Melanie Fried-Oken

An initial vocabulary for nonspeaking preschool children based on developmental and environmental language sources

A single word composite vocabulary list is presented for preliterate, preschool children with severe expressive communication disabilities. The proposed lexicon was formed from single words collected from the following sources: the word lists generated by parents and clinicians of 15 young, nonspeaking children; language samples elicited from 30 normally developing peers matched for age and gender; and word lists generated by parents of the speaking children. Database comparisons for word commonality and frequency of occurrence were performed. There were only 2,114 word types identified from 36,000 total words generated. No one word appeared on every list. Ninety-four percent of the words generated by the 90 sources were repeated by at least two sources, indicating that the vocabulary pool for preschool augmentative and alternative communication (AAC) users may be a small, manageable set. The most common word, mom, appeared on 85 of the 90 vocabulary lists. Only 46 words were common to half of the vocabul...

Purposes of AAC device use for persons with ALS as reported by caregivers

Thirty-four informal caregivers who support 26 persons with ALS reported on AAC technology use. Each caregiver completed the Communication Device Use Checklist, a survey tool developed for this study based on Lights () classification of the purposes of social interaction (Augmentative and Alternative Communication, 4, 66 – 82). The checklist includes 17 purposes of communication and asks participants to judge importance, mode, and frequency of use for each purpose. Results show that the three communication purposes used most frequently and valued as important by caregivers involve regulating the behavior of others for basic needs and wants (getting needs met; giving instructions or directions to others; and clarifying needs). Consistent reports of use and frequency for the purposes of staying connected (social closeness) and discussing important issues (information transfer) indicate that AAC technology can assist the dyad in maintaining previous relationships. The face-to-face spontaneous conversation mode is used most frequently, despite the slow rate of production, the lack of permanence, and the demands on conversational partners during message generation. Clinical and research implications are discussed.

Access Interface Strategies

ABSTRACT Individuals who rely on augmentative and alternative communication (AAC) devices to support their communication often have physical movement challenges that require alternative methods of access. Technology that supports access, particularly for those with the most severe movement deficits, have expanded substantially over the years. The purposes of this article are to review the state of the science of access technologies that interface with augmentative and alternative communication devices and to propose a future research and development agenda that will enhance access options for people with limited movement capability due to developmental and acquired conditions.

RSVP keyboard: An EEG based typing interface

Humans need communication. The desire to communicate remains one of the primary issues for people with locked-in syndrome (LIS). While many assistive and augmentative communication systems that use various physiological signals are available commercially, the need is not satisfactorily met. Brain interfaces, in particular, those that utilize event related potentials (ERP) in electroencephalography (EEG) to detect the intent of a person noninvasively, are emerging as a promising communication interface to meet this need where existing options are insufficient. Existing brain interfaces for typing use many repetitions of the visual stimuli in order to increase accuracy at the cost of speed. However, speed is also crucial and is an integral portion of peer-to-peer communication; a message that is not delivered timely often looses its importance. Consequently, we utilize rapid serial visual presentation (RSVP) in conjunction with language models in order to assist letter selection during the brain-typing process with the final goal of developing a system that achieves high accuracy and speed simultaneously. This paper presents initial results from the RSVP Keyboard system that is under development. These initial results on healthy and locked-in subjects show that single-trial or few-trial accurate letter selection may be possible with the RSVP Keyboard paradigm.

Current and future AAC research considerations for adults with acquired cognitive and communication impairments

ABSTRACT Adults with acquired language impairments secondary to stroke, traumatic brain injury, and neurodegenerative diseases are candidates for communication supports outside of the traditional restoration-based approaches to intervention. Recent research proves repeatedly that augmentative and alternative communication (AAC) provides a means for participation, engagement, conversation, and message transfer when individuals can no longer expect full return of pre-morbid communication skills and that inclusion of communication supports should begin early. We discuss current research and future directions for integrated systems of technical supports that include low-technology, high tech, and partner-dependent strategies for adults with severe and chronic aphasia, cognitive-communication problems resulting from traumatic brain injuries, and primary progressive aphasia.

Feedback on AAC intervention from adults who are temporarily unable to speak

The purpose of this study was to assess through retrospective patient interviews the effectiveness of augmentative and alternative communication (AAC) interventions in acute care medical settings. ...

Noninvasive Brain–Computer Interfaces for Augmentative and Alternative Communication

Brain-computer interfaces (BCIs) promise to provide a novel access channel for assistive technologies, including augmentative and alternative communication (AAC) systems, to people with severe speech and physical impairments (SSPI). Research on the subject has been accelerating significantly in the last decade and the research community took great strides toward making BCI-AAC a practical reality to individuals with SSPI. Nevertheless, the end goal has still not been reached and there is much work to be done to produce real-world-worthy systems that can be comfortably, conveniently, and reliably used by individuals with SSPI with help from their families and care givers who will need to maintain, setup, and debug the systems at home. This paper reviews reports in the BCI field that aim at AAC as the application domain with a consideration on both technical and clinical aspects.

AAC aphasiology: partnership for future research

This paper explores issues related to augmentative and alternative communication (AAC) interventions for aphasia. Recent literature on functional communication treatment is reviewed with a goal of clarifying how aphasiologists see AAC fitting into aphasia treatment. AAC assessment models are proposed as a method for achieving the objectives of functional communication treatment. Recent AAC and aphasia treatment efficacy studies are critically examined for their use of accepted AAC assessment models. Recommendations address the need to incorporate AAC assessment when addressing questions of effectiveness, efficiency, and generalization in AAC aphasiology research.

Intelligibility of modifications to dysarthric speech

Dysarthria is a motor speech impairment affecting millions of people. Dysarthric speech can be far less intelligible than that of non-dysarthric speakers, causing significant communication difficulties. The goal of our work is to understand the effect that certain modifications have on the intelligibility of dysarthric speech. These modifications are designed to identify aspects of the speech signal or signal processing that may be especially relevant to the effectiveness of a system that transforms dysarthric speech to improve its intelligibility. A result of this study is that dysarthric speech can, in the best case, be modified only at the short-term spectral level to improve intelligibility from 68% to 87%. A baseline transformation system using standard technology, however, does not show improvement in intelligibility. Prosody also has a significant (p<0.05) effect on intelligibility.

Brain–Computer Interface With Language Model–Electroencephalography Fusion for Locked-In Syndrome

Background. Some noninvasive brain–computer interface (BCI) systems are currently available for locked-in syndrome (LIS) but none have incorporated a statistical language model during text generation. Objective. To begin to address the communication needs of individuals with LIS using a noninvasive BCI that involves rapid serial visual presentation (RSVP) of symbols and a unique classifier with electroencephalography (EEG) and language model fusion. Methods. The RSVP Keyboard was developed with several unique features. Individual letters are presented at 2.5 per second. Computer classification of letters as targets or nontargets based on EEG is performed using machine learning that incorporates a language model for letter prediction via Bayesian fusion enabling targets to be presented only 1 to 4 times. Nine participants with LIS and 9 healthy controls were enrolled. After screening, subjects first calibrated the system, and then completed a series of balanced word generation mastery tasks that were designed with 5 incremental levels of difficulty, which increased by selecting phrases for which the utility of the language model decreased naturally. Results. Six participants with LIS and 9 controls completed the experiment. All LIS participants successfully mastered spelling at level 1 and one subject achieved level 5. Six of 9 control participants achieved level 5. Conclusions. Individuals who have incomplete LIS may benefit from an EEG-based BCI system, which relies on EEG classification and a statistical language model. Steps to further improve the system are discussed.