Personal narrative telling by individuals with ALS who use AAC devices
Background. Augmentative and Alternative Communication (AAC) technology is typically introduced to individuals with Amyotrophic Lateral Sclerosis (ALS) when their speech rate has slowed and intelligibility is inconsistent in difficult listening situations such as talking in a group situation (Yorkston, Miller, & Strand, 2004). However little research has been conducted on how individuals with ALS construct personal narratives using AAC devices. Unlike other types of narrative, the construction of personal narratives is more collaborative and central to the life of an individual with ALS. Purpose. This exploratory study investigated how individuals with ALS used their AAC devices to tell personal narratives to their familiar partners. The production of personal narratives was compared to narrative retells, which are often used clinically to assess narrative production of AAC users. Methods. Two groups of participants were included in this study, including an ALS group and a control group. The ALS group consisted of seven adults with ALS and their familiar partners. The control group consisted of five natural speaking participants and their familiar partners. The ALS participants were asked to be the narrator. In the control group, one participant in a dyad was randomly selected to be the narrator. The participants were asked to participate in two narrative activities, including a personal narrative activity and a narrative retell activity. The obtained narrative samples were analyzed in respect to the interaction pattern and the narrative structure. Results. The results demonstrate that narratives were collaboratively constructed by the ALS participants and their partners via the process of "grounding" (i.e. achieving mutual understanding) (Clark, 1996). The ALS participants' contribution was affected by the narrative type and their physical abilities. As for the narrative structure, the ALS participants and the partners did not include every narrative component identified by Norrick (2000). The most frequently used components were orientation and main action. Another frequently used component was interaction, which was used to maintain the interaction rather than adding new information to a narrative. Discussion. The results suggest that the use of AAC devices changes how the ALS participants, as the narrators, interact with their partners in the narrative telling context. The AAC device impedes the ALS participants' ability to contribute to the narrative when both parties in the interaction have access to the narrated events (i.e. shared personal experiences). The ALS participants and their partners interact differently when telling different narratives. The results suggest that when assessing how AAC users use their device to tell narratives, multiple narrative activities should be used. This study also supports the notion that individuals with ALS can be used as a model to assess the effects of AAC devices on communication interactions because they present themselves as a relatively homogenous group. Theoretical and clinical implications are discussed.