Synthetic Speech: Does it increase social interaction?

1
Synthetic SpeechDoes it increase social
interaction?

• Melissa Bairos, Emily Emanuel,
• Aviva Krauthammer, Jen Perkins,
• Holly Reis, and Beth Zaglin

2
Description of AAC User

• Elizabeth 76 year old girl
• Spastic Cerebral Palsy
• Mild-Moderate Cognitive Delay
• Impaired vision

3
Description of Elizabeth

• Attends a self-contained first grade classroom
• Has a one-on-one aid at all times
• Uses wheelchair for mobility
• Not motorized due to vision impairment
• Dependent for all activities of daily living

4
Description of Elizabeth

• No functional verbal output
• Uses BIGmack switches to say hello/goodbye
• Turns head to side for No
• Knocks for Yes
• Range of motion with arms good
• Able to make fist and point
• Unable to isolate finger to point
• Able to hold pointer in fist and purposefully
  point

5
Description of Elizabeth

• Parents, IEP team want Elizabeth to use a speech
  generating device (SGD)
• Social interaction
• Express wants and needs
• Recommendation 7-Level Communication Builder

6
Well-built question

• Will the use of a speech generating device
  increase social interaction for a child with AAC
  needs?

7
Search Strategies

• Data Base ResearchEBSCOTerms usedSynthetic speech
  and requestYield4 references, one of which
  included information pertaining to topic (Affect
  of Speech output on maintenance of requesting and
  frequency of vocalization in 3 children with
  developmental disabilities Sigafoos et al)
• Hand SearchReview of Affect of Speech output on
  maintenance of requesting and frequency of
  vocalization in 3 children with developmental
  disabilities Sigafoos et alAcquisition and
  functional use of voice output communication of
  persons with profound multiple disabilities
  Behavior Modification Journal Vol 20, pgs.
  451-468, 1996
• Data Base ResearchPsycInfoTerms usedAugmenatative
  and Alternative Communication and palsy and
  socialYieldOne article included information
  related to the topics (Functional Communication
  training with assistive devices Effects on
  challenging behaviors and affect)
• Data Base ResearchCINAHLTerms usedOutput and
  communication and peerYield20 references, 2
  included sections pertaining to topics1-
  Influence of communicative competence in AAC
  technique on childrens towards a peer who uses
  AAC.2- Attitudes of school aged kids toward peers
  who use AAC
• Data Base ResearchPsycInfoTerms usedPalsy and
  children and language and requestingYield1
  reference, (Developing functional requesting
  Acquisition, durability, and generalization of
  effects.)
• Data Base ResearchPsycInfoTerms usedRequesting
  and cerebral palsyYield1 reference, (Extending
  the application of constant time delay Teaching
  a requesting skill to students with severe
  multiple disabilities)
• Data Base ResearchPsycInfoTerms usedRequest and
  language and cerebral palsyYield1 references,
  (Functional Communication training using
  assistive devices Effects on challenging
  behavior and affect)

8
Evidence Sources

• Attitudes of children towards an unfamiliar peer
  using an AAC device with and without a voice
  output (Lilienfeld and Allant, 2002)
• An overview
• The study found that childrens attitudes towards
  peers who use AAC devices are more positive when
  the AAC device has voice output
• The more positive the attitude of the peers the
  more likely that social interaction will increase

9
Validity

• Internal high
• Difference in attitudes toward AAC user can be
  attributed to speech output device vs. non-speech
  output device
• Instrumentation used has been proven to have good
  construct validity (Lilienfeld and Allant, 2002)
• External medium
• Study can be replicated.
• Not in the US, used peers and AAC user of average
  intelligence, and videotape as opposed to real
  interaction
• Social low
• Results were not discussed with relevant
  stakeholders and consumer
• No social comparison

10
Evidence Sources

• The effects of information and Augmentative
  Communication Technique on attitudes toward
  non-speaking individuals (Gorenflo and
  Gorenflo1991)
• An overview
• Less favorable attitudes towards user of low tech
  (alphabet board) than user of a high tech (voice
  output) device
• This study also demonstrated that the more
  positive the attitude of the peers the more
  likely that social interaction will increase

11
Validity

• Internal high
• The difference in attitudes toward the AAC user
  can be attributed to the different AAC devices
  used (alphabet board vs. VOCA)
• The instrumentation used has been proven to be
  internally consistent and valid (Gorenflo
  Gorenflo)
• External medium
• Study can be replicated
• AAC user was adult male of average intelligence
  and within a controlled setting
• Social low
• Results were not discussed with relevant
  stakeholders and consumer
• No social comparison

12
Communication of Findings

• Overall conclusion even though we cannot
  directly answer our question based on the
  available research, we can draw indirect
  conclusions that an SGD would promote social
  interaction.

• Attitudes were more positive when an SGD was used
  compared to a non-SGD.

• There is no evidence stating that non-SGD
  increases social interaction.

13
Question for You

• Have you worked in a setting with a child who
  used an AAC speech generating device?
• How did the peers respond to the AAC user?

14
Questions for us?