Visual Scenes Display: A New AAC Interface for Persons with Severe Chronic Visual Scenes Display: A New AAC Interface for Persons with Severe Chronic

AphasiaAphasia Aimee R. Dietz, Miechelle McKelvey, David Beukelman, Kristy Weissling, and Karen HuxFunded in part by: AAC-RERC, NIDRR, USDEFunded in part by: AAC-RERC, NIDRR, USDE

PurposePurpose• To design an visual-contextual interface for

people with aphasia that FACILITATES message representation and navigation of a dynamic display system thus, successful communication of messages/intent

• To investigate the impact of a visual-contextual interface on the interactions of people with severe, chronic aphasia and their families

What is a Visual What is a Visual Scenes Display?Scenes Display?

• An interface organized through use of contextual pictures

• People, actions, and objects are integrated to create a holistic context

– Familiar

– Reveals competence

– Reduces cognitive load

EquipmentEquipmentAAC Technology

– DynaVox Tablet XL

– Prototype Software

– Digital cameras for collecting pictures to use in themes

– Programming Computer

Navigation StrategiesNavigation StrategiesThemes• Organizational

strategy for navigation

Color & CONTRAST• Learning • Memory• Pattern recognition• Organization

THEMES

COLOR

Theme DevelopmentTheme DevelopmentTheme development is the process by which the content of the Visual Scenes Display (VSD) is personalized.

Three Phases

1.Informant Phase

2.Programming Phase

3.Validation Phase

INFORMANT PHASE

• Download or scan pictures into PC editor

• Informant provides details regarding people, places, and activities in the images

• Theme emerges

Theme DevelopmentTheme DevelopmentProgramming Phase• AAC facilitator

assembles and programs the theme into the VSD

Validation Phase• The person with

aphasia is provided time to explore the content

• The facilitator works with the person with aphasia and the informant to edit content

Functional Outcomes: Functional Outcomes: Family ReportFamily Report

Participants• Adult daughters of 2 people with severe

chronic aphasia – Primary informants during theme

development phase– 1 lives with mother, primary caregiver – 1 lives close to mother, legal guardian

Data Collection

• Communication Confidence Scales

• Communication Device Use Checklist

• Semi-structured Interview

Communication Communication Confidence ScaleConfidence Scale

• Participants rated interaction quality of their mothers with and without VSD using a 5-point Likert Scale

• 1 = “very uncomfortable” and 5 = “very comfortable” with VSD without VSD

Comfort 4.5 2.5

Confidence 5 (n=1) 3.0 (n=1)

Connectedness 4.5 3.0

Pleasure 4.5 3.0

Communication Device UseCommunication Device Use

Qualitative ThemesQualitative Themes

• Re-expansion of Social Roles

• Navigation of VSD

• Family Acceptance

• Additional Use Patterns

Re-expansion of Re-expansion of Social RolesSocial Roles

• Before she had this computer…she couldn't tell the stories, but now…if she has new information in there (VSD) she loves to sit down and just go through each story and they'll sit there with her and they just love it. She may not be able to speak about it but she still has it…she can communicate it.

• Now she’s more apt to take people in and show them her computer and when they’re in there she doesn’t want them to leave. She wants to talk about everything.

• She can just point to the word. It’s easier for her…because she really didn't communicate to very many people…she didn't know how…to do it.

• She just kept pointing (to the VSD) until we could make the connection…but she doesn’t stop until you understand her.

• …but it is her voice through those pictures and actions.

NavigationNavigation • I am really impressed with her wanting to

learn it, wanting to use (it), and she’s not too worried about getting around in it.

• …(she) shows them what’s new on her computer and how she gets around in it.

• …pictures mean a lot more than words do. So at least it is easy for her to find things…if she sees a picture she remembers what's behind that picture.

Family AcceptanceFamily Acceptance• …I think this is the best thing that

anybody could get.

• I thought it was great.

• …after she showed me (daughter)…it was just a touch screen type thing I just knew it was going to work out for her.

• But 75% of the time, I notice…he (husband) doesn't have the…patience…I think he gets more out of her using her communication book

• …so he (husband) is not afraid of computers… he just isn’t gonna work with her that way because he can communicate with her (without the VSD)

• Now the grandkids, I think they understand.

Additional Use PatternsAdditional Use Patterns

• …she doesn’t want it out laying around in a place where it could get dirty or something could happen to it…so it’s on her desk (in her bedroom).

• …she doesn’t use the computer for that (basic needs).

• I think…that she forgets that she's got this wonderful thing…she tries to write it down first then we'll say, “Is it on your computer?” Then she'll go to it.

DiscussionDiscussionPeople with chronic aphasia:• Re-expanded their social roles with VSD

• Used VSD frequently for storytelling purposes

• Learned to navigate the VSD easily

• Used VSD more with adult children, grandchildren, and peers than spouses

• http://aac.unl.edu/

Participant 2Participant 2

Participant 1Participant 1

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Percent Time Used

VSD

Low Tech

Vocalizations

Gestures

Writing

Basic Needs New Information Social Closeness

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Percent Time Used

VSD

Low Tech

Vocalizations

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Writing

Basic Needs New Information Social Closeness