1. Visual Scenes Display: A New AAC Interface for Persons with Severe Chronic Aphasia Aimee R. Dietz, Miechelle McKelvey, David Beukelman, Kristy Weissling, and Karen Hux Funded in part by: AAC-RERC, NIDRR, USDE Purpose 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 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 Equipment AAC Technology –DynaVox Tablet XL –Prototype Software –Digital cameras for collecting pictures to use in themes –Programming Computer Navigation Strategies Themes Organizational strategy for navigation Color & CONTRAST Learning Memory Pattern recognition Organization THEMES COLOR Theme Development Theme 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 Development Programming 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: Family 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 Confidence 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 VSDwithout VSD Comfort4.52.5 Confidence5 (n=1)3.0 (n=1) Connectedness4.53.0 Pleasure4.53.0 Communication Device Use Qualitative Themes Re-expansion of Social Roles Navigation of VSD Family Acceptance Additional Use Patterns Re-expansion of Social 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. Navigation 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 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 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. Discussion People 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 2 Participant 1 New InformationSocial Closeness Basic Needs New InformationSocial Closeness