2000 Conference Proceedings
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FACILITATING DISCOURSE IN NEWLY AUGMENTED
COMMUNICATORS
Donald B. Egolf, Ph.D.
Department of Communication
1117 Cathedral of Learning
University of Pittsburgh
Pittsburgh, PA 15260
Voice Mail: 1-412-624-6763
FAX: 1-412-624-1878
Email: ratchet@vms.cis.pitt.edu
One factor characterizing many nonspeakers is the passive
role they play in discourse. Because of their inability to
speak, nonspeakers and their speaking partners manage their
discourse by frequently resorting to a "20-questions" kind of
interaction. The natural speaker becomes the interlocuter and
the nonspeaker serves as the "yes-no" respondent. This mode of
interaction has some functionality, particularly in determining
the needs, wants, and preferences of the nonspeaker. At the
same time, however, this mode of interacting is slow and it
maintains the nonspeaker in a passive role.
The purpose of this study was to determine if at the time of
the introduction of programmable, electronic, communication
aids, the emergence of discourse initiation behaviors could be
promoted and facilitated in nonspeakers.
METHOD
Subjects
Subjects in this study were seven nonspeaking, nonreading,
school-age children. All subjects had experienced some form of
"low-tech" communication augmentation but none had been exposed
to a programmable, electronic, communication aid with
synthesized speech output. All were cerebral palsied
individuals whose symptoms were moderate to severe. The average
age of the subjects was 12.8 years with a range from 9.9 to
18.8 years.
Pre-Study Observations
Subjects were observed interacting with their speech-language
clinicians on two occasions, with the speech-language clinician
from this project, with a teacher, and with a school-age peer.
Each interactive period ranged from 15 to 20 minutes in length
and each was videotaped for later review by the project staff.
In the subsequent review the general nature of the subjects'
interaction skills was evaluated. It was found that they had
some knowledge of discourse skills, responding to questions,
turn-taking, giving feedback, and initiation, for example.
However, these discourse forms were manifested globally and
primarily through nonverbal modalities. Moreover, pervading the
interactions were "yes-no" responses from the nonspeakers. The
nonspeakers were passive givers of information. Could these
patterns be changed? This study sought the answer to this
question. Equipment Equipment used in this study included
videotape equipment and programmable, electronic, augmentative
communication aids with synthesized voice output: Touch Talkers
and Light Talkers. Each of the communication devices had a 128
space keyboard which could be rezoned in descending powers of 2
(64, 32, 16, 8). Recording Interaction Patterns During
Discourse A recording system for analyzing the interactions in
this study was developed. It was based on Bales (1950)
Interaction Process Analysis and it included twelve categories
into which subject utterances could be categorized.
DATA RECORDING SESSIONS
Baseline-Type Session
Each subject was seen in a baseline-type interaction session
prior to the introduction of the communication aids. In this
session the project's speech-language clinician interacted with
each subject with the only instruction being, "Have a chat."
These instructions were analyzed using the Bales-based system,
and the results of the analyses were later used for comparison
data. Training Sessions Next, the communication devices were
introduced to the subjects. Decisions about the assignment of a
touch-activated device or a light-activated device were made in
conjunction with the subjects' school-employed speech-language
clinicians. While each decision was multi-faceted, of primary
consideration was finding that part of the body that gave the
most reliable voluntary motoric response.
Following the assignment of the devices, training sessions for
subjects were held in the use of the devices. Further decisions
were made about the zoning of keyboards in order to accommodate
the respective motor disabilities of the subjects. Experimental
Interaction Sessions Preparations for the experimental
interaction sessions involved the coding of the communication
devices. Since the subjects were nonreaders and nonspellers,
programming required the use of icons on the keys instead of
letters. We used some icons provided by the manufacturer of the
Touch Talker and Light Talker but the majority of icons were
produced by us. The communication devices were programmed so
that the activation of a tactile or light sensitive "key"
generated a synthesized speech message. Since we were
interested in having our subjects become initiators in
discourse and not passive recipients, we programmed into the
device utterances that were requests: asking for opinions,
information, or action. Complementing the requests were other
utterances related to greetings, farewells, and likes and
dislikes. Of prime importance in programming the devices was to
devise tasks that promoted meaningful discourse and not just
random and repetitive key activation.
To determine if the subject were responding in an appropriate
and meaningful manner, communication tasks were designed so
that the subject was requesting actions from a limited set. In
Task 1, for example, subjects requested that the clinician give
them a red, yellow, blue, or white piece of paper. There were
five pieces of each color. Therefore, subjects could not
continue asking for pieces of blue paper because after five
such requests, the sixth request would be inappropriate since
the supply of blue pieces of paper would have been
exhausted.
In like manner in Task 2, subjects requested through their
speaking devices that the clinician put specific coins from a
limited coin set into a bank (an "Uncle Sam" bank where Uncle
Sam would "drop" the coin from his hand into a pouch). If a
subject requested that a dime be dropped into the bank and no
dimes were available, the response was inappropriate. In Task
3, the subjects requested that specific Christmas-tree
decorations be placed on a tree. Again, there was a limited set
of decorations. To have the devices request colors, coins, and
ornaments, "literal" icons were used -- color patches, coins,
and small ornaments.
The requests for paper, coins, and ornaments were imbedded in
the context of social discourse. For example, subjects had
programmed into their devices greeting utterances, e.g.,
"Hello, how are you today?": Icon = smile face; farewell
utterances, e.g., "Goodbye, have a nice day": Icon = waving
hand; like and dislike utterances, e.g., "Do you like chocolate
cake?": Icon = picture of a chocolate cake; utterances to
correct the clinician, e.g., "You gave me the wrong one": Icon
= circle with slash; courtesy utterances, e.g., "Thank you":
Icon = praying hands; feeling utterances, e.g., "I don't feel
well": Icon = medical thermometer; and pacing utterances, e.g.,
"Wait a minute": Icon = stop sign. Post-Intervention Sessions A
post-intervention session was held for each subject after the
three tasks were executed. This was similar to the
baseline-type session except that subjects retained their
augmentative communication devices. Paper, money, and tree
ornaments were removed from the subjects' devices and icons
related only to social discourse remained. Thus subjects could
use their devices to talk about likes and dislikes of theirs
and of the clinician, they could produce greeting and farewell
utterances, express feelings, and could control the output of
their speaking partners by asking them to repeat, slow down or
tell more.
RESULTS
Data for the baseline, tasks, and post-intervention sessions
were recorded on the Bales-based analysis system discussed
above. Extracted from the Bales analysis forms were the
frequencies with which subjects' utterances fell across the
twelve categories. Visual inspection of the data showed that
over 90% of the utterances fell into six categories, "Gives
opinion, information, or action;" and "asks for opinion,
information or action." These six categories were focused upon
and the remaining were ignored since their incidence was
marginal (<10%). Further, the six utilized categories were
collapsed into two: (1) "Giving opinions, information, and
action;" and (2) "Asking for opinions, information and action."
This collapsing created two categories of interest in regard to
nonspeakers: the first category reflects responding while the
second reflects initiation, an area in which nonspeakers in
general are, and our subjects in particular were,
deficient.
The average frequencies of occurrence of the "asking" and
"giving" responses during the task sessions were compared with
the frequencies during the baseline-type session, and the
baseline-type session frequencies were compared with the
frequencies from the post-intervention session through the use
of the Fisher Exact Probability Test (Siegel, 1956). Using the
Fisher test (appropriate for an N as low as seven), it was
found that during the communication tasks, a significant
(p<.05) number (7 of 7) of subjects changed from being
predominantly passive givers of opinions, information, and
action to being predominantly "askers" of opinions,
information, and action. An identical significant (p<.05)
change occurred when the baseline-type session was compared
with the data from the post-intervention session.
DISCUSSION
This study has shown that providing school-age nonspeakers with
a properly programmed communication device with a voice
synthesizer can lead to a significant change in their discourse
styles. They changed from passive receivers to active
initiators. We acknowledge that a criticism of our research is
that we programmed the devices to get what we wanted from our
subjects: namely, a significant increase in the frequency of
their active initiation responses. If you give someone a hammer
he will go about pounding the world so the aphorism goes and if
you give a nonspeaker a device that can speak utterances that
ask for opinions, information, or action, that is, indeed, what
you will get. Our answer to this criticism is two-fold. First,
we designed our tasks to guard against inappropriate responses,
random and repetitious activations, for example. Inappropriate
responses were not counted. Second, the purpose of any
prosthetic device, communication devices included, is to
correct some dysfunction. Eye glasses are designed to correct
dysfunctional vision and communication devices are designed to
correct dysfunctional communication. And so we did program the
devices to enable the subjects to produce what we and they
wanted to produce just as the optometrist prescribes lenses to
obtain the desired result.
The results produced in this study constitute only a beginning
in satisfying our subjects' communication needs. But a major
initial step was taken. Our positive quantitative results were
complemented by the subjects' expressions of joy and
satisfaction when they produced spoken initiation utterances
which gave them control over their conversational partners.
REFERENCES
Bales, R. F.(1950). "Interaction Process Analysis: A Method for
the Study of Small Groups." Reading, MA: Addison-Wesley.
Siegel, S. (1956). "Nonparametric Statistics for the
Behavioral Sciences." New York: McGraw-Hill Book Co.
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