Visual Scenes - On Display at Adapted Learning

If you have read my previous writing about Visual Scene Displays (VSD) you now that I am an agnostic when it comes to their use in our populations of learners with multiple special needs.

Now there is an article by Phyl T. Macomber on the Adapted Learning site lauding VSDs. Yet there is still no evidence that these work for more than a few users or that they are best practice in speech therapy, special education or AAC.

Here are some of the claims in the article:

• "Visual scene displays organize and depict vocabulary in scenes relevant to the communicator"
• "Research shows that visual scene displays offer more immediate success for emerging communicators and for many individuals with communication deficits due to congenital or acquired disabilities."

First, I wonder if these scenes really are relevant to our students who use them to communicate. How many of our students with significant physical challenges have looked in cabinets for food, looked in a closet for certain articles of clothing or even climbed into their own bed to indicate they are tired? Those things are not necessarily relevant to our students, at the very least they are no more or less relevant that selecting a symbol of "food" to get to choices of food, selecting a symbols of "clothing" to get to clothing choices or selecting a symbol for "feelings" to say they are tired. More over these scenes are usually cartoon drawings or photos of somewhere our students have never been. In my experience and from many research studies we know that our students do not generalize well, thus how likely are they to generalize a cartoonish bedroom with a bed that looks nothing like theirs for their bedroom or a random movie theatre that looks nothing like the local theatre?

Second, there is the claim that research shows that VSDs offer more immediate success for emerging communicators and for individuals with disabilities, yet no studies are cited. There are only five published studies about VSD. Four done on individuals with aphasia and one on a small sample of young children with autism. (All of these are cited here.) Truthfully we do not know if VSDs are better for emergent or communicators with disabilities and we won't until more research is completed. Right now VSDs are a guess for our learners. However, it seems safe to say that VSD is a good choice for aphasia.

Macomber also decribes how to design low tech VSDs to use. She says of these:

• VSD's "Empower the communication partners to be much more active in the communication process – it gives them something to talk to their AAC user about by referencing the real-life environmental image,"
• VSD's "Reduce the cognitive demand for symbol learning – it is easier to learn communication symbols displayed in the context in which they are used, as opposed to numerous squares,"
• VSD's "Improve the motivation of not only the AAC user, but also the team implementing the tool because it makes sense to them and they see successful communication quickly"

She is clear that her experiences show these things to be true and it is difficult to argue with experience. Here are some experiences of my own. Students are less likely to use their communication device if they do not know exactly what in a visual scene display is "selectable". Students tend to use communication devices based on location, much like how we dial a phone. When using a visual scene display you move the burden of communicating from thinking about what you want to say and allowing muscle memory to select it (be it with direct select, head or eye tracking) to looking at the scene and determining what is a symbol and if that symbol will portray the message you want. Communication symbols can be learned in many ways that are possibly more contextual that a VSD. A language rich classroom and home, with picture symbols labeling everything and symbolic literacy experiences in the classroom are also contextual. Context is a broad word and visual scene displays are not the only way to create context. Clicking on "morning circle" and then seeing 6, 12 or 32 symbols that relate to morning circle is also contextual. Finally comes the issue of motivation. Motivation for communicating needs to come from a desire to communicate, to get needs met, to create social connection, to regulate and refuse, to get a point across.

My goal is to have all my students communicating because they are motivated to do just that and to see communication partners engage because they want to have a conversation, want to connect with a student. A student in my class came to me with tons of VSDs on her device and she only used the "feelings" page, which was not a VSD. The SLP eliminated the VSDs with enormous, unprecedented success. The student's parents have told us many times about how much more this student is communicating, how she is voluntarily turning on the device in the morning, how she is "talking" about her classmates on days she is home sick. We have seen her learn to order at McDonald's and explain to the physical therapist why she is terrified of the stairs. In fact she is insisting on taking her device with her to PT so she CAN explain that. Visual Scene Displays increased the cognitive load for this student. VSDs confused her. VSDs confused her parents and her staff. The data collected on her AAC use indicate a 75% increase in her use of the device since the elimination of VSDs. A more logical, traditional grid system made all the difference.

In short, VSD might be great for some learners. Research says it is worth a shot for those with aphasia and possibly those with autism. Yet traditional displays are great for others. We, as educators, therapists, AT specialists and caregivers, need to fully assess the student, how the student relates to the world, the student's ability to generalize, the student's grasp of general knowledge to determine whether or not VSDs, traditional displays or some other type of set up is best.


“Sections were reprinted from Phyl T. Macomber’s free AT Solutions At-A-Glance Newsletter. Subscribe at http://www.PracticalATSolutions.com.”

P.S. Have you voted?

Visual Scenes - What Do They Mean to Our Students

The big trend right now in AAC is visual scene displays (VSDs). All of the major AAC manufacturers (Dynavox on InterAACt, PRC (PRC calls them context scenes), Boardmaker SDP, low tech VSD devices by Enabling Devices and on the Boardmaker Activity Pad) are offering VSD on their devices, some companies are even offering them to the exclusion of traditional grids of symbols or photos or they are making it very, very difficult to use traditional grids of symbols photos within their software (hours of reprogramming VSDs to grids - this is true on InterAACt on the emerging communicator level).

However many of those involved with the decision when choosing AAC hardware and software do not have any idea what research has been done on VSDs and whether or not they would be beneficial to the individual who will be using the AAC device. Then the device arrives and suddenly there is this huge demand to learn how to use VSDs or reprogram to avoid the VSDs.

The research on VSDs seems to be primarily done on older (elderly) AAC users who have aphasia and secondarily done on those with autism spectrum disorders. There is some theroretical writing about VSDs and young children, but not much research. There is little research on VSDs in other populations (cerebral palsy, brain injury, Down Syndrome, Fragile X, etc.), nor is there any research on VSDs when the access method is not some kind of direct selection (i.e. for those who use auto- or step-scanning). Where there is research, i.e. this study for small children, the sample size is small (n=5) or the research focuses on personally relevant VSDs (photos of a person's actual surroundings as opposed to abstract drawings). This leaves decision makers in a void of information and presents a challenge when working with individuals outside of the areas that have been researched (everyone except young children, those with ASD and those with aphasia).

There is an assumption that visual scene displays reduce cognitive load, but this likely varies by individual (i.e. some individuals may find VSDs easier, but others may find traditional grids with no questions as to what is selectable vs. what isn't easier. If you are a PC user think about whether or not you like to view folders in thumbnail, icon, list or another format. This varies from person to person and task to task. The need for VSD may also change based on the persons style of learning - highly visual people, like most people with ASD may prefer the VSDs while others may prefer traditional grids). There is also an assumption that visual scenes will act as a visual cue to prompt conversation, but while this is possible it is also possible that a VSD can act as a distractor and lead away from the point that needed to be made (think about how often we write in IEPs to decrease visual distraction as an accomodation).

In short we don't know what visual scenes mean to our students. We are left where we are often left when teaching those with low incidence multiple or severe disabilities: direct trials and data collection is the only way to determine what will work and what won't. That means in the current trend of VSDs it is even more important than previously to rent an AAC devices for an extended period of time and run trials of the different types of software (with VSDs like InterACCt software and without VSDs like Gateway software) before you order. Additionally it is imperative that trials be done on the most current software available because if the software has changed the ability to access it may also change.


Bibliography of VSD research and presentations:

• Beukelman, D., Deitz, A., Hux, K., McKelvey, M., & Weissling, K. (2005). Performance in chronic aphasia using visual scenes interface with AAC. The ASHA Leader, 139.
• Beukelman, D., Dietz, D., Hux, K., McKelvey, M. Weissling, K. (2005). Visual scenes: An AAC prototype for people with aphasia. The ASHA Leader, 139.
• Dietz, K, McKelvey, M, & Beukelman, D (2006). Visual scene displays (VSD): New AAC interfaces for persons with aphasia. Perspectives on Augmentative and Alternative Communication, 15, 13-17.
• McKelvey, M., Dietz, A., Hux, K., Weissling, K, & Beukelman, D. (2007). Performance of a person with chronic aphasia using personal and contextual pictures in a visual scene display prototype. Journal of Medical Speech Language Pathology, 15, 305-317.
• Shane, H. (2006). Using Visual Displays to Improve Communication and Communication Instruction in Persons with Autism Spectrum Disorder. Perspectives on Augmentative and Alternative Communication. 15:1, 7-13.
  
• Ongoing Research

The AAC run down on visual scenes

• CallTalk (runs on BM/SDP, The Grid) - traditional grids
• Chailey Communication System (runs on Mind Express) - traditional grids
  
• Communicate 4 (BM/SDP, it originally ran on DV4s) - traditional grids
  
• Dynavox InterAACt - default visual scenes, elimiating is difficult
  
• Dynavox Gateway - traditional grids
• Express Talk (runs on Mind Express) - traditional grids
• Ingfield Express (runs on Mind Express) - traditional grids
• PRC Lite Devices - visual context scenes (not sure if default or optional)
• PRC Devices - Unity/Minspeak on a traditional grid, some have "learning scenes" option
• Point to Pictures (JR Cooper devices) - traditional grid
  
• Symbol Chat (runs on The Grid) - traditional grids
  
• Talking Screen - traditional grids
  
• TALK Boards (runs on BM/SDP) -traditional grids, text based, not for emergent communicators
  
• Velocity (runs on DV, SM/SDP) -traditional grids
• WordPower (runs on DV, PRC, BM/SDP, The Grid) - traditional grids, not for emergent communicators

Hardware/Software Mentioned (what board sets above run on)

• Dynavox
• PRC
• Boardmaker Speaking Dynamically Pro (aka BM/SDP)
• The Grid
• Mind Express
• Talking Screen