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The Center for Disease Control estimates that one in 88 births result in a diagnosis of autism (CDC, 2012). Of those individuals diagnosed with autism approximately 25-61% fail to develop vocal output capabilities (Weitxz, Dexter, & Moore, 1997). The use of Augmentative and Alternative Communication (AAC) systems, such as Picture Exchange (PE) and Voice Output Communication Aids (VOCA) has been demonstrated as effective for those individuals to acquire a mand repertoire (Mirenda, 2003). The focus of the current study was to compare mand acquisition using PE and the iPad as a VOCA, in terms of acquisition rate and participant device preference, and with regard to collateral effects on vocalizations and disruptive behaviors. Additionally, the study evaluated the effectiveness of a teaching strategy using constant time delay with full-physical prompts (Sigafoos, Doss, & Reichel, 1989) in the acquisition of a mand repertoire using PE and the iPad as a VOCA, in five preschool aged children with autism. Finally, the devices were assessed in terms of their social validity. Three participants acquired the ability to communicate using the iPad as a VOCA more readily and two participants acquired the ability to communicate more quickly using PE, while the overall rate of independent manding was higher for four participants using the VOCA. The results of the study also indicate that the use of a constant time delay procedure with full-physical prompts was effective in the acquisition of both PE and the VOCA device. Regarding preference, four participants demonstrated a clear preference for the VOCA device and one for PE, when presented with the option to respond with either device. With respect to collateral effects, the data were largely inconclusive. For one participant there was an overall increase in vocalizations, for one participant there was an overall decrease in vocalizations, for the remaining three there was no systematic change in their rate of vocalizations during or following communication training. Regarding disruptive behaviors, an overall decrease in the occurrence was seen for two participants, for the remaining three the rates of occurrence did not change systematically following communication training. Finally, in terms of social validity, both the VOCA device and PE were found to be acceptable communication tools, with educators reporting that they would not only include such training within their classroom routines, but would also recommend its use in the future. / Educational Psychology

The purpose of this study has been to examine the use of augmentative and alternative communication in special school The study examine which methods and various purpose AAC used by and with the students and what it is that determines what form to use according to educators. The research shows how important communication is for a child's cognitive development and that it is largely a question of competence on how AAC is used in special school. It is a qualitative study based on observations at three different special schools and three interviews with five educators who all work with students having development disabilities in early stages and use AAC in their daily activities. The empirical data has been analyzed from a socio-cultural perspective, focusing on the concepts of artifacts and mediation. The results show that they use both aided and unaided AAC. AAC are used to structure the day visually in schematically pictures, to enhance their speech, to help to show their intention and to help their memory. The result also shows that, according to educators, students' abilities and previous experience is crucial to which form of AAC that they will use. It is also clear that many cases the teachers themselves is the one who analyze the abilities that students have and then choose an AAC method to work with. Another factor that also influences is the financial resources allocated to special school and the teachers 'and assistants' lack of expertise in the field. The result also reveal that a very small portion of AAC use is about how students communicate with AAC, to make their opinions and voices heard in a more independent way. The conclusion is that there are many different forms of AAC in special school. The purpose of the AAC is usually about structuring and make the world more understandable to students. It is generally the student's abilities that determine what form of AAC used, but there are other factors that also affect. Financial resources and lack of expertise are some of these factors. In other words, the special teacher have in their profession an important role in which type of AKK that are used and in which knowledge those who working in special school have of AAC. / Syftet med studien är att undersöka användningen av alternativ och kompletterande kommunikation (AKK) i grundsärskolan. I studien undersöks vilka olika former och i vilka olika syften AKK används av och med eleverna, samt vad det är som avgör vilken form man använder enligt pedagogerna. Forskningen visar hur viktig kommunikationen är för ett barns kognitiva utveckling och att det till stor del handlar om kompetens på hur AKK-användningen ser ut. Studien är en kvalitativ undersökning som bygger på tre observationer i grundsärskolan samt tre intervjuer med fem pedagoger som alla arbetar med elever på tidig utvecklingsnivå och använder AKK i den dagliga verksamheten. Empirin har analyserats ur ett sociokulturellt perspektiv med fokus på begreppen artefakter och mediering. Resultatet visar på att det både används hjälpmedelsberoende och hjälpmedelsoberoende AKK. AKK används i syfte att strukturera vardagen visuellt i form av schemabilder, förstärka det talade språket, att förmedla sin vilja och som minneshjälp. Resultatet visar även på att det enligt pedagogerna är elevernas förmågor och tidigare erfarenheter som är avgörande för vilken form av AKK som används, det framgår också att det många fall är pedagogerna själva som analyserar vilka förmågor som eleverna har och därefter tar fram en AKK-metod som man arbetar med. En annan faktor som också påverkar är vilka ekonomiska resurser som tilldelats grundsärskolan samt pedagogers och assistenters brist på kompetens inom området. Resultatet visar även på att en väldigt liten del av AKK användandet handlar om hur eleverna kommunicerar med AKK för att göra sin röst hörd eller sina egna åsikter på ett mer självständigt sätt. Slutsatsen är att det finns många olika former av AKK i grundsärskolan. Syftet med AKK handlar oftast om att strukturera och göra omvärlden mer begriplig för eleverna. Det är i huvudsak elevens förmågor som avgör vilken form av AKK som används, men det finns andra faktorer som också spelar in. Ekonomiska resurser och brister i kompetens är några av dessa faktorer. Med andra ord så har specialläraren i sin profession en viktig roll i vilken typ av AKK som används och i hur kompetensen hos de som arbetar i grundsärskolan ser ut.

The aim of this study is to describe interaction between mothers/ caregivers and their profoundly mentally retarded and multiply handicapped children, and to describe the function of play in communicative interaction. In the study I describe the communicative interaction of six children aged 1:3 to 10 years. The children have been studied in their homes and preschools or schools. Each child had five or six handicaps in addition to their profound retardation. The study is based on interviews with parents, information from naturally-occurring conversations and videoobservations. Meals and play were selected for video-recording. The results indicate that the most important function of play is as a means of communication and learning. Play most often involves sensory stimulation and body play. Communicative interaction is non-verbal and described in terms of gaze/eye contact, facial expressions, gestures and body movements. A pattern of interaction has been found. This consists of four phases: an impression-receiving phase with orientation, an expressive phase with motor activity, a pause with processing and preparation of an answer and finally a break or a limited reaction. These children have, however, a communicative competence. The ability of the mothers to interpret the children’s signals is extremely context-dependent. These mothers adjust their communicative behaviour to the child and facilitate the child’s communicative interaction. The ability of the mothers/ caregivers to interpret the signals of these children is often underestimated by professionals. The living conditions of the parents have emerged as an important factor for play, communication and the development of the child.

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The present diploma thesis deals with the topic of communication support in patients with multiple sclerosis in the terminal stage of the disease. Since the number of institutions in the Czech republic which deal with this issue is extremely limited, the questions addressed in the thesis are more topical than ever. In the first part of the thesis, the author introduces to the reader the disease as such, with its clinical picture and pathologies, types, diagnostics, progress, and treatment. The aim of the thesis is to characterize the needs and forms of support for patients with respect to communication and in order to reach this aim the author conducted a survey in an institution in the form of an exploratory research. Answers to the research questions were sought in case studies of patients who were willing to participate in the research and who shared their life stories and provided insight into their intimate struggle to cope with the disease in the best way possible. Their goal was prosaically simple - to keep control over their lives and their human dignity for as long as possible. KEYWORDS multiple sclerosis, augmentative communication, alternative communication, technical aids, non-technical aids

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2016-12-01T12:12:16Z No. of bitstreams: 1 Tatiana Lanzarotto Dudas.pdf: 814347 bytes, checksum: a80e4af7d5ddb06d2e13ea103595161b (MD5) / Made available in DSpace on 2016-12-01T12:12:16Z (GMT). No. of bitstreams: 1 Tatiana Lanzarotto Dudas.pdf: 814347 bytes, checksum: a80e4af7d5ddb06d2e13ea103595161b (MD5) Previous issue date: 2016-10-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The growing number of students with disabilities issues has challenged schools, teachers, especially those that act as support in regular education. Usually, these students present difficulty or absence of speech what commit on establishing bond with each other and affect the process of teaching in school. Despite this finding, focus on language and its impact on school life these kids haven’t received enough attention, often them assigns to organic or mental framework. In fact, there have been placed emphasis on the importance of involving alternative forms of communication in order to “make it feasible” them with features built in the area of Supplementary and alternative communication system (ACS). The objective is, above all, educational inclusion, more than social. This thesis leads us to a discussion of the centrality of language on the issue of inclusion in regular education of people with physical disability and who do not speak. Mobilize my experience in training courses for educators in the area of alternative communication and also my experience in particular sessions and to long-stay institutions that, by definition, are trademarks of "exclusion". The absence of "speech", often in severe cases of Cerebral Palsy (CP), has led to the assumption that if the subjects doesn’t speech, it is out of the language. It is assumed, in this thesis, the decisive force of language: the incidence of interpretation about the baby's body, inclusion in the sphere of human beings and responsible for the Constitution of this body in “parlête’s body” (Lacan’s expression). In this work are central, therefore: (1) the recognition of the order's own language (SAUSSURE, 1916), and (2) the recognition of the subject of the unconscious, introduced by Freud and formulated by Lacan. The theoretical perspective pursued in this work is being developed in the CNPq research group: Acquisition, pathologies and language clinic (LAEL-PUC-SP), coordinated by Prof. Dr. Maria Francisca Lier-DeVitto and Prof. Dr Lúcia Arantes / O número crescente de alunos com quadros de deficiência tem desafiado equipes escolares, professores e, em especial aqueles que atuam como apoio em classes de ensino regular. Característica usualmente presente nesses alunos é dificuldade ou ausência de fala - o que os compromete no estabelecimento de laço com o outro e prejudica o processo de ensino–aprendizagem na escola. Apesar desta constatação, foco na linguagem e em sua incidência na vida escolar dessas crianças não tem recebido atenção suficiente - recurso frequente é atribui-las ao quadro orgânico ou mental. Tem-se, é fato, colocado ênfase na importância de envolver formas alternativas de comunicação de modo a instrumentaliza-las com recursos construídos na área da Comunicação Suplementar e Alternativa. O objetivo é, antes de tudo, a inclusão pedagógica, mais do que social. Esta tese volta-se para uma discussão sobre a centralidade da linguagem na questão da inclusão no ensino regular de pessoas com deficiência física e que não falam. Mobilizo minha experiência em cursos de formação para educadores na área da Comunicação Alternativa e, também, minha experiência em atendimentos particulares e em instituições de longa permanência - locais que, por definição, são marcas de “exclusão”. A ausência de “oralização”, frequente em casos graves de PC, tem levado à suposição de que se não há fala, o sujeito está fora da linguagem. Assume-se, nesta tese, a força determinante da linguagem: a incidência da interpretação sobre o corpo do bebê o insere na esfera do humano e responde pela constituição desse corpo em corpo-falante. Neste trabalho são centrais, portanto: (1) o reconhecimento da ordem própria da língua (SAUSSURE, 1916) e, também, (2) o reconhecimento do sujeito do inconsciente, introduzido por Freud e formulado por Lacan. A perspectiva teórica perseguida neste trabalho é a vem sendo desenvolvida no Grupo de Pesquisa CNPq: Aquisição, patologias e clínica de linguagem (LAEL-PUCSP), liderado pelas Professoras Doutoras Maria Francisca Lier-DeVitto e Lúcia Arantes