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Facilitated communication (FC) has been a heavily debated and documented topic across multiple disciplines, including sociology, education, psychology, pediatrics, speech-language pathology, and disability studies. Although many professionals from various disciplines and advocates have offered opinions, suggestions, and research on the topic, there has been minimal input from the occupational therapy (OT) profession. The lack of OT input is noteworthy as OTs are experts in enabling upper extremity performance and independence through a variety of training, adaptation and modification strategies, and use of external supports. Because of their professional code of ethics and a specific knowledge base, OTs are uniquely positioned to provide a host of ethical and evidence-based strategies that enable independent access to communication technology. The consideration of multiple access options is contrary to the typical facilitated encounter where facilitators exclusively choose to manipulate an upper extremity in order for letters to be selected on a display or keyboard. The purpose of this paper is threefold: (a) To offer insight into the standard of care by OTs including their ethical standards; (b) to identify varied accommodations that enable access using a feature-matching standard of care that eliminates the need for a facilitator; and (c) to highlight how to increase independent assistive technology/augmentative and alternative communication access, thus dissuading the need or use of facilitated access to letters. [ABSTRACT FROM AUTHOR]

Children with significant communication difficulties who experience pain need appropriate means to communicate their pain in order to receive appropriate treatment. Augmentative and alternative communication (AAC) strategies could be used to enable children to self-report pain. The aim of this research study was to identify the common vocabulary children with typical development use to describe physical pain experiences and develop and socially validate an appropriate pain-related vocabulary list for children who use or could benefit from using AAC. A sequential, exploratory, mixed-method design was employed. This paper focuses on the quantitative phase. A set of scenarios was developed to gather pain-related vocabulary appropriate for children aged 6;0–7;11 (years;months) and children aged 8;0–9;11, from 74 children, 61 parents, and 56 teachers. Some 629 pain-related words or phrases were suggested and then classified into seven categories. A composite list of the 84 most frequently occurring pain-related vocabulary items was compiled and socially validated by three adults who used AAC. They emphasized the need to individualize vocabulary and provided suggestions for vocabulary organization for display on any type of AAC system. Despite similarities in the categories of words offered by the various respondent groups, the differences underscore the importance of more than one perspective (particularly that of children and adults) in generating a comprehensive vocabulary list. [ABSTRACT FROM PUBLISHER]

This paper presents the findings of a review of 13 studies of attitudes toward individuals who use augmentative and alternative communication (AAC). The following factors that influenced attitudes were found: characteristics of typically developing individuals, characteristics of the person using AAC, and characteristics of AAC systems' output. This research base indicates that females reported more positive attitudes than males, and that individuals with previous experience with people with disabilities reported more positive attitudes than did individuals who had no previous experience with people with disabilities. The AAC system and other factors studied did not appear to be influential as single factors; however, data from the studies reviewed provide support for the hypothesis that attitudes are formed by the interaction of many different factors. There has been limited research in techniques to change attitudes toward individuals who use AAC. A recommendation from this review is that future research should focus on strategies to modify both attitudes and behavior in order to reduce barriers to social interaction. [ABSTRACT FROM AUTHOR]

The contribution of cross-age peer e-mentoring on reported experiences of participation during online conversations using social media was explored in this pre-experimental study. Young people (n = 4, aged 13; 4–18;3 [years; months]) who used augmentative and alternative communication (AAC) participated in an e-mentoring intervention. Two mentors who also used AAC had regular conversations with the participants via Facebook1, email, or Skype2. It was predicted that the mentoring support would contribute to experiences of participation in online conversations outside of the e-mentoring intervention. Reported experiences of participation in online conversations with communication partners other than the mentor were measured at four time points. The Self-Reported Experiences of Activity Settings was used for this purpose because it consists of five domains: Personal Growth, Psychological Engagement, Social Belonging, Meaningful Interactions, and Choice and Control. These domains are associated with the construct of involvement in activity settings. Results showed varied scores between participants and across the domains. Reported experiences of choice and control increased slightly across time. Despite some variation in self-ratings, the participants reported experiencing choice and control, psychological engagement, and social belonging in online conversations. There is need for more research in this emerging area. [ABSTRACT FROM AUTHOR]

Augmentative and alternative communication (AAC) is always about intervening and the subsequent effects of the interventions (e.g., on the AAC user, family perspectives, educational outcomes, and vocational outcomes). AAC intervention research is about generating new knowledge by studying some aspect of AAC delivery in a planned manner so that it can be replicated and then translated into clinical/educational practice. This commentary on AAC intervention research highlights the complexities inherent in this type of research and the range of components that contribute to it, and reflects on emerging trends that we must consider as we continue to develop and enhance intervention research. Conducting AAC intervention research is a commitment to understanding how change occurs when an intervention is delivered and its broader impact on the field and the people who use AAC. [ABSTRACT FROM AUTHOR]

The social validity of different communication modalities is a potentially important variable to consider when designing augmentative and alternative communication (AAC) interventions. To assess the social validity of three AAC modes (i.e., manual signing, picture exchange, and an iPad®-based speech-generating device), we asked 59 undergraduate students (pre-service teachers) and 43 teachers to watch a video explaining each mode. They were then asked to nominate the mode they perceived to be easiest to learn as well as the most intelligible, effective, and preferred. Participants were also asked to list the main reasons for their nominations and report on their experience with each modality. Most participants (68–86%) nominated the iPad-based speech-generating device (SGD) as easiest to learn, as well as the most intelligible, effective, and preferred. This device was perceived to be easy to understand and use and to have familiar and socially acceptable technology. Results suggest that iPad-based SGDs were perceived as more socially valid among this sample of teachers and undergraduate students. Information of this type may have some relevance to designing AAC supports for people who use AAC and their current and future potential communication partners. [ABSTRACT FROM AUTHOR]

Augmentative and alternative communication (AAC) systems serve as the primary communication mode for many students with complex communication needs. The aim of this study was to describe the naturally occurring communication opportunities of students using AAC systems. We observed 23 students for a total of 117 hours across general education, special education, and non-academic settings. For each communication event, we recorded the setting, communication partner, student communication mode, availability of the AAC system, independent or prompted responses, and the consequence. Communication events primarily occurred with adults and very few spontaneous initiations were observed. On average, students were presented with 17 opportunities to respond per hour. However, in nearly half of these opportunities, students did not have access to their AAC system. Results from our observations indicated more deliberate efforts are needed to ensure students have appropriate access and opportunity to use AAC systems across school environments. [ABSTRACT FROM PUBLISHER]

This study examined the attitudes of children with typical development towards an unfamiliar peer with complex communication needs using augmentative and alternative communication (AAC) systems. Specifically, the study aimed to compare attitudes when the peer used mobile technology (i.e., iPad©1) with an AAC-specific application (Proloquo2Go™2) versus a low-technology communication board. A within-group crossover design was utilized involving 78 children. Half of the participants (i.e., Group 1) viewed Video 1 of an unfamiliar peer with complex communication needs in a scripted communication interaction using an iPad with Proloquo2Go followed by Video 2 of the same interaction using a communication board. The other half of the participants (Group 2) viewed these videos in the reverse sequence. The Communication Aid/Device Attitudinal Questionnaire (CADAQ) was completed after watching each video. Results indicated that both groups were more positive towards Video 1 (iPad with Prologuo2Go) on certain dimensions of the CADAQ. The results are discussed and recommendations for future research provided. [ABSTRACT FROM AUTHOR]

Hospitalization is a stressful context for all children and their families, but especially for children with communication difficulties. Effective communication using augmentative and alternative communication (AAC) strategies can play a critical role in preparing and supporting everyone involved in such situations to have discussions that minimize insecurity, allow children to express their concerns, and so decrease negative stress and anxiety. However, there is a critical need to identify robust and reliable ways of evaluating the effectiveness of interventions that seek to achieve this aim. This research note illustrates some of the challenges and problems that require attention and suggests possible new research tools, for example, the use of physiological measures. The evaluation of an AAC intervention on a day surgery ward is described and used to illustrate one potential physiological measure for evaluating the impact of an intervention. [ABSTRACT FROM PUBLISHER]

The aim of this study was to investigate the influence of types of message errors on the attitudes of Korean adults toward a person who uses AAC. The attitudes of 72 adults who speak native Korean were examined through attitude questionnaires completed after viewing videotaped conversations between a boy with cerebral palsy and an adult without disabilities. Each interaction video involved a message with one of six error types, including various types of syntactic, semantic, and pragmatic errors. The participants provided information on their attitude towards the person who used AAC, and ranked their preferences among the six messages. The results provide evidence that attitudes towards the individual using AAC were most positive (in comparison with other conditions) when a pragmatic error was observed. Messages containing a syntactic error were ranked most favorably. Spearman's correlation analyses revealed some relationship between attitudes rating and preferences ranking. Our results provide evidence that specific language and cultural contexts may play an important role in shaping attitudes toward those who use AAC. [ABSTRACT FROM AUTHOR]

Positive family influences have a significant impact on addressing school barriers to academic success for students from socially disadvantaged backgrounds. Due to inequities and attitudes toward people with complex communication needs, positive family influences may be critical in the academic success of students using AAC. This study asked the following question of eight United States high school graduates who have used augmentative and alternative communication (AAC): How do family influences positively affect the ability of students who use AAC to succeed in the secondary academic environment? Five themes emerged from the qualitative analysis of participants' narratives: (a) the impact of the family in seeking appropriate education, (b) homework as a challenge that was made easier through the involvement of the family, (c) the role of the family in communicating the importance of education, (d) mothers as driving forces of support, and (e) family encouragement for self-determination. This research allows families and schools to recognize the needs of students and to take action to meet them. It identifies the needs of families and schools in establishing relationships with each other, in terms of supporting requirements for accommodation, learning, motivation, and self-determination of students with complex commmunication needs. [ABSTRACT FROM AUTHOR]

Many children with autism require intensive instruction in the use of augmentative or alternative communication systems, such as the Picture Exchange Communication System (PECS). This study investigated the use of PECS with three young boys with autism to determine the impact of PECS training on use of pictures for requesting, use of intelligible words, and maladaptive behaviors. A multiple baseline-probe design with a staggered start was implemented. Results indicated that all of the participants quickly learned to make requests using pictures and that two used intelligible speech following PECS instruction; maladaptive behaviors were variable throughout baseline and intervention phases. Although all of the participants improved in at least one dependent variable, there remain questions regarding who is best suited for PECS and similar interventions. [ABSTRACT FROM AUTHOR]

Aspects of the classroom environment relevant to the communicative spontaneity of 23 children with high support needs who used AAC were examined in this study. Specifically, antecedents associated with different modes of communication and the effectiveness of requesting and rejection were examined. Most communication was identified as occurring in natural routines. Aided AAC was predominantly associated with prompts, such as questions and, in particular, system presentation. In relation to the pragmatic functions of requesting and rejecting, the probability of communication being successful decreased with increasing spontaneity. Several possible implications of these findings for intervention are discussed. [ABSTRACT FROM AUTHOR]

In the present study, the communicative spontaneity of 23 children with high support needs who used Augmentative and Alternative Communication (AAC) in a classroom setting was evaluated. In contrast to previous research, spontaneity was evaluated on a continuum rather than being treated as a binary variable. Spontaneity was found to be highly variable, but some students clearly lacked the range of spontaneity that would be associated with fully functional communication. Aided AAC systems were notably less spontaneous than signing or nonsymbolic communication. There was also evidence of systematic variation in spontaneity across pragmatic function, with instrumental functions being more spontaneous than commenting. The results of the present study highlight the need to consider spontaneity when assessing individuals who use AAC systems. [ABSTRACT FROM AUTHOR]

The effect of memory aids on conversations between nursing aides and residents with dementia during 5-minute conversations was examined. Nursing home units in seven nursing homes were randomly assigned to treatment and control conditions. Residents in the treatment condition were given 12-page memory books consisting of autobiographical, daily schedule, and problem resolution information. Their assigned nursing aides were trained to use the memory books during care interactions and throughout the day. The duration and quality of verbal interactions between dyads of a resident and their nursing aide during 5-minute conversations were measured pre-and post-treatment using computer-assisted observational techniques and verbatim transcriptions of videotaped conversations (N = 66; 33 treatment dyads and 33 control dyads). The results revealed improvements on a variety of quantitative conversational measures (e.g., duration of speaking time, frequency of utterances) between treatment and control conditions as a function of memory book use. Similarly, the quality of conversations, as measured by the frequency of discourse characteristics (e.g., facilitative behaviors), improved as a function of memory book use for treatment dyads. Nursing aides' judgment of residents' depressive symptoms improved with memory aid use, suggesting changes in resident quality of life as a result of an AAC technique that enhanced information sharing and social closeness. [ABSTRACT FROM AUTHOR]