This study surveyed speech-language pathologists (SLPs) working in medical settings in the state of Florida in order to: (a) assess the availability of AAC devices, related materials, and services in acute, sub-acute, long-term care, and outpatient medical facilities, (b) examine barriers and supports in providing AAC services to patients with complex communication needs (CCN) in the aforementioned settings, and (c) determine perceived levels of AAC knowledge of health care practitioners. One of the study's major findings was that 97.59% of SLPs served at least one patient they identified as having CCNs, and 94.1% of respondents indicated that their patients could benefit from increased access to AAC devices and service delivery. A notable finding relating to the need for increased AAC-related communication partner instruction (CPI) is as follows: 97% and 100% of respondents indicated that increased CPI for medical practitioners/staff and family members, respectively, were important elements in order to ensure functional communication for individuals with AAC needs in the medical setting. Major barriers to providing AAC services related to device access (i.e., lack of AAC supports / devices, lack of funding for equipment, length of time of device funding). Other barriers were related to the nature of medical settings (i.e., frequently changing caseloads, limited time with patients) and demands of the job (i.e., lack of time to prepare AAC materials / devices). Supports to providing AAC services included low-tech AAC options and mobile technologies. In terms of practitioner knowledge, 57.6% of respondents rated themselves not at all or somewhat knowledgeable regarding AAC. Physicians, nurses, and other rehabilitation professionals were rated as less than knowledgeable by 95%, 97%, and 84.3% of participants, respectively. Overall, the findings of this study suggests there is a high prevalence of patients in medical settings with AAC needs, and some face unmet communication needs resulting from barriers related to the setting itself, lack of access to AAC devices and materials, and limited time spent on AAC service delivery.

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The main purpose of this study was to compare how the Step-by-Step™ (S-b-S) and the newly developed How Was School Today (HWST) prototype can support participation in narrative activities for a 10-year-old boy with complex communication needs (CCN) when he interacts with two typically developed peers. The researchers wanted to find out how the use of the different communication aids affected interaction. The S-b-S is a low technology communication device with a voice recording function. The HWST prototype is a simulation of the HWST system, which is a high technology system that automatically collects information and creates stories about what the user has done in school. The researchers focused on different aspects of gaze and questions as vital communicative practices for the boy‟s involvement in the interaction, and hence, thestory telling activity. The data was analysed mainly qualitatively with conversation analysis (CA). A descriptive quantitative analysis was also developed. The results indicate that the HWST prototype provides a framework for establishment of joint orientation towards the prototype and questions about it. The S-b-S on the other hand creates a context in which it is easier to establish eye contact. There is an uneven distribution of questions with a much higher frequency in the session where the HWST prototype was used. There are not many studies on narrative ability in children with CCN together with peers. Future research on shared stories in natural environments is suggested. / Denna studies huvudsyfte var att jämföra hur kommunikationshjälpmedlen Step-by-Step™ (S-b-S) och den nyligen utvecklade How Was School Today-prototypen (HWST) kan stödja deltagandet i berättandeaktiviteter för en 10-årig pojke med komplexa kommunikativa behov när han interagerar med två typiskt utvecklade kamrater. Forskarna ville ta reda på hur användandet av de olika kommunikationshjälpmedlen påverkade interaktionen. S-b-S är ett lågteknologiskt kommunikationshjälpmedel med röstinspelningsfunktion. HWST-prototypen är en simulering av HWST-systemet, som är ett högteknologiskt system som automatisk samlar in information och skapar berättelser om vad användaren har gjort i skolan. Forskarnas fokuserade på olika aspekter av blickriktning och frågor, som centrala kommunikativa praktiker för pojkens involvering i interaktionen, och därmed i berättandet. Data analyserades främst kvalitativt med metoden samtalsanalys. Det utvecklades även en deskriptiv kvantitativ analys. Resultaten visar att HWSTprototypen förser samtalet med ett ramverk som underlättar etablerandet av gemensam orientering till prototypen och frågor som rör den. S-b-S skapar å andra sidan en kontext i vilken det är lättare att utveckla ögonkontakt. Det är en ojämn fördelning av frågor, med en mycket högre frekvens i sessionen där HWST-prototypen användes. Det finns inte många studier om narrativ förmåga hos barn med CCN i samtal med kamrater. Framtida studier av berättande i naturliga miljöer föreslås. / "How was School today…?" in the Wild