Supporting Communication in Stressful Times

When researching ideas for how to explain complex issues in and around COVID-19 and other related stressful situations for our Winston Churchill Memorial Trust Action Fund project, there seemed to be very little guidance specific to those who struggle with communication. No matter how hard we try there is often limited amounts of time available to support someone who has speech and language difficulties during stressful times.

It is essential that both effective and calming conversations take place and when thinking how to develop communication charts that could be adapted and used in a wide range of environments, several concerns may arise…

How do those coping with social distancing i.e. 2 metres or around six feet) cope with small text or those working in visors and other types of personal protection equipment (PPE) manage?
How do the usual single word labels used with simple symbols support those for whom English is not their first language or where other disabilities have an impact on spoken conversations?

We have been collecting charts such as those offered by Widgit ‘To help patients communicate in hospital and critical care‘ or Patient Provider Communication with their ‘Adult General Needs‘ charts and many others. The symbols and words are clear, but what if one has a visual, hearing or cognitive impairment and more explanation is needed. How could anyone adapt the content or images? Their use with computerised text to speech or screen reading is possible, but what else would help?

‘AccessAbility 2: A Practical Handbook on Accessible Graphic Design‘ highlights some of the difficulties individuals may have, such as:

Distinguishing sounds from background noise.
Focusing or staying on task.
Memorizing and recalling information.
Understanding and following directions.
Understanding complex logic.
Understanding abstract ideas.
Understanding language usage.
Communicating in speech or wrltlng.
Working with numbers.
Keeping expected pace in any number of cognitive tasks.

This means that we need to be thinking how we can make communication in all its forms as easy as possible, not just depending on speech. Dr Rachael Grimaldi has worked with a team to develop an online app called CardMedic (that also works on tablets and phones) where she has used phrases and sentences for example in an assessment situation.

In discussion with colleagues the use of phrases and sentences is felt to be helpful, in particular when working with individuals where English is not their first language. This might apply to the professional as well as the client. ‘Easy-to-read‘ sentences with a symbol can provide context and can be read out exactly as written. We are adapting our present version of Boardbuilder to support this wider audience.

As a result of helping to support work on the W3C Web Content Accessibility Guidelines for cognitive impairment we have also been researching which font type would best suit the situation. A recently pulished article by Gareth Ford Williams (Head of UX Design from the BBC) further helped decision making on the subject. ‘A Guide to Understanding What Makes a Typeface Accessible, and How to Make Informed Decisions‘.

Meanwhile, Global Symbols now has many more freely available medical type symbols (that have beeen added to the original AAC symbol sets) that can be downloaded and adapted in line with their open licences. These new symbol sets include the UN OCHA Humanitarian Icons, the OpenMoji symbol set, and the Guemil icons which have a range of emergency images.Language English French Croatian Serbian (Cyrillic) Serbian (Latin)

WebSci 2020 Digital (In)Equality, Digital Inclusion, Digital Humanism

The WebSci 2020 conference had a special workshop on Digital (In)Equality, Digital Inclusion, Digital Humanism and we were able to present our work related to “Multilingual Symbolic Support for Low Levels of Literacy on the Web“

Our Alan Turing Institute AI and Inclusion pilot project included work related to our linking of symbol sets and there were some interesting questions at the end of the presentation that provided a chance to explain some of the issues that have been arising as well as the positives!

The YouTube video has no captions, so I have added a transcript thanks to Otter.ai WebSci workshop Transcript

Welcoming OpenMoji, Guemil and OCHA to GlobalSymbols

United Nations OCHA, OpenMoji and Guemil symbols

Global Symbols now has the OpenMoji symbol set, which comes with an open licence and has been developed by “50+ students and 2 professors of the HfG Schwäbisch Gmünd (Design University) and external contributers”.

The Guemil icons come from UC School of Design, Santiago, Chile and are “an open source pictogram initiative, aimed at representing situations of risk and emergency”

Finally, we added the 376 UN OCHA Humanitarian Icons which have a range of emergency images

All these icons or symbols have been developed for informational purposes and at the moment are on the website in English only.

Designing symbols that can work with other open licenced symbol sets.

voting criteria We have been having exciting times this summer setting up a series of AAC modules to introduce some of the ideas we have about making open AAC symbols accessible to all and to offer a voting system for localisation of some of the images that really do not fit some cultures and fail to represent AAC users’
home settings or personal needs.

We have written some voting survey instructions that we hope will help you to discover a way of making the symbol choices as democratic as possible. You can upload a draft set of symbols that you feel need to be discussed with anyone interested in their use. They can become part of an online survey with easy accesptance levels
on a scale of 1-5. The process makes seeing where issues are arising easy with a chance to mark the look and feel of a symbol or whether it represents a chosen label, colour contrast is good and cultural concerns are highlighted. There is also a chance to gather general comments.

It is interesting to see that Carole Zangari discussed the idea of “Using Multiple AAC Symbol Sets and Systems with AAC Learners: Considerations for Thoughtful Interventionists” in August 2017. She confirms that from a “learning perspective, it makes sense to have a consistent symbol type across the expressive tools that the client will use.” However, we have found that many of the symbols in some of the main open symbol sets can be used in many different settings, such as everyday objects or some foodstuffs such as fruit. So perhaps there is a case for learning which are the symbols that really need to be designed for local use and personalisation?

Designing for consistency and use of the same symbols across all devices, charts and keyring etc is important for a young user just starting out on the AAC journey. So having chosen a particular symbol set, the task of developing new symbols is more about creating a similar look and feel with clear guidance about size, transparency and format (download Word docx).
Then being comfortable that the new symbols will work alongside the symbols that cross cultures and finally to ensure that the symbol really is easy to learn – so guessability ratings are high wherever possible when thinking about early intervention.

Jellow, cBoard and Yuudee 2 update – more languages and evaluations.

In the last few months we have seen some very exciting updates appearing from the UNICEF Innovation Funded Jellow, cBoard and Yuudee teams. It has been so interesting acting as mentors and we have been working hard to connect up the Jellow and StraightStreet symbols to ConceptNet so they will soon be available on our site.

The Jellow Communicator on Google Play is now available in Bengali and it won the “#mbillionth South Asia award for Inclusion and Empowerment”

cBoard which is available on Github, has 33 languages on their app, but as the languages are using machine translation they require proofreading, The cBoard team have been asking for translation help – you do not need to be a programmer!

Both these teams aim to use the The Psychosocial Impact of Assistive Devices Scales (PIADS) evaluation tool for their apps as it can be translated into any language and has a very easy to understand 26 questionnaire for assessing “the effects of an assistive device on functional independence, well-being, and quality of life”.

Yuudee2 have also been busy with evaluations and training – you might need to use Google Translate if you are not a Chinese linguist and if you select the image below you will also learn more about the interactive nature of their app with its hand drawn animated gifs to aid those with Autism.
Yuudee2

Localised images to aid recognition – What about free localised AAC symbols?

Thanks to a note from Aejaz Zahid about an article on the BBC website we came across a wonderful example of how localised and personalised pictures can help those who find it hard to read or remember important items in their social setting. The article reminds one of the importance of knowing the local situation in which those with literacy difficulties or speech and language disabilities find themselves, and understanding the imagery that brings it alive. Being aware of personalisation and social circumstances cannot be stressed more highly with regards to the way symbols are developed but sometimes it is possible to use readymade versions to speed things up.

In the article titled ‘Spanish grandson’s doodles help grandma find phone numbers’ it is interesting to see that the grandson has used images that perhaps could have been taken from the ARASAAC set of AAC symbols which has been funded by the EU and the Government of Aragon in northeastern Spain, had he known they existed. Examples shown in the photographs include equivalent symbols such as a red cross for medical problems and a hospital, a vet for the dog and a mobile phone number.

red cross hospital mobile phone vet

The more we can spread the news about repositories that have freely available AAC symbols such as the English language OpenSymbols.org or the free application such as PictoSelector that offers a way of making communication boards from the symbol sets it holds, the more we can help people like Pedro Ortega’s grandmother.

We hope that our soon to be multilingual symbol dictionary, will be used by more people wanting these types of pictograms, symbols or images for supporting those with literacy difficulties and cognitive impairments as well as those who need augmentative and alternative forms of communication (AAC) in many languages.

global symbols Did I say multilingual symbol dictionary? Watch this space, we are developing, thanks to a UNICEF innovation fund grant, a way of being able to add new free symbol sets that can be seen in multiple languages – think open source and ConceptNet then possibly in the future AI and machine learning, for a glimpse into the technical side of the sorts of things we want to achieve! Crowdsourcing also comes to mind when errors need correcting and additions have to be added! These symbol sets will all be linked to their owners and we will be stressing the types of licences under which they are provided and hoping you will join us on this new adventure! Símbolos gracias a ARASAAC

Classifying AAC symbols for ease of use

With thanks to Techcess and the SCORE layout

There has been a long history and much debate about the way we classify AAC symbols for ease of use. Do we make it easy for people to choose the symbols they want on a communication board from a label? Should we try to provide categories and if so which ones? Do we need to think about semantics and the meaning of words, phrases, or text in context as concepts and syntax (sequencing words into grammatically correct sentences) when we are searching? What happens when people want to make visual displays based on different topics?

These questions become even more important when considering a range of languages which may have very few similarities in particular if they are not part of the European group of languages. Issues around orthography as well as left to right and right to left placement if one is thinking about text to speech output on electronic devices and moving through a sentence or phrases with a minimal number of selections and distance to cover.

Once again we would like to use share our questions with others in the field in order to make decisions that suit as many AAC users, carers, families and professionals as possible. Here are some key points in a set of slides available on SlideWiki

Global versus Universal?

“Global” reflects the nuance of culture and language, “Universal” assumes that one size fits all.

voting hands around the world Working with UNICEF and the AAC Cohort is one of the most exciting things we have been doing recently. We have had telemeetings with lots of discussions about opening the world of AAC symbols to the widest possible audience. Topics have ranged from different open licences such as Creative Commons and open source software to what it takes to develop Alternative and Augmentative Communication (AAC) symbols that can be used across the world and on to more complex ideas including Artificial Intelligence (AI), machine learning and AAC!

You might ask why are we thinking about the meaning of words such as ‘Global’ and ‘Universal’ whilst building a symbol repository. We feel that global recognises different languages, cultures, religions and social settings and environments. In part this is because we have promised ourselves that we will not be introducing yet another symbol set that includes symbols that are universally recognised. We accept that there are many symbols that can be said to be universal because they are recognised worldwide, but we are looking at the nuances that occur in different countries and where localisation is important.

what time is it?

What time is it?

drink

We discussed the idea of “Symbols for different settings across the world” when we were working on the Tawasol Symbols in 2016 and looked at some of the issues that W3C highlighted for web developers thinking about localisation and globalisation or internationalisation. such as:

“Numeric, date and time formats
Use of currency
Keyboard usage
Collation and sorting
Symbols, icons and colors
Text and graphics containing references to objects, actions or ideas which, in a given culture, may be subject to misinterpretation or viewed as insensitive.
Varying legal requirements
and many more things.”

We discovered that No.8 ‘many more things’ included the criteria below when working on the Tawasol Symbols and that these features came about as a result of our voting sessions with AAC users, their families, carers and the professionals working with them. criteria for symbol design

Global Symbols aims to ensure that all the open symbols we add will have been reviewed by those using AAC and those involved in supporting AAC users in the locality where they have been developed, whilst also allowing for personalisation.

Watch this spot for all the changes we plan for the Global Symbols web site in the coming months! The first group of symbols will be coming from the UNICEF AAC cohort members – Jellow designed by those developing the app in India and cBoard, developed in Argentina and Israel, at present using the Mulberry Symbols from Straight Street that were voted on by users and AAC supporters in the UK over a period of several years.

hello

We will be updating this blog as we add symbols and please join us on Facebook to discuss the changes! We will also be tweeting about updates

Thank you UNICEF for this very thought provoking, challenging and interesting partnership.

Celebrating Global Accessibility Awareness Day 2018

GAAD

We are celebrating Global Accessibility Awareness Day with many others around the world! Companies and organisations are offering accessibility advice and support alongside exciting new ideas that have been filling our twitter feeds and @gbla11yday

The Australian Network on Disability has started the day by providing a useful collection of videos, articles and resources all linked to making things easier to use by those with disabilities.

In the UK the BBC have a theme of Access All Areas 2018 with talks about Accessible Gaming, Deaf awareness in the workplace, Voice assistants and spoken interfaces to name just a few of the subjects from well known experts. The Accessible Gaming is linked to the work of Microsoft and they have launched an AI for Accessibility theme saying:

“We have started to see the impact AI can have in accelerating accessible technology. Microsoft Translator is today empowering people who are deaf or hard of hearing with real-time captioning of conversations. Helpicto, an application that turns voice commands into images, is enabling children in France with autism to better understand situations and communicate with others. And, Seeing AI and auto alt-text features are helping narrate the world for people who are blind or low vision.” (Microsoft, May 7th, 2018)

Abilitynet have blogged about their GAAD news and all the events they are involved with over the day including a fast talking video on Web site accessibility that highlights the fact cost of ignoring the ‘purple pound’. “Disabled people represent a massive untapped market for business with a collective spending power estimated at £249 billion.” (Independent Living)

Each week Debra Ruh, Neil Milliken, and Antonio Santos host a Twitterchat providing practical advice given by experts in the field of inclusion and digital accessibility. You can find them on https://twitter.com/AXSChat. Neil will be hosting a day of talks at ATOS with live streaming of the speakers

The Paciello Group has a series of YouTube videos that cover topics from the use of screen readers to ‘The Future of Work: How Emerging Workplace Trends are Affecting People with Disabilities’. These will be streamed online in USA Eastern time from 0800.

communication Thinking about Global Symbols there is something else to look forward to The “2018 AAC In the Cloud Conference Schedule” June 26, 2018. All sessions are broadcasted live, and will be available on YouTube afterwards. You can see a link to uploaded resources/slides/handouts on the conference home page. http://aacconference.com/schedule-3/

Watch out for Coughdrop and their range of free communication boards, symbols and online support.

Techcess introduce SCORE (UK) working with Core vocabularies.

basic vocab charts An event held at The Barnsley Hospital Education Centre was an interesting morning concerning the translation of a core vocabulary system developed by Professor Jens Boenisch and his team from the University of Cologne. The use of core vocabularies on a series of personalised communication charts have been translated into English from the German originals and can be provided in a folder that offers a way of encouraging the growth of language and literacy skills. Some members of the Tawasol symbols team were lucky enough to meet Professor Boenisch in 2016 when they discussed the possible translation of the system into Arabic. The visit was reported in our blog with an image of the original communication folder

Low tech to high tech Techcess with Bart Noe (Jabbla) have developed a way of working with these charts on speech generating devices that speed access to symbols and therefore the creation of phrases and sentences that are read aloud with speech synthesis. The SCORE system has been built to work with Mind Express on Windows tablet AAC systems and with the present configuration users can choose to use Symbol Stix, PCS or Widgit Symbols. MindExpress is available as a demo for 60 days and SCORE will be available for 30 days. The system is being sold for £228 as a folder and £220 as a vocabulary that works with MindExpress.

You may have noticed that colour coding has been used with the symbols. In this case the a modified version of the Fitzgerald key colour system has been used to encourage correct sentence structure.

“Modified Fitzgerald Key

Blue: Adjectives
Green: Verbs
Yellow: Pronouns
Orange: Nouns
White: Conjunctions
Pink: Prepositions, social words
Purple: Questions
Brown: Adverbs
Red: Important function words, negation, emergency words
Grey: Determiners ” Praactical AAC . Another example of the code is shown below.

Fitzgerald colour key

The SCORE symbol layout system illustrates how important it is to aim for the smallest number of keystrokes that can be achieved to select a required word. So high frequency words can be reached with one stroke, most are two strokes away and fringe words should not be more than four key strokes away. When working in different languages (for bilingual situations) it is important to not only have the core words within easy reach, but to also be aware of word placement within phrases and sentences with correct use of grammar. This means that charts may have parts of speech appearing in different places depending on the language being used.

The SCORE vocabulary allows for the use of natural language, with a full range of correct grammar, to create sentences with both symbols and alphabetical options so suits both children and adults. Users can adapt charts with additional symbols and layouts, but it is important to maintain consistent word/symbol positioning for individual languages, so that predictable motor patterns can be developed to aid automaticity and speed communication.

International Symbol Dictionary for AAC

Global Symbols for All