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Augmentative and alternative communication (AAC) approaches offer expressive and receptive supports for the segment of the population of individuals with autism spectrum disorder (ASD) who have little or no functional speech. The National Center for Autism Evidence and Practice (NCAEP) declared augmentative and alternative communication (AAC) interventions for individuals with autism an "evidence-based practice." Following a brief analysis of the breakdown of studies included in NCAEP by dependent variable, we introduce each of the four papers published as part of this special issue on Advances in Augmentative and Alternative Communication Research for Individuals with Autism Spectrum Disorder. In addition to elucidating the contributions and advances of each paper to the research base, including the NCAEP report, we provide a critical commentary as applicable in the hopes of stimulating and guiding further research. [ABSTRACT FROM AUTHOR]

This is the second of two papers summarizing studies reporting on the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems. The aim of this paper was to describe the design approaches used and to determine to what extent the principles of human-centred design (HCD) were reflected in the design approaches and processes used. A scoping review was conducted. A multifaceted search resulted in the identification of 28 studies meeting the selection criteria. Data were extracted relating to four areas of interest, namely, (1) the general characteristics of the studies, (2) features of the systems designed, (3) availability of the systems to the public and (4) the design processes followed. In this paper, findings related to the last area are presented. Design approaches were often inconsistently described. User-centred design was mentioned more often than HCD. Even so, various HCD principles were considered in most studies. Notably, stakeholders were involved in the design process in all studies. However, users were not involved in all studies and stakeholder roles were predominantly informative rather than collaborative. Prototype and product evaluations focussed mostly on usability rather than user experience. Although many design teams were multidisciplinary, engineers and computer scientists predominated. There is a need for designers to be more transparent about the type of design approach used to guide the system design and also to clearly report on design approaches and processes used. The application of HCD to the design of graphic symbol-based AAC systems is still limited. Human-centred design approaches can productively guide the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems. Creative methods are needed to involve stakeholders with complex communication needs in all phases of the design process. Evaluation of electronic graphic symbol-based AAC systems should consider both usability and user experience. [ABSTRACT FROM AUTHOR]

This is the first of two papers summarizing studies reporting on the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems, to determine the state of the field. The aim of this paper was to provide an overview of the general characteristics of the studies and to describe the features of the systems designed. A scoping review was conducted. A multifaceted search resulted in the identification of 28 studies meeting the selection criteria. Data were extracted relating to four areas of interest, namely (1) the general characteristics of the studies, (2) features of the systems designed, (3) availability of the systems to the public, and (4) the design processes followed. In this paper, findings relating to the first three areas are presented. Most study authors were affiliated to fields of engineering and/or computer science and came from high-income countries. Most studies reported the design of AAC applications loaded onto mobile technology devices. Common system features included customizable vocabulary items, the inclusion of graphic symbols from both established AAC libraries and other sources, a dynamic grid display, and the inclusion of digital and/or synthetic speech output. Few systems were available to the public. Limited justifications for many of the complex design decisions were provided in the studies, possibly due to limited involvement of rehabilitation professionals during the design process. Furthermore, few studies reported on the design of graphic symbol-based AAC systems specifically for middle- and low-income contexts and also for multilingual populations. Complex design decisions about electronic graphic symbol-based augmentative and alternative communication (AAC) systems should be made purposefully and with sufficient justification. Increased collaboration between designers and rehabilitation professionals during the design of electronic graphic symbol-based systems could improve the products. Design of AAC systems for populations residing in low and middle-income contexts and also for multilingual populations are urgently needed. [ABSTRACT FROM AUTHOR]

This paper considers teacher education for teachers of learners with severe to profound disabilities (SPD) in South Africa, in both formal and non-formal learning programmes within a disability studies in education framework. Qualitative data were collected from a range of education stakeholders including non-governmental (NGOs) and disabled people organisations (DPOs). Based on a thematic analysis, findings show limited pre-service teacher education programmes focused on teaching learners with SPD. In-service teacher training through education departments and NGOs and DPOs, is usually through basic short courses or workshops and are not complemented by on-going support. We argue for a reconceptualization of teacher education in South Africa to prepare teachers to meet the diverse needs of learners, including those with SPDs within an inclusive education context. Skills in addressing barriers to learning should be infused throughout initial teacher education, in line with the principles of universal design for learning while impairment-specific knowledge can be offered in related modules that focus on reasonable accommodation for children with disabilities. In-service education can occur in formal and informal programmes and should empowers teachers to become lifelong learners. [ABSTRACT FROM AUTHOR]

Participation in society is the cornerstone to living a meaningful, connected, and healthy life. Persons with complex communication needs, however, often have restricted opportunities to participate in everyday contexts and situations. Reasons for this include societal attitudinal barriers, as well as limited knowledge and skills about augmentative and alternative communication (AAC) to enhance participation. Enhancing participation of persons with complex communication needs requires a holistic and multi-faceted approach. The 17 Sustainable Development Goals (SDGs) with their disability-inclusive agenda provide an impetus for shaping the approach of the Centre for Augmentative and Alternative Communication (CAAC) in enhancing participation of persons with complex communication needs in South Africa. This paper aims to provide a reflective description and application of the work conducted by the CAAC in addressing the SDGs in South Africa. Research and training conducted by the CAAC is shown to be aligned to five SDGs, namely zero hunger (SDG 2), good health and well-being (SDG 3), quality education (SDG 4), decent work and economic growth (SDG 8) and peace, justice, and strong institutions (SDG 16), with a focus on reaching these goals in order to benefit persons with complex communication needs. The paper demonstrates that, despite some gains in addressing the SDGs, research and clinical practice still needs to be on these and the remaining SDGs. Furthermore, there is a need to also find ways to integrate the SDGs to ensure participation of persons with complex communication needs in major life activities and society. [ABSTRACT FROM AUTHOR]

This commentary describes the development of global partnerships, capacity-building, and the basis for the creation of a website (Leadersproject.org) used throughout the world that contains free educational resources for the assessment and treatment of people with communication disabilities (PWCD). This website contains speech-language assessment and treatment materials, online skill-building courses, over 200 instructional videos, train-the-trainer course materials, and syntheses of important research and trainings in over 30 languages. This commentary relates the work from leadersproject.org to the United Nations Sustainable Development Goals (SDGs). Through this website, the authors have established ongoing global partnerships with other health and education professionals. Moreover, PWCD and their families have used the website for information and support throughout the world. Speech-language pathologists (SLPs) and other health and education professionals use these materials to host capacity-building trainings and to support the development of knowledge and skills to local professionals for the benefit of PWCD. The Leadersproject.org resources have been influential and impactful as measured by approximately 24 000 visits from over 130 countries throughout the world. The authors of this paper continue to establish partnerships worldwide to spread education and increase the quality of care provided to PWCD. This commentary paper focuses on the United Nations Sustainable Development Goals (SDGs): good health and well-being (SDG 3), quality education (SDG 4), decent work and economic growth (SDG 8), reduced inequalities (SDG 10), partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

This paper describes the implementation of a comprehensive strategy for the structural typification of historical buildings located in earthquake-prone regions using digital technologies such as HBIM and Augmented Reality. The paper starts by presenting a detailed analysis of a selected sample of case studies in Peru in which key structural and architectural features were identified, aiming at proposing a preliminary typological classification. This typification was then optimized by analyzing its application in a larger data set consisting of 311 churches located in the Central Andes region. This allowed formalizing 12 structural typologies, which demonstrated to have the potential to provide an accurate description of the geometrical, material, and structural characteristics of Andean churches. The paper underlines the importance of combining digital technologies and comprehensive engineering analyses for creating tools that will facilitate further structural evaluations and seismic vulnerability assessments at a territorial scale. For the study, these tools improved information management processes, analyses, and post-processing tasks, and facilitated communication and decision-making among stakeholders. [ABSTRACT FROM AUTHOR]

Children who use augmentative and alternative communication (AAC) are multimodal communicators. However, in classroom interactions involving children and staff, achieving mutual understanding and accomplishing task-oriented goals by attending to the child's unaided AAC can be challenging. This study draws on excerpts of video recordings of interactions in a classroom for 6–9-year-old children who used AAC to explore how three child participants used the range of multimodal resources available to them – vocal, movement-based, and gestural, technological, temporal – to shape (and to some degree, co-control) classroom interactions. Our research was concerned with examining achievements and problems in establishing a sense of common ground and the realization of child agency. Through detailed multimodal analysis, this paper renders visible different types of practices rejecting a request for clarification, drawing new parties into a conversation, disrupting whole-class teacher talk-through which the children in the study voiced themselves in persuasive ways. It concludes by suggesting that multimodal accounts paint a more nuanced picture of children's resourcefulness and conversational asymmetry that highlights children's agency amidst material, semiotic, and institutional constraints. [ABSTRACT FROM AUTHOR]

Within the context of the mid-sixteenth-century movement of spelling standardisation in England, John Hart (c. 1501–1574) wrote three linguistic texts in English (rather than in Latin), on orthographic reform focused on phonetic principles: one letter only represents one sound, and vice versa. This paper aims to examine how Hart appealed to medical imagery in his discussion of English orthography. First, Tudor concepts of medicine (such as the theory of 'elements' and 'humours') were employed to frame his expounding of orthographic problems; second, the procedure of medical treatment was transferred to organise the structure of his argument, i.e. to set up the steps of orthographic reform and to treat specific orthographic problems. The former focuses on the content aspect of his argument while the latter on the structural aspect. Moreover, Hart was very much of his time in his fascination with appropriating political language. During the English Renaissance, medical metaphors were widely used in both political and religious texts, and they were borrowed by Hart and constituted a constant feature of his linguistic writings, published or unpublished. Drawing upon contemporary political tracts, I will demonstrate the religio-political nature of his medical metaphor and how his use of this type of metaphor facilitated communication on spelling reform. [ABSTRACT FROM AUTHOR]

ICH E9(R1) introduces the estimand framework to strengthen dialogues between sponsors and regulators during drug development. A well-structured benefit-risk assessment (BRA) framework also intends to facilitate communication among stakeholders. However, the estimand in ICH E9(R1) is written mainly from the perspective of a single measure of treatment effect in clinical trials. There is lack of systematic discussion on estimand in the context of BRA. This paper initiates the BRA discussion under the estimand framework. By identifying two types of BRA approaches, we summarize and discuss completed clinical trials, using the estimand language for BRA. Benefits and challenges of using estimand for BRA are also discussed. [ABSTRACT FROM AUTHOR]

This study's goal was to inform the selection of the most frequently used words to serve as a reference for core vocabulary selection for Hebrew-speaking children who require AAC. The paper describes the vocabulary used by 12 Hebrew-speaking preschool children with typical development in two different conditions: peer talk, and peer talk with adult mediation. Language samples were audio-recorded, transcribed, and analyzed using the CHILDES (Child Language Data Exchange System) tools to identify the most frequently used words. The top 200 lexemes (all variations of a single word) in the peer talk and adult-mediated peer talk conditions accounted for 87.15% (n = 5008 tokens) and 86.4% (n = 5331 tokens) of the total tokens produced in each language sample (n = 5746, n = 6168), respectively. A substantially overlapping vocabulary of 337 lexemes accounted for up to 87% (n = 10411) of the tokens produced in the composite list (n = 11914). The results indicate that a relatively small set of words represent a large proportion of the words used by the preschoolers across two different conditions. General versus language-specific implications for core vocabulary selection for children in need of AAC devices are discussed. [ABSTRACT FROM AUTHOR]

Families are the most significant communication partners for an individual with complex communication needs. Even though family-centered approaches are recommended to support augmentative and alternative communication (AAC) services for an individual, it is difficult to establish a successful plan that fits each individual's family. A framework for practitioners is proposed to effectively obtain and understand information about a family's unique dynamics as part of service delivery to positively impact AAC device uptake and long-term use. The goal of using this model is to minimize the disruption to the family while maximizing the integration of the AAC system. This paper proposes and illustrates a framework to enrich AAC services through the integration of several theoretical models of family systems theory, family paradigms, and a procedure called the self-created genogram. This paper begins by reviewing ecological family systems theory and family systems to guide and provide a framework to support effective AAC implementation. The process of self-creating genograms is then introduced as a means to obtain a rich perspective on family characteristics and dynamics that is informed by the individual who uses AAC. All of this information allows professionals to provide relevant information and tailor options for the family. As a result, the family is able to make informed decisions about AAC intervention in a manner most consistent with how they typically operate. Finally, we apply this framework to a hypothetical case of a child with autism and complex communication needs across three timepoints (preschool, late elementary/early middle school, and high school/post-secondary transition) to demonstrate how this framework can be used in clinical practice. [ABSTRACT FROM AUTHOR]

In programmes of assessment with both high and low-stakes assessments, the inclusion of open-ended long answer questions in the high-stakes examination can contribute to driving deeper learning among students. However, in larger institutions, this would generate a seemingly insurmountable marking workload. In this study, we use a focused ethnographic approach to explore how such a marking endeavour can be tackled efficiently and pragmatically. In marking parties, examiners come together to individually mark student papers. This study focuses on marking parties for two separate tasks assessing written clinical communication in medical school finals at Southampton, UK. Data collected included field notes from 21.3 h of marking parties, details of demographics and clinical and educational experience of examiners, examiners' written answers to an open-ended post-marking party questionnaire, an in-depth interview and details of the actual marks assigned during the marking parties. In a landscape of examiners who are busy clinicians and rarely interact with each other educationally, marking parties represent a spontaneous and sustainable community of practice, with functions extending beyond the mere marking of exams. These include benchmarking, learning, managing biases and exam development. Despite the intensity of the work, marking parties built camaraderie and were considered fun and motivating. [ABSTRACT FROM AUTHOR]

In this paper, we examine some basic linguistic abilities in a small sample of adults with minimal receptive vocabulary, whose receptive mental verbal age ranges from 1;2 to 3;10. In particular, we examine whether the participants in our study understand noun phrases consisting of a noun modified by an adjective. We use stimuli that they can recognise by name. Except for one participant, we find that, while all of them understand the noun and adjective in isolation, none seems to understand these noun phrases, which means that they seem to not do linguistic composition. In order to test whether the difficulty is linguistic or conceptual, we ran two other studies, one on concept composition, and the other on iconic symbolic composition (composition of pictograms). Results suggest that linguistic composition is particularly difficult in this population, and that vocabulary breadth may not predict compositional abilities. [ABSTRACT FROM AUTHOR]

Children with complex communication needs often have multiple disabilities including visual impairments that impact their ability to interact with aided augmentative and alternative communication (AAC) systems. Just as the field benefited from a consideration of visual cognitive neuroscience in construction of visual displays, an exploration of psychoacoustics can potentially assist in maximizing the possibilities within AAC systems when the visual channel is either (a) not the primary sensory mode, or (b) is one that can be augmented to ultimately benefit AAC outcomes. The purpose of this paper is to highlight background information about psychoacoustics and present possible future directions for the design of aided AAC system technologies for children with visual impairments who rely on auditory information to learn and utilize AAC. [ABSTRACT FROM AUTHOR]

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]

The purpose of this paper was to review best-practice methods of collecting and analyzing speech production data from minimally verbal autistic speakers. Data on speech production data in minimally verbal individuals are valuable for a variety of purposes, including phenotyping, clinical assessment, and treatment monitoring. Both perceptual ("by ear") and acoustic analyses of speech can reveal subtle improvements as a result of therapy that may not be apparent when correct/incorrect judgments are used. Key considerations for collecting and analyzing speech production data from this population are reviewed. The definition of "minimally verbal" that is chosen will vary depending on the specific hypotheses investigated, as will the stimuli to be collected and the task(s) used to elicit them. Perceptual judgments are ecologically valid but subject to known sources of bias; therefore, training and reliability procedures for perceptual analyses are addressed, including guidelines on how to select vocalizations for inclusion or exclusion. Factors to consider when recording and acoustically analyzing speech are also briefly discussed. In summary, the tasks, stimuli, training methods, analysis type(s), and level of detail that yield the most reliable data to answer the question should be selected. It is possible to obtain rich high-quality data even from speakers with very little speech output. This information is useful not only for research but also for clinical decision-making and progress monitoring. [ABSTRACT FROM AUTHOR]

Earth system science is an interdisciplinary effort to understand the fundamentals and interactions of environmental processes. Interdisciplinary research is challenging since it demands the integration of scientific schemes and practices from different research fields into a collaborative work environment. This paper introduces the framework F4ESS that supports this integration. F4ESS provides methods and technologies that facilitate the development of integrative work environments for Earth system science. F4ESS enables scientists a) to outline structured and summarized descriptions of scientific procedures to facilitate communication and synthesis, b) to combine a large variety of distributed data analysis software into seamless data analysis chains and workflows, c) to visually combine and interactively explore the manifold spatiotemporal data and results to support understanding and knowledge creation. The F4ESS methods and technologies are generic and can be applied in various scientific fields. We discuss F4ESS in the context of the interdisciplinary investigation of flood events. [ABSTRACT FROM AUTHOR]

Open collaborative design of physical products between remote partners poses unique challenges. This is due to both the complex and interconnected data required for product design and manufacture, and to the centralised computing infrastructure traditionally used to manage product lifecycle data. While modern cloud-based solutions to collaborative design are gaining popularity, they diminish the control of each design partner. In contrast, software designers readily collaborate on highly complex software, while retaining direct control of the files they are editing due to the dominance of distributed version control. Distributed version control for software is often coupled with 'Developer Operations' or DevOps tools to automate critical processes and facilitate communication. This paper explores how DevOps workflows can be adapted for open development of hardware. An example of how DevOps for hardware (HardOps) can be implemented is provided by the OpenFlexure Microscope project. While much ground remains to be broken in this field, HardOps can support a new paradigm of distributed hardware development, with enormous benefits not only for open-source hardware, but also commercial hardware. [ABSTRACT FROM AUTHOR]

Motor speech and augmentative and alternative communication (AAC) interventions are commonly used with children with cerebral palsy (CP) but there is limited literature comparing the effectiveness of these interventions. The purpose of this study was to investigate the effectiveness of intensive AAC, Rapid Syllable Transition Treatment (ReST), and blended intervention, a combination of motor-speech and AAC, on speech accuracy and sentence length and complexity. A single case experimental design across participants with repeated measurements across phases (ABACADA design) was used. Four participants aged 8–14 years with CP who used a speech-generating device (SGD) received three 6-week intervention blocks that included ReST, AAC, and blended intervention. Measures were taken during intervention and baseline phases and at maintenance two and four weeks after the last intervention phase. Participants were randomized to starting with either ReST or AAC with the blended intervention delivered last. All participants improved their speech accuracy and sentence length and complexity in speech and with their SGD in all three interventions. The data demonstrated overall immediacy of the effect with all interventions and retention of gains across the whole sequence of phases. The order of AAC or ReST interventions or the severity of CP did not impact the intervention gains. This study suggests that intensive AAC, a multi-modal approach, and ReST improve speech accuracy and sentence length and complexity in children with moderate CP, but all require further investigation. In this paper intensive AAC intervention with a speech generating device (SGD), ReST treatment and multimodal blended intervention were effective in improving speech accuracy and sentence length and complexity in both verbal speech and on communication with the SGD. ReST treatment has not been used with children with CP before. This study established a proof of concept for its effectiveness in children with CP. Further research is warranted. [ABSTRACT FROM AUTHOR]

One of the basic features facilitating communication on the Internet in a variety of languages is Unicode code-layout. It standardizes the representation of most of the world's writing systems on digital media, thus enabling the process and transmission of information through such technologies. Unicode is a contemporary character code, and this paper traces its evolvement out of previous code-layouts, starting with Morse code in telegraphy. Focusing on the adaptations of character codes to Modern Hebrew, I show how representing languages in technology is intertwined with internal and transnational regional concerns, and argue that from its beginning character code has been a locus of struggle over power and sovereignty: first between colonial regimes and resistance movements, and then between global corporations and local agents. [ABSTRACT FROM AUTHOR]

Key-word-signing (KWS), an unaided augmentative and alternative communication (AAC) strategy, has an important role to play in the education system. To date, limited research exists regarding the use of unaided AAC strategies in the school environment, especially in low- and middle-income countries. To address this research gap, the current study aimed to explore the perceptions of South African teachers toward the use of KWS strategies in the educational context. The study used a descriptive paper-based survey comprised of both closed and open-ended questions that was completed by 101 special education teachers. The sample was drawn from 10 public and independent schools for learners with special education needs in five urban school districts within South Africa's Gauteng province. These schools accommodate students with a broad spectrum of disabilities and are likely to include learners with complex communication needs. The participants identified various factors and challenges that influenced the use of KWS within the education system (e.g., school culture, parents and other team members, community awareness, learner-related considerations, and training needs). These factors and challenges are assessed and discussed in relation to both local and international norms. Recommendations are made regarding expanding both an understanding and acceptance of unaided AAC strategies as a further means to support learning in the educational context. [ABSTRACT FROM AUTHOR]

It is estimated that approximately 97 million people in the world have complex communication needs and may benefit from alternative and augmentative communication (AAC). Although AAC is considered an evidenced-based intervention, device abandonment remains common, and researchers have attempted to analyze the causes of people abandoning devices. These devices have been prescribed following extensive assessment and often a protracted period of negotiation with a funding body. In this paper, we present the process of AAC prescription using a new model called the Communication Capability Approach by adding the Capability Approach from Amartya Sen to the widely used Participation Model. This allows clinicians to see individual daily decision-making as a valid choice of the individual. We propose reframing the concept of device abandonment as the person and their family making a choice to use a full range of multimodal communication to meet their own needs. This changes the tone of the narrative to viewing the person using AAC as competent and able to exercise self-determination and agency in this decision rather than as abandoning the device. AAC choices can be made on a day-to-day basis, according to the context of use so that people do not abandon devices but rather use whichever mode of communication is appropriate to the context. [ABSTRACT FROM AUTHOR]

Purpose: Communication changes in multiple sclerosis (MS) are under-explored and under-recognised. Persons with MS (PwMS) are experts in their condition and play a valuable role in informing clinicians and researchers of their condition. This study aimed to investigate the perspectives of PwMS on: (1) MS-related communication changes, (2) the impact of these communication changes across key aspects of a person's life, including work/studies, relationships, and general quality of life, and (3) strategies used to facilitate communication in daily interactions. Method: Two-hundred and sixty PwMS were recruited internationally and completed an online questionnaire. Content analysis was used to analyse open-ended questionnaire responses. Result: One-hundred and ninety-seven (75.8%) participants reported communication changes, including language, cognitive, speech, voice, and fluency changes. Participants described a variety of personal and environmental factors that influence communication negatively, such as fatigue, stress, and heat. Communication changes were reported to impact on psychological wellbeing, interpersonal relationships, participation and identity in the workforce and career pathways, and tertiary studies. Around 40% of participants reported using a range of overt and covert strategies to manage communication changes. Only 11.2% (n = 22/197) of participants who reported communication changes accessed speech-language pathology (SLP) services. Conclusion: PwMS can experience a wide spectrum of communication changes. These communication changes can have a profound and far-reaching impact on psychological wellbeing and societal participation. Engagement with SLP services is limited compared to the reported prevalence of communication changes. There is a need to raise awareness of the role of SLP in service provision for PwMS to manage communication changes. This paper discusses and provides suggestions for SLP services for PwMS with communication changes. There is a timely need to develop evidence-based interventions to support PwMS manage communication changes and reduce their impact. [ABSTRACT FROM AUTHOR]

Multilingual individuals who use augmentative and alternative communication (AAC) often shift between language environments and speakers of different languages; thus, code-switching (or alternating between languages or dialects within or across contexts) becomes necessary for effective communication. Recently, AAC product developers have responded to this need by building multilingual AAC systems; however, research in multilingualism and AAC is lacking. In this paper, we discuss theoretical and practical implications for research related to code-switching using aided AAC. We use available literature investigating the sociolinguistic, psycholinguistic, and usage-based aspects of code-switching in spoken or signed modalities as a starting point for considering code-switching using aided AAC. We present examples illustrating the varied expression of codeswitching across aided AAC modalities and discuss directions for future research. [ABSTRACT FROM AUTHOR]

Significant advances have been made in interventions to maintain communication and personhood for individuals with neurodegenerative conditions. One innovation is Message Banking, a clinical approach first developed at Boston Children's Hospital (BCH). This paper outlines the Message Banking process as implemented at BCH, which includes the option of "Double Dipping," where banked messages are mined to develop personalized synthesized voices. More than a decade of experience has led to the evolution of six core principles underpinning the BCH process, resulting in a structured introduction of the associated concepts and practices with people with amyotrophic lateral sclerosis (ALS) and their families. These principles highlight the importance of assigning ownership and control of the process to individuals with ALS and their families, ensuring that as a tool it is empowering and offers hope. Changes have been driven by feedback from individuals who have participated in the BCH process over many years. The success of the process has recently been extended through partnerships that allow the recorded messages to be used to develop individual personalized synthetic voices to complement banked messages. While the process of banking messages is technically relatively simple, the full value of the process should be underpinned by the values and principles outlined in this tutorial. [ABSTRACT FROM AUTHOR]

Conversational repair has been found to play a fundamental role in the acquisition of language. This paper describes existing research on conversational repair and its relationship to language learning, whether a first language or a second language, as well as its relevance to augmentative and alternative communication (AAC). A case is made for incorporating prompts to repair in conversation-based language interventions with children learning to use AAC. We argue that interventions targeting linguistic complexity should encourage self-repair in conversation in order to develop linguistic and operational competency as well as increase automaticity when using AAC. Clinical implications and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

The current study sought to identify decisions speech-language pathologists (SLPs) make and their rationale for those decisions when designing an AAC display for a hypothetical school-aged child who was a beginning communicator. Augmentative and alternative communication (AAC) displays support communicative interactions for children who are unable to use spoken language to meet their communication needs. Children who are at the early stages of learning language, often termed beginning or emerging communicators, may rely heavily on the AAC display to support comprehension and expression. Thus, it is important for speech-language pathologists (SLPs) to design a display that facilitates beginning communicators' communication development. This paper reports on the answers related to a specific case study presented in an online survey completed by 77 SLPs with experience in AAC. Data illustrated design decisions driven by child-specific characteristics and informed by research regarding type of layout, representation, and the importance of various design features. Suggestions for future research are provided, including identifying goals and communicative functions best supported by different types of displays, clinicians' challenges/successes growing a system with the child, and determining the importance of symbol arrangement and organisation in communicative tasks by AAC users. Identification of current practices reported by speech-language pathologists given a case study to develop and implement future research. A gap between research and practice suggests the need for better dissemination and application of research supporting the inclusion of people engaged in the event depicted in a visual scene display. Foundations for future research to provide guidance regarding best design of and communication goals supported by visual scene displays and grid-based displays. [ABSTRACT FROM AUTHOR]

Collaboration among health care providers is intended to dissolve boundaries between the sectors of health care systems. The implementation of adequate augmentative and alternative communication (AAC) care of people without natural speech depends highly on collaboration among multiple stakeholders such as speech and language pathologists, teachers, or physicians. This paper examines existing barriers to and facilitators of collaboration from a stakeholder perspective. Five heterogeneous focus group interviews were conducted with N= 32 stakeholders including speech and language pathologists, AAC consultants, teachers, employees of sheltered workshops, parents, and relatives of AAC users, and other educational professionals (e.g., employees of homes for persons with disabilities) at three AAC counseling centers in Germany. Interview data were analyzed by structured qualitative content analysis. The results show very different experiences of collaboration in AAC care. Factors were identified that can have both positive and negative effects on the collaboration between all stakeholders (e.g., openness toward AAC, knowledge about AAC, communication between stakeholders). In addition, stakeholder-specific influencing factors, such as working conditions or commitment to AAC implementation, were identified. The results also reveal that these factors may have an impact on the quality of AAC care. Overall, the results indicate that good collaboration can contribute to better AAC care and that adequate conditions such as personnel, and time-related resources, or financial conditions need to be established to facilitate collaboration. [ABSTRACT FROM AUTHOR]

Institutionalised participation in South Africa's local government is a process that compels municipal officials to fulfil specific legislative imperatives, such as the coordination of all resources and the development of Integrated Development Plans (IDPs) and budgets, to ensure effective service delivery. However, for participation to be genuine and active, should it not be approached as an end in itself and not a means to achieve pre-defined imperatives? As an answer to this question, this article proposes a participatory communication framework to facilitate institutionalised participation, thereby theoretically reconceptualising participation, dialogue, and empowerment from Freirean and Habermasian perspectives. [ABSTRACT FROM AUTHOR]

This research examined an evidence based dialogic shared reading strategy which incorporated aided language modelling and increased communication partner responsiveness with two children with complex physical, cognitive, and sensory needs (CPCSN) who use auditory plus visual partner assisted scanning (PAS) to access a Pragmatic Organised Dynamic Display (PODD) communication book. The dialogic reading strategy prompted the communication partner to comment on the story, invite a communication turn, and respond contingently to the child. A case study design was employed, and data were collected via child and adult communication frequency measures, field notes, observations, and a semi-structured interview with the children's teacher. Overall, the results indicated a positive effect on the children's communication skills, both within the intervention sessions and the classroom. This included increases in turn taking, initiations, efficiency, and conveying meaning. Shared storybook interventions that include strategies such as aided language stimulation, responsiveness and wait time can support the communication outcomes of children with CPCSN who use PAS. [ABSTRACT FROM AUTHOR]

The purpose of this study was to select a core vocabulary list obtained from Mandarin Chinese-speaking Taiwanese persons without disabilities. Mandarin Chinese is dominant and official language of Taiwan. A total of 28 participants, equally divided among seven age groups, were recruited for the study. In all, 112 samples across different communication contexts were collected. Results indicated that 100 core words selected had coverage of 66.7% of the entire composite sample. The proportion of function words versus content words in the top 100 core words was 11% and 89%, respectively. The core vocabulary was categorized into eight parts of speech, including nouns, pronouns, numbers, adverbs, determiners, prepositions, adjectives, and verbs. Implications, limitations, and further research are discussed. [ABSTRACT FROM AUTHOR]

Augmentative and alternative communication (AAC) has been used by patients with acquired expressive communication disorders as an alternative to natural speech. The use of symbols to express pain, which is intangible, is challenging because designing a series of comprehensible symbols to represent personal experiences such as pain is not straightforward. This study describes (a) the development of symbols to express pain that were derived from Chinese pain-related similes and metaphors for an AAC mobile application developed specifically for this study known as PainDiary and (b) an assessment of the appropriateness of the app compared to conventional methods of collecting pain information. The symbols depicted headache pain and discomfort, which is prevalent among neurosurgical patients. The participants were 31 patients diagnosed with acquired expressive communication disorders who were receiving treatment in a neurosurgery general ward of Chang Gung Memorial Hospital in Taiwan and 14 nurses who worked on the ward. Pain information was collected by nurses using conventional methods and the PainDiary app. Assessment data, including the accuracy and efficiency of and user satisfaction with PainDiary, are compared. The results show that use of the app was effective in reporting pain and that patients required less time to report a pain event. The results further indicate that the PainDiary app was better received by younger individuals than by their older counterparts. [ABSTRACT FROM AUTHOR]

The worldwide Covid-19 pandemic has highlighted inequities faced by persons with complex communication needs (CCN) in accessing health information and education. This study reports on the perspectives of South African rehabilitation professionals regarding access to health information and education for youth with CCN. Two asynchronous online written focus groups were conducted with 15 rehabilitation professionals. Participants' contributions were thematically analysed. Participants reported that youth with CCN faced a variety of challenges when accessing health information, related, amongst others, to the format and quality of the information. Participants reported on strategies they had successfully used to support comprehension of health information and the youth's communication during healthcare encounters. Participants suggested various Covid-19-related and general health topics of value to youth, as well as a variety of multimodal and multilingual presentation formats to make health information accessible. This information was used in the development of accessible health information resources that are now freely available on the authors' institutional website. The results confirmed that there is an urgent need to make accessible health information available in order to include South Africans with CCN in health services during the pandemic and beyond. Health information and education (including information and education provided with respect to the Covid-19 pandemic) has often not been accessible to youth with complex communication needs (CCN). South African rehabilitation professionals reported on a variety of challenges that youth with CCN face when attempting to access health information and education, but also reported on strategies that had helped to support them in this. They also highlighted Covid-19-related and general health topics that would be of value to youth, and suggested a variety of information formats and strategies to make health information more accessible. This information can assist in the design of appropriate and accessible health information resources for youth with CCN and other individuals who experience communication challenges. [ABSTRACT FROM AUTHOR]

Incremental rehearsal (IR) is a flashcard intervention that involves the interspersal of previously mastered targets and immediate error correction. Previous research indicates IR is an effective intervention for teaching discrete skills. Much of existing research, however, was conducted with typically developing students. The current study aimed to extend the literature by being the first to implement IR with students diagnosed with autism spectrum disorder and an intellectual disability receiving instruction in a self-contained special-education setting. A multiple probe design across sets of stimuli was used to evaluate the effectiveness of IR on sight word and letter acquisition among three early elementary students with autism and cognitive impairment. Results indicated that IR was effective for all participants. Further, the results provided evidence that IR can be used with known stimuli from a stimulus class other than the stimulus class from which unknown stimuli are being drawn. Future research should compare IR to other flashcard interventions regularly employed with this student population. The present study suggests that IR is an effective intervention for teaching sight words to students with developmental disabilities. [ABSTRACT FROM AUTHOR]

Individuals who use augmentative and alternative communication (AAC) are often excluded from learning literacy skills that use phonological approaches due to challenges with verbal production of speech sounds. This study was conducted to evaluate the effectiveness of systematic literacy instruction with materials modified to teach letter-sound correspondences (LSC) to pre-adolescent and adolescents with autism spectrum disorders (ASD) with minimal or no speech who use AAC. A single subject design across three letter-sound sets was used, with three individuals with ASD. A total of 12 LSC were targeted in the intervention. During the intervention, the participants were instructed using model, guided, and independent practice trials using low-tech letter tiles followed by two extension activities: letter sorting and initial letter-sound picture books. A functional relationship was established between the LSC intervention and the percent of correct responses on the LSC assessment probes. Very large and large effects sizes were calculated for all participants across the three LSC sets. The study adds to the very limited research base related to phonics instruction for older learners (ages 9 to 18) with ASD, demonstrating that LSC progress can still be made at an older age with systematic instruction. [ABSTRACT FROM AUTHOR]

To describe the extent, type, and quality of studies involving robots for augmentative manipulation during play by children with severe motor impairments (CwSMI), and to explore how they influenced children's cognitive skills and engagement. Web of Science, Scopus, PubMed & EBSCO were systematically searched for articles published until March 2021, that reported cognitive skills and/or engagement outcomes from interventions involving the use of robots in play activities, where participants included CwSMI, and full-text was available. Data extracted comprised characteristics of participants, study design, purpose of the study, outcomes assessed, collection methods, and intervention carried out (robot-environment interaction and robot used). Eight mobile robots and five robotic arms were reported in the 17 included and reviewed articles. Most of them informed a positive impact on CwSMI's cognitive skills and/or engagement. However, the studies scored poorly on a five-criteria quality assessment, and only one single-case design proved strong evidence of treatment. None of the analysed interventions was an evidence-based practice. The use of manipulative robots during play activities may have a positive impact on the CwSMI's cognitive skills and engagement in activities. However, further studies with higher internal and external validity are needed to support stronger evidence. The use of robots for augmentative manipulation during play activities may have a positive influence on the cognitive functions and the engagement in activities of children with severe motor impairments. Through manipulative robots, this population could be able to show the abilities that are hidden due to their motor impairments, and subsequently, receive educational and physical training more aligned with their real capacities and potential. [ABSTRACT FROM AUTHOR]

The study aim was to develop and assess the measurement properties of the Functional Impact of Augmentative and Alternative Communication – Educator (FIAAC-E) scale – an educator-reported measure designed to detect change in factors associated with communicative participation in students who use augmentative and alternative communication (AAC). The study had three phases. In phase 1 (content validity), 22 content specialists independently rated the relevancy of 22 dimensions proposed for the new scale. In phase 2 (item generation, face validity), 8 educators independently completed a preliminary version of the FIAAC-E scale and flagged items that were unclear. Next, these educators adjusted the wording of unclear items during consensus-building sessions. In phase 3 (item reduction, reliability, convergent validity), 62 educators completed an online survey that included the revised FIAAC-E scale. Survey data were used to shorten the scale, estimate its reliability, and evaluate support for its convergent validity. In phase 1, the 11 dimensions ranked most highly by content specialists were selected for inclusion in the preliminary scale. In phase 2, educators reviewed 113 items and revised 33 to improve clarity. In phase 3, correlational statistics informed the selection of 77 items for the shortened scale. Subsequent data analyses indicated acceptable levels of internal consistency and test-retest reliability and support for convergent validity of the preliminary measure. The study provides emerging evidence that supports the FIAAC-E scale as a reliable way to evaluate communicative participation in children and youth who use AAC systems at school. Using a reliable means to measure the effectiveness of AAC for children and youth at school may reveal important factors that influence successful communicative, academic, and social participation in school. The FIAAC-E scale is a promising educator-reported questionnaire to inform the development of communication goals and monitor progress towards meeting these goals for students with complex communication needs. [ABSTRACT FROM AUTHOR]

The rise of large online communities in China has gone hand-in-hand with heavy regulation by the Chinese party-state. Caught between the party-state and demanding users, how do online platforms govern online communities to please both, and stay competitive against rivals? Drawing on public documents, interviews, and ethnographic observations, we study Bilibili, a leading online participatory platform for Generation Z. We argue that Bilibili has adopted a "bidirectional mediation" approach to actively mediate between users and the party-state. In this approach, the key to online governance is finding, or even cultivating, common grounds between users and the party-state and proactively facilitating communications between the two sides. We illustrate Bilibili's bidirectional mediation through its Disciplinary Committee, an organization that enables users to participate in regulating online content on the Bilibili platform. The Bilibili case provides important insights into the evolution of online communities and state-society relations in China. [ABSTRACT FROM AUTHOR]

Yolŋu (Aboriginal Australians of northeast Arnhem Land) are interested in developing augmentative and alternative communication (AAC) systems in their own languages to support communication opportunities and participation for their family members living with Machado–Joseph disease. Designing AAC systems in Aboriginal languages requires consideration of unique linguistic and cultural elements. Participatory action research in strength-based communication contexts was carried out by Yolŋu and Balanda (the Yolŋu word for non-Aboriginal people) researchers working together through a collaborative intercultural process. Culturally responsive literacy, language, and AAC activities were used to develop four prototype Yolŋu AAC sytems for Yolŋu with varied literacy skills. Data were coded using gerunds to identify and focus on action in the data. Reflective and analytical collaborative, oral group discussions were used to identify key considerations and, ultimately, a Yolŋu metaphor for the research. Yolŋu language, culture and worldview impacted all aspects of prototype design and decision making. Salient considerations related to representation, organization, layout, and access, are presented. Clinical implications and future research considerations are outlined. [ABSTRACT FROM AUTHOR]

Children with intellectual disabilities experience well-documented challenges in the development of problem-solving, particularly related to mathematical word-problem solving. Such challenges are related to both linguistic and conceptual skills. While interventions to assist children in developing conceptual skills are well reported, linguistic interventions within the mathematical field are limited. This study aimed to determine the effect of an augmented-input intervention, on subtraction word-problem solving for children with intellectual disabilities. A multiple baseline across behaviours design was used and replicated across the seven participants. Intervention was provided in three tiers (one week each) for change, combine, and compare subtraction word-problems. Intervention was withdrawn for a four week period and followed by a maintenance phase. Results suggested that for older participants with higher receptive language and numerical operation scores, the augmented-input intervention provided significant gains across all three types of word-problems. Overall, four of the seven participants showed improvement in subtraction word-problem solving. Augmented input may provide language supports for subtraction word-problem solving for some children with mild intellectual disability. [ABSTRACT FROM AUTHOR]

It is important to directly engage children and adolescents with disabilities (CAWD) in health promotion research to ensure their health needs are met. Arts-based research methods may help CAWD better express their ideas; photo-elicitation is one such technique, using self-captured photographs to enhance verbal descriptions of complex concepts. This review 1) summarizes findings from health promotion studies using photo-elicitation with CAWD; 2) explores benefits and challenges of using photo-elicitation; 3) identifies recommended photo-elicitation practices. A scoping review was conducted using rapid review principles. Four health and social science databases were searched (2009–2019) using terms related to children, adolescents, disability, and photo-elicitation. Articles meeting inclusion criteria were summarized and analyzed thematically. Eight studies met inclusion criteria and explored a range of health promotion topics. Benefits of photo-elicitation included the ability to mediate communication and direct participants' focus. Challenges included difficulty operating a camera and understanding instructions about photograph subject matter. Four recommended practices were identified: 1) brainstorming photograph ideas; 2) photograph-taking training; 3) having CAWD select photographs for discussion; 4) limiting the number of photographs CAWD could capture. Integrating practices to support CAWD in using photo-elicitation can help researchers more fully understand their health experiences. There is a need to directly engage children and adolescents with disabilities to express themselves in health promotion research. The arts-based method of photo-elicitation may help children and adolescents with disabilities convey how they view and experience health. Children and adolescents with disabilities may need supports, including camera training, to participate in photo-elicitation. [ABSTRACT FROM AUTHOR]

Background: Collaborative referencing tasks have evolved from historically being used as experiments to study human interactions in various disciplines, to being adapted as a clinical intervention for individuals with cognitive-communication disorders such as aphasia. For both neurotypical adults and adults with cognitive-communication disorders, evidence on successful referencing is heavily based on spoken language data. The patterns of collaborative referencing in individuals with severe spoken language impairments who extensively use hand gestures for communication remain unclear. Aims: We aimed to investigate the patterns of collaborative referencing between Clyde, an individual with severe Wernicke's aphasia using co-speech hand gestures, and a clinician-partner during the collaborative referencing intervention (CRI). Methods & Procedures: This case study included 15 CRI sessions between Clyde and the clinician-partner. Each session consisted of a photo-matching game in which the pair completed six trials with alternating turns to describe and match treatment cards over a low barrier. Data analysis included (a) measuring the mean card placement accuracy; (b) measuring the mean length of CRI trials; and (c) analysing the frequency and type of hand gestures used in no common ground and common ground conditions, and then examining if the multimodal references (i.e., labels for treatment cards produced using verbal expressions and hand gestures) simplified across CRI sessions. Outcomes & Results: Largely, the results were consistent with previous evidence on CRI: the pair scored 99.63% mean card placement accuracy and completed each trial in shorter time periods, indicating reduced collaborative effort. During the no common ground condition, the pair used a high frequency of hand gestures and a variety of gesture-type combinations to reference each card, while they used a low frequency of hand gestures dominated by iconic gestures in the common ground condition. The multimodal references were found to be simplified across sessions by the shift from using indefinite to definite verbal references, and reduced frequency and specific (iconic) types of hand gestures. Conclusions: Despite severe spoken language impairments, speakers and partners can develop common ground for successful collaborative referencing by effectively using hand gestures. Clinical implications including the role of clinicians in being a skilful and multimodal communication partner and the rich communicative environment offered by CRI will be discussed. [ABSTRACT FROM AUTHOR]

The purpose of this systematized review was to investigate how attitudes toward low-tech AAC might be impacting its use in acute care settings. A comprehensive and systematic search of databases identified 23 articles for inclusion. Thematic analysis using the World Health Organization International Classification of Functioning, Disability and Health (ICF) framework facilitated a narrative synthesis of findings. Results suggest that in acute care settings (a) adult patients, families, nursing staff, medical team, and allied health professionals all have opportunities to use but do not regularly engage with AAC; (b) individuals reject low-tech AAC devices for a variety of reasons, including that they are not useful, necessary, suitable, or appropriate in settings such as intensive care units; (c) negative attitudes toward AAC are linked to a lack of initial training and ongoing support, perceived impersonal content, limited functionality, and a lack of consistent availability; and (d) positive attitudes toward low-tech AAC are more prevalent when training and support are offered, low-tech AAC effectiveness is demonstrated, and organizational, financial, and procedural commitments are provided. Limitations of the research are highlighted and future research opportunities are identified. [ABSTRACT FROM AUTHOR]

Despite the potential positive impact of augmentative and alternative communication, the literature suggests that many individuals with disabilities experience barriers in developing communication skills and access to appropriate supports. Parents can provide valuable insight into the barriers and facilitators experienced by their children with complex communication needs. Previous studies exploring parent perspectives of the complex communication needs of children with various disabilities have revealed similarities and differences in experiences. This supports the need to examine the barriers and facilitators experienced by different populations, including individuals with Koolen de Vries syndrome (KdVS). As a newly identified syndrome, information on individuals with KdVS is limited, and studies examining parent experiences in supporting the communication needs of children with KdVS have not been conducted. This study obtained parents' perspectives regarding the communication barriers and facilitators experienced by their children with KdVS. Fifteen parents participated in one of two focus group sessions. The data were analyzed through qualitative content analysis, resulting in 13 categories discussed in relation to previous research and conceptual frameworks. Research and practical implications for developing a deeper understanding of the barriers experienced by children with KdVS are proposed. [ABSTRACT FROM AUTHOR]

Parental support is an important part of introducing an augmentative and alternative communication (AAC) system to a child. Professionals providing AAC services to children with complex communication needs should practice family-centered service provision. The aim of this study was to explore Sri Lankan parents' perspectives on AAC and their lived experiences. Semi-structured interviews were conducted with 10 parents of children with complex communication needs. Thematic analysis was used to analyze the findings, with the following themes identified: (a) External Systems, (b) Impact on the Family, (c) Impact on the Child, and (d) Communication (including AAC). Findings from this study provide important information for speech-language therapists providing services to families from low- and middle-income countries. In particular, parents reported several positive aspects of AAC. However, parents also reported challenges, including speech-language therapist's lack of knowledge of and training in AAC. [ABSTRACT FROM AUTHOR]

This study explored performance on expressive and receptive graphic symbol tasks and spoken comprehension by individuals who use augmentative and alternative communication (AAC) as well as the relationship of performance with participants' skills and characteristics. Participants were 19 children and youth (aged 5- to 18-years-old) who used aided communication. Four experimental tasks were administered, with either speech or symbols as input (stimuli) and symbols or choice from an array of pictures as output (response). Symbols were not accompanied by written or spoken labels in the tasks. Measures of receptive vocabulary, receptive syntax, memory, and visual cognitive skills as well as information regarding participant characteristics were collected. There were strong relationships among all experimental tasks. Cluster analysis revealed different response patterns that may suggest a progression in expressive and receptive performance with graphic symbol sentences. Individual differences in receptive language, particularly receptive syntax, were related to task performance. The findings suggest that different ways of experiencing symbols, in addition to spoken comprehension of the sentences and receptive spoken language more generally, may contribute to expressive graphic symbol sentences. Performance on receptive symbol tasks may uncover a level of facility with the graphic-symbol modality not observed through expressive symbol use in communicative situations. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the reported responses of speech-language pathologists (SLPs) to the rejection or abandonment of AAC systems for children with complex communication needs. Methods: Semi-structured in-depth interviews were conducted with 16 SLPs who worked with children with complex communication needs. Interviews were transcribed and coded using thematic analysis. Results: Four themes describing SLPs' responses were identified: (1) SLPs work with families; (2) SLPs respect families' wishes; (3) SLPs "push ahead" with AAC irrespective of families' wishes; and (4) SLPs reflect and acknowledge emotions. Conclusions: SLPs varied in the degree to which they remained family-centred and utilised clinical reflection following the rejection or abandonment of AAC systems for the children they worked with. SLPs also described experiencing a range of negative emotions following the rejection or abandonment of an AAC system, which could impact upon ongoing client care. In this research SLPs reported variability in the degree to which they remained family-centred following the rejection or abandonment of an AAC system for the children they worked with. SLPs should reflect on their emotional responses to the rejection or abandonment of AAC systems by their clients. This research suggests that SLP services should consider monitoring the reflective practices of their clinicians to ensure ongoing clinical development and optimisation of client care. [ABSTRACT FROM AUTHOR]

This article explores how deafblind Australian Sign Language (Auslan) users, who communicate through an alternative range of modalities including tactile (hands) and kinetic (body movement) inputs, manage turn transitions. Studies of deafblind communication have typically employed a signal-based approach. In contrast, this article applies broader Conversational Analysis (CA) frameworks, which have been developed based on interlocutors who primarily rely on auditory-vocal and visual resources but have been productively applied to a range of languages, participants, and settings. Through fine-grained analyses of a single case study, this article examines how tactile Auslan signers orient to the relevance of turn transitions at possible completion points. The research illuminates the mechanics of how tactile Auslan signers negotiate turns and advances our understanding of both the analytical potentials of CA and the ways particular deafblind Auslan signers coordinate sequences, actions, and multimodalities in their interactional choreography. Data are in tactile Auslan. [ABSTRACT FROM AUTHOR]

This study explored the perceptions of staff members regarding the implementation of a new communicative approach at a multidisciplinary neurorehabilitation centre in Denmark. Communication partner training according to Supported Conversation for Adults with Aphasia (SCATM) was combined with augmentative strategies from the KomHIT programme to increase the influence of patients with aphasia on their own rehabilitation process. A qualitative approach was used involving two semi-structured group interviews with multidisciplinary staff in two wards. Three staff members from each ward participated. The recorded interviews were transcribed, and a thematic analysis of the data was conducted. Three main themes emerged from the analysis. Participants reported increased influence of patients with aphasia on their own rehabilitation process, as well as an increased focus on communication with patients with aphasia. Challenges included time restrictions and dilemmas in goal setting. Increasing staff knowledge of communication support and augmentative strategies seemed to improve the influence of patients with aphasia on their own rehabilitation process. Because the results were based on interviews with a small number of staff, they cannot be generalized and require further investigation that should also include interviews with the patients themselves and their families. The combination of partner training with augmentative strategies may increase staff understanding of all individuals' rights to have their communicative needs met. The combination of partner training with augmentative strategies may support the influence of persons with aphasia on their own rehabilitation. Goal setting discrepancies between staff and patients with aphasia can be brought to light by more successful communication. The implementation of a new communicative approach can be challenged by a number of factors, e.g., time restrictions. The implementation process needs to be supported by actions on a higher organisational level. [ABSTRACT FROM AUTHOR]