Verb class distinctions and AAC language-encoding limitations

Comparison of Preschooler Verbal and Graphic Symbol Production Across Different Syntactic Structures

The present study focuses on the impact of graphic symbols used in Augmentative and Alternative Communication (AAC) on clause construction. It is not yet well-understood to what extent communication produced via graphic symbols differs from verbal production. This study attempts shed light on the impact of the graphic symbol modality on message construction beyond individual differences, language knowledge, and language-specific patterns by providing a direct comparison between children's verbal and graphic symbol production. Nineteen typically developing Hebrew-speaking children aged 4-5 years were presented with 16 short videos of actions and were asked to express what they saw verbally and by choosing among graphic symbols displayed on an iPad communication board. The 570 clauses produced by the children were coded and analyzed. A significant difference was found in favor of verbal speech across different syntactic structures in terms of utilization of the target lexicon, syntactic complexity, and expected target word order. These results are consistent with the existing literature for English. Implications for AAC practices are discussed, highlighting the notion that using graphic symbols to represent spoken language may not reflect actual linguistic knowledge and that adequate, explicit instruction is necessary for graphic representation of more complex linguistic structures.

The decision-making process in recommending electronic communication aids for children and young people who are non-speaking: the I-ASC mixed-methods study

Background

This project [Identifying Appropriate Symbol Communication (I-ASC)] explored UK decision-making practices related to communication aid recommendations for children and young people who are non-speaking. Research evidence related to communication aid decision-making is limited. The research aims were to increase understanding of influencers on the decision-making process in recommending electronic communication aids, and to develop guidance tools to support decision-making. An additional, post hoc aim was to evaluate the public involvement contribution to the I-ASC project. The research focused on the identification of attributes and characteristics that professionals, family members and those who use communication aids considered important in the recommendation process. Findings informed the development of guidance resources. The evaluation of public involvement focused on what could be learned from a nationally funded project with involvement from public contributors typically regarded as hard to include.

Methodology

For the clinical decision-making component, the methodological investigation adopted a three-tier approach with three systematic reviews, a qualitative exploration of stakeholder perspectives through focus groups and interviews, and a quantitative investigation surveying professionals’ perspectives. The public involvement evaluation adopted a mixed-methods approach. A total of 354 participants contributed to the decision-making data set, including professionals, family members, and children, young people and adults who use communication aids; 22 participants contributed to the public involvement evaluation. The literature review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thematic analysis and framework approach supported the analysis of qualitative data. Two stated preference surveys, a best–worst scaling and a discrete choice experiment, allowed the relative importance of factors in decision-making to be determined. Analysis was grounded in random utility theory.

Public involvement

Two public involvement co-researchers, an adult using a symbol communication aid and a parent of a communication aid user, were core members of the research team. The I-ASC public involvement resulted in an additional award to evaluate the impact of public involvement across the project.

Results

Factors influencing decision-making are not always under the control of the decision-makers, for example professional knowledge, referral criteria and service structure. Findings suggest that real clinical decisions contrast with hypothetical decisions. Survey responses indicated that children’s physical characteristics are less important than their language, communication and learning abilities; however, during real-time decision-making, the opposite appeared to be true, with access needs featuring most prominently. In contrast to professionals’ decisions, users and family members prioritise differing aesthetic attributes of communication aids. Time allocated to system learning remains underspecified. The research informed the development of decision-making guidance tools (https://iasc.mmu.ac.uk/; accessed 8 June 2020). A public involvement evaluation suggests that successful public involvement of individuals with disabilities requires significant resources that include staff time, training and personal support (https://iasc.mmu.ac.uk/publicinvolvement; accessed 8 June 2020).

Future work

Further research is needed in the areas of language assessment, communication aid attributes, types of decision-making episodes and service user perspectives. These data highlight the need for mechanisms that enable public involvement co-researchers to be paid for their contributions to research bid preparation.

Limitations

Individuals who benefit from communication aids are a heterogeneous group. We cannot guarantee that this study has captured all relevant components of decision-making.

Funding

This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 45. See the NIHR Journals Library website for further project information.

Reading acquisition, AAC and the transferability of english research to languages with more consistent or transparent orthographies

Research on reading in augmentative and alternative communication (AAC) is primarily provided for the English language, which has nontransparent orthographic depth and a complex syllable structure. While there is a great deal to learn about English reading in AAC, there is substantially more information regarding reading in AAC in English than in other languages. In this article we compare reading acquisition in English and German, drawing from the existing research regarding reading for children with complex communication needs and describing how that might apply to German and other European languages with orthography that is more consistent than English (e.g., Swedish, Spanish, Finnish; Aro & Wimmer, 2003). The goal is to support the development of cross-linguistic understandings in reading and AAC.

Evaluating the morphological competence of children with severe speech and physical impairments

Reports present mixed findings on the extent to which the development of receptive language skills in children with severe speech and physical impairments (SSPI) is compromised by their difficulty with speaking (V. W. Berninger & B. M. Gans, 1986; D. V. M. Bishop, B. Byers Brown, & J. Robson, 1990; O. Udwin & W. Yule, 1990). In this study, grammaticality judgments were used to measure the sensitivity of 4 school-age children with SSPI to different morphological errors. These errors included violations of agreement between the subject and auxiliary verbs (e.g., she are falling), the marking of aspect (e.g., she is play the horn), and the marking of past tense on regular and irregular verbs (e.g., he jump, he fall, he falled). Performance of the participants with SSPI was compared to groups of typically developing children and adults. Results indicated that children in the SSPI and control groups made similar judgments. All groups showed high levels of sensitivity to agreement violations, aspect-marking errors, and tense-marking errors involving irregular verbs. Participants with SSPI had greater difficulty detecting tense-marking errors involving regular verbs. Implications for improving clinical assessments within this population are discussed.