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I den här studien läggs fokus på elevassistentens roll och förutsättningar för arbete inom grundsärskolans inriktning ämnesområden och i mötet med elever som har komplexa kommunikationsbehov. Syftet är att belysa hur elevassistenter själva ser på sin yrkesroll och sitt uppdrag. Kvalitativa intervjuer genomfördes med nio elevassistenter verksamma inom grundsärskolan. Situerat perspektiv användes för analys av det empiriska materialet. Studiens resultat visar att elevassistenter ser sig själva fylla en viktig funktion i grundsärskolans verksamhet, både genom att stötta elever under skoldagens olika moment och även för att stöttas pecialläraren i det pedagogiska arbetet. Elevassistentyrket ses som en bortprioriterady rkesgrupp vars arbetsbelastning är hög samtidigt som de inte erkänns för sin arbetsinsats. Studiens resultat bekräftar tidigare forskning som bedrivits inom området - elevassistenter efterfrågar större möjlighet till fortbildning och kompetensutveckling framför allt inom undervisning, alternativ och kompletterande kommunikation samt lågaffektivt bemötande. I studien diskuteras även de maktförhållanden som kan uppstå inom skolans verksamheter. Både mellan lärare och assistenter, men även mellan nya och mer erfarna assistenter på arbetsplatsen. / In this study, focus is placed on the role of paraeducators within special compulsory school in Sweden, in their work with students with severe intellectual disabilities and complex communication needs. The purpose of this study is to elicit how paraeducators view their professional role and assignment, and their work as a communicative resource. Interviews were conducted with nine paraeducators, and the theory of situated learning is used as the framework through which the empirical material is analysed. The results of the study show that paraeducators see themselves fulfilling an important function in the activities of special compulsory school, both by supporting students during the schoolday and by supporting the special needs teacher with regards to educational strategies. Paraeducators are seen as a deprioritized group who often work hard on their own with little recognition. The results of the study confirm previous research conducted in the field, that paraeducators demand greater opportunities for further education and development, especiallyin special education, augmentative and alternative communication, and low-arousal approach. The study also discusses the power relations that may appear between teachers and paraeducators, as well as those between newer paraeducators and those who are more experienced.

The purpose of this study is to help increase knowledge of using augmentative and alternative communication (AAC) in the music education in compulsory schools for pupils with learning disabilities. The study aims to identify and analyze how this use affects these pupils’ communication and participation, in educational and social context. Three issues are based on the purpose, focusing on: 1) how AAC is used in music education, 2) what possibilities are provided for pupils to use AAC, and 3) what effect this usage has upon the participation and learning of the pupils. This is a qualitative case study, based on one case representing a larger group. The theoretical framework is a communicative relationship-based perspective (KoRP) which assumes that communication, participation and learning are closely connected and interdependent. An established model (the participation model) has been used in the analysis to identify and analyze different aspects of participation. Methods used are direct observations during lessons, and also informal conversations with the teacher. The result shows that AAC is used more by the teacher than the pupils, as indicated in previous research. Time, cooperation and practical conditions seem to affect the possibilities of using AAC in the classroom. The result also shows that AAC is used mostly in teaching, with much less use in creating relationships. Pictures and gestures are most frequently used, however, the result also indicates that music itself is used both by teachers and pupils as an instrument for communication, participation and learning.

This thesis investigates best practices for teaching and supporting bilingual augmentative and alternative communication (AAC) users as they develop their communication skills. Although there are guidelines that inform best practices for teaching and supporting bilingual AAC users, there is very little information on what these practices look like. This thesis investigates the techniques and strategies that bilingual speech-language pathologists (SLPs) who practice in Catalunya, a bilingual community in northeastern Spain, use to evaluate, teach, and support people who use pictogram-based AAC modalities to communicate. To do this, six SLPs who practice in Catalunya participated in interviews regarding their practices when teaching bilingual AAC users. These interviews were analyzed thematically, based on an iterative, inductive coding process. Analysis revealed that most bilingual AAC users have access to an AAC system in only one language of the community. This may reflect a monolingual mindset (Tonsing & Soto, 2020), and limits the opportunities for engagement with both the larger community, and the individuals’ home communities. This is particularly true for those who speak a language other than those of the community with their families. Despite this, AAC users seem to understand both languages, develop bilingual identities, and “feel bilingual.” Additionally, despite the lack of access to multilingual AAC systems, professionals employ practices that show respect for the home language, whether it is Castilian Spanish, Catalan, or another language. The results suggest that the monolingual mindset is a deeply-ingrained part of educational and therapeutic systems in both monolingual and bilingual communities, even when individual practitioners respect and value their clients’ home language(s) and bilingual identities.

Multiprofessionella team i rehabiliteringsverksamheter kräver att patienter kontinuerligt uttrycker sina önskningar och behov för att teammedlemmar ska kunna arbeta personcentrerat. För patienter med kommunikativa svårigheter kan det uppstå hinder i vårdsammanhang i form av minskad delaktighet gällande sin vård. För att effektivisera kommunikationen och motverka låg delaktighet behöver anpassningar göras. Anpassningar kan komma i form av alternativ och kompletterande kommunikation (AKK) eller andra strategier som underlättar ett samtal för båda samtalsparter. Föreliggande studie undersöker interaktionen mellan logopeder och patienter med kommunikativa svårigheter med respektive utan AKK under vårdbesök. Studien innefattar dessutom vårdpersonals samt patienters upplevelser avseende AKK och kommunikation.  Materialet bestod av videoinspelningar av två behandlingsbesök med två logopeder och två patienter som använder AKK. I samband med videoinspelningarna intervjuades även patienterna. Därtill inkluderades intervjuer med tio deltagare som representerade fem olika professioner. Det inhämtade videomaterialet analyserades med hjälp av multimodal interaktionsanalys och intervjuerna analyserades tematiskt. Resultatet som framkom i studien indikerade att interaktionen mellan vårdpersonal och patienter generellt förbättras vid AKK-användning. Däremot finns faktorer som påverkar effektiviteten av AKK-användningen, till exempel vad det är för omgivning, patientens motivation, frustration respektive insikt om kommunikationssvårigheterna samt vårdens bemötande och vilka anpassningar som tillämpas. Intervjuerna med vårdpersonalen visade att logopeden har en betydande roll inom teamet i relation till att öka kunskapen och medvetenheten avseende hur man samtalar med patienter med kommunikativa svårigheter. Videoinspelningarna och tillhörande patientintervjuer stöttade flera aspekter som framkom i vårdpersonalintervjuerna samtidigt som de bidrog med ytterligare perspektiv. Slutsatsen som dras i föreliggande studie är behovet av ökad kunskap avseende kommunikation och AKK, vilket kan leda vidare till ett tätare samarbete mellan teammedlemmar som arbetar med patienter med kommunikativa svårigheter. Slutligen är det av vikt att betona att kommunikativa svårigheter inte endast beror på en patients insjuknande, utan de blir mer påtagliga när goda förutsättningar i olika sammanhang inte finns. / Multiprofessional teams within rehabilitation clinics are dependent on patients verbalizing their needs and wishes in order for the team members to work with a person-centered approach. Patients with communication difficulties may experience reduced participation regarding their own healthcare. Therefore, it is important that adjustments are implemented to increase communication efficiency and the patient’s participation. The adjustments can be Augmentative and Alternative Communication (AAC) or other strategies that facilitate a conversation between the participants. The present study investigated interaction between speech and language pathologists (SLPs) and patients with communication difficulties with or without AAC during a medical appointment. The study also investigates experiences of healthcare professionals and patients regarding communication and AAC.  The data consisted of video recordings of two treatment visits between two SLPs and two patients that use AAC. The patients were interviewed after the visit. The data also consisted of interviews with ten participants that represented five different professions that regularly work with patients who use AAC. The video data was analyzed using multimodal interaction analysis and for analysis of the interviews with professionals, thematic analysis was employed. The findings indicated that the interaction between healthcare professionals and patients was improved when AAC was used. There were, however, factors that may affect the effectiveness of AAC, such as the type of environment, the patient’s motivation, frustration and an awareness of the communication difficulties, as well as healthcare providers’ attitudes and adjustments that are implemented. Analysis of the interview conducted with healthcare providers demonstrated the vital role of the SLP in a team in regard to improving knowledge and awareness of how to communicate with patients with communication difficulties. The video recordings with complementary patient interviews supported many aspects that emerged in the interviews with healthcare providers. Video analysis also contributed to additional perspectives.  Results of the present study imply that there is a need to improve the knowledge of communication and AAC in interprofessional teams, which could also lead to enhanced collaboration between team members. Lastly, it is of importance to highlight that communication difficulties are not solely due to a patient’s illness.  Communication difficulties become more pronounced when various contextual conditions are not favorable.

La présente recherche a pour objet la pratique orthophonique en suppléance à la communication (SC) auprès de personnes qui ont une déficience intellectuelle (DI). Des recherches ont montré que les aides à la communication à sortie vocale (ACSV) pouvaient améliorer la communication des personnes ayant une DI. Cependant, la plupart de ces recherches ont été menées dans des conditions idéales qui ne reflètent pas nécessairement celles que l’on retrouve dans les milieux cliniques typiques. On connaît peu de choses sur les pratiques professionnelles en SC auprès des personnes ayant une DI. Le but de cette recherche est de décrire la pratique orthophonique, de documenter les perspectives des utilisateurs sur les résultats des interventions et de décrire l’implication des parents et leurs habiletés à soutenir leur enfant dans l’utilisation d’une ACSV afin de proposer un modèle d’intervention en SC auprès de cette clientèle qui tienne compte de ces différentes perspectives. Une méthode qualitative a été choisie pour réaliser la recherche. Des entrevues individuelles semi-structurées ont été réalisées avec onze orthophonistes francophones et avec des parents ou familles d’accueil de dix utilisateurs d’ACSV et des entrevues structurées ont été menées avec huit utilisateurs d’ACSV. Un outil d’entrevue a été conçu à l’aide de pictogrammes pour permettre aux utilisateurs d’ACSV de répondre à des questions portant sur leur appréciation et utilisation de leur ACSV, leur satisfaction et priorités de communication. Un cadre conceptuel a été conçu à partir des guides de pratique clinique et un codage semi-ouvert a été utilisé pour réaliser les analyses thématiques des données provenant des orthophonistes. Un codage ouvert a servi à analyser les données provenant des parents. Des analyses descriptives ont servi à examiner les réponses des utilisateurs. Diverses procédures ont assuré la crédibilité des analyses. Entre autres, les analyses des entrevues des orthophonistes ont été validées lors d’un groupe de discussion avec sept participantes orthophonistes. Les résultats montrent que les ACSV sont utilisées surtout dans le milieu scolaire. Elles sont parfois utilisées lors des loisirs et dans la communauté, mais ces contextes sont ceux où les utilisateurs ont exprimé le plus d’insatisfaction et où se situe la majeure partie des priorités qu’ils ont identifiées. Les analyses ont permis d’identifier les facteurs qui rendent compte de ces résultats. Les orthophonistes manquent d’outils pour réaliser des évaluations exhaustives des capacités des clients et elles manquent de procédures pour impliquer les parents et obtenir d’eux une description complète des besoins de communication de leur enfant. Conséquemment, l’ACSV attribuée et le vocabulaire programmé ne répondent pas à l’ensemble des besoins de communication. Certaines orthophonistes manquent de connaissances sur les ACSV ou n’ont pas le matériel pour faire des essais avec les clients. Il en résulte un appariement entre la personne et l’ACSV qui n’est pas toujours parfait. À cause d’un manque de ressources en orthophonie, les parents sont parfois laissés sans soutien pour apporter les changements à la programmation lors des transitions dans la vie de leur enfant et certains ne reçoivent pas d’entraînement visant à soutenir l’utilisation de l’ACSV. Un modèle d’intervention en SC est proposé afin d’améliorer la pratique orthophonique auprès de cette population. / This research targets the practices in Augmentative and Alternative Communication (AAC) of speech-language pathologists (SLPs) who work with individuals who have an intellectual disability (ID). Prior research has shown that speech generating devices (SGDs) can help individuals with ID to improve their communication. However, these studies were conducted under ideal conditions, which do not necessarily reflect those that prevail in typical clinical settings. We have little information about AAC practices with individuals with ID or about the efficacy of SGD attribution and AAC intervention under typical conditions. The goals of this research are therefore to describe AAC practices of SLPs with individuals who have an ID, to document the users’ perspectives on the outcome of AAC interventions and to describe the parents’ implication and their abilities to support their child’s use of an SGD in order to propose an intervention model that takes into account these different perspectives. Qualitative methods were chosen to address these questions. Individual semi-structured interviews were conducted with eleven French-speaking SLPs and with the parents or foster families of ten SGD users, and structured interviews with eight SGD users. These interviews were analyzed in order to gather information about research questions. An evaluation tool, made of graphic symbols, was developed to gather information from SGD users about their use of their SGD, their satisfaction, and communication priorities, and about their appreciation of their SGDs. A conceptual framework was developed based on clinical practice guidelines to analyze SLP’s interviews, and a thematic analysis was conducted with semi-open coding. Open coding was used for the data from parents’ interviews, and descriptive analysis of the SGD users’ responses was performed. Steps were taken to ensure credibility of the findings; in particular a focus group was conducted with seven of the participating SLPs to validate the interview results. The results showed that the SGDs are used most frequently in school settings. They are used only occasionally in leisure activities and in the community, but these are the contexts in which the users were most dissatisfied with their communication and in which they most frequently indicated priorities for communication. Factors that explain these results were identified through thematic analysis. SLPs lack the tools they need to perform a comprehensive evaluation of the users’ capacities. They lack procedures for involving parents in the evaluation and for obtaining a thorough description of their child’s communication needs. This might result in attribution of SGSs and identification of vocabulary that do not meet the user’s needs. Some of the SLPs lack sufficient knowledge and do not have SGDs available for trials with their clients, resulting in a less-than-perfect matches between the users and the SGDs. Lack of professional resources leaves parents without support to make changes needed in times of transition in their child’s life. Parents may be unable to support their child’s use of SGD in a variety of contexts. An attribution and AAC intervention model is proposed in order to improve AAC intervention and SLP’s practices.

The diploma thesis entitled "Education of Pupils with parallel hearing and mental disabilities in the 1st grade of Primary School for the hearing impaired " analyzes the accessibility of teaching aids for students frequenting Grades 1-6 of elementary schools for students with hearing problems. With respect to the subject treated, exploring part of the thesis focuses on on the collaboration of the teacher with the hearing-impaired educator or the educator's assistant. Also discussed are the types of communication systems most frequently used by the teachers during their work. In the thesis there is also an overview of elementary schools in the Czech Republic, in which students with hearing impairments and parallel mental retardation are educated on the 1st grade. The objective of this diploma thesis is to point out the shortage of teaching aids for students with this form of health impairment, who require a variety of educational strategies, given their specific educational needs. The research work was undertaken using methods of a semi-structured interview, observation and an analysis of teaching products. The outcome of the research conducted for the purposes of this diploma thesis was the conclusion that the availability of teaching aids for students with parallel hearing and mental impairments...

The diploma thesis entitled "Education of Pupils with parallel hearing and mental disabilities in the 1st grade of Primary School for the hearing impaired " analyzes the accessibility of teaching aids for students frequenting Grades 1-6 of elementary schools for students with hearing problems. With respect to the subject treated, one part of the thesis focuses on the instruction methods used for the teaching and education of such children and on the collaboration of the teacher with the hearing-impaired educator or the educator's assistant. Also discussed are the types of communication systems most frequently used by the teachers during their work. The second part of the thesis provides an overview of elementary schools in the Czech Republic, in which students with hearing impairments and parallel mental retardation receive education. The objective of this diploma thesis is to point out the shortage of teaching aids for students with this form of health impairment, who require a variety of educational strategies, given their specific educational needs. The research work was undertaken using methods of a semi-structured interview, observation and an analysis of teaching products. The outcome of the research conducted for the purposes of this diploma thesis was the conclusion that the availability of...

Made available in DSpace on 2016-04-28T18:24:14Z (GMT). No. of bitstreams: 1 Roseli Vasconcellos.pdf: 1453622 bytes, checksum: e7c7e34df88afe178f5c1080bbbafb3a (MD5) Previous issue date: 2010-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study discusses issues related to the distinction between the body conceived as an organism and the body approached as parlêtre (Lacan s expression). This subject-matter emerged from my clinical practice carried on with persons with Cerebral Palsy (CP). It is assumed that a theoretical dialogue with the fields of Medicine (Neurology) and with the Speech Pathology and Therapy is necessary and extremely relevant. Therefore, two chapters were dedicated to the literature of those areas. Recent papers and manuals, concerning CP, were selected. It is pointed out that the most recent research conclusions suggest, in fact, a strong convergence between what is taken as new and what is said to be old knowledge in the field of CP. Freud s statement, written in 1897, should, no doubt, be viewed as up-to-date. Some critical comments related to the Alternative Communication Systems (CA) were also included and a brief presentation of the Blissymbols and the Picture Communication Symbols (PCS) were followed by considerations about their importance for the Language Clinic theoretical development. I tried to point to the fact that such a Clinic takes clear distance from all others, since the CA introduction is guided by the specific language and subject conceptions assumed in this study. The theoretical orientation, here assumed, allowed me to address the problematic distinction between organic body and language body. This doctoral dissertation, which departs from the clinical practice with persons with Cerebral Palsy, is committed to the theorization undertaken in the CNPq Research Group, headed by Maria Francisca Lier-DeVitto, at LAEL PUCSP. It must be said that the Language Clinic is affiliated to the Interacionism in Language Acquisition, proposed by Cláudia de Lemos. Such a theoretical framework has strong links with the so called european structuralism as interpreted by Jacques Lacan. Such a theoretical trend triggered the inclusion of the psychoanalytical reflection on the subject speaker and about the relationship between child-language-speech. The difference this study introduces is illuminated by the clinical effects of the implementation of Alternative Communication Systems. It is worth saying that it is the therapist s body and speech that provide and support the materialization of the significant. The heterogeneous clinical effects analyzed led to considerations about the nature of listening, about transference and about the tension between conflict and pleasure that accompany some subtle and fragile vocalized speech. Data were discussed here and the interpretation conveyed sustains, I believe, the clinical and theoretical supposition proposed and advanced in this doctoral dissertation, i. e., that the body as organism and the body as parlêtre do not coincide / Esta tese discute a questão da diferença entre organismo e corpo, a partir do atendimento de sujeitos com Paralisia Cerebral (PC) na Clínica de Linguagem. Para falar em corpo, não o corpo-orgânico da Medicina, um diálogo inicial com a Neurologia é desenvolvido. Enfoco, para tanto, investigações recentes em torno da PC e assinalo que os mais novos achados sugerem uma forte convergência entre o novo e o mais antigo, nesse caso. Refiro-me a afirmações feitas há muito por Freud acerca da PC a partir de sua clínica com essas pessoas. Do mesmo modo, assumo a importância da interlocução com o campo da Comunicação Alternativa (CA). Uma breve apresentação do Bliss e do Picture Communication Symbols (PCS) é seguida por pontuações sobre sua importância modo de introdução na Clínica de Linguagem. Dou ênfase, nesta parte, ao distanciamento desta Clínica em relação a todas as outras que operam com a CA. A particularidade da Clínica e Linguagem decorre das concepções de linguagem e sujeito assumidas nesta tese. Com o intuito de delinear a natureza da literatura produzida sobre a CA, em nosso país e em âmbito internacional, ofereço um panorama de trabalhos representativos e de interesse para a Clínica de Linguagem com pacientes com PC. A direção teórica assumida, que tornou possível abordar a distinção entre corpo-orgânico e corpo-linguagem ou corpo pulsional, parte dos estudos desenvolvidos no interior da Clínica de Linguagem, pelo grupo de pesquisa liderado por Maria Francisca Lier-DeVitto, no LAEL PUCSP. A Clínica de Linguagem tem laço de filiação com o Interacionismo em Aquisição de Linguagem, proposto por Cláudia De Lemos, vertente teórica que, ao aproximar-se do Estruturalismo Europeu através da leitura de Lacan, dispara implicações entre Lingüística e Psicanálise, pondo em questão a relação criança-língua-fala do outro. A diferença tanto teórica, quanto clínica, que introduzo nesta tese, relativamente ao tratamento de pacientes com PC que não oralizam, é iluminada pelos efeitos dessa clínica que inclui a CA e a materialização do significante, que se faz pela via do empréstimo do corpo e da voz do outro-terapeuta. Abordo a heterogeneidade dos efeitos desta Clínica que suscitaram considerações sobre a escuta, sobre a transferência e sobre o prazer ou o conflito que acompanham a produção de certas falas vocalizadas de alguns pacientes. Os dados analisados nesta tese falam a favor da presença de um corpo-linguagem: um corpo que irrompe em manifestações significantes e que fala (como pode) - o que corrobora a afirmação que remete ao título desta tese: a de que sujeito e organismo não coincidem