Rajinder Koul

Augmentative and alternative communication (AAC) systems support individuals with significant communication challenges. In mainland China, AAC implementation remains limited, particularly within school settings due to a shortage of certified speech-language pathologists (SLPs). This study surveyed AAC-related knowledge, practices, and training needs among special education personnel in Tianjin, China, where educators often serve as de facto AAC providers. A 10-item questionnaire was administered to 383 teaching and non-teaching staff across ten special schools (response rate: 64.6%). The survey explored self-reported AAC competence, populations served, preferred training formats, and reading materials. Respondents reported limited knowledge of AAC, especially in low- and high-tech modalities. Most participants expressed a strong desire for training, favoring mentorship and workshops. Those with experience supporting students with autism, intellectual disabilities, and cerebral palsy showed stronger preferences for evidence-based materials and structured training. Principal component analysis (PCA) revealed a uniformly high interest across training topics, indicating broad foundational needs. Findings highlight the urgent need for accessible, entry-level AAC training tailored to the educational context in China. Results can inform national policy, curriculum development, and cross-sector collaboration to build sustainable AAC capacity.

Recent scoping reviews suggest that artificial intelligence (AI) is transitioning from an emerging technological innovation to a clinical tool with growing relevance across rehabilitation and commu...

Augmentative and alternative communication (AAC) has potential to significantly enhance the QoL for those with severe communication impairment as a consequence of acquired neurological disorders. Whilst there has been a progress in the research on AAC for individuals with acquired neurological disorders and effects on QoL, there are still unanswered questions that need further investigation, specifically in the area of communication-related quality of life (CRQoL). The purpose of this scoping review is to explore tools to evaluate CRQoL in adults with acquired neurological disorders who use AAC. It examines areas of communication these tools are focused on and methods of access for individuals with acquired communication disorders who might also experience physical, cognitive, and linguistic impairment. Six databases were searched with predetermined search terms. Results indicated that 10 papers used assessment tools related to CRQoL. Gaps in the research included limited data on how communication partners were involved in assessment. Overall, findings indicate a lack of information about how AAC users can access assessment tools with adaptations or communication partner support. Future research should focus on CRQoL tools and access methods for AAC users.

Purpose: The purpose of this study was to examine the effectiveness of an augmentative and alternative communication (AAC) intervention package consisting of systematic instruction and aided AAC modeling with speech-output technology on the acquisition, maintenance, and generalization of socio-communicative behaviors in four minimally speaking, preschool-aged, autistic children. Method: A multiple-probe design across behaviors (i.e., initiating a request for a turn, answering questions, and commenting) replicated across participants was implemented to evaluate the effects of the intervention package on socio-communicative behaviors. Furthermore, a pretreatment and posttreatment multiple-generalization-probe design was used to assess generalization across typically developing peers who were not a part of the intervention. Maintenance data were collected 3 weeks post intervention. Results: Visual analysis, corroborated by nonoverlapping of all pairs statistics, established a strong functional relationship between the AAC intervention package and all targeted socio-communicative outcomes for two participants. For the other two participants, inconsistent intervention effects were observed. In terms of generalization from interacting with the researcher to typically developing peers, a functional relationship between the intervention and generalization outcomes for all targeted behaviors was established for only one participant (i.e., Aiden). Conclusion: The outcomes of this study suggest that aided AAC modeling and systematic instruction using a speech-output technology may lead to gains in socio-communicative behaviors in some minimally speaking, preschool-aged, autistic children. Supplemental Material: https://doi.org/10.23641/asha.27091879

Purpose: Communication with nonspeaking patients is a critical challenge of person-centered care. This scoping review aimed to map the literature on augmentative and alternative communication (AAC) interventions for nonspeaking mechanically ventilated and tracheostomy patients in critical and acute care settings. Method: Electronic database, ancestry, and forward citation searches were conducted using eligibility criteria established a priori. Data were extracted, synthesized, and summarized according to scoping review methodology. Studies were categorized by type of intervention and summarized in terms of purpose, participants, design, quality appraisal (including validity and reliability of selected efficacy measures), and efficacy. Results: Small-to-large treatment effect sizes indicated demonstrable impact on patient health and communication efficacy with high-tech and no-tech visual interface–based interventions and systematic nurse training interventions. Treatment effects primarily pertained to dependent variables of patient anxiety, communication satisfaction, comfort, symptom self-reporting, and nursing practice changes. Conclusions: There is a paucity of high-quality AAC intervention research for mechanically ventilated and tracheostomy patients in critical and acute care settings. Emergent evidence suggests that select visual interface and nurse training interventions can impact efficacy of patient–provider communication and patients' overall health. Supplemental Material: https://doi.org/10.23641/asha.26506102

Purpose: Effective communication between nonspeaking patients and providers is critical for the quality of care in intensive care units (ICUs). This study aims to evaluate perspectives of health care providers and nonspeaking patients on effective communication and communication barriers in the ICU. Method: Qualitative and quantitative survey methodologies were employed to evaluate providers' and patients' perspectives on effective communication. Rating scales were utilized to measure patients' frustration levels and communication effectiveness. Open-ended questions were employed to reflect on barriers to communication in the ICU, instances of ineffective communication, and recommendations for enhancing effective communication. Results: The results of the study suggest that nonspeaking patients experienced high levels of frustration due to ineffective communication. However, the data reveal that access to appropriate augmentative and alternative communication (AAC) strategies and materials could help mitigate patients' frustration. Providers mainly communicated via asking yes/no questions, which largely limited the information patients conveyed, leading to frequent communication breakdowns. Providers expressed a desire to participate in training programs to utilize appropriate AAC strategies and promote effective communication. Conclusions: This study provides preliminary survey results on perspectives of patients and providers on effective communication in the ICU. Both providers and patients reported experiencing challenges and frustration during their communication, due to barriers such as providers' insufficient training experience and lack of access to AAC materials. Skill training is warranted to promote effective patient–provider communication in intensive care settings. Supplemental Material: https://doi.org/10.23641/asha.26339623

As artificial intelligence (AI) makes significant headway in various arenas, the field of speech–language pathology is at the precipice of experiencing a transformative shift towards automation. This study introduces QuickPic AAC, an AI-driven application designed to generate topic-specific displays from photographs in a “just-in-time” manner. Using QuickPic AAC, this study aimed to (a) determine which of two AI algorithms (NLG-AAC and GPT-3.5) results in greater specificity of vocabulary (i.e., percentage of vocabulary kept/deleted by clinician relative to vocabulary generated by QuickPic AAC; percentage of vocabulary modified); and to (b) evaluate perceived usability of QuickPic AAC among practicing speech–language pathologists. Results revealed that the GPT-3.5 algorithm consistently resulted in greater specificity of vocabulary and that speech–language pathologists expressed high user satisfaction for the QuickPic AAC application. These results support continued study of the implementation of QuickPic AAC in clinical practice and demonstrate the possibility of utilizing topic-specific displays as just-in-time supports.

As artificial intelligence (AI) makes significant headway in various arenas, the field of Speech-Language Pathology is at the precipice of experiencing a transformative shift towards automation. This study introduces QuickPic AAC, an AI-driven application designed to generate topic-specific displays from photographs in a "just-in-time" manner. Using QuickPic AAC, this study aimed to (a) determine which of two AI algorithms (NLG-AAC and GPT-3.5) results in greater specificity of vocabulary (i.e., percentage of vocabulary kept/deleted by clinician relative to vocabulary generated by QuickPic AAC; percentage of vocabulary modified); and to (b) evaluate perceived usability of QuickPic AAC among practicing speech-language pathologists. Results revealed that the GPT-3.5 algorithm consistently resulted in greater specificity of vocabulary and that speech-language pathologists expressed high user satisfaction for the QuickPic AAC application. These results support continued study of the implementation of QuickPic AAC in clinical practice and demonstrate the possibility of utilizing topic-specific displays as just-in-time supports.