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Aided language stimulation is an augmented input strategy that facilitates the expressive and receptive language skills of persons who require augmentative and alternative communication (AAC). The aim of this study was to determine and compare the acquisition of receptive vocabulary items during implementation of aided language stimulation with dosages of 40% and 70%, respectively. An adapted alternating treatment design was replicated across six participants with complex communication needs and severe intellectual disability. All participants demonstrated receptive vocabulary acquisition when aided language stimulation was provided with a dosage of 70%, and two participants demonstrated acquisition when a dosage of 40% was provided. Receptive vocabulary acquisition was maintained following a 6-day withdrawal period. The dosage of augmented input may impact receptive vocabulary acquisition for children with complex communication needs and severe intellectual disability, with higher dosages being more effective for some participants. The findings indicate that clinicians should be aware that dosage is an important consideration when providing aided language stimulation to facilitate receptive vocabulary acquisition in children with complex communication needs and severe intellectual disability.

Background: An individual's ability to make autonomous decisions is fundamental to self-determination. The presence of neurological pathology, for example, aphasia, and its associated difficulties with language and/or cognition, may affect an individual's capacity to make decisions, or their ability to reveal their capacity to make decisions. Decision-making by persons with aphasia (PWA) can be enhanced when communication partners are trained and if communication supports are provided, for example, supports that reduce the linguistic and cognitive demands of the task, and/or that facilitate expression. Aims: The main aim of this review is to identify the types of decisions for which persons with post-stroke aphasia receive support, the communication partners involved in supporting decision-making by PWA and the communication strategies implemented to support decision-making by PWA. Methods & Procedures: A multifaceted search strategy was used. Specific keywords were used to search seven electronic databases. Hand-searches of two journals, as well as ancestral searches of the reference lists of selected articles was also performed. Through the application of predefined selection criteria, 16 journal articles, spanning from 1998 to 2021, were selected from the initial yield of 955 articles for inclusion in this review. Data pertaining to the aims of the study were extracted using a data-extraction form. Outcomes & Results: This review shows that most of the research to date has focused on supporting persons with post-stroke aphasia in decisions pertaining to discharge planning or accommodation, and decisions pertaining to informed consent for participation in research. The communication partners cited most frequently as supporting decision-making by PWA are speech-language pathologists and family members. A range of communication strategies, most of which are components of Supported Conversation Techniques for Adults with Aphasia (SCA™), support decision-making by PWA. The most frequently listed strategies include augmenting information with different modalities, acknowledging the competence of the PWA, thereby inviting initiation and collaboration by the PWA, and the allocation of sufficient time for the decision-making process. Conclusions & Implications: This review presents research trends regarding the support of PWA in decision-making. Future research should focus on the effectiveness of the different strategies identified, and on the support of PWA in the making of a greater variety of complex decisions.

Quality early home literacy experiences, specifically young children's shared storybook reading experiences, have been identified as critical for establishing the foundations of reading and writing skills. Despite this, literature reports that children with complex communication needs (CCN) have limited exposure to literacy material. There is, however, a paucity of research regarding the home literacy experiences of children with disabilities specifically those with CCN and in developing countries contexts. This study aims to analyse the behaviours of both primary caregivers and their children with CCN during shared storybook reading using a descriptive, observational design. Twelve primary caregivers and their children participated in the study. The 12 participating dyads were video recorded during shared storybook reading activity. Their interactions were analysed using a communicative behaviour checklist coding communicative behaviour of both dyad participants during the shared storybook reading. Results were similar to previous studies conducted on children with CCN from developed countries. The caregivers showed higher rates of interaction as compared to their children, whilst they focused on labelling the pictures rather than reading the story verbatim. Although patterns of interaction varied across the caregivers, they seldom asked complex questions or related the story to the child's utterances. The children, on the other hand, seldom asked questions or commented on the stories. Their interaction patterns could have been improved, should the children have had access to communication devices and caregivers guided on using strategies to facilitate learning during these shared literacy activities.

Background: Friendship is a crucial relationship for young adults with disabilities as it offers practical support and enjoyment, and it is essential to well-being and health. The present study examined the friendships of young adults with physical disabilities whose challenges with natural speech necessitate the use of augmentative and alternative communication. Methods: Ten adults aged 19-32 were interviewed about their friendships. The semi-structured interviews were often co-constructed conversations between the participant, the carer and the interviewer. A process of largely inductive thematic analysis was followed, although this was guided by the existing literature on friendship experiences of persons using AAC. Results: Four themes were identified, namely companionship, quality of friendship, desire for independence, and the role of technology in mediating friendships. Conclusion: The participants in this study experienced positive relationships with friends. The importance of being understood by their friends and the role of social media in maintaining these friendships were highlighted.

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.

In South Africa, many children with extensive support needs—including children who require AAC—are accommodated in care centers rather than the public schooling system. Caregivers employed at these centers need training in order to support children's communication using augmentative and alternative methods. A total of 29 center-based caregivers took part in this study. A single group pretest-posttest design was used to evaluate the effect of a 5-day training workshop on caregivers' ability to demonstrate and implement five AAC strategies. The effect of the workshop on caregivers' perceptions of their own skills as well as the social validity of the training were also evaluated. Results suggest that the workshop effectively taught caregivers to demonstrate the skills in a simulated roleplay situation. A proportion of caregivers also supplied video footage after the workshop that suggests the ability to implement the strategies in the care center contexts. Caregivers also perceived their own skills to have improved post workshop, and evaluated the training positively. [ABSTRACT FROM AUTHOR]

Participation is a fundamental human right, and being able to communicate is an essential component of participation in various life situations, such as at school, with peers, and in the community. Augmentative and alternative communication (AAC) interventions aim to facilitate communication and social interaction, independence, and participation in all aspects of life. The purpose of this study was to summarize and map the AAC intervention outcomes for children with complex communication needs onto the Family of Participation-Related Constructs (fPRC) framework. The scoping review identified 270 studies for inclusion, and the data gathered was extracted and mapped onto the fPRC framework. The results indicate that although many studies have reported on participation-related constructs such as activity competence and context, there is still insufficient focus on attendance and involvement, sense of self, and environment constructs. Hence, future research in the field of AAC is needed on the various constructs of participation proposed by the fPRC framework. [ABSTRACT FROM AUTHOR]

Assistive technology (AT) with context-aware computing and artificial intelligence capabilities can be applied to address cognitive and communication impairments experienced by persons with dementia (PwD). This paper aims to provide an overview of current literature regarding some characteristics of intelligent assistive technology devices (IATDs) for cognitive and communicative impairments of PwD. It also aims to identify the areas of impairment addressed by these IATDs. A multi-faceted systematic search strategy yielded records. Predefined criteria were applied for inclusion and data extraction. Thereafter data was thematically analysed and synthesised. This review demonstrates that almost all of the research involving IATDs has focused on cognitive impairments of PwD and has not yet evolved past the conceptual or prototype stages of development. Summaries of commercially available IATDs for PwD and relevant prototypes are provided at the end of this review. This research concluded that IATDs for PwD targeting cognition and communication problems primarily focus on social robots, and that they address cognitive impairments of attention, affect, and social-pragmatic communicative impairments. Future research endeavours concerning AT for PwD should explore collaboration between computer engineering and health practitioners to address the identified gaps. This may contribute to the available information for evidence-based decision making for PwD. [ABSTRACT FROM AUTHOR]

AbstractSince effective and successful AAC service delivery relies on the knowledge and competence of professionals in the field of AAC, sufficient training in AAC will equip professionals to provide quality AAC service delivery. However, many professionals lack training in AAC and structured opportunities for professional development are sorely needed. As there is no consensus on the amount, mode of delivery and content of AAC training, the purpose of this scoping review was to identify AAC training programs for professional development and to describe the characteristics and effects of such programs. A five-pronged search strategy was used to identify relevant studies. The certainty framework was used to appraise the quality of included studies. Charted data included general study characteristics; participant characteristics; training characteristics (i.e., training goals; instructional materials and strategies; training duration); quality appraisal; and reported effects of the training. The scoping review identified 34 studies for inclusion. The results showed the potential of AAC training programs for continuous professional development to increase professionals’ skills in AAC intervention. A range of training characteristics was identified to guide the development of future training programs. Gaps in the research related to the training of AAC professionals were also identified to guide future research. [ABSTRACT FROM AUTHOR]

Purpose: Despite general agreement on the importance of person-centered care in speech-language pathology, guidelines for developing person-centered interventions for those with dementia are limited. This study aimed to obtain expert opinion on the components of a person-centered augmentative and alternative communication (AAC) intervention for persons with dementia. Method: A modified electronic Delphi technique was employed in a single round. A purposively sampled panel of experts was invited to provide their opinion on three open-ended questions related to (a) the elements of person-centered care, (b) communication supports, and (c) the interaction outcomes of a person-centered intervention. Thirty-one experts from nine countries participated on the panel. The majority were speech-language pathologists primarily involved in research. Qualitative written data were coded and analyzed using content analysis. Results: Nine components were identified across the three open-ended questions: (a) the unique characteristics of the person with dementia, (b) working with a person with dementia, (c) preserving personhood, (d) a different view on person-centered care, (e) a range of communication supports, (f) supportive conversational partners, (g) designing communication supports, (h) interaction outcome measure, and (i) meaningful interaction outcomes. Conclusion: This study identified nine components that are useful in guiding speech-language pathologists in crafting future person-centered AAC interventions for people with dementia. [ABSTRACT FROM AUTHOR]

Background: Communication is an important priority in dementia research. Communication strategies and scaffolds, specifically through augmentative and alternative communication (AAC), offer vital compensatory support for persons with dementia in an attempt to maintain the latter's quality of life and well-being through participation with others. To date, no research review has been published that synthesizes the current research of AAC in the field of dementia. Aims: To provide an overview of current AAC strategies and techniques used for supporting communication in dementia by surveying the literature base in a systematic manner, synthesizing the findings and highlighting trends and gaps. Methods & Procedures: A multifaceted search strategy included nine electronic database searches, using specific keywords. Application of predefined selection criteria during screening procedures led to the inclusion of 39 studies. Data were extracted and studies synthesized according to communication partners; description of AAC strategies and techniques; outcome measures; and communication outcomes. Main Contribution: This review shows that the majority of the research to date has focused on supporting the interactions of persons with dementia of the Alzheimer's type (DAT) using non-electronic memory and communication aids. Future research should focus on social participation and person-centred communication to optimize functional communication with AAC. Training programmes targeting dyadic interaction and supporting persons with dementia from diverse ethnic backgrounds are avenues for further research. Conclusions: Research trends and, more importantly, the gaps highlighted in this research review present speech-language therapists and researchers with a set of current priorities that are necessary for the advancement of the knowledge base.

Background Aim Method & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the practical and clinical implications of this work? Over 8 million children with disabilities live in Africa and are candidates for augmentative and alternative communication (AAC), yet formal training for team members, such as speech–language therapists and special education teachers, is extremely limited. Only one university on the continent provides postgraduate degrees in AAC, and other institutions provide only short modules at an undergraduate level. The need for an introductory training course on AAC that is accessible by university students continent‐wide was identified. An online programme, namely an intelligent tutoring system (ITS), was identified as a possible option to facilitate interactive learning without the need for synchronous teaching. The use of an ITS is shown to be effective in developing knowledge and clinical reasoning in the health and rehabilitation fields. However, it has not yet been applied to student teaching in the field of AAC.To determine both the feasibility of an ITS to implement an AAC curriculum for students in four African countries, and the usability and effectiveness of such a system as a mechanism for learning about AAC.The study included two components: the development of a valid AAC curriculum; and using the ITS to test the effectiveness of implementation in a pre‐ and post‐test design with 98 speech–language therapy and special education students from five universities.Statistically significant differences were obtained between pre‐ and post‐test assessments. Students perceived the learning experience as practical, with rich content.The findings suggest that the ITS‐based AAC curriculum was positively perceived by the students and potentially offers an effective means of providing supplementary AAC training to students, although modifications to the system are still required. Professionals typically lack formal training in AAC. In Africa, this presents a serious challenge as there are over 8 million children who are candidates for AAC. A need for an introductory training course on AAC, which can be accessed by university students continent‐wide, was identified. An AAC curriculum was developed and integrated into an ITS, an online programme allowing interactive learning through asynchronous teaching. Students from four African countries completed the AAC ITS curriculum. The curriculum was positively received by the students and statistically significant changes in knowledge were identified. This feasibility study shows that the use of an ITS is an effective means of providing AAC training to university students in these African countries. The results provide a valuable contribution toward ensuring the equitable distribution of AAC training opportunities in the African context. This will have a significant positive impact on those who are candidates for AAC. [ABSTRACT FROM AUTHOR]

Student engagement is a prerequisite for successful learning. Due to the tremendous change in the use of information and communication technologies, the nature of this engagement has had to adapt to fit a hybrid approach of teaching and learning. In this qualitative study, three focus group discussions were conducted that aimed to investigate adult learners' perspectives on their engagement in a hybrid learning postgraduate programme. Deductive content analysis was done of the transcribed data using Pittaway's Engagement Framework. Main findings were that adult learners' computer literacy skills impacted on their own self-efficacy towards their ability to study and use technology. Lecturers' social engagement, especially their support to students, was also highlighted. Other factors, such as Internet access and power failures, hampered adult learners' access to online activities. An adapted engagement framework for adult learners is proposed and should be taken into account when developing new online programmes for adult learners.

Background: Interactive engagement, specifically attention and initiation, are considered important skills for facilitating development and learning in students with severe/profound intellectual and multiple disabilities. Prior research has suggested that music therapy and multisensory storytelling are two promising interventions for supporting interactive engagement in this population. However, there are no known/published studies that have investigated the effect of combining relevant elements from musical interaction and multisensory storytelling for this group of students. This study aims to determine the effect of a novel educational approach—MultiSensory Music Drama (MSMD)—on the interactive engagement of students with severe/profound intellectual and multiple disabilities. Methods: A single‐case experimental design, specifically an ABAB design across three participants, was used to describe the effect of MSMD on interactive engagement when compared with a control activity. School staff members' perceptions of student interactive engagement and social validity were obtained. Findings: Coded video observations showed significantly higher levels of interactive engagement during MSMD for all three participants when compared to the control activity. Furthermore, the ratings on the interactive engagement from school staff members improved for two of the three participants. Finally, school staff members scored the social validity and perceived educational usefulness of the MSMD as very high. Conclusions: The findings provide initial evidence that MSMD may be effective in supporting the interactive engagement of some students with severe/profound intellectual and multiple disabilities. Accessible summary: Engagement in activities is important for development and learning.Many people enjoy music activities and taking part in storytelling.In this study, a combination of music, drama and sensory stimulation was tested with three students with intellectual and multiple disabilities.The activity was engaging for the students and was positively viewed by their teachers. [ABSTRACT FROM AUTHOR]

This article describes the family quality of life among families who are raising a young child with autism spectrum disorder. Survey research was conducted with 180 families of children with autism spectrum disorder who were receiving disability-related services in the Gauteng province of South Africa. The principle measure used was the Beach Center Family Quality of Life Scale to assess five subdomains: family interaction, parenting, emotional well-being, material/physical well-being, and disability-related support. Results indicated that families felt the most satisfied with disability-related support and the least satisfied with the family's emotional well-being. Family income, family type, and the severity level of autism were significantly associated with how satisfied families felt about their quality of life.

A central tenant of early childhood intervention (ECI) is collaboration between professionals and the caregivers of children receiving these services. There are limited studies on caregiver perceptions of collaboration in ECI teams particularly in resource-limited countries. Sixty-four caregivers participated in this study by completing a questionnaire on their perceptions of collaboration in ECI services in South Africa. The questionnaire survey was administered in a group setting by a trained research assistant who was proficient in the Setswana language. The results revealed that caregivers have a good understanding of collaboration in ECI services. However, collaboration, in relation to family-centered practices, appeared to be undervalued by caregivers. These results are discussed and the limitations of the study as well as future recommendations are outlined.

Background: An individual's ability to make autonomous decisions is fundamental to self‐determination. The presence of neurological pathology, for example, aphasia, and its associated difficulties with language and/or cognition, may affect an individual's capacity to make decisions, or their ability to reveal their capacity to make decisions. Decision‐making by persons with aphasia (PWA) can be enhanced when communication partners are trained and if communication supports are provided, for example, supports that reduce the linguistic and cognitive demands of the task, and/or that facilitate expression. Aims: The main aim of this review is to identify the types of decisions for which persons with post‐stroke aphasia receive support, the communication partners involved in supporting decision‐making by PWA and the communication strategies implemented to support decision‐making by PWA. Methods & Procedures: A multifaceted search strategy was used. Specific keywords were used to search seven electronic databases. Hand‐searches of two journals, as well as ancestral searches of the reference lists of selected articles was also performed. Through the application of predefined selection criteria, 16 journal articles, spanning from 1998 to 2021, were selected from the initial yield of 955 articles for inclusion in this review. Data pertaining to the aims of the study were extracted using a data‐extraction form. Outcomes & Results: This review shows that most of the research to date has focused on supporting persons with post‐stroke aphasia in decisions pertaining to discharge planning or accommodation, and decisions pertaining to informed consent for participation in research. The communication partners cited most frequently as supporting decision‐making by PWA are speech–language pathologists and family members. A range of communication strategies, most of which are components of Supported Conversation Techniques for Adults with Aphasia (SCA™), support decision‐making by PWA. The most frequently listed strategies include augmenting information with different modalities, acknowledging the competence of the PWA, thereby inviting initiation and collaboration by the PWA, and the allocation of sufficient time for the decision‐making process. Conclusions & Implications: This review presents research trends regarding the support of PWA in decision‐making. Future research should focus on the effectiveness of the different strategies identified, and on the support of PWA in the making of a greater variety of complex decisions. WHAT THIS PAPER ADDS: What is already known on the subject: PWA have the right to be given the opportunity to participate in personally relevant decision‐making through all stages of life. Research has shown that decision‐making can be enhanced with trained communication partners and if supports are provided that reduce the linguistic and cognitive demands of the task, and that support the expressive abilities of PWA. What this study adds to existing knowledge: This scoping review is the first to synthesize the findings of research regarding the types of decisions for which persons with post‐stroke aphasia receive support, the communication partners supporting PWA in making these decisions and the communication strategies implemented to support decision‐making by PWA. What are the potential or actual clinical implications of this work?: Clinicians working with PWA may be sensitized to the role they can play in supporting decision‐making by PWA, the current state of the literature regarding types of decisions that may need to be supported, communication partners who can provide such support and communication strategies that may be helpful in this regard. [ABSTRACT FROM AUTHOR]

Various factors influence the selection of assistive technology for young children within a context with limited resources, such as South Africa. Rehabilitation professionals are required to weigh up different factors as part of their professional reasoning process when making assistive technology (AT) selections. Insight into the perceived influence of different factors may assist in understanding how professionals make decisions about AT in this context. An online survey with questions designed using best–worst scaling was distributed to rehabilitation professionals throughout South Africa. Factors influencing assistive technology selection included in the best–worst survey were identified in previous phases of a larger project. A total of n = 451 rehabilitation professionals completed the survey by selecting the factors that were most and least influential on their assistive technology provision. Results of the survey were obtained by calculating the number of times each factor was selected as most influential across the entire sample, and across all questions, enabling the researchers to sort the items in terms of the frequency of selection. Even though the rehabilitation professionals that participated in the study provide services in a context with limited resources, assessment and factors pertaining to the assistive technology itself were generally perceived to be of greater influence than environmental factors. It is recommended that these factors be reflected in frameworks and models of AT selection. The family's ability to support the implementation of AT is an important resource that is perceived to influence the selection of AT by an RP. Insight into the mind-set of professionals that are used to selecting AT within settings with limited resources may provide RPs in well-resourced contexts with guidance on how to do more, with less. RPs should aim to determine child preference and attitude towards AT during the AT selection process. RPs should be aware of their own influence on AT selection. Existing AT Selection models should be adapted to clearly reflect the influence of the recommending professional. [ABSTRACT FROM AUTHOR]

This article describes the family quality of life among families who are raising a young child with autism spectrum disorder. Survey research was conducted with 180 families of children with autism spectrum disorder who were receiving disability-related services in the Gauteng province of South Africa. The principle measure used was the Beach Center Family Quality of Life Scale to assess five subdomains: family interaction, parenting, emotional well-being, material/physical well-being, and disability-related support. Results indicated that families felt the most satisfied with disability-related support and the least satisfied with the family's emotional well-being. Family income, family type, and the severity level of autism were significantly associated with how satisfied families felt about their quality of life., Author(s): Liezl Schlebusch [sup.1] , Shakila Dada [sup.1] , Alecia E. Samuels [sup.1] [sup.2] Author Affiliations: (1) 0000 0001 2107 2298grid.49697.35Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, [...]

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]