Elizabeth K. Hanson

Communication Support through Multimodal Supplementation:A Scoping Review

Abstract Speech supplementation strategies improve spoken communication for people with motor speech disorders who experience reduced speech intelligibility. The purpose of this review was to summarize the literature on traditional supplementation strategies (e.g., alphabet supplementation, topic supplementation, and gestural supplementation) and to expand the definition of speech supplementation to include additional modalities, such as augmenting speech with pictures via mobile technology, and conversation management strategies. Results showed that studies of traditional supplementation consistently reported positive outcomes, including increased intelligibility, decreased speech rate, and positive attitudes toward speakers. New modalities, such as supplementing speech through digital photos, may come to be integrated with traditional approaches, given the proliferation of digital photography and mobile tablet technologies. In addition, new research is exploring the role of communication partners in dyads where one speaker has dysarthria, as well as strategies that communication partners employ to understand dysarthric speech.

AAC Technology Learning Part 3: Regular AAC Team Members

The specific purposes of this article were (a) to study the computer technology interest levels, achievement goal orientation, self-efficacy, and learning mode preferences regarding AAC technology in AAC team members; and (b) to study the relationships among these variables to understand factors related to, and predictive of, learning mode preference. The companion articles focused on AAC intervention specialists and on pre-professional students. AAC team members reported relatively low interest in computer technology per se. They reported high mastery achievement goal orientation with a somewhat lower performance orientation and a relatively low social orientation. As a group the AAC specialists and regular AAC team members who participated in this investigation did not report strong learning mode patterns. However, the correlation analysis revealed some interesting trends. Self-efficacy was highly correlated with technology learning mode preference. Those with relatively high self-efficacy preferred to learn technology alone and did not prefer direct, step-by-step instruction. Those with relatively low self-efficacy preferred learning via step-by-step instruction over learning alone.

The impact of alphabet supplementation and word prediction on sentence intelligiblity of electronically distorted speech

Alphabet supplementation is a low-tech augmentative and alternative communication (AAC) strategy that involves pointing to the first letter of each word spoken. Sentence intelligibility scores increased an average of 25% (Hanson et al., 2004) when speakers with moderate and severe dysarthria (a neurologic speech impairment) used alphabet supplementation strategies. This project investigated the impact of both alphabet supplementation and an electronic word prediction strategy, commonly used in augmentative and alternative communication technology, on the sentence intelligibility of normal natural speech that was electronically distorted to reduce intelligibility to the profound range of <30%. Results demonstrated large sentence intelligibility increases (average 80% increase) when distorted speech was supplemented with alphabet supplementation and word prediction.

Telephone talk: effects of timing and use of a floorholder message on telephone conversations using synthesized speech.

Telephone interaction remains a challenging form of communication for many who use speech-generating devices (SGDs). The purpose of this study was to investigate the effect of delayed starts and floorholder information at the beginning of synthesized-speech telephone calls to local businesses. Calls were placed to 100 randomly selected businesses asking for business hours. Each call was randomly assigned to one of four experimental conditions: a floorholder present with no delay, a floorholder present with a delay, floorholder absent and no delay, and floorholder absent with a delay. Overall, 76% of the calls were unsuccessful because the participant hung up or otherwise did not provide the information requested. The majority of successful calls occurred in the floorholder present and no delay condition.

Communication Supports for People with Motor Speech Disorders.

Communication supports for people with motor speech disorders can include strategies and technologies to supplement natural speech efforts, resolve communication breakdowns, and replace natural speech when necessary to enhance participation in all communicative contexts. This article emphasizes communication supports that can enhance participation, as described in the World Health Organizations International Classification of Functioning, Disability and Health. The article begins with a discussion of partner and patient-reported assessments to evaluate participation levels and barriers to participation. Then, it provides an overview of communication supports for speakers with motor speech disorders, organized by the status of the disorder as stable, improving, or degenerative. The article includes nine case examples to illustrate principles and provide examples of how to address stable and changing needs.

Telephone talk: effects of two access methods on phone call success

Abstract The slower and unnatural timing of speech inherent to speech-generating devices (SGDs) can be a barrier to successful aided telephone calls. The timing of message delivery when using an SGD may vary depending on the type of access method used. We measured the difference in the success rate of telephone calls made with an SGD either using switch scanning or direct selection with eye gaze. The scripted calls, asking for directions, were placed to 100 randomly selected businesses. Analysis showed a statistically significant difference in the success rate between the two conditions, with eye gaze access resulting in more successful calls. Findings from this study suggest that people who use SGDs for phone calls may improve the timing of message delivery by using eye gaze access compared to switch scanning.

Effects of Alphabet-Supplemented Speech on Brain Activity of Listeners: An fMRI Study

PURPOSE The purpose of this article was to examine the neural mechanisms associated with increases in speech intelligibility brought about through alphabet supplementation. METHOD Neurotypical participants listened to dysarthric speech while watching an accompanying video of a hand pointing to the 1st letter spoken of each word on an alphabet display (treatment condition) or a scrambled display (control condition). Their hemodynamic response was measured with functional magnetic resonance imaging, using a sparse sampling event-related paradigm. Speech intelligibility was assessed via a forced-choice auditory identification task throughout the scanning session. RESULTS Alphabet supplementation was associated with significant increases in speech intelligibility. Further, alphabet supplementation increased activation in brain regions known to be involved in both auditory speech and visual letter perception above that seen with the scrambled display. Significant increases in functional activity were observed within the posterior to mid superior temporal sulcus/superior temporal gyrus during alphabet supplementation, regions known to be involved in speech processing and audiovisual integration. CONCLUSION Alphabet supplementation is an effective tool for increasing the intelligibility of degraded speech and is associated with changes in activity within audiovisual integration sites. Changes in activity within the superior temporal sulcus/superior temporal gyrus may be related to the behavioral increases in intelligibility brought about by this augmented communication method.

Effects of Clinician-Guided Emergent Literacy Intervention Using Interactive Tablet Technology for Preschool Children With Cochlear Implants

The purpose of this study was to investigate if intervention based on a mobile application would improve the print knowledge and vocabulary of preschool children with and without hearing loss. This was a multiple baseline study that included four preschool children. Two of the children had hearing loss and utilized cochlear implants, while the other two had normal hearing. Clinicians utilized a mobile application to facilitate print knowledge (i.e., sound-symbol relationships) and to acquire new vocabulary. By the end of the study, all four children demonstrated improved familiarity with the targeted letter sounds and improved knowledge of the vocabulary words that were utilized during the study. The results of this study indicate that the mobile application, in combination with clinician scaffolding, was an effective tool for facilitating early literacy skills in preschool children. Prior print knowledge and vocabulary development appeared to be stronger indicators of response to treatment than hearing status.