Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer's disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.

Naturalistic mealtime interactions between a child with complex communication needs and her caregiver (focus dyad) and a child without disabilities and her caregiver (comparison dyad) were investigated. An activity-based communication analysis was used to outline the contextual background factors of the dyads' activities, and the dyads' conversational topics were analyzed. For the child and her caregiver (the focus dyad), the natural mode of communication at mealtime was unaided. Communication mostly concerned immediate mealtime issues. Other, shorter, topics were introduced but were also anchored to immediate issues. In contrast, the child and caregiver who comprised the comparison dyad conversed about a variety of personal topics that extended beyond the present. Topic patterns are exemplified using discourse excerpts and are discussed in relation to aided communication and development.

Better access to remote communication trough assistive technology such as speech synthesis and picture symbols would make remote communication easier and facilitate participation for people with communicative and cognitive disabilities. Implications for rehabilitation People with communicative and cognitive disabilities face challenges with access to remote communication. Access to communication technology including remote communication is important for self-determination, for personal safety and for overall participation in society. Communication technology should be considered in the rehabilitation process and training is crucial. To understand the possible benefits of remote communication, people with communicative and cognitive disability need to get the possibility to practice. Professionals play a key role in the assessment and intervention of remote communication for their patients.

Talking Mats could be a valuable resource for people with Huntington's disease and their conversation partners. It could be used for social purposes, for understanding a person's opinions and for making decisions. Additional research is necessary in order to generalize the results to the population of individuals with Huntington's disease and to understand better the mechanisms behind the positive effects observed.

BackgroundIt is known that dysarthria arising from Parkinson's disease may affect intelligibility in conversational interaction. Research has also shown that Parkinson's disease may affect cognition and cause word-retrieval difficulties and pragmatic problems in the use of language. However, it is not known whether or how these problems become manifest in everyday conversations or how conversation partners handle such problems.AimsTo describe the pragmatic problems related to the use of words that occur in everyday conversational interaction in dyads including an individual with Parkinson's disease, and to explore how interactants in conversation handle the problems to re-establish mutual understanding.Methods & ProceduresTwelve video-recorded everyday conversations involving three couples where one of the individuals had Parkinson's disease were included in the study. All instances of other-initiated repair following a contribution from the people with Parkinson's disease were analysed. Those instances involving a trouble source relating to the use of words were analysed with a qualitative interaction analysis based on the principles of conversation analysis.Outcomes & ResultsIn 70% of the instances of other-initiated repair the trouble source could be related to the semantic content produced by the individual with Parkinson's disease. The problematic contributions were typically characterized by more or less explicit symptoms of word search or use of atypical wording. The conversation partners completed the repair work collaboratively, but typically the non-impaired individual made a rephrasing or provided a suggestion for what the intended meaning had been.Conclusions & ImplicationsIn clinical work with people with Parkinson's disease and their conversation partners it is important to establish what type of trouble sources occur in conversations in a specific dyad. It may often be necessary to look beyond intelligibility and into aspects of pragmatics to understand more fully the impact of Parkinson's disease on everyday conversational interaction.

Speech and language therapy has an important role to play in the management of communication problems in Huntington's disease.As the disease progresses the effectiveness of communication becomes increasingly compromised by a combination of changes in motor function, diminishing cognitive linguistic skills and neuropsychiatric changes, such as depression and apathy.Signs and symptoms associated with Huntington's disease are distinctive but there is considerable variation between individuals on the extent, rate and natural course of disability within the disease. For these reasons assessment and review must be comprehensive and consideration should be given to a number of factors such as mood, motivation and behavior, which will be pertinent to performance.As a variety of symptoms can affect communication no single course of treatment will be effective throughout the disease. The consensus of opinion is that the therapy management will vary and that interventions will at different times be rehabilitative, facilitative, informative and supportive.All interventions must be timely and responsive to the changing needs of the individual and to the challenges faced by the family and others.Augmentative and alternative communication can compensate for communication difficulties in Huntington's disease and can increase the individual's chance for participation in daily life but strategies need to be implemented while there is still motivation and learning capacity.It is vital to understand the value and importance in involving family and caregivers in developing and facilitating effective communication strategies. These are well recognized for the positive impact they can have on the overall well being of the individual with Huntington's disease.

<p>Keywords</p><p>early intervention, parental education, communication development, augmentative and alternative communication (AAC), parents' experiences</p><p>Abstract</p><p>The aim of this study was to evaluate parents and course leaders' experiences of the ComAlong early intervention course; a parental course about communication, communication development, play, responsive communication strategies and augmentative and alternative communication (AAC). ComAlong targets parents of pre-school children with extensive communication difficulties and, at times, additional disabilities. Data consisted of course evaluation surveys filled out by 86 parents (57 mothers and 29 fathers) and one grandmother and interviews of four parents and four course leaders. Overall, parents were positive about the course. This was shown in ratings of 21 statements, in written answers to seven open questions and in the interviews. The total mean value for all statements was 4.4 (max 5) and the median was 4 or 5. The means for the 20 statements varied between 3.9 and 4.8 and half of all statements had mean values of 4.5 or higher. The mean value for the course (parents&rsquo; rating of the course on a 1 to 10 scale where 10 was the best) was 8.5 (Mdn and mode = 8, SD = 1.1). On the whole, parents and course leaders were satisfied. Parents learned about communication and AAC and experienced that communication with the child had changed to the better. In particular, parents appreciated meeting respectful and competent course leaders and other parents to children with varying disabilities. Information about the course before it started was a problematic issue. These and other findings are discussed with regard to early intervention for parents of children who use augmentative and alternative communication.</p>

The aim of this study was to develop and evaluate an instrument - the Responsive Augmentative and Alternative Communication Style (RAACS) scale Version 2 - to assess the communicative style of parents as they interact with their children using augmentative and alternative communication (AAC). This scale was used to analyze play interactions between 43 parents and 28 children with different diagnoses (including Down syndrome, autism, cerebral palsy, and intellectual disability), aged between 12 and 60 months. Parent-child interactions were observed both before and after parent participation in ComAlong, a training course on using responsive communication and AAC to support interaction with children. Based on an analysis of the results, Version 3 of the RAACS scale was developed and is recommended for future use. Analyses of Version 3 showed acceptable inter- and intra-coder reliability, and excellent internal consistency.