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.

ABSTRACT Speech-language pathology practice in the acute hospital setting has changed dramatically over the last 25 years. A significant increase in the number of referrals and a broadening of the speech-language pathologist’s caseload to include patients with dysphagia has meant there has been less time to see hospital inpatients with communication disabilities. This change in practice has caused speech-language pathologists working in the acute hospital setting to question their role in relation to patients with communication disabilities in the acute hospital setting. The thesis applies the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework to explore the role of speech-language pathologists in the acute hospital setting, specifically the acute hospital stroke unit, in relation to patients with communication disabilities. The ICF proposes that a health condition can be understood in terms of four separate components. These components are Body Structures and Functions, Activities and Participation, Environmental Factors and Personal Factors. Whilst the distinction between body structures and body functions within the ICF Body Functions and Structures component is clear, there is less clarity about the relationship between the ICF concepts of activity and participation in the ICF Activities and Participation component. Therefore, the first part of the thesis explores the conceptual similarities and differences between the concepts of activity and participation generally and communication activity and communication participation in particular. This discussion concludes that the ICF concepts of activity and participation are distinct concepts that are considered separately in this thesis. Following this conceptual clarification, the thesis applies the ICF framework to patients with communication disabilities in the acute hospital stroke unit. Specifically, patients with communication disabilities are described from the perspective of communication-related body functions within the ICF Body Structures and Functions component, communication activities within the ICF Activities and Participation component and communication-related environmental factors in the ICF Environmental Factors component. It is important to understand how many patients experience a communication disability in the acute hospital stroke unit so that adequate supports can be developed. Therefore an efficient way of identifying patients in acute hospital stroke units with a communication-related body function impairment such as hearing, vision, speech, language and/or cognitive communicative impairment was required. Hence, the first study describes the development of ICF compatible scales, called the OHW scales, to rate a patient’s degree of speech, language and cognitive communicative impairment. These three rating scales were called the OHW scales because they reflect the WHO framework and also represent the authors’ initials. The concurrent validity and interrater reliability of the OHW scales were then investigated. Results indicated that the OHW had acceptable levels of concurrent validity against standardised measures of speech, language and cognitive communicative impairment. The speech and cognitive communicative OHW scales also demonstrated moderately high interrater reliability, but exact agreement on the OHW language impairment scale was low. At a minimum, the OHW scales were valid measures of speech, language and cognitive communicative impairment and therefore they were used by the researcher to determine the number of patients with communication-related impairments in the acute hospital stroke unit. Patients in acute hospital stroke units may have communication-related impairments, such as speech, language or cognitive communicative impairments as a consequence of stroke. Patients may also have communication-related impairments (e.g., in hearing, vision and cognitive communicative) due to ageing and age related illnesses. Therefore, the second study of the thesis describes the number of patients with communication-related impairments in acute stroke units, regardless of the cause. Of the 69 patients screened, 88% had a mild or more severe communication-related impairment. In addition, 69% of inpatients, screened on two or more measures, had multiple communication-related impairments. Although many patients in acute stroke units have communication-related impairments, what may be particularly important is how many patients experience difficulty communicating their healthcare needs with healthcare providers in acute hospital stroke units. The ICF describes a person’s ability to carry out an activity, such as communicate healthcare needs, as an activity limitation. The ICF describes activity limitations in four different ways. Two ways are capacity with assistance and performance. Capacity with assistance indicates the person’s highest probable level of function in an activity given assistance and performance indicates a person’s level of function in the context of everyday life. Therefore, the third study of the thesis details how many patients experienced capacity with assistance limitation, that is, difficulty communicating their healthcare needs given assistance, and performance limitation, that is, difficulty communicating their healthcare needs during everyday healthcare routines. Results indicated that 51% of 65 patients had a capacity with assistance limitation and 57% had a performance limitation. Strong and significant relationships were found between patients’ degree of communication-related impairments and their degree of communication activity limitation, in both capacity with assistance and performance. Furthermore, the presence of a communication-related impairment accounted for up to 77% of the variance in a patient’s capacity with assistance limitation. Such impairments only accounted for up to 32% of the variance in a patient’s performance limitation. This finding suggests that other factors, such as environmental factors also affect a patient’s ability to communicate, particularly during everyday health care routines. In light of this, a review of the literature on the range of environmental factors that influence communication between patients with communication-related impairments and healthcare providers in the acute hospital setting was conducted. The review of the literature indicated the need for research on the environmental factors that influence communication between patients and healthcare providers in the acute hospital stroke unit. Therefore, the final study of the thesis investigates this further. This study employed a focused ethnographic methodology to identify the range of environmental factors that appeared to influence communication between patients and their healthcare providers. Seven themes were identified including the healthcare providers’ knowledge of communication-related impairments, skills, attitudes, and individual characteristics. Other themes included the presence of family, the physical environment and hospital systems and services. In summary, this series of studies indicates that the majority of patients admitted into acute hospital stroke units have a communication-related impairment and approximately half to two thirds of patients experience difficulty communicating their healthcare needs with healthcare providers. Whilst having a communication-related impairment increases the likelihood that a patient will experience difficulty communicating with healthcare providers, other factors, such as the communicative environment also appear to play an important role. Speech-language pathologists working in the acute hospital stroke unit may have an important role in identifying patients who are experiencing difficulty communicating their healthcare needs and supporting these patients and their healthcare providers to communicate in optimal ways. Further research is required to demonstrate that improving a patient’s ability to communicate with his or her healthcare providers improves a patient’s health outcomes. With this evidence, speech-language pathologists may be more able to support patients with communication disabilities to get the healthcare they deserve.

The aim of this study was to describe maternal self-efficacy beliefs within the parenting domain and maternal rating of pre-school child’s language abilities, where the child has a communication disability. The association between these two constructs was also investigated. Twenty-five Mothers completed a questionnaire consisting of two subsections: parental self-efficacy and maternal rating of child language ability. The results revealed that mothers generally had high self-efficacy beliefs within certain parenting roles, in spite of the fact that their child has a communication disability. The lowest competence was reported in discipline and teaching roles. In addition, mothers’ reports of patterns of child ability correlated with what has been written in the literature. Correlation statistics generally revealed weak association between the constructs, with the strongest association between the parental domain of discipline and maternal reports of their child’s receptive language abilities. Possible reasons suggested for the weak correlation values include the presence of a disability, which may alter the factors that contribute to the way parents construct and maintain self-efficacy beliefs; as well as the fact that the two sections of the questionnaire measure maternal appraisals at two very different levels (objective observations and evaluative self-regulatory processes). Suggestions for further research are provided. / Dissertation (M (Augmentative and Alternative Communication))--University of Pretoria, 2006. / Centre for Augmentative and Alternative Communication / unrestricted

This Master's thesis explores how developmental dysarthria and communication disability effect the socialization and communication abilities of people with cerebral palsy. The thesis is divided into two primary sections: theoretical and empirical. The theoretical part is divided into four sections (cerebral palsy, disrupted communication abilities in people with cerebral palsy, dysarthria, communication and socialization in people with cerebral palsy). The next part of the work presents the analysis of dysarthria and disrupted communication abilities effect of the socialization and communication abilities in people with cerebral palsy. The empirical section is based on original research, primarily employing qualitative methods, namely semi-⁠structured interviews. I interviewed six individuals all of whom are affected by cerebral palsy and developmental dysarthria. Research goals included how disrupted communication skills, known as developmental dysarthria, affect the individuals' communication and socialization skills, how it affects them in daily situations, what the main hallmarks of these situations are, what these situations have in common and how developmental dysarthria affects the individuals' motivation towards socializing. The results showed that the degree to which disrupted...

The diploma thesis deals with the issue of providing all elements of the comprehensive rehabilitation of handicapped people. The goal of this thesis was to determine, what experiences adult handicapped people have in terms of being taken care of in their home environment and in an institution. Another goal was to try and find out what criteria are important for the way they evaluate these. And, the last goal of the thesis was to propose an effective model of taking care of these people given obtained results and given financial capacities of the state and today's regulations. The theoretical part shows the section and development of care provided to handicapped people from the beginning of humanity until today including valid legal regulations. The following part describes briefly the issue of a coordinated rehabilitation and the efforts to ensure the legal regulation thereof in the Czech Republic. The last chapter of the theoretical part is devoted to the D.R.A.K. Association, the clients of which are the relevant research set. For the research itself the qualitative research strategy was chosen. The data were acquired using semi-structured interviews with clients, their family members and those who care for them in the D. R. A. K. Association. Acquired data were processed using the qualitative contents analysis of interviews. The set of participants included nine clients, members of the D.R.A.K. Association, the target group of which are adult handicapped people. Next, I spoke with five family members and three experts from D. R. A. K. Results are divided into three chapters according to research questions. The first chapter contains answers of clients, how they perceive the difference when being taken care of in an institution (D.R.A.K. Association) and in the natural environment (at home). The second chapter of results describes criteria, which are decisive and important for clients and have emerged during interviews.

The diploma thesis deals with the topic of field language and speech therapy for people with dysphagia. The work is divided into four chapters, while the first three define the theoretical framework of the work, the fourth chapter is empirical. The introductory chapter provides an insight into the physiology of swallowing and the anatomy of the orofacial area. The following chapter is devoted to the issue of dysphagia. The final theoretical chapter offers an insight into speech therapy intervention in patients with dysphagia. The fourth chapter presents a mixed design of a research survey focusing on the provision of field speech therapy care for people with dysphagia in the Czech Republic. The main goal of the research survey was to analyze the provision of this care in our country. This was followed by setting partial goals of the work and research questions. Within them, the work tries to analyze the specifics and barriers to the provision of field speech and language therapy care for patients with dysphagia. A questionnaire survey among clinical speech therapists and interviews with some of them was developed. The conclusion of the work is a summary of the results of the research survey supplemented by recommendations for speech therapy practice. The appendix contains a list of contacts of...

This thesis is concerned with communication disability and possibilities its therapy by the help of augmentative and alternative communications methods. It describes basic forms disturbed communications possibility and their symptomology too. Further it is focusing on disorders of speech and communication, whichs are consequence of other different disorder, e.g . child's cerebral palsy, autism, sensuous infliction . This work is bent on methods of augmentative and alternative communication ( AAC), which are accessible in the Czech republic.Practical part is engaged on experiences of individual informants (parents which look after the child with disturbed communications ability) with augmentative and alternative communications systems. It deals with possibilities of the usage of AAK system and its benefit for children.

This thesis deals with specific language impairment. The theoretical part introduces related terminology, classification, etiology, symptomatology and diagnostic issues. The research section analyzes the different linguistic levels in a sample of children and devotes a common specific variations in verbal production that could be designed as diagnostic markers. The qualitative study was an analysis of verbal production of nine children ranging in age from 5.4 to 5.7 years, with specific language impairment. In all the statements were reflected deficits in the use of sibilance, skipping voice in the first position, disruption of understanding to varying extents, incorrect naming and difficulties výbavností words and disturbance of speech and other prosodic factors. Morphology and syntax has always seen the most significant disruption, but was very heterogeneous. Powered by TCPDF (www.tcpdf.org)

La communication avec les proches, tout comme celle avec des interlocuteur·trice·s non famili·ère·s comme le personnel à l’épicerie ou à la pharmacie, est au centre de nombreuses activités qui permettent d’exercer une participation sociale satisfaisante. Or, pour réaliser une société inclusive, des adaptations humaines sont essentielles pour les personnes vivant avec un trouble de la communication. En effet, les interactions difficiles avec les individus rencontrés dans leur(s) communauté(s) pourraient restreindre leur participation sociale. Notamment, leur accès au transport collectif semble freiné par les attitudes et habiletés de communication du personnel. Considérant le rôle clé des transports collectifs dans la participation sociale, cette thèse présente un projet de recherche qui a pour ambition d’améliorer les échanges entre les chauffeur·e·s de transport adapté et les passager·ère·s du service vivant avec un trouble de la communication. Une formation des partenaires de communication, une intervention orthophonique visant à outiller des interlocuteur·trice·s à mieux interagir avec des personnes vivant avec un trouble de la communication, a été développée spécialement pour les chauffeur·e·s de transport adapté d’une société de transport public d’une grande ville québécoise. Son développement a été encadré par un modèle provenant du domaine de l’éducation aux adultes, le modèle andragogique de processus d’apprentissage. La formation intitulée Pour une communication inclusive dans les transports publics a été offerte à treize chauffeur·e·s de transport adapté. Ses effets sur les chauffeur·e·s ont été explorés avec un devis exploratoire à groupe unique. La première étude de la thèse consiste en une revue de la portée. Elle décrit les écrits scientifiques sur la formation des partenaires de communication destinée à des travailleur·euse·s ou des interlocuteur·trice·s non familier·ère·s visant à améliorer la communication avec des personnes vivant avec un ou plusieurs troubles neurologiques acquis de la communication. Les constats de cet article sont que la majorité des formations des partenaires de communication abordent un seul trouble de la communication et qu’elles sont principalement offertes à du personnel ou des étudiant·e·s du domaine de la santé. Malgré une variabilité dans les mesures utilisées pour évaluer les effets de ces formations, les résultats rapportés étaient prometteurs pour améliorer les interactions entre les personnes formées et les individus vivant avec un trouble de la communication. La deuxième étude de la thèse explore l’utilité du modèle andragogique de processus d’apprentissage. L’étude souligne que le modèle s’est avéré utile pour développer, déployer et évaluer une formation en milieu de travail qui a semblé être appréciée des participant·e·s, et ce bien que la majorité des éléments du modèle ait été adapté pour répondre aux contraintes organisationnelles. L’étude souligne que l’appréciation des besoins d’apprentissage, l’établissement d’une ambiance de bienveillance, d'acceptation, de confiance et de respect propice à l’apprentissage ainsi que le choix des méthodes de formation semblent constituer des éléments clés du modèle. La troisième étude explore les effets de la formation sur treize chauffeur·e·s de transport adapté. Après avoir été formé·e·s, les chauffeur·e·s semblent avoir plus de connaissances sur la communication avec une personne vivant avec un trouble de la communication. De plus, l’analyse des vidéos des déplacements de passager·ère·s vivant avec un trouble de la communication par les chauffeur·e·s-participant·e·s révèle que ces dernier·ère·s ont amélioré leur communication relationnelle et ont augmenté le nombre de gestes utilisés avec ces passager·ère·s. La présente thèse soutient qu’une formation des partenaires de communication basée sur des théories de l’éducation aux adultes a le potentiel d’améliorer les échanges entre les chauffeur·e·s de transport adapté et les personnes vivant avec un trouble de la communication. Elle pose les bases pour d’autres études qui devront, elles, tâcher d’évaluer l’efficacité et de comprendre davantage les effets de formations similaires. Cette thèse réaffirme l’importance des recherches sur les formations des partenaires de communication, car celles-ci représentent une intervention prometteuse pour réaliser une société plus inclusive à l’égard des individus vivant avec un trouble de la communication. / Communicating with family and friends, as well as with unfamiliar partners such as grocery store or pharmacy staff, is at the heart of many activities that enable satisfactory social participation. However, to achieve an inclusive society, human adaptations are essential for people living with a communication disability. Indeed, difficult interactions with individuals encountered in their community(ies) could restrict their social participation. In particular, their access to public transportation seems to be hindered by staff attitude and communication skills. Considering the key role of public transport in social participation, this thesis presents a research project that aims to improve interactions between adapted transport drivers and their passengers living with a communication disability. A communication partner training program, a speech-language pathology intervention aiming to train communication partner to better interact with people living with a communication disability, has been developed specifically for drivers of an adapted transport service in a large Quebec city. Its development was guided by a model from the field of adult education, the andragogical process model for learning. The training entitled Accessible Communication in Public Transportation was offered to thirteen adapted transport drivers. Its effects on the drivers were explored using an exploratory single-group design. The first study of the thesis is a scoping review. It describes the scientific literature on paid worker and unfamiliar partner communication training aiming to improve communication with people living with one or more acquired neurogenic communication disorders. The findings of this study are that the majority of communication partner training programs are disorder-specific and that they are mainly offered to health care staff or students. Despite variability in the measures used in the studies, the reported effects were promising for improving interactions between the people trained and individuals living with a communication disability. The second study of the thesis explores the usefulness of the andragogical process model for learning. The study points out that the model is useful for developing, delivering, and evaluating a workplace training that seemed to be appreciated by participants, even though the majority of the model's elements were adapted to meet organizational constraints. The study also points out that the assessment of learning needs, the establishment of an atmosphere of caring, acceptance, trust and respect conducive to learning, and the choice of training methods appear to be key elements of the model. The third study explores the effects of the communication partner training on thirteen adapted transport drivers. After being trained, the drivers appeared to have more knowledge about communicating with a person living with a communication disability. In addition, analysis of videos of the travel of passengers living with a communication disability by the driver-participants reveals that the drivers improved their relational communication and increased the number of gestures used with these passengers. This thesis suggests that a communication partner training based on adult education theories has the potential to improve interactions between adapted transport drivers and people living with communication disabilities. It lays the groundwork for further studies to evaluate the effectiveness and understand further the effects of similar trainings. This thesis reaffirms the importance of research on communication partner training as a promising intervention to realize a more inclusive society for people living with communication disabilities.

This diploma thesis deals with alternative and augmentative communication systems using at the individuals with pervasive development disorders. Thesis is divided the theoretical and the experimental part. Theoretical part contains mainly informations about communication disability, speech development, diagnosis of communication abilities, alternative and augmentative communication systems and possibilities of aid to the families with child with pervasive development disorder. Experimental part presents research using questionnaire, which was send to the parents or legal representatives with child with pervasive development disorder. The research prepares base for next extensive researchs.