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H Cockerill - One of the best experts on this subject based on the ideXlab platform.
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speech Communication and use of Augmentative Communication in young people with cerebral palsy the sh pe population study
Child Care Health and Development, 2014Co-Authors: H Cockerill, Diana Elbourne, Elizabeth Allen, David Scrutton, Elspeth Will, A McneeAbstract:Background Communication is frequently impaired in young people (YP) with bilateral cerebral palsy (CP). Important factors include motoric speech problems (dysarthria) and intellectual disability. Augmentative and Alternative Communication (AAC) techniques are often employed. The aim was to describe the speech problems in bilateral CP, factors associated with speech problems, current AAC provision and use, and to explore the views of both the parent/carer and young person about Communication. Methods A total population of children with bilateral CP (n = 346) from four consecutive years of births (1989–1992 inclusive) with onset of CP before 15 months were reassessed at age 16–18 years. Motor skills and speech were directly assessed and both parent/carer and the young person asked about Communication and satisfaction with it. Results Sixty had died, eight had other conditions, 243 consented and speech was assessed in 224 of whom 141 (63%) had impaired speech. Fifty-two (23% of total YP) were mainly intelligible to unfamiliar people, 22 (10%) were mostly unintelligible to unfamiliar people, 67 (30%) were mostly or wholly unintelligible even to familiar adults. However, 89% of parent/carers said that they could communicate 1:1 with their young person. Of the 128 YP who could independently complete the questions, 107 (83.6%) were happy with their Communication, nine (7%) neither happy nor unhappy and 12 (9.4%) unhappy. A total of 72 of 224 (32%) were provided with one or more types of AAC but in a significant number (75% of 52 recorded) AAC was not used at home, only in school. Factors associated with speech impairment were severity of physical impairment, as measured by Gross Motor Function Scale level and manipulation in the best hand, intellectual disability and current epilepsy. Conclusions In a population representative group of YP, aged 16–18 years, with bilateral CP, 63% had impaired speech of varying severity, most had been provided with AAC but few used it at home for Communication.
A Mcnee - One of the best experts on this subject based on the ideXlab platform.
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speech Communication and use of Augmentative Communication in young people with cerebral palsy the sh pe population study
Child Care Health and Development, 2014Co-Authors: H Cockerill, Diana Elbourne, Elizabeth Allen, David Scrutton, Elspeth Will, A McneeAbstract:Background Communication is frequently impaired in young people (YP) with bilateral cerebral palsy (CP). Important factors include motoric speech problems (dysarthria) and intellectual disability. Augmentative and Alternative Communication (AAC) techniques are often employed. The aim was to describe the speech problems in bilateral CP, factors associated with speech problems, current AAC provision and use, and to explore the views of both the parent/carer and young person about Communication. Methods A total population of children with bilateral CP (n = 346) from four consecutive years of births (1989–1992 inclusive) with onset of CP before 15 months were reassessed at age 16–18 years. Motor skills and speech were directly assessed and both parent/carer and the young person asked about Communication and satisfaction with it. Results Sixty had died, eight had other conditions, 243 consented and speech was assessed in 224 of whom 141 (63%) had impaired speech. Fifty-two (23% of total YP) were mainly intelligible to unfamiliar people, 22 (10%) were mostly unintelligible to unfamiliar people, 67 (30%) were mostly or wholly unintelligible even to familiar adults. However, 89% of parent/carers said that they could communicate 1:1 with their young person. Of the 128 YP who could independently complete the questions, 107 (83.6%) were happy with their Communication, nine (7%) neither happy nor unhappy and 12 (9.4%) unhappy. A total of 72 of 224 (32%) were provided with one or more types of AAC but in a significant number (75% of 52 recorded) AAC was not used at home, only in school. Factors associated with speech impairment were severity of physical impairment, as measured by Gross Motor Function Scale level and manipulation in the best hand, intellectual disability and current epilepsy. Conclusions In a population representative group of YP, aged 16–18 years, with bilateral CP, 63% had impaired speech of varying severity, most had been provided with AAC but few used it at home for Communication.
Jonathan R Wolpaw - One of the best experts on this subject based on the ideXlab platform.
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Brain-computer interfaces for Communication and control.
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2002Co-Authors: Jonathan R Wolpaw, Dennis J Mcfarland, Gert Pfurtscheller, Niels Birbaumer, T M VaughanAbstract:For many years people have speculated that electroencephalographic activity or other electrophysiological measures of brain function might provide a new non-muscular channel for sending messages and commands to the external world - a brain-computer interface (BCI). Over the past 15 years, productive BCI research programs have arisen. Encouraged by new understanding of brain function, by the advent of powerful low-cost computer equipment, and by growing recognition of the needs and potentials of people with disabilities, these programs concentrate on developing new Augmentative Communication and control technology for those with severe neuromuscular disorders, such as amyotrophic lateral sclerosis, brainstem stroke, and spinal cord injury. The immediate goal is to provide these users, who may be completely paralyzed, or 'locked in', with basic Communication capabilities so that they can express their wishes to caregivers or even operate word processing programs or neuroprostheses. Present-day BCIs determine the intent of the user from a variety of different electrophysiological signals. These signals include slow cortical potentials, P300 potentials, and mu or beta rhythms recorded from the scalp, and cortical neuronal activity recorded by implanted electrodes. They are translated in real-time into commands that operate a computer display or other device. Successful operation requires that the user encode commands in these signals and that the BCI derive the commands from the signals. Thus, the user and the BCI system need to adapt to each other both initially and continually so as to ensure stable performance. Current BCIs have maximum information transfer rates up to 10-25bits/min. This limited capacity can be valuable for people whose severe disabilities prevent them from using conventional Augmentative Communication methods. At the same time, many possible applications of BCI technology, such as neuroprosthesis control, may require higher information transfer rates. Future progress will depend on: recognition that BCI research and development is an interdisciplinary problem, involving neurobiology, psychology, engineering, mathematics, and computer science; identification of those signals, whether evoked potentials, spontaneous rhythms, or neuronal firing rates, that users are best able to control independent of activity in conventional motor output pathways; development of training methods for helping users to gain and maintain that control; delineation of the best algorithms for translating these signals into device commands; attention to the identification and elimination of artifacts such as electromyographic and electro-oculographic activity; adoption of precise and objective procedures for evaluating BCI performance; recognition of the need for long-term as well as short-term assessment of BCI performance; identification of appropriate BCI applications and appropriate matching of applications and users; and attention to factors that affect user acceptance of Augmentative technology, including ease of use, cosmesis, and provision of those Communication and control capacities that are most important to the user. Development of BCI technology will also benefit from greater emphasis on peer-reviewed research publications and avoidance of the hyperbolic and often misleading media attention that tends to generate unrealistic expectations in the public and skepticism in other researchers. With adequate recognition and effective engagement of all these issues, BCI systems could eventually provide an important new Communication and control option for those with motor disabilities and might also give those without disabilities a supplementary control channel or a control channel useful in special circumstances.
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eeg based Communication presence of an error potential
Clinical Neurophysiology, 2000Co-Authors: Dennis J Mcfarland, Jonathan R Wolpaw, Gerwin Schalk, Gert PfurtschellerAbstract:Abstract Background : EEG-based Communication could be a valuable new Augmentative Communication technology for those with severe motor disabilities. Like all Communication methods, it faces the problem of errors in transmission. In the Wadsworth EEG-based brain-computer interface (BCI) system, subjects learn to use mu or beta rhythm amplitude to move a cursor to targets on a computer screen. While cursor movement is highly accurate in trained subjects, it is not perfect. Methods : In an effort to develop a method for detecting errors, this study compared the EEG immediately after correct target selection to that after incorrect selection. Results : The data showed that a mistake is followed by a positive potential centered at the vertex that peaks about 180 ms after the incorrect selection. Conclusion : The results suggest that this error potential might provide a method for detecting and voiding errors that requires no additional time and could thereby improve the speed and accuracy of EEG-based Communication.
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brain computer interface research at the wadsworth center
International Conference of the IEEE Engineering in Medicine and Biology Society, 2000Co-Authors: Jonathan R Wolpaw, Dennis J Mcfarland, Theresa M VaughanAbstract:Studies at the Wadsworth Center over the past 14 years have shown that people with or without motor disabilities can learn to control the amplitude of /spl mu/ or /spl beta/ rhythms in electroencephalographic (EEG) activity recorded from the scalp over the sensorimotor cortex and can use that control to move a cursor on a computer screen in one or two dimensions. This EEG-based brain-computer interface (BCI) could provide a new Augmentative Communication technology for those who are totally paralyzed or have other severe motor impairments, Present research focuses on improving the speed and accuracy of BCI Communication.
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Brain-computer interface technology: a review of the first international meeting.
IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society, 2000Co-Authors: Jonathan R Wolpaw, William J. Heetderks, L A Quatrano, Dennis J Mcfarland, P. Hunter Peckham, Emanuel Donchin, C. J. Robinson, Gerwin Schalk, Niels Birbaumer, T M VaughanAbstract:Over the past decade, many laboratories have begun to explore brain-computer interface (BCI) technology as a radically new Communication option for those with neuromuscular impairments that prevent them from using conventional Augmentative Communication methods. BCI's provide these users with Communication channels that do not depend on peripheral nerves and muscles. This article summarizes the first international meeting devoted to BCI research and development. Current BCI's use electroencephalographic (EEG) activity recorded at the scalp or single-unit activity recorded from within cortex to control cursor movement, select letters or icons, or operate a neuroprosthesis. The central element in each BCI is a translation algorithm that converts electrophysiological input from the user into output that controls external devices. BCI operation depends on effective interaction between two adaptive controllers, the user who encodes his or her commands in the electrophysiological input provided to the BCI, and the BCI which recognizes the commands contained in the input and expresses them in device control. Current BCI's have maximum information transfer rates of 5-25 b/min. Achievement of greater speed and accuracy depends on improvements in signal processing, translation algorithms, and user training. These improvements depend on increased interdisciplinary cooperation between neuroscientists, engineers, computer programmers, psychologists, and rehabilitation specialists, and on adoption and widespread application of objective methods for evaluating alternative methods. The practical use of BCI technology depends on the development of appropriate applications, identification of appropriate user groups, and careful attention to the needs and desires of individual users. BCI research and development will also benefit from greater emphasis on peer-reviewed publications, and from adoption of standard venues for presentations and discussion.
Tom Chau - One of the best experts on this subject based on the ideXlab platform.
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implementing an ipad based alternative Communication device for a student with cerebral palsy and autism in the classroom via an access technology delivery protocol
Computers in Education, 2014Co-Authors: Tania Desai, Katherine Chow, Leslie Mumford, Fanny Hotze, Tom ChauAbstract:Individuals with a comorbid diagnosis of cerebral palsy and autism spectrum disorder can have significant Communication deficits. The implementation of an alternative and Augmentative Communication (AAC) device is often essential to promote language development and participation in school, home and community environments. The present study evaluated the impact of introducing a high-tech alternative and Augmentative device, namely an Apple iPad with the "GoTalk Now" Communication application to a student diagnosed with cerebral palsy and autism spectrum disorder. Integration of the technology focused on promoting key elements associated with long term AAC usage, namely, targeted training of the student, teacher, educational assistant and parents, over the course of the school year. Marked increases in the student's Communication skills and non-academic school functioning were observed. The need for Communication partner prompting declined over time while the student, teacher and parent remained engaged by the iPad solution. This case study supports the classroom implementation of high-tech Communication devices for those with complex Communication needs via a comprehensive access delivery protocol that invokes systematic student, teacher, educational assistant and parent training. iPad-based Communication solution fostered Communication skill development.Training of teaching staff and parent promoted device use in the classroom.Non-academic school function improved and required prompting decreased.
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Augmentative Communication based on realtime vocal cord vibration detection
IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2010Co-Authors: Tiago H Falk, Julie Chan, Pierre Duez, Gail Teachman, Tom ChauAbstract:A binary switch based on the detection of periodic vocal cord vibrations is proposed for individuals with multiple and severe disabilities. The system offers three major advantages over existing speech-based access technologies, namely, insensitivity to environment noise, increased robustness against user-generated artifacts such as coughs, and reduced exertion during prolonged usage periods. The proposed system makes use of a dual-axis accelerometer placed noninvasively in proximity of the vocal cords by means of a neckband. Periodic vocal cord vibrations are detected using the normalized cross-correlation function computed from anterior-posterior and superior-inferior accelerometry signals. Experiments with a participant with hypotonic cerebral palsy show the proposed system outperforming a popular commercial sound-based system in terms of sensitivity, task time, and user-perceived exertion.
Angela T Morgan - One of the best experts on this subject based on the ideXlab platform.
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Communication interventions for autism spectrum disorder in minimally verbal children
Cochrane Database of Systematic Reviews, 2018Co-Authors: Amanda Brignell, Karen Chenausky, Huan Song, Jianwei Zhu, Chen Suo, Angela T MorganAbstract:Background Autism spectrum disorder (ASD) has an estimated prevalence of around 1.7% of the population. People with ASD often also have language difficulties, and about 25% to 30% of children with ASD either fail to develop functional language or are minimally verbal. The ability to communicate effectively is an essential life skill, and difficulties with Communication can have a range of adverse outcomes, including poorer academic achievement, behavioural difficulties and reduced quality of life. Historically, most studies have investigated Communication interventions for ASD in verbal children. We cannot assume the same interventions will work for minimally verbal children with ASD. Objectives To assess the effects of Communication interventions for ASD in minimally verbal children. Search methods We searched CENTRAL, MEDLINE and Embase as well as 12 other databases and three trials registers in November 2017. We also checked the reference lists of all included studies and relevant reviews, contacting experts in the field as well as authors of identified studies about other potentially relevant ongoing and unpublished studies. Selection criteria Randomised controlled trials (RCTs) of Communication-focused interventions for children (under 12 years of age) diagnosed with ASD and who are minimally verbal (fewer than 30 functional words or unable to use speech alone to communicate), compared with no treatment, wait-list control or treatment as usual. Data collection and analysis We used standard Cochrane methodological procedures. Main results This review includes two RCTs (154 children aged 32 months to 11 years) of Communication interventions for ASD in minimally verbal children compared with a control group (treatment as usual). One RCT used a verbally based intervention (focused playtime intervention; FPI) administered by parents in the home, whereas the other used an alternative and Augmentative Communication (AAC) intervention (Picture Exchange Communication System; PECS) administered by teachers in a school setting.The FPI study took place in the USA and included 70 participants (64 boys) aged 32 to 82 months who were minimally verbal and had received a diagnosis of ASD. This intervention focused on developing coordinated toy play between child and parent. Participants received 12 in-home parent training sessions for 90 minutes per session for 12 weeks, and they were also invited to attend parent advocacy coaching sessions. This study was funded by the National Institute of Child Health and Human Development, the MIND Institute Research Program and a Professional Staff Congress-City University of New York grant. The PECS study included 84 minimally verbal participants (73 boys) aged 4 to 11 years who had a formal diagnosis of ASD and who were not using PECS beyond phase 1 at baseline. All children attended autism-specific classes or units, and most classes had a child to adult ratio of 2:1. Teachers and parents received PECS training (two-day workshop). PECS consultants also conducted six half-day consultations with each class once per month over five months. This study took place in the UK and was funded by the Three Guineas Trust.Both included studies had high or unclear risk of bias in at least four of the seven 'Risk of bias' categories, with a lack of blinding for participants and personnel being the most problematic area. Using the GRADE approach, we rated the overall quality of the evidence as very low due to risk of bias, imprecision (small sample sizes and wide confidence intervals) and because there was only one trial identified per type of intervention (i.e. verbally based or AAC).Both studies focused primarily on Communication outcomes (verbal and non-verbal). One of the studies also collected information on social Communication. The FPI study found no significant improvement in spoken Communication, measured using the expressive language domain of the Mullen Scale of Early Learning expressive language, at postintervention. However, this study found that children with lower expressive language at baseline (less than 11.3 months age-equivalent) improved more than children with better expressive language and that the intervention produced expressive language gains in some children. The PECS study found that children enrolled in the AAC intervention were significantly more likely to use verbal initiations and PECS symbols immediately postintervention; however, gains were not maintained 10 months later. There was no evidence that AAC improved frequency of speech, verbal expressive vocabulary or children's social Communication or pragmatic language immediately postintervention. Overall, neither of the interventions (PECS or FPI) resulted in maintained improvements in spoken or non-verbal Communication in most children.Neither study collected information on adverse events, other Communication skills, quality of life or behavioural outcomes. Authors' conclusions There is limited evidence that verbally based and ACC interventions improve spoken and non-verbal Communication in minimally verbal children with ASD. A substantial number of studies have investigated Communication interventions for minimally verbal children with ASD, yet only two studies met inclusion criteria for this review, and we considered the overall quality of the evidence to be very low. In the study that used an AAC intervention, there were significant gains in frequency of PECS use and verbal and non-verbal initiations, but not in expressive vocabulary or social Communication immediately postintervention. In the study that investigated a verbally based intervention, there were no significant gains in expressive language postintervention, but children with lower expressive language at the beginning of the study improved more than those with better expressive language at baseline. Neither study investigated adverse events, other Communication skills, quality of life or behavioural outcomes. Future RCTs that compare two interventions and include a control group will allow us to better understand treatment effects in the context of spontaneous maturation and will allow further comparison of different interventions as well as the investigation of moderating factors.