1. What is Camp?Methods and Observations Measuring EnvironmentMeasuring Physical EngagementMeasuring Social Engagement MelissaNaomiJulieMari Interaction between Social & Physical Engagement at Aphasia Camp Heather Buhr & Dr. Jerry Hoepner, University of Wisconsin-Eau Claire Aphasia Camp is a three day experience open to individuals with aphasia and their guests (family, friends, etc). Camp follows a life participation model that engages campers in meaningful activities in a supportive context. Activities include boating, fishing, woodworking, technology, and much more. Campers and their guests are accompanied by community speech-language pathologists and volunteers from the UW-Eau Claire CSD program. The World Health Organization – International Classification of Functioning (WHO-ICF, 2001) is a model for classifying an individual’s response to disease and disability. Past investigations of Aphasia Camp have examined the role of environment in facilitating successful interaction at camp. This current investigation will access the role of physical engagement on campers social interaction. In this collaborative project between kinesiology and communication disorders, both qualitative and quantitative measures were utilized evaluate any relationship between social and physical engagement. Participants included four campers from Aphasia Camp, varying in age and severity of aphasia. Video recordings captured social interaction and participants wore accelerometers to capture their physical activity levels. Analysis included coding of the social interaction with Damico’s Clinical Discourse Analysis and Kagan’s MPC & MSC ratings. Physical activity data from the accelerometers was coded. Environment codes, as defined by the World Health Organization – International Classification of Functioning (WHO-ICF, 2001), were used to evaluate environmental impacts on the camper’s interactions. In addition, field notes were utilized to assessment any factors not assessed with other measures. Clinical Discourse Analysis Codes Failure to provide significant information to listeners Use of Nonspecific Vocabulary Linguistic Non-fluency Revision Failure to Structure Discourse Physical engagement was represented by level of physical exertion and complexity. This was measured through an X-Model accelerometer and through investigator field notes. Level of physical exertion was measured by the accelerometer, which was attached to each participant. Measure of physical complexity was identified through investigator field notes and verified through video review. Accelerometer exertion levels are indicated to the right (0-100 = sedentary, 101-759 = light, 760-2019 = moderate, > 2019 = heavy). Social engagement was measured through level of discourse success vs. struggle and through qualitative measures of participation. Clinical Discourse Analysis (CDA) (Damico, 1991) was used to analyze success vs. struggle. Most frequent CDA codes are shown in the table to the right. The MSC and MPC (Kagan, 1998) were also used to measure success of engagement within dyadic interactions. Environment includes aspects of the physical setting and partners present. Physical setting includes the spaces (outdoor and indoor), furnishings, technologies, lighting, climate, and sounds. Each of these factors was measured using the WHO-ICF coding system (WHO-ICF, 2001). See figures. PerformanceDemands & Facilitators Technology Session Social Exchange High A supported conversation with only 19% of utterances impacted by CDA behavior Environmental: Physical Neutral e150.2e250.2 Environmental: Partner Substantial Facilitator e320.+1 e325.+1 e360.+3 e420.+2 e455.+2 E125.+3 Outcomes Even in an environment with high demands Naomi’s data shows that with substantial partner support Naomi’s social output can remain high. Her partner’s support in this situation capitalized on the use of Talking Mats and Written Choice, further supporting conversation in a noisy and busy environment. PerformanceDemands & Facilitators Fitness Assessment Social Exchange Low Problems behaviors occurring 30% of the time Environmental: Physical Neutral e120.+2 (AFO) e150.+1 e250.1 Environmental: Partner Mild Facilitator e310.+1 e410.+1 e360.1 e455.+1 Outcomes Mari’s physical environment remained neutral, but communication output was impeded by additional communication support. In an environment where she was required to perform various physical tasks, additional communication support would have been beneficial to social output. PerformanceDemands/Facilitators Fitness Assessment Physical Exertion Low Sedentary: 96%Low: 4% Social Exchange Low CDA behaviors in 30% of the utterances MPC Interaction: MPC Transaction: Environmental: Physical Neutral e150.+1e250.1 Environmental: Partner Mild Facilitator e360.1e455.+1 Frisbee Golf Physical Exertion High Sedentary: 33%Low: 67% Social Exchange High No CDA behaviors notedOver 75% of utterances consist of fillers such as “oh’ and “yeah” Environmental: Physical Neutral e120.+1 e120. 1 Environmental: Partner Substantial Facilitator e320.+1 e325.+1 e360.+2 e420.+1 e440.+1 e455.+2 Outcomes Julie’s data shows that it’s not the physical demands in the environment that directly impact the social exchange, but rather the amount of partner support. The attitudes and support offered from volunteers in the Frisbee golf activity helped Julie overcome physical exertion and physical environment barriers. Acknowledgements Findings & Implications Lighting, noise, terrain # of Partners, level of scaffolding Physical exertion, complexity Environment Physical Demands Social Exchange The interaction between environmental demands or supports and physical demands or supports influences participation Several factors can serve as either supports or demands A match between demands and supports yields more effective social exchange. When supports don’t effectively meet demands, social exchange is limited. World Health Organization: International Classification of Functioning, Disability and Health [Final Draft] [http://www.who.int/icidh], 2001.