Context Based

Communication

Using High Tech Solutions to Cue Communication

Vicki Clarke & Elisabeth Dolloff

Dynamic Therapy Associates, Inc.

GATE 2015, Atlanta, GA

Handout Link:

http://bit.ly/1TxfjL8

My Scene: Cueing Communication

What Is Context Based Communication?

Messages that pertain specifically to a particular

context (environment)

Presented in a grid format or in a visual scene display

With less emphasis on pairing words creatively and

more emphasis on single button/area message selection

Which are highly individualized to the AAC user’s

world

Message Characteristics

Occur regularly

Have high social value

Motivating

Meet a significant communication need

Purpose of Context Based

Communication

Improve independent navigation

Support sustained social interactions

Simplify social messaging by highlighting

contextually relevant messages

Allow communication to meet individual’s

identified needs

Increase participation in the AAC user’s

natural environment

Increase rate of learning for new messages.

Common Concerns Regarding Use

Context Based Communication

• Lack of consistent location of messages

• Need for extensive modifications

• Doesn’t enhance language development

• Limits spontaneous novel utterance generation

How to Manage Primary Concerns

• LACK OF CORE VOCABULARY AND GENERATIVE LANGUAGE INSTRUCTION:

• Access to core vocabulary and instruction, taught in conjunction with context based messaging options

• LACK OF CONSISTENT PLACEMENT OF WORDS

• Use the placement of the word in the patient’s core vocabulary pages to drive the location of semantically similar messages in subsequent context-based pages

• EXTENSIVE MODIFICATION NEEDS:

• Use of systematic collection of messaging needs in environments

• Train family or primary care providers to make basic modifications in real time as needed.

Increase Rate of Learning

• Narrow field of potential messages

to those that are most likely to be

needed in an environment

• Messages are contextually relevant,

familiar and significant

• Symbols can be more concrete and

immediately recognizable

Case Studies: Anne

• Difficulty with comprehension of

abstract symbols

• Appears to be not motivated by

social interaction

• Social interaction is challenging

• Uses language primarily to request

objects

Communicating in My Home

Simplify Navigation

• Conceptually easy to

locate photograph to

match environment for

navigation.

• 1-2 step link to

environmentally relevant

messages

• Decrease demand for

comprehension of

symbol association or

categorization

Case Studies: Nicholas and Harrison

• Difficulty with comprehension of

abstract symbols

• Difficulty with categorization

• Socially motivated

Harrison and Nicholas

Increase Rate of Interaction

Increase rate of

communication of routine

phrases

less navigation

less activation of buttons

less segmented messages

Decrease attention demand

in distractible environments

Case Studies: Kasey & Robert

Kasey:

• Decreased rate of

communication secondary to

motor difficulties

• Social motivation is limited by

the effort necessary to interact

• Working to increase

independence in the community

Increase Rate of Interaction: Kasey

Increase Rate of Interaction: Robert

• Social anxiety

• Difficulty with delayed

gratification

• Anxiety with functional

demands

• Strong motivation to

communicate and

participate

Introduction to Novel Environments

• Prepare AAC user through

images and sequences of

upcoming events

• Allow for discussion of

events prior to occurrence

• Allow for review of event

after the activity.

• Give AAC user an element

of control in stressful

environment with minimal

access demands

Novel Environments: Chad

• Difficulty interacting in unfamiliar

environments

• Multiple, on-going medical

concerns

• History of self-abusive and

aggressive behaviors

• History of property destruction

Medical Environment Supports

AAC Vocabulary Organization Decision Tree:Considerations for Initial Setup and Components

Social Messages

Core Vocabulary

Categories

Context/Visual Scenes

Functional Messaging

Case Study: Mason

• 6 years old

• Severe Apraxia of speech

• Receptive language within normal limits

• Expressively at a single word level

• Emerging ability to creatively combine 2 words

• Just learning to navigate and functionally use his new device

• Uses Unity 45 Sequenced

• Has social messages preprogrammed into the Activity Row

Planning for Context Based Messaging

Selection of display type (visual scene or

grid display)

Visual processing skills

Physical access method (yes you can use scanning!)

Symbol comprehension

Capabilities of current or proposed system

Delineation of Messages

Schedule Analysis Sample- Dynamic

Therapy

Schedule Analysis Sample- Dynavox

DAGG-2 Schedule Analysis

Capability of Current/Proposed System

AAC Devices that Support Context Based

Communication

NovaChat

Accent Series

Tobii Dynavox Compass

Tobii Dynavox

Communicator: SonoPrimo

Apps that Support Context Based

Communication

SonoFlex

GoTalk Now

TouchChat

Autismate 365

Tobii Dynavox Compass