Janice Light

Toward a definition of communicative competence for individuals using augmentative and alternative communication systems

This paper proposes a definition of communicative competence for individuals using augmentative and alternative communication (AAC) systems. The proposed definition suggests that communicative competence is a relative and dynamic, interpersonal construct based on functionality of communication, adequacy of communication, and sufficiency of knowledge, judgement, and skill in four interrelated areas: linguistic competence, operational competence, social competence, and strategic competence. Linguistic and operational competencies refer to knowledge and skills in the use of the tools of communication; social and strategic competencies reflect functional knowledge and judgement in interaction. The paper urges future research to validate the proposed definition of communicative competence and suggests some implications for assessment and intervention in the AAC field.

Interaction involving individuals using augmentative and alternative communication systems: State of the art and future directions

This paper reviews the research which has considered the interaction patterns of individuals using augmentative and alternative communication (AAC) systems and highlights the major methodological issues and findings. Most noteworthy of the limitations to this research is the lack of reliable and socially valid measures to evaluate the outcomes of intervention in the field. Directions for future research are suggested. Specifically, it is proposed that future research is required to articulate a model of communicative competence for individuals using AAC systems. This model should consider both the personal perspective of the user and the broader social perspective, as determined by partners and by third party observers.

The iPad and Mobile Technology Revolution: Benefits and Challenges for Individuals who require Augmentative and Alternative Communication

Abstract The iPad and other mobile technologies provide powerful new tools to potentially enhance communication for individuals with developmental disabilities, acquired neurogenic disorders, and degenerative neurological conditions. These mobile technologies offer a number of potential benefits, including: (a) increased awareness and social acceptance of augmentative and alternative communication (AAC), (b) greater consumer empowerment in accessing AAC solutions, (c) increased adoption of AAC technologies, (d) greater functionality and interconnectivity, and (e) greater diffusion of AAC research and development. However, there remain a number of significant challenges that must be addressed if these benefits are to be fully realized: (a) to ensure the focus is on communication, not just technology, (b) to develop innovative models of AAC service delivery to ensure successful outcomes, (c) to ensure ease of access for all individuals who require AAC, and, (d) to maximize AAC solutions to support a wide variety of communication functions. There is an urgent need for effective collaboration among key stakeholders to support research and development activities, and to ensure the successful implementation of mobile technologies to enhance communication outcomes for individuals who require AAC and their families.

Communicative interaction between young nonspeaking physically disabled children and their primary caregivers: Part I—discourse patterns

The study analyzed the communicative interaction patterns of eight congenitally nonspeaking physically disabled children (between the ages of 4 and 6 years) and their primary caregivers. The dyads were videotaped in a free play situation for 20 minutes. The videotaped interaction was transcribed in its entirety and coded with respect to three categories of variables: discourse status, communicative function, and mode of communication. Findings related to the discourse patterns are reported in the present article; those related to the communicative functions and modes of communication will be reported in subsequent articles. The data were analyzed to reflect the frequencies of the specific communicative behaviors of the participants and the patterns of interactional sequences within the conversations. Results indicated that the interaction patterns were transactional in nature with caregivers and children clearly influencing each other in the course of the exchanges. The patterns, although synchronous, wer...

AAC technologies for young children with complex communication needs: State of the science and future research directions

Augmentative and alternative communication (AAC) technologies offer the potential to provide children who have complex communication needs with access to the magic and power of communication. This paper is intended to (a) summarize the research related to AAC technologies for young children who have complex communication needs; and (b) define priorities for future research to improve AAC technologies and interventions for children with complex communication needs. With the realization of improved AAC technologies, young children with complex communication needs will have better tools to maximize their development of communication, language, and literacy skills, and attain their full potential.

Home literacy experiences of preschoolers who use AAC systems and of their nondisabled peers

A survey was employed to compare the home literacy experiences of physically disabled preschoolers who use augmentative and alternative communication (AAC) systems to the experiences of their nondisabled (ND) peers. Questionnaires were completed by 15 parents of children in each group. Results of the survey indicated that the general reading and writing environments in the households of the two groups were similar: there were available a range of literacy materials and regular models of others reading and writing. Although both groups of children were reported to be interested in literacy activities, the children in the AAC group had less opportunity to use printed materials or to participate in writing/drawing activities. When engaged in story reading activities, the children in the AAC group seemed to be less involved in initiating and asking questions about the text than the children in the ND group. Parental priorities for their children differed somewhat between the two groups. The parents in the AAC...

Communicative interaction between young nonspeaking physically disabled children and their primary caregivers: Part II—communicative function

The study analyzed the communicative interaction patterns of eight congenitally nonspeaking physically disabled children (between the ages of 4 and 6 years) to determine the range and frequency patterns of their communicative functions in two separate contexts: in a 20-minute free play situation with their primary caregivers and in a series of structured play contexts with a clinician trained in augmentative communication. The childrens performances within the eliciting contexts were compared with their performances within the free play interaction with their primary caregivers. The children produced a limited range of communicative functions in the free play interactions with their caregivers. Most of the childrens communicative turns were yes/no responses (a mean of 39%) or provisions of specific information requested by the caregivers (a mean of 18.4%). The children seldom requested information, requested clarification, or produced social conventions (e.g., greetings, closings). The children produced...

The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who use AAC

A single subject, multiple probe design across participants was used to evaluate the impact of using aided AAC modeling to support multi-symbol message production. Five preschoolers (three who used voice output communication systems, two who used non-electronic communication boards) participated in the study. Aided AAC models were provided by pointing to two symbols on the childs aided AAC system and then providing a grammatically complete spoken model while engaging in play activities. Four of the five preschoolers learned to consistently produce multi-symbol messages; the fifth did not demonstrate consistent gains. The four preschoolers who met criterion all evidenced long-term use of symbol combinations and generalized use of symbol combinations to novel play routines. Results, clinical implications, and future research directions are discussed.

A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communication.

AIMS AND OBJECTIVES To systematically review the research regarding communication between nurses and patients with complex communication needs (CCN). The research was reviewed with respect to the following themes: (a) the importance of communication; (b) the barriers to effective communication; (c) the supports needed for effective communication; and (d) recommendations for improving the effectiveness of communication between nurses and patients with CCN. Augmentative and alternative communication (AAC) strategies that can be used by nurses to facilitate more effective communication with patients with CCN are discussed. BACKGROUND Effective nurse-patient communication is critical to efficient care provision. Difficulties in communication between nurses and patients arise when patients are unable to speak. This problem is further complicated because nurses typically receive little or no training in how to use AAC to communicate with patients with CCN. DESIGN Systematic review. METHOD This paper reviewed the published research focusing on the perspectives of nurses, patients with CCN and their caregivers regarding the challenges to effective communication between nurses and patients with CCN. Further, specific strategies (i.e., using AAC) that nurses can use to improve and facilitate communication with patients with CCN are provided. CONCLUSIONS Communication between nurses and patients is critical to providing and receiving quality care. Nurses and patients have reported concern and frustration when communication is not adequate. Using AAC strategies will help nurses and patients better communicate with each other when speech is not an option. RELEVANCE TO CLINICAL PRACTICE Communication with all patients is very important to the provision of quality nursing care. Communication cannot always be achieved using the speech modality. Nurses need to have tools and skills that will allow them to communicate with all of their patients whether or not they can speak.

Augmentative and alternative communication to support receptive and expressive communication for people with autism

In this article the authors discuss the use of augmentative and alternative communication (AAC) as used to enhance comprehension and expression of people with autism. A theoretical model for AAC assessment and intervention planning is presented. Application of the model is illustrated through a case report of a 6-year-old boy with autism who had severe expressive and receptive language impairments.