Technologies and strategies for people with communication problems following brain injury or stroke

Communication problems experienced following a brain injury or stroke not only impact a person’s ability to participate in their desired social and vocational roles but may also impact their ability to participate in decision-making about their care, participate in therapy and receive counseling and education. Many technologies exist, including Augmentative and Alternative Communication (AAC), which can help increase communication and life participation following a brain injury or stroke. This article will define and describe a variety of AAC technologies and interventions for people with communication problems following acquired brain injury as well as discuss assessment, training and funding issues.

from Neurorehabilitation

Augmentative and alternative communication intervention in children with traumatic brain injury and spinal cord injury

Children and youth who sustain a traumatic brain injury (TBI) and/or spinal cord injury (SCI) may have temporary or permanent disabilities that affect their speech, language and communication abilities. Having a way to communicate can help reduce children’s confusion and anxiety, as well as enable them to participate more actively in the rehabilitation process and thus, recover from their injuries. In addition, effective communication with family, care staff, peers, teachers and friends is essential to long-term recovery and positive outcomes for children with TBI and SCI as they are integrated back into their communities. This article describes how rehabilitation teams can use augmentative and alternative communication (AAC) and assistive technologies (AT) to support the communication of children recovering from TBI and SCI over time.

<p><p>from the <a href=”Journal” _mce_href=”http://iospress.metapress.com/content/r356165877796720/”><em>Journal”>http://iospress.metapress.com/content/r356165877796720/”><em>Journal of Pediatric Rehabilitation Medicine</em></a></p>

Effects of AAC interventions on communication and language for young children with complex communication needs

Children with complex communication needs (CCN) who require augmentative and alternative communication (AAC) are at considerable risk in many aspects of their development: (a) functional communication skills, (b) speech development, (c) language development, (d) cognitive/conceptual development, (e) literacy development, (f) social participation, (g) access to education, and (h) overall quality of life. Early intervention is critical to address these areas and provide successful and functional outcomes. AAC offers the potential to enhance communication, language, and learning for children with significant communication disabilities. This paper provides an overview of the effects of AAC interventions on communication, behavior, language, and speech outcomes for young children with CCN for pediatricians and other medical and rehabilitation professionals. Future research directions to maximize the communication development of young children with CCN are also discussed.

<p><p>from the <a href=”Journal” _mce_href=”http://iospress.metapress.com/content/h8l62630x7337655/”><em>Journal”>http://iospress.metapress.com/content/h8l62630x7337655/”><em>Journal of Pediatric Rehabilitation Medicine</em></a></p>

Communication vulnerable patients in the pediatric ICU: Enhancing care through augmentative and alternative communication

Children in pediatric intensive care units (PICUs) may experience a broad range of motor, sensory, cognitive, and linguistic difficulties that make it difficult for them to communicate effectively. Being unable to communicate is emotionally frightening for children and can lead to an increase in sentinel events, medical errors and extended lengths of stay. Implementation of augmentative and alternative communication (AAC) tools and strategies can address the communication needs of children in the PICU by enabling them to communicate their wants, needs and feelings to healthcare providers and family members and participate in their own care more productively.<p><p>from the <a href=”Journal” _mce_href=”http://iospress.metapress.com/content/17214k076508n4k7/”><em>Journal”>http://iospress.metapress.com/content/17214k076508n4k7/”><em>Journal of Pediatric Rehabilitation Medicine</em></a></p>

A Nonverbal Phoneme Deletion Task Administered in a; Dynamic Assessment Format

The purpose of the project was to design a nonverbal dynamic assessment of phoneme deletion that may prove useful with individuals who demonstrate complex communication needs (CCN) and are unable to communicate using natural speech or who present with moderate-severe speech impairments.

from the Journal of Communication Disorders

Disentangling the social threads within a communicative environment: a cacophonous tale of alternative and augmentative communication (AAC)

Alternative and augmentative communication (AAC) technology is being increasingly recognised as an important means of fostering the literacy of students with significant disabilities. However, the coordinated use of AAC technology continues to challenge professionals, families and users leading to dissonant meanings and fragmented use. This paper is an attempt to inquire into, and disentangle some of, the social threads that made up the communicative environment of one first-grade student with significant disabilities – Trevor – for whom augmentative communication technology was procured. The ethnographic study reported in this paper documents the conflicting meanings of access and participation that surfaced among the multiple participants under whose guidance Trevor was required to use AAC. The paper discloses the assumptions implicit in these practices and in the conceptions of literacy enacted by different professionals. The paper notes the significance of these issues for Trevor’s narrative construction of himself and concludes with implications for practitioners.

from the European Journal of Special Needs Education

An Investigation of Aided Language Stimulation: Does it Increase AAC Use with Adults with Developmental Disabilities and Complex Communication Needs?

A single subject ABAB design was used to determine the efficacy of aided language stimulation to teach the use of AAC techniques to adults with developmental disabilities. Sixteen participants were divided into two equal groups. In each group, half of the participants were able to communicate functionally using spoken language and half had complex communication needs and did not have functional, symbolic communication systems. Each group met twice weekly for 30 min per session. Researchers modeled the use of AAC and followed scripts during music-based interventions. Sessions focused on social greetings, choosing songs to play, learning words and movements for the songs, and discussing the songs. Participants were encouraged to interact with each other and to facilitate each other’s communications. Results suggest that responsiveness and use of AAC increased for all participants with complex communication needs.

from AAC: Augmentative and Alternative Communication

An Investigation of Aided Language Stimulation: Does it Increase AAC Use with Adults with Developmental Disabilities and Complex Communication Needs?

A single subject ABAB design was used to determine the efficacy of aided language stimulation to teach the use of AAC techniques to adults with developmental disabilities. Sixteen participants were divided into two equal groups. In each group, half of the participants were able to communicate functionally using spoken language and half had complex communication needs and did not have functional, symbolic communication systems. Each group met twice weekly for 30 min per session. Researchers modeled the use of AAC and followed scripts during music-based interventions. Sessions focused on social greetings, choosing songs to play, learning words and movements for the songs, and discussing the songs. Participants were encouraged to interact with each other and to facilitate each other’s communications. Results suggest that responsiveness and use of AAC increased for all participants with complex communication needs.

from AAC: Augmentative and Alternative Communication

Aphasic speech with and without SentenceShaper® : Two methods for assessing informativeness

Conclusions: That the percentage of CIUs was higher in SSR-aided samples than in unaided samples confirms the central finding in Bartlett et al. (2007), based on subjective judgements, and thus extends the evidence that aided effects from SentenceShaper are demonstrable across a range of measures, stimuli and participants (cf. Linebarger, Schwartz, Romania, Kohn, & Stephens, 2000). The data also attest to the effectiveness of the CIU analysis for quantifying differences in the informativeness of aphasic speech with and without SentenceShaper; and they support prior studies that have shown that CIU measures correlate with the informativeness ratings of unfamiliar listeners.

from Aphasiology

Communication Access in the Library for Individuals who use Augmentative and Alternative Communication

Libraries for All is a community-based program that aims to enhance communication access to the library for individuals who use augmentative and alternative communication (AAC), by providing resources and instruction. The goals are to (a) provide communication boards, (b) complete facilitator training, and (c) promote the program. To accomplish these goals, four communication boards were created and provided to all public libraries in London, Ontario. A train-the-trainer model was employed to ensure that all members of the library staff were familiar with the boards and aware of strategies to communicate more effectively with individuals who use AAC. Marketing materials were sent to potential stakeholders. The success of the program in meeting these three goals is highlighted.

from AAC: Augmentative and Alternative Communication

Speech synthesis in background noise: Effects of message formulation and visual information on the intelligibility of American English DECTalk™

The purpose of the current research was to investigate the intelligibility of synthesized speech in noise, when listeners are able to watch an individual using augmentative and alternative communication (AAC) formulate messages on-line and when they are listening to a speaker without any visual information. A total of 80 participants were randomly assigned to four groups, with 20 participants in each group. Each group listened to sentences delivered using a different message formulation strategy: prestored; audibly formulated (messages are formulated on-line and the listener is able to hear the formulation as the message is being encoded); audibly formulated with no repeat (the full sentence at the end is not repeated); and quietly formulated (the message is formulated on-line, but the listener is not able to hear the system feedback throughout the formulation). The speaker for this study was a 35-year-old woman with cerebral palsy who used a VOCA with DECTalk™ (Beautiful Betty, American English) to communicate. Half of the sentences were presented in an auditory-only condition and half were presented in an auditory-visual condition. The dependent variable was intelligibility, as measured by the percentage of words correctly transcribed by each listener. The overall intelligibility of the sentences in the Audibly Formulated with No Repeat group was statistically significantly lower than in each of the other message formulation type groups. Visual information did not have an effect on intelligibility for this speaker. Clinical implications, limitations, and directions for future research and development are discussed.

from AAC: Augmentative and Alternative Communication

People with severe and moderate aphasia and their partners as estimators of communicative skills: A client-centred evaluation

Conclusions: The results of the present study indicate that people with severe and moderate aphasia are able to assess their communication skills with modified, aphasia-friendly self-assessment tools. The results also indicate that people with aphasia and their partners perceive the communicative skills quite similarly, especially after the intervention has begun. The use of accessible measures enables people with severe aphasia to participate in the evaluation of therapy outcomes, as suggested by the philosophies of the social model of rehabilitation.

from Aphasiology

‘Communication is everything I think.’ Parenting a child who needs Augmentative and Alternative Communication (AAC)

from the International Journal of Language and Communication Disorders

Conclusions: These parents are experts on their children and may also be experts on AAC. Many factors impact on parents and the level and type of involvement they have with their children and their upbringing. Speech and language therapists need to acknowledge parents’ knowledge and expertise regarding their children. They need to recognize that there are parent, child, family and external factors which impact on parents’ ability and willingness to be involved in speech and language therapist provision, and that these factors are not static over time. The use of ethnographic interviewing techniques should be considered a valuable aspect of speech and language therapist intervention.

An AAC Personnel Framework: Adults with Acquired Complex Communication Needs

from AAC: Augmentative and Alternative Communication

A personnel framework designed to support people who rely on augmentative and alternative communication (AAC) because of acquired medical conditions and those who assist them is described. The roles of AAC finders, general practice clinicians, AAC intervention specialists, AAC facilitators, and AAC experts are summarized. These roles are described in detail for people with amyotrophic lateral sclerosis, brainstem impairment, and severe chronic aphasia. The personnel preparation needs for each of these support personnel groups are identified.

“Reach for the Stars”: Five Principles for the Next 25 Years of AAC

from AAC: Augmentative and Alternative Communication

Basing our work on the published writings of individuals who use augmentative and alternative communication (AAC) and their family members, we offer five principles to guide AAC assessment, intervention, research, and development: (a) The time for AAC is now; (b) One is never enough; (c) My AAC must fit my life; (d) AAC must support full participation in all aspects of 21st century life; and (e) Nothing about me without me. These five principles are individually important, but also interconnected, and are meant to provide clear goals for the field of AAC as we work towards the achievement of communication and participation for all.