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

Analysis of Assessment Results of Cerebral Palsy Children with Barriers to Complex Communication Needs

This study describes the analysis of assessment results in cerebral palsy children with barriers to complex communication needs. The assessment used is a developmental assessment on motor, cognitive, and language aspects. The research was conducted using qualitative descriptive research. Based on the results of assessments conducted on cerebral palsy children with complex communication needs barriers, a child profile related to the child's potential, obstacles, and needs can be formulated. Where the child's profile is useful for designing communication programs for complex communication needs children so that it can help them communicate both using expressive language and receptive language. Keywords: analysis of assessment results, cerebral palsy, complex communication need

Supporting children with complex communication needs

Many children face significant challenges communicating, expressing themselves, and sharing their creative thoughts and ideas with others. Interactive technologies are playing an increasing role in addressing these challenges. This workshop will be an opportunity to discuss design, implementation, and evaluation methods, the needs of specific communities, as well as experiences in previous and current projects

Parental Directiveness and Responsivity toward Young Children with Complex Communication Needs

Purpose: The aim of the present study was to determine if parent responsiveness to their children with complex communication needs (CCN) during naturalistic play changed over an 18-month period and determine if any such changes were influenced by the child’s overall level of receptive and expressive language development, motor development or differing play contexts. This longitudinal information is important for early intervention speech-language pathologists and parents of children with developmental disabilities for whom the use of parent-directed responsivity interventions may be encouraged. Method: Over an 18-month period, 37 parents of young children who had physical and/or neurological disabilities participated in three home-based parent–child play episodes. Videotapes of each play episode were extracted and coded. Result: Results indicated parents who were initially responsive showed a significant tendency to continue to be so. Early on, parents were significantly more likely to be directive during object play than social play and significantly more likely to interact responsively during social play than object play. Conclusion: Parents of children with developmental disabilities were not consistently less responsive to their children based on motor or language capabilities. Previous reports of higher parental directiveness with children who have developmental disabilities may be attributable to object-based play interactions

TEACHING SOCIAL COMMUNICATIVE INTENTS TO ELEMENTARY AGED STUDENTS THROUGH THE USE OF AIDED LANGUAGE MODELING

The purpose of this study was to extend the research of using aided language modeling as an intervention with elementary aged students with extensive support and complex communication needs. A multiple probe design across participants was used to determine if there is a functional between an aided language modeling intervention and improvements in contextually relevant initiations (i.e., requests and comments) between children with extensive support and complex communication needs. The results showed that using aided language modeling within play-based sessions was effective in teaching social communicative intents to students with extensive support and complete communication needs

Encouraging Emotional Conversations in Children With Complex Communication Needs : An Observational Case Study

Ajuts: A research grant by the Mexican National Council of Science and Technology (CONACYT, reference: 692379-440601) to GR-R supported this study.Children with complex communication needs (CCN) regularly have barriers to express and discuss emotions, and have fewer opportunities to participate in emotional conversations. The study explores and analyzes the changes after a training program focused on offering an interactive home learning environment that encouraged and modeled emotion-related conversations between a parent and a child with CCN within storybook-reading contexts. An observational design (nomothetic/follow-up/multidimensional) was used to explore and analyze the changes in the communicative interaction around emotions between mother-child. Augmentative and alternative communication (AAC) technologies were used to provide the child access to emotion-related vocabulary. The training program resulted in the mother providing more opportunities to engage her child in emotional conversations, suggesting that when opportunities and resources to talk about emotions were promoted, the child showed more engagement in emotion-related conversations using his AAC system. The mother-child communicative patterns and behavioral relationships observed during the phases are also presented. This case study illustrates the importance of a primary communication partners' role in facilitating emotional conversations, and the promising efficacy of a training program implemented in a storybook interactive learning environment to promote conversations about emotion-related events while encouraging children with CCN to learn, explore, express, and discuss emotions

Exploring the Use of Augmentative and Alternative Communication with Emergent Literacy Learners

Augmentative and alternative communication (AAC) has the opportunity to transform the lives of individuals with complex communication needs (CCN). For neurodivergent learners who use AAC to communicate, their acquisition of language and literacy is often dependent on the tools they use and the amount of support and intervention they receive. Through the analysis of twenty-two studies, risks of delayed language development, use of AAC with emergent literacy learners, and implications for classroom context are explored. Although results indicate that AAC can benefit neurodivergent students in their acquisition of language and literacy, further research is needed to completely understand the value AAC brings to neurodivergent individuals with complex communication needs

Applying the Verona Coding Definitions of Emotional Sequences (VR-CoDES) in the dental context involving patients with complex communication needs : an exploratory study

This study was conducted as part of a larger collaborative study funded by the EPSRC, between the University of St Andrews and the University of Dundee.Objective The VR-CoDES has been previously applied in the dental context. However, we know little about how dental patients with intellectual disabilities (ID) and complex communication needs express their emotional distress during dental visits. This is the first study explored the applicability of the VR-CoDES to a dental context involving patients with ID. Methods Fourteen dental consultations were video recorded and coded using the VR-CoDES, assisted with the additional guidelines for the VR-CoDES in a dental context. Both inter- and intra-coder reliabilities were checked on the seven consultations where cues were observed. Results Sixteen cues (eight non-verbal) were identified within seven of the 14 consultations. Twenty responses were observed (12 reducing space) with four multiple responses. Cohen's Kappa were 0.76 (inter-coder) and 0.88 (intra-coder). Conclusion With the additional guidelines, cues and responses were reliably identified. Cue expression was exhibited by non-verbal expression of emotion with people with ID in the literature. Further guidance is needed to improve the coding accuracy on multiple providers’ responses and to investigate potential impacts of conflicting responses on patients. Practice implications The findings provided a useful initial step towards an ongoing exploration of how healthcare providers identify and manage emotional distress of patients with ID.PostprintPeer reviewe

17 ways to say yes:Toward nuanced tone of voice in AAC and speech technology

People with complex communication needs who use speech-generating devices have very little expressive control over their tone of voice. Despite its importance in human interaction, the issue of tone of voice remains all but absent from AAC research and development however. In this paper, we describe three interdisciplinary projects, past, present and future: The critical design collection Six Speaking Chairs has provoked deeper discussion and inspired a social model of tone of voice; the speculative concept Speech Hedge illustrates challenges and opportunities in designing more expressive user interfaces; the pilot project Tonetable could enable participatory research and seed a research network around tone of voice. We speculate that more radical interactions might expand frontiers of AAC and disrupt speech technology as a whole

Evaluating High- and Low-Tech Visual Scene Displays in Children with Complex Communication Needs

Visual Scene Displays (VSDs) are a form of Augmentative and Alternative Communication (AAC) that utilize pictured scenes with hot spots to provide individuals with the opportunity to develop language in a contextualized environment. This investigation identified and assessed 12 peer-reviewed articles pertaining to the implementation of high- and low- tech VSDs for children and adolescents presenting with a range of complex communication needs. All articles were evaluated and scored using a published rating scale consisting of 11 predetermined criteria. Following assessment of the articles, it was found that VSDs are an effective form of AAC for children and adolescents with CCN, as VSDs facilitate language development and peer interactions