this study was to monitor the implementation and equitable delivery of the CP Cog protocol in Sweden between the years 2017-2020. MATERIALS AND METHODS: In this cross-sectional study, registry data were extracted from the combined follow-up program and national registry for individuals with CP (CPUP), and a convenience sample of psychologists responded to an online survey.RESULTS AND CONCLUSIONS: Each year, less than 5% of eligible children had registered cognitive assessments in CPUP. There was underuse of AAC during assessments and a discrepancy between the registered versus reported use of interpreters. Psychologists perceived AAC as more reliable for cognitive assessments than interpreters. Greater availability of and capacity to offer cognitive assessments in other formats and languages could help increase test accessibility for all children with CP.Implications for RehabilitationThe cognitive assessment of children with cerebral palsy (CP) is a complex but important issue within disability and re/habilitation.Individualized cognitive assessments should be offered and carried out by psychologists.Rehabilitation centers should strive to be inclusive through reliable test adaptations for functional abilities, means of communication, and language.Greater availability of- and capacity to offer cognitive assessments in more formats and languages could help increase test accessibility for children with disabilities