Title: Symbols! Symbols!
1Symbols, Symbols What to use????
2Clinical Scenario
- Why do Speech Pathologists make use of graphic
symbols? - Graphic symbols may take many forms
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8 baby
9High degree of resemblance Abstract
10How our question developed?
A members personal experience She asked Why?
What is the evidence for this?
11Clinical Question In people who use AAC are
coloured photographs easier to comprehend than
line drawings?
12Level of evidence Study design Number of articles
3ii Narrative reviews 2
4 Case series 2
13Key Findings
- Evidence found of lower level suggestive only
- Population included in studies individuals who
were basically non-verbal and had intellectual
disability (varying /severe) autism
14Finding (cont.).
- Sevcik Romski (1986)
- 8 participants between ages of 9 -22years all
had severe intellectual disability - Participants with functional language skills were
able to match objects to photographs and line
drawings. They performed better on matching tasks
than those with non-functional language skills - Participants with no functional language and
limited comprehension of words could match
objects to photos but not objects to line
drawings
15Findings (cont.)
- Mirenda and Locke (1989) Study on symbol
transparency - 40 participants non-verbal with varying degrees
on intellectual disabilities age range 4 21
non speaking - A greater number of non-verbal people in the
study identified photographs more easily than a
range of symbols and line drawings
16Mirenda an Locke (cont.)
- Included 8 participants with severe intellectual
disabilities who had poor comprehension of spoken
language. None could match non- identical
objects, only 3 able to match photographs to
objects and only 1 could match line drawings to
objects. This groups performance was much worse
than that of participants with functional
language
17Finding (cont.)
- Kozleski (1991b) compared acquisition rates of a
variety of abstract to more iconic symbols,
including coloured photographs and line drawings,
for requesting function across four individuals
with autism fewer sessions were needed for
highly iconic symbols.
18Clinical Bottom Line
- There is insufficient high level evidence to
conclusively inform choice of one graphic symbol
set over another. - Some minimal level of language skill may make the
use of certain symbol types easier to learn - Consider CAT limitations
19CAT Limitations
- Clinical question very narrow
- Our inclusion/exclusion criteria did we
restrict ourselves too much? - Recognition of pictures and using pictures as
symbols are different skills
20Clinical implications
- In absence of strong evidence
- Monitor the integrity of our intervention
- Define interventions in observable terms
- Outcome measures
- Data collection sheets
21Possible other variables to consider when
people are learning to use picture symbols
- Spoken word comprehension
- Reinforcement value
- Symbol experience
- Understanding of intent
- Setting
22(cont.)
- Instruction
- Support
- Generalization
- Available resources
- Stakeholders
23References
- Sevcik, RA and Romski, MA (1986). Representation
matchings skills o persons with severe
retardation. Augmentative and Alternative
Communication. 2(4), 160-164 - Mirenda and Locke (1989). A comparison of symbol
transparency in non-speaking person with
intellectual disabilities. Journal of Speech and
Hearing Disorders. 54, 131-149. - Schlosser, RW and Sigafoos, J (2002). Selecting
graphic symbols for an initial request lexicon
Integrative review. Augmentative and Alternative
communication. 18, 102-123 - Stephenson (2009). Iconicity in the Development
of Picture Skills Typical Development and
Implications for Individuals with Severe
Intellectual Disabilities Augmentative and
Alternative Communication. 25 (3), 187-201
24AAC EBP Group Natalie Albores Alana Bain Anna
Bech Lauren Chaitow Mary-ann Dowsett Haley
Gozzard Jenny Lee Cecillia Rossi Nitha
Thomson David Trembath Angela Vass Jenny Wood
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