Voices from the field: exploring service providers' insights into service delivery and AAC use in Canada.

Use of augmentative and alternative communication (AAC) often relies on the involvement of AAC service providers; however little is known about how AAC services are delivered across Canada. This study aimed to explore AAC service provision and factors influencing use of AAC from the perspectives of service providers across Canada who are involved in providing and/or supporting use of AAC systems. The 22 participants from nine (of the 10) provinces participated in online focus groups. Participants were speech-language pathologists, occupational therapists, communicative disorders assistants, and a teacher. Transcripts of the audio recordings were analyzed using reflexive thematic analysis. Four themes were generated that reflect service-related factors contributing to the use of AAC in Canada: Support of Organizational Structures, Concordant Relationships and Goals, Making the Right Decisions, and Influence of Knowledge and Attitudes. These themes highlight how government systems, key stakeholders, assessment practices, and knowledge of AAC influence service provision and use of AAC. Voices from across Canada highlighted shared experiences of services providers as well as revealed variability in service delivery processes. The findings bring to attention a need for further research and development of service provision guidelines to support consistency, quality in practice, and equity in AAC services.

Canadian manufacturer and technician perspectives on the design and use of augmentative and alternative communication technology.

PURPOSE: Device manufacturers and technicians (MaTs) of augmentative and alternative communication (AAC) systems play key roles in the design and successful uptake of communication devices. This study aims to investigate MaT perspectives on AAC device design and effective use. MATERIALS AND METHODS: To investigate their perspectives, a focus group of MaTs within Canada was conducted. Reflexive thematic analysis was used to analyze data. FINDINGS: Three major themes resulted from analysis, which reflect MaT's views: AAC hardware and software flexibility, AAC knowledge and implementation, and social good versus financial resources. CONCLUSIONS: This study provides insights into the complexities faced by MaTs in balancing technical support of system end-users and the financial resources necessary for that support. These insights indicate a need for increased financial resources and the expansion of individuals who qualify for AAC system candidacy. MaTs suggest that an increase in resources and candidacy could lead to more successful AAC implementation and a greater understanding of AAC for all stakeholders.

Augmentative and Alternative Communication (AAC):• AAC technology provides individuals with communication disabilities a form of alternative communication.• The success of AAC systems is dependent on multiple factors including AAC stakeholders, system design, and system implementation.• This study explores AAC manufacturers and technicians perspectives on how to make AAC systems as effective and widely accessible as possible.

Models and frameworks for guiding assessment for aided Augmentative and Alternative communication (AAC): a scoping review.

BACKGROUND: Augmentative and Alternative Communication (AAC) supports individuals with complex communication needs. Conceptual models and frameworks exist to evaluate, implement, and assess the needs of persons with communication disabilities, however, it is unknown which models were grounded in previous evidence-based research. OBJECTIVE: What are the models and frameworks grounded in empirical or conceptual research that enable communication outcomes for persons who require aided AAC systems? ELIGIBILITY CRITERIA: The study had to be the original publication of a defined model or framework that included aided AAC and the model had to be developed through research, either conceptual or empirical. SOURCES OF EVIDENCE: Eleven databases were searched using terms associated with AAC devices, conceptual models, and assessment processes. Fifteen articles presenting 14 independent assessment models were included. CHARTING METHODS: A custom data extraction form included model development using existing models and research evidence, the model's input parameters, and explicit outcome measures. RESULTS: Four models were specific to AAC while ten models were general evaluations for assistive technology systems. Models used a variety of descriptive traits during assessment including: person, technology, environment and context, and the activity or task. Only nine models sought to iteratively assess the client. Eleven of the models identified the inclusion of members from different disciplines in the assessment process. CONCLUSIONS: There is a need to standardize descriptive traits: personal abilities, environmental characteristics, potential assistive technology, and contextual factors. Models should include teams of different disciplines to provide holistic assessments. Models should include outcomes and include iterative solutions.Implications for RehabilitationStandardizing the definitions of descriptive traits used in the assessment of the personal abilities, environmental characteristics, potential assistive technology, and contextual factors would enable better evaluation of outcomes across disciplines and abilities.By identifying what factors are instrumental in the successful recommendation of assistive technology, professionals may achieve a well-organized and efficient assessment tool.An assessment model tailored specifically to individuals who may benefit from Augmentative and Alternative Communication (AAC) should be considered that are rooted in existing theories, research evidence, and the experiences of those in the AAC community.An AAC specific model would allow for consistent outcome tracking across individuals or assessment teams and the comparison of the effectiveness of various models for research purposes.

Development of BrailleBunny: a device to enhance braille learning.

PURPOSE: Braille use has been linked to higher rates of employment, education, financial self-sufficiency, and self-esteem. One area of the world particularly impacted by braille illiteracy is the Philippines. In 2016, Digital Learning for Development and All Children Reading released a "Grand Challenge for Development" that challenged researchers to address the need for assistive technologies to help children with sensory disabilities learn to read in the Philippines. The purpose of this research was to identify technical specifications, and then co-design and test a device that could be used both in developed and developing countries, specifically Canada and the Philippines. METHODS: An iterative, co-design process was undertaken to develop a prototypical device, BrailleBunny. The extent to which the device fulfilled the design criteria and directions for future development were determined through a series of case studies with 25 end-users. RESULTS: The prototypical device requires improvement in financial accessibility, durability and reliability. All other criteria were met. CONCLUSIONS: Despite identified areas for improvement, the user feedback was positive, with the majority of users identifying that this device could provide transferrable learning to standard-size braille. With improvements, BrailleBunny, could be a valuable tool to increase the uptake of learning braille in the Philippines.Implications for RehabilitationAn inexpensive device, BrailleBunny was developed to promote transferable braille literacy skills including writing with a slate and stylus for children learning to read.The BrailleBunny provides real-time auditory and tactile feedback, and functions in either English or Tagalog (the languages which are taught in the Filipino curriculum).Feedback from 25 children and adults indicated the potential for use within schools in both Canada and the Philippines.

Barriers and facilitators to accommodations in the workplace for adults who use augmentative and alternative communication (AAC): a systematic review.

Workplace accommodations can reduce barriers to employment for people who use augmentative and alternative communication (AAC), however, the lack of accommodations continues to challenge participation in employment. This systematic review identified and analyzed barriers and facilitators to implementing workplace accommodations for adults (19 years and over) who use AAC. A systematic search of nine databases was conducted to identify relevant studies using the search terms "AAC" and "workplace accommodations" and variations of each term. Results were imported into Covidence. Seventeen studies met the inclusion criteria. Results were presented using the International Classification of Functioning, Disability, and Health (ICF) framework. The Oxford levels of evidence and Confidence in Evidence from Review of Qualitative Research (GRADE-CERQual) were used to assess the quality of the studies and confidence in findings, respectively. Environmental barriers related mainly to attitudes and technology, and personal barriers related to job qualifications, education, and work-related skills. A combination of facilitators such as personal strengths, access to technology, and supportive relationships contributed to successful implementation of accommodations. The findings of this review suggest that implementing workplace accommodations for adults who use AAC strategies is complex and further research is needed to advance practices and policies that support the implementation of workplace accommodations.

Effectiveness of technology for braille literacy education for children: a systematic review.

PURPOSE: Despite the well-documented importance of braille for people who are blind or visually impaired, few studies explore technology for facilitating braille literacy education. Evaluations of the impact of using assistive devices on academics for children and youth who are blind or visually impaired are needed. This systematic review aimed to evaluate the effectiveness of technology used to support braille literacy education for children and youth. MATERIALS AND METHODS: The population of interest was defined as children and youth aged 0-21 years who were blind or visually impaired, learning literacy through braille as their primary medium, and had not previously learned to read through sighted methods. Sixteen academic education, health sciences, multidisciplinary, rehabilitation, and engineering databases were searched. RESULTS: Twelve peer-reviewed, English-language articles were included in the review evaluating a total of 176 participants. In general, the quality of research was low with little evidence to support the use of current technology for braille literacy education. CONCLUSIONS: Standards of technology evaluation for braille literacy must be developed. Furthermore, assistive technologies for braille literacy education for children and youth should provide real-time auditory and tactile feedback, enable independent study/practice and editing of work, and be easy to use, motivational, and engaging. IMPLICATIONS FOR REHABILITATIONStandards must be developed to ensure technology evaluation is consistent among researchers and clinicians to achieve the best outcomes.Technologies for braille literacy education for children and youth should provide real-time auditory and tactile feedback, enable independent study/practice and editing of work, and be easy to use, motivational, and engaging.

Matuto, Magbasa, Maglaro: Learning to read braille through play.

In September 2016, Digital Learning for Development and All Children Reading released a "Grand Challenge for Development" urging researchers to explore the barriers that children with sensory disabilities in the Philippines face with respect to learning how to read. We sought to address one component of this challenge; engagement of persons with visual impairment in learning how to read in braille. The primary goal of this study was to engage in the co-design process to create a device to help young children with visual impairments learn to identify letters and short words in braille as a first step to reading.Participant questionnaires identified barriers of current reading devices including: accessibility, portability, durability, usability, and function. A design was prototyped based on results from a weighted evaluation matrix and feedback from partners who taught reading to persons with visual impairments. Usability testing showed that the device was easy to use and interactive. Suggestions for improvement included adding various learning modes and reducing the size, weight, and cost of the device.Results from this study highlight advantages of engaging in the co-design process and provide important data for other researchers developing devices for persons with visual impairments.

The reliability of isoinertial force-velocity-power profiling and maximal strength assessment in youth.

The purpose of this study was to quantify the inter-session reliability of force-velocity-power profiling and estimated maximal strength in youth. Thirty-six males (11-15 years old) performed a ballistic supine leg press test at five randomized loads (80%, 100%, 120%, 140%, and 160% body mass) on three separate occasions. Peak and mean force, power, velocity, and peak displacement were collected with a linear position transducer attached to the weight stack. Mean values at each load were used to calculate different regression lines and estimate maximal strength, force, velocity, and power. All variables were found reliable (change in the mean [CIM] = - 1 to 14%; coefficient of variation [CV] = 3-18%; intraclass correlation coefficient [ICC] = 0.74-0.99), but were likely to benefit from a familiarization, apart from the unreliable maximal force/velocity ratio (CIM = 0-3%; CV = 23-25%; ICC = 0.35-0.54) and load at maximal power (CIM = - 1 to 2%; CV = 10-13%; ICC = 0.26-0.61). Isoinertial force-velocity-power profiling and maximal strength in youth can be assessed after a familiarization session. Such profiling may provide valuable insight into neuromuscular capabilities during growth and maturation and may be used to monitor specific training adaptations.

Effect of different training methods on running sprint times in male youth.

The primary purpose of this paper was to provide insight into the effect of different training methods on sprinting time in male youth aged 8-18 years. Specific and nonspecific training methods were identified, the participants of the five teen studies categorized into pre, mid- and postpeak height velocity and effect sizes and percent changes calculated for each training method were appropriate. Plyometric training had the most effect on sprint times in pre- and midpeak height velocity participants, while combined training methods were the most efficient in postpeak height velocity participants. However, it is difficult to quantify the effects of different training methods due to the limited knowledge in this area e.g., resisted training on pre-PHV participants. Furthermore, it may be worthwhile to investigate additional variables (i.e., stride length, stride frequency, horizontal force), to better determine effect of training methods in different maturity statuses, the development of sprinting and possible stages where individual development can be optimized by training.

Where did that sound come from? Comparing the ability to localise using audification and audition.

PURPOSE: A prototype device was developed to allow individuals to hear ultrasound reflections off environmental obstacles. Previous studies have shown that this device allows for better distance judgement than audition and allows for effective passage through the centreline of apertures. The purpose of this research was to evaluate audification as a method to localise direct sound sources as compared to audition. METHOD: In an anechoic environment, participants localised point-sound sources for three conditions: auditory, audified ultrasound with receivers facing laterally, and audified ultrasound with receivers facing forward. RESULTS: Azimuth localisation was similar within a range of -35° to 35° in front of the participant among all conditions. At the periphery, -70° and 70°, audified ultrasound was more accurate than audition for novice participants. No difference was evident in user elevation accuracy for these signals among the different conditions. CONCLUSION: Audification of ultrasound can be effective for localising point-source sounds in the azimuth direction, but more evidence is required to evaluate accuracy in the vertical direction. [Box: see text].

What's that sound? Distance determination and aperture passage from ultrasound echoes.

PURPOSE: Individuals with visual impairment have difficulty detecting obstacles that are above waist height. A prototype device was developed to allow individuals to hear ultrasound reflections off environmental obstacles. The purpose of this research was to evaluate novices' ability to evaluate distance and pass through apertures using this device. METHOD: The first experiment evaluated the ability to judge the distance from a wall using the ultrasound system as compared to using auditory echolocation. The second examined time for passage, centreline accuracy and angle of rotation through different sized apertures. RESULTS: Distance judgement was found to be better with audified ultrasound than with auditory echolocation. When passing through apertures, audified ultrasound enabled centreline precision similar to that of vision, but individuals did not rotate their shoulders while passing through suggesting that more practice is necessary to combine perceptive information with proprioceptive action. CONCLUSIONS: The ability to judge distance and navigate through an environment with obstacles using a device which audifies ultrasound was shown to be better than using auditory echolocation, but not as effective as vision. This device will allow individuals with visual impairments to better detect and avoid environmental obstacles.