Acutely ill patients, across the age continuum, often present with complex communication needs (CCN) due to motor, sensory, cognitive and linguistic barriers they may experience during their hospital encounter. While hospital administrators recognize the importance of improving communication among the healthcare team members to increase quality and safety measures, few have focused on improving the patient-provider communication process, especially for patients with CCN. Recent Joint Commission standards mandates hospitals and healthcare providers improve communication for patients with CCN across all points of the care continuum. The study investigated the effectiveness of AAC training protocols for acute care nurses and ancillary healthcare providers using an on-line instructional medium for clinical skills teaching. The study design allowed for the measurement of learning following exposure to the tutorial and the analysis of possible clinical skill application. The current study invited a total of 377 nurses and graduate students to participate. Eight-three participated in the study and were divided randomly into two groups. Seventeen (20.5%) were assigned to in the control group, and 66 (79.5%) participants were into the test group. Both groups were directed to complete a pre-test measure. This was followed by exposure to the tutorial for the test group. The groups then were instructed to complete a post-test measure. For all participants in the test condition, the mean difference score (post-pre) was 19.2. The average pre-test score was 60.8 with a standard deviation of 12.4 while the average post-test score was 80.1 with a standard deviation of 11.3. This difference was significant (p

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.

Children with complex communication needs (CCN) routinely have difficulty attaining appropriate literacy skills. Two indicators of literacy development are the alphabetic principle and phonemic awareness (Byrne & Fielding-Barnsley, 1989). The acquisition of minimal literacy skills such as letter sound knowledge can give children with CCN the opportunity to communicate and generate their own messages, instead of being reliant on vocabulary provided by others. In order to identify appropriate intervention approaches, nonverbal assessments of phonological and phonemic awareness for individuals with CCN are needed. The purpose of this study was to determine the reliability of the Dynamic Assessment of the Alphabetic Principle, as well as determine to what extent the performance of DAAP was associated with other measures of phonological and phonemic awareness and emergent reading skills. The DAAP was administered over the course of one to five session to seven participants with an assortment of developmental and language disorders. In addition to the DAAP, participants were administered a letter-sound knowledge task, a sound matching task that evaluated awareness of first sounds of words and separately evaluated awareness of the last sounds of words (i.e., either sound matching from the Comprehensive Test of Phonological Processing – 2nd edition [CTOPP-2; Wagner, Torgesen, Reshotte, & Pearson, 2013] or initial sound matching and final sound matching from the Phonological and Print Awareness Scale [PPA; Williams, 2014]). The reliability of the DAAP was calculated in two different ways. First, Cronbach alphas were calculated to estimate the reliability of items within subscales and between the subscales. Reliability of the items within each subscale ranged from .96 to .99 and the reliability of the items between each subscale ranged from .87 to .99. Overall the alpha between all four of the subscales was .96. Next, bivariate correlations were calculated between each subscale score. Values ranged from .82 to .99, and all were significant according to bootstrapped 95% confidence intervals that did not contain 0. This information indicated that there was a high degree of internal consistency for the items and the subtests for the DAAP. To evaluate the extent to which performance on the DAAP was associated with other measures of phonemic awareness, Bivariate Pearson correlations with standard significance values and bootstrapped 95% confidence intervals were calculated. The scores on the onset, rime, coda, and vowel subtests of the DAAP were correlated with sound matching first (SM-First), sound matching last (SM-Last) and sound matching chance (SM-chance) variables. The rime subtest of the DAAP was found to be significantly correlated with SM-First variable. Furthermore, the rime and vowel subscales of the DAAP were found to be significantly correlated with SM-Last variable. All four subtests of DAAP were significantly correlated to SM-chance variable. Lastly, to evaluate the performance on the DAAP in association to other measures of emergent reading skills, bivariate Pearson correlations were calculated between the subtests of the DAAP and letter sound knowledge (LSK). Scores on LSK was significantly related to rime, coda, and vowel. The data suggest that the DAAP is a reliable assessment. Furthermore, many conventional measures of phonological awareness and emergent reading skills were significantly correlated with subtests of DAAP. The pattern of the results suggests that the DAAP may be a reliable tool for measuring acquisition of the alphabetic principle in children with CCN.

No description available.

Caregivers of children with Complex Communication Needs from low socio-economic  backgrounds are deprived of facilities for communication training. As a result, they struggle to communicate with their children even for activities of daily living. This study focuses on how professionals help such parents to communicate with their non-verbal children. Also, it looks into the condition of parents and the facilitators and the barriers professionals face while working in such situations. To conduct the study qualitative study design with an interview method was chosen. Data were collected from seven participants who are special educators. The results revolves around various themes related to the aim. The main results deal with the burden of caregivers, their motivation level, issues related to lack of training, building rapport with parents, the role of parents, and teaching basics. Studying the barriers and facilitators of professionals identified changes in children, parents' positive attitude, regular follow-up, mother as a caregiver, and other support services as facilitators. Barriers were focused on lack of changes, negative attitudes, grandparents as caregivers, hygiene, transportation, and workload. The results indicate that issues were rooted in low socio-economic backgrounds and the need to provide extra support for caregivers to communicate effectively with their children.

No description available.

Early reading literacy is foundational to all other academic learning. It is imperative that elementary students with and without disabilities be provided with evidence-based reading instruction. Elementary students with developmental disabilities (DD) and complex communication needs (CCN) benefit from evidence-based reading instruction that incorporates individualized, explicit instruction and appropriate assistive technology. Research to identify evidence-based practices for students with DD and CCN is necessary to assist teachers to close the gap in overall achievement for this group of learners. The purpose of this study was to determine the efficacy of the early reading program Go Talk Phonics (Ahlgrim-Delzell, Browder, &Wood, 2014) that incorporated evidence-based systematic instruction delivered through assistive technology to teach reading to elementary students ( n = 2 ) with DD and CCN. The two participants in this single-case designed study did not make adequate progress toward the objectives of Lesson One of the intervention in order to continue on to Lessons Two and Three. Although the participants in this study were less successful in the objectives of the lesson than participants in the Ahlgrim-Delzell et al., (2014) study, there were differences in the participants, assistive technology, and design of the experiment. Important considerations were revealed when selecting academic interventions for students with CCN and DD. Assessment of broader aspects of the students' skills and literacy experience, as well as differential reinforcement procedures specific to instructional demands may be necessary to see gains from instruction.

Phonological awareness is the ability to recognize, reflect on and manipulate sound structures of a language. This ability has been shown to be crucial when acquiring literacy. The PhonicStick is a speech-generation communication device, which was initially developed for individuals with complex communication needs (CCN) though more recent research has focused on the effects of the device on factors important for literacy acquisition. In the present study the effects on phonological awareness were evaluated after seven group training sessions with the PhonicStick. The participants of the study were 20 typically developing South African 5-6 year old children. All participants where pre and post tested with The Phonological Awareness Test part c) isolation and a PhonicStick test which tested the ability to produce isolated phonemes and combinations of three phonemes with the device. The results of the study showed that training with the PhonicStick did not appear to improve results on The Phonological Awareness Test part c) isolation. However, it was found that the participants of the training group had improved their ability to manoeuvre the PhonicStick and to produce isolated phonemes and combinations of three phonemes. / Fonologisk medvetenhet är förmågan att känna igen, reflektera över och manipulera ett språks ljudstrukturer. Denna förmåga har visat sig vara betydelsefull vid tillägnandet av läs- och skrivförmåga. The PhonicStick är ett talgenererande kommunikationshjälpmedel som ursprungligen utformades för individer med komplexa kommunikationsbehov. Senare forskning har även fokuserat på hjälpmedlets effekter på faktorer som är viktiga vid tillägnandet av läs- och skrivförmåga. I föreliggande studie utvärderades effekterna på fonologisk medvetenhet hos 20 normalutvecklade sydafrikanska barn i åldrarna 5-6 år efter sju gruppträningstillfällen med the PhonicStick. Alla deltagare i studien pre- och posttestades med två test. Deltest c) från The Phonological Awareness Test rörande förmågan att isolera ljud, samt ett PhonicStick test. Detta testade förmågan att producera isolerade fonem och kombinationer bestående av tre fonem med the PhonicStick. Studiens resultat visade att träning med the PhonicStick inte resulterade i förbättrat resultat på The Phonological Awareness Test del c) isolerade fonem. Däremot tydde resultatet på att deltagarna i testgruppen förbättrade sin förmåga att styra the PhonicStick samt producera isolerade fonem och fonemkombinationer bestående av tre fonem.

Augmentative and alternative communication (AAC) is an evidence-based practice targeting the communication deficits of children with complex communication needs (CCN). While young children with communication disorders are attending preschool and using AAC, and specifically speech-generating devices (SGDs), with increasing frequency, best practices for implementation with this population are largely unexplored. In an effort to contribute to the knowledge base for teachers, the essential communication partners for children in the classroom setting, this research explored the interactions of four teacher-child dyads and analyzed the prompts and cues used to elicit communicative acts from the children. Results of statistical and descriptive analyses revealed that, while teachers overwhelmingly favor and use verbal prompts over other stimuli, these prompts were no more effective in eliciting communicative acts. These results indicate that teachers would benefit from instruction in a variety of techniques for enhancing communication via AAC; future research directions towards this purpose are detailed.

This study examined teacher characteristics and practices identified as effective through current research for teaching students with complex communication needs. For this population, communication issues are more complex than those typically encountered in other settings. Specifically, the researcher asked: what are the desired characteristics and practices for this population, and are the desired characteristics and practices present in current settings? Working with six teachers in a large urban school district, this study utilized a multiple case study design. Criteria for participation included the teacher as the primary reading/language arts instructor for a student who used an augmentative and alternative communication system (AAC). This study builds on prior research and fills a gap in current research through a focus on the teacher. This study was conducted through three phases: a survey of teacher characteristics, observations of teacher practices, and a semi-structured interview. Four instruments were utilized to ensure validity. Results suggest that teachers for this population require knowledge on language and literacy specific to the non-verbal child. AAC training is critical in regard to programming and navigation. The use of other technology supports which offer auditory, visual, and access options are essential. Strong collaborative teams (school and district) are also important. However, one of the most significant findings documents that success may lie with the teacher's 'choice' to embrace challenges with this population. This issue of 'choice' questions the teacher's willingness (personally or professionally) to accept this commitment. This finding also questions the degree to which teachers are willing to pursue opportunities. Recommendations include the need for: training (teachers and paraprofessionals), pursuit of opportunities for supports, addressing parent issues, a district-based liaison between home and school, and to examine issues which prevent the recommended instructional time (90 minutes of reading instruction plus 45 minutes of supplemental instruction). Conclusions indicated that participants ranged from effective to ineffective. The identification of 'highly qualified' teachers through level of education and amount of experience did not correlate with participants' level of effectiveness. Given the limited research available, this study addresses a need in the field and lays the foundation for future research with this population.