Young Adults with Complex Communication Needs: Research and Development in AAC for a “Diverse” Population

Transition to Adulthood for Individuals With Complex Communication Needs: A Scoping Review

Transitioning to adulthood is a complex and challenging process for youth with complex communication needs (CCN) and/or who use augmentative and alternative communication (AAC). This scoping review examined and consolidated available evidence documenting transition barriers and facilitators. Eight databases were searched systematically using complex communications needs/augmentative and alternative communication, transition programs, and adulthood as key terms. Participants aged 14-35 years and interventions focused on transition to occupations, including education, employment, leisure pursuits, or socializing/relationships. The search yielded 3459 records, which were screened by three independent raters. Twenty-three articles met the inclusion criteria. Studies focused primarily on employment (n =18), postsecondary education (n = 10), and socializing/relationships (n = 13). Programs experience and outcomes varied. Enabling factors included organizations, transition-focused programs, and social networks. Barriers included low expectations, lack of programs/supports, and limited literacy skills. Future studies must include richer descriptions of programs/services and participants, while more work is required to explore long-term outcomes.

Effects of Interventions Involving Tablet-Based Speech-Generating Devices for Individuals with ASD: A Meta-analysis

The purpose of this review was to assess the effectiveness of tablet-based speech-generating devices (SGDs) in improving communication skills for individuals with autism spectrum disorder (ASD). A total of 31 single-case design intervention studies involving 84 individuals with ASD were reviewed and included in the analysis. We calculated Tau-U to evaluate the impact of interventions involving tablet-based SGDs on four different communication responses: specifically, mands, intraverbals, tacts, and vocalizations. To explore potential moderating variables for mand outcomes, we used the Kruskal-Wallis one-way test. The analysis revealed that interventions utilizing tablet-based SGDs led to improvements in communication responses. Specifically, large to very large changes were observed in mand and intraverbal responses, whereas moderate changes were noted in tact responses and vocalizations. The findings of this review underscore the potential of tablet-based SGDs in enhancing communication among individuals with ASD. We discuss the findings and provide implications for future research and practice.

Towards E-textiles in augmentative and alternative communication - user scenarios developed by speech and language therapists

PURPOSE

E-textiles have been the focus of interest in health technology, but little research has been done so far on how they could support persons with complex communication needs. A global estimate is that 97 million people may benefit from Augmentative and Alternative Communication (AAC). Unfortunately, despite the growing body of research, many persons with complex communication needs are left without functional means to communicate. This study aimed to address the lack of research in textile-based AAC and to build a picture of the issues that affect novel textile-based technology development.

MATERIALS AND METHODS

We arranged a focus group study for altogether 12 speech and language therapists to elicit user scenarios to understand needs, activities, and contexts when implementing a novel, textile-based technology in a user-centred approach.

RESULTS AND CONCLUSION

As a result, we present six user scenarios that were created for children to enhance their social interaction in everyday life when using textile-based technology that recognizes touch or detects motion. The persistent availability and the individual design to meet a person's capability along with ease of use and personalization were perceived important requirements. Through these scenarios, we identified technological constraints regarding the development of e-textile technology and its use in the AAC field, such as issues regarding sensors and providing power supply. Resolving the design constraints will lead to a feasible and portable e-textile AAC system.

Possibilities of intelligent textiles in AAC - perspectives of speech and language therapists

PURPOSE

The growth of new high-technology devices in the field of augmentative and alternative communication (AAC) has been rapid. However, a vast number of individuals with complex communication needs are left without functional means to communicate in their lives. Intelligent textiles are one of the growing industries in health technologies yet to be explored for the possibility of implementation as an AAC solution. This study aimed to investigate the potential of intelligent textiles and their functions in daily life perceived by experienced speech and language therapists and to obtain data, which will offer direction on how to proceed with prototype development.

MATERIALS AND METHODS

Focus group discussions were conducted remotely within two groups of experienced speech and language therapists (n = 12). The data obtained from the discussions were analysed thematically.

RESULTS AND CONCLUSION

According to the stakeholders in question, intelligent textiles were perceived most useful for individuals with motor disabilities and those with severe intellectual disabilities. The most prominent themes for the purpose of using the intelligent textiles were social interaction and accessing meaningful activities independently. The participants also described how this technology could be used in terms of the textile, the input needed and the output the technology provides. The versatile results are discussed along with directions for future research.

Text messaging "Helps Me to Chat": exploring the interactional aspects of text messaging using mobile phones for youth with complex communication needs

This study explored the interactional aspects of text messaging on mobile phones for youth with complex communication needs. A qualitative case study design was used to investigate aspects such as reasons, place, timing of communication, content and communication partners. Data were gathered from seven youth with complex communication needs (primary participants) and one communication partner for each youth (secondary participants). In addition to using a questionnaire and tests to obtain participant background information, four data collection methods were used: (a) face-to-face interviews with the primary participants via text messaging, (b) researcher observations of these participants interacting via text messaging, (c) an asynchronous text-messaging focus group involving all seven primary participants, and (d) asynchronous interviews with the secondary participants via text messaging. The thematic data analysis highlighted numerous interactional benefits, most notably that text messaging offered the youth with complex communication needs a means of expressing themselves that was easier than face-to-face interactions. It also emphasizes interaction symmetry with a wide range of communication partners including groups, the privacy to interact with others beyond their often-restricted environments (absent presence), and a measure of anonymity and control over interactions. The study concluded that text messaging provides youth with complex communication needs with new communication possibilities.

How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR's Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a "total approach to rehabilitation", combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970's, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program.

Towards Advancing Knowledge Translation of AAC Outcomes Research for Children and Youth with Complex Communication Needs

The production of new knowledge in augmentative and alternative communication (AAC) requires effective processes to leverage the different perspectives of researchers and knowledge users and improve prospects for utilization in clinical settings. This article describes the motivation, planning, process, and outcomes for a novel knowledge translation workshop designed to influence future directions for AAC outcomes research for children with complex communication needs. Invited knowledge users from 20 pediatric AAC clinics and researchers engaged in the collaborative development of research questions using a framework designed for the AAC field. The event yielded recommendations for research and development priorities that extend from the early development of language, communication, and literacy skills in very young children, to novel but unproven strategies that may advance outcomes in transitioning to adulthood.

Communication intervention in Rett syndrome: a survey of speech language pathologists in Swedish health services

PURPOSE

To investigate communication intervention that speech language pathologists (SLPs) provide to people with Rett syndrome.

METHODS

A web-based survey targeting all Swedish SLPs working with people currently receiving support from habilitation services.

RESULTS

The SLPs reportedly followed recommended practice in the following aspects: (1) Information on communicative function was collected from several sources, including observation in well-known settings and reports from the client s social network, (2) Multimodal communication was promoted and, (3) Responsive partner strategies were largely targeted in the intervention. However, few instruments or standard procedures were used and partner instruction was given informally. Most SLPs used communication aids in the intervention and their general impression of using communication aids was positive. Further, augmentative and alternative communication (AAC) was estimated to increase and clarify communicative contributions from the person.

CONCLUSIONS

Communication aids were reported to have a positive influence on communicative functions. Swedish SLP services followed best practice in several aspects, but there are areas with potential for development. Tools and best practice guidelines are needed to support SLPs in the AAC process for clients with Rett syndrome. [Box: see text].

Putting people first: re-thinking the role of technology in augmentative and alternative communication intervention

Current technologies provide individuals with complex communication needs with a powerful array of communication, information, organization, and social networking options. However, there is the danger that the excitement over these new devices will result in a misplaced focus on the technology, to the neglect of what must be the central focus - the people with complex communication needs who require augmentative and alternative communication (AAC). In order to truly harness the power of technology, rehabilitation and educational professionals must ensure that AAC intervention is driven, not by the devices, but rather by the communication needs of the individual. Furthermore, those involved in AAC research and development activities must ensure that the design of AAC technologies is driven by an understanding of motor, sensory, cognitive, and linguistic processing, in order to minimize learning demands and maximize communication power for individuals with complex communication needs across the life span.