Utilization of a shared augmentative and alternative communication device display screen during two different communication tasks involving individuals with amyotrophic lateral sclerosis
Fulcher, Katrina R.
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Background: Due to the amount of time it takes to construct utterances, conversants who utilize Augmentative and Alternative Communication (AAC) technologies to construct utterances during face-to-face interaction are at a great disadvantage. Communicating via a technological medium interrupts the expected temporal timing and flow of talk, and often users of AAC technology have difficulty contributing relevant contributions in real time. This leads to communication breakdowns and repairs, as well as augmented speakers being perceived as passive communicators who contribute less to the ongoing interaction when compared to their speaking counterparts. Purpose: Due to these timing disadvantages associated with AAC, investigation of multiple communication resources used to construct and contribute utterances in real time is warranted. The current study aims to understand what impact a shared AAC device display screen has on communication performance, process, and workload measures during two different communication tasks. Method: Seven individuals with ALS and their selected communication partners participated in this study. The seven dyads interacted during two different communication tasks--a map task and a personal shared narrative--while the mouth speaker either had or did not have visual access to the AAC device display screen, for a total of 4 interactions. After each interaction participants were given three surveys to assess workload, communicative competence, and conversational rate and quality. These dimensions were analyzed in order to understand if the presence of the shared screen impacted the participants' subjective reports. All talk and actions used by participants were transcribed and coded. Coding was used in order to understand how participants constructed talk and mutually agreed on the meaning of each contribution under each communication task and screen condition. Transcriptions were also used to understand how participants resolved problematic talk. In addition, measures of task completion time and task success were used to assess overall communication performance across tasks and conditions. Results: Overall the current study did not find any statistically significant differences in regards to screen conditions across communication tasks and participants. The study did reveal statistically significant differences in terms of differential tasks demands. Statistically significant differences were found in terms of rate of grounded contributions and contribution type when comparing the map task to the narrative task. The rate of grounded contributions and presentation-level contributions increased in the narrative task compared to the map task. While not statistically significant, examination of median values showed that rate of repairs and workload decreased in the narrative task compared to the map task. In addition, statistically significant differences were found when comparing the number of repair turns initiated for communication tasks across participant groups. Mouth speakers initiated the majority of repair turns needed, regardless if their utterances were the trouble source. Conclusion: The current investigation found limited evidence to support the use of a shared visual display screen during AAC-mediated investigations. This was potentially impacted by the type of communication task used, media constraints, and participant communication strategies. Future studies should consider differential task demands and the ways in which they will impact study outcomes.