In a recent article published by the SID 12 Perspectives in Augmentative and Alternative Communication, Visual Scenes Displays: Low Tech Options, Weissling and Beukelman described Low Tech Visual Scene Templates, which are available to be downloaded at http://aac.unl.edu and www.aac-rerc.com).

About the templates:

On the website you can download (WITHOUT COST) visual scene materials in a variety of sizes and configurations. You can then size and position digital images, add text to the pictures, edit and print communication and memory materials. See examples below. You can also download a manual from the site.  According to Beukelman, close to 9000 downloads of this material have occurred since November 1, 2006. NOTE: You will need Microsoft Publisher software, which you can purchase through local software supply outlets or from http://office.microsoft.com/en-us/FX010857941033.aspx.

About the article:

Based on AAC-RERC projects underway at the University of Nebraska, researchers are working to support the communication of people with cognitive-linguistic challenges, including adults with aphasia. They have found success using visual scenes (rather than isolated symbols or pictures) to represent meaning and to support interface navigation in high tech devices (Blackstone, 2005  Dietz, McKelvey, & Beukelman, 2006; Drager & Light, 2006; Shane, 2006). In their ASHA SID 12 Perspective article, Weissling and Beukelman note that features making visual scenes a desirable option for use in speech generating devices (SGDs) also make them attractive for consideration in the development of low-tech AAC strategies.

What are Visual Screen Displays?

VSDs as displays that “utilize contextually rich visual images to represent meaning and support navigation through AAC strategies.” Suppose, for example,

A person with cognitive-linguistic difficulties has recently acquired a new service dog, a Labrador retriever, and wishes to include information in a communication/memory book to support a conversation about his animal. An icon of a generic large dog (no context and no personal relevance) might not be sufficient to support her efforts to communicate or remember information about her dog. A picture of a similar dog (low personal relevance) in a relatively generic scene at an unknown park (low personal relevance with relatively high context) might or might not be support her communication.   However, a picture of his/her own Labrador (high personal relevance) in the presence of a familiar scene such as the dog with her near the picnic table in her own back yard (high context and high personal relevance) might trigger the necessary support.  (Example is from SID 12 Perspectives Article).

VSDs are designed so that both contextual complexity and personal relevance is personalized so the individual can use the scene to communicate more effectively, and their communication partners have more access to information they can use to support the individual. In the Perspective article, the authors present three true intervention stories that demonstrate how visual scenes were used in low-tech applications.  One example follows:

A.C.’s Story

A.C. is a 74-year-old woman who had an ischemic stroke.  One year post-onset, her comprehension was significantly impaired and her spoken output was limited to a single stereotypic utterance (e.g., “and I can go”).  She had been discharged from acute rehabilitation that focused almost exclusively on language restoration and was referred to the university clinic for continued therapy to establish an effective communication system. Initially, she was quite passive during therapy and was not always able to understand what the clinician wanted her to do. While her family was willing to consider AAC strategies, their primary desire was for her to recover spoken language.  Because A.C. had such limited ability to respond to standard decontextualized therapy materials, AAC strategies were employed in combination with standard restoration techniques in an attempt to provide a compensatory communication system while maximizing speech/language recovery. The therapy plan included Melodic Intonation Therapy (Helm-Estabrooks, Nicholas, & Morgan, 1989), semantic based therapy (Drew & Thompson, 1999), and stimulation approach (Schuell, Jenkins, & Jimenez-Pabon, 1964).  These therapy techniques were expanded with the use of visual scenes and AAC strategies such as scales, written choice, and communication boards (Garrett & Lasker, 2005). She also was given AAC options to select the stimulus materials she wanted to use (e.g., “which picture of bathroom is best”) and utilized visual scenes to choose which activities to complete first, second, and third. Materials used included places, items, and people that were familiar to her at the time.  For example a semantic fill-in-the-blank task was developed around restaurants she often frequented (e.g., “let’s to ______).  A communication book was developed that included a section to be utilized in therapy session which allowed her to make requests (e.g., I want some water), control the therapy activities (e.g., “Let’s move onto _____”), and discuss past events (e.g., “Last week we discussed the Fourth of July”).  Additional sections included favorite places to shop and eat, specific personal care items she might ask a family member to purchase for her and several stories depicting family traditions and favorite activities. Each section was added slowly with the initial work being completed on communication “boards” without binding them into a book.  Each section of the book was then divided by a visual scene navigation tab. A. C. continues to receive services and utilizes low-tech strategies with her daughter at home. Her receptive understanding has improved significantly, and her participation in therapy is active. She is able to attempt new therapy tasks with increased ease.” (Story from Dietz, McKelvey, & Beukelman, D. (2006). Visual scene display (VSD): New AAC interface for persons with aphasia. Perspectives in Augmentative and Alternative Communication, 15, 13-17.)

References

Blackstone, S. (2004). Visual scene displays. Augmentative Communication New, 16, 1-16.

Dietz, A., McKelvey, M., Beukelman, D. (2006). Visual scene display (VSD): New AAC

interface for persons with aphasia. Perspectives in Augmentative and Alternative Communication, 15, 13-17.

Drager, K. & Light, J. (2006). Designing dynamic display AAC systems for young children with complex communication needs. Perspectives in Augmentative and Alternative Communication, 15, 3-7.

Drew, R. L. & Thompson, C. K. (1999). Model-based semantic treatment for naming deficits in aphasia. Journal of Speech, Language, and Hearing Research 42, 972-989.

Garrett, K. L., & Lasker, J. (2005). Adults with severe aphasia. In D. R. Beukelman & P. Mirenda (Eds.), Augmentative and alternative communication: Supporting children and adults with complex communication needs (3rd ed.; pp. 467-504). Baltimore: Paul H. Brookes.

Helm-Estabrooks, N., Nicholas, M., & Morgan, A. (1989). Melodic Intonation Therapy program. San Antonio, TX: Special Press.

Parente, R. & Herrmann, D. (2003). Retraining cognition: Techniques and applications (2^nd ed). Austin, TX: Pro-ed.

Schuell, H., Jenkins, J. J., & Jimenez-Pabon, E. (1964). Aphasia in adults: Diagnosis, prognosis, and treatment. New York: Harper and Row.

Shane, H. (2006). Using visual scene displays to improve communication and communication instruction in persons with autism spectrum, Perspectives in Augmentative and Alternative Communication, 16, 8-13.

Weissling. K. & Beukelman, D. (2006). Visual Scenes Displays: Low Tech Options, Perspectives in Augmentative and Alternative Communication, 16, 15-17.

Fig. 1 Example of a low-tech communication book page with partner instructions

Fig. 2 Example of a low-tech communication book page with color-coding

Fig. 3 Example of low-tech communication book page without partner instruction