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Social Interaction Involving Non-speaking Children with Severe Cerebral Palsy and Intellectual Disability: The role of communication partners and speech-generating devices
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness.ORCID iD: 0000-0002-6410-1332
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to investigate the use of speech-generating device (SGD)-mediated interaction with children with anarthria, severe physical impairments and intellectual disabilities due to cerebral palsy with a focus on partner strategies and social practices.

Studies I and II were cross-sectional studies that used questionnaires, which were analyzed using descriptive statistics and directed content analysis. In Study I, speech and language pathologists’ (SLPs) practices and perceptions of communication partner training in SGD-mediated interaction were examined. In Study II, communication partners’ (i.e., caregivers’, teachers’, and assistants’) practices and perceptions of communication partner training in SGD-mediated interaction were examined.

Studies III and IV were qualitative observational studies that used video recordings, which were analyzed with ethnomethodological conversation analysis. Study III investigated how multiparty classroom interaction was organized when one of the students used an eye-gaze accessed SGD. Study IV explored the social actions that mobilized SGD-mediated responses when the child was a beginner user of the eye-gaze accessed SGD.

The findings suggest the following: all participants (i.e., SLPs, caregivers, teachers, and assistants) considered that SGD-mediated interaction was beneficial for the children. SLPs were important providers but they provided few training sessions and used mostly verbal instructions. Communication partners could benefit from more support from SLPs and SLPs should consider using additional instructional approaches such as feedback and role-play when coaching communication partners in SGD-mediated interaction. Children could interact with their eye-gaze accessed SGDs in multiparty classroom interactions provided that the turn-taking in Initiation-Response-Evaluation (IRE) sequences was applied and that the teacher or the assistant provided contingent on-screen gaze and deictic scaffolding actions. Communication partners to children who were beginner users of an eye-gaze accessed SGD may need to produce repeated turn transition relevance places and use contingent on-screen gaze and deictic practices to scaffold an SGD-mediated response.

This thesis brings new knowledge to the field of SGD-mediated interaction. Partner strategies that can enhance children’s linguistic skills were seldom used in multiparty classroom interaction, but other social practices were used, which facilitated social inclusion and participation.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2020. , p. 123
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1639
Keywords [en]
Augmentative and Alternative Communication, Speech-Generating Device, Partner Strategies, Social Practices, Cerebral Palsy, Intellectual Disability, Multiparty Interaction, Classroom, Ethnomethodological Conversation Analysis
National Category
Other Medical Sciences not elsewhere specified Other Health Sciences General Language Studies and Linguistics
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-404004ISBN: 978-91-513-0874-6 (print)OAI: oai:DiVA.org:uu-404004DiVA, id: diva2:1392438
Public defence
2020-03-27, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:14 (English)
Opponent
Supervisors
Available from: 2020-03-05 Created: 2020-02-07 Last updated: 2020-03-27Bibliographically approved
List of papers
1. Speech and language pathologists' perceptions and practises of communication partner training to support children's communication with high-tech speech generating devices
Open this publication in new window or tab >>Speech and language pathologists' perceptions and practises of communication partner training to support children's communication with high-tech speech generating devices
2019 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 14, no 6, p. 581-589Article in journal (Refereed) Published
Abstract [en]

Purpose: This study examined speech and language pathologists' (SLPs') perceptions and practices of communication partner training with high-tech speech generating devices (SGDs).

Method: Fifteen SLPs were recruited throughout Sweden. The SLPs answered a study-specific questionnaire on communication partner training in relation to communication partners to children with severe cerebral palsy and intellectual disability. The results were analysed with descriptive statistics (closed-ended questions, responses on Likert scales) and content analysis (open-ended question) using ICF-CY.

Results: Twelve SLPs completed the survey. Half had no or one training session with communication partners in the last year. One-third never used documents for goal-setting. Half seldom or never taught communication partner strategies. Three quarters only used verbal instructions. The main obstacles were environmental factors.

Conclusions: This study contributes valuable knowledge about high-tech SGD interventions targeting communication partners. The high-tech SGD intervention may benefit from goal-setting, extended number of training sessions and a range of instructional approaches.

Keywords
Augmentative and alternative communication, speech generating device, high technology, cerebral palsy, speech and language pathologist, communication partner training
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-351346 (URN)10.1080/17483107.2018.1475515 (DOI)000476551900007 ()29790394 (PubMedID)
Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2019-09-19Bibliographically approved
2. Caregivers’, teachers’, and assistants’ use and learning of partner strategies in communication using high-tech speech-generating devices with children with severe cerebral palsy
Open this publication in new window or tab >>Caregivers’, teachers’, and assistants’ use and learning of partner strategies in communication using high-tech speech-generating devices with children with severe cerebral palsy
2019 (English)In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614Article in journal (Refereed) Published
Abstract [en]

Communication with speech generating devices (SGDs) with children with severe physical, communicative and cognitive impairments, such as children with cerebral palsy (CP), can be difficult. Use of partner strategies facilitates the communication and instructional approaches such as feedback and role play facilitate communication partners' learning in how to use partner strategies. To describe communication partners' use and learning about partner strategies in SGD-mediated communication with children with severe CP. Questionnaires (n = 65) were sent to caregivers (n = 30), teachers (n = 17), and teaching or personal assistants (n = 18) of children with severe CP. Response rate was 80%. To ask open-ended questions was the most frequently used partner strategy and aided augmented input the least frequently used partner strategy. Most commonly, participants learned partner strategies from speech and language pathologists (SLPs) who used verbal instructions when teaching partner strategies but seldom or never feedback, role play or video examples. Communication partners' learning about partner strategies in SGD-mediated communication is inadequate and needs to be improved. SLPs, who are the main prescribers of SGDs and responsible for training and support in using them, should consider using instructional approaches when teaching communication partners about partner strategies in communication with an SGD.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-378593 (URN)10.1080/10400435.2019.1581303 (DOI)
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-03-07Bibliographically approved
3. Classroom Interaction Involving Students with Cerebral Palsy using Eye-gaze Accessed Speech-Generating Devices
Open this publication in new window or tab >>Classroom Interaction Involving Students with Cerebral Palsy using Eye-gaze Accessed Speech-Generating Devices
(English)Manuscript (preprint) (Other academic)
National Category
Basic Medicine
Identifiers
urn:nbn:se:uu:diva-403710 (URN)
Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2020-02-03Bibliographically approved
4. Features of Social Action that Mobilize Response when Professionals Interact with Young Beginner Users of Eye-gaze Accessed Speech Generating devices
Open this publication in new window or tab >>Features of Social Action that Mobilize Response when Professionals Interact with Young Beginner Users of Eye-gaze Accessed Speech Generating devices
(English)Manuscript (preprint) (Other academic)
National Category
Basic Medicine
Identifiers
urn:nbn:se:uu:diva-403708 (URN)
Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2020-02-03Bibliographically approved

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