Gunilla Thunberg

Children with Autistic Spectrum Disorders and Speech-Generating Devices: Communication in Different Activities at Home.

The communication of four children with autistic spectrum disorder was investigated when they were supplied with a speech‐generating device (SGD) in three different activities in their home environment: mealtime, story reading and “sharing experiences of the preschool day”. An activity based communication analysis, in which collective and individual background factors for the activities were outlined, was used as a basis for the discussion of linguistic coding data derived from video‐recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn‐taking, communicative form, function and effectiveness. An increase in communicative effectiveness was more noticeable when the SGDs could be used to fulfil goals and roles within the activity. The instruction to the parents to use the SGDs in their communication with the child had an important influence on the activities.

Measuring Responsive Style in Parents who use AAC with their Children: Development and Evaluation of a new Instrument

The aim of this study was to develop and evaluate an instrument – the Responsive Augmentative and Alternative Communication Style (RAACS) scale Version 2 – to assess the communicative style of parents as they interact with their children using augmentative and alternative communication (AAC). This scale was used to analyze play interactions between 43 parents and 28 children with different diagnoses (including Down syndrome, autism, cerebral palsy, and intellectual disability), aged between 12 and 60 months. Parent–child interactions were observed both before and after parent participation in ComAlong, a training course on using responsive communication and AAC to support interaction with children. Based on an analysis of the results, Version 3 of the RAACS scale was developed and is recommended for future use. Analyses of Version 3 showed acceptable inter- and intra-coder reliability, and excellent internal consistency.

Assessing Children's Anxiety Using the Modified Short State-Trait Anxiety Inventory and Talking Mats: A Pilot Study

Background. Preoperative anxiety complicates treatment and requires assessment by nurses in children. Children, with or without disability, are helped when pictures are used to support communication. The purpose of this pilot study was to test the reliability and validity of the modified short State-Trait Anxiety Inventory (STAI) using a modified Talking Mats method in children undergoing day surgeries. Method. A modified short STAI with pictorial support along the lines of the Talking Mats method was pre- and postoperatively administered to 42 typically developing children aged three to nine years. The parents assessed the childrens anxiety, simultaneously and independently, by scoring the short STAI by proxy. Results. The modified short STAI showed moderate internal consistency and good construct validity in the age group seven to nine years. Conclusions. The results of this study support the use of the instrument for self-reports in children aged seven to nine years. Future research will explore the possibilities of also using this instrument for children with cognitive and communicative difficulties.

Speech-Generating Devices Used at Home by Children with Autism Spectrum Disorders: A Preliminary Assessment.

Three children diagnosed within the autism spectrum between the ages of 5 and 7 years at different stages of communication development were supplied with speech-generating devices (SGDs) in their homes. The parents were taught to introduce the SGDs into home routines and the effects were evaluated naturalistically. Videotapes recorded by the parents before and during SGD use were coded with respect to communication effectiveness, mode, role in turn taking, and engagement in activity. Findings varied among the children and activities, but an increased level of communication effectiveness was seen during SGD use for all children. Variations of outcome among the three children and factors of importance for effective SGD use in the homes of children with autism spectrum disorders are discussed.

Strategies that assist children with communicative disability during hospital stay Parents’ perceptions and ideas

There is a lack of research on the use of augmentative and alternative communication (AAC) in paediatric care, despite the fact that most children in need of AAC frequently need to visit hospitals and sometimes have to stay for long periods. The aim of this study was to investigate parents’ experiences of the hospital visits with their children with communicative disabilities and to collect their ideas about how to optimize communication in this situation. Ten parents who had children with communicative disability took part in three focus group interviews. The analysis had a retrospective qualitative content theory. In the qualitative content analysis of the focus group interviews, 4 categories and 17 subcategories were identified. Overall, the results highlighted the importance of enabling direct communication between the child and the staff during the hospital stay. Parents of children with communication difficulties highlighted the importance of listening to their children and understanding their needs during hospital care and that hospital staff are in need of more knowledge in communicative disability and AAC to accomplish this. Training programmes for health-care professionals should be established to facilitate these requirements and connect to the United Nations conventions. Hospitals should provide and use AAC/communicative support.

Autism, communication and use of a speech-generating device in different environments - a case study

Purpose – This paper aims to examine interaction patterns in two activities at home and one activity at school when a seven‐year‐old boy with autism and learning disabilities was supplied with a speech‐generating device (SGD).Design/methodology/approach – Activity‐based communication analysis (ACA) was used as the basis for analysing and discussing of communicative behaviours in video recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn‐taking and communicative form, function and effectiveness. Conversational topics were also analysed.Findings – Activity characteristics seemed important for the outcome. In the two more structured activities (story reading at home and morning circle at school), the child could use the SGD to communicate more effectively within the given frames. During mealtime at home, topic length increased and the instruction to the parents to also use the SGD resulted in positive changes in this activity. ACA hi...

Development and evaluation of a Minspeak™ application using Blissymbols: Experiences from two case studies

This article describes the development and structure of two Minspeak™ applications based on Blissymbols. The work was carried out in the form of case studies, and a qualitative evaluation of the two applications was completed. Based on previous findings in the literature and the results of this case study, we concluded that there are positive outcomes associated with the combining of Blissymbols and Minspeak. The study found that a phrase-based application was not sufficient for the communicatively advanced study participants, who required a wordbased vocabulary of their Blissymbol boards to maximize voice output communication aid (VOCA) use. These results, along with other findings relevant to the introduction of VOCAs, are discussed.

Evaluating the Impact of AAC Interventions in Reducing Hospitalization-related Stress: Challenges and Possibilities

Abstract Hospitalization is a stressful context for all children and their families, but especially for children with communication difficulties. Effective communication using augmentative and alternative communication (AAC) strategies can play a critical role in preparing and supporting everyone involved in such situations to have discussions that minimize insecurity, allow children to express their concerns, and so decrease negative stress and anxiety. However, there is a critical need to identify robust and reliable ways of evaluating the effectiveness of interventions that seek to achieve this aim. This research note illustrates some of the challenges and problems that require attention and suggests possible new research tools, for example, the use of physiological measures. The evaluation of an AAC intervention on a day surgery ward is described and used to illustrate one potential physiological measure for evaluating the impact of an intervention.

Gaze-controlled communication technology for children with severe multiple disabilities: Parents and professionals’ perception of gains, obstacles, and prerequisites

ABSTRACT The aim of this study was to explore parents’ and professionals’ thoughts of how a gaze-controlled computer can be beneficial to children with severe multiple disabilities. All systems were provided primarily for symbol-based communication, but were also used for other purposes such as play, leisure and school activities. A further aim was to investigate factors affecting usability, specifically for communication. The study used a qualitative approach, involving content analysis of semistructured interviews with the children’s key persons (N = 11). The analysis yielded three categories and twelve subcategories. There were gains for the children in terms of empowerment, social interaction, learning opportunities and efficient computer use. Inaccessibility, liability issues and technical failure were seen as obstacles, while the prerequisites included time, collaboration, stimulating content, know-how and opportunities. To sum up, this study suggests that gaze-controlled technology can provide children who have multiple disabilities involving severe motor dysfunction and communicative and cognitive problems with new opportunities to communicate, interact and perform activities independently, as long as conditions are right.

Using Picture and Text Schedules to Inform Children: Effects on Distress and Pain during Needle-Related Procedures in Nitrous Oxide Sedation.

During hospital visits, children often undergo examinations and treatments that may involve an experience of pain and distress that is also connected to the staffs treatment. The United Nations Convention on the Rights of Persons with Disability advocates the use of Universal Design. One way of implementing this idea within paediatric nursing is to increase the use of pictorial supports, and the few studies that have been published show promising results. The aim of this study was to do a comparison between two groups of children in regard to the pre- and postconditions of implementing an intervention including staff instruction and the use of pictorial support. The support consisted of a visual schedule with pictures and text, used both preparatory to and during the hospital visit. One hundred children aged 5–15 (50 children during the preinterventional data collection and 50 children postinterventionally) reported pain intensity and distress during needle-related procedures in nitrous oxide sedation. The results showed that the intervention had a positive effect in significantly lowering the level of preprocedural distress. The results showed that the pain intensity was also lowered however not reaching statistical significance. This confirms other positive research results on the use of visual supports within paediatric care, a topic that has to be further studied.