Prior studies have shown that individuals with disabilities, especially those with communication disabilities, are at higher risk for being exposed to domestic violence. The Swedish National Board of Health and Welfare recommend the municipal social services to use Augmentative Alternative Communication (AAC) as a means to facilitate communication with such individuals. Further, it is recommended that the social services use a standardized instrument called FREDA-risk assessment to ask clients about domestic violence. However, little is known about the use of those instruments among LSS administrators who handle service and support for individuals with disabilities, who may also have communication disabilities. The aim of this study was to investigate the use of FREDA- risk assessment and AAC among LSS administrators, and to explore whether the use of AAC affects the use of FREDA-risk assessment. In order to do so, a digital survey was conducted, in which 366 respondents spread over 144 municipalities participated. The results show that both instruments are not use at their full potential and that the use of AAC could facilitate the use of FREDA- risk assessment. Implications for social work practice and further research are discussed.

Studiens syfte är att belysa hur speciallärare med specialisering mot utvecklingsstörning lyfter fram metoder som gynnar kommunikationsutveckling för elever på särskolan. Vidare belyses vilka sociala sammanhang och verktyg som används för att främja kommunikationen för elever i särskolan. I studien tolkas resultatet ur det sociokulturella perspektivet där artefakter, kultur och den närmaste utvecklingszonen är de centrala begrepp som används i tolkningen. En hermeneutisk ansats används i studien och kvalitativa intervjuer av semistrukturerad karaktär genomfördes med åtta speciallärare, verksamma inom grund- och gymnasiesärskolor runt om i Sverige. En förhoppning var att studien skulle ge aha-upplevelser gällande hur lärare kan arbeta med kommunikation samt ge oss en större verktygslåda i vår profession som speciallärare. Resultatet presenteras i kategorier som framkommit vid analys av empirin. Resultatet visar att kommunikation inom särskolan innefattar många olika artefakter, och de artefakter som används mest är bilder och tecken. Kulturer som förekommer för att gynna kommunikationsutvecklingen för elever på särskolan är läsande och spela spel för att eleverna ska kunna bli så självständiga som möjligt. För de på tidig utvecklingsnivå lyfts imitation som centralt för att utveckla kommunikationen. I studien framkommer att både speciallärare och elever behöver stöttning i den närmaste utvecklingszonen vad det gäller kommunikation. Miljöerna är kommunikativt tillgängliga men dock endast på individ och gruppnivå och inte på organisationsnivå. / The purpose of the study is to shed light on how special education teachers with a focus on developmental disabilities, to highlight methods that benefit communication development for students at the special school. Furthermore, the social contexts and tools that are used to promote communication for students in special schools are highlighted. The study interprets the results from the socio-cultural perspective where artifacts, culture and the immediate development zone are the central concepts used in the interpretation. A hermeneutic approach is used in the study and qualitative interviews of a semi-structured nature were conducted with eight special teachers, active in primary and secondary special schools around Sweden. One hope was that the study would provide aha-experiences regarding how teachers can work with communication and give us a larger toolbox in our profession as special teachers. The results are presented in categories that emerged from the analysis of the empirical data.The results show that communication within the special school includes many different artifacts, and the artifacts that are used most are images and signs. Cultures that exist to promote communication development for students at the special school are reading and playing games so that the students can become as independent as possible. For those at an early stage of development, imitation is emphasized as central to developing communication. The study shows that both special needs teachers and students need support in the immediate development zone when it comes to communication. The environments are communicatively accessible, but only at the individual and group level and not at the organizational level.

Denna studie redogör för hur personal verksamma i grundsärskolan med inriktning träningsskola, beskriver sitt arbete med elevers kommunikationsutveckling genom AKK, Alternativ och Kompletterande Kommunikation. Studien utgår från semistrukturerade intervjuer som genomförts på rektorer, specialpedagoger, pedagoger och elevassistenter. Intervjuerna har analyserats genom tematisk innehållsanalys (Braun & Clarke, 2006). Ianalysarbetet framkom gemensamma mönster, kring hur utveckling av elevers kommunikation med hjälp av AKK beskrivs av personal. Dessa redovisas under tre huvudteman i resultatdelen; samverkan för utveckling, resurser i elevens omgivning samt utvecklingsområden. Syftet med denna induktiva studie (Bryman, 2011) har varit att få en fördjupad insikt kring hur informanterna beskriver kommunikationsutveckling genom AKK. Resultatet visade attpersonal har en tydliggörande struktur genom AKK, framför allt genom bilder i olika former.Tecken som stöd används för att förstärka och förtydliga kommunikationen. Multimodal kommunikation anses vara gynnsamt. Personal motiverar eleverna till att använda AKK genom att vara förebilder, och strävar efter att använda det hela tiden. Samverkan för kommunikationsutveckling är en viktig faktor. AKK är personlig och det är omgivningens ansvar att tolka elevens kommunikation. / In this study we have investigated how staff working in compulsory school for children with severe learning disabilities, describe their work with students' communication development through AAC, Augmentative and Alternative Communication. The survey is based on semi-structured interviews conducted with principals, special educators, teachers and student assistants. The interviews have been analysed through thematic analysis (Braun & Clarke, 2006). In the analysis work we found common patterns, about how development of student communication with help of AAC is described by staff. These are reported and named under different themes in the introductory section. The purpose of this inductive study (Bryman, 2011) has been to gain a deeper understanding into how informants describe communication development through AKK. The result indicated that staff have a clear structure through AAC, especially images in different forms. Signs as support are used to reinforce and clarify communication. Multimodal communication is considered to be favourable. Staff motivate students to use AAC by being role models and strive to use it in all time. Collaboration for communication development is an important factor. AAC is personal and it is the responsibility of the environment to interpret the pupil´s communication.

Många barn behöver alternativ och kompletterande kommunikation (AKK) för att tillgodogöra sig undervisningen i förskolan. AKK kan därmed bidra till undervisningen av kemi, speciellt undervisning för de allra yngsta barnen. Studien syftar till att bidra med kunskap om hur förskollärare kommunicerar kemi med barn i åldern 1–3 år i förskolans undervisning, med fokus på AKK. Semistrukturerade intervjuer med tio förskollärare har genomförts. För att studera fenomenet AKK som didaktiskt verktyg i kemiundervisning har vi använt oss av en fenomenografisk ansats. För att beskriva lärande och undervisning i resultatet har vi arbetat utifrån det sociokulturella perspektivet. Studiens resultat visar att AKK skulle kunna användas som hjälpmedel i kemiundervisning med barn 1–3 år, men än så länge saknas rutiner för att använda dessa metoder i undervisningen. Förskollärare ger exempel på en variation av sätt att undervisa i ämnet kemi i förskolan. Bland annat tar de upp planerade experiment och hur de kan konkretisera kemi i barnens vardag. Vidare lyfter förskollärarna att det krävs ett fungerande arbetslag och ämnesspecifikt material för att skapa intresseväckande undervisning i kemi för de yngsta barnen. Begränsningar som framkommer är bland annat bristande ämneskunskaper och sviktande självkänsla. AKK beskrivs gynna alla barn och är ett av de viktigaste redskapen att använda i undervisningen. Samtidigt framkommer organisatoriska begränsningar som att det är tidskrävande att förbereda AKK material samt att det saknas rutiner för att bibehålla en kontinuitet i verksamheten. Sammanfattningsvis visar studien både på en vilja och ett behov av att arbeta aktivt med AKK i kemiundervisningen. / Many children require augmentative and alternative communication (AAC) to benefit from the education in pre-school. Thereby AAC can contribute to teaching chemistry, especially to the youngest children. The aim of this study is to bring more knowledge on how pre-school teachers communicate chemistry to children aged 1–3 years, focusing on AAC. Semistructured interviews with ten pre-school teachers were conducted. In order to study AAC as a didactic tool in chemistry education a phenomenographic approach was used. The result has been analysed from a sociocultural perspective as a means to describe learning and teaching.  The study results show that AAC could be a helpful tool in chemistry education for children aged 1–3 years, but so far routines to use these methods in the education is missing. Pre-school teachers describe a number of ways to teach chemistry in pre-school, for example by preparing experiments in advance and integrating chemistry in the children’s everyday life. Furthermore, pre-school teachers mean that a functioning work team and subject specific materials are required to arouse the interest of chemistry in the youngest children. Among other things, insufficient subject-specific knowledge and failing self-esteem are described as limitations. AAC is reported as beneficial for all children and is one of the most important educational tools. At the same time, organisational constraints such as the time-consuming work of preparing AAC material and the lack of routine procedures to maintain educational and working continuity are described. In summary, the study shows both the willingness and the necessity of actively working with AAC in chemistry education.

[pt] A interação social é fator fundamental para o desenvolvimento do ser humano, a partir do uso de instrumentos e de signos, sendo o processo de comunicação essencial para esse desenvolvimento. Compreendemos que a comunicação se desenvolve ao longo da vida do sujeito e é estruturada como um complexo processo de aquisição da linguagem, tendo esta uma dupla função comunicativa, a primeira como um meio de comunicação e a segunda como um processo de compreensão e representação do pensamento. Nos casos de comprometimentos severos ou déficits na comunicação, ao menos um dos envolvidos acaba sendo prejudicado. Nestes casos a utilização de comunicação alternativa vem contribuindo com subsídios para complementar, suplementar ou construir esse processo de comunicação. Sendo assim, o objetivo geral desta tese foi desenvolver um sistema de comunicação alternativa de forma colaborativa, junto às famílias de crianças com deficiência múltipla em decorrência da Síndrome Congênita do Zika Vírus (SCZV) não oralizadas com foco em atividades que estimulem o desenvolvimento da capacidade de comunicação. Esse trabalho está vinculado aos estudos realizados no Grupo de Pesquisa Educação e Mídia, Grupem, no Programa de Pós-Graduação em Educação da Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), com o Projeto “Estudo longitudinal de intervenção e acompanhamento do desenvolvimento da habilidade de comunicação de crianças com Síndrome Congênita do Zika Vírus”, que é um subprojeto do Projeto Pesquisas e ações intersetoriais entre educação e saúde na promoção da escolarização e do desenvolvimento de crianças com Síndrome Congênita do Zika Vírus na Baixada Fluminense. A pesquisa foi realizada na região da Baixada Fluminense, RJ, com seis famílias de crianças que nasceram com a Síndrome Congênita do Zika Vírus (SCZV). Realizamos uma pesquisa qualitativa, baseada nos pressupostos metodológicos da pesquisa colaborativa. Através desta metodologia, construímos, em conjunto com as famílias das crianças participantes, alternativas para as dificuldades de comunicação apresentadas por elas, assim como para o desenvolvimento do App Comunika, um protocolo digital voltado ao desenvolvimento da capacidade de comunicação e de interação social de crianças com SCZV. O trabalho de campo foi desenvolvido em dois momentos. No primeiro realizamos visitas às casas das famílias participantes da pesquisa para realização de entrevista e aplicação de questionário socioeconômico e do Participation and Environment-Children and Youth (PEM-CY), instrumento de avaliação da capacidade de participação das crianças na família, na escola e na comunidade. No segundo momento as famílias participaram de reuniões no Instituto Multidisciplinar (IM), campus da Universidade Federal Rural do Rio de Janeiro (UFRRJ), onde iniciamos o desenvolvimento do App Comunika. Realizamos a produção de dados utilizando a observação (com registro em diário de campo), entrevistas semiestruturadas, questionário socioeconômico e o documento PEM-CY. Como referencial teórico, empregamos a teoria histórico-cultural de Vigotski, tomando seus conceitos como aportes para a compreensão das especificidades do desenvolvimento das crianças participantes e para a criação das atividades que integraram o App. A partir os dados produzidos, elaboramos as atividades que o constituem. Foram criadas 100 atividades para trabalhar a comunicação e ampliar a participação dessas crianças com base nas expectativas e necessidades apresentadas pelas famílias. De toda essa investigação emergiram como principais resultados: compreender as possibilidades advindas dos recursos de tecnologias assistivas (TA) e comunicação alternativa (CA) e abordá-las como instrumentos para a compensação de limitações em benefício dos processos de participação e comunicação das crianças com deficiência múltipla não oralizadas em decorrência da SCZV; a importância do trabalho em colaboração com as famílias para a elaboração do App, assim como da mediação na relação com o contexto, mediatizados por instrumentos, signos e símbolos desenvolvidos culturalmente; o (re) conhecimento das famílias das capacidades e diversidades de comunicação das crianças para possíveis aprendizagens futuras, assim como o quanto consideram o recurso de comunicação alternativa como uma possibilidade para trabalhar o desenvolvimento e ampliação da comunicação com seus filhos em suas casas e, posteriormente fomentando sua participação em outros contextos e com outros interlocutores; o desenvolvimento e a disponibilização do App Comunika como um recurso disponível gratuitamente na web para celular, smartphone e tablete com sistema operacional Android. / [en] Social interaction is a key factor for human development, from the use of instruments and signs, with the communication process being fundamental to this development. We understand that communication develops throughout the life of the subject, and is structured as a complex process of language acquisition, which has a dual communicative function, the first as being a means of communication and the second, as a process of understanding and representing thought. In cases of severe impairment or communication deficits, at least one of those functions end up being harmed. In these cases, the use of alternative communication has contributed with subsidies to complement, supplement or build this communication process. Therefore, the general objective of this thesis was to develop an alternative communication system in a collaborative way, together with the families of non-oralized children with multiple disabilities due to Congenital Zika Virus Syndrome (SCVZ), with focus on activities that encourage the development of communication skills. This research is linked to studies carried out in the Education and Media Research Group (Grupem), in the Graduate Program in Education at the Pontifical Catholic University of Rio de Janeiro (PUC - Rio), with the project Longitudinal study of intervention and monitoring of the development of communication skills in children with Congenital Zika Virus Syndrome, which is a subject of the project Research and intersectoral action between education and health in promoting schooling schooling and development of children with congenital zika virus syndrome at Baixada Fluminense. The research was carried out in Baixada Fluminense, RJ, with six families of children who were born with Congenital Zika Virus Syndrome (SCVZ). We carried out qualitative research, based on the methodological assumptions of collaborative research. Through this methodology, we built, with the help of the families of the participating children, alternatives for the communication difficulties presented by them, as well as the development of the app Comunika, a digital protocol aimed at developing communication skills and social interaction in children with SCVZ. The field work was carried out in two moments. On the first one, we carried out visits to the homes of the families participating in the research to carry out an interview and apply a socioeconomic questionnaire and the Participation and Environment- Children and Youth (PEM-CY), an instrument for evaluating the children s ability to participate in the family and in the community. On a second moment, the families participated in a meeting at the Multidisciplinary Institute (IM), campus of the Federal Rural University of Rio de Janeiro (UFRRJ), where we started the development of the Comunika app. We produced data using observation (with a field diary) semi-structured interviews, a socioeconomic questionnaire and the PEM-CY document. As a theoretical framework, we used Vigotski s cultural-historical theory, taking his concepts as contributions to understanding the specificities of the participating children s development, and creating the activities that integrated the app. Based on the produced data, we developed activities that made constitute it. 100 activities were created to work on communication and expand the participation of these children based on expectations and needs presented by the families. The main results emerged from all this research: understanding the possibilities arising from TA and CA resources and approaching them as instruments for compensating limitations in favor of the participation and communication processes of children with multiple non-oralised due to SCVZ; the importance of working in collaboration with families for the development of the app, as well as the meditation in the relationship with the context, mediated by culturally developed instruments, signs and symbols; the knowledge of families of children s communication skills and diversity for possible future learning, as well as how much they consider the alternative communication resource as a possibility to work on the development and expansion of communication with their children at home and, subsequently, encouraging their participation in other contexts and with other interlocutors; the development and availability of the Comunika app as a resource available free of charge on the web for cell phones, smartphones and tablets with operating Android system.

Huvudsyftet med studien har varit att utvärdera hur en fem timmar lång kommunikationsutbildning riktad till sjukgymnaster på habilitering påverkar sjukgymnasternas kommunikativa stil i interaktion med barn/ungdomar som på grund av cerebral pares saknar tal. Utbildningen utformades som en inlärningsmodell i åtta delmoment (åttastegsmodellen). I utbildningen och studien ingick sex habiliteringssjukgymnaster som interagerade med var sitt barn/ungdom som till följd av cerebral pares kommunicerar med alternativt och kompletterande kommunikation (AKK) i form av kommunikationskartor. Interaktionen videofilmades vid tre separata tillfällen: en inspelning före utbildning, en inom två veckor efter utbildningen samt en sista filmning tre månader efter avslutad utbildning. Analys av videomaterialet gjordes med hjälp av en kombination av kvantitativ och kvalitativ analysmetod. Analysformuläret KOMMUNIKATIV användes för att analysera sjukgymnasternas kommunikation och kompletterades med en mer detaljerad kvalitativ samtalsanalys (Conversation Analysis, CA) där interaktionen mellan individerna analyserades. Utöver detta besvarade sjukgymnasterna en enkät. Utbildningens utformning baserades på tidigare forskning i form av av miljömodifierande strategier, responsiv kommunikationsstil samt AKK-modell i form av att pekprata. Resultatet av KOMMUNIKATIV påvisade en statistiskt signifikant förändring av sjukgymnasternas kommunikativa beteende efter avslutad utbildning. Det fanns även en fortsatt mätbar, men inte statistiskt signifikant, förändring mellan andra och tredje mättillfället. Sjukgymnasterna möjliggjorde, efter utbildning, att barnen/ungdomen i större utsträckning kunde kommunicera med sin kommunikationskarta. De pekpratade i större utsträckning och var mer lyhörda för barnets/ungdomens kommunikation. Endast en av tio kommunikativa förmågor som analyseras i KOMMUNIKATIV försämrades: sjukgymnastens förmåga att förtydliga sig. Samtalsanalysen bekräftade den kvantitativa analysen på flera sätt och visade att barnet/ungdomen efter utbildning anpassade sig till sjukgymnasternas förändrade beteende och uttryckte sig i längre fraser. Interaktionsmönstret ändrades från att före utbildning vara mer styrt av sjukgymnasten till att barnet/ungdomen efter utbildning kunde införa nya ämnen och delta i reparerande sekvenser. Samtalsanalysen visade även hur sjukgymnasterna ändrade sin användning av en engagerad röstkvalitet. Före kursen användes den i flera olika kontexter, inklusive problematiska kommunikativa kontexter där den snarare förvärrade problemen. Efter kursen varierade sjukgymnasterna sina strategier för att lösa olika typer av problematiska situationer, och undvek därmed i högre grad kommunikativa problem. Åttastegsmodellen som provades i genomförandet av kursen var framgångsrik på två olika sätt. Dels medgav den att varje deltagare fick en individuell målsättning baserad på en förmätning, och dels medförde modellen ett aktivt lärande vilket bidrog till att befästa den nya kunskapen. En slutsats av utvärderingen är att en interventionsutbildning enligt åttastegsmodellen med fördel kan användas för att lära ut kommunikativa strategier till habiliteringspersonal. / The main purpose of this study was to examine how a five hour communication course given to physiotherapists working at a habilitation center changes their communication when interacting with non-speaking children and teenagers with cerebral palsy. An instructional model for teaching learning strategies in eight steps was tested. Six physiotherapists took part of a five hour communication course on three occasions. The course contained receptive communication, environmental arrangements and aided language stimulation as suggested by previous research. Interaction between physiotherapist and child/teenager communicating with a communication board was videotaped just before the course, within two weeks after the course and also three month later. The course was analyzed using a combination of quantitative and qualitative methods. KOMMUNIKATIV is a quantitative method measuring ten communication abilities of the physiotherapists. Conversation Analysis (CA) was used as a detailed qualitative complementary analysis to KOMMUNIKATIV in order to examine the interaction between physiotherapist and child/teenager. Results from KOMMUNIKATIV showed a statistically significant change within two weeks after the course. Continued changes were measured between the second and the third point of measure but that change was not statistically significant. These results strongly indicate that the physiotherapists adopted a more receptive communication style after the course. They made it possible for the child/teenager to communicate with the communication board and they increased the number of AAC-modeling. One aspect, the physiotherapists’ ability to simplify the communication, declined from the first to the second and third point of measure. The child´s/teenager´s communication adapted in some ways to the changed communicational behavior of the physiotherapists. After the course, the child/teenager used longer phrases and started to make repairs. The detailed interaction analysis verified the change in communicative behavior in several ways. One significant change was the way the physiotherapists used an engaged voice quality to encourage the child/teenager to respond to requests for action. Before the course this voice quality was used in many different contexts, including communicatively problematic contexts, where it increased the problems. After the course the physiotherapists used a more varied set of strategies to solve problematic situations, thereby avoiding communicative problems. The instructional model for teaching communicative strategies in eight steps that was used in the study was successful in two ways. Firstly, the model provides the possibility to set individual goals for each member based on preassessments. Secondly, this model enables active learning which seem to consolidate the new ability. A conclusion from the evaluation of the eight step model is that it can be used for teaching communicative strategies to professionals.

ABSTRACT Background: A language is an individual tool for stimulating and organizing concepts and thinking. Through a language, the individual is also given opportunities to understand the outside world and himself. Not having access to a functional language and means to communicate results in a potential loss of opportunities for development and limitations in all aspects of life. For individuals with language-, speech- and communication difficulties, there are Augmentative and Alternative Communication (AAC). AAC is a collective term for various tools and methods that aim to improve and facilitate communication and interaction between the individual and the persons surrounding them. One type of AAC is Pragmatic Organized Dynamic Display (PODD). Aim: This study aims to investigate what happens during interaction with PODD in conversations between two people using the methodology of Conversation Analysis (CA). Method: A qualitative case study was conducted during a day at a training school where an AAC user ("Adam") and his communication partner ("Elin) interacted with PODD in different everyday activities. The observation was documented with two video cameras. Result: The recorded material totaled three hours. From this amount of video material, a couple of sequences were selected for analysis. The analysis of the material shows that the interaction with PODD is built up sequentially through cooperation between the participants. Participants used different approaches to initiate, maintain and terminate communicative projects with PODD. The analysis also shows that PODD was used to perform various social actions within several different activity types. The results also indicate that it is the partner’s ability to pay attention to, interpret, support and guide the AAC user's communicative initiative, which gives the AAC user the opportunity to participate in the joint communicative projects. / SAMMANFATTNING Bakgrund: Ett språk är ett individuellt redskap för att stimulera och organisera begrepp och tänkande. Genom språket ges individen också möjligheter att förstå omvärlden och sig själv. Att inte ha tillgång till ett funktionellt språk och kommunikationssätt innebär att individen riskerar att gå miste om många utvecklingsmöjligheter och bli starkt begränsad i livets samtliga aspekter. För individer med språk, tal och kommunikationssvårigheter finns Alternativ och Kompletterande Kommunikation (AKK). AKK är ett samlingsbegrepp för olika redskap och metoder som avser att förbättra och underlätta kommunikation och interaktion mellan individen och personerna i dennes omgivning. En form av AKK är Pragmatisk Organiserad Dynamisk Display (PODD). Syfte: Denna studie syftar till att med metodologin för Conversation Analysis (CA) undersöka vad som sker i interaktion med PODD under samtal mellan två personer. Metod: En kvalitativ fallstudie som genomfördes under en dag på en träningsskola då en AKK-användare (”Adam”) och hans kommunikationspartner (”Elin) interagerade med PODD i vardagliga aktiviteter. Observationen dokumenterades med två videokameror. Resultat: Det inspelade materialet uppgick till totalt tre timmar. Utifrån denna mängd valdes ett par sekvenser ut för analys. Analysen av materialet visar att interaktionen med PODD byggs upp sekventiellt genom ömsesidigt samarbete mellan deltagarna. Deltagarna använde sig av olika tillvägagångssätt för att initiera, upprätthålla och avsluta kommunikativa projekt med PODD. Analysen visar även att PODD användes för att utföra olika sociala handlingar inom flera olika aktivitetstyper. Resultaten tyder också på att det är kommunikationspartnerns förmåga att uppmärksamma, tolka, stötta och vägleda AKK-användarens kommunikativa initiativ som ger AKK-användaren möjlighet att delta i det gemensamma kommunikativa projektet.

Manual signs are an augmentative and alternative communication mode which enables and facilitates communication for persons with impairments in speech, language and hearing. There are different ways of teaching signs to persons with intellectual disabilities. One of them is milieu teaching, which is a method where the teaching takes place in natural settings. This method has proven to give good results in generalization and maintenance. Teaching signs to staff in groups has been shown to be effective. The purpose of the present study was to investigate whether sign intervention affected the number of signs and the number of different signs, used by two persons with Down’s syndrome and eleven staff on a day center. The study was carried out as a single-subject design. A sign intervention was conducted at the day center with the two participants with Down’s syndrome. They were educated individually with a procedure inspired by milieu teaching. When the intervention with the two participants was terminated, the staff was educated in a group format. The number of signs and the number of different signs used by the two participants with Down’s syndrome and the staff were registered. The sign intervention with the two participants led to an increased use of signs for one of them and the sign intervention with the staff led to an increased use of signs for the staff together with one of the participants. The main reason for why the sign intervention was effective for one of the two participants with Down’s syndrome and for one group of staff, but not for the other participant or the other group of staff, seems to be that the participants use of signs had an impact on each other. One of the participants with Down’s syndrome and one group of staff seems to have had a positive impact on each others use of signs. The intervention also seems to have been too short and therefore has not given effect for all of the participants.

The study explored how a practitioner and a teacher accommodated children living with cerebral palsy in Grade R, also referred to as the reception year, at two special schools, especially how they adapted the environment and used assistive devices. Cerebral Palsy is the most common form of a neurological disorder that appears in infancy or early childhood, permanently affecting body movement and muscle coordination. Research has illuminated that early specialist intervention such as assistive devices, augmentative and alternative commutation methods and assistive technology can make the world of difference to the future of the child. My research afforded me the opportunity to observe the children in Grade R living with cerebral palsy, with the practitioner and the teacher in their natural setting at school level. I followed the deductive paradigm, and adopted a case study design. The use of assistive devices and argumentative and alternative communication has historically been the domain of occupational-, speech- and physiotherapists. With the introduction of inclusive education and the new screening, identification, assessment and support policy to be conducted in all Grade R classes at all schools in South Africa, my research will be beneficial to mainstream and full-service schools, as well as special schools. Young children living with cerebral palsy will be included in all these schools and will need support from expert teachers and practitioners, who are knowledgeable about their requirements for an adapted environment and the use of assistive devices and augmentative and alternative communication methods. The study found that the Grade R staff at the special schools were knowledgeable, but their knowledge was superficial, their classrooms lacked adapted toys, and assistive technology was non-existent. Teachers and practitioners need practical training on the importance of movement for children living with cerebral palsy and the training should emphasize that experiencing the world through assistive devices alleviates barriers to learning and development. / Inclusive Education / M. Ed. (Inclusive Education)

People withmobilityandspeechrestrictionssimultaneoushaveverbalcommunicationandbody language impaired.Inthemostextremecasesthepatientsaredeprivedofalltheirmovements and speechcapabilities.ThissituationischaracterizedastheLocked-inSyndrome(LIS).The augmentativeandalternativecommunicationtechnologiesprovidemethodsandsoftwaresthat allowthesepatientstocommunicatewiththeexternalenvironmentandpeoplearoundthem. Among thevariousmethodsandexistingcommunicationprogramswecanhighlightthevirtual keyboard.However,datainputusingthiskindofkeyboardisconsiderablyslowerandmore tiresome forpeoplewithLIS.Thisworkaimstobuildanassistivevirtualkeyboardtoassist patients withseveremobilityrestrictionsandspeechtocommunicate.Toachievethisgoalit wasconductedtwosystematicreviewsandaliteraturereview.Fromtheknowledgegained from theseresearchswemodeledanddevelopedanassistivevirtualkeyboard.Moreover,we designed andimplementedanevolutionarymethodologythatallowsthekeyboardtoadaptitself to user svocabularyandwritingmode.Finally,anexperimentthatcomparesthetraditional method keyboardsoptimizationwiththemethodologyproposedinthisthesiswascarriedout. / Pessoas comrestriçõesmotorasedefalasimultâneastêmacomunicaçãoverbalealinguagem corporal prejudicadas.Noscasosmaisextremosopacienteéprivadodetodososseusmovimen- tos edacapacidadedefala.EssasituaçãoécaracterizadacomoaSíndromedoEncarceramento (SE). Astecnologiasdecomunicaçãoaumentativaealternativasãoresponsáveisporproporcio- narem métodose softwares que possibilitamacomunicaçãodospacientescomoambienteeas pessoas queoscercam.Entreosváriosmétodoseprogramasdecomunicaçãoexistentespode-se destacar otecladovirtual.Porém,aentradadedadosutilizandotecladosvirtuaiséconsidera- velmentemaislentaecansativaparapessoascomSE.Oobjetivodestetrabalhoéconstruirum teclado virtualassistivoparaauxiliarpacientescomrestriçõesmotorasgravesedefalaaseco- municarem. Paraatingiresseobjetivoforamrealizadasduasrevisõessistemáticaseumarevisão de literatura.Apartirdoconhecimentoadquiridodessasrevisõesfoimodeladoedesenvolvido um tecladovirtualassistivo.Alémdisso,foielaboradaeimplementadaumametodologiaevolu- tivaquepermiteotecladoseadaptaraovocabulárioeomododeescritadousuário.Finalmente, foi realizadoumexperimentoquecomparaométodotradicionaldeotimizaçãodetecladoscom a metodologiapropostanestatese. / Doutor em Ciências