Background: Parents of children who have complex communication needs and require augmentative and alternative communication (AAC) are often faced with complex decisions about language choices and practices when their children are raised in multilingual contexts. Understanding parents’ perception in this matter can assist AAC service providers in supporting them better in this process. This study aimed to investigate South African parents’ perceptions on their language choices and practices with regard to their children aged 5-12 years who use AAC, and who are regularly exposed to multiple languages. Specifically, the study aimed to (i) to describe parents’ current language choices and practices with their children who use AAC; (ii) to describe the factors that parents consider to be influencing their language choices and practices with their children who use AAC; and (iii) to describe parents’ perceptions of the outcomes of their language choices and practices with their children who use AAC. Methods: This study followed a qualitative design employing semi-structured interviews. Five parents, who fit the selection criteria, were recruited via an e-mail sent out to an e-mail list, to which they responded. The perceptions of these parents whose children use AAC and are raised in multilingual environments, were explored using open-ended interview questions, loosely guided by an interview guide. Data from the interviews were transcribed and thematically analysed using an inductive process to identify themes and subthemes. Results: Four themes were identified, namely (a) language practices and choices; (b) influences on language practices and choices; (c) consequences of language practices and choices; and (d) feelings and beliefs. Parents were found to take many aspects into consideration when making language choices for their children in need of AAC. Factors mentioned related the child and to the environment. The child’s disability played a distinct role in parents’ decision making process, with an overriding perception that multilingualism would currently not be beneficial for the child; a perception seemingly reinforced by the advice of professionals. Conclusion: The language choices and practices of parents of children in need of AAC growing up multilingually are influenced by a variety of factors. AAC service providers need to take cognizance of these factors in order to understand parents’ decision-making and support them in a way that is respectful of their wishes and ideals, as well as congruent with current research evidence. Keywords: Augmentative and alternative communication (AAC), bilingualism, complex communication needs (CCN), cultural diversity, heritage, language maintenance, linguistic diversity, multilingualism, parents, perspectives / Mini Dissertation (MAAC)--University of Pretoria, 2019. / Centre for Augmentative and Alternative Communication (CAAC) / MAAC / Unrestricted

Background: The current mandate in dementia research is to develop interventions that are evidence-based and person-centred. However, person-centred augmentative and alternative communication interventions in dementia are limited. Method: A multimethod research design was conducted in three Phases. Phase one reviewed current research evidence to inform the development of a person-centred intervention. Phase two developed a person-centred augmentative and alternative communication intervention package with four components, (a) elements of person-centred care; (b) an electronic conversational support; (c) augmentative and alternative communication outcomes; and (d) an outcome measure. Phase three tested the feasibility of these four components by considering them in two ways (phase 3A and phase 3B). In 3A, Q-methodology was employed to obtain professionals’ viewpoints. In 3B, a case study was used to test the feasibility of the researcher’s implementation of an electronic conversational support with a participant with dementia and the scoring reliability of an outcome measure developed in this study. Results: Q-methodology results revealed professional views on (i) person-centred authorship, (ii) person-centred language style using supportive strategies (iii) adapted participatory methods with persons with dementia in their interventions. Case study results indicated that an electronic conversational support could be reliably implemented. Inter-rater reliability was not at an acceptable level for the multimodal domain of an outcome measure developed in this study. Conclusion: This study highlights the importance of using person-centred scaffolding strategies and exploring the potential of adapted participatory methods to develop and implement evidence-based, person-centred interventions in persons with dementia. / Thesis (PhD)--University of Pretoria, 2020. / Sponsor 1: National Institute for the Humanities and Social Sciences (NIHSS), in collaboration with the South African Humanities Deans Association (SAHUDA). Opinions expressed in this report and conclusions arrived at are those of the author and are not necessarily to be attributed to the NIHSS and SAHUDA. Sponsor 2: Andrew W. Mellon Foundation / Centre for Augmentative and Alternative Communication (CAAC) / PhD / Unrestricted

Mainstream mobile messaging is a widely researched theme as it is a favoured means of interaction by youth who are the so-called digital natives. To limit marginalisation and promote inclusion, it is essential for youth with complex communication needs to participate in the same activities as their peers without disabilities. However, there is a paucity of research regarding the use of messaging by youth with complex communication needs in both the disability literature and in the information and communication technology literature. Therefore, the main aim of this study was to explore and describe the interactional aspects of mainstream mobile messaging (related to the why, who, what, when, where and how of communication) for youth with complex communication needs. These aspects were considered in terms of the enduring Human Activity Assistive Technology model, which was supplemented in the current study to include a communication partner (or group of partners) using the same type of technology (smartphones) to engage in the same activity (messaging). A qualitative case study design was used to gather data from three sources using four data collection methods: (i) face-to-face participant interviews using WhatsApp (n=7); (ii) WhatsApp communication partner interviews (n=7); (iii) an asynchronous WhatsApp focus group; and (iv) observations of youth interacting on WhatsApp. All data was analysed using thematic analysis. The results showed that messaging afforded the participants new communication possibilities despite certain limitations. These affordances included a degree of interaction symmetry; the possibility to interact with a wide range of partners including groups; interaction with others outside their often-restricted environments (absent presence); privacy; a measure of anonymity and control over interactions; a means of expressing themselves that was easier than face-to-face interactions; and the ability to meaningfully connect with others. Future research should explore these affordances in more detail and consider the impact of limited literacy skills and the expressive use of pictures in mainstream mobile messaging. / Thesis (PhD)--University of Pretoria 2019. / University of Pretoria: Postgraduate bursary / Centre for Augmentative and Alternative Communication (CAAC) / PhD / Unrestricted

Many adults with intellectual disability are unable to meet their everyday communication needs due to various communication difficulties. Opportunities for meaningful social interactions, self-determination and community participation are thus significantly restricted. Support staff working within residential facilities for adults with intellectual disability play an important role in facilitating and interpreting the adult’s communication as staff frequently interact with the adults. Studies have found that AAC strategies and tools prove effective in supporting the understanding and use of language in adults with ID, however the success of AAC intervention rests on the extent to which it is implemented and maintained by those interacting with and supporting them. The aim of this research is to describe the communication skills, resources and needs of adults with intellectual disability living in residential facilities in the Western Cape and their support staff, as reported by facility managers. Managers of 19 residential facilities for adults with ID in the Western Cape agreed to complete a self-administered questionnaire. The questionnaire was developed based on a range of both local and international previous studies and aimed to gain information pertaining to the (1) background of the facility and adults (2) communication- and related skills of the adults (3) communication skills of the care staff working directly with the adults as well as (4) current availability of communication-related resources and support for the adults and staff. The results obtained indicated that approximately a third of nearly 1000 adults with ID were unable to communicate effectively. Adults with no or limited functional speech most often relied on informal, unaided AAC strategies to communicate requiring interpretation from the care staff. Facility managers reported most care staff used a variety of practices that facilitated communication. Furthermore, aided and unaided AAC strategies and tools to support comprehension were implemented by some of the facilities which were obtained from individuals or organisations knowledgeable in AAC. However, few facilities implemented a formal mode of aided or unaided AAC to support expressive language due to a variety of environmental barriers relating to a lack of staff skill and knowledge as well as limited access to appropriate professions such as speech-language therapy for AAC related training or support. More than three quarters of participants indicated that was some or an extensive need for training pertaining to communication support. Broadly, a need exists for (1) aided AAC to support the comprehension and expression of language for adults with ID in residential facilities (2) staff to obtain knowledge and skills in more formal AAC strategies through ongoing training as well as (3) access to professionals who are knowledgeable and skilled in AAC to provide individualised support to the adults and guidance to the multi-disciplinary team supporting the communication skills of the adults. / Mini Dissertation (MA)--University of Pretoria, 2019. / Centre for Augmentative and Alternative Communication (CAAC) / MA / Unrestricted

The purpose of this study was to describe the experiences of students with intellectual disability (ID) and their teachers throughout the implementation process of an augmentative and alternative communication (AAC) device. Two students and three teachers at an arts-based school for adults with developmental disabilities were trained by a speech and language pathologist on how to use the device. The students were selected by the teachers because they had limited ability to produce speech, and it was thought that they would benefit from using the device. The three teachers made up the school’s faculty, and the speech and language pathologist was selected based on her expertise working with people with developmental disabilities. Self-determination theory (Deci & Ryan, 1985) framed the study, and, it guided the observations and discussion of this thesis. Student experiences were explained through the lens of this theory, but teacher experiences were more applicable to Guskey’s (1989) model of teacher change. This framework was used to interpret the experiences of the teachers. Data were collected through direct observations and teacher journals throughout the implementation process, and semi-structured interviews, post-implementation. A total of 10, one-hour observations per student were conducted between January 15, 2013 and March 11, 2013; with one additional observation of an unplanned follow-up session that lasted one-and-a-half hours on May 8, 2013. The researcher observed student communication and engagement before, during, and after the device was brought into the class. The implementation steps included: introduction and experimentation with the AAC device in-class; teacher-only training; in-class student coaching and modeling; and withdrawal of SLP support. This study found that that there were practical and logistical challenges with AAC device implementation for both students and teachers. Limited time for in-class training, strategic planning, goal-setting, and financial resources, such as funds to hire supply teachers so that teachers could observe in-class training, were barriers to implementation. One student, more than the other, used the AAC device to communicate throughout the study. Recommendations emerging from the study included more purposeful advance planning, goal-setting, developing teacher pedagogical knowledge prior to implementation, and collectively-planned in-class training sessions for students and teachers. / Thesis (Master, Education) -- Queen's University, 2014-01-30 11:38:38.195

Low literacy levels have been argued to partially contribute to poor health literacy and poor health outcomes. Low health literacy refers to the inability to apply health information in pursuit of good health. While several strategies have been used to assist persons with low literacy to understand health information, these strategies have been focused primarily on improving medication taking in persons with low literacy. There is a paucity of research on the effects of these strategies on understanding chronic illness and self-management of these illnesses. This study aimed to determine the effects of a specific strategy, viz. visual aids, on the understanding of HIV health information in persons with low literacy. The study encompassed two tasks – the experimental and the iconicity tasks. The experimental task utilised a multi-group pre-test-post-test design comprising 90 participants who were divided into three groups. Group 1 received the HIV health education programme of the National Department of Health (NDoH) verbally and with visual aids (Intervention 1), Group 2 received the same programme verbally only (Intervention 2), and Group 3 served as the control group and did not receive the programme. Within-group analysis found statistically significant differences in pre-test and post-test scores of Groups 1 and 2 (p<0.05) and not for group 3. Between-group analysis found no statistically significant difference between Group 1 and Group 2 in terms of their understanding of HIV health information. There were, however, statistically significant differences between Groups 2 and 3 (p<0.001) and between Groups 1 and 3 (p<0.001). The iconicity task (N=39) adopted a survey related to the transparency and translucency of the visual aids used in the NDoH’s health education programme. It was apparent that none of the visual aids (0/19) used in this health education programme met the International Organization for Standardization score for transparency, while 13 of the 19 visual aids met the recommended score for translucency. It was concluded that the NDoH’s health education programme provided to both Groups 1 and 2 influenced the participants’ understanding of health information. However, the expected superior effect associated with the addition of visual aids was not evident in this study. This may be attributed to the inadequate transparency scores for the visual aids in the NDOH’s health education programme. Further studies to investigate the effects of visual aids with higher transparency values are recommended, as well as efficacy studies that will use visual aids developed with appropriate guidelines for persons with low literacy. / Thesis (PhD)--University of Pretoria, 2020. / The University of Pretoria for the Research Support Bursary / The University of Pretoria for the Postgraduate Bursary / The National Institute for Humanities and Social Sciences Scholarship / The Medical Research Council for the Research Development Grant / Centre for Augmentative and Alternative Communication (CAAC) / PhD (AAC) / Unrestricted

Research has shown that using Picture Exchange Communication System (PECS) and Speech Generating Devices (SGD) helps in the increase of verbal communication in those with limited verbal communication. The purpose of this study was to 1.) Investigate the impact of various low-technology and high-technology on the increase in social-communicative behavior in individuals with limited verbal communication and 2.) Create a resource of PECS and SGD, and their uses, to guide teachers and other educators to determine which device best fits the student’s communication needs. Qualitative and quantitative research design, surveying educators from four Northeast Indiana schools, was used in this study. The survey, which included force-choice and open-ended questions, was distributed to educators, including specials teachers, paraprofessionals, and speech language pathologist, in the general and special education setting. Seven educators completed the survey. Research showed that based on the devices used within the school, teachers agreed that augmentative and alternative communication devices were beneficial for various aspects of communication for students with limited verbal communication within the classroom. <br>

Manual signing using keywords, an unaided augmentative and alternative communication (AAC) strategy, has an important role to play in the education system. To date, limited research exists with regard to the usage and effectiveness of unaided AAC strategies in the school environment. This gap is even more pronounced in the South African context. To address this research gap, the current study aimed to explore the perceptions of teachers towards the use of unaided AAC strategies in the educational context. The study used a quantitative, non-experimental survey, involving fixed and open-ended questions. The sample focused upon five urban school districts within the Gauteng province and considered both public and private schools for learners with special educational needs (LSEN), since these schools accommodate learners with a broad spectrum of disabilities and are likely to include learners with complex communication needs (CCN). A total of 101 teachers from ten schools participated. The participants identified various factors which influence manual signing within the educational system. These factors are related to the teachers’ school and classroom context (e.g. school culture), the team members involved (e.g. parents), community awareness, learner related factors and training needs. These identified factors and challenges are assessed and discussed with reference to both local and international norms. Recommendations are made with regard to expanding both an understanding and acceptance of unaided AAC strategies as a further means to support learning in the educational context for learners with special educational needs. / Mini Dissertation (MAAC)--University of Pretoria, 2019. / UP Post graduate bursary / Centre for Augmentative and Alternative Communication (CAAC) / MAAC / Unrestricted

This study described the effect of a non-augmented (Spoken Communication, SC) and two augmented language interventions (Augmented Communication-Input, AC-I or Augmented Communication-Output, AC-O) on the upper-body, gross and fine motor skills of toddlers at the onset and conclusion of the intervention. The data presented are from a longitudinal study by Romski, Sevcik, Adamson, Cheslock, Smith, Barker, & Bakeman (2010). Three standardized assessments and five observational measures examined the participants' motor skills used to activate the speech generating device (SGD), language abilities and outcomes. The AC-O intervention decreased physical prompting, increased error-free symbol activations, and increased developmentally appropriate gross and fine motor use. An augmented intervention that utilizes a SGD may facilitate both language and motor development through the combination of the communicative goals and increased motor learning opportunities when accessing the SGD device.

Reading skills are critically important for a child’s development and continued growth in school. The home and school literacy experiences of children who have developmental disabilities have been found to be qualitatively different from the experiences of their same age peers without disabilities. In addition to access to instruction, a number of intrinsic factors including cognitive ability, receptive language and expressive speech skills have been suggested as factors that may place children with developmental disabilities at a greater risk for limited development of reading skills. Currently, little is understood about how children who have developmental disabilities and may have limitations in productive speech learn to read. This study identifies key intrinsic and extrinsic factors that are related to the development of phonological awareness in 42 children between 4 years and 5 years 9 months of age with developmental disabilities and a range of speech abilities. Aims of this project were to 1- systematically assess children’s intrinsic factors of speech ability, receptive and expressive language and vocabulary, cognitive skills and phonological awareness to determine key intrinsic factors related to phonological awareness and 2- describe the extrinsic factors of home literacy experience and preschool literacy instruction provided to children. Children were found to have frequent and positive home literacy experiences. No significant correlations between speech ability and frequency of shared reading experiences were found. Parents reported low levels of preschool literacy instruction. Significant correlations were found between instruction in decoding and word recognition and children’s sound-symbol awareness. Correlations were found between the use of technology and media and Augmentative and Alternative Communication (AAC) and children’s speech ability. Positive, significant relationships were found between phonological awareness and all direct assessment measures of developmental skill, speech ability and early reading skills but were not found between phonological awareness and home or school literacy experiences. Speech ability did not predict a significant amount of variance in phonological awareness skill beyond what would be expected by cognitive development, receptive language and orthographic knowledge. This study provides important implications for practitioners and researchers alike concerning the factors related to early reading development in children with limited speech ability.