Vocabulary to support socially-valued adult roles

Augmentative and Alternative Communication for Children with Intellectual and Developmental Disability: A Mega-Review of the Literature

Establishing evidence- and research-based practices relies upon research synthesis of individual studies in reviews and meta analyses. Further summarizing scientific evidence about a specific topic by synthesizing reviews is an area of need to determine practices that have a strong evidence base and to identify areas of methodological weakness and gaps in the literature. A mega-review of literature reviews, systematic reviews, and meta-analyses on interventions using aided augmentative and alternative communication (AAC) interventions for children with intellectual and developmental disabilities from 2000 to mid-2020 was conducted. Participant and interventionist demographics, interventions, settings, outcomes, and recommendations of each review were reported and summarized. A MeaSurement Tool to Assess systematic Reviews Revised (AMSTAR 2; Shea et al., 2017) was used to examine the methodological rigor of 84 included reviews. Over the past 20 years, published reviews have increased slightly in methodological rigor but demonstrate a number of methodological weaknesses that detract from the strength of evidence for AAC interventions with this population. Suggestions for improving the methodological rigor of literature reviews and areas for future research specific to AAC interventions are discussed.

Surface electromyographic control of a novel phonemic interface for speech synthesis

Many individuals with minimal movement capabilities use AAC to communicate. These individuals require both an interface with which to construct a message (e.g., a grid of letters) and an input modality with which to select targets. This study evaluated the interaction of two such systems: (a) an input modality using surface electromyography (sEMG) of spared facial musculature, and (b) an onscreen interface from which users select phonemic targets. These systems were evaluated in two experiments: (a) participants without motor impairments used the systems during a series of eight training sessions, and (b) one individual who uses AAC used the systems for two sessions. Both the phonemic interface and the electromyographic cursor show promise for future AAC applications.

Communication Services and Supports for Individuals With Severe Disabilities: Guidance for Assessment and Intervention

The National Joint Committee for the Communication Needs of People With Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities.

What We Write about When We Write About AAC: The Past 30 Years of Research and Future Directions

For the past 30 years, the Augmentative and Alternative Communication (AAC) journal has both documented and instigated change in the field of AAC. We reviewed the papers published in the AAC journal from 1985-2014 in order to identify trends in research and publication activities. Intervention research made up the largest proportion of the four types of research (i.e., intervention, descriptive, experimental, and instrument and measurement development) reported in the journal. Intervention research has most commonly focused on the individual with complex communication needs, and most frequently on younger individuals (aged 17 and younger) with developmental disabilities. While much has been learned in the past 30 years, there continues to be a need for high quality research in a large number of areas. There is a special need for reports of interventions with older individuals with complex communication needs as a result of acquired disabilities, and for information on effective interventions for the communication partners of persons with complex communication needs.

Development of a measure of knowledge use by stakeholders in rehabilitation technology

Objectives:

Uptake of new knowledge by diverse and diffuse stakeholders of health-care technology innovations has been a persistent challenge, as has been measurement of this uptake. This article describes the development of the Level of Knowledge Use Survey instrument, a web-based measure of self-reported knowledge use.

Methods:

The Level of Knowledge Use Survey instrument was developed in the context of assessing effectiveness of knowledge communication strategies in rehabilitation technology. It was validated on samples representing five stakeholder types: researchers, manufacturers, clinician–practitioners, knowledge brokers, and consumers. Its structure is broadly based on Rogers’ stages of innovation adoption. Its item generation was initially guided by Hall et al’s Levels of Use framework. Item selection was based on content validity indices computed from expert ratings (n₁ = 4; n₂ = 3). Five representative stakeholders established usability of the web version. The version included 47 items (content validity index for individual items >0.78; content validity index for a scale or set of items >0.90) in self-reporting format. Psychometrics were then established for the version.

Results:

Analyses of data from small (n = 69) and large (n = 215) samples using the Level of Knowledge Use Survey instrument suggested a conceptual model of four levels of knowledge use—Non-awareness, Awareness, Interest, and Use. The levels covered eight dimensions and six user action categories. The sequential nature of levels was inconclusive due to low cell frequencies. The Level of Knowledge Use Survey instrument showed adequate content validity (≈ 0.88; n = 3) and excellent test–retest reliability (1.0; n = 69). It also demonstrated good construct validity (n = 215) for differentiating among new knowledge outputs (p < 0.001) and among stakeholder types (0.001 < p ≤ 0.013). It showed strong responsiveness to change between baseline and follow-up testing (0.001 < p ≤ 0.002; n = 215).

Conclusion:

The Level of Knowledge Use Survey instrument is valid and reliable for measuring uptake of innovations across diffuse stakeholders of rehabilitation technologies and therefore also for tracking changes in knowledge use.

Reducing the risk of being a victim of crime in South Africa: you can tell and be heard!

People who use Augmentative and Alternative Communication (AAC) know that silence is not always golden. Persons with disabilities and in particular those with complex communication needs, have a heightened risk of becoming victims of crime, abuse, and neglect. This study looked at the vocabulary needed to disclose or report crime or abuse in South Africa, and also focussed on the development of communication boards for this purpose, in four of the 11 official South African languages (Afrikaans, English, Sepedi, and isiZulu). Thirty-six participants in four language-based focus groups (English, Afrikaans, Sepedi, and isiZulu) were asked to generate a list of possible words they deemed important when wanting to disclose a crime, abuse or neglect. Participants then prioritized the top 55 words. A total of 56 words appeared on two or more of the lists from the four language groups. The board was developed using Picture Communication Symbols (PCS), the most frequently used symbol set in South Africa, according to an electronic mail survey. A discrepancy analysis revealed that these 56 words could be represented by 219 symbols. Symbols were developed for two words (swear, threaten) for which no PCS symbols existed. The process of developing the communication boards described in this paper may be useful to AAC communities in other countries, and the boards can serve as templates for other languages.