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Synthetic Speech:Does it increase social interaction?
Melissa Bairos, Emily Emanuel,
Aviva Krauthammer, Jen Perkins,
Holly Reis, and Beth Zaglin
Description of AAC User
Elizabeth: 7;6 year old girl Spastic Cerebral Palsy Mild-Moderate
Cognitive Delay Impaired vision
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
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
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
Well-built question
Will the use of a speech generating device increase social interaction for a child with AAC needs?
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 children’s 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)
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 children’s 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
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
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
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
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.
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?