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Objectives: This study reviewed previous studies examining the effect of augmentative and alternative communication (AAC) intervention on expressive language ability, cognitive ability, and quality of life of individuals with dementia to provide effective treatment approaches in clinical settings.Methods: A total of 8 studies on AAC interventions for dementia were selected through a literature search in the database and selection process. To comprehensively analyze the intervention effect sizes reported in the literature, a metaanalysis method was applied, and the effect size Hedges’ g was calculated for each measurement variable.Results: Results showed that the overall effect size of the AAC intervention was g= .864, which was statistically significant and effective at 95% confidence intervals. To be specific, there were significant positive effects on cognitive ability and quality of life. However, the AAC intervention did not have a significant effect on the expressive language ability of individuals with dementia.Conclusion: The meta-analysis method was applied to comprehensively analyze whether AAC intervention had a significant effect on the communication and quality of life of patients with dementia. By reviewing the results of the previous studies, effective AAC interventions in language, cognition, and quality of life of dementia patients were reviewed. Directions for future studies on AAC intervention in dementia were discussed.

Objectives: To provide empirical evidence that can be applied in medical settings, this study aimed to examine the effects of AAC display types on message production ability in patients with cognitive-communication disorders who are hospitalized and the correlation with the patients’ reading abilities.Methods: Twenty patients with cerebral vascular accidents who were diagnosed with cognitive-communication disorders participated in this study. Message production abilities were examined by measuring accuracy scores and response times under three AAC display conditions: (1) text-based visual scene display (VSD), (2) mixed type (text and graphic symbol-based) of VSD, and (3) graphic symbol-based GRID.Results: The graphic symbol-based GRID showed significantly high accuracy scores and short response time compared to the text-based VSD. There was no significant difference between the graphic symbol-based GRID and the mixed type of VSD in terms of accuracy scores and response time. In addition, significant correlations between the VSD type of display and the reading task scores were found.Conclusion: This study showed that the VSD types of AAC display do not enhance the communication efficacy more than the graphic symbol-based GRID in medical settings. It is at odds with a previous study that claims the effectiveness of text-based VSD without considering patients’ reading ability. These results suggest that rather than perceiving VSD itself to be more effective than other display types, it is important to provide individual graphic symbols so that reading impaired patients can understand the meaning of each message.

Objectives: People with complex communication needs who have intact literacy skills such as individuals with amyotrophic lateral sclerosis may require a complementary approach by using augmentative and alternative communication (AAC) tools that allow them to communicate only with eye movements. To provide empirical evidence on letter-based AAC intervention for adults with severely limited physical movement, this study examined message production ability in two eye-gazed selection conditions by using the Eyelink board and the E-Tran board.Methods: Forty healthy young adults participated in this study. They completed the message production task by using the Eyelink board and the E-Tran board for the same target messages. Task performance was analyzed by measuring the accuracy scores and response times.Results: When participants used the Eyelink board, the accuracy scores were significantly higher than that of the E-Tran board. They also showed a significantly shorter response time with the Eyelink board. The preference survey showed that the Eyelink board scored high.Conclusion: This study has clinical implications showing that the Eyelink board is a more accurate and efficient way as an eye-gaze low-tech AAC system for people with severely impaired physical movement compared with the E-Tran board. Based on these results, clinical support and training need to be provided to help them use the boards in their daily life with their communication partners.

Objectives: There are increasing demands for personal assistance services which help the disabled to carry out their daily life. To use augmentative and alternative communication (AAC) approaches more effectively in daily communication, it is essential to include the appropriate core and fringe vocabulary in the AAC system. Considering the fact that there are few studies in Korea which have reported fringe vocabulary compared to core vocabulary, this study is aimed to develop a noun list that can be used to promote interactive communication between the disabled and their assistants in each communication situation.Methods: A literature review was conducted to elicit frequently used nouns in each communication situation. Then, a survey was carried out to identify nouns with high word commonality across 105 personal assistants.Results: Sixty-three nouns with more than 50% of word commonality across personal assistants were identified from the 244 fringe vocabulary; consisting of 112 nouns in the area of going out, 29 in cleaning, 27 in personal hygiene, 26 in cooking, 20 in meal supporting, 20 in other service areas, and 10 in commuting.Conclusion: The identified nouns are expected to help people with complex communication needs to express their needs and wants more clearly and effectively using those nouns embedded in their AAC systems. The list of nouns can be used not only for people who receive personal assistance services, but also for people who rely on AAC systems to express their daily needs.

Purpose This study is aimed to identify the high-frequency vocabulary (HFV), otherwise termed “core vocabulary” for adults with complex communication needs. Method Three major characteristics of the HFV—a relatively small number of different words (NDW), a relatively high word frequency, and a high word commonality across speakers—were examined so as not to lose any candidate words for the HFV. Specifically, instead of applying the traditionally used cutoff word frequency of 0.5‰, a grouped frequency distribution was used to examine the appropriate frequency ranges to determine the HFV candidates. To improve the representativeness of the HFV across ages, social backgrounds, conversation situations, and topics, 330,000 spoken words of 66 adults (29 men and 37 women; M age = 45.47 years, SD = 16.07) were extracted from the British National Corpus database for analysis. Results A distinct pattern of NDW was observed from the frequency of 0.1‰ in the grouped frequency distribution. In total, 671 words were found to be candidates for the HFV, accounting for 90.94% of the total sample words. After the word commonality analysis indicated at least 80% commonality across speakers, 203 words were selected for the final HFV; accountability was calculated at 80.62%. Conclusions With the innovative word analysis approach, this study provided an HFV list that can be used for a wide range of conversation topics. This method provides a scientific and principled approach to identifying and organizing vocabulary for augmentative and alternative communication (AAC) intervention that does not exist in many AAC resources that promote “core vocabulary” with identifying the source for vocabulary selection.

To identify the relationship between non-verbal working memory and graphic symbol selection, this study examined whether the response time to select target symbols in a sentence construction task differed between two groups: a high non-verbal working memory group and a low non-verbal working memory group. The interaction effect between non-verbal working memory skills and the degree of exposure to graphic symbols was also examined. Thirty-two non-disabled young adults participated in this study. Based on the quartile of the participants' scores on the non-verbal working memory task (i.e., the backward matrix task), data were selected from the sentence construction task completed by seven participants who belonged to the 25%ile and less and seven who belonged to the 75%ile and more; these data were used to examine group differences. A Mann-Whitney

The purpose of this study was to develop a language-based augmentative and alternative communication (AAC) diagnostic classification system (LAAC-D) that can be used in the assessment and intervention phases of AAC for people with complex communication needs in Korea. A comprehensive literature review was conducted focusing on linguistic competence and the four major factors (intentionality, symbolic use, word combination, and grammatical complexity) that play essential roles in classifying communication and expressive language development stages. Seven pieces of literature reported communication levels that are being used for AAC diagnostic system. Among them, only one reflected all factors into the communication level. Most of the literature did not consider the grammatical complexity factor. After examining the characteristics and limitations of each literature, the LAAC-D was developed consolidating the evidence and reflecting the four factors. The characteristics and clinical implications of LAAC-D were discussed.

Beef contains functional fatty acids such as conjugated linoleic acid and long-chain fatty acids. This review summarizes results from studies comparing the fatty acid composition of beef from cattle fed either grass or grain-based feed. Since functional lipid components are contributed through dietary consumption of beef, the fatty acid composition is reported on mg/100 g of meat basis rather than on a percentage of total fat basis. Beef from grass-fed contains lesser total fat than that from grain-fed in all breeds of cattle. Reduced total fat content also influences the fatty acid composition of beef. A 100 g beef meat from grass-fed cattle contained 2,773 mg less total saturated fatty acids (SFA) than that from the same amount of grain-fed. Grass-fed also showed a more favorable SFA lipid profile containing less cholesterol-raising fatty acids (C12:0 to C16:0) but contained a lesser amount of cholesterol-lowering C18:0 than grain-fed beef. In terms of essential fatty acids, grass-fed beef showed greater levels of trans-vaccenic acid and long-chain n-3 polyunsaturated fatty acids (PUFA; EPA, DPA, DHA) than grain-fed beef. Grass-fed beef also contains an increased level of total n-3 PUFA which reduced the n-6 to n-3 ratio thus can offer more health benefits than grain-fed. The findings signify that grass-fed beef could exert protective effects against a number of diseases ranging from cancer to cardiovascular disease (CVD) as evidenced by the increased functional omega-3 PUFA and decreased undesirable SFA. Although grain-fed beef showed lesser EPA, DPA, and DHA, consumers should be aware that greater portions of grain-fed beef could also achieve a similar dietary intake of long-chain omega-3 fatty acids. Noteworthy, grain-fed beef contained higher total monounsaturated fatty acid that have beneficial roles in the amelioration of CVD risks than grass-fed beef. In Hanwoo beef, grain-fed showed higher EPA and DHA than grass-fed beef.

배경 및 목적: 복합적인 의사소통 요구를 지닌 장애인의 성공적인 AAC 사용을 도모하기 위해서는 관련 전문가들의 기기 및 애플리케이션 활용능력이 뒷받침되어야 한다. 본 연구에서는 언어치료 역량 강화를 위한 목적으로 언어재활사를 대상으로 AAC 훈련을 실시하고, 추후에 보다 향상된 전문가 교육을 제공하고자 훈련프로그램에 대한 만족도조사를 실시하였다. 방법: 훈련에 참가한 총 24 명(sex=female, mean age=35yrs, SD=9.90, max=59, min=23)을 대상으로 설문 조사를 실시하였다. 훈련은 미국 피츠버그대학교의 대학원 석사과정과 미국의 비영리기관인 AAC institute에서 일반 언어치료사들 대상으로 활용하고 있는 로테이션 방식의 AAC 훈련방식을 도입하여 국내 실정에 맞게 수정하여 실시하였다. 훈련이 종료된 직후 모든 참가자를 대상으로 응답자의 기본정보, AAC 교육 및 임상경험 그리고 본 훈련에 대한 만족도 조사항목으로 구성된 설문을 실시하였다. 결과: 설문조사 결과 참가자의 다양한 연령과 학력, 근무지형태와 지역이 확인되었으며 대학의 정규과정을 통해 AAC 과목을 이수한 사람은 반 이상인 것으로 나타났다. 그러나 이들 중 상당수가 수업 중에 전혀 AAC기기를 실습하지 않은 것으로 나타났으며 현재까지 AAC 치료를 해오고 있는 것으로 확인되었다. 훈련에 대한 만족도 조사결과 실습시간과 관련된 문항을 제외한 대부분의 문항에서 4.08 부터 4.58 에 이르는 비교적 긍정적인 리커트 평점 척도 분포가 나타났다. 논의 및 결론: 참가자의 항목별 점수와 주관적인 의견을 토대로 추후 효과적인 교육을 개발하기 위한 방안이 논의되었다.

배경 및 목적: 선행연구에 따르면 상징선택 과정에서 다양한 요인들이 영향을 주는 것으로 보고되고 있으나 상징의 인식에 국한하여 살펴보고 있기 때문에 실제 상징을 선택하는 과정에서 반응시간에 어떠한 영향을 주는지는 설명해 주고 있지 못하다. 이에 본 연구에서는 정상 성인을 대상으로 AAC 그림상징에 대한 판별능력에 따라 상징을 선택하는 시간에 차이가 있는지를 살펴보고자 하였다. 방법: 정상성인 32 명을 대상으로 부사에 해당하는 상징을 판별하는 과제를 목표어와 비목표어에 대하여 실시하였고, 명사-부사-동사로 구성된 문장을 AAC 의사소통판에서 선택하는 과제를 통해 부사에 해당하는 상징선택시간을 측정하였다. 결과: 대상자들이 판별과제에서 보인 평균 반응시간을 사분위로 구분하여 네 집단으로 나눈 뒤 이들 집단의 상징선택시간을 비모수통계를 통해 분석한 결과 집단 간 유의한 차이가 있었으며 상징판별시간이 오래 걸린 집단일수록 상징선택에도 오랜 시간이 걸리는 것으로 나타났다. 논의 및 결론: 그림상징을 정확하게 판별하는 능력은 목표상징과 비목표상징이 혼재되어 제시되는 AAC 의사소통판에서도 일관성있게 작용하는 것으로 확인되었으며 이에 대한 이론적 임상적 의의가 논의되었다.

배경 및 목적: 본 연구는 AAC 그림상징의 배열조건에 따라 언어적/비언어적 작업기억능력과 상징에 대한 노출횟수가 문장구성 과제의 수행에 미치는 영향을 살펴보고자 하였다. 방법: 총 32명의 정상성인을 대상으로 고정과 비고정배열조건에서 자극문장(명사-부사-동사)에 대한 목표 상징들을 순차적으로 선택하도록 하였고, 피험자들의 정반응수와 반응속도를 측정하였다....

배경 및 목적: 중증 의사소통장애인들이 보완대체의사소통의 그림상징을 사용하여 문장 수준까지 효과적으로 산출해내기 위해서는 다양한 품사의 목표 상징들을 정확하고 빠르게 판별해내는 능력이 필요하다. 본 연구에서는 근거기반의 중재를 위한 기초자료를 마련하기 위해 품사별로 그림상징의 판별 능력에 차이가 있는지를 살펴보고 목표어휘와 그림상징 간의 일치성 여부가 이에...

배경 및 목적: 본 연구는 알츠하이머성 치매(Alzheimer’s disease, AD) 환자의 동사산출과 이해 과정에서 나타나는 의미지식의 손상에 대한 이해를 확장하고자 도구성에 초점을 맞추어 실시된 연구이다. 방법: 경도 및 중등도로 진단받은 AD환자 12명과 정상노인 12명을 대상으로 동사 대면이름대기과제와 낱말-그림짝맞추기과제를 실시하였다. 도구동사...

배경 및 목적: 격자 레이아웃 기반의 AAC 디스플레이가 임상현장에서 높은 활용을 보임에도 불구하고 그림상징의 고정된 배열이 주는 효과에 대해서는 보고된 바가 거의 않다. 본 연구는 복합적인 의사소통 장애를 가진 사람들에게 근거 기반의 AAC 중재를 제공하고자 문장구성 과제를 통하여 상징의 고정배열이 주는 효과를 살펴보았다. 방법: 20대와 30대로 구성된...

Objectives: The potential value of gestures needs to be evaluated as an unaided alternative and augmentative communication (AAC) method to improve the naming ability of persons with Alzheimer's disease (AD). Considering the possible effect of ideomotor apraxia (IMA) in AD patients, the current study...

배경 및 목적: 핵심어휘는 보완대체의사소통(augmentative and alternative communication, AAC) 사용자들의 성공적인 의사소통을 결정짓는 중요한 요소이다. 본 연구에서는 성인 AAC 사용자가 다양한 어미와의 결합을 통하여 용언을 활용할 수 있는 AAC 체계를 구축하고자 정상성인의 발화샘플을 중심으로 고빈도 용언의 기본형을...

Background Vocabulary frequency results have been reported to design and support augmentative and alternative communication (AAC) interventions. A few studies exist for adult speakers and for other natural languages. With the increasing demand on AAC treatment for Korean adults, identification of high-frequency or core vocabulary (CV) becomes essential. Aims The overall objective was to identify the frequency and commonality of spoken Korean words that occurred in spontaneous conversations for the development of AAC interventions. The specific aims were: (1) to generate a Korean CV list based on the conversations of Korean adults; (2) to address the characteristics of the identified words; and (3) to determine whether a quantitative data analysis procedure, based on a grouped frequency distribution, would support identifying high- and low-frequency words. Methods & Procedures Language samples were collected from 12 native Korean-speaking adults during conversation. CV words were identified based on a grouped frequency distribution analysis and a word commonality analysis. Outcomes & Results Results established a Korean CV list of 219 words with high frequency and commonality accounting for 60.82% of the total sample. Analysis of word types showed a wide range of particles and verb endings in the CV list. Finally, a distinct distribution pattern was identified from a frequency of 0.2‰ to support high-frequency word selection. Conclusions & Implications The CV list and consideration of the linguistic characteristics of Korean are expected to be used to develop Korean AAC interventions. The grouped frequency distribution revealed a robust method to distinguish high-frequency words and to improve AAC vocabulary selection and organization.

Brain-computer interfaces (BCIs) may potentially be of significant practical value to patients in advanced stages of amyotrophic lateral sclerosis and locked-in syndrome for whom conventional augmentative and alternative communication (AAC) systems, which require some measure of consistent voluntary muscle control, are not satisfactory options. However, BCIs have primarily been used for communication in laboratory research settings. This article discusses 4 critical issues that should be addressed as BCIs are translated out of laboratory settings to become fully functional BCI/AAC systems that may be implemented clinically. These issues include (1) identification of primary, secondary, and tertiary system features; (2) integrating BCI/AAC systems in the World Health Organization's International Classification of Functioning, Disability and Health framework; (3) implementing language-based assessment and intervention; and (4) performance measurement. A clinical demonstration project is presented as an example of research beginning to address these critical issues.

INTRODUCTION Brain-computer interfaces (BCIs) are emerging from laboratory testing to become a consideration as augmentative and alternative communication (AAC) assistive technology. The field of AAC applies evidence-based practice to address the human need for interactive and intentional communication [1-2] ([dagger]) BCIs are becoming a viable communication option for veterans with the most severe communication and movement disorders, such as advanced amyotrophic lateral sclerosis (ALS) or locked-in syndrome. A BCI uses central nervous system outputs by recording brain signals, extracting measures from them, and converting these measures into commands that operate assistive technologies to augment the user's natural functions [3]. A BCI using the P300 event-related potential can allow users, such as people with ALS, to choose among items in a matrix as a means of communication [4-5]. Until recently, capacity to use BCI technologies for communication has been evaluated under controlled laboratory conditions. BCIs for AAC intervention must measure performance during spontaneous, novel communication. Collection and analysis of language samples that represent independent, daily BCI use is an essential aspect of measuring the effectiveness of BCIs as AAC devices. A critical step in language sample analysis is reporting the reliability of the procedures for transcribing spontaneous language samples without complete knowledge of conversational context. Measures of Brain-Computer Interface Performance BCI research has focused on continued improvement of the technology and calibration process in order to increase the accuracy and speed of text generation whether the BCI functions as an invasive or noninvasive system. Invasive BCI systems where the electrode array is surgically implanted have been used for elicited production of isolated phonemes with a speech synthesizer [6]. Invasive BCI systems have never been used for production of connected speech or generative language. More external evidence has been published on the performance of noninvasive BCIs in highly controlled laboratory settings. Several attempts have been made in noninvasive BCI studies to improve the accuracy and speed of the control movement by improving the selection of signal features, by optimizing information transfer rates, and by improving the interaction between the user and the BCI system [7]. Wolpaw et al. developed a response verification procedure in which stimuli were presented across two trials to confirm that subjects gave consistent responses to the same stimulus across trials [8]. Miner et al. used the response verification task to investigate the use of an electroencephalography (EEG)-based cursor control to answer yes/no questions [9]. In the second presentation of same stimuli questions in the response verification task, it showed 64 to 87 percent consistency to the initial answers. Ahi et al. demonstrated that the BCI with a modified user interface in which the location of letters in the conventional A to Z matrix were rearranged through an error analysis improved accuracy in spelling four-letter words on a character-by-character basis when a set of target words are stored in a dictionary [10]. All 14 healthy subjects in this study increased their accuracy in selecting cued letters (copy-spelling) to form four-letter words. However, it is not clear whether improved accuracy using an interface modified for a word-level task can generalize to improved performance in interactive conversation. Ryan et al. investigated whether word prediction would increase speed of BCI use by reducing the number of selections needed to generate text with a BCI device [11]. They found that the time needed to copy a 58-character sentence using a BCI device with spelling and word prediction was less than the time needed to copy the same sentence using a BCI device with spelling alone. …

Vocabulary frequency results have been reported to design and support augmentative and alternative communication (AAC) interventions. A few studies exist for adult speakers and for other natural languages. With the increasing demand on AAC treatment for Korean adults, identification of high-frequency or core vocabulary (CV) becomes essential.The overall objective was to identify the frequency and commonality of spoken Korean words that occurred in spontaneous conversations for the development of AAC interventions. The specific aims were: (1) to generate a Korean CV list based on the conversations of Korean adults; (2) to address the characteristics of the identified words; and (3) to determine whether a quantitative data analysis procedure, based on a grouped frequency distribution, would support identifying high- and low-frequency words.Language samples were collected from 12 native Korean-speaking adults during conversation. CV words were identified based on a grouped frequency distribution analysis and a word commonality analysis.Results established a Korean CV list of 219 words with high frequency and commonality accounting for 60.82% of the total sample. Analysis of word types showed a wide range of particles and verb endings in the CV list. Finally, a distinct distribution pattern was identified from a frequency of 0.2‰ to support high-frequency word selection.The CV list and consideration of the linguistic characteristics of Korean are expected to be used to develop Korean AAC interventions. The grouped frequency distribution revealed a robust method to distinguish high-frequency words and to improve AAC vocabulary selection and organization.