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This paper uses Conversation Analysis to examine four dyads of speech-generating device (SGD) mediated interaction involving two non-speaking children (Steve and Lucas) with severe physical impairments and intellectual disability. Participation in interaction with an SGD is often hard work. For example, turn production is prolonged in time (Savolainen et al., 2020) which affects temporality and sequentially, and the vocabulary is chosen and arranged by someone else. Embodied resources may be quicker and easier to use, but in the long run, SGD-mediated interaction can enhance non-speaking participants opportunities to participate in interaction (Caron & Light, 2016). The video recordings (5 hr 46 min) were collected at Lucas’ and Steve’s schools in Sweden between May to November 2018. The first 30 minutes of every session were transcribed and screened for sequences where initiatives by the communication partner’s were followed by a contribution with the child’s’ SGD. We identified 134 sequences, and they were analysed for practices that mobilised the child’s SGD use. The analysis showed that a combination of different practices mobilised SGD-mediated contributions: (a) environmental arrangements, (b) explicit embodied practices, (c) features of linguistic and prosodic resources, and (d) shifts from spoken turns that constructed an epistemic asymmetry to turns that increased the deontic pressure to use the SGD. Response mobilisation in SGD-mediated interaction involving beginner non-speaking users with intellectual disability appeared as joint communicative projects achieved within extended interactional sequences. These results indicate that non-speaking children with intellectual disability who are beginner SGD users need communication partners who show enhanced other-orientedness and responsiveness, and who use multimodal practices in motivating and joyful activities. References Caron, J. G. and J. Light (2016). "Social media experiences of adolescents and

This multimodal conversation analysis study is part of a larger video ethnographic project that explores the media literacy practices that children develop as they use digital and mobile technologies. The study investigates how Swedish students in grades 3–4 make use of text to speech (TTS) technology as an interactional resource during collaborative writing on iPads in the classroom. The results show that students routinely make use of synthetic voicings to display and claim knowledge about the voiced written units and negotiate writing roles with differing epistemic rights and obligations to assess voicings and practice repair.

Interaction mediated by speech-generating devices (SGDs) may promote participation and independence for non-speaking children, but developing skills to use the SGD is time consuming and demanding. The present conversation analysis study aimed to identify features of interactional projects that mobilized SGD-mediated responses by two children with intellectual disability who were beginner-level users. The children and their professional communication partners were video recorded when interacting in an institutional setting. The analysis shows that SGD-mediated responses were mobilized by multimodal and sequentially organized actions combining different types of spoken initiatives, SGD modelling, and embodied resources that facilitated SGD use and hence participation. These results indicate a need for communication partners to use a wide range of practices to facilitate SGD-mediated interaction.

Conversation Analysis was used to explore how teachers, personal care assistants, and students organized inclusive multiparty classroom interaction when one of the students in the classroom used an eye-gaze accessed speech-generating device (SGD). Scaffolding and collaborative practices that created a response space for the construction of the eye-gaze accessed SGD-mediated turn were identified and analyzed. The participants were two adolescent students with severe cerebral palsy and intellectual disability who relied on eye-gaze accessed SGDs, and their teachers, personal care assistants, and classmates with intellectual disabilities. The data consisted of 2 hr and 40 min of video recordings collected in the participants’ classrooms. Three practices were identified (a) the practice of explicit turn allocation organization and the use of display questions, (b) the practice of locally contingent on-screen scaffolding activities, and (c) the practice of dealing with turn competition by classmates. Teacher and assistant practices differed with regard to the student’s access to the vocabulary relevant to answering the teacher’s question. The practices were found to create a response space for students using SGDs accessed via eye gaze, thereby ensuring their educational inclusion in the classroom.

Eye gaze accessed speech generating device (SGD)-mediated communication presupposes additional communicative competence of both aided speaking and speaking interlocutors. For example, speaking interlocutors need to interpret the aided speaking interlocutor’s deviant gaze practice and handle the temporally dislocated SGD-mediated utterances clause-by-clause (Engelk & Higginbotham 2013; Hörmeyer & Renner 2013). This study investigates how interaction, mediated by a SGD that is accessed with eye gaze technology, is organized in four different interactional contexts, and how these contexts impact Steve’s abilities to participate. The participant using the SGD, Steve, is 18 yrs and has physical and cognitive disabilities due to cerebral palsy. He communicates through gaze practice, facial expression, vocalization and the SGD. Steve has no oral speech and cannot read or write. Steve interacts with four conversational partners; his teacher, his personal assistant and his two occupational therapists. He had known the teacher for 1 year, the assistant for 1 ½ year, and the occupational therapists for 12 years and 5 months respectively. Data were collected using video recordings of social interaction at Steve’s school between August and November 2018. Two cameras were used to capture (1) the SGD screen and (2) Steve and his interlocutor. The interactions were transcribed and analysed using the methods and principles of Conversation Analysis (Sidnell 2012; von Tetzchner & Basil 2011). The analysis demonstrates that the interaction between Steve and his speaking partners was differently organized, depending on the partner’s ways of scaffolding the interaction, such as confirming, reformulating, voicing and asking questions. The use of scaffolding practices varied significantly between the four partners, which provided Steve with different interactional opportunities to participate and co-construct meaning. Steve’s ability to use the SGD, gaze, facial expressi

This conversation analysis study investigates facilitators’ simultaneous use of speech and aided means in instructional interaction with children with complex communication needs (CCN), who use aided communication in an everyday setting. The participants were children with severe speech impairments and their everyday communication partners. The analysis focused on facilitators’ aided turns immediately following aided turns by the children, within so-called retro-sequences. Retro-sequences were found in interactions involving four out of nine children. The facilitators systematically combined a spoken turn with an aided turn, a speaking and pointing (SAP) practice. The pointing consisted of a single graphical word, mostly a noun. The multimodal practice generally highlighted, emphasized, or exposed graphical words that increased noticeability and understandability within the local context. Adult repeats were treated as requests for confirmation of a candidate understanding and were responded to by the child using vocal and embodied resources. Reformulations (recasts) were treated as profferings of candidate understandings and were responded to using the communication device. The findings indicate that the partner’s use of a spoken and aided follow-up action shaped the immediate context for device use. The findings are relevant for the design of naturalistic interventions and may be used to improve treatment descriptions in augmentative and alternative communication (AAC) interventions.

This Conversation Analysis study investigated how a speech and language therapist (SLT) created opportunities for communication aid use in multiparty conversation. An SLT interacted with a child with multiple disabilities and her grandparents in a home setting, using a bliss board. The analyses demonstrated a practice where the SLT employed sequential and multimodal methods to open up interactional spaces for board use. The board was used within this space either by the child, or by the SLT. The space was then closed by the SLT's attentive checking for confirmation or rejection of the meaning of the board indication. The meaning-making processes were actively initiated, supported, and closed by the therapist, using a variety of linguistic and bodily methods such as questions, non-finished turns, indication modeling, and adjusting the board's position. The child confirmed or rejected the therapist's moves using board indications, vocalizations, gaze, head movements, and smiles. The analysed practice creates opportunities for teaching and possibly also for learning how to use a communication aid.

INTRODUCTION: A number of safety signals-complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), and chronic fatigue syndrome (CFS)-have emerged with human papillomavirus (HPV) vaccines, which share a similar pattern of symptomatology. Previous signal evaluations and epidemiological studies have largely relied on traditional methodologies and signals have been considered individually. OBJECTIVE: The aim of this study was to explore global reporting patterns for HPV vaccine for subgroups of reports with similar adverse event (AE) profiles. METHODS: All individual case safety reports (reports) for HPV vaccines in VigiBase(®) until 1 January 2015 were identified. A statistical cluster analysis algorithm was used to identify natural groupings based on AE profiles in a data-driven exploratory analysis. Clinical assessment of the clusters was performed to identify clusters relevant to current safety concerns. RESULTS: Overall, 54 clusters containing at least five reports were identified. The four largest clusters included 71 % of the analysed HPV reports and described AEs included in the product label. Four smaller clusters were identified to include case reports relevant to ongoing safety concerns (total of 694 cases). In all four of these clusters, the most commonly reported AE terms were headache and dizziness and fatigue or syncope; three of these four AE terms were reported in >50 % of the reports included in the clusters. These clusters had a higher proportion of serious cases compared with HPV reports overall (44-89 % in the clusters compared with 24 %). Furthermore, only a minority of reports included in these clusters included AE terms of diagnoses to explain these symptoms. Using proportional reporting ratios, the combination of headache and dizziness with either fatigue or syncope was found to be more commonly reported in HPV vaccine reports compared with non-HPV vaccine reports for females aged 9-25 years. This disproportion

Asking a question can be a highly challenging task for a person with multiple disabilities, but questions have not received much attention in research on augmentative and alternative communication (AAC). Conversation analysis is employed to examine an instance of multiparty interaction where a speech and language therapist supports a child with multiple disabilities to ask a question with a communication board. The question is accomplished through a practice where the action is built as a trajectory of interactional steps. Each step is built using ways of involvement that establish different participation spaces designed to deal with different aspects of asking a question: agreeing on the action type, the speaker and recipient, the content of the question, and then asking the question. The segmentation of a question into discrete steps and participation spaces can be used in intervention to model the construction of a question for AAC users and significant others.