This study investigates the practice of achieving common understanding in aided Augmentative and Alternative Communication (AAC). The aims are to explore whether communicative contributions can be described as turns, as defined in conversation analytic terms, and how then the contributions to the interaction can be designed. The principles and practices of Conversation Analysis (CA) were used to record, transcribe and analyse conversations between a non-speaking boy with cerebral palsy with, on different occasions, his mother, his assistant and his friend. The boy augments his communication with aided AAC, bliss symbolics. The analysis indicates that the participants can collaborately create and orient to units in interaction equivalent to turns in interaction although they differ dramatically from ordinary turns-at-talk. In order to capture the nature of the described units, the category turn-at-action is suggested. The analyses demonstrate that the boy’s turn-at-actions are oriented to as a co-constructed and thus interactionally achieved unit: the boy points at a bliss symbol which is given voice by the speaking co-participant. In and through the relevant made voicing of the turn-at-action, a turn constructional unit (TCU) emerges, and the turn-at-action is designed and oriented to as a TCU-based unit. The analysis will also show that turns can be designed as non TCU-based units. These findings may have implications for CA theory as well as for clinical intervention.

Asking a question can be a highly challenging task for a person with multiple disabilities, but questions have not received much attention in research on augmentative and alternative communication (AAC). Conversation analysis is employed to examine an instance of multiparty interaction where a speech and language therapist supports a child with multiple disabilities to ask a question with a communication board. The question is accomplished through a practice where the action is built as a trajectory of interactional steps. Each step is built using ways of involvement that establish different participation spaces designed to deal with different aspects of asking a question: agreeing on the action type, the speaker and recipient, the content of the question, and then asking the question. The segmentation of a question into discrete steps and participation spaces can be used in intervention to model the construction of a question for AAC users and significant others.

This Conversation Analysis study investigated how a speech and language therapist (SLT) created opportunities for communication aid use in multiparty conversation. An SLT interacted with a child with multiple disabilities and her grandparents in a home setting, using a bliss board. The analyses demonstrated a practice where the SLT employed sequential and multimodal methods to open up interactional spaces for board use. The board was used within this space either by the child, or by the SLT. The space was then closed by the SLT's attentive checking for confirmation or rejection of the meaning of the board indication. The meaning-making processes were actively initiated, supported, and closed by the therapist, using a variety of linguistic and bodily methods such as questions, non-finished turns, indication modeling, and adjusting the board's position. The child confirmed or rejected the therapist's moves using board indications, vocalizations, gaze, head movements, and smiles. The analysed practice creates opportunities for teaching and possibly also for learning how to use a communication aid.

This conversation analysis study investigates facilitators’ simultaneous use of speech and aided means in instructional interaction with children with complex communication needs (CCN), who use aided communication in an everyday setting. The participants were children with severe speech impairments and their everyday communication partners. The analysis focused on facilitators’ aided turns immediately following aided turns by the children, within so-called retro-sequences. Retro-sequences were found in interactions involving four out of nine children. The facilitators systematically combined a spoken turn with an aided turn, a speaking and pointing (SAP) practice. The pointing consisted of a single graphical word, mostly a noun. The multimodal practice generally highlighted, emphasized, or exposed graphical words that increased noticeability and understandability within the local context. Adult repeats were treated as requests for confirmation of a candidate understanding and were responded to by the child using vocal and embodied resources. Reformulations (recasts) were treated as profferings of candidate understandings and were responded to using the communication device. The findings indicate that the partner’s use of a spoken and aided follow-up action shaped the immediate context for device use. The findings are relevant for the design of naturalistic interventions and may be used to improve treatment descriptions in augmentative and alternative communication (AAC) interventions.

This study is an investigation of the practice of achieving shared understanding in Augmented and Alternative Communication (AAC) using natural modes. The interaction between a girl with severe speech and physical impairment (SSPI) and moderate intellectual disability and her everyday communication partners is explored. The aims are to investigate how the participants create meaning through the girl’s coordination of gaze direction and arm/hand movements and vocalizations, as they occur in natural interaction with everyday communication partners. e principles of conversation analysis (CA) were used to record, transcribe and analyse the interaction. The analysis demonstrates that the participants collaboratively create local meaning in and through the coordination of gaze and arm/hand movement. us, the speaking co-participants ascribe meaning to the girl’s actions of directing gaze and arm/hand movement at the same target. e analysis shows that the ascription of a specific meaning is context-specific. These findings highlight the importance of taking into account all interaction-relevant modalities and the relevance of systematic details in the micro-context of interaction when looking for processes of sensemaking. In addition, the role of the communication partner is emphasized. These findings may have implications for clinical intervention.