Browsing by Author "Drager, K.D.R."

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The Effects of an intervention using Low-Tech visual scene displays and aided modeling with young children with complex communication needs
(Sage Publishing, 2022) Muttiah, N.; Drager, K.D.R.; Beale, B.; Bongo, H.; Riley, L.
Young children with complex communication needs are often severely restricted in their ability to communicate and develop language skills. A major barrier preventing these children from accessing communication is a lack of appropriate means to communicate. The present study investigated the implementation of nonelectronic visual scene displays (VSDs) as an augmentative and alternative communication (AAC) tool, in combination with aided modeling with preschool children with complex communication needs. A single case, multiple probe design across participants was used to evaluate an intervention combining low-tech VSDs and aided modeling to increase the number of communication turns and unique semantic concepts expressed by preschool children. All children demonstrated notable increases in the number of communication turns and unique semantic concepts expressed. The findings of this study indicate preliminary positive results for a novel, low-cost AAC intervention that could be useful for preschool children to increase their participation in social communication contexts
Evaluating an AAC Training Program for Special Education Teachers Based in a Developing Country
(Faculty of Medicine, University of Kelaniya, 2014) Muttiah, N.; Drager, K.D.R.
There is limited research conducted on Augmentative and Alternative Communication (AAC) in developing countries (Srinivasan, Mathew, & Lloyd, 2011). We have only a limited understanding of how best to support the development of knowledge and skills of individuals who provide AAC support in developing countries with low resource settings. Research has documented that providing AAC training to communication partners can equip them with strategies that can facilitate increasing both the frequency and quality of communication interactions with children who have Complex Communication Needs (CCN). The current study evaluated the effectiveness of implementing training best practices identified by Muttiah et al. (2014) for special educators in Sri Lanka. The training was based on principles of adult learning. A one-group interrupted time series design was utilized with nine teacher-children dyads to measure the effectiveness of the AAC training. The special education teachers were taught to promote interactions with children who have CCN by providing evocative communication opportunities that included asking an open-ended question, comment or choice, providing a means for the child to respond, and waiting five seconds or more for a response. Results of the study indicated that teachers provided an increased number of evocative communication opportunities following the training. An increase was also seen in the number of communication turns that were taken by children with CCN. The results of this study provide preliminary evidence for a training framework that could be implemented in developing countries and other low-resource communities. The training content and format identified in this study can serve as a guide for others planning trainings in similar contexts. In addition, this study adds to the limited research base on AAC in developing countries.
Parent perspectives on augmentative and alternative communication in Sri Lanka
(Williams and Wilkins, 2022) Muttiah, N.; Seneviratne, A.; Drager, K.D.R.; Panterliyon, N.A.
Parental support is an important part of introducing an augmentative and alternative communication (AAC) system to a child. Professionals providing AAC services to children with complex communication needs should practice family-centered service provision. The aim of this study was to explore Sri Lankan parents' perspectives on AAC and their lived experiences. Semi-structured interviews were conducted with 10 parents of children with complex communication needs. Thematic analysis was used to analyze the findings, with the following themes identified: (a) External Systems, (b) Impact on the Family, (c) Impact on the Child, and (d) Communication (including AAC). Findings from this study provide important information for speech-language therapists providing services to families from low- and middle-income countries. In particular, parents reported several positive aspects of AAC. However, parents also reported challenges, including speech-language therapist's lack of knowledge of and training in AAC.
A scoping review of Augmentative and Alternative Communication (AAC) interventions in Low-and Middle-Income Countries (LMICs).
(Taylor & Francis, 2022) Muttiah, N.; Gormley, J.; Drager, K.D.R.
Currently, a small number of studies discuss augmentative and alternative (AAC) interventions in low- and middle-income countries (LMICs). The primary purpose of this scoping review was to summarize the current evidence base on communication-based interventions and partner training in LMICs, to explore and identify gaps in the AAC evidence base and guide future research. A total of 18 studies were identified. The results revealed many positive outcomes arising from AAC interventions, including increased communication, improved participation, increased knowledge about communication, and increased use of partner communication strategies, thus adding to the evidence base that AAC can be successfully implemented in LMICs. However, these studies did not broadly represent most LMICs and there were only a handful of indirect intervention studies training communication partners. To this end, there is an urgent need to expand the level of AAC intervention research conducted in LMICs in order to better serve individuals with complex communication needs living in these countries.
Strategies for implementing augmentative and alternative communication in classroom settings in low- and middle-income countries
(Routledge, Taylor and Francis Group, 2023) Muttiah, N.; Drager, K.D.R.; Samarasingha, I.S.
Individuals with severe communication disabilities benefit from using augmentative and alternative communication (AAC) to communicate. Many of these individuals live in low- and middle-income countries (LMICs). Appropriate implementation of augmentative and alternative communication (AAC) systems and methods within an LMIC requires two main components: linguistically and culturally appropriate AAC systems and communication partners with the relevant training to support individuals with communication disabilities. In low-resource countries, one option is to use less costly, low-tech (non-electronic) AAC systems, for example low-tech visual scene displays (VSDs). This low-tech AAC tool has been successfully implemented by paraprofessionals with children who have complex communication needs. Another example is the use of adapted books to facilitate social communication with children who have complex communication needs. Finally, it is not enough to provide children with communication disabilities with AAC tools. Communication partners interacting with these children, such as teachers, need to be trained so they can better facilitate children's communication in both inclusive and special classrooms. This is critically important in LMICs where there is frequently a shortage of speech-language pathologists and other specialists. This chapter will discuss both AAC tools and partner communication training that can be implemented in contexts that may have limited resources.