Interaction Between Children With Cerebral Palsy And Their Peers 2:

Understanding Initiated VOCA-Mediated Turns

Michael Clarke and Ray Wilkinson (UK)

This paper is the second in a series of two that examines aspects of interaction between children with cerebral palsy who use voice output communication aids (VOCAs) and their peers. The first paper reported how ‘naturally’ speaking children set up opportunities for the aided speakers to use their VOCAs by asking questions that required VOCA use for an answer, or by specifically prompting VOCA use. This second paper looks at what happened when aided speakers initiated new turns. By that we mean turns that were not a response to ‘natural’ speakers’ questions or prompts.

This second paper focuses on interactions between two pairs of children: Jamal and Colin, and Tina and Lucy. Jamal and Tina use VOCAs and Colin and Lucy do not have communication difficulties. The interaction is analysed using a method called Conversation Analysis (CA). In brief, CA is a method for determining how people in conversation go about organising their interaction.

It was found that when aided speakers initiated turns that related in some way to what the ‘natural’ speaker had just said, then the ‘natural’ speakers tended to understand what the aided speakers wanted to say. However, ‘natural’ speakers nearly always seemed to try to make sense of aided speakers’ turns by relating them to their own turns that had just taken place. This was not always an appropriate strategy, and caused significant breakdowns in understanding then aided speakers wanted to say something new, or something that related to a topic much further back in the conversation. In these situations both children had to work very hard to come to a shared understanding of the meaning of the aided speakers’ turn. This finding could have consequences for the ways in which professionals and aided speakers work together to support aided speakers’ communication skills development.

“I have chosen to live life abundantly” Perceptions of Leisure by Adults who use Augmentative and Alternative Communication

John Dattilo, Gus Estrella, Laura Estrella, Janice Light,

David McNaughton and Meagan Seabury (USA)

An online focus group was used to investigate perceptions of eight adults with cerebral palsy who use AAC systems about their recreation activities and leisure experiences. Six themes emerged from discussions on benefits of leisure and community recreation: improved physical health, enjoyment, improved mental health, increased independence, enhanced social connections, and education of society. Nine barriers to leisure participation were identified including: personal, social, communication, technology, financial, accessibility, safety, transportation, and personal care attendants. Despite numerous barriers to leisure, participants described six supports that helped them overcome these barriers: personal, social, family, personal care attendants, AAC devices, and other assistive technologies. Participants provided recommendations for other individuals who use AAC, their families, and service providers. The finding that participants indicated that a primary reason for being involved in leisure was for enjoyment brings credence to the belief that developing skills to engage in recreation activities of sufficient scope and variety is important. Enjoyment motivates people to do things that contribute to their development and enjoyment contributes to functional improvements. The more skills people master, the more likely it is that they will view an activity as presenting a manageable challenge. Therefore, it is helpful to encourage people to develop an array of recreation skills that contribute to meaningful leisure. This research supports the contention that leisure and recreation is important with respect to the time devoted to it and potential benefits associated with it. This study also extends “consumer driven” research that supports the value of leisure and the need to provide a supportive environment so people using AAC systems can make and communicate their preferences. Once individuals are empowered to communicate their preferences, they are better able to act on these preferences so that they might experience enjoyment associated with leisure.

Further Considerations of Visual Cognitive Neuroscience in Aided AAC: The Potential Role of Motion Perception Systems in Maximizing Design Display

Vinoth Jagaroo and Krista Wilkinson (USA)

Current augmentative and alternative communication technologies allow animation within visual symbol displays. Clinicians therefore have the option of incorporating motion-based effects into AAC displays. Yet despite their increasingly widespread availability, there is a virtual absence of associated research that might help guide clinicians in this decision-making process.  Questions that remain unanswered include: How many motion-based symbols should be presented on a single display?  Is there some maximum limit, beyond which the visual display simply becomes overwhelming?  Should the motion-based symbols on a display move all at once, or sequentially?  What kinds of motion are best used for specific purposes?

The lack of research in support of daily clinical decision making is a critical and potentially serious concern. Our proposal in this paper is fairly simple: We should examine the rich potential source of evidence and ideas from the basic science of visual processing and cognitive neuroscience. Our immediate goal is to introduce and exploit basic science concerning visual motion perception as it might relate to the construction of aided AAC displays. We begin by detailing a range of specific possible applications of motion effects to AAC symbols. We then describe different types of motion, highlighting in particular ones with important implications for aided communication. We wrap up with a description of the relevant neuro-cognitive theory concerning the neurological and theoretical bases upon which our suggestions for clinical practice are based.

“A Child Needs to be Given a Chance to Succeed”:

Parents of Individuals who use AAC Describe the Benefits and Challenges of Learning AAC Technologies

David McNaughton, Tracy Rackensperger, Elizabeth Benedek-Wood,

Carole Krezman, Michael B. Williams, and Janice Light (USA)

Parents of children who use AAC play a critical role in supporting a child’s use of augmentative and alternative communication (AAC), but we know relatively little about their view of supports and barriers to the effective use of AAC technology. We asked parents of children with complex communication needs to participate in a focus group discussion on the acquisition and use of AAC. The discussion was held on the internet  - the lack of face-to-face interaction may have influenced the conversation, but we also believe that the ability to log on and participate at any time convenient to the parent may also have enabled participation for people leading extremely busy lives! The on-line conversation addressed issues such as issues in the selection of AAC technology, knowledge and skills needed to use AAC technology, barriers to learning AAC technology, teaching the individual, educating society, and recommendations to others. We hope this study is of interest to professionals who provide services to individuals who use AAC, AAC researchers and manufacturers, and of course to individuals who use AAC and their parents.