Thesis advisor: Susan Bruce / Augmentative and alternative communication (AAC) is central to the lives of many individuals who are not able to effectively use spoken language. AAC systems are an essential component of a student’s ability to access his/her world, including daily communication and school content. The provision of such systems is a high priority in the field and supports the emancipation of those with limited voice, power, and independence that must function within a social structure that has been designed for the more typically abled. The study employed a single-case multiple staggered baseline design with randomized intervention implementation and intervention schedule using the What Works Clearinghouse (WWC) standards from 2010. Five students with complex disabilities using advanced speech generating devices with the LAMP method, Language Acquisition Through Motor Planning, (Halloran & Halloran, 2006), of picture symbol organization participated in the study. The LAMP method was examined, and the potential impact on language and communication it may have. Specifically, the ability to use print versus picture symbols for communication and literacy was investigated within the context of a highly structured 1:1 literacy lesson facilitated by interventionists. Results indicated that all students made varying degrees of gains in the use of print words. These gains were sustained in the generalization phase. Operational skills were impacted demonstrated by increased skill development in navigation of the speech generating device and the type of vocabulary selected. In addition, communication functions were expanded, and in some cases, there was a significant increase in the complexity of word usage across people and settings. Discussions on interventionists perceptions are presented and integrated within individual student results providing context and direction on training needs. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Lynch School of Education. / Discipline: Teacher Education, Special Education, Curriculum and Instruction.

Up to 1.2% of the population is unable to meet daily communication needs using typical speech and may use augmentative and alternative communication (AAC) strategies to communicate, including manual sign language, facial gestures, and aided strategies such as selecting targets on an onscreen keyboard. However, for individuals whose impairments affect both speech and non-speech motor systems (e.g., spinal cord injury, amyotrophic lateral sclerosis, multiple sclerosis), their ability to use manual sign and access computer systems are impacted. AAC access methods in this population remain inherently slow and effortful (e.g., eye-tracking, head-tracking, mechanical switches). Thus, optimizing communication interfaces for alternate access methods may provide significant improvements in communication rates and quality of life. In this series of studies, we developed and evaluated methods for improving communication rates through optimization and prediction in communication interfaces. These interfaces enabled participants to select sounds (phonemes) instead of letters and were computationally optimized offline via a model of human movement in order for targets likely to be selected together to be in close proximity. Online prediction was implemented such that likely targets were dynamically enlarged. Computational simulations suggested that optimized phonemic interfaces could increase communication rates by up to 30.9% compared to random phonemic interfaces. Communication rates were empirically evaluated in 36 participants without motor impairment using an alternate computer access method to produce messages with phonemic interfaces over 12 sessions. Results suggested that optimization increased communication rates by 10.5–23.0% compared to a random phonemic interface. Prediction increased communication rates during training sessions, but was not a significant factor in communication rates during the final session. Empirical evaluations in individuals with motor impairment revealed that all participants strongly agreed that they would improve with practice, and four out of six participants strongly preferred the interface with prediction. Results of these studies suggest that optimized and predictive phonemic interfaces may provide increased communication rates for individuals with motor impairments affecting both oral communication and computer access. Methods for dynamically enlarging targets may also be applicable to other (non-phonemic) interfaces to increase communication rates. Further research is needed to fully translate these results into clinical practice. / 2020-10-24T00:00:00Z

Resumo: A avaliação é um processo que demanda tempo, uma vez que visa não só avaliar os déficits do sujeito, mas também suas necessidades e habilidades. No caso de alunos não-falantes, os familiares têm grande importância no processo de avaliação, pois os pais são os maiores conhecedores das formas de expressão de seus filhos, sendo imprescindíveis para obtenção de informações a respeito dos centros de interesse, habilidades comunicativas e vocabulário do aluno. Após um trabalho anterior realizado pelos pesquisadores com a finalidade de construir um Protocolo para Avaliação de Habilidades Comunicativas para Alunos Não-Falantes Em Situação Familiar, o objetivo dessa pesquisa foi desenvolver esse mesmo protocolo. Para tanto, o desenvolvimento do protocolo foi realizado por estudos. No Estudo 1, reformulamos a primeira versão do Protocolo para Avaliação de Habilidades Comunicativas para Alunos Não-Falantes em Situação Familiar e criamos uma outra versão desse mesmo protocolo, intitulada protocolo reformulado, que contava com as seções: Identificação, Principal, Rotina, Preferências, Profissionais e Auxiliares, sendo que a seção Principal continha 59 itens. Ainda no Estudo 1, fizemos a aplicação do protocolo reformulado e analisamos os resultados dessa aplicação. A aplicação ocorreu na cidade de Curitiba-Pr e contou com a participação de 17 pais de alunos com deficiência. Os resultados do Estudo 1 deram origem à segunda versão do protocolo, que continha as mesmas seções das versões anteriores, sendo que a seção Principal continha 64 itens. No Estudo 2, realizamos a aplicação da segunda versão e fizemos a análise dos resultados dessa aplicação, que também aconteceu em Curitiba-Pr e contou com a participação de 17 pais e uma avó de alunos com deficiência. No Estudo 3, realizamos a aplicação e a reaplicação da segunda versão do protocolo... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The evaluation is a time-demanding process, since not only is it aimed at evaluating the subject deficits but also its needs and skills. In case of non-speaking students, family members have great importance on the evaluation process, for parents know better their children’s forms of expression and are irreplaceable for the purpose of acquiring information concerning student’s center of interest, communication skills, and vocabulary. Following a previous work by the authors trying to set the frame of an Evaluation Protocol of Communication Skills for Non-Speaking Students in Family Situation, the present research intends to establish the Protocol’s final version. For doing so, the Protocol’s development was carried at trough studies. In Study 1, we have reformulated the first version of the Evaluation Protocol of Communication Skills for Non-Speaking Students in Family Situation, and created another version of the protocol, named Reformulated Protocol, which was formed by sections: Identification, Principal, Routine, Preferences, Professionals, and Auxiliaries, noticing that the Principal section contained 59 items. Still in Study 1, we have applied the reformulated protocol and analyzed its results. It took place in the city of Curitiba, Pr, and 17 parents of challenged students participated. Results of Study 1 originated the second version of the protocol, which was formed by the same sections of previous versions, noticing that the Principal section contained 64 items. In Study 2, we applied the second version and proceeded with the analysis of the results, which also happened to take place in the city of Curitiba, Pr, and 17 parents and one grandparent of challenged students participated. In Study 3, we applied and reapplied the second version of the protocol on the same subject, a challenged student’s mother, with the purpose of verifying whether or not the second version... (Complete abstract, click electronic address below) / Orientador: Eduardo José Manzini / Coorientador: Débora Deliberato / Banca: Leila Regina d'Oliveira de Paula Nunes / Banca: Tânia Moron Saes Braga / Mestre

User Centred Design is accepted as being essential to good software design, only by involving the users throughout the development process can the developers understand what the end users really want (Sharp et al., 2007). One area which has in the past had little experience of User Centred Design is Assistive Technology, and in particular Augmentative and Alternative Communication software (Waller et al., 2005a). Augmentative and Alternative Communication (AAC) offer the possibility of being able to access communication for people with Severe Speech and Physical Impairments.This thesis describes a software development study which investigated methods currently used in software development and how they could be adapted for use with this population. The way difficulties cited in the literature when working with this population were tackled are also discussed. The study involved four adults with Severe Speech and Physical Impairments in the User Centred Development of a piece of assistive software.The study found that with careful planning it was possible to conduct User Centred Design with participants with Severe Speech and Physical Impairments, the lessons from this study were translated into recommendations and provided to a second developer who wished to work with adults with Severe Speech and Physical Impairments. The second study found similar levels of contribution to the features of the software were found in the pilot study. This work has demonstrated the potential for adults with Severe Speech and Physical Impairments to be actively involved (i.e. contribute a high proportion of the features) in the development of Augmentative and Alternative Communication software. A number of areas for further investigation have been identified including the differences found in usability of devices developed using User Centred Design compared to traditional methods, and also how adults with Severe Speech and Physical Impairments can be more actively included in a range of research fields.

Having a meaningful system for expressing common needs and thoughts is important for overall quality of life for students with intellectual disability and limited expressive language. The current study was conducted to evaluate whether one communication system, Proloquo2Go ($249.99) or SwiftKey Symbols (FREE), is more effective in the acquisition of targeted expressive phrases in one student with intellectual disability who exhibited expressive communication difficulties. The student was provided with instruction in both systems using task analytic instruction and system of least prompting and encouraged to use each system at different times in a single case, alternating treatment design. Results indicated that Proloquo2Go led to faster acquisition of targeted phrases, although gains were shown with both devices. Although, given the cost difference, teachers and parents may want to consider free options, like SwiftKeys, given the student made gains with this device. Future research is needed to provide generalizability of these results.

Music therapists frequently work with clients with Autism Spectrum Disorder (ASD) who use Augmentative and Alternative Communication (AAC). The purpose of this study was to gather information on music therapists’ current experiences with AAC training as well as music therapists’ perceptions of their own communication abilities when communicating with clients who have ASD using their preferred AAC system. The researcher invited 7,279 board-certified music therapists to participate in this study via email, of which 366 completed the survey. Participants reported most often providing services to children and adolescents with ASD, and frequently using electronic AAC and electronic apps with their clients with ASD. The majority (71.2%) of participants stated that they would like additional training in the use of AAC. Of the music therapists who had participated in previous AAC training, many had received training at work or by an SLP or other certified professional. Results of this study provide information about the current practices and perceptions of board-certified music therapists working with clients with ASD.

McGreevy, Fry, and Cornwall (2014) developed an assessment within the Essential for Living (EFL) manual for clinicians to identify which communication modality should be used for each individual. This assessment identifies an AAC based on the learner’s skills, level of problem behavior, similarities between AAC and vocal community, and size of the verbal community. However, to date, no research has evaluated if this assessment identifies the communication modality that will result in faster acquisition of mands in individuals with ASD. Thus, the purpose of this study was to compare acquisition of mands across a modality identified by the EFL communication modality assessment and two other commonly used modalities. A secondary purpose was to determine if participants acquire mands using the mode of AAC identified by EFL. Finally, a third purpose was to determine if the communication modality identified by EFL communication modality assessment matches the modality currently used by the individual. Findings showed that although all three participants acquired mands across the three communication modalities, mands in the modality of communication recommended by the EFL assessment were acquired faster only by 1 out of the 3 participants.

Literacy development in Spanish-speaking children is a growing concern in the United States (Invernizzi, 2009). Phonological awareness is a predictor of literacy achievement in most alphabetic languages (Anthony et al., 2011; Davison & Brea-Spahn, 2012; Durgunoğlu, Nagy, & Hancin-Bhatt, 1993; Goikoetxea, 2005). Bilingual children with complex communication needs (CCN) demonstrate increased difficulties in speaking, reading, and writing, making learning two languages a difficult task (Toppelberg, Snow, & Tager-Flusberg, 1999). Literacy attainment in bilingual individuals who have CCN is important to improve their overall language development and communication interaction skills (Harrison-Harris, 2002). A valid and reliable phonological awareness assessment that does not require speech is needed in order to provide appropriate instruction and address desired literacy goals (Barker, Bridges, & Saunders, 2014). The goal of this study is to describe pilot data from the Dynamic Assessment of Phonemic Awareness in Spanish (DAPA-S), a new dynamic phonological awareness assessment that does not require speech responses, with children from Latin American Spanish-speaking backgrounds, in order to determine its construct validity. DAPA-S was administered over the course of one to three sessions to ten participants (six males and four females). Participants also received the Identificación de letras y palabras (Letter-Word Identification; LWID) subscale from the Woodcock-Muñoz Language Survey–Revised (WMLS-R; Woodcock, Muñoz- Sandoval, Ruef, & Alvarado, 2005) as an emergent reading skill task and three subtests from the Test of Phonological Sensitivity in Spanish (TOPSS; Brea, Silliman, Bahr, & Bryant, 2003):letter-name and letter-sound, elision, and rapid automatized naming (RAN) as assessments of phonological awareness. To evaluate concurrent validity, Pearson correlations and bootstrapped 95% confidence intervals were calculated between the DAPA-S total score and the measures of phonological awareness from the TOPSS. The DAPA-S demonstrated strong and significant correlations with elision, RAN, and the letter-sound subtests rs = –.67 to .87, ps = .00 to .03. These results indicated that the DAPA-S likely measured the same construct as the other measures of phonological awareness from the TOPSS. To evaluate convergent validity, Pearson correlations and bootstrapped 95% confidence intervals were calculated between LWID of the WMLS-R and the DAPA-S total score. The DAPA-S demonstrated a strong and significant correlation, r = .75, p < .05. The data suggest a high degree of both concurrent and convergent validity, as many of the conventional measures of phonological awareness and emergent reading were significantly correlated with the DAPA-S, including letter-sound, RAN, and LWID. Overall, the pattern of results suggests that the DAPA-S may be a reliable and valid tool for measurement of phonological awareness in Spanish.

<p>Då vi i vår omgivning uppmärksammat en viss okunskap angående alternativ kommunikation ökade intresset att göra en studie om förskollärares uppfattning om ämnet. Avsikten var även att studien skulle ha en informativ substans och därav bidra med mer kunskap inom detta område. Syftet med studien blev därmed att undersöka hur förskollärare definierar alternativ kommunikation. Ett vidare syfte var även att belysa förskollärarnas relation till ämnet, tillika utröna deras framtidstro. För att kunna synliggöra detta har vi inspirerats av fenomenologin som fokuserar på en persons beskrivning av ett fenomen, vilket i detta fall är alternativ kommunikation. Studien är av kvalitativ karaktär och vi intervjuade sex informanter på tre skilda förskolor vars arbetsätt gällande alternativ kommunikation skiljde sig åt. Resultatet visade att förskollärarna hade en relativt klar bild gällande vad alternativ kommunikation innebär för dem. Deras syften skiljde sig dock åt då barnen hade skilda behov och därav även verksamheternas olika pedagogiska inriktningar. Informanterna uppfattade alternativ kommunikation som en viktig del i framtiden vilket kommer att utvecklas då de menar att det är något som gynnar alla barn.</p>

The purposes of this qualitative inquiry were as follows: (a) to understand how mothers of children with fragile X syndrome (FXS) used augmentative and alternative communication (AAC) systems in the home, (b) to capture their views regarding AAC use, and (c) to examine the support they received in the process. Data was collected using participant observations, semi-structured interviews and review of archival educational records and were analyzed using grounded theory methods. Results revealed that for children with FXS, the interplay of children’s complex developmental challenges, mothers’ internal struggles, and the absence of external supports leads to limited and variable use of AAC in the home.