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

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

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

Entre outras características, o autismo tem desdobramentos na habilidade de uma pessoa compreender e se expressar por meio de recursos simbólicos. O contexto desta tese é a Tecnologia Assistiva, área da Comunicação Aumentativa e Alternativa (CAA) aplicada aos processos de aprendizagem mediada de crianças com autismo. A CAA, por definição, consiste em um sistema integrado de símbolos, recursos, técnicas e estratégias. Para subsidiar a pesquisa, planejamos e implementamos uma intervenção junto a três mães para a orientação quanto à implementação de CAA com recursos de baixa e alta tecnologia junto a seus filhos, crianças de 5 a 8 anos, visando ao desenvolvimento da comunicação no cotidiano. O objetivo geral da pesquisa consistiu em analisar os processos de mediação para pôr em curso o desenvolvimento da linguagem e da comunicação dessas crianças. Tratou-se de uma pesquisa de natureza qualitativa baseada nos pressupostos da Teoria Sócio-Histórica e da metodologia de pesquisa-ação. Os materiais e instrumentos de pesquisa incluíram análise documental, observações, análises de registros em áudio e vídeo, diário de campo, materiais produzidos no período de intervenção além da Matriz de Comunicação (ROWLAND, 1996). Discutimos os dados gerados referentes a instrumentos de avaliação para definir o perfil da criança e nortear a definição de objetivos de intervenção; referentes a nosso programa de intervenção; referentes à mediação com CAA para desenvolvimento da comunicação e referentes à dimensão afetiva da mediação com CAA. Os resultados indicam que a Matriz de Comunicação é um instrumento adequado para avaliar o nível de desenvolvimento de habilidades de comunicação e nortear a definição de objetivos de intervenção com CAA com crianças com autismo que não falam. Um programa colaborativo para implementar CAA deve ser sensível ao contexto e a suas necessidades enquanto provê apoios onde são necessários para promover a aderência e a consecução dos objetivos. Durante o processo, percebemos o entrelaçamento da mediação simbólica, da mediação do desempenho e da mediação afetiva na implementação e uso da CAA. A partir de uma perspectiva epistêmica Sócio-Histórica, concluímos que a CAA, enquanto sistema, se configura como artefato cultural potente de mediação que engloba simultaneamente símbolos e instrumentos. No entanto, a mediação não existe per se, se realiza na e pela ação conjunta, de processos interpsicológicos rumo aos intrapsicológicos, na mediação da ação e também da afetividade. Uma vez que esse conjunto de elementos funcionam de modo sinérgico no uso da CAA, observamos o estabelecimento de sentidos mutuamente compartilhados, o desenvolvimento da função comunicativa bem como a regulação do comportamento da criança com autismo. No nível macro, reside o potencial da CAA para fornecer os apoios para o acesso à informação e a superação das barreiras de comunicação, à medida que se amplia a participação social de pessoas com autismo com limitações na fala. / Among other features, autism has consequences on people’s ability to understand and express themselves through symbolic resources. The context of this thesis is in the Assistive Technology field of Augmentative and Alternative Communication (AAC) as applied to mediated learning processes children with autism. AAC, by definition, consists of an integrated system of symbols, resources, techniques and strategies. We planned and implemented an intervention with three mothers for guidance on the implementation of AAC with their 5-8 years old autistic children. The intervention aimed at the development of communication in daily life. The overall objective of the research was to analyze the mediation process to put language and communication development in progress. It is a qualitative research based on the principles of the Socio-Historical Theory and action research methodology. Materials and research strategies included document analysis, observations, analysis of audio and video recordings, field notes, materials produced during the intervention period as well as the Communication Matrix (ROWLAND, 1996). We discussed data related to assessment tools to define children’s profile and guide the definition of objectives for intervention; data from our intervention program; data from mediation with AAC to foster the development of communication and data from the affective dimension of mediation with AAC. According to results, the Communication Matrix proved to be an adequate tool to assess the level of development of communication skills and to guide the establishment of intervention objectives with AAC for children with autism who do not speak. A collaborative program for AAC implementation with the family should be sensitive to a family’s context and needs while providing support where needed to foster adherence and accomplishment of goals. During the process, we noticed an intertwining of three types of mediation: symbolic, performance and affect mediation in the implementation and use of AAC. From a Socio-Historical epistemic perspective, we conclude that, taken as a system, AAC consists of a powerful cultural artifact of mediation, which simultaneously encompasses symbols and instruments. However, mediation does not exist per se. Mediation takes place in and by joint action, from interpsychological through intrapsychological processes, where performance and affect mediation also play a role. Once that set of elements work synergistically in the use of AAC, we can expect the emergence of shared meanings, the development of communicative functions and the regulation of the child’s behavior in the micro level. In the macro level lies the potential of AAC for bridging gaps for access to information and overcoming communication barriers as social participation of people with autism with limited speech increases. / Entre otras características, el autismo tiene consecuencias en la capacidad de una persona para comprender y expresarse a través de recursos simbólicos. El contexto de esta tesis es la Tecnología Asistida en el ámbito de la Comunicación Aumentativa y Alternativa (CAA) aplicada a los procesos de aprendizaje mediado en niños con autismo. CAA, por definición, consiste en un sistema integrado de símbolos, características, técnicas y estrategias. Para apoyar la investigación, planificamos e implementamos una intervención con tres madres para orientarlas sobre la aplicación de CAA con recursos de baja y alta tecnología a sus hijos de entre 5 y 8 años con objetivo de desarrollar la comunicación en la vida cotidiana. El objetivo general de la investigación fue analizar el proceso de mediación para poner en marcha el desarrollo del lenguaje y la comunicación de los niños. Esta fue una investigación cualitativa basada en los fundamentos de La teoría Socio-Histórico y metodología de investigación. Los materiales e instrumentos de investigación incluyen el análisis de documentos, observaciones, análisis de registros de audio y video, diario de campo e materiales producidos durante el período intervención, además de la Matriz de Comunicación (ROWLAND, 1996). Se discuten los datos producidos en relación a los instrumentos de evaluación para definir el perfil del niño y orientar a la definición de los objetivos de la intervención; en relación con el programa de intervención; en ilación a la mediación con la CAA para el desarrollo de la comunicación y la relación con la dimensión afectiva de la intercesión con la CAA. Los resultados indican que la Matriz de Comunicación es una herramienta apropiada para evaluar el nivel de desarrollo de las habilidades de comunicación y guiar el desarrollo de los objetivos para la con CAA en niños con autismo que no hablan. El programa de colaboración para poner en práctica CAA debe ser sensible al contexto y a las necesidades al mismo tiempo que proporciona apoyo donde sea necesario para promover la adhesión y el logro de las metas. Durante el proceso, nos dimos cuenta de la coorelación de la mediación simbólica, el rendimiento de la mediación y la mediación afectiva en la implementación y uso de la CAA. Desde una perspectiva epistémica socio-histórica, llegamos a la conclusión de que la CAA, como sistema, se configura como un poderoso artefacto de mediación cultural que abarca simultáneamente ambos símbolos e instrumentos. Sin embargo, la mediación no existe per se. La mediación se lleva a cabo en y por la acción conjunta de los procesos inter-psicológicos hacia los intra-psicológicos en la mediación de la acción y también la afectividad. Una vez que este conjunto de elementos trabajan de forma sinérgica en el uso de CAA, se pudo comprobar la creación de significados compartidos mutuamente, el desarrollo de la función comunicativa y la regulación del comportamiento del niño con autismo. A nivel macro, el potencial de la CAA es proporcionar apoyo para el acceso a la información y la superación de las barreras de comunicación, al extender la participación social de las personas con autismo con habla limitada.

Orientador: Débora Deliberato / Banca: Dionísia Aparecida Cusin Lamônica / Banca: Sadao Omote / Resumo: Os enunciados produzidos por usuários de sistemas de Comunicação Suplementar e Alternativa (CSA), baseados em símbolos gráficos, são freqüentemente descritos como reduzidos ou diferentes quando comparados com sentenças faladas, em crianças, adolescentes e adultos. A expansão dos enunciados capacitaria o usuário de CSA a operar significados mais complexos e, assim, aumentar as possibilidades de expressão de seu vocabulário funcional, importantes para a recontagem de histórias. A presente pesquisa visou a caracterização dos enunciados de um aluno não-falante com paralisia cerebral durante o reconto de histórias com e sem o tabuleiro de comunicação suplementar. Participou deste estudo, com consentimento livre e esclarecido de seus responsáveis, um aluno de sala especial, usuário de recurso suplementar de comunicação, do gênero masculino, de onze anos de idade, com paralisia cerebral e severo distúrbio da expressão oral. A coleta de dados fundamentou-se na contagem pela professora do aluno, com seu consentimento, por meio da leitura de dezesseis histórias selecionadas e adequadas ao conteúdo pedagógico do aluno, em dois dias consecutivos e em semanas sucessivas. Após ter tido acesso auditivo à história por ele escolhida, o aluno era solicitado a recontá-la, primeiramente sem a utilização de seu tabuleiro de comunicação suplementar e, no dia seguinte, após o conto de outra história, utilizando seu tabuleiro disponível. A ordem de reconto das histórias foi seqüencialmente alternada. Os procedimentos pertinentes à coleta de dados, realizada na própria sala de aula do aluno, em meio aos demais colegas de sala, foram registrados por meio de duas filmadoras, em dois focos distintos e de um caderno para registro contínuo, cujas informações foram transcritas e compiladas em um documento escrito. / Abstract: The statements produced by users of augmentative and alternative communication systems based on graphical symbols, frequently have been described as reduced or different when compared with spoken sentences of children, adolescents and adults. The expansion of the statements could enable the AAC user to operate more complex significances and, thus, to increase the possibilities of expression of ones functional vocabulary, such as important meanings to the histories' recount. The present research aimed to characterize the statements of a non-speaking student with cerebral palsy during histories' recounts with and without his augmentative communication tray. It had participated of this study, with free and clarified concernment of his responsible relatives, an eleven-year-old of masculine gender student of a special classroom, user of augmentative communication resource, with cerebral palsy and severe impairment on verbal expression. The data collection was based on the counting by the teacher of the student, with her consent, by means of the reading of sixteen histories selected and adjusted to the student pedagogical content, in two consecutive days and successive weeks. After he'd had auditory access of history chosen by himself, the student was requested to recount it, primary without the use of his augmentative communication tray. After that, another history should be counted by his teacher and his augmentative communication tray would be available for that. The order of the histories' recount was sequentially alternated. The pertinent procedures of the data collection, which were carried through in the proper student classroom, among his colleagues of room, had been registered by two cameras, in two distinct focus, and a notebook for continuous register, which information had been transcribed and compiled in a written document for the accomplishment of content analysis. / Mestre

Orientador: Débora Deliberato / Banca: Sadao Omote / Banca: Célia Maria Giacheti / Banca: Leila Regina d'Oliveira de Paula Nunes / Banca: Dionísia Aparecida Cusin Lamônica / Resumo: Pesquisadores da área de comunicação suplementar e alternativa têm discutido a falta de instrumentos para avaliar crianças e jovens com necessidade complexa de comunicação. Este trabalho teve por objetivo selecionar vocábulos para um instrumento de avaliação do repertório de vocabulário de crianças não-oralizadas com idade de dois a onze anos e onze meses. Para a seleção dos vocábulos foram realizados três estudos. O primeiro estudo identificou e descreveu instrumentos disponíveis para avaliação do vocabulário receptivo e suas listas de vocábulos. O segundo estudo identificou e descreveu pesquisas que apresentaram inventários ou listas de vocábulos empregados por crianças e seus parceiros de comunicação. O terceiro estudo utilizou o Protocolo de Habilidades de Comunicação para alunos não-falantes em situação familiar e escolar com o objetivo de identificar o vocabulário relatado por pais e professores durante a rotina de crianças e jovens com deficiência nãooralizados. A partir do resultado de vocábulos identificados nos três estudos foram estabelecidos critérios para análise do material: o número de ocorrência dos vocábulos; a classificação do sistema Picture Communication Symbols e uma classificação semântica e sintática. A classificação dos vocábulos de acordo com o sistema Picture Communication Symbols e a classificação semântica e sintática passaram por julgamento de juízes para verificar o índice de concordância. Com respeito à freqüência de ocorrência dos vocábulos, dos 1.181 vocábulos identificados nos três estudos observou-se que 648 (54,87%) vocábulos foram citados uma única vez, 1.014 (85,86%) dos vocábulos ocorreram de uma a quatro vezes e somente 167 (14,14%) vocábulos foram verificados com freqüência de ocorrência igual ou maior que cinco. Com respeito à classificação dos vocábulos pelo sistema Picture... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Researchers in the field of alternative and supplementary communication have studied the lack of instruments to assess children and young people with a complex communication need. This study is focused in selecting words for an assessment tool of vocabulary range in nonspeaking children aged between two and eleven years and eleven months old. Three studies were necessary to select the words. The first study identified and described tools available for the assessment of receptive vocabulary and its lists of words. The second study identified and described the research which showed inventories or lists of words used by children and their partners in communication. The third study used the Communication Skills Protocol for nonspeaking students in school and family situations in order to identify the vocabulary reported by parents and teachers during the routine of those non-speaking children and teenagers. Based on the result of words identified in the three studies, criteria were established to analyze the material: the number of word occurrence, the classification of the Picture Communication Symbols system and a syntactic and semantic classification. The classification of words according to the Picture Communication Symbols system and the syntactic and semantic classification were verified by judges so that the agreement index could be checked. Regarding the frequency of word occurrence, it was found that, out of 1.181 words identified in the three studies, the study indicated that 648 (54.87%) words were mentioned only once, 1.014 (85.86%) words were mentioned between one and four times, and only 167 (14.14%) words were verified with an occurrence of frequency greater than or equal to five. Concerning the classification of words by the Picture Communication Symbols system, it was observed that the classification of words which were concrete and abstract nouns represented a greater number... (Complete abstract click electronic access below) / Doutor

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-03-20T12:47:08Z No. of bitstreams: 1 Luciana Maria Galvão Wolff.pdf: 905504 bytes, checksum: 075c5fa7927dda297ac0a30f867142ab (MD5) / Made available in DSpace on 2018-03-20T12:47:08Z (GMT). No. of bitstreams: 1 Luciana Maria Galvão Wolff.pdf: 905504 bytes, checksum: 075c5fa7927dda297ac0a30f867142ab (MD5) Previous issue date: 2018-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: There is a considerable increase in the number of children diagnosed with Autism Spectrum Disorder (ASD) and being this population with a great chance of presenting complex communication needs, the speech language pathology intervention with Augmentative and Alternative Communication (AAC) is essential. The scientific knowledge production on these areas, specifically on the construction of language assessment instruments considering communication possibilities with AAC on this population is still incipient. Thus, it is justified by the development of an assessment tool proposed here. Aim: This research was developed through two integrated studies: Study 1 - development and content validation on language assessment instrument (CSA_Linguagem) in small children with complex communication needs using AAC. Study 2 - Application of this instrument in children diagnosed with ASD. Method: Study 1: the instrument was prepared from a bibliographic review, along with the clinical experience of the researcher. The instrument was then evaluated by expert judges in the area and a new final version was constructed with the collaborations computed. Study 2, the instrument was applied on children with ASD, on interaction situations, using AAC graphic symbols. Results: Study 1: The Instrument was improved with the judges contribution. Study 2: it was possible to observe the communication form chosen by the child, and the possibility of some communication effect, in the use of the AAC. The instrument proved to be operational, easy to apply and low cost / Introdução: Existe um aumento considerável do número de crianças diagnosticadas com Transtorno do Espectro do Autismo (TEA) e tendo essa população grandes chances de apresentar necessidades complexas de comunicação, a intervenção fonoaudiológica com a Comunicação Suplementar e Alternativa (CSA) deve ser considerada. A produção de conhecimento científico nessas áreas especificamente na elaboração de instrumentos de avaliação de linguagem considerando as possibilidades de comunicação por meio da CSA com essa população é ainda incipiente. Dessa forma, justifica-se a elaboração do instrumento de avaliação aqui proposto. Objetivo: Essa pesquisa foi desenvolvida por meio de dois estudos integrados: Estudo 1 - Elaboração e validação de conteúdo do instrumento de avaliação de linguagem (CSA_Linguagem) em crianças pequenas com necessidades complexas de comunicação utilizando a CSA. Estudo 2 - Aplicação desse instrumento em crianças diagnosticadas com TEA. Método: Estudo 1 - o instrumento foi elaborado a partir de revisão bibliográfica, em conjunto com a experiência clínica do pesquisador. Em seguida o instrumento foi avaliado por juízes especialistas na área e uma nova versão foi construída, incorporando as colaborações dos juízes. Estudo 2 - o instrumento foi aplicado em crianças com TEA, em situações de interação com a utilização de símbolos gráficos da CSA. Resultados: Estudo 1: o instrumento foi aprimorado com a contribuição dos juízes. Estudo 2: foi possível observar a forma de comunicação eleita pela criança, e a possibilidade de efeitos na comunicação com o uso da CSA. O instrumento se mostrou operacional, de fácil aplicação e baixo custo

For people without speech, voice output communication aids are an assistive technology––but can also be restrictive: whilst Text-To-Speech synthesis can say anything, it affords little choice of how this is spoken. An absence of nuanced tone of voice can inhibit social interaction. This research explores this profound but relatively overlooked issue in augmentative and alternative communication through the lens––with the sensibilities and skills––of interaction design. Tone of voice is such an elusive and intangible quality: difficult for even phoneticians to define, let alone AAC users and carers to discuss in the context of their everyday lives. Therefore the activities of design exploration and design practice have been employed to visualise tone of voice, in order to catalyse new conversations, through two original research projects: Six Speaking Chairs, curated with Andrew Cook, is a collection of interactive artefacts that illustrate alternative models of tone of voice developed by academics and practitioners as diverse as sociolinguists and playwrights;Speech Hedge, created with the assistance of Ryan McLeod, is a visualisation of how someone might interact with nuanced tone of voice using a conventional communication aid in combination with an interface on a smart phone. Audience responses to each project have illuminated the perspectives from which laypeople conceive of tone of voice, challenging the conventional emotional model that dominates speech technology in favour of something more complex and heterogeneous. In order to reconcile such complexity with simplicity of use, design principles have been distilled that could inspire future user interfaces but also inform further research. This research has been published and presented within different academic fields, including design research, interaction design and augmentative and alternative communication.

The purpose of the study was to evaluate the effectiveness of teaching a picture communication system to students with moderate to severe disabilities using the PECS Phase III application. A multiple probe across participants design was used to conduct the study and evaluate the effectiveness of the training on the PECS Phase III application. The results of the study demonstrated that teaching a picture communication system on an augmentative and alternative communication device is effective in the school setting with young adults with moderate and severe disabilities.