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How can technology assist youth who have complex communication needs in developing social relationships?

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How can technology assist youth who have complex communication needs in developing social relationships?

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1. Individual Connections

Peers

Family members

Others

"The primary participants also used text messaging to interact with work colleagues, classmates, teachers, personal aids, and members of their church" (Wepner et al., 2021, p. 81).

2. Group (Belonging)

Group chats

Church

"The majority of primary participants reported that they belonged to messaging groups, in particular church groups, as well as study groups, social groups, and support groups. The support groups typically consisted of members whom the primary participants had not met in person, a situation which they viewed as beneficial" (Wepner et al., 2021, p. 80).

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Increased Enjoyment of use of Technology

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Increased Enjoyment of use of Technology

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For the youth with complex communication needs.

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Range of Topics and Functions for the Communication (i.e., Content)

“The participants…reported that they used text messaging for chatting about topics such as their interests (for example music and poetry), day-to-day experiences, relationships and love interests, the challenges they face, and their secrets” (Wepner et al., 2021, p. 82).

Functions as a Means to Communicate Easily, Considering the Individual's Abilities and Needs

Such as communicating emotions using emojis, where facial expressions in person might be challenging to express (Wepner et al., 2021).

Provides for private messages.

"Text messaging also created for them a communication environment in which they could privately connect with communication partners, an important consideration for an individual in a group home or in an impoverished setting with no personal privacy" (Wepner et al., 2021, p. 83).

Time (delayed responses)

“In addition, certain messaging features were found to enhance the maintenance of communication…a messaging thread remained on the device, and there was the option of responding to older text messages within a thread” (Wepner et al., 2021, p. 81).

"The use of asynchronous communication by individuals with disability-related challenges allows them to interact in their own time, thereby reducing response-time pressures" (Blackstone, Williams, & Wilkins, 2007; Paterson, 2017).

Repairs Breakdowns

"The primary and secondary participants commented that although communication breakdowns sometimes occurred during text messaging, these were infrequent and easily repaired by asking for clarification by sending a "?" (Wepner et al., 2021, p. 81).

Better Understood (greater understanding from outside viewers)

The participants of this study often found that they were actually better understood in a written format, like on Facebook, than they were in their everyday lives using the ACCs. (Hynan, Murray, & Goldbart, 2014)

Equal interaction opportunities

Unlike past interventions with AAC’s, where a child without disabilities would be deemed as a “helper recipient”, the iPads with visual scene displays worked to help children with CCN engage in shared storybook reading with their peers, thus creating new and equal opportunities to interact socially (Therrien & Light, 2016).

Friendship and identity building

AAC supports young adults in forming friendships and identity, especially when devices connect with texting, Facebook, and other social media  (McNaughton et al., 2012).

Stakeholder Knowledge as a Barrier

All stakeholders mentioned a lack of AAC knowledge as a barrier. 44% of parent-carers, 90% educators and 55% clinicians ranked this in their top three barriers of AAC use. When stakeholders lacked technical and practical knowledge in AAC, there would be fewer and briefer AAC conversations with users. (Yau et al., 2024)

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Acceptance of Errors

“The primary participants found it particularly advantageous that text messaging was brief and that language and spelling errors in the text messages were not frowned upon by others” (Wepner et al., 2021, p. 83).

Identity and Self-Expression

“Text messages enable them to connect privately and to manage their own identities, reducing the stigma associated with having a disability” (Wepner et al., 2021, p. 81).

"They found that when individuals with disabilities were able to manage their own personal identities on mobile phones, it helped them to escape the stigma of disability" (Wepner et al., 2021, p. 82).

Overcoming Limits

The participants in this study could produce more language during structure interviews. This demonstrates that when given the right support, they were able to communicate extremely well. Therefore, this resulted in surpassed expectations and the stigma around the limits to communication growth to be effectively challenged (Soto & Clarke, 2018).

Greater Understanding

The participants of this study often found that they were actually better understood in a written format, like on Facebook, than they were in their everyday lives using the ACCs. (Hynan, Murray, & Goldbart, 2014)

Design Matters

iPads are far more common these days and familiar, thus making them less stigmatizing than traditional AAC devices. Youth want AAC devices that are “fast” and “cool,” showing that design can reduce stigma, increase confidence and make technology more socially acceptable (McNaughton et al., 2012).

Attitudes and Stigma as a Barrier

"88% of parent-carers, 80% of educators and all clinicians mentioned experiencing negative attitudes towards AAC use and uptake. Stakeholders raised concerns that AAC would hamper a child’s development and potential, and more pragmatic concerns around being responsible for damaging expensive equipment." (Yau et al., 2024)

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Desire to be Online

Just like youth who do not use AACs, those who do still have a desire to be online and experience socializing in a digital way. Many participants described feeling “happy and excited” when they were able to access the internet, and some even said they could not imagine life without it (Hynan, Murray, & Goldbart, 2014).

Enjoyable Engagement

When adolescents used their SGDs in personally meaningful and enjoyable activities, they were further motivated to participate in the discussion. In these contexts, they were able to focus on sections of the adults' language input that made sense to them and could practice expressing themselves in ways that felt natural. Therefore, when technology was being used in engaging and motivating activities, adolescents’ were more likely to enjoy and continue using the technology to communicate socially (Soto & Clarke, 2018).

“They also sent brief text messages with little punctuation and enjoyed using shortened words that enhanced the ease and rate of interaction” (Wepner et al., 2021, p. 81).

Shared Tech is Desired

According to Therrien & Light  (2016)

Children involved in the study found storybook reading more enjoyable when using iPads, peers also preferred sessions with the sharable technology.

AAC Device Fit as a Barrier

‘Device Fit’ was rated as a top three barrier to AAC use by all parent-carers, 80% of eight educators and 73% clinicians, due to poorly customised fit or sensory overwhelm to the user.

“Ideally we’ll have the AAC on him all the time, like having the tablet sling on his shoulder … but it does hinder his movement.” (Parent-Carer 3 on the bulkiness of the AAC).

“There were just too many (distracting) icons” (Educator 8 on why they abandoned a high-tech AAC for an autistic child).

“… the voice … is robotic or American (in an Australian context)… not representative voice” (Educator 10)

(Yau et al., 2024)

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Keeping Connections Alive

Technology helps people stay connected by making communication easier across distances. For those using AAC, tools like email, texting, and social media provide ways to keep in touch with friends, teachers, and old classmates. Platforms such as Facebook and messaging apps help their users to maintain relationships and feel close to people they may not see often (Hynan, Murray, & Goldbart, 2014).

Interactive Exchanges (Practicing Conversation Skills)

The conversation-based intervention (using SGDs in meaningful tasks) done in this study allowed the participating adolescents to have interactive exchanges with their clinician. Within these exchanges, the adolescents were able to practice taking turns in conversation and expand their language use within a social setting. Due to the fact this intervention included constant back-to-back exchanges, it supported the foundation of building new relationships (Soto & Clarke, 2018).

Generalizes social skills

Repeated sessions with iPads has been proven to encourage children to be engaged in ongoing interaction. This can suggest that technology can help sustain relationships once they start. One child was able to generalize the behaviour of  turn taking with an AAC device for 3 weeks without any intervention. (Therrien & Light, 2016)

Participation in Modern Day Social Lives

McNaughton et al., (2012) argues that

AAC should let youth take part in modern social life, like using Facebook, Twitter, and sharing media, which are important for keeping friendships.

AAC User Engagement as a Barrier

In our coding, most stakeholders (89% of parent-carers, 60% of educators and 55% of clinicians) identified a user’s willingness to use the AAC as a barrier. “(Name) has the ability and knows where most of the words are. But his willingness to engage … Or wanting to use it as a communication. That’s the biggest barrier.” (Parent-Carer 7). (Yau et al., 2024)

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CCN - Complex Communication Needs

AAC - Augmentative and Alternative Communication