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AAC LANGUAGE ACTIVITY MONITORING AND ANALYSIS FOR CLINICAL INTERVENTION AND RESEARCH OUTCOMES
Katya Hill CCC-SLP
Barry Romich, P.E.
INTRODUCTION
Communication is a skilled, turn-taking activity requiring the exchange of ideas and information between a speaker and a listener (McCormick & Schiefelbusch, 1990). Since the emergence of the field of AAC, professionals, family members and consumers have agreed that the desire to communicate is the primary reason for using an AAC system. However, there is little research based on the actual communication of people who rely on AAC. Further, the AAC clinical intervention process seldom takes into consideration the use of the AAC system between periodic therapy sessions. Conventional methods of monitoring AAC system use are based on personal observation and video or audio recording with subsequent observation, timing, and/or transcription. The cost of this approach is high because of the human time investment. Consequently, professionals seldom collect data on the actual daily environmental use of AAC systems by consumers.
The obvious solution to this situation is the automation of the language data collection and analysis processes. There have been some efforts made in this area, all integral to specific communication or writing systems (Miller, et.al., 1990; Ahlsen and Stromqvist, forthcoming; Copestake and Flickinger; forthcoming). This paper describes a set of tools that have been developed and assembled for the purpose of performance monitoring for any communication or writing system with serial output. They are a Language Activity Monitor (LAM), a Language Editor (LE), and language analysis programs.
LANGUAGE ACTIVITY MONITOR
The Language Activity Monitor (LAM) is a recording device that can be attached and connected to any AAC system with an RS-232c serial data output. The LAM records each output (one or more letters, words, phrases, sentences, etc.) from the AAC system and attaches a time stamp. The data stored in the LAM over time is then periodically uploaded to a computer for analysis. This uploading process can happen without custom computer software so that the data can be transmitted as an email attachment or saved on a floppy disk for transmission or transport to a different location for analysis. The protocol for data recording and uploading includes a number of commands and features to deal with enabling and disabling recording, identifying non-language information and time stamps, and setting the clock. Push buttons and indicators on the LAM make it easy to enable and disable recording manually, as may be desired during therapy sessions and other times when recording could skew results.
One important issue in the use of any recording device is privacy. For people who are able to do so, the serial output of the AAC system can be turned off. Also, the recording protocol provides for enabling and disabling the recording process using specific character string commands. It is strongly recommended that people whose communication is being monitored be clearly informed and that public use of recorded communication be anonymous.
LANGUAGE EDITOR
The Language Editor (LE) is Windows environment software that receives raw data from the LAM. The LE is custom software that separates the language content from time stamps and other non-language items such as functional designations. This function may require human intervention to make judgments and allow further editing. Examples are timing issues, such as grouping, if rate information is to be extracted, and spelling correction so that there is no confusion during the language analysis process. The primary output of this component is text.
LANGUAGE ANALYSIS PROGRAMS
After LAM data is uploaded into the computer and the raw data has been edited, the text is analyzed using standard and/or custom vocabulary and language analysis software applications. Various parameters to be analyzed could include:
- morphological usage
- lexical or semantic usage
- syntactic structures
- developmental levels
To satisfy needs other than those addressed by standard language analysis programs it may be necessary to develop custom applications or use manual methods to analyze the LAM data. Examples of this could be analysis of use of particular vocabulary items since the previous therapy session, calculation of communication rate using the time stamps, methods used for language representation (spelling vs. words and phrases), and error rates and types.
RESEARCH APPLICATIONS
The LAM and Language Editor are tools for gathering information on the daily environmental use of an AAC system. These tools provide the data to conduct empirical research on a variety of language parameters associated with AAC system use. Researchers have identified the need to develop and investigate performance monitoring systems in order to improve the level of accountability for AAC service delivery (Kohn, 1994; DeRuyter, 1998). These tools provide the opportunity to conduct research on the outcomes management process and the standard outcomes dimensions of clinical status, functional status, quality of life, satisfaction, and cost (DeRuyter, 1998). In addition, researchers will be able to compare the languge activity of AAC users with child and/or adult models and normative studies on content, form and use.
CLINICAL INTERVENTION APPLICATIONS
Current best practice in AAC implementation emphasizes communication outcomes based on a team selecting outcomes from a functional curriculum model (Blackstone, 1990; Hill, 1996; Gray, 1998). AAC outcomes can be determined by noting positive changes in the attitudes of teachers, classmates, co-workers and others toward the consumer (Calculator, 1998). However, the tools described here provide more objective data to analyze systematically the scope and sequence of expected AAC outcomes. Clinicians will be able to document daily use of targeted vocabulary, or morphologic and syntactic structures, thus facilitating the intervention process across environments and team members. In particular, the team will have the instrumentation to develop and monitor Individual Education Program (I.E.P.) goals and objectives. The team will not only be able to quantify the I.E.P. objectives, but will be able to qualify the implementation strategies and techniques used to facilitate AAC system use.
REFERENCES
Ahlsen, E. and Stromqvist, S. (forthcoming). ScriptLog: A tool for logging the writing process and its possible diagnostic use. Proceedings of the 1998 ISAAC Research Symposium (Dublin, Ireland, August 1998). John Clibbens, Filip Loncke, and Lyle Lloyd (editors). Whurr Publishers, London.
Blackstone, S. (1990). In pursuit of opportunities and interdependence. Augmentative Communication News. 3:1-4.
Calculator, S.N. (1998). AAC and individuals with severe to profound disabilities. Handbook of Augmentative and Alternative Communication. S.L. Glennen, DeCoste, D.C. San Diego, Singular Publishing Group, Inc.
Copestake, A. and Flickinger, D. (forthcoming). Evaluation of NLP technology for AAC using logged data. Proceedings of the 1998 ISAAC Research Symposium (Dublin, Ireland, August 1998). John Clibbens, Filip Loncke, and Lyle Lloyd (editors). Whurr Publishers, London.
DeRuyter, F. (1998). Concepts and rationale for accountability in assistive technology. Volume I: RESNA resource guide for assistive technology outcomes: measurement tools. RESNA.
Gray, S. (1998). AAC in the educational setting. Handbook of Augmentative and Alternative Communication. S.L. Glennen, DeCoste, D.C. San Diego, Singular Publishing Group, Inc.
Hill, K.J. (1996). Welcome to the real world using quality management tools to support the implementation process. Proceedings of the 10th U.S. Minspeak Conference.
Kohn, J.G., LeBlanc, M. & Mortola, P. (1995). Measuring quality and performance of technology: results of a prospective monitoring program. Assistive Technology. 6:120-125.
Miller, L.J., Demasco, P.W., Elkins, R.A. (1990). Automatic data collection and analysis in an augmentative communication system. Proceedings of the 13th Annual RESNA Conference. Washington, DC 99-100.
Katya Hill, CCC-SLP
Research Associate
School of Health and Rehabilitation Science
University of Pittsburgh Rm. 5064 Forbes Tower
University of Pittsburgh, Pittsburgh, PA 15260
Tel: 412-647-1289
Fax: 412-885-8548
Email: kjhill+@pitt.edu
Barry Romich, P.E.
Prentke Romich Company
1022 Heyl Road
Wooster, OH 44691
Tel: 330-262-1984 ext. 211
Fax: 330-263-4829
Email: bromich@aol.com