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Designing AAC Systems that Provide Dynamic Shared Interactive Contexts-Adults

David Beukelman (University of Nebraska)


Typically people with acquired cognitive/linguistic limitations such as aphasia (language impairment) or traumatic brain injury (TBI) (linguistic/cognitive impairment) experience difficulty using traditional AAC technology. This is not only because of the severity of their cognitive/linguistic impairments, but also the linguistic, cognitive, and new learning requirements of AAC technologies.

These individuals present unique AAC challenges because they want to participate, tell stories and express their thoughts, feelings and opinions. Further, they typically transition into new social contexts from home, to rehabilitation, to assisted living or the home of a family member, or to a care facility—and must learn to communicate with new care-givers and residents.

adult using AAC


•To determine the impact of Visual Scene Display (VSD) strategies on the operational, social and linguistic competence of AAC users with severe TBI and aphasia;

• To develop design specifications for these populations to incorporate into new AAC prototypes; and

• To evaluate the effects of these design features to determine whether they enhance the communication performance of individuals with severe TBI and severe aphasia.

Planned Activities:

This research project will be divided into three separate phases.

Phase 1. We will conduct a series of investigations to determine the impact of personally and contextually relevant contexts on the language and communication performance of individuals with severe, chronic aphasia or with TBI. Participants will be videotaped under a variety of conditions. In each condition participants will be responding to specific requests and answering questions.

Phase 2. We will identify design features and instructional strategies that support the use of AAC technologies based on Phase 1 findings. Phase 2 participants will include selected participants from Phase 1 with cognitive/linguistic limitations, their primary AAC facilitators, AAC specialists who provide AAC intervention services, representatives from our corporate partner on the project, and staff from the project research team. These individuals will propose additional design features (based on personal experience and research collected in Phase 1) that can enhance AAC performance of adults with severe aphasia and TBI.

Phase 3. Using a series of single case design studies, participants from Phase I will evaluate a simulation of desirable features in an AAC interface and in prototype applications developed by our corporate partner. These studies will compare individual communication performance across baseline and experimental conditions.

Annual Update (May, 2011)

By the end of the third year of the project, our research has shown that people with severe, chronic aphasia perform much more accurately with personalized and contextualized images than with non-personalized but contextualized images or iconic images.

People with severe, chronic aphasia strongly preferred personalized images over non-personalized images. A series of studies demonstrated that people with moderate, chronic aphasia, who could speak somewhat to communication, demonstrated that the amount and effectiveness of the communication was enhanced when a visual scene containing personalized content was used to create a shared communication environment.

An initial study of AAC navigation using visual scene images with a dynamic display revealed that TBI survivors who demonstrated enough cognitive flexibility to pass the CLQT Trials test performed much better than those who did not pass the Trails Test. In addition, those who did not pass the Trails Test performed more accurately with contextualized images than iconic images.

Research completed in this project guided the upgrade from Visual Scenes for Adults with Aphasia from Version 1 to Version 2 in the Dynavox V, as well as the upgrades in the application that is included in the Dynavox Maestro.

Knowledge Transfer

David Beukelman

AAC for Aphasia: A Review of Visual Scenes Display Project

David Beukelman (University of Nebraska) describes recent research on effective AAC interventions for adults with Aphasia.



Ball, L., Fager, S., Nordness, A., Kersch, K., Mohr, B., Pattee, G., & Beukelman, D. (in press). Eye-gaze access of AAC technology for persons with amyotrophic lateral sclerosis. Journal Medical Speech Language Pathology.

Beukelman, D., Dietz, A., McKelvey, M., Hux, K., & Weissling, K. (in press). Visual scene displays: AAC design specifications aimed at reducing the cognitive/linguistic load for people with chronic aphasia. Disability & Rehabilitation.

Hux, K., Buechter, M., Wallace, S., & Weissling, K. (in press). Using visual scene displays to create a shared communication space for a person with aphasia. Aphasiology.

McKelvey, M., Hux, K., Dietz, A., Beukelman, D. (2010). Impact of personal relevance and contextualization on comprehension by people with chronic aphasia. American Journal of Speech Language Pathology, 19, 22-33. (Abstract)

Wallace, S., Hux, K., & Beukelman, D.R. (in press). Navigation of a dynamic screen AAC interface by survivors of severe traumatic brain injury. Augmentative and Alternative Communication.