Janice Murray

Development of The Viking Speech Scale to classify the speech of children with cerebral palsy

Surveillance registers monitor the prevalence of cerebral palsy and the severity of resulting impairments across time and place. The motor disorders of cerebral palsy can affect childrens speech production and limit their intelligibility. We describe the development of a scale to classify childrens speech performance for use in cerebral palsy surveillance registers, and its reliability across raters and across time. Speech and language therapists, other healthcare professionals and parents classified the speech of 139 children with cerebral palsy (85 boys, 54 girls; mean age 6.03 years, SD 1.09) from observation and previous knowledge of the children. Another group of health professionals rated childrens speech from information in their medical notes. With the exception of parents, raters reclassified childrens speech at least four weeks after their initial classification. Raters were asked to rate how easy the scale was to use and how well the scale described the childs speech production using Likert scales. Inter-rater reliability was moderate to substantial (k>.58 for all comparisons). Test-retest reliability was substantial to almost perfect for all groups (k>.68). Over 74% of raters found the scale easy or very easy to use; 66% of parents and over 70% of health care professionals judged the scale to describe childrens speech well or very well. We conclude that the Viking Speech Scale is a reliable tool to describe the speech performance of children with cerebral palsy, which can be applied through direct observation of children or through case note review.

‘Happy and excited’: Perceptions of using digital technology and social media by young people who use augmentative and alternative communication:

Young people are using digital technology and online social media within their everyday lives to enrich their social relationships. The UK government believes that using digital technology can improve social inclusion. One well-recognized outcome measure for establishing social inclusion is to examine opportunities for self-determination. Individuals with physical disabilities and complex communication needs who use forms of augmentative and alternative communication (AAC) have lower social participation opportunities. The integration of mainstream digital technology into high-tech forms of AAC (voice output communication aids), and the recent appearance of voice output applications, or ‘apps’, on Apple and Android products, has provided increased opportunities for people who use AAC to engage with digital technology. Research exploring this area, especially in regard to online social media, with people who use AAC is extremely limited, and a specific gap for self-reported experiences exists within the UK. This article describes qualitative, interview-based, grounded theory research with 25 adolescents and young adults who use AAC about their use of digital technology and online social media. The data presented here are part of a larger study, and the findings within this article suggest that participants have a desire to use the internet and online social media as it is perceived to increase opportunities for self-determination and self-representation whilst enriching friendships. The wide diversity of literacy and language skills amongst participants, as well as accessibility challenges, mean collaborating with others and receiving technical support from educational settings, families and friends are vital.

Emergence of working memory in children using aided communication

Purpose – Working memory (WM) is a key component of effective and efficient communication in typical communicators, with, potentially, even greater significance for those who benefit from augmentative communication. This study aims to explore the emergence of WM strategies in children with complex communication needs who may be reliant on aided communication strategies.Design/methodology/approach – A quasi‐experimental repeated measures, multi‐factorial research design, comparing 30 children with complex communication needs (CCN) aged three to six years and 30 age‐matched typically developing peers. Picture stimuli representing verbs and adjectives in three categories: control words, long words and phonologically similar words are presented visually or silently in sequences of increasing length to establish each participants memory span.Findings – Articulatory rehearsal does not appear to be used as a memory strategy with verb material. With adjective material, there is limited evidence of emerging artic...

A grounded theory of Internet and social media use by young people who use augmentative and alternative communication (AAC)

Abstract Purpose: This paper presents a conceptual grounded theory for how young people with a diagnosis of cerebral palsy who use augmentative and alternative communication (AAC), perceive using the Internet and social media. The aims of the research were to understand and contextualise their perceptions of access and use and explore implications for self-representation and social participation; to date literature on this topic is limited. Method: A constructivist grounded theory research approach concurrently collected and analysed interview data from 25 participants (aged 14–24 years) who use AAC and additional sources. Results: A conceptual grounded theory was developed around an emergent core category that showed young people who use AAC have a clear desire to use the Internet and social media. This was underpinned by eight supporting categories: reported use, described support, online challenges, access technology, speech generating device (SGD) issues, self-determination, self-representation and online social ties. Conclusion: The conceptual grounded theory supports understanding of facilitators and challenges to use of the Internet and social media by young people with a diagnosis of cerebral palsy who use AAC. The grounded theory illustrates how the desire to use the Internet and social media is based upon perceived benefits for enriching social relationships and enhancing opportunities for self-representation and self-determination that are synonymous with identified antecedents for community-based social inclusion. Some of the participants are engaging with the Internet and social media through collaborative practice and the implications for how this phenomenon may impact on orthographic literacy and the personal care workforce are raised. Implications for Rehabilitation This research has created a conceptual grounded theory framework to support a deeper understanding of the perspectives of young people (with a diagnosis of cerebral palsy) who use augmentative and alternative communication (AAC) in relation to engaging with the Internet and social media. The conceptual framework illustrates factors that facilitate and/or challenge use of the Internet and social media and can be used to guide future research and funding organisations. The core message of the grounded theory is that the young people who use AAC have a desire to engage with the Internet and social media due to perceived benefits for enriching social relationships and enhancing opportunities for self-representation and self-determination. The paper illustrates how these digital communication benefits are synonymous with identified antecedents for perceptions of community-based social inclusion. Participants describe collaborating with others to use the Internet and social media which may have implications for the development of orthographic literacy and the personal care workforce.

Cognitive and language acquisition in typical and aided language learning: A review of recent evidence from an aided communication perspective

Augmentative and alternative communication (AAC) is a discipline that has seen recent developments as a consequence of the worldwide technological revolution. Children with complex communication needs, who benefit from such systems, are now afforded an opportunity to develop independent communication skills. The aim of this paper is to review theory and research relating to language acquisition in typical and aided language learning. Becoming a skilled aided communicator takes many years, but as this review demonstrates, little is known about the processes of skill development. In particular there is limited research evidence to support current language and communication intervention strategies typically used by practitioners working in the field of AAC. This review synthesizes current knowledge within an evidence-based framework and provides a summary to support practice and future research activity.

Parachute Without a Ripcord: The Skydive of Communication Interaction

Identifying and rating the outcomes of an intervention is not a new concept, but has gained impetus and currency with the emergence of evidence-based practice to support clinical decision making. In this paper, we present a metaphor as a unifying framework for the many different goals and outcomes that may come into focus across extended interventions with individuals who use aided communication. The metaphor is that of skydiving. We explore the value of this metaphor in understanding outcome measures for interventions, using analysis of interview data collected with adults who have used high-tech aided communication devices over many years.

Using video-reflexive ethnography and simulation-based education to explore patient management and error recognition by pre-registration physiotherapists

BackgroundUpon graduation, physiotherapists are required to manage clinical caseloads involving deteriorating patients with complex conditions. In particular, emergency on-call physiotherapists are required to provide respiratory/cardio-respiratory/cardiothoracic physiotherapy, out of normal working hours, without senior physiotherapist support. To optimise patient safety, physiotherapists are required to function within complex clinical environments, drawing on their knowledge and skills (technical and non-technical), maintaining situational awareness and filtering unwanted stimuli from the environment. Prior to this study, the extent to which final-year physiotherapy students were able to manage an acutely deteriorating patient in a simulation context and recognise errors in their own practice was unknown.MethodsA focused video-reflexive ethnography study was undertaken to explore behaviours, error recognition abilities and personal experiences of 21 final-year (pre-registration) physiotherapy students from one higher education institution. Social constructivism and complexity theoretical perspectives informed the methodological design of the study. Video and thematic analysis of 12 simulation scenarios and video-reflexive interviews were undertaken.ResultsParticipants worked within the professional standards of physiotherapy practice expected of entry-level physiotherapists. Students reflected appropriate responses to their own and others’ actions in the midst of uncertainty of the situation and physiological disturbances that unfolded during the scenario. However, they demonstrated a limited independent ability to recognise errors. Latent errors, active failures, error-producing factors and a series of effective defences to mitigate errors were identified through video analysis. Perceived influential factors affecting student performance within the scenario were attributed to aspects of academic and placement learning and the completion of a voluntary acute illness management course. The perceived value of the simulation scenario was enhanced by the opportunity to review their own simulation video with realism afforded by the scenario design.ConclusionsThis study presents a unique insight into the experiences, skills, attitudes, behaviours and error recognition abilities of pre-registration physiotherapy students managing an acutely deteriorating patient in a simulation context. Findings of this research provide valuable insights to inform future research regarding physiotherapy practice, integration of educational methods to augment patient safety awareness and participant-led innovations in safe healthcare practice.

Communicating the unknown: descriptions of pictured scenes and events presented on video by children and adolescents using aided communication and their peers using natural speech

Abstract The facility to describe scenes and events is important in everyday communication, but little is known about the description skills and strategies of young people using aided communication. This article explores how 81 children and adolescents using aided communication and 56 peers using natural speech, aged 5–15 years, described pictured scenes and events presented on video to a partner who had no prior knowledge of the content. The group who used aided communication took longer and included fewer elements in their descriptions than the reference group; however, the groups did not differ in their use of irrelevant or incorrect elements, suggesting that both groups stayed on topic. Measures related to aided message efficiency correlated significantly with measures of spoken language comprehension. There were no significant differences between groups for their descriptions of pictured scenes and video events. Analyses showed both unpredicted group similarities and predictable differences, suggesting key components for future research consideration.

Distance and proximity: research on social media connections in the field of communication disability

Social media connects people in digital spaces, affording opportunities for personal, local and global communication. For some people with severe communication disabilities secondary to lifelong or acquired health conditions social media is a usual part of everyday communication, and may provide a welcome reprieve from the usual ‘‘temporal imperative’’ that ‘‘dominates faceto-face communication’’ [1]. The expressions possible within social media also enable multi-modal communication using text, pictures, and videos to augment or replace face-to-face interactions, and this may be particularly useful to people who cannot rely on natural speech to communicate. Social media and virtual worlds evoke feelings of both distance and proximity [2] between people who share online spaces, and this is reflected in the current field of research on the use of social media by people with communication disabilities. With limited research to date, we are distant from a full appreciation and understanding of how people with communication disabilities experience and participate in online forums, or the supports that are needed in encountering barriers to online participation. Adults with communication disabilities experience social exclusion, isolation, and loneliness, and also lack access to information, have limited social networks, and are often dependent upon direct support workers or family members for access to information. Despite social media offering a ‘‘level playing field’’ and removing the need for the use of spoken language, the uptake and use of social media by people with communication disabilities is at lower rates than in the general population [3]. While governments and community organizations increasingly turn to social media to convey information to service users and the public, people with communication disabilities experience many barriers to participation online, are underrepresented in the social media [3], and their use of social media is under-researched [4]. And yet, with this special issue on Social Media and Communication Disability and the forward research agenda of these and other researchers, we are also now closer in our understanding of how people with communication disabilities and those who work with them view and experience social media forums. This collection of evidence shows that Twitter [5–7], Facebook [8,9], Second Life [10,11], and many other platforms [6,7,8,12], including Instagram , YouTube , and Skype offer people with communication disabilities and those who work with them valuable connections with friends, celebrities, the general public, other people with communication disabilities, and service providers. People with acquired [7,12], or lifelong [6,8,9,11], communication disabilities may find social media to be a valuable medium for inclusion, support, and connection; and one that relieves some difficulties associated with face-to-face communication and enhances interactions in the real world. Documented herein are many ways in which people with communication disability can and might use social media, for a range of purposes and with different styles. As Wolf, an adult with autism, explained of Second Life: ‘‘friends I make here help me refine my models of friendship and social interaction in RL [Real Life].’’ [11]. We look forward to discovering how studies contained in this special issue inform or influence ongoing social media research, policies, and practices to increase social media participation by people with communication disabilities worldwide.

Constructing narratives to describe video events using aided communication

Abstract Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be lacking. This study reports on the analysis of narratives generated in interactions involving aided communication in response to short, silent, video vignettes depicting events with unintended or unexpected consequences. Two measures were applied to the data: the Narrative Scoring Scheme and the Narrative Analysis Profile. A total of 15 participants who used aided communication interacted with three different communication partners (peers, parents, professionals) relaying narratives about three video events. Their narratives were evaluated with reference to narratives of 15 peers with typical development in response to the same short videos and to the narratives that were interpreted by their communication partners. Overall, the narratives generated using aided communication were shorter and less complete than those of the speaking peers, but they incorporated many similar elements. Topic maintenance and inclusion of scene-setting elements were consistent strengths. Communication partners offered rich interpretations of aided narratives. Relative to the aided narratives, these interpreted narratives were typically structurally more complete and cohesive and many incorporated more elaborated semantic content. The data reinforce the robust value of narratives in interaction and their potential for showcasing language and communication achievements in aided communication.