Participation is a human right. Participation is a complex concept, including a variety of different aspects such as attendance, involvement and engagement. The aim of this study was to investigate the levels of participation of individuals with either congenital or acquired communication impairments. A systematic review was carried out, which included 24 studies published between 2010 and 2020. The results showed participation restriction in the following areas: leisure activities, school/work, social networks and communication. Individuals with communication impairments participated in few activities, left the home more rarely and interacted mostly with family members and familiar people. They often had a passive role in communicative contexts. These restrictions affected both individuals with congenital impairments and those with acquired brain injury. Communication is fundamental to participation. Therefore, it is important that speech and language interventions include a focus on communicative aspects that enhance participation. Keywords: participation, communication impairments, congenital impairment, acquired brain injury. / Delaktighet är en mänsklig rättighet. Begreppet är komplext och innefattar en mängd olika aspekter såsom närvaro, involvering och engagemang. Denna magisteruppsats syftade till att undersöka delaktighet hos individer med kommunikations-, språk- och/eller talsvårigheter som beror på antingen medfödd funktionsnedsättning eller förvärvad hjärnskada. En systematisk översikt gjordes och den innefattade 24 studier publicerade mellan åren 2010 och 2020. Resultaten visade att det finns delaktighetsinskränkningar inom områdena fritidssysselsättningar, skola/arbete, sociala nätverk och kommunikation. Individer med kommunikations-, språk- och/eller talsvårigheter deltar i ett begränsat antal aktiviteter, vistas ofta hemma och interagerar mest med familjemedlemmar eller kända personer. De blir ofta passiva i kommunikativa sammanhang. Dessa begränsningar gäller både individer med medfödd funktionsnedsättning och dem med förvärvad hjärnskada. Kommunikation spelar en stor roll för delaktighet, därför är det viktigt att logopedisk intervention inkluderar ett fokus på språkliga aspekter som bidrar till ökad delaktighet. Nyckelord: delaktighet, kommunikationssvårigheter, medfödd funktionsnedsättning, förvärvad hjärnskada.

Samtalsanalys har tidigare använts som ett komplement till traditionellt använda standardiserade tester för att undersöka mer funktionella aspekter av kommunikation (Wells & Local, 1992; Yont, Hewitt & Miccio, 2002; Samuelsson 2009). Syftet med föreliggande studie är att utifrån sytematiska analyser av vardagliga samtal och logopedisk intervention utforska relationen mellan kommunikativa behov i vardagen och mål med intervention för barn med språkstörning. Tre barn med språkstörning filmades i vardagliga samtal hemma och på förskolan samt vid ett behandlingsbesök hos logopeden. Materialet transkriberades och analyserades enligt samtalsanalytiska principer. Intervjuer och retrospektioner genomfördes med föräldrar, förskolepersonal samt behandlande logoped för att ytterligare belysa barnens kommunikativa situation. I föreliggande studie framkommer att de kommunikativa behov barnen har relaterar till de mål som sätts upp i logopedisk behandling. På grund av deras fonologiska svårigheter påverkas barnens kommunikation då det ofta uppstår problemkällor, deras yttranden ignoreras och deras talutrymme inskränks. Reparationsstrategier används av både vuxna och barn för att reda ut de situationer där missförstånd uppstår. Dessa strategier kan, med hjälp av retrospektioner, uppmärksammas och diskuteras i logopedisk intervention i syfte att undvika framtida situationer där barnens svårförståeliga yttranden inte reds ut. / Conversation analysis has been used as a complement to traditional standardized testing to evaluate the functional aspect of communication (Wells & Local, 1992; Yont, Hewitt & Miccio, 2002; Samuelsson 2009). The purpose of the present study is to explore the relationship between everyday communicative needs and objectives set in speech and language intervention through systematic analysis of everyday conversations and speech and language intervention. Three children with language impairment were video recorded during everyday interaction at home, at the preschool and during one speech and language therapy session. The material was transcribed and analyzed according to principles of conversation analysis. Interviews and retrospections were conducted with parents, preschool teachers and the treating speech and language pathologists in order to further illustrate the participating children’s communicational situation. The results in the present study show that the communicational needs does relate to the objectives set up in speech and language intervention for the children in the current study. The children’s communication is primarily afflicted by their phonological difficulties in the way that it fuels for sources of communicational breakdowns, the children’s utterances become ignored and it restrains their participation in conversation. Repair strategies are used by both adults and children to solve sequences where mutual understanding is not achieved. These strategies may, through retrospections, be identified and discussed in speech and language intervention in order to avoid future situations where unintelligible utterances are not solved.

In speech and language intervention, the ability to interact is seldom evaluated; rather intervention is evaluated in terms of improved testresults.  If goal-setting in intervention also is based on everyday communicative needs, the relevance of the treatment may be increased and intervention outcome may be implemented in the patient’s natural environment. The present study, as part of a research-project, is based on analyses of interaction and interviews to examine everyday conversations and speech and language intervention. The aim was to explore if there is a relation between everyday communication needs and goal-setting in speech and language intervention for people with aphasia. A further aim was to investigate if there are everyday communicative needs that may form goals for speech and language intervention. Two individuals with aphasia and one individual with both dysarhtria and aphasia participated in the study. Three speech and language pathologists and two relatives also participated in the study. Everyday interaction and intervention sessions were recorded and transcribed according to Conversation Analysis principles and analysed from an interactional perspective. Interviews regarding intervention and everyday communication were carried out with all participants. Recordings were presented and discussed with all participants, in so called retrospections. Four phenomena that illustrate communication needs of the participating patients were identified: repair, alternative and augmentative communication, co-construction and feedback. Analysis, interviews and retrospections have revealed that communication needs can form the basis of goal-setting in speech and language intervention. It is also demonstrated that intervention mainly is based on the everyday communication needs of the patient. Retrospections were also shown to be useful in order to observe communication needs in everyday life and in order to evaluate speech and language intervention. The retrospections were found to be beneficial to an open dialogue between speech and language pathologist, patient and relatives regarding the content and aim of the intervention.

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