Functional communication training using assistive devices: recruiting natural communities of reinforcement.
We evaluated the effectiveness of functional communication training (FCT) as an intervention for the problem behavior exhibited by 5 students with severe disabilities both in school and in the community. Following an assessment of the function of their problem behavior, the students were taught to use assistive communication devices in school to request the objects and activities that presumably were maintaining their behavior. Multiple baseline data collected across the students indicated that not only did the students use their devices successfully, but the intervention also reduced their problem behavior. In addition, data from community settings showed generalization to untrained community members. These results replicate other successful efforts to use FCT with individuals having limited communication skills, and demonstrate the value of teaching skills to recruit natural communities of reinforcement in order to generalize intervention effects to meaningful nontraining environments. (+info)
Empowering the deaf. Let the deaf be deaf.
Deafness is often regarded as just a one and only phenomenon. Accordingly, deaf people are pictured as a unified body of people who share a single problem. From a medical point of view, we find it usual to work with a classification of deafness in which pathologies attributable to an inner ear disorder are segregated from pathologies attributable to an outer/middle ear disorder. Medical intervention is thus concerned more with the origin, degree, type of loss, onset, and structural pathology of deafness than with communicative disability and the implications there may be for the patient (mainly dependency, denial of abnormal hearing behaviour, low self esteem, rejection of the prosthetic help, and the breakdown of social relationships). In this paper, we argue that hearing loss is a very complex phenomenon, which has many and serious consequences for people and involves many factors and issues that should be carefully examined. The immediate consequence of deafness is a breakdown in communication whereby the communicative function needs to be either initiated or restored. In that sense, empowering strategies--aimed at promoting not only a more traditional psychological empowerment but also a community one--should primarily focus on the removal of communication barriers. (+info)
Using the picture exchange communication system (PECS) with children with autism: assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior.
The picture exchange communication system (PECS) is an augmentative communication system frequently used with children with autism (Bondy & Frost, 1994; Siegel, 2000; Yamall, 2000). Despite its common clinical use, no well-controlled empirical investigations have been conducted to test the effectiveness of PECS. Using a multiple baseline design, the present study examined the acquisition of PECS with 3 children with autism. In addition, the study examined the effects of PECS training on the emergence of speech in play and academic settings. Ancillary measures of social-communicative behaviors and problem behaviors were recorded. Results indicated that all 3 children met the learning criterion for PECS and showed concomitant increases in verbal speech. Ancillary gains were associated with increases in social-communicative behaviors and decreases in problem behaviors. The results are discussed in terms of the provision of empirical support for PECS as well as the concomitant positive side effects of its use. (+info)
Predictors of successful self control during brain-computer communication.
OBJECTIVES: Direct brain-computer communication uses self regulation of brain potentials to select letters, words, or symbols from a computer menu to re-establish communication in severely paralysed patients. However, not all healthy subjects, or all paralysed patients acquire the skill to self regulate their brain potentials, and predictors of successful learning have not been found yet. Predictors are particularly important, because only successful self regulation will in the end lead to efficient brain-computer communication. This study investigates the question whether initial performance in the self regulation of slow cortical potentials of the brain (SCPs) may be positively correlated to later performance and could thus be used as a predictor. METHODS: Five severely paralysed patients diagnosed with amyotrophic lateral sclerosis were trained to produce SCP amplitudes of negative and positive polarity by means of visual feedback and operant conditioning strategies. Performance was measured as percentage of correct SCP amplitude shifts. To determine the relation between initial and later performance in SCP self regulation, Spearman's rank correlations were calculated between maximum and mean performance at the beginning of training (runs 1-30) and mean performance at two later time points (runs 64-93 and 162-191). RESULTS: Spearman's rank correlations revealed a significant relation between maximum and mean performance in runs 1-30 and mean performance in runs 64-93 (r= 0.9 and 1.0) and maximum and mean performance in runs 1-30 and mean performance in runs 162-191 (r=1.0 and 1.0). CONCLUSIONS: Initial performance in the self regulation of SCP is positively correlated with later performance in severely paralysed patients, and thus represents a useful predictor for efficient brain-computer communication. (+info)
The effects of speech output technology in the learning of graphic symbols.
The effects of auditory stimuli in the form of synthetic speech output on the learning of graphic symbols were evaluated. Three adults with severe to profound mental retardation and communication impairments were taught to point to lexigrams when presented with words under two conditions. In the first condition, participants used a voice output communication aid to receive synthetic speech as antecedent and consequent stimuli. In the second condition, with a nonelectronic communications board, participants did not receive synthetic speech. A parallel treatments design was used to evaluate the effects of the synthetic speech output as an added component of the augmentative and alternative communication system. The 3 participants reached criterion when not provided with the auditory stimuli. Although 2 participants also reached criterion when not provided with the auditory stimuli, the addition of auditory stimuli resulted in more efficient learning and a decreased error rate. Maintenance results, however, indicated no differences between conditions. Finding suggest that auditory stimuli in the form of synthetic speech contribute to the efficient acquisition of graphic communication symbols. (+info)
Everyone here speaks TXT: deaf people using SMS in Australia and the rest of the world.
This article examines the extent to which Short Message Service (SMS) messages are breaking down communication barriers among deaf people and between deaf and hearing people. It is predicted that deaf texters will use SMS to increase the bonds between themselves in deaf communities, creating new opportunities to develop relationships, understanding, and intimacy with those not physically present. The most exciting question raised by this article is whether those kinds of relationships, understanding, and intimacy will develop to the same extent with hearing colleagues, friends, and intimates. (+info)
Patients with disabilities and complex communication needs. The GP consultation.
BACKGROUND: People with complex communication needs vary in terms of their underlying disability and the methods and strategies they use to communicate. OBJECTIVE: This article describes the varied communication profiles that a general practitioner is likely to encounter in patients with disabilities, and the various types of augmentative and alternative forms of communication that might be used in such consultations. DISCUSSION: This article provides strategies to facilitate doctor-patient communication involving patients with complex communication needs, some of which are illustrated in a case study of a young woman with an intellectual disability. (+info)
Test-retest reliability of fMRI during nonverbal semantic decisions in moderate-severe nonfluent aphasia patients.
Cortical reorganization in poststroke aphasia is not well understood. Few studies have investigated neural mechanisms underlying language recovery in severe aphasia patients, who are typically viewed as having a poor prognosis for language recovery. Although test-retest reliability is routinely demonstrated during collection of language data in single-subject aphasia research, this is rarely examined in fMRI studies investigating the underlying neural mechanisms in aphasia recovery. The purpose of this study was to acquire fMRI test-retest data examining semantic decisions both within and between two aphasia patients. Functional MRI was utilized to image individuals with chronic, moderate-severe nonfluent aphasia during nonverbal, yes/no button-box semantic judgments of iconic sentences presented in the Computer-assisted Visual Communication (C-ViC) program. We investigated the critical issue of intra-subject reliability by exploring similarities and differences in regions of activation during participants' performance of identical tasks twice on the same day. Each participant demonstrated high intra-subject reliability, with response decrements typical of task familiarity. Differences between participants included greater left hemisphere perilesional activation in the individual with better response to C-ViC training. This study provides fMRI reliability in chronic nonfluent aphasia, and adds to evidence supporting differences in individual cortical reorganization in aphasia recovery. (+info)