How long does it take to learn to use a MinSpeak-based AAC system?

This blog post contains extracts from a message that I posted to the CM-AAC-Forum in 2009, as one of many contributors to a lengthy discussion about “Icon vs Text Based Communication Systems”. This was was one of several branches of a thread that had originated with a discussion about word prediction software.


The question, “How long does it take to learn to use a MinSpeak-based system?”,  is just as valid for any other AAC system, but there is a particular reason why I am concerned about the MinSpeak question.  This is that I have been quoted as reporting in 1989 that it took 200 hours of direct therapy to teach a cognitively intact adult to use a MinSpeak system fully.  I was a bit baffled by this as I did not recall ever have said any such thing and could not imagine where this “fact” had come from.

 

I was reminded of this issue when @SpeechReka recently tweeted a link to the marvellous SCOPE resource, “Supporting Communication through AAC“, so I dug out the old CM-AAC-Forum email discussion.

So, to correct the facts. . .

Having Googled around a bit, the earliest citing of this misinformation I could find was in Module number 2 in the package “Supporting Communication through AAC” published by SCOPE:

http://www.scope.org.uk/help-and-information/communication/aac

There is an FAQ’s section in Module 2 and the relevant Q and A are as follows:

How long does it take to become an efficient and effective communicator using AAC?

This is also a question that is frequently asked but on which there is little if any data. Panton (1989) relates the case of an adult man who suffered an accident that left him without speech but otherwise cognitively unimpaired. This man took 200 hours of teaching by a speech and language therapist (SLT), experienced in the use of Voice Output Communication Aids (VOCAs), to learn to use a symbol based communication system (Minspeak). The 200 hours does not include the time that the man worked on the device on his own. Since this man had full language and was an experienced communicator before his accident, we must accept that learning to use one of the symbol based VOCAs will be a lengthy business for any child, particularly those with additional disabilities. This has particular implications for service and support issues.

The correct facts are found in a paper titled “Modified Word Strategy and Acquired Dysphasia” (Panton, 1989) in the Proceedings of the 1st UK MinSpeak Conference, 1989, UMIST (see links at the end of this post to the copy on Scribd or to download directly from this blog).

This presentation is about a young adult man (DF) who had a very severe stroke that left him without speech and with some significant cognitive and physical impairments. Although he had “full langage and was an experienced communicator” before his stroke (not “accident”) he had very limited language after the stroke.

However, he retained better than average visual memory for some things (but not words or letters) and better than average mathematical skills (he had been about to start a PhD in robotics when he had his stroke).

My first contact with DF was about 6 months after his stroke, when I taught him AmerInd over a period of several months (American Indian Handtalk – not as daft as it sounds as it is meant to be “guessable” by people who have not come across the signs before). About three years later, I worked with him using MinSpeak for 20 hours (twenty – not 200) over 28 days. This involved me in 40 hours of preparation over that period and he also worked enthusiastically at home for several hours a day. This is the therapy referred to in the SCOPE AAC FAQs.

Therefore, this conclusion in the SCOPE FAQ paragraph is still true, even though the facts cited to support it are not:

” . . . we must accept that learning to use one of the symbol based VOCAs will be a lengthy business for any child, particularly those with additional disabilities. This has particular implications for service and support issues.”

It seems likely that the reference to 200 hours and a cognitively intact adult should have been attributed to a presentation by Bruce Baker in 1988 at a Minspeak Seminar, in which he described the development of the Word Strategy Minspeak Application.

The outcome of my period of trial therapy with DF is also relevant to the “choice” question originally posed on the CM-AAC-Forum, ie. Icon-based verses Text-based AAC Systems.

DF had previously made very limited use of a nifty little QWERTY device called a Sharp Memowriter. He liked this because it looked good but he was dissatisfied with the fact that he could do so little with it. In the period of trial therapy described in the 1989 paper he learned to make far more use of the TouchTalker with modified Word Strategy. This success was still very limited, but a vast improvement on what he could manage without the TouchTalker.

Use of a VOCA in therapy (not in “real life”) also had a dramatic impact on his insight into his own language problems, on his strategies “in real life” to successfully compensate for them and on his increasingly sophisticated use of AmerInd.

The main benefits of the intensive therapy were NOT that he learned to use MinSpeak to communicate effectively but rather the impact of a form of communication and language therapy that used modified WordStrategy (MinSpeak) on a VOCA and “dialoguing” as therapy tools and methods. There was also a very unexpected down-side:  

“The trial was successful in that gains in functional communication were made and DF demonstrated that he could manipulate lexical items to produce appropriate, grammatical sentences in a highly structured therapy task. That this frightened and distressed him was unforseen and is an eventuality that is maybe specific to DF, perhaps analogous to the threat fluency presents to some long-term stammerers or maybe represents the challenge of coming to terms with an acquired disability.”

In terms of other studies about the time needed to learn MinSpeak-based systems, there might be some among the electronic copies of the US MinSpeak Conference Proceedings here: http://www.minspeak.com/users/MinspeakAroundtheWorld.php

The UK/European Proceedings are listed on that page but have not been uploaded yet. Perhaps someone at Liberator could have a root around the Minspeak archives in the UK to see if there are any studies that could provide some data on this?

I have scanned my original paper, using Optical Character Recognition to produce a file of a manageable size, as the methods and findings might still be of use to others. This copy is on Scribd:

Modified Word Strategy and Acquired Dysphasia Liz Panton 1st Annual UK Minspeak Conference 1989

or download pdf: ModifiedWordStrategyAndAcquiredAphasia-LizPanton-1989

8 Comments to "How long does it take to learn to use a MinSpeak-based AAC system?"

  1. September 27, 2015 - 2:08 PM | Permalink

    @everhopeful1000 @rsocialskills AAC-Forum http://t.co/4L9XZcCSfX

  2. September 26, 2015 - 4:41 PM | Permalink

    How long does it take to learn to use a MinSpeak-based AAC system? http://t.co/FWLXPCXMb0 via @salt_mine

  3. paul andres's Gravatar paul andres
    December 13, 2011 - 8:45 PM | Permalink

    I presented at CM on just this subject this year. Using the LAM feature that Russel talked about we didn’t track the quantity of intervention, though it is certainly in our data.

    We tracked every word that L spoke with his device from the day he got a machine at 4 it to the week he started school. We the purpose of this tracking was to support distance support. This involved an average of aout 10 minutes a day email contact and telephone discussion with his mum.

    Together with the lam which allowed us to look at his language activity on a daily basis we also did a straightforward study of 3 aspects of normal language development.

    The thought of discussing how well someone uses a talker sounds to me like discussing how many hours you need to be able to play an instrument. There is no point where you couldn’t do it yesterday but can today.

    After about 80 hours of distance support in 10 to 15 minute blocks, and 8 hours of direct intervention (mostly at the start I decided I didn’t have much to teach him or his family when he started school and greeted his mum at breakfast the second day with “I used to be kindergarten child, but now I am a schoolboy, but I still think about kindergarten”

    To get an idea of where L is now look in youtube under “Warum ist darfjäder schwarz?” there are subtitles.

  4. October 11, 2011 - 5:00 PM | Permalink

    I hope you have a great time in Pittsburgh and San Diego – your self-sacrifice in the cause of duty knows no bounds :-)Give my best regards to Bruce. I have fond memories of his look of bafflement at a MinSpeak training day, when he asked for suggestions for a UK idiom to express “thirsty” and I came out with, “I could MURDER a cuppa!”

  5. etyman's Gravatar etyman
    October 11, 2011 - 4:41 PM | Permalink

    I’m presenting at a seminar in Pittsburgh next week so I’ll see if Bruce has a copy of his original “200 hours” paper. I’m thinking – and that’s always tricky – it was a single case of a chappie using Word Strategy, and it took about 200 hours for him to become fluent, and by “fluent” I think Bruce meant able to use the system without much effort for core vocabulary.

    I use the Language Activity Monitoring feature of the PRC devices to do some data analysis with individuals on request. This is more to do with taking a snapshot of their current use and coming up with some possible future directions to take. With a little effort I suppose I could do some more ABA type stuff with folks but that takes time – and a Review Board to monitor progress!

    Barcelona was indeed fun and I remember having a meeting there at a beach bar! Now if ALL meetings were like that, I could like them better 😉 I’ll be at the next ISAAC in Pittsburgh as it’s really a “local” one for me – just 3 hours away so I can get there and back in a day if I need to.

    My next conference is ASHA in November, which is in San Diego. Yeah, I know, it’s a dirty job but someone has to do it!If I come across any new papers on Minspeak measurement, I’ll keep you in mind. A colleague from Denver is going to work with me to do a joint paper for ISAAC and present a case study, the data from which I will be tasked with analyzing, so that’s less than a year off. If you’re heading to that one, let me know and I’ll see if you can get some “Bruce” time – he’s a great host!

  6. October 9, 2011 - 3:52 PM | Permalink

    Hi Russell,

    Lovely to hear from you! Not only some great information and references but now I have also found you on Twitter – and your “Etyman Language Blog” http://etyman.wordpress.com 🙂

    I found a lot of useful info in the Research Section of the Minspeak site when I became aware of this “misattribution” issue in 2009: http://www.minspeak.com/students/researchinformation.php

    I managed to track back through time, following other people’s references to the “200 hours” statement, and the source of the Nile seemed to be a presentation by Bruce Baker in 1988, although I could not find a copy of the paper itself. So I was unable to verify whether or not the statement in the Scope document accurately reflected what Bruce had said in 1988 (that sounds even longer ago than it actually was, like Dickens might have been around then!)

    Searching my emails, I see that I emailed Bruce back in 2009 to check the email address I found for him, and that had a reply from Bob Conti confirming that it was correct – but that I failed to follow it up (bad me!) Better late than never!

    It is a shame about research into MinSpeak dropping almost entirely off the map (ha!). I have been back to the MinSpeak website and see that I can register for an email newsletter so will do that too: http://www.minspeak.com/newsletter.php

    Don’t know why Posterous was so rude to “real you” – cheek! I received an email from Ppsterous asking me to moderate both your posts but the earlier one had disappeared into the ether ;-/

    I will tweet the link to your comment and credit @etyman – was not sure from what you said whether you also have an “AAC-Russell” Twitter ID too.

    (I was in Barcelona when CM’11 was on – hard choice but the fireworks won!)

    Best wishes,Liz P

  7. etyman's Gravatar etyman
    October 9, 2011 - 2:08 PM | Permalink

    Hi Liz

    This is Russell Cross posting from my Twitter account because Posterous wouldn’t let me post as “me” – said I was spam!! So I’ve switched to my other persona – or “what I do when I have a life other than AAC! Hence the “etyman” name 😉

    Digging into the past, I found three specific references to how long it can take to teach a Minspeak system, all from conference papers. Here are the summaries:

    • Reid (1990) taught a 12-year-old boy with an understanding level of a 5-year-old how to produce spontaneous one- and two-word utterances. [Reid, B. (1990). The challenge of the National Curriculum: A curriculum for all children. In Proceedings of the Second Annual European Minspeak Conference, 15-18. Liberator Ltd., Swinstead.]
    • Dennis (1991) worked with a 7-year-old using a TouchTalker over an intensive six-week program with four days per week and one hour per day, for a total of 24 hours. He was able to build sentences of up to four words, yet had been placed in an “educable mentally handicapped” school. [Dennis, M. (1991). Tyler, a touching experience – a case study. In Proceedings of the Sixth Annual Minspeak Conference, 23-25. Prentke Romich Company, Wooster, OH.]
    • Mackenzie (1993) taught a 7-year-old child with CP and receptive language problems how to use a 128-location Liberator device and produce sentences using two-three key sequences for each word. [Mackenzie, J. (1993). You are a nutcase! A review of three children suing their Liberators. In Proceedings of the Fifth Annual European Minspeak Conference, 18-26. Liberator Ltd., Swinstead.]

    Research into using Minspeak has effectively disappeared. We forget sometimes how small the field is, and there are not thousands of AAC departments out there looking for things to do. Another confounded influence is that the “seduction of the new” means that research tends to focus on the latest and greatest techniques and technology rather than more established ones. Cathy Binger at the University of New Mexico continues to do research into AAC and morphology, and she includes uses of Unity in her studies with some success. Her latest article is Binger et.al (2011). [Binger, C., Macguire-Marshall, M., & Kent-Walsh, J. (2011). Using aided AAC models, recasts, and contrastive targets to teach grammatical morphemes to children who use AAC. Journal of Speech, Language, and Hearing Research, 54, 160-176.]

    OK, just wanted to add to the discussion! I was planning to to CM this year but I was in Austria just before and the cost to go from there to the UK and then back to the US was… er… unappealing 😉

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