Transcript heather hunter

Social Validity of Technology Assisted Language Intervention
for Children who are Deaf or Hard-of-Hearing
Stephen Hill MA , Heather Innis BS , Molly Murrison BS, Sandra Grether PhD, Lisa Hunter PhD, Jareen Meinzen-Derr PhD
Leadership Education in Neurodevelopmental and related Disabilities (LEND) Program
The Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center
The University of Cincinnati University Center for Excellence in Developmental Disabilities
Background
Method
Results: Focus Group
Discussion
• Children who are Deaf or Hard-of-Hearing (DHH) are at-risk for
language delays and possible language impairments which can
impact social and communication functioning (Meinzen-Derr et al.,
Participants:
•
Audiologists
•
Speech-Language Pathologists
•
Educators of DHH children
•
Representatives of the Audiology Family Advisory Council
•
Families of children who are DHH
Data Collection:
Interviews were conducted with families by telephone using
structured questions. Different questions were used with
professionals and community partners in the focus group.
Parents of children in the study were invited to attend the
focus group as well. Examples of questions and responses are
shown below in Figures 2 and 3.
What are strengths of children who are DHH?
• Strong visual perceptual skills
• Just like typical kids; can do everything but hear
• Families reported that TALI was successful in general.
2013 Coch Imp Intl; 2014 J Dev Behav Pediatr).
• Technology Assisted Language Intervention (TALI) is a novel
approach that focuses on the feasibility of using augmentative
and alternative communication (AAC) as an intervention for
children who are DHH.
• TALI combines AAC strategies with up-to-date and socially
acceptable technology (iPads®) to enhance and support
language development in children who are DHH and continue
to display clinically significant gaps in language.
• TouchChat HD AAC with WordPower is a language system on
the iPad® that varies in the number of buttons per page. It
has a keyboard and is predictive in its automatic navigation,
offering grammatically appropriate options of what to say
next.
Fig 2 and 3: Discussions with
professional partners are displayed.
Responses to each of the focus
group questions were recorded and
matriculated to general responses
and trends.
Fig 1: TouchChat HD with WordPower with 60-cell overlay
Aims
• The purpose of this research study was to investigate the
social validity of the Technology Assisted Language
Intervention (TALI) for children who are DHH.
• It is important to investigate the feasibility of this new
intervention across varied settings. Success of an intervention
depends on the ability to generalize it to other environments.
• While results were positive in individual therapy sessions, we
investigated the feasibility of using this intervention in the
child’s natural environments (home and school).
• We gathered qualitative data from the parents of children
enrolled in this study to better understand their perspective
on the use of this intervention outside of therapy.
• We also gathered qualitative data from professionals and
community partners who work with children who are DHH to
better understand their perspective on the use of this
intervention in their setting.
Data Analysis:
Group level assessment approach was used to group
comments into common themes. This was done through
group discussion and consensus.
Results: Family Interviews
Positive Feedback
• Enhanced attention and perseverance
• Enjoyment and excitement with devices
• Expanded language and vocabulary
• Involves a variety of communication partners
• Relatively easy to use
To Work On
• Difficulty coming regularly to therapy location
• Getting school on board with device use
• Prioritizing time for TALI use at home
• Needing assistance to match child’s developmental level
How would you describe communication needs of children
who are DHH?
• Supportive communication partners
• Supportive communication environment
What are some obstacles that children who are DHH face?
• Communication limitations
• Socio-economic obstacles
• Social-emotional difficulties
• Difficulty in diagnosis and recommendations
What are your expectations for children who are DHH?
• Same as hearing children
• Able to communicate with everyone
• Some positive themes noted were: ease of use, enjoyment,
enhanced attention and perseverance. Language
improvements and expanded vocabulary led to
communication with more partners.
• Parents cited inconvenient location of therapy, prioritization
among other therapies, difficulty working with the school,
and assistance needed for child’s developmental age.
• Focus group participants indicated excitement about the
TALI intervention and its potential to help children with
hearing loss.
• Focus group participants conceded that implementation of
the devices may be complicated due to classroom
transition, unfamiliarity with the technology and updating
the technology to meet the child’s advancing
communicative needs.
What behaviors would you expect for children who are DHH?
• Positive behaviors with appropriate intervention
• Negative behaviors without appropriate intervention
• Appropriate expectations are needed
Conclusions
•
What are your reactions to using AAC to develop language
with our children?
• Positive: exciting, easy, builds on strength, ownership
• Negative: complicated
TALI was viewed positively by parents and professionals for
use in expanding vocabulary and verbal communication
skills.
•
Children found use of TALI enjoyable and motivating.
•
Barriers were adoption by school settings and modification
of TALI to keep up with child’s advancing language skills.
A child comes into your setting with an iPad with a
communication application. What are your concerns and
what are the positives?
• Concerns: usage, care, appropriateness, consistency
• Positives: supports for learning, use in writing lessons
Based on our discussion so far, how can you incorporate this
into your daily practice?
• Speech/Language: incorporate into lesson, augment goals
• School: teaching writing and sentence structure
Next Steps
•
Include additional community partners and parents in
future studies of social validity
•
Investigate if TALI would have a significant impact on
language development for children with additional
disabilities
•
Consider training and support programs necessary to
support families, schools, and other partners
Acknowledgements
This project is funded by Maternal and Child Health Bureau
Grant T73MC00032. The Schmidlapp Women’s Scholar Fund
and the March of Dimes. Families who make this work possible
through participation.