RERC III Partner Call

1. April 17, 2009 Confidential Discussion Encouraged--Slides Designed to Provide Context and Support Discussion RERC III Partner Call

2. R1-B: Contextual Support for Adults with Acquired Cognitive /Linguistic LimitationsProject Personnel David Beukelman, Karen Hux, Kristy Weissling--UNL(incoln) Susan Fager--Madonna Rehab, Lincoln Amy Nordness--UN Medical Center Amy Dietz, Cincinnati University Miechelle McKelvey--UNK(earney) Sarah Wallace--Duquesne University (Summer) Students: Kristen Lommel, Emily Quinn, Pamela McCauley, Erin Bush Consultants: Pat G. & Daughter; Eddie P., & Son; Hilda M & Daughters; Judy Harvey, Gail Vinsans

3. Purpose: To investigate the impact of various types of contextually, relevant information on the communication performance of people with severe, acquired cognitive/linguistic limitations; to propose and evaluate further design specifications to reduce cognitive/linguistic load, and to evaluate the impact of these specifications on communication performance

4. Background Issues 1. Aphasia Experts (researchers) “Basic” processes (research on representation of content) Maybe, restoration 2. Aphasia Specialists (Interventionists) Restoration Maybe --Integration of restoration and compensation 3. AAC Specialists (Interventionists) Functional communication-compensation Assist consumers to accommodate to traditional AAC strategies 4. Aphasia Families: RESTORATION 5. AAC Technology Companies: Prefer to develop technology that requires minimal (no) personalization

5. AAC-RERC III----Phases Phase 1: Series of investigations to determine the impact of personally and contextually relevant contexts on language and communication performance/AAC competence

6. Background AAC-RERC II Work THEMES Representation Navigation COLOR

7. Accuracy: Across Personalization and Contextualization Representation

8. Preference: Across Personalization and Contextualization Representation

9. AAC-RERC III--Phase 1, Project 1: Using VSD to Create a Shared Communication Space (Integrating Low-Tech VSD and Residual Speech) Representation

10. Using VSD to Create a Shared Communication Space (Integrating Low-Tech VSD and Residual Speech) Representation

11. Tech Transfer: Low Tech VSD 1. Weissling and Beukelman Develop Templates 3. Freeware on Internet using MS Publisher (64,923) 4. MJ developed Prototype Templates for BoardMaker 5. Prototype Templates being evaluated 6. MJ distribution plans???

12. Phase 1, Project 2 AAC system navigation by brain injury survivors (TBI): Effects of prompt and image contextualization Sarah Wallace, Karen Hux, David Beukelman Navigation and Representation

13. Questions • What effect do images varying in the amount of contextual information have on the speed and accuracy with which TBI survivors navigate an AAC system? • What effect does the type of verbal prompt given to BI survivors have on their AAC system navigation speed and accuracy?

14. Methods • 18 survivors of severe brain injury • Select 60 target words from Level 3 (20 in each image condition and 30 in each prompt condition) • Image conditions – high context, low context, no context • Prompt conditions – matching, non-matching

15. Experimental Stimuli • No-context Images • Low-context Images • High-context Images

16. Experimental Stimuli • Using these 3 sets of stimuli, 3 versions of the experimental AAC system—one for each experimental condition • 3 levels of AAC system • navigation to “envelope”

17. Procedures - Session 2 • Researcher: • “I bought an envelope at the post office. Find envelope” • Presents prompt card • Participant: • Sees level 1 • Selects “town” envelope

18. Procedures - Session 2 • Screen changes to level 2 • Participant: • Selects “post office” • Screen changes to level 3 • Participant: • Selects “envelope” • Researcher: • “are you ready to go on?” • Changes system back to level 1 • After 20 prompts switches AAC system to 2nd image condition, and then 3rd

19. Preliminary Results • Data collected from 18 of 18 participants • Participants are equally accurate across image • Trend toward more accurate in high context. • Participants are more accurate during the consistent prompt condition • Participants take longer to select items when using high-context images.

20. Phase 1, Project 3: Effects of Context on the Communicative Performance of People with Chronic Aphasia Sarah Wallace, Karen Hux, Kristy Weissling Representation 20

21. Questions What is the effect of on the comprehension of people with aphasia when listening to story with either no pictorial support or pictorial support in one of three differing levels of contextual richness? What is the effect on a person with aphasia’s ability to retell a narrative when provided with either no pictorial support or pictorial support in one of three differing levels of contextual richness? 21

22. Experimental Stimuli Contextual drawing Contextual photograph Isolated Photograph 22

23. Methods Projected: 24 people with aphasia Listened to four narratives accompanied with one of 4 types of pictorial support (no support, isolated photograph, contextual drawing, contextual photograph) Answered 9 multiple choice questions related to each story Using one of 4 types of pictorial support, the participant retells the narrative to a naïve listener 23

24. Preliminary Results Data collected for 2 participants 24

25. Future Research • Other populations (aphasia, dementia) • “Real” communication tasks • Other types of images (icons)

26. Phase 2: Identify design features and instructional strategies that support the use of VSD strategies

27. Phase 2, Project 1: AAC Facilitator Training (VSD) Emily Quinn & David Beukelman Purpose to compare the impact of distance instruction and side-by-side instruction of AAC Facilitators Independent variables: Distance Instruction--Virtual Network Computing and Telephone Side-by-Side Instruction--Facilitator and Instructor positioned side by side

28. Preliminary Outcomes N = 20 Beginning SLP Graduate Students Accuracy on follow-up probe test--no difference Preference--distance over side-by-side Ongoing Work: AAC Aphasia Facilitators (N = 2) Future Work: SLP Generalists

29. Phase 2, Project 2: Navigation Study: VSD vs. Traditional Levels Pamela McCauley & David Beukelman Theoretical Background: Recognition vs. Recall Memory Same thematic organization Same content Same images and text

30. Visual Scene Display

31. Traditional Levels

32. Part 1: Evaluation by 4 Groups PARTICIPANTS Aphasia Specialists AAC Specialists AAC Facilitators People with Aphasia MEASURES Ease of Setup (Rate and Rank) Ease of Use (Rate and Rank) Potential Benefit (Rate and Rank) Fit my accustomed routine (Rate and Rank) Accept for routine use (Rate and Rank)

33. Part 2: Use by People with Aphasia Planning Stage--Part of Case Study Phase Use both strategies Measure Performance Measure Preference

34. Phase 2--Project 3: VSD Templates to Support Single Message Per Image Design Feature changes (additions) Identified by survey and interview Aphasia Specialists Dynavox Representatives AAC Facilitators Preferred Single Message Per Image Template(s) Communication about specific items or acts Naming practice Speech Practice

35. Delphi Procedure Participants review Current VSD App. Participants review the change ideas of “One message per image” goal (purpose) Participants individually propose design options Survey and interview (see next slide) Project staff select options Participants rank order options

36. Draw design features for the popup--to best meet the :One message per image” goal. + E

37. Simulations:Ranking Task: NEW VSD TEMPLATE Options Please review the proposed templates for the VSD application. Dave B. will contact you and ask you to rank order your preferences for the 3 and 6 template versions. Please note: if a template does not have TEXT or Speak buttons, assume that each image button can be assigned to speak.

38. S S S Text Text Text + B

39. Text Text Text S S S + A

40. + E

41. Text S Text S Text S + D

42. + G

43. S Text S Text S Text Text S Text S Text S + F

44. VSD Revisions - Proposed to Dynavox S S S Text Text Text +

45. Proposed to Dynavox S Text S Text S Text Text S S Text S Text +

46. Dynavox Prototype

47. Technology Transfer Participants Provided Ideas Project Staff Provided Simulations Participants rank Ordered stimulations Dynavox Staff Developed Prototype Project Staff Reviewed Prototype (Recommended Changes) Dynavox Upgraded Prototype Project Staff Field & Respondents Evaluated Prototypes (Ongoing) Dynavox Staff Considering Distribution Decision (Internet download, CD, Only new purchases, Only upon request)(Ongoing)

48. Phase 2, Project 3: Enlarging Images Similar Dephi Procedures as previous project Develop strategies for dynamically enlarging images to support a shared communication space Enlarge images to support use by people with TBI and Visual Limitations Collecting information about potential design features from respondents. Develop Simulation Evaluate prototypes

49. Enlarged Images--Simulations One tap--enlarge; one tap reduce No text or speech behaviors when enlarged

50. Future Projects Investigate and respond to visual/cognitive limitations of people with severe TBI Dynamic capture of images/content for VSD--is dependent on the work on the R2-B (Dynamically Capturing and Representing Communication Environments) as well as the work of other RERC Partners (Light, Higginbotham, Fried-Oken, Jakobs)