In dialogue with the body: a phenomenological exploration of the interrelationship between people who use AAC and their AAC devices.

This paper explores the intricate relationship between people who use Augmentative and Alternative Communication (AAC) and their AAC devices. Drawing upon insights from phenomenology, I conducted a modified systematic review to explore the enduring phenomenon of low AAC device adoption and as a means to unravel the moments of embodiment and disembodiment experienced by people who use AAC with their devices. The discussion begins with an introduction to phenomenology as a philosophical inquiry and the guiding principles I employed to explore the phenomenon, namely, parte extra parte and object embodiment. Subsequently, I analyze the hegemony of a device-centric approach within the AAC landscape and delve into the first-person experiences of people who use AAC in living with their devices. Lastly, I discuss the embodiment and disembodiment of people who use AAC with their devices, conceptualize the interrelationship between them, and provide future directions for a more holistic and participatory AAC development and investigation that centers on the lived experiences of people who use AAC.

Frequency of Hebrew word usage by children with intellectual and developmental disabilities: implications for AAC core vocabulary.

Appropriate vocabulary selection for augmentative and alternative communication (AAC) intervention is crucial to support communication and language development in children with intellectual and developmental disabilities (IDD). Core vocabulary lists are commonly used to guide this process, and there is a need for language-specific consideration. This paper aimed to develop a wordlist for selecting the core vocabulary for AAC intervention for young Hebrew-speaking children with IDD. Five children (age 3;5-8;4) were audio-recorded in naturalistic interactions with an interviewer and family members. Using Levy's clinical corpus in the Child Language Data Exchange System (CHILDES) and Child Phonology Analyzer (CPA) tools and preestablished codes, wordlists with usage frequencies were extracted and coded for lexeme, lexical categories and functions or content. The percentages of the 20, 50, 100, and 200 most frequent lexemes were calculated for each child and for the five children combined. The top 200 most frequently used lexemes constituted 85% of the composite lexicon. A comparison was made between this study list and a previous list derived from language samples of typically developing (TD). Lexemes representing function words dominated, albeit with a slight preference for content words in children with IDD. Among the content words, children with IDD used more adverbs, while children with TD used more verbs. Implications for AAC core vocabulary are discussed.

Successful use of an eye gaze AAC communication board by a young adult with advanced Sanfilippo Syndrome (MPS IIIA): Case report.

Sanfilippo syndrome (Mucopolysaccharidosis Type III or MPS III) is a family of rare, lysosomal disorders characterized by progressive cognitive and motor deterioration. Even though individuals with MPS III present with complex communication needs, research regarding augmentative and alternative communication (AAC) in this population is scarce. While life expectancy for individuals with MPS IIIA typically does not exceed 20 years of age, this case report involves a 22-year-old adult with postregression MPS IIIA. Prior to this study, the participant could not communicate using speech and only responded to yes/no questions using eye blink responses. The participant was given a low-tech AAC system utilizing eye gaze so that she could respond to a variety of caregiver questions and take conversational turns. The following communication outcomes were measured during each session in which caregivers used the AAC system: number of eye gaze responses, total number of responses (using any means), the percent of responses to questions asked, and the total count of expressive vocabulary words available to the participant with the AAC system. Increases were observed in the number of eye gaze responses per session and in the expressive vocabulary accessible via the eye gaze board. A higher percentage of responses given caregiver questions was noted for the intervention sessions (71%) compared to the baseline sessions (55%). There were also qualitative changes characterized by the types of questions the participant could respond to during conversational exchanges. Despite the progression of MPS IIIA, the results suggest that use of the eye gaze board resulted in quantitative and qualitative changes in functional communication. This case report provides preliminary evidence that AAC can improve communication in a young adult with postregression MPS IIIA.

Successful use of an eye gaze AAC communication board by a young adult with advanced Sanfilippo Syndrome (MPS IIIA): Case Report This article reports a case of a 22-year-old woman who was diagnosed with mucopolysaccharidosis type III (MPS III) or Sanfilippo Syndrome. MPS III is a rare lysosomal disorder characterized by progressive cognitive and motor deterioration. Children with MPS III experience regression in speech and communication skills and speech is typically lost by age eight years. AAC (Augmentative and Alternative Communication) are systems or devices that can be used by individuals with limited to no speech to aid or supplement communication. Even though individuals with MPS III have significant impairment in communication and could potentially benefit from AAC, research regarding the use of AAC (Augmentative and Alternative Communication) by this population is scarce. In this case, an eye-gaze AAC system was introduced to a young adult with postregression MPS IIIA who is well beyond average life expectancy for this disease. Despite the progression of MPS IIIA and complicating medical issues, there were quantitative and qualitative changes and improvement in this woman's functional communication after the eye gaze board was introduced. This case study provides preliminary evidence that AAC use can potentially improve communication in individuals with postregression MPS IIIA.

The role of the body in SGD-mediated interactions.

Most research about augmentative and alternative communication (AAC) has focused on improving use of and access to speech generating devices (SGDs). However, many adults with significant physical and developmental disabilities express a preference for unaided, embodied forms of communication. This study used conversation analysis (CA) techniques to analyze the forms and functions of embodied communication that occurred during interactions between a young man who used unaided, embodied communication and an SGD to communicate with a familiar communication partner. Close analysis revealed that embodied resources were required for both unaided and aided forms of communication. Furthermore, both participants used their bodies to establish interactional spaces with different focal points during interaction, which placed different demands on the aided speaker. Unfortunately, when the SGD was the focal point, problematic demands were placed on the aided speaker, which in turn resulted in increased embodied effort on his part. The forms and functions of the body, differences in the participants' interactions when communication did and did not involve the SGD, and implications for research and practice are all reported and discussed.

Introducing a self-managed early communication resource for parents - A mixed methods feasibility study of the Swedish "ComAlong online".

BACKGROUND: Web-based programmes offer parents of children with communication difficulties promising access to parent-mediated, early interventions. However, empirical evaluations of such programmes are limited. This study focused on parents and used mixed methods to examine the feasibility of ComAlong online. METHODS: ComAlong online is a Swedish, self-managed web-resource teaching parents supportive strategies to promote child communication. Data of different types were collected from a total of 71 parents: ten individual parent interviews, 21 pre-questionnaires and 10 post-questionnaires, and finally 50 anonymous digital evaluation surveys. Descriptive statistics and deductive qualitative content analysis were used. RESULTS: Findings indicate that parents perceived improved child communication and own competence after using the ComAlong online. The most valued parts included podcasts with experts and videos of parent-child interaction. Parents reported that the resource was easy to use, but they wanted to have gained access to the resource when the child was younger. Suggestions for changes included adding a chat function with experts, a parent net forum, and the possibility of creating personalised playlists of videos and podcasts. Evaluation of the research process revealed difficulties in recruiting parents from local child healthcare services and parents of children not yet with a diagnosis. CONCLUSIONS: This study supports the potential for self-managed, web-based resources to disseminate evidence-based parent training for supporting early communication development. Importantly, parents lack individual guidance from experts and contact with other parents. Also, measures need to be made to disseminate the resources within local child healthcare services.

Web-based service delivery programmes and digital technology offer promising access to parent-mediated interventions to support children with communication difficulties, but the empirical evaluations of such programmes are limited.Parents perceive web-based, self-managed resources teaching supportive strategies to promote child communication, in this case ComAlong online, easy to use, and such resources may improve child communication and increase competence in parents.Parents want to have access to web-based communication resources, such as ComAlong Online, early in the child's life, and a chat function with experts, a parent forum, and the possibility of creating personalised playlists of videos and podcasts are desired functionality.

What stakeholders with neurodegenerative conditions value about speech and accuracy in development of BCI systems for communication.

This research examined values of individuals with neurodegenerative conditions about features of speed and accuracy as they consider potential use of augmentative and alternative communication brain-computer interface systems (AAC-BCI). Sixty-six individuals with neurodegenerative disease responded to prompts about six hypothetical ethical vignettes. Data were analyzed with qualitative content analysis. The following themes emerged. (1) Disease progression may contribute to the trade-off between speed and accuracy with AAC-BCI systems. (2) Individual experiences with technology use inform their views about the speed-accuracy trade-off. (3) There is a range of views about how slow or inaccurate communication may impact relationships, the integrity of a message, and quality of life. (4) Design solutions are proposed to address trade-offs in AAC-BCI systems. With the rapid development of AAC-BCI systems, user-centered design must integrate values of potential end-users illustrating that context, partner, message, and environment impact the prioritization of speed or accuracy in any communication exchange.

QuickPic AAC: An AI-Based Application to Enable Just-in-Time Generation of Topic-Specific Displays for Persons Who Are Minimally Speaking.

As artificial intelligence (AI) makes significant headway in various arenas, the field of speech-language pathology is at the precipice of experiencing a transformative shift towards automation. This study introduces QuickPic AAC, an AI-driven application designed to generate topic-specific displays from photographs in a "just-in-time" manner. Using QuickPic AAC, this study aimed to (a) determine which of two AI algorithms (NLG-AAC and GPT-3.5) results in greater specificity of vocabulary (i.e., percentage of vocabulary kept/deleted by clinician relative to vocabulary generated by QuickPic AAC; percentage of vocabulary modified); and to (b) evaluate perceived usability of QuickPic AAC among practicing speech-language pathologists. Results revealed that the GPT-3.5 algorithm consistently resulted in greater specificity of vocabulary and that speech-language pathologists expressed high user satisfaction for the QuickPic AAC application. These results support continued study of the implementation of QuickPic AAC in clinical practice and demonstrate the possibility of utilizing topic-specific displays as just-in-time supports.

Meeting the Needs of People With Severe Quadriplegia in the 21st Century: The Case for Implanted Brain-Computer Interfaces.

BACKGROUND: In recent decades, there has been a widespread adoption of digital devices among the non-disabled population. The pervasive integration of digital devices has revolutionized how the majority of the population manages daily activities. Most of us now depend on digital platforms and services to conduct activities across the domains of communication, finance, healthcare, and work. However, a clear disparity exists for people who live with severe quadriplegia, who largely lack access to tools that would enable them to perform daily tasks digitally and communicate effectively with their environment. OBJECTIVES: The purpose of this piece is to (i) highlight the unmet needs of people with severe quadriplegia (including cases for medical necessity and perspectives from the community), (ii) present the current landscape of assistive technology for people with severe quadriplegia, (iii) make the case for implantable BCIs (how they address needs and why they are a good solution relative to other assistive technologies), and (iv) present future directions. RESULTS: There are technologies that are currently available to this population, but these technologies are certainly not usable with the same level of ease, efficiency, or autonomy as what has been designed for the non-disabled community. This hinders the ability of people with severe quadriplegia to achieve digital autonomy, perpetuating social isolation and limiting the expression of needs, opinions, and preferences. CONCLUSION: Most importantly, the gap in digital equality fundamentally undermines the basic human rights of people with severe quadriplegia.

Smart Predict: adding partner-suggested vocabulary to increase efficiency in a dual tablet AAC typing application.

Smart Predict is a novel two-tablet application developed to improve conversational efficiency for people who use augmentative and alternative communication (AAC) devices. The Smart Predict system consists of two distinct applications that were built for use with two Android tablets and/or phones with Bluetooth® capability. One application is referred to as the AAC User app and the second application is called the Partner app. Smart Predict integrates vocabulary supplementation from communication partners in real-time while persons who rely on AAC generate text and maintain full control to choose words within a word prediction line. Using single-case research designs with adapted alternating treatments under two counterbalanced treatment conditions (AAC User app alone versus AAC User app + Partner app), we examined message efficiency with persons who rely on switch scanning for on-screen keyboards. User experience questionnaires were administered to determine satisfaction and workload, and to provide feedback for future development efforts. Three adults with complex communication needs and motor impairments conversed with research staff about fourteen movie trailers. Characters per minute and switch selections per character produced by the person with complex communication needs and motor impairments were measured during 15-minute interviews to represent communication speed and effort. Results indicate that message efficiency increased with the dual-tablet Smart Predict, indicating faster message generation with the vocabulary supplementation system. User satisfaction increased and perceived effort decreased under the Smart Predict conditions. Given these results within a research and development framework, the Smart Predict concept is a viable feature that could be considered within smart AAC technologies.

The effect of AAC training programs on professionals' knowledge, skills and self-efficacy in AAC: a scoping review.

Since effective and successful AAC service delivery relies on the knowledge and competence of professionals in the field of AAC, sufficient training in AAC will equip professionals to provide quality AAC service delivery. However, many professionals lack training in AAC and structured opportunities for professional development are sorely needed. As there is no consensus on the amount, mode of delivery and content of AAC training, the purpose of this scoping review was to identify AAC training programs for professional development and to describe the characteristics and effects of such programs. A five-pronged search strategy was used to identify relevant studies. The certainty framework was used to appraise the quality of included studies. Charted data included general study characteristics; participant characteristics; training characteristics (i.e., training goals; instructional materials and strategies; training duration); quality appraisal; and reported effects of the training. The scoping review identified 34 studies for inclusion. The results showed the potential of AAC training programs for continuous professional development to increase professionals' skills in AAC intervention. A range of training characteristics was identified to guide the development of future training programs. Gaps in the research related to the training of AAC professionals were also identified to guide future research.

A tutorial: self-created film as a semiotic resource in AAC.

Sharing personal stories with others is essential to human interaction and language development. To communicate, individuals use a variety of semiotic resources, including images, symbols, and written and spoken language. These modes are deployed in the co-construction of a daily face-to-face conversation. A self-created film can serve as a valuable resource to facilitate a deeper understanding of a personal experience, especially where spoken or written language may present a challenge, for example, for people who rely on augmentative and alternative communication (AAC). Although the AAC literature indicates that using videos delivers benefits for aided communicators, guidelines on how to self-create, use, and transcribe them are rare. The present paper, a tutorial, describes how people who use AAC can develop a personal-video-scene (PVS) via the Film as Observable Communication (FaOC) method to utilize self-created films in sharing their stories. The first part of this paper, the theoretical framework, describes theories, methods, and practices from the fields of AAC, social semiotics, and visual anthropology, on which the FaOC method is based. The second part provides a step-by-step tutorial delivering practical guidance on how to create, use, and transcribe the PVS as a resource in conversations.

Using PAALSS for the manual analysis of language samples of individuals who use aided AAC in Spanish: A pilot study.

This pilot study describes the application of the Protocol for the Analysis of Aided Language Samples in Spanish (PAALSS), specifically designed for the manual analysis of language samples from individuals in the early stages of Spanish aided language development. Data were collected from 22 language samples from 16 individuals who use aided AAC and are at the earlier stages of Spanish language development. The primary objective of this study was to explore the feasibility of using PAALSS as an analytical tool to describe various aspects of the language samples, including lexical productivity, lexical diversity, morphology, grammatical complexity, and syntax. Results are presented according to four different groupings, based on the language samples' grammatical complexity scores. The study provides preliminary evidence of the potential of PAALSS as a useful tool for the manual analysis of language samples from users of AAC in Spanish. However, future studies are needed to establish its formal psychometric and measurement properties.

Brain-computer interface for augmentative and alternative communication access: The initial training needs and learning preferences of speech-language pathologists.

PURPOSE: To enable the codesign of a training framework for brain-computer interfaces for augmentative and alternative communications access (BCI-AAC), the aim of this study is to evaluate the initial BCI-AAC training needs and preferred learning strategies of speech-language pathologists (SLPs) with AAC experience. METHOD: Eleven SLPs employed across a broad range of settings completed a semi-structured interview. A grounded theory approach alongside peer debriefing and review, member checking, and triangulation procedures were utilised for thematic analysis to help ensure data reliability and credibility. RESULT: Regarding critical training needs, SLPs identified the subthemes of (a) personalisation of intervention, (b) technical aspects, (c) BCI-AAC system types and access, and (d) how to support stakeholders in BCI-AAC implementation. Regarding learning strategy preferences, participants discussed (a) expert guidance and demonstrations, (b) hands-on experience, alongside (c) media and presentations. CONCLUSION: Findings present a continuum of critical training needs ranging from more foundational information to more personalised assessment and intervention consideration. These thematic results present a first step in developing a basic framework for SLP training in BCI-AAC to utilise and build from as technology development continues, and provides an important initial starting point for the codesign of clinically focused BCI-AAC trainings.

The development of synthetic child speech in three South African languages.

It is well-known that children with expressive communication difficulties have the right to communicate, but they should also have the right to do so in whichever language they choose, with a voice that closely matches their age, gender, and dialect. This study aimed to develop naturalistic synthetic child speech, matching the vocal identity of three children with expressive communication difficulties, using Tacotron 2, for three under-resourced South African languages, namely South African English (SAE), Afrikaans, and isiXhosa. Due to the scarcity of child speech corpora, 2 hours of child speech data per child was collected from three 11- to 12-year-old children. Two adult models were used to "warm start" the child speech synthesis. To determine the naturalness of the synthetic voices, 124 listeners participated in a mean opinion score survey (Likert Score) and optionally gave qualitative feedback. Despite limited training data used in this study, we successfully developed a synthesized child voice of adequate quality in each language. This study highlights that with recent technological advancements, it is possible to develop synthetic child speech that matches the vocal identity of a child with expressive communication difficulties in different under-resourced languages.

Picture book videos incorporating key word signing for children who require AAC and their families: design and evaluation of a multimedia-enhanced setting.

Key word signing (KWS) is an unaided form of augmentative and alternative communication (AAC) and is frequently used by children with cognitive impairments and their families. Successful implementation of KWS requires a family environment that provides aided language input by modeling the signs. However, families face challenges implementing the signs in their everyday lives. KWS requires effort and sustained parental commitment. Users may also struggle with finding good learning resources and stimulating and enjoyable shared contexts for communication. Signed videos of popular children's books may help to implement KWS and create a signing environment which exposes children and their families to KWS in meaningful ways. The aim of this study was to create videos of this type and investigate whether and how they might serve as an attractive medium of support for families' KWS experience. Three families tested the videos. A triangulated qualitative study incorporating interviews and participant observation explored the families' experience of using these videos as a context for shared communication. The findings suggest that picture book videos supplemented by KWS may be appropriate resources for the use of KWS in everyday family life. They serve as a child-centered activity involving KWS exposure, in which children and their families can participate joyfully and naturally.

Augmentative and alternative communication for individuals with post-stroke aphasia: perspectives of South African speech-language pathologists.

This qualitative study aimed to describe speech-language pathologists' (SLPs') perspectives on augmentative and alternative communication (AAC) use for people with post-stroke aphasia focusing on: (a) current AAC practice, (b) factors that influence the use of AAC, and (c) the success and relevance of AAC interventions. Semi-structured interviews took place with ten South African SLPs with experience in aphasia intervention. The transcribed interviews were thematically analyzed using a six-phase process of inductive and deductive analysis within a phenomenological framework. All the participants use AAC with their clients, employing a variety of approaches that reflect their diverse settings, experiences, and perspectives on AAC. AAC use is complex, and SLPs make conscious choices considering multiple factors. Barriers to use were often associated with limited resources in the low- and middle-income country (LMIC) context, but most participants retained a positive view of AAC, actively working to circumvent barriers to use. Participants consistently emphasized the vital role of partners in communication interactions, linked to the importance of defining AAC broadly. It is necessary to advance the integration of AAC into rehabilitation plans to improve communication and social participation outcomes for people with post-stroke aphasia, especially in LMICs such as South Africa.

Role of Alternative and Augmentative Communication in Three Cases of Severe Acquired Brain Injury: A Neurorehabilitative Approach.

BACKGROUND: Augmentative and Alternative Communication (AAC) improved communicative skills in adults with post-stroke aphasia demonstrating the effectiveness in speech disorders and consequent improvement of patients' communication skills. This study aimed to report the efficacy of AAC in the rehabilitation of cognitive disorders and to estimate how the changes in cognitive and communicative functions could enhance the quality of life in patients affected by severe acquired brain injury. METHODS: Three patients with pontine cerebral ischemia, traumatic brain injury (TBI), and meningioma expressed in the posterior cranial fossa, respectively, were submitted to rehabilitative training with AAC for 6 months. Patients underwent to neuropsychological and mood evaluations at the beginning of AAC treatment (T0) and after rehabilitative training (T1). RESULTS: The results support the efficacy of AAC in the improvement of cognitive functions, particularly in memory, attention, and language domains. In addition, we described also an improvement in the quality of life and a decrease in depressive symptoms. CONCLUSIONS: The AAC seems to be an important rehabilitative technique for the recovery of cognitive functions with a consequent effect in improvement of psychological aspects and quality of life in patients with Acquired Brain Injury (ABI).

Funcionalidade de pessoas hospitalizados em vulnerabilidade comunicativa pela CIF / Functioning of hospitalized people in vulnerable communication by the ICF / Funcionalidad de las personas hospitalizadas con vulnerabilidad comunicativa por el CIF

Introdução: Pacientes hospitalizados, por causas diversas, podem apresentar comprometimentos de fala e linguagem que os coloquem em situação de vulnerabilidade comunicativa, influenciando sua funcionalidade. Adota-se a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para análise, sob esta perspectiva. Objetivo: Analisar a linguagem e funcionalidade de pessoas em vulnerabilidade comunicativa, em cuidados intensivo e semi-intensivo no hospital, pela CIF, como base conceitual. Método: Estudodescritivo e transversal, constituído por 18 participantes. Para a coleta de dados realizou-se: (i) levantamento dos prontuários, para caracterização do perfil sociodemográfico e das condições clínicas dos participantes; (ii) aplicação do protocolo ICUCS (Intensive Care Unit Communication Screening Protocol);(iii) introdução da Comunicação Suplementar e/ou Alternativa (CSA) e (iv) diário de campo (registro dos relatos). Os resultados foram analisados pela CIF e realizada análise estatística descritiva. Resultados: A maioria dos participantes estava alerta e compreendia comandos simples, sendo que 39% apresentaram problema grave de expressão de linguagem. Quanto à atividade e participação, 50% apresentaram dificuldade grave no falar, 33%, em iniciar e em manter conversas. Quanto aos fatores ambientais, familiares e profissionais de Saúde foram apontados tanto como facilitadores quanto como barreiras para a comunicação. A CSA foi vista como facilitadora da comunicação. Conclusão: Os participantes apresentaram alteração de expressão da linguagem oral, com compreensão preservada e dificuldades de atividade e participação, com impacto nos fatores ambientais, sendo a CSA uma facilitadora da comunicação. Reafirma-se a aplicabilidade da CIF no contexto hospitalar, para pessoas em vulnerabilidade comunicativa, para cuidado ampliado e humanizado.

Introduction: Hospitalized patients, due to various causes, may present impairment of speech and language which may lead them to a situation of communicative vulnerability, influencing its functioning. The ICF - International Classification of functioning, Disability and Health is adopted to perform this analysis, under this perspective. Purpose: To analyze the language and functioning of people in communicative vulnerability, under intensive or semi-intensive care at the hospital, according to ICF, as a concept basis. Methods: Descriptive and cross-sectional study, composed by 18 participants. Data collected through: (i) hospital chart survey analysis, in order to characterize sociodemographic profile and clinical conditions of the participants; (ii) application of ICUCS - Intensive Care Unit Communication Screening Protocol; (iii) introduction of AAC - Augmentative and Alternative Communication and (iv) field journal (entries of reports). The results were analyzed by ICF and then performed descriptive statistic analyses. Results: Most participants were alert and could comprehend simple commands, from which 39% presented severe problems regarding language expression. Regarding activity and participation, 50% presented severe difficulty of speaking and 33% of starting and keeping conversations. Regarding environmental, family and health professionals factors, they have all been appointed both as facilitators and barriers to communication. AAC was seen as a communication facilitator. Conclusion: Participants presented alteration of oral language expression, preserved comprehension and difficulties in activity and participation with impact in environmental factors, being AAC a communication facilitator. Reassurance of applicability of ICF in hospital context, directed to people in communicative vulnerability, regarding ample and humanized treatment.

Los pacientes hospitalizados, por las causas diversas, pueden presentar deterioro de la funcionalidad del habla y del lenguaje que se sitúa en el discurso comunicativo, lo que influye en su funcionalidad. Se utiliza la Clasificación Internacional del Funcionamiento de la Discapacidad y de la Salud (CIF) para análisis desde esta perspectiva. Objetivo: Analizar el lenguaje y la funcionalidad de personas en vulnerabilidad comunicativa, en cuidados intensivos y semiintensivos hospitalarios, utilizando la CIF, como fundamento conceptual. Método: Estudiodescriptivo y transversal, con 18 participantes. La recogida de datos incluyó: (i) estudios de las historias clínicas, para caracterizar el perfil sociodemográfico y las condiciones clínicas de los participantes; (ii) la aplicación del protocolo ICUCS (Intensive Care Unit Communication Screening Protocol);(iii) la introducción de la Comunicación Aumentativa y Alternativa (CAA) y (iv) un diario de campo (registro de informes). Los resultados se analizaron por la CIF y se realizó un análisis estadístico descriptivo. Resultados: La mayoría de los participantes estaban alerta y entendían órdenes sencillas, el 39% presentaron graves problemas para expresarse en el lenguaje. Em cuanto, a la actividad y la participación, el 50% tenía graves dificultades para hablar, y el 33%, para iniciar y mantener conversaciones. Los factores ambientales, los miembros de la familia y los profesionales sanitarios fueron identificados tanto como facilitadores como obstáculo para la comunicación. Se consideró que el CAA facilitaba la comunicación. Conclusión: Los participantes presentaban alteración en la expresión del lenguaje oral, con entendimiento resguardado y dificultades en la actividad y la participación, con impacto en los factores ambientales, siendo la CAA facilitadora de la comunicación. Se reafirma la aplicabilidad de la CIF en el contexto hospitalario, para personas en vulnerabilidad comunicativa, para la atención ampliada y humanizada.

Use of an intelligent tutoring system for a curriculum on augmentative and alternative communication: Feasibility for implementation.

BACKGROUND: Over 8 million children with disabilities live in Africa and are candidates for augmentative and alternative communication (AAC), yet formal training for team members, such as speech-language therapists and special education teachers, is extremely limited. Only one university on the continent provides postgraduate degrees in AAC, and other institutions provide only short modules at an undergraduate level. The need for an introductory training course on AAC that is accessible by university students continent-wide was identified. An online programme, namely an intelligent tutoring system (ITS), was identified as a possible option to facilitate interactive learning without the need for synchronous teaching. The use of an ITS is shown to be effective in developing knowledge and clinical reasoning in the health and rehabilitation fields. However, it has not yet been applied to student teaching in the field of AAC. AIM: To determine both the feasibility of an ITS to implement an AAC curriculum for students in four African countries, and the usability and effectiveness of such a system as a mechanism for learning about AAC. METHOD & PROCEDURES: The study included two components: the development of a valid AAC curriculum; and using the ITS to test the effectiveness of implementation in a pre- and post-test design with 98 speech-language therapy and special education students from five universities. OUTCOMES & RESULTS: Statistically significant differences were obtained between pre- and post-test assessments. Students perceived the learning experience as practical, with rich content. CONCLUSIONS & IMPLICATIONS: The findings suggest that the ITS-based AAC curriculum was positively perceived by the students and potentially offers an effective means of providing supplementary AAC training to students, although modifications to the system are still required. WHAT THIS PAPER ADDS: What is already known on the subject Professionals typically lack formal training in AAC. In Africa, this presents a serious challenge as there are over 8 million children who are candidates for AAC. A need for an introductory training course on AAC, which can be accessed by university students continent-wide, was identified. What this paper adds to existing knowledge An AAC curriculum was developed and integrated into an ITS, an online programme allowing interactive learning through asynchronous teaching. Students from four African countries completed the AAC ITS curriculum. The curriculum was positively received by the students and statistically significant changes in knowledge were identified. What are the practical and clinical implications of this work? This feasibility study shows that the use of an ITS is an effective means of providing AAC training to university students in these African countries. The results provide a valuable contribution toward ensuring the equitable distribution of AAC training opportunities in the African context. This will have a significant positive impact on those who are candidates for AAC.

Augmentative and alternative communication in autism spectrum disorder: transitioning from letter board to iPad - a case study.

This case study examines the effective use of Augmentative and Alternative Communication (AAC) tools in enhancing communication skills in a 15-year-old male with Autism Spectrum Disorder (ASD). Initially exhibiting non-verbal tendencies, the subject experienced significant improvements in communication and social interaction following the introduction of a letter board and subsequent transition to an iPad. These AAC tools facilitated a marked development in his ability to articulate thoughts, engage in academic activities, and express complex ideas, particularly in science. The study highlights the role of AAC in expanding the communicative capabilities of individuals with limited or no verbal language, demonstrating notable advancements in both verbal expression and cognitive engagement. The findings underscore the transformative impact of personalized AAC interventions and suggest the potential for broader application in ASD support strategies. This case highlights the need for further research, including randomized controlled trials, to explore the efficacy of AAC tools in diverse ASD contexts.