I investigated the presence, utility, and emergence of tacit knowledge in 9 study participants who used assistive-augmentative technology. I conducted phenomenologic interviews, audio-taping, and transcribed the interview with the written consent of the participants. Sixteen highly trained experts critiqued the final product of the interviews and answered a 25-question survey instrument. Non-parametric statistical processes were chosen to conduct inferential hypotheses testing. Wilcoxon - Mann Whitney U tests and Kruskal - Wallis One-Way ANOVA (alpha level of 0.05) were used for questions 1-10, and a 2 x R (R = 3 or 4) contingency table and Fisher's Exact Chi-Square were used for questions 11- 25. The responses to survey questions showed no statistically significant differences or interaction for the variables gender, expertise, and service (p < 0.0017). Qualitative analysis found discernable heuristics and ideation that was indicative of the presence of implicitly learned tacit knowledge in study participants; the utility of tacit knowledge emerged during direct observation or when participant's engaged in analogy, storytelling, and metaphor. The participants in this study used introspeculation, a learning style framed by reflection and introspection on the validity of one's own knowledge and the value of what is learned from life experience and in the classroom. The introspeculative examined the presence and utility of tacit knowledge in decision-making, and questioned the veracity of sources and resources that guide them on the path of life. The study suggested that tacit knowledge not only informs the practice of therapists and technology users but may assist classroom teachers facing student involvement in individual education plans (IEPs), Individuals with Disabilities Education Act (IDEA), or section 504 of the Americans with Disabilities Act (ADA).

There is a growing population of individuals using Augmentative and Alternative Communication (AAC) in need of evidence-based intervention from highly qualified personnel. However, not all speech pathology programs offer AAC coursework and/or practicum opportunities, and practicing speech-language pathologists (SLPs) report low levels of confidence and expertise in working with individuals using AAC. Therefore, there is a need to develop more innovative pre-professional training programs to better equip the next generation of SLPs with the knowledge and skills necessary to provide high-quality, evidence-based AAC interventions. Telepractice is emerging as an inventive way to provide both direct and indirect intervention services, and could theoretically be used to support pre-professional training by providing clinicians the opportunity to engage in direct services with individuals using AAC concurrently while receiving supervision from a skilled mentor. A thorough review of the literature revealed limited information and data regarding tele-AAC for direct and indirect service delivery. This investigation examined the feasibility and effectiveness of utilizing telepractice to train pre-professional clinicians regarding AAC interventions while in the context of service delivery both on-site and via telepractice. A single-subject, multiple baseline design was employed to examine the impact of real-time supervisory guidance offered via telepractice to pre-professional clinicians (Active Consultation) on the performance of the clinicians and the clients in each service delivery condition. Data was gathered on the number of target language acts modeled by the clinicians and generated by the clients when Active Consultation was provided. The results supported the use of telepractice for supervision, and as a service delivery method for AAC users.

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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

Dyskinetic Cerebral Palsy (DCP) is mainly characterized by alterations in muscle tone and involuntary movements. Therefore, these people present with difficulties in coordination and movement control, which makes walking difficult and affects their posture when seated. Additionally, their cognitive performance varies between being completely normal and severe mental retardation. People with DCP were selected as the objective of this thesis due to their multiple and complex limitations (speech problems and motor control) and because their capabilities have a great margin for improvement thanks to physiological control systems. Given their communication difficulties, some people with DCP have good motor con-trol and can communicate with written language. However, most have difficulty using Augmentative and Alternative Communication (AAC) systems. People with DCP gen-erally use concept boards to indicate the idea they want to communicate. However, most communication solutions available today are based on proprietary software that makes it difficult to customize the concept board and this type of control system. This is the motivation behind this thesis, with the aim of creating an interface with characteristics, able to be adapted to the user needs and limitations. Thus, this thesis proposes an Augmentative and Alternative Communication System for people with DCP based on physiological control. In addition, an innovative system for direct con-trol of concept boards with EMG is proposed. This control system is based on a physi-cal model that reproduces the muscular mechanical response (stiffness, inertia and viscosity). It allows for a selection of elements thanks to small pulses of EMG signal with sensors on a muscle with motor control. Its main advantage is the possibility of correcting errors during selection associated with uncontrolled muscle impulses, avoid-ing sustained muscle effort and thus reduced fatigue. / La Parálisis Cerebral de tipo Discinésica (DCP) se caracteriza principalmente por las alteraciones del tono muscular y los movimientos involuntarios. Por ello, estos pacientes presentan dificultades en la coordinación y en el control de movimientos, lo cual les dificulta el caminar y afecta su postura cuando están sentados. Cabe resaltar que la capacidad cognitiva de las personas con DCP puede variar desde completamente normal, hasta un retraso mental severo. Las personas con DCP han sido seleccionadas como objetivo de esta tesis ya el margen de mejora de sus capacidades es amplio gracias a sistemas de control fisiológico, debido a sus múltiples y complejas limitaciones (problemas de habla y control motor). Debido a sus dificultades de comunicación, algunas personas con DCP se pueden comunicar con lenguaje escrito, siempre y cuando tenga un buen control motor. Sin embargo, la mayoría tienen dificultades para usar sistemas de Comunicación Aumentativos y Alternativos (AAC). De hecho, las personas con DCP utilizan generalmente tableros de conceptos para indicar la idea que quieren transmitir. Sin embargo, la mayoría las soluciones de comunicación disponibles en la actualidad están basadas en software propietario que hacen difícil la personalización del tablero de conceptos y el tipo de sistema de control. Es aquí donde surge esta tesis, con el objetivo de crear una interfaz con esas características, capaz de adaptarse a las necesidades y limitaciones del usuario. De esta forma, esta tesis propone un sistema de comunicación aumentativo y alternativo para personas con DCP basado en control fisiológico. Además, se propone un Sistema innovador de control directo sobre tableros de conceptos basado en EMG. Este Sistema de control se basa en un modelo físico que reproduce la respuesta mecánica muscular (basado en parámetros como Rigidez, Inercia y Viscosidad), permitiendo la selección de elementos gracias a pequeños pulsos de señal EMG con sensores sobre un músculo con control motor. Sus principales ventajas son la posibilidad de corregir errores durante la selección asociado a los impulsos musculares no controlados, evitar el esfuerzo muscular mantenido para alcanzar un nivel y reducir la fatiga. / La Paràlisi Cerebral de tipus Discinèsica (DCP) es caracteritza principalment per les alteracions del to muscular i els moviments involuntaris. Per açò, aquests pacients presenten dificultats en la coordinació i en el control de moviments, la qual cosa els dificulta el caminar i afecta la seua postura quan estan asseguts. Cal ressaltar que la capacitat cognitiva de les persones amb DCP pot variar des de completament normal, fins a un retard mental sever. Les persones amb DCP han sigut seleccionades com a objectiu d'aquesta tesi ja el marge de millora de les seues capacitats és ampli gràcies a sistemes de control fisiològic, a causa dels seus múltiples i complexes limitacions (problemes de parla i control motor). A causa de les seues dificultats de comunicació, algunes persones amb DCP es poden comunicar amb llenguatge escrit, sempre que tinga un bon control motor. No obstant açò, la majoria tenen dificultats per a usar sistemes de Comunicació Augmentatius i Alternatius (AAC). De fet, les persones amb DCP utilitzen generalment taulers de conceptes per a indicar la idea que volen transmetre. No obstant açò, la majoria les solucions de comunicació disponibles en l'actualitat estan basades en programari propietari que fan difícil la personalització del tauler de conceptes i el tipus de sistema de control. És ací on sorgeix aquesta tesi, amb l'objectiu de crear una interfície amb aqueixes característiques, capaç d'adaptar-se a les necessitats i limitacions de l'usuari. D'aquesta forma, aquesta tesi proposa un sistema de comunicació augmentatiu i alternatiu per a persones amb DCP basat en control fisiològic. A més, es proposa un sistema innovador de control directe sobre taulers de conceptes basat en EMG. Aquest sistema de control es basa en un model físic que reprodueix la resposta mecànica muscular (basat en paràmetres com a Rigidesa, Inèrcia i Viscositat), permetent la selecció d'elements gràcies a xicotets polsos de senyal EMG amb sensors sobre un múscul amb control motor. Els seus principals avantatges són la possibilitat de corregir errors durant la selecció associat als impulsos musculars no controlats, evitar l'esforç muscular mantingut per a aconseguir un nivell i reduir la fatiga. / Díaz Pineda, JA. (2017). Advanced Augmentative and Alternative Communication System Based in Physiological Control [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/90418

Syftet med denna studie är att undersöka hur elever i grundsärskolan inriktning träningsskola kommunicerar med hjälp av digitala verktyg respektive pappersbilder, med frågeställningen; på vilket sätt ger pappersbilder respektive appen Widgit Go elever stöd i sin kommunikation? Detta har undersökts i en kvalitativ studie med deltagande observationer som metod. Fem deltagare deltog i studien. Under sammanlagt tio tillfällen använde deltagarna först pappersbilder sen en kommunikationsapp i en Ipad för att begära olika föremål. Resultatet visade att båda hjälpmedlen fungerade som stöd deltagarnas kommunikation och att de använder Ipaden och pappersbilderna på samma sätt för att kommunicera. Kommunikationen med pappersbilder visade fördelar genom att deltagarnas uppmärksamhet i kommunikationen riktades mot mottagaren. Ipaden visade sig ha fördelar genom att den minskade risken för missuppfattningar i kommunikationen. / The aim of this study was to investigate how pupils in a special training school communicate with digital tools and paper images. The specific research question was in what way paper images and the Ipad communication app Widgit Go could support pupils in their communication. The method used involved qualitative participant observation on two occasions with five different pupils. In all, ten observations were conducted where the participants first used paper images followed by the Ipad app to request certain objects. The results showed that both tools supported the communication of the participants and that the app and the paper images were used in a similar manner to communicate. The paper imageshowed advantages by directing the attention of the communication towards the receiver. The Ipad app showed advantages by decreasing the risk for misunderstandings in the communication.