Augmentative and alternative communication methods in locked-in syndrome

This article aims to increase the dental teams’ awareness of communicating with people with learning disabilities who have additional communication impairments. The paper presents a brief account of the factors behind why some people with learning disabilities may find it difficult to verbally communicate, and highlights the importance of ensuring high levels of care for all patients. It provides an overview of the principles of communication development and some of the most commonly used augmentative and alternative communication approaches. The paper concludes with suggestions of simple communication techniques as well as practical ideas, which can be easily incorporated into daily general dental practice in order to increase opportunities for successful interactions and minimise communication breakdown. By becoming more aware of the range of communication methods used to support those who have learning disabilities, the dental team will be more able to provide a better experience to their patients and ensure that their needs are met.

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“Everyone Deserves AAC”: Preliminary Study of the Experiences of Speaking Autistic Adults Who Use Augmentative and Alternative Communication

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2021_persp-20-00220 ◽

2021 ◽

pp. 1-12

Author(s):

Amy L. Donaldson ◽

endever* corbin ◽

Jamie McCoy

Keyword(s):

Augmentative And Alternative Communication ◽

Online Survey ◽

Academic Research ◽

Alternative Communication ◽

Semantic Level ◽

Supportive Environment ◽

Preliminary Study ◽

Autistic Adults ◽

The Moment ◽

Communication Methods

Purpose Autistic adults use a variety of communication methods, including both speech and augmentative and alternative communication (AAC); however, there has been limited, if any, academic research in this area. The purpose of this study was to examine the experiences of speaking autistic adults who use AAC. Method Using a participatory research method, we completed an online survey that included five demographic questions and 29 open-ended questions related to communication choice, communication access, attitudes, and recommendations. Six autistic adults who use AAC participated. The data were analyzed with thematic analysis using an inductive approach at the semantic level. Results Participants reported identifying AAC as a communication choice as adults, after using speech during childhood. They described how forced communication choices have greatly impacted their lives, both historically and today, and reported on the successes they experience when communication autonomy is promoted within a supportive environment. Participants further described what impacts their in-the-moment decision making related to use of different communication methods. Finally, they discussed the importance of normalizing AAC use and disability in general and provided recommendations for other AAC users, families, and professionals. Conclusions Historically, AAC intervention was considered a “last resort” for children who did not develop functional speech. Speaking autistic adults encourage families, professionals, and society to promote and accept all communication as equal—ensuring opportunities for all children to develop full and rich communication without delay and without stigma.

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Augmentative And Alternative Communication Systems For Post-Stroke Patients With Severe Communication And Motor Impairment

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.ca1.66 ◽

2017 ◽

pp. 66

Author(s):

Talieh Zarifian ◽

Amin Mahnam ◽

Atabak Vosoughi

Keyword(s):

Eye Movements ◽

Augmentative And Alternative Communication ◽

Motor Impairment ◽

Written Language ◽

Alternative Communication ◽

Stroke Patients ◽

Neurological Condition ◽

Post Stroke ◽

The Impact ◽

Communication Methods

Background and aims: Adults with acquired neurological disorders (stroke, Traumatic Brain Injury ...) develop their verbal communication and literacy capabilities as typical speakers and writers. They use these skills to participate academically, vocationally, recreationally, and socially. Depending upon their neurological condition, they gradually or suddenly lose their speech or language capabilities and are required to rely on Augmentative and Alternative Communication (AAC) systems to meet their communication needs. In addition to the loss of their spoken communication, the impact of their neurological condition on their participation patterns is potentially profound with reduced ability to care for themselves, a reduction or loss of employment, and usually a sudden or gradual restriction of their social networks. AAC is an umbrella term that encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. During the past five decades, AAC technologies have been developed to compensate for these natural communication losses. Stroke is one of the main causes of disability in the world. About 20% of stroke patients experience aphasia, with 20-30% of these individuals exhibiting severe communication deficits for at least a portion of their recovery period. Augmentative and Alternative Communication (AAC) encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production of spoken or written language. Specifically designed Human Computer Interfaces (HCI), as an assistive technology, provides new channels of communication for patients with aphasia, dysarthria, and dyspraxia, when accompanied by movement impairments. In this workshop after stating a science review of the following types of issues: AAC acceptance (individually, culturally); AAC availability; AAC use patterns; AAC limitations are main issues, an AAC technology for post-stroke patients will be presented which developed by a knowledgebase company in Iran. The system allows patients with communication and motor impairment to state their intentions and feelings by a minimum movement in their body, or just by moving their eyes. Different sensors and switches are available to adopt based on the limited ability of the patients. For detecting eye movements, a novel wearable miniaturized system has been developed that is worn as a headband and detects eye movements based on processing electro-oculogram. A high performance graphical user interface has been developed to type letters and numbers in Persian language. The system also provides words prediction, text to speech conversion with natural voice, and sending/receiving messages in the mobile networks for a convenient communication experience. The developed system has been tested successfully by more than 20 patients with different disabilities, and is now commercially available.The proposed system can also help the severely disabled people with amyotrophic lateral sclerosis, quadriplegia, muscular dystrophy or cerebral palsy to communicate with others and mention their intentions, needs and feelings. This low-cost wearable device assures high level of comfort for the user without fatigue and do not need long time training. The system can also be adapted for the patients who can speak, but could not move their hands, to work with the computer and enjoy using the internet.

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Individuals Who Use Augmentative and Alternative Communication and Participate in Active Recreation: Perspectives From Adults With Developmental Disabilities and Acquired Conditions

American Journal of Speech-Language Pathology ◽

10.1044/2021_ajslp-21-00179 ◽

2022 ◽

pp. 1-15

Author(s):

David J. Hajjar ◽

John W. McCarthy

Keyword(s):

Developmental Disabilities ◽

Focus Groups ◽

Augmentative And Alternative Communication ◽

Team Sports ◽

The United States ◽

Alternative Communication ◽

Communication Partners ◽

Individual Sports ◽

Communication Methods ◽

Active Recreation

Purpose: The aim of the study was to gather the perspectives and lived experiences of 10 adults who use augmentative and alternative communication (AAC) and participate in active recreation. Active recreational participation includes individual sports such as adaptive skiing, surfing, and cycling, as well as unified team sports such as soccer, bocce, and basketball. Method: This research involved a qualitative study with two separate asynchronous online focus groups each conducted over a 6-week span. The focus groups included literate individuals who use AAC and engage in active recreational pursuits across the United States. One focus group included five individuals with acquired conditions, and the other group included five individuals with developmental disabilities. Results: Thematic analysis of the data from both focus groups revealed five primary themes with corresponding subthemes: barriers (intrinsic and extrinsic), supports (intrinsic and extrinsic), benefits (intrinsic and extrinsic), communication (methods), and recommendations for communication partners and people who use AAC. Conclusions: This study provides important information to individuals who use AAC and their communication partners about the benefits of active recreation and the supports needed to make these experiences successful. As a result of this study, speech-language pathologists, related professionals, and caregivers will gain a better understanding of how they can support recreational participation for people who use AAC with a specific focus on enhancing communication and expanding social networks. Supplemental Material https://doi.org/10.23641/asha.17701043

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Communicating to Non-Speaking Critically Ill Patients: Augmentative and Alternative Communication Technique as an Essential Strategy

SAGE Open Nursing ◽

10.1177/23779608211015234 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110152

Author(s):

Asaad Nasser Salim Al-Yahyai, RN, BSN ◽

Judie Arulappan, RN, RM, BSC (N), MSC (N), PhD (N), DNSc ◽

Gerald Amandu Matua ◽

Sultan Marhoon Al-Ghafri, RN, BSN ◽

Sami Hamood Al-Sarakhi, RN, BSN ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Augmentative And Alternative Communication ◽

Communication Strategies ◽

Sampling Technique ◽

Critically Ill Patient ◽

Body Parts ◽

Alternative Communication ◽

Communication Technique ◽

Communication Methods

Introduction Communication with hospitalized patients is crucial to improve the quality and safety of health care. Methods The study assessed the communication methods used by nurses while communicating to non-speaking critically ill patients. The participants included staff nurses working in ICU, CICU, HD units of neuro- surgical, orthopedic, medical and oncology wards. Purposive sampling technique was used to recruit a total number of 194 nurses. The communication methods used were assessed by a questionnaire comprised of a list of 21 strategies used to communicate with non-speaking patients. Results The most commonly used strategies were reading the patient’s mouthing words, encouraging the patient by telling them that they are doing well and nurses helping them to get better, assessing the patients for their communication ability, “thumps up” to indicate “yes”, “shake head” indicating “no”, use OK, or point to body parts, speaking slowly and waiting for the patient’s response, spending time to listen patiently to what the patient say and touching the non-speaking critically ill patient when the nurse speaks with the patient. Conclusion The study reported that the nurses used variety of communication strategies while communicating to non- speaking critically ill patients. However very few nurses used Augmentative and alternative communication strategies to communicate to non-speaking critically ill patients. The study recommends the importance of establishing Augmentative and Alternative Communication strategies in the hospitals.

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The Effect of Symbol Background Color on the Speed of Locating Targets by Adults Without Disabilities: Implications for Augmentative and Alternative Communication Display Design

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00017 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1482-1488

Author(s):

Jennifer J. Thistle

Keyword(s):

Augmentative And Alternative Communication ◽

Reaction Times ◽

The Other ◽

Background Color ◽

Alternative Communication ◽

Display Design ◽

Line Drawings ◽

Research With Children ◽

Study Participants ◽

Perceptual Factors

Purpose Previous research with children with and without disabilities has demonstrated that visual–perceptual factors can influence the speech of locating a target on an array. Adults without disabilities often facilitate the learning and use of a child's augmentative and alternative communication system. The current research examined how the presence of symbol background color influenced the speed with which adults without disabilities located target line drawings in 2 studies. Method Both studies used a between-subjects design. In the 1st study, 30 adults (ages 18–29 years) located targets in a 16-symbol array. In the 2nd study, 30 adults (ages 18–34 years) located targets in a 60-symbol array. There were 3 conditions in each study: symbol background color, symbol background white with a black border, and symbol background white with a color border. Results In the 1st study, reaction times across groups were not significantly different. In the 2nd study, participants in the symbol background color condition were significantly faster than participants in the other conditions, and participants in the symbol background white with black border were significantly slower than participants in the other conditions. Conclusion Communication partners may benefit from the presence of background color, especially when supporting children using displays with many symbols.

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Improving Patient Safety and Patient–Provider Communication

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0021 ◽

2019 ◽

Vol 4 (5) ◽

pp. 1017-1027 ◽

Cited By ~ 1

Author(s):

Richard R. Hurtig ◽

Rebecca M. Alper ◽

Karen N. T. Bryant ◽

Krista R. Davidson ◽

Chelsea Bilskemper

Keyword(s):

Acute Care ◽

Augmentative And Alternative Communication ◽

Health Care Team ◽

Provider Communication ◽

Alternative Communication ◽

Patient Provider Communication ◽

Acute Care Settings ◽

Nurses Perceptions ◽

Communication Needs ◽

The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

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An Exploratory Study on Augmentative and Alternative Communication Classroom Integration Training for Special Educators Who Work With Children With Complex Communication Needs in the Bahamas

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0007 ◽

2019 ◽

Vol 4 (5) ◽

pp. 991-1016

Author(s):

Shameka Stanford ◽

Ovetta Harris

Keyword(s):

Augmentative And Alternative Communication ◽

Special Educators ◽

Communication Disorders ◽

Alternative Communication ◽

The Bahamas ◽

Complex Communication Needs ◽

English Speaking ◽

Communication Needs ◽

Classroom Integration ◽

And Training

Purpose In 2011, the United Nations estimated there were between 180 and 220 million youth with disabilities living around the world, and 80% of them resided in developing countries. Over the last 6 years, this number has increased significantly, and now, over 1 million people live in the Caribbean with some form of disability such as communication disorders resulting in complex communication needs (CCN). Method This publication discusses the benefits of an exploratory, descriptive, nonexperimental study on augmentative and alternative communication (AAC) classroom integration training for 8 special educators in the Bahamas who work with children with CCN. Results The results of this study revealed that 100% of the participants reported the study to be effective in increasing their knowledge and skill in the area of implementing AAC into their classrooms, enhancing their ability to team teach and incorporate AAC opportunities for all students with CCN within their classrooms, and increasing their knowledge and skill overall in the areas of AAC and CCN. Conclusion The findings highlight an important area of potential professional development and training that can be replicated in other English-speaking Caribbean territories focused on AAC classroom integration training program for special educators who teach students with CCN.

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Instruction Using Augmentative and Alternative Communication Supports: Description of Current Practices by Speech-Language Pathologists Who Work With Children With Autism Spectrum Disorder

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00045 ◽

2020 ◽

Vol 29 (2) ◽

pp. 586-596 ◽

Cited By ~ 1

Author(s):

Kaitlyn A. Clarke ◽

Diane L. Williams

Keyword(s):

Autism Spectrum Disorder ◽

Augmentative And Alternative Communication ◽

Communication Systems ◽

Diagnostic Category ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Alternative Communication ◽

Speech Language Pathologists ◽

Processing Differences

Purpose The aim of this research study was to examine common practices of speech-language pathologists (SLPs) who work with children with autism spectrum disorder (ASD) with respect to whether or not SLPs consider processing differences in ASD or the effects of input during their instruction. Method Following a qualitative research method, how SLPs instruct and present augmentative and alternative communication systems to individuals with ASD, their rationale for method selection, and their perception of the efficacy of selected interventions were probed. Semistructured interviews were conducted as part of an in-depth case report with content analysis. Results Based on completed interviews, 4 primary themes were identified: (a) instructional method , (b) input provided , (c) decision-making process , and (d) perceived efficacy of treatment . Additionally, one secondary theme, training and education received , was identified . Conclusions Clinicians reported making decisions based on the needs of the child; however, they also reported making decisions based on the diagnostic category that characterized the child (i.e., ASD). The use of modeling when teaching augmentative and alternative communication to individuals with ASD emerged as a theme, but variations in the method of modeling were noted. SLPs did not report regularly considering processing differences in ASD, nor did they consider the effects of input during instruction.

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