Ulrika Ferm

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.

Semantic trouble sources and their repair in conversations affected by Parkinson's disease

Background It is known that dysarthria arising from Parkinsons disease may affect intelligibility in conversational interaction. Research has also shown that Parkinsons disease may affect cognition and cause word-retrieval difficulties and pragmatic problems in the use of language. However, it is not known whether or how these problems become manifest in everyday conversations or how conversation partners handle such problems. Aims To describe the pragmatic problems related to the use of words that occur in everyday conversational interaction in dyads including an individual with Parkinsons disease, and to explore how interactants in conversation handle the problems to re-establish mutual understanding. Methods & Procedures Twelve video-recorded everyday conversations involving three couples where one of the individuals had Parkinsons disease were included in the study. All instances of other-initiated repair following a contribution from the people with Parkinsons disease were analysed. Those instances involving a trouble source relating to the use of words were analysed with a qualitative interaction analysis based on the principles of conversation analysis. Outcomes & Results In 70% of the instances of other-initiated repair the trouble source could be related to the semantic content produced by the individual with Parkinsons disease. The problematic contributions were typically characterized by more or less explicit symptoms of word search or use of atypical wording. The conversation partners completed the repair work collaboratively, but typically the non-impaired individual made a rephrasing or provided a suggestion for what the intended meaning had been. Conclusions & Implications In clinical work with people with Parkinsons disease and their conversation partners it is important to establish what type of trouble sources occur in conversations in a specific dyad. It may often be necessary to look beyond intelligibility and into aspects of pragmatics to understand more fully the impact of Parkinsons disease on everyday conversational interaction.

Problematic topic transitions in dysarthric conversation

Abstract Purpose: This study examined the nature of topic transition problems associated with acquired progressive dysarthric speech in the everyday conversation of people with motor neurone disease. Method: Using conversation analytic methods, a video collection of five naturally occurring problematic topic transitions was identified, transcribed and analysed. These were extracted from a main collection of over 200 other-initiated repair sequences and a sub-set of 15 problematic topic transition sequences. The sequences were analysed with reference to how the participants both identified and resolved the problems. Result: Analysis revealed that topic transition by people with dysarthria can prove problematic. Conversation partners may find transitions problematic not only because of speech intelligibility but also because of a sequential disjuncture between the dysarthric speech turn and whatever topic has come prior. In addition the treatment of problematic topic transition as a complaint reveals the potential vulnerability of people with dysarthria to judgements of competence. Conclusion: These findings have implications for how dysarthria is conceptualized and how specific actions in conversation, such as topic transition, might be suitable targets for clinical intervention.

Text messaging with pictures and speech synthesis for adolescents and adults with cognitive and communicative disabilities – professionals' views about user satisfaction and participation

BACKGROUND: Complex communication needs and problems with accessibility may restrict people who use augmentative and alternative communication (AAC) to communicate on the phone. New technology is promising. People with limited skills in reading and writing can communicate on the phone by using symbols representing words or phrases. METHODS: This interview study examines professionals’ views of satisfaction, participation and involvement in daily life in seven individuals with cognitive and communicative disabilities who tried text messaging with picture symbols and speech synthesis in smartphones. The users’ experiences of text-messaging are reported elsewhere. RESULTS: The results suggest that texting with picture symbols and speech can increase independence and participation in adults with cognitive and communicative disabilities. Results also point to the necessity of individual assessments. Important factors for user satisfaction include products which can be adapted according to the individual’s needs. Speech synthesis, user friendly lay-out and functions making devices easy to handle are necessary. CONCLUSIONS: This study is promising and informative for professionals working with communication technology. It supports enabling of texting today as well as future development of smartphone applications for persons with cognitive and communicative disabilities.

Participation and Enjoyment in Play with a Robot between Children with Cerebral Palsy who use AAC and their Peers

Abstract This study explores children with complex communication needs, their peers and adult support persons in play with the talking and moving robot LekBot. Two triads were filmed playing with LekBot at pre-school. LekBot was developed to facilitate independent and enjoyable play on equal terms for children with significant communication disabilities and their peers. Using Conversation Analysis, participatory symmetry and enjoyment were investigated in relation to spoken and gestural communication, embodied stance, gaze, and affective display. Data originated from three video-recorded sessions that were approximately 2 hours long. Four different interaction situations were identified and explored: Participatory Asymmetry, Adult Facilitation, Greater Participatory Symmetry and Creativity, and Turn-taking and Enjoyable Play with LekBot. Neither participatory symmetry nor enjoyment were easily achieved in the play sessions and may require considerable effort, including adult involvement, but creative, spontaneous and highly enjoyable play, correlating with participatory symmetry to various degrees, was observed in a few instances. The findings are discussed with regard to play, AAC and the future development of robots to facilitate play.

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.

Digital communication support and Alzheimer’s disease

Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer’s disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.

Patterns of communicative interaction between a child with severe speech and physical impairments and her caregiver during a mealtime activity

Abstract Background Interaction between caregivers and children with severe impairments is closely related to the demands of daily activities. This study examines the relationship between interaction and the routine mealtime activity at home. Method Patterns of interaction between a child (aged 6 years and 6 months) with severe speech and physical impairments and her caregiver (focus dyad) and a child without impairments (aged 6 years and 6 months) and her caregiver (comparison dyad) were analysed using video recordings and activity-based communication analysis. Results The focus dyads interaction was unaided. The dyad did not use the Blissymbol board but communicated using words, vocalisations, word approximations, and body communication. Interaction in the focus dyad included relatively few pauses and frequent interchanges of short and sometimes simultaneous communicative contributions. Strong relations between patterns of interaction and immediate activity management goals such as assisting with eating, eating and drinking were found and compared for the two dyads. Results were discussed with regard to child development and communication intervention. Conclusions The focus dyad showed interactive efficiency and the fulfilment of goals relating to basic understanding and closeness, but mainly with regard to immediate mealtime issues. The comparison child and caregiver were more independent in the activity which made it possible for them to reach more extensive, and from a child perspective, age-adequate goals than the focus dyad.

“That is how I speak nowadays” – experiences of remote communication among persons with communicative and cognitive disabilities

Abstract Purpose: The aim of the study was to explore the experiences of remote communication (i.e., communication between persons who are not in the same place) among people with communicative and cognitive disabilities. Materials and methods: Eleven adolescents and adults were interviewed using Talking Mats and interview data was analyzed qualitatively with systematic text condensation. Results: The use of remote communication varies between the participants. The participants also value remote communication differently. Having the possibility to choose between different means of remote communication is important. Being able to determine whether to communicate independently or with support from another person is also valued as relevant. Strategies used to manage remote communication include facilitating for the communication partner and preparing for future communication situations. Those who are able to use writing as an alternative to problematic spoken remote communication like phone calls, for example by using chat or text messaging. Decisions regarding means of communication and human support relate to the concept of self-determination. Conclusion: Better access to remote communication trough assistive technology such as speech synthesis and picture symbols would make remote communication easier and facilitate participation for people with communicative and cognitive disabilities. Implications for rehabilitation People with communicative and cognitive disabilities face challenges with access to remote communication. Access to communication technology including remote communication is important for self-determination, for personal safety and for overall participation in society. Communication technology should be considered in the rehabilitation process and training is crucial. To understand the possible benefits of remote communication, people with communicative and cognitive disability need to get the possibility to practice. Professionals play a key role in the assessment and intervention of remote communication for their patients.