Caregivers, teachers, and assistants require more instruction and guidance on strategies for using speech-generating devices to communicate with children with cerebral palsy (CP), a study shows.
These findings suggest that speech language pathologists should implement broader approaches when teaching these communication partners — those who need to communicate regularly with the child — strategies for using a speech-generating device with children with CP.
The study, “Caregivers’, teachers’, and assistants’ use and learning of partner strategies in communication using high-tech speech-generating devices with children with severe cerebral palsy,” was published in Assistive Technology.
Although high-tech speech-generating devices can help children with severe physical, communication, and cognitive issues communicate, using these devices is sometimes problematic, requiring skills, training, and effort on all sides.
Strategies have been developed to assist in helping communication partners use speech-generating devices to communicate with these children. These devices can range from mid-tech battery-operated to high-tech computerized devices with synthetic or digitalized speech.
However, communication partners report that poor professional support limits their ability to communicate with CP children using these devices.
To learn more about the issue, researchers from Uppsala University in Sweden examined how communication partners of children with severe cerebral palsy used and learned partner strategies for communicating with speech-generating devices.
The researchers developed two study-specific questionnaires regarding the use of and learning about partner strategies for speech-generating device-based communication targeting caregivers, teachers, and assistants.
Based on previous research and clinical experience, the questionnaires covered five domains: background data (i.e., demographics), hardware and software of the speech-generating device, use of the device, use of partner strategies, and learning about partner strategies.
Findings of this study were based on reports from 52 respondents — 23 caregivers, 14 teachers, and 15 assistants — who used high-tech speech-generating devices to communicate regularly with 16 children with severe cerebral palsy and intellectual disability.
Asking open-ended questions was the partner strategy most frequently used in speech generating device-based communication. Aided augmented input — pointing to and naming symbols on a speech-generating device during ongoing conversation to model language — was the least frequently used communication technique. According to responding communication partners, children with severe cerebral palsy used speech-generating devices unimpeded, which meant that aided augmented input was not needed.
“A high use of open-ended questions is promising because this strategy contributes to vocabulary expansion and grammatical improvement and it provides individuals with severe physical and communicative impairments with the opportunity to choose the topic,” the researchers wrote. “A lower rate of use of aided augmented input could be problematic because this strategy has been found to contribute to extending vocabulary and the use of multi-symbol utterances.”
Participants mostly learned about communicating with speech-generating devices from speech language pathologists. These professionals often used verbal descriptions of partner strategies and rarely or never used feedback or role-play approaches when teaching partner communication strategies. The respondents requested further support from speech language pathologists.
“A considerable number of the participants reported that speech-language pathologists never used feedback and role play, which is problematic because communication partners need to practice the use of partner strategies and they need positive feedback to implement the strategy,” the researchers wrote.
These findings suggest that speech language pathologists, who most often prescribe speech-generating devices and are responsible for training and supporting users and communication partners, should consider additional approaches (e.g., feedback, role play) when teaching communication partners of children with severe cerebral palsy to use these devices.
“This study adds valuable information about caregivers’, teachers’, and assistants’ use and learning of partner strategies in speech generated device-mediated communication with children with severe physical, communicative and cognitive impairments due to cerebral palsy,” the researchers concluded.