Day 1

Papers

Papers: Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication and Down Syndrome: A literature review and PhD overview

Elaine Scougal, PhD Student, University of Dundee

e.scougal@dundee.ac.uk

Verbal communication can be challenging for individuals with Down syndrome due to a number of factors including phonological delays or disorders, hearing loss, and motor difficulties. This can result in communication breakdown, particularly when communicating with unfamiliar communication partners, forming a barrier to achieving independence, agency, and participation in society. The term 'Augmentative and Alternative Communication' (AAC) refers to strategies and technology that can enable or support communication for those without a voice or who have difficulty speaking. AAC can be unaided, without technology, such as the use of gestures or signing systems. In contrast, aided AAC involves technology and can be paper based, such as the use of symbols, communication boards or books, or digital, including voice output communication aids (VOCAs) or visual scene displays (VSDs). These differing AAC methods may be used exclusively or used in combination by adopting a multi-modal AAC approach. This presentation will introduce these different forms of AAC in addition to providing a brief overview of the research literature relating to the use of AAC for individuals with Down syndrome across the lifespan. The presenter will also outline her PhD project (currently in its infancy) exploring the use of AAC to facilitate the communication of children and young people with Down syndrome, considering the perspectives of individuals with Down syndrome, caregivers, and wider stakeholders. Feedback relating to the project is welcome and encouraged.

Summary

Elaine Scougal, Postgraduate Research Student, University of Dundee

(Supervised by Prof. Annalu Waller, Dr. Alissa Melinger, University of Dundee).

  • Augmentative and Alternative Communication (AAC) refers to methods of communicating other than spoken language, and can be used alongside, or in the absence of, speech. Using AAC if/when required can reduce frustration and increase independence, participation, and self-advocacy for people with verbal communication challenges across the life span, including those with Down syndrome.
  • Using AAC can enhance communication skills, such as increased vocalizations, communicative turns, and vocabulary.
  • Modelling a relevant AAC method when communicating with someone who uses AAC is important where possible to illustrate and motivate use, such as signing, or using the device or communication book.
  • Allowing a user to develop or show a preference for a communication method, or methods, can also influence AAC interaction. Using multiple AAC approaches can also be beneficial to offer alternative ways of communicating when a strategy has limitations, such as using symbols if a communication partner cannot sign or if a device battery has run flat.
  • Within my PhD project, I aim to address current gaps in the research literature surrounding AAC and Down syndrome, specifically exploring real-world, functional experiences of using AAC. The project will involve the perspectives of individuals with Down syndrome, caregivers, speech and language therapists and educators, with recruitment commencing in Spring/Summer 2022.

Find me on Twitter: @EMScougal

For more information on AAC generally, please see:

and for an overview related to Down syndrome:

de Barbosa, R.T. A., de Oliveira, A.S.B., de Lima Antão, J.Y.F., Crocetta, T.B., Guarnieri, R., Antunes, T. P. C., … de Abreu, L. C. (2018). Augmentative and alternative communication in children with Down’s syndrome: A systematic review. BMC Pediatrics, 18(1), 1–16. https://doi.org/10.1186/s12887-018-1144-5

The Development of a Core Key Word Signing Vocabulary (Lámh) to Facilitate Communication with Children with Down Syndrome in the First Year of Mainstream Primary School in Ireland

Pauline Frizelle and Caoimhe Lyons, Department of Speech and Hearing Sciences, University College Cork, Ireland

p.frizelle@ucc.ie

Background: Key word signing, an unaided augmentative and alternative communication (AAC) system, is commonly used by children with Down syndrome who attend mainstream primary schools. However, to ensure the successful use of key word signing within a mainstream environment, a meaningful, contextually appropriate sign vocabulary must be available to all communication partners.

Aim: The aim of this study was to develop a core school-based key word signing vocabulary to facilitate effective communication between children with Down syndrome and their communication partners in the first year of mainstream primary school.

Method: Along with the experimenter, four key groups (participants with Down syndrome, their peers, teachers, and special needs assistants), contributed to the vocabulary over the course of an academic year, through observations, semi-structured interviews, and guided tours of the school environment. Two criteria, frequency (the number of times a sign was recommended across each group) and commonality (the number of groups that recommended a given sign) were used to determine which vocabulary items were defined as core.

Results: Applying the criteria of frequency and commonality resulted in 132 signs to be included in the core vocabulary. In addition eight words, for which there is currently no Lámh sign, met the core vocabulary inclusion criteria.

Conclusion: The current study provides new insights into the complex process of vocabulary selection for children who use key word signing at school and highlights the importance of access to a functional sign vocabulary in facilitating inclusive education practices.

Summary

The study will be published open access later this month in Augmentative and Alternative Communication. Contact: p.frizelle@ucc.ie

  • This study reported on the development of a core school-based key-word signing vocabulary (Lámh) to facilitate effective communication between children with Down syndrome and their communication partners in the first year of mainstream primary school
  • Multiple participants and methodologies were used to generate an appropriate school-based vocabulary
    • Speech and language therapist (SLT) (through observations in the classroom)
    • Children with Down syndrome (through leading the SLT to places, people and activities that were important to them in the school – using a mosaic approach)
    • Teachers (through interviews)
    • Special needs assistants (through interviews)
    • Peers of children with Down syndrome (through interviews supported by the use of a puppet)
  • Two criteria, frequency (the number of times a sign was recommended across each group) and commonality (the number of groups that recommended a given sign) were used to determine which vocabulary items were defined as core.
  • 140 vocabulary items were generated, 8 of which do not currently have a sign
  • The vocabulary included a much higher number of verbs and adjectives than in the current Lámh training available to teachers in schools in Ireland.

The impact of embedding key word sign prompts in a shared book reading activity, on children with Down syndrome and their parents

Pauline Frizelle, Rebecca Allenby, Elizabeth Hassett, Orlaith Holland, Eimear Ryan and Ciara O'Toole;

Department of Speech and Hearing Sciences, University College Cork, Ireland

p.frizelle@ucc.ie

Aims: This study aimed to compare two methods of completing a shared book reading activity - one in which Lámh sign prompts were embedded in a book (signed condition) and the other in which a book was read as normal (unsigned condition). Measures of child and parent behavior were taken in each condition to establish if differences emerged.

Methods: 36 children with DS and their mothers took part in the study. Parent-child dyads were videoed reading two books, one in a signed and one in an unsigned condition. Child measures included total number of Lámh signs produced in each condition and levels of attention and initiation as measured by the Pivotal Behavior Rating Scale. Parent measures included total number of utterances; mean length of utterance (MLU) in Morphemes; and Vocabulary Diversity (VOCD). Parental measures were transcribed using the Codes for Human Analysis Transcripts software (CHAT) and analyzed by the Computerized Language Analysis software (CLAN).

Results: Results showed that children attempted to sign significantly more in the signed than the unsigned condition (p < .001) as well as showing a significant increase in their level of attention to the activity (p = .003). There was also a significant difference in the total number of utterances used by parents in each condition (p = .001), driven by more utterance repetitions in the signed condition. Lastly, MLU in morphemes and lexical diversity remained the same in both conditions.

Conclusion/Implications: This study shows that embedding Lámh signs into commercially available books during reading, is likely to be beneficial to the language development of children with DS in that it resulted in an increased dose of utterance exposure. The increase in children's attention implies that using Lámh prompts is an effective method of engaging young children with DS in shared book reading.

Summary

  • This study compared two methods of completing a shared book reading activity with young children with Down syndrome- one in which key-word sign prompts were embedded in a book (signed condition) and the other in which a book was read as normal (unsigned condition).
  • When parents signed key words during book reading, children with Down syndrome significantly increased
    • their number of sign attempts
    • their level of participation in the activity
  • When reading books with embedded signs, parents
    • Increased the amount of language they used (mostly through repetition)
    • Decreased the complexity of their language