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January - February 2000March - April 2000(published July 2000)

Volume 13Numbers 1 and 2

Clinical NewsGestures in AAC

Case ExamplesCarlos and Billy

For ConsumersMyths and realities

AssessmentAssessing gestures

InterventionTeaching gestures

On the WebWebsites on gestures

The AAC-RERCRERC projects: Year 2 update

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Gestures in AACwith Mary Hunt Berg

Gestures are actions performed withthe intent to communicate. Theyalso are an adjunct to speech, addingto the meaning of utterances.Gestural actions involve the use offingers, hands and limbs (waving,pointing, pounding), facial features(blowing a kiss, a grimace) and totalbody movements (bouncing up anddown).2

Gestures enhance meaning forboth speakers and listeners.3 Theycan function as utterances, standingon their own (e.g., thumbs up), or ascomponents of utterances. Some

gestures alternate withspeech (“It goes likethis…,” he said,making a circular

motion). Other gesturesaccompany and can facilitate speech(moving hands while giving direc-tions). Gestures, like speech,perform important communicativefunctions. They also help define theunique interaction styles of eachperson.

When speech is unavailable,gestures become an even morecritical component of an individual’scommunication system. Gesturesplay an important role across thelifespan for all people, especiallythose who rely on AAC. 4 Someaugmented communicators usemanual signs, but everyone uses

In the sixties and seventies bodylanguage was a popular topic ofmagazines and books. Now, thepopular press seems more interestedin body building than body lan-guage. I recall learning aboutBirdwhistle’s research on nonverbalcommunication back then... when Iwas in graduate school. Reflecting, Ialso realize that every single aug-mented communicator I’ve everknown has used gestures (no matterwhat other AAC techniques they’veused); and many have used themquite creatively and very effectively.Yet, in our literature and at ourconferences, there has been littleattention paid to the role thatgestures play in AAC intervention.

Gestures can play many roles inenhancing the communicativecompetencies of someone who relieson AAC. Little is currently knownabout how various AAC systemcomponents interact with anindividual’s use of gesture, or howthe use of gesture affects the devel-opment of other AAC modalities.One valuable role gestures play is to“disambiguate” messages. Forexample, if someone understandsbut cannot produce the names ofobjects clearly (e.g., says the samesound “kuh” for car, cup, candy,etc.), the message may not beunderstood. Gestures (pointing ormanual signs) can increase theintelligibility of an augmentedcommunicator’s output and thusincrease the efficiency, ease and

success of interactions.Another role gesturescan play is enablingpeople who are at a

non-symbolic level tohave a means of expression. Requir-ing someone to use speech orgraphic symbols for communicationbefore they are ready or capablemay contribute to communicationfailure and reduce the person’sdesire to communicate (thus feedinginto a passive communication style).

Why should AAC professionals,augmented communicators andparents/caregivers care aboutgestures? As Susan Goldin-Meadowsaid, “Gestures are an importantwindow to the mind, one that

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Clinical News, Continued from page 1

Upfront, Continued from page 1

gestures to regulate interactions andconvey information more efficiently.In AAC, gestures are referred to as atype of “unaided” communicationand are readily used in combinationwith other AAC techniques.

Kendon continuumKendon, a gestural researcher,

proposed that gestures exist along acontinuum. In this continuum, asdescribed below and depicted inFigure 1, the obligatory presence ofspeech declines as (1) the language-like properties of gestural behaviorsincrease and (2) idiosyncraticgestures are replaced by sociallyregulated signs.

5 Kendon’s con-

tinuum is useful both in observingand describing how people use

gestures:

♦ Spontaneous gesticulations.Spontaneous gesticulations areon one end of the continuum.

While seemingly unintentionaland nonlinguistic, they accom-pany and facilitate the process ofspeaking. They do not occurwithout speech.

♦ Language-like gestures.Language-like gestures are iconicand metaphoric, but they lackconsistency and are context-dependent. For example, acircular movement may refer to“a tape recording” or “returning”or “repeating.” Meaning dependson the message being conveyedthrough speech.

♦ Pantomime is a way of convey-ing information using gestures todepict an event, experience orfeeling. Pantomime requires theuse of shared conventions, butthere are no linguistic rulesunderlying the meanings con-veyed. A sequence of panto-mimed gestures functions like aseries of snapshots rather than alinguistic utterance.

♦ Emblems are single gestures thathave well-defined meanings.Emblems differ from culture toculture, but often express positivefeelings or insults and obsceni-ties, e.g., expressing an opinionabout someone’s driving behav-ior. Emblems differ from reallanguage forms in that they arenot typically combined insentence-like utterances. Em-blems do not need to be accom-panied by speech.

♦ Sign language is at the linguisticend of Kendon’s gesture con-tinuum. Sign languages are avisual form of language. Singlemanual signs have specificmeanings and are combined withother manual signs according tospecific rules (syntax). Whenaugmented communicators use

researchers ignore at their peril.”Gesture is a widespread androbust phenomenon, occurringacross ages, tasks and cultures.1

Our Berkeley CA AAC StudyGroup began reading and discuss-ing the role gestures play (orshould play) in AAC interventionalmost one year ago. Without thisgroup, most particularly MaryHunt Berg, this issue of ACNwould not exist. She and FilipLoncker provided much of thecontent. Mary Wrenn, NicoleLiborin, Elisa Kingsbury andNaomi Dayton contributed caseexamples (unfortunately we wereable to use only two). Also, MaryHunt Berg and Filip Lonckerpresented some of this informa-tion at the ISAAC BiennialConference in D.C., August 2000.

Clinical News introducesinformation about gestures and therole they play in the developmentof communicative competence.Case Examples shares informa-

tion about the gestures two youngaugmented communicators usewith peers, teachers and parents.For Consumers points out mythsand facts about gestures. TheAssessment and Interventionsections offer suggestions toincorporate into our clinicalpractices. Finally AAC-RERCsummarizes current progress inresearch activities at the leadinstitutions participating in ourAAC “virtual” research andengineering center.

Sarah W. Blackstone,Ph.D., CCC-SPP.S. Don’t forget to check out ourwebsite (www.augcominc.com)

Figure 1. The Kendon continuum

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Continued on page 4

manual signs, they typicallyfunction as emblems, rather thanas sign language.

Cultural basis of gesturesThe meanings of specific

gestures vary widely, depending onthe functional and cultural context.In the USA, for example, a shrug ofthe shoulders means I don’t know. Ahead crooked to the side may mean,I’m thinking about that or I’m notsure. Gestures such as crossing yourfingers to mean good luck areculture-specific. When visitinganother country, people may inad-vertently use gestures that havemeanings they are unaware of. Forexample, in Thailand, pointing withone’s foot is an insult, while in theWest, it can mean it’s over there.

Gestures can be taughtThe development of meaningful

gestures is a collaborative process,i.e., it is dependent not only on aperson’s intent to convey meaning,but also on the partner’s recognitionthat a message is being conveyed.

Gestures, by definition, may beunconventional or even uninten-tional to be communicative. Manychildren and adults who dependupon AAC have communicativesignals that are difficult to observeand interpret. Nevertheless, idiosyn-cratic signals can (and do) developinto meaningful gestures. Readabil-ity (the ease with which partnerscan assign meaning to a physicalbehavior) and predictability (theease with which partners can predictthe meaning of behaviors in aspecific context) often determinewhether a gesture becomes part of aperson’s communicative repertoire.6

In fact, individuals who use AACtechniques often create their ownidiosyncratic gestures. For example,Tony, who has cerebral palsy and

uses a range of AAC strategies,wiggles his foot when he wants totalk about Nintendo. This gestureemerged because he runs thecontroller with his foot.

Development of gesturesEarly gestural development (like

speech development) requires thatadults collaborate with children tocreate shared meaning. This requiresthat adults both recognize andrespond to a child’s gestures asmeaningful communication signals.For example, when a “bouncygame” is interrupted and the childwants it to continue, the parentinfers meaning from the child’sbehavior (bouncing) and may say,Oh, you want to do it again! Recog-nizing behavior as meaningful andthen labeling it increases the likeli-hood that a meaningful gesture willbecome established.

Table 1 depicts how gesturesdevelop in young children. First toemerge are deictic gestures. Theyare nonrepresentational and contextbound. Pointing, reaching andgiving are examples of deicticgestures. Initially, children use theseas contact gestures, then proximal

and, finally, as distal gestures.Representational gestures alsodevelop early. These gestures oftenhave fixed references and emergefrom daily routines.7

Ten reasons to encouragegestures

There are many reasons toincrease the gestural repertoires ofaugmented communicators.

1. Gestures are always available anddo not require equipment.

2. Gestures convey informationefficiently. Augmented commu-nicators can use gestures to makeinteractions more efficient,which will enhance communica-tive competence.

3. Everyone uses gestures. Gestur-ing is integral to the communica-tion process and may reflect oreven facilitate the thinking thatunderlies spoken language.5

Children who are blind usegesture despite having never seena gesture.8 Deaf children notexposed to speech or signlanguage spontaneously invent

Table 1. Development of Gestures (adapted from Volterra & Erting, 1994)7

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Clinical News, Continued from page 3

language-like “home sign”systems.9 People with severephysical impairments often usegestures that convey meaning.

4. Even highly subtle gestures areinterpretable. Sign languageresearchers are still discoveringhow deaf individuals assignmeaning to the facial expressionsused in conjunction with manualsigns. Ongoing research suggeststhere are at least 50 morphologi-cal markers, i.e., meaningfulunits expressed in facial move-ments, that occur on the face inAmerican Sign Language—ASL.In sign language, the faceprovides prosody (tone of voiceand intonation), and eyebrowsare used as conventionalizedmorphological markers.10

5. Gestures are useful across thelife-span. AAC clinicians canfacilitate the use of gestures ineach individual’s AAC repertoire,even those with restricted move-ments, and as a result buildcommunicative competence forthe future.

6. Gestures may help developinternal representations/concepts.When infants begin to usegestures, they are not aware theirbodies are a medium of expres-sion. Early gestures depictactions, not referents or theirproperties. For example, whendrinking from a cup, a child isbuilding a mental representationof what a cup does. Only laterwill the child’s concept of cupinclude his knowledge that it is adrinking utensil, a round objectwith a handle, and so on.11

7. Gestures are important forcommunication development.Early gestural production func-

tions “much like the boostingstage of a rocket propelling earlyproductive language”12 Develop-mentally young children maypractice initiating and respond-ing, turn-taking, requesting andsharing using simple gestureslong before they begin to usewords, manual signs, AACdevices and graphic symbols.

8. Gestures may actually facilitatethe development of symbolicabilities. Encouraging someoneto use physical behaviors insymbolic ways may facilitate theeventual use of other symbolicforms.13

9. Enhanced gestural input maybenefit language development.Enhanced gestural input occurswhen adults mindfully usegestures and signs (invented orborrowed from sign languages)to facilitate early speech andlanguage development. Research-ers and clinicians are nowencouraging parents of youngchildren to use “enhancedgestural input” with childrenbecause gestures are so closelyand supportively linked toachievements in languagedevelopment.13,14 Before andduring the one word phase, forexample, children seem able toutilize input in both forms(gesture and spoken language).Some favor gestures; othersgravitate toward spoken words.The extent to which childrendevelop a predominance ofgestural communication maydepend on the severity of theirdelay in developing speech.11,15

10. For individuals who do notunderstand that pictures representa specific existing reality,gestures provide access tomeaningful expression. Research

suggests that it may be develop-mentally inappropriate to usepictures as symbols at earlystages of development,16 espe-cially when gesturing is possible.In typical development, childrenunderstand and use physicalgestures as symbols at about 12months—the same time theybegin using words.13,17 However,typically developing children donot understand that picturesrepresent a specific, existingreality until they are almost threeyears old.16

SummaryResearch and best practices

suggest that people who have severespeech impairments and rely onaugmentative communicationtechniques benefit greatly from theuse of gestures in their daily activi-ties, throughout the life span. Tomaximize these benefits, we need(1) to understand more clearly basicinformation about gestures and therole they play in the development ofcommunicative competence, (2) toappreciate the many reasons forencouraging the use of gesturesamong augmented communicatorsand (3) to learn how to support andreinforce the use of gestures moreeffectively.

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Carlos and BillyAs the Berkeley Study Groupmembers began learning aboutgestures and applying what welearned to our clinical work, webegan to notice many more waysaugmented communicators wereusing gestures and how essentialgestures were to successful interac-tions. Two brief examples follow:

Example #1: Carlos, a 6-year-old boy with cerebral palsy, spasticquadriplegia, severe hypertonia anda seizure disorder, relies primarilyon his left hand for fine motor tasks.He has a manual wheelchair formobility, but he is only able to pushhimself for short distances. He livesin a bilingual household and isincluded in a first grade classroom,with support from a special educa-tion teacher, instructional assistant,speech/language pathologist,occupational therapist, assistivetechnology specialist, adaptive P.E.teacher and physical therapist. Hisreceptive language skills are moder-ately impaired, and approximate athree- to four-year-old level. Hisspeech is severely dysarthric andintelligibility is poor. In addition tovocalizations and word approxima-tions, Carlos uses a DynaVox,language boards, manual signs,gestures and miming to communi-cate.

Gestural repertoire: Carlos usesspontaneous gesticulations, lan-guage-like gestures, pantomime andemblems (manual signs) to clarifyverbal attempts and/or discuss topicsnot accessible with his DynaVox orlanguage boards. For example:

♦ When asked what hehad done the previousweekend, Carlos usedboth hands together to

mime using a lightsaber, in order to explain he

had watched “Star Wars.”

♦ He pointed to the ceiling andshivered to explain that a loudnoise on the roof scared him.

♦ He bared his teeth and bit whilepointing to the multi-use room inorder to explain there had beenan assembly with an alligator thatday.

Other students in his class serveas interpreters and understand manyof his gesture/signs. One classmateexplained that by pointing to thepumpkin on his language board andthen making an I LOVE YOU signdirected toward the floor (similar tothe way Spiderman shoots websfrom his wrist), Carlos was tellingeveryone he was going to beSpiderman for Halloween.

Example #2. Billy is an eight-years-old boy with an acquiredencephalopathy. His academic andlanguage skills are delayed, approxi-mating the five-year level. He hasexcellent social skills and is enrolledin a special day class in a non-publicschool—with 20% of his day in asecond grade general educationclass. He uses speech approxima-tions, gestures, manual signs,communication displays withgraphic symbols and a VanguardAAC device with Unity software togenerate utterances for which heknows the symbol sequences. Onlow-tech displays, he combines oneor two symbols with gestures toproduce messages.

Gestural repertoire: Billy usesspontaneous gesticulations, lan-guage-like gestures, (thumbs up/

thumbs down), emblems (inventedsigns and manual signs like FIN-ISHED, PLEASE) and mime.Exampls of his gestures are:

♦ Points hand toward speaker and“clicks” the remote button (Bemute/stop talking.)

♦ Drums on his cheek (Wait aminute.)

♦ Taps his temple (I’m thinking.)

♦ Hand up (Stop.)

He mimics actions using his wholebody and his hand.♦ When he saw a boa constrictor at

a school assembly he imitated theway it wriggled its body andmoved its tongue as he watchedit.

♦ After a helicopter flew over theplayground at recess he movedhis hand in circles over his trayand pointed to the sky.

SummaryYogi Berra said, “You can ob-

serve alot just by watching.” Byobserving people like Carlos andBilly from the specific point of viewof their gesturing habits, we are ableto get a more complete picture oftheir communicative competence.

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Myths and realitieswith Filip Loncke

Myth #1. Gestures can slow downthe development of speech anddecrease a person’s motivation totalk.Reality. This is an ever-recurringmyth! Exactly the same is said aboutmanual signing, graphic symbolsand voice output communicationdevices. This myth is also known asthe “incompatibility hypothesis.”18

No research supports it. On thecontrary, hundreds of case studiesshow individuals can and do acquirespeech after learning other commu-nication systems first, just as peopleacquire multiple languages. Forexample, thousands of hearingchildren with deaf parents developsign language as their first languageand learn to talk later on.

Also, when people learn to readand write, they use graphic symbols.If the incompatibility hypothesiswere correct, the more literatesomeone became, the more speechwould be lost. Instead, individualswho are frequent readers are oftenmore fluent speakers.

As for gesture, there is animpressive amount of evidence thatgestures help launch speech devel-opment. Thus, researchers andclinicians are now encouragingparents with young children to usegestures and a number of manualsigns (from sign language) tofacilitate their child’s early speechand language development.13

Clinical and experimental reportsof AAC users demonstrate thatindividuals who rely predominantlyon gestures in presymbolic stages of

communication oftentransition to usingsymbolic communica-tion forms.19 There alsois evidence that gestures

can help people access speech, andmay actually enable individuals withword finding difficulties (the tip ofthe tongue phenomenon) to retrievea word. For some adults withaphasia (a severe difficulty in usinglanguage and speech), gesturaltherapies have been used to improvelanguage and communicationskills.

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Myth #2. By using gestures, aperson will lose the motivation touse other communication forms.Reality. This myth assumes that the“law of effect” and the “law of leasteffort” guide people’s communica-tion behavior.21

♦ The “law of effect” states youwill be satisfied once you reachyour goal. If gesturing gets youwhat you want, you won’t botherto use anything else.

♦ The “law of the least effort”implies you will not want toinvest time and energy learningdifferent forms of expression ifyou can do the job the easy way,i.e., by gesturing.

Both are misleading. Eachdisregards issues of effectiveness incommunication. Gestures, becauseof their inherent limitations, mayactually motivate people to learnlinguistically-based communicationforms. For example, you’re morelikely to get the snack you want ifyou combine a pointing gesture witha graphic symbol or word.

Myth #3. Gestures can only beused if the motor system is intact.Reality. Gestures are like handwrit-ing—each person has a gesturalstyle that reflects his or her person-

ality. Some use big, expressivegestures whenever they speak, whileothers use small gestures ratherinfrequently.

Individuals with motor impair-ments may use gestures in ways thatare different and perhaps subtle, buttheir gestures are still appropriateand can be meaningful when othersunderstand them. Gestures, evenidiosyncratic ones, can help get apoint across, structure a message,indicate the need to say something,and convey agreement or disagree-ment with what is being said. Unlikemanual signs, there are no strictrules about how to produce a “good”or “appropriate” gesture. All indi-viduals have different gesturingstyles. What counts is effectiveness.

Myth #4. Gesture and signlanguage are the same.Reality. While gestures developalongside spoken language, signlanguages develop as a substitute forspoken language. Gestures andmanual signs may look alike andmay even be identical, but there aremajor differences. First, the manualsigns of sign language are producedand sequenced according to gram-matical rules widely accepted by thelinguistic community. Sign languageusers can tell you when you’ve madean error, much like speakers ofspoken languages can correct yourmispronunciations and syntax.Gestures are not language and carryno strict rules. Also, no one is likelyto say, “Hey, you used the wronggesture.”

Myth #5. When you use manualsigns and gestures as supplements tospeech, you are using sign language.Reality. Many people who havedifficulty talking learn to use some“signs” to express ideas and refer topersons and things. Typical manualsigns taught are TOILET, MOREand FINISHED. When someone

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uses manual signs, it does not meanhe is using sign language anymorethan it means someone who says, “Iwant a burrito,” is speaking Spanish.

Fluent signers of ASL will signMORE YOU? with raised eyebrows,tilting their head slightly backwardto mean, Do you want more? Incontrast, individuals who use a fewmanual signs as AAC symbols arelikely to sign MORE and then pointto a graphic symbol or a person toask, Do you (or someone else) wantmore? The language of the AACuser in the example is English. Themanual sign serves as a meaningfulgesture that accompanies an utter-ance.

Myth #6. Gesture is only impor-tant at very early stages of commu-nication development.Reality. Gestures continue to playan important role throughout the lifespan. Psycholinguists like McNeillbelieve that humans who speak areusing a double channel system—spoken and gestural.5 Gestures serveas both a support and rescue system.For example, in giving directions,most people use gestures.

Myth #7 As speech outputcommunication devices becomemore advanced, gestures and signswill become less useful.Reality. Even when we have equip-ment ten times more sophisticatedthan we now use, speech itself isvery unlikely to disappear andneither will gestures. Speech andgestures are basic biological func-tions in humans. Some anthropolo-gists and psycholinguists feel thathuman gestures are even moredeeply rooted in our genetics thanspeech. While this is controversial,the fact remains that gestures areacquired naturally and are used byhumans to master, convey andreceive information.

Myth #8. The use of gesturesoccurs in a similar fashion acrossall cultures.Reality. It is important to payattention to the background and theculture of an augmented communi-cator before introducing gestures.5,22

Gestures are used more explicitly insome cultures than others. Thestereotype is the Italian man whoshouts, moves his hands and waveshis arms to make a point. In theJapanese culture, men and womenare more restrained in their use ofgestures. In southern Europeannations, wide gestures are commonand perceived as normal, but peoplein Nordic European countries mayinterpret those gestures as inappro-priate or bizarre. Also there areconventions for male and femalegesturing. Making the wronggesture to another driver on a LosAngeles freeway can constitute alife-threatening act.

AAC users are more likely tolearn gestures that are emphasized,visible and acceptable within theircommunities. Thus, in cultureswhere gestures are used morediscretely, clinicians may discusswith the person and caregivers thetype of gestures to encourage.Myth. #9. The purpose of gestures isto clarify the messages of a speakerso the listener will understand them.

Reality. Gestures are usedregardless of whether the listenerunderstands the message. This isobvious during phone conversations,when people often wave their handseven though their communicationpartner can not see them. One rolegestures play is to help speakersplan messages and access sentencestructures and words.

SummaryGestures are an important

component of everyone’s communi-cative repertoire. This sectiondiscussed some of the myths thatsurround the use of gestures. Thesemyths can be harmful. They canlimit the way AAC professionals,augmented communicators andfamily members think about ges-tures. In our current clinical prac-tices, too little consideration is givento gestures. The reality supports aneed to pay serious attention to theuse of gestures throughout the lifespan of each person who relies onaugmentative communicationdevices, techniques and strategies.

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Assessing gestures with

Mary Hunt Berg & Filip Loncke

This section suggests ways to assessthe gestural behaviors of augmentedcommunicators. The approachesdiscussed include parent/caregiverreport, interviews with augmentedcommunicators and their partners,naturalistic observations and tasksthat elicit gestures. These ap-proaches are not mutually exclusive.More than one approach may beneeded to insure a valid and reliableassessment

Parent/caregiver reportParents, spouses and others close

to an augmented communicator havevaluable information about how theindividual communicates. In addi-tion, the greater the communicationpartner’s knowledge about AACtechniques, the better. Thus, involv-ing primary partners in the assess-ment process makes sense. Two waysto collect information are:

Diary. A diary describing specificgestures, when they are used, howthey are produced and whether theyoccur in combination with vocaliza-tions, graphic symbols, speech andAAC devices can provide valuableinformation about a person’s gesturalrepertoire. Diaries can also revealpatterns of gestural development overtime and information about the use ofother AAC techniques.

Checklist. A portion of theMacarthur Communication Devel-opment Inventory: Words andGestures includes commonlyproduced gestures, actions and playbehaviors for use with very youngchildren.23 Even when a particular

child’s gestures differfrom those listed in theinventory, the formatcan help parents

understand what typesof gestures to look for.

InterviewInterviews with augmented

communicators and/or primarycommunication partners enableservice providers to ask about dailyroutines, and how the personcommunicates special needs orrequests across contexts. Interviewsare often used in conjunction withother methods.

Interview questionsHow do you know that___wants more food?

How do you know__ has enough food?

When___is frustrated, how do you ascertain thereason for the frustration?

How does__ refuse something?

Questions like the ones above, alongwith naturalistic observations, allowspeech-language pathologists andothers to understand more about thegestures and other modes a personuses with familiar partners.

Signal inventory. In 1991, HuntBerg and Blackstone developed atool to assist in gathering informa-tion from parents and serviceproviders about the gestural behav-iors a person uses to express variouscommunicative functions.24 (See

Cynthia Cress’s website for a recentexample: www.unl.edu/barkley/present/cress/csichart.html)

Personalized gesture dictionary.As depicted in Table 2, a gesturedictionary contains informationsimilar to the signal inventory. AnAAC team develops the dictionaryearly in the intervention process andcan use it to measure progress.25

Naturalistic observationsService providers can learn

methods for observing gestures forbrief periods of time, across con-texts and partners. Sometimesnatural observations can helpidentify subtle communicationbehaviors that otherwise would havegone unnoticed. The ReadabilityChart in Table 3 is helpful in struc-turing naturalistic observations.6

For a highly detailed analysis ofgestures, the CHILDES system nowincludes options for coding thegestures and signs produced duringnatural interactions (childes.psy.cmu.edu).26 Although language research-ers are the primary users of theCHILDES system, speech-languagepathologists may find it increasinglyhelpful. It now offers conventional-ized transcription and codingschemes for a detailed analysis ofgesture and manual signs, in additionto spoken language.27 The potential

Table 2. Personalized gesture dictionary

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Table 3. Determining the readability of gestures(adapted from Kublin, Wetherby, Crais & Prizant)6

application of this approach toresearch in AAC was discussed at theISAAC’s Research Symposium inAugust 2000.

Eliciting gesturesImitation. One way to elicit

gestures is to ask an individual toproduce the adult form of a gesture.One procedure, originally used byresearchers to explore the relation-ship between a person’s ability toimitate gestures and subsequentlanguage development, asks indi-viduals to imitate single gestures orsequences of gestures following anadult model. Imitation tasks canquickly suggest whether someone isable to learn new gestures andretrieve symbols. Research suggeststhese tasks can be used to differenti-ate children who are truly languagedelayed from those who are “latebloomers.”11

Communication temptations.Another way to elicit gestural

communication from children is touse the “communication tempta-tions” section of the Communicationand Symbolic Behavior Scales(CSBS).28 These tasks elicit a child’suse of gestures, vocalizations orwords without relying on adult verbalprompting. The temptations includestructured play formats such as wind-up toys, balloons, bubbles, peek-a-boo, Cheerios in a closed jar, toyshidden in a bag and books. Thesetasks may be used separately fromthe entire CSBS battery.

Other tasks. Other tasks that mayelicit gestures are borrowed fromresearch paradigms. Effective waysto elicit gestures include: (1) askingsomeone to give directions to aspecific location, (2) retelling a storyabout some adventure and/or (3)participating in conservation tasksand explaining why quantities don’tchange.

1 Depending upon the type of

gestures a clinician wants to elicit,

these tasks can provide valuableinformation.

What do these data tell us?Because a major goal of AAC

intervention is to increase communi-cative competence across the life-span, the more we know about allaspects of the person’s communica-tion system, the better. An assess-ment of gestural behavior answerssome important questions: “Does anindividual use meaningful gestures?How effectively? For what purposes?How frequently? It also helps clarifywhat modes a person relies on andunder what circumstances.

Fortunately, researchers havedeveloped some new and useful toolsthat can make the assessment ofgestural behavior more systematicand more accurate. It behooves us tobecome better informed about theways in which these tools cansupport and improve clinical practice.

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Teaching gestureswith Mary Hunt Berg

All augmented communicators usegestures. Many use gestures as apreferred mode of communicationin specific situations. This is true forthose who are literate and competentAAC device users, as well as thosewho are at early stages of communi-cation development. Together withlimited speech, gestures can be afaster and more efficient way toachieve shared understanding thanusing graphic symbols or VOCAs.29

An AAC assessment helpsdetermine which gestures arealready in use and which behaviorscan be shaped into more effectivecommunication acts. During dailyactivities, there are multiple oppor-tunities to shape physical signalsand behaviors into gestures.

The transactional nature ofcommunication is reflected in the“input, intake, output, and uptake”paradigm.

• Input refers to the social andlinguistic context, i.e., theamount and type of language(spoken, graphic, manual) aperson is exposed to over time.

• Intake refers to an individual’sunderstanding of language andother forms of communicationover time.

• Output refers to the augmentedcommunicator’s expressiverepertoire—the quantity andquality of speech, manual signs,gestures, graphic symbols andspeech output from a device, etc.

that a person produces innatural contexts.

• Uptake refers to thepartner’s understanding

of the augmentedcommunicator’s output, i.e.,

the intelligibility (comprehensi-bility) of the communication actsproduced.

Each component of this paradigmco-occurs with the others, contribut-ing to the communication process. Auseful way to help plan for AACintervention is to consider eachcomponent of the process. In aprevious issue of ACN (volume 10,#1 and 2), the paradigm was used toorganize intervention planning forthe development of language inindividuals who use AAC.30 In thisissue, however, “input, intake,output and uptake” are used to helpus think about how to increase thequantity and quality of an aug-mented communicator’s gesturalrepertoire. The paradigm reflects thecomplexity of the communicationprocess and seeks to clarify specificcomponents for intervention.

Some ideas follow that mayassist clinicians, teachers and familymembers who wish to support theuse of gestures. The augmentedcommunicator produces messagesand needs to understand what peopleare saying/doing. Partners provideessential input and also interpret theoutput (including gestures of theaugmented communicator.

InputTo support the development of an

augmented communicator’s gesturalrepertoire, speech-language patholo-gists and others can teach primarypartners about the importance ofgestures and help them recognize,value and respond to the augmentedcommunicator’s gestural behaviors.

Examples are:

• Giving partners informationabout how gestures develop andteaching them (1) what to lookfor, (2) how augmented commu-nicators use gestures and (3)what they can expect. This canhelp partners provide moreappropriate input.5,11

• Helping communication partnersto notice and interpret idiosyn-cratic gestural behaviors asmeaningful, so they can giveinput in ways that facilitatesuccessful interaction andlearning.

• Providing gestural feedback.Gershoff-Stowe shows thatimitating and responding tosomeone’s gestural productionsand idiosyncratic movements islikely to increase both thenumber of different gestures aperson uses and the frequency ofgesture use.31

• Providing enhanced gesturalinput. This means that cliniciansand caregivers use ordinarygestures and add other gestureswhen interacting with the aug-mented communicator. Additionalgestures used for input includethose that are specifically adaptedfrom action schemes, invented bythe individual or borrowed fromsign language.14

IntakeTo increase an individual’s ability

to understand available communica-tion forms, including gestures, aspeech-language pathologist maywork toward increasing comprehen-sion of gestures and other communi-cation modes. Examples are:

• Being responsive. People tend tolearn the gestures that otherpeople respond to. Researchsuggests that children who use

11

frequent, clear communicationhave mothers who respond totheir communication behaviors asmeaningful and try to negotiatethe meaning of unintelligiblecommunication behaviors.2,31

• Labeling the person’s gesturalbehaviors using spoken language.Higher rates of facilitative input(verbal models of nonverbalbehaviors) may help the aug-mented communicator under-stand the meaning and value ofgestures and may result in higherrates of gestural communica-tion.31

• Increasing the person’s repertoireof re-enactment gestures. Ges-tures that consist of repeating anaction from an event to make itreoccur are known as enactive-indexical gestures. They show aperson has communicative intent,even when they have a limitedsymbolic means to express thatintent.11 By increasing the use ofre-enactment gestures, partnersmay facilitate symbolic develop-ment.

• Research demonstrates that whencaregivers present messages bysaying with words and showingwith gestures, children bettercomprehend the spoken input.32

Output Encouraging people to use

symbolic gesturing not only in-creases the number of gestures intheir repertoire, but also increasesthe frequency of gestural communi-cation and may even facilitatecognitive and spoken languagedevelopment. AAC professionals canencourage output by:

• Increasing the intelligibility,readability and predictable use ofthe person’s gestures.

• Encouraging the use of gesturesin conjunction with other AACtechniques and natural speech.Best practice in AAC supportsthe use of multi-modalities.

• Teaching augmented communi-cators how to use gestures andgraphic symbols. When gesturesare produced in conjunction withgraphic symbols, meaning maybe more easily understood thansimply touching or pointing to agraphic symbol.29 AAC users canuse gestures that are redundant inmeaning to clarify messages, foremphasis or to supplementgraphic symbols on a low-techdisplay or a voice output device.

• Encouraging individuals tocommunicate using their bodies.Research suggests gestures mayserve as a scaffold to the devel-opment of conventional symbollearning and use.1, 11

• Providing prompts during interac-tion to encourage gestural use.Prompting strategies includemovement cues,33 waiting andproviding meaningful conse-quences when a specific gestureis produced.29

• Teaching gestures with uniquecombinations of motor actionsthat are distinct from one another(i.e., differ widely in handshape,arm movement, location).29 Forexample, gestures for ‘eat’ and‘drink’ are likely to be similar,thus clinicians would not teachthese gestures at the same time,especially to people with im-paired motor skills and to thosewho are in the early stages ofcommunication development.

• Providing opportunities toengage in gestural imitationtasks. For example, when a childimitates movements, the adult

and child share an experienceand an understanding. Gesturalimitations can be taught in thecontext of songs, games andrepetitive action routines.

• Creating opportunities to usegestures during daily communi-cation exchanges. Gesturesprovide a means to engage infunctional communicationexchanges and lay the foundationfor communication using non-speech symbols and signals.Creating ritualized routines thatinclude the use of gestures mayhelp develop larger gesturalrepertoires.

UptakeA major purpose of the field is to

increase the intelligibility of anaugmented communicator’s commu-nication attempts. AAC profession-als can increase the uptake ofgestures by:

• Helping people identify idiosyn-cratic gestures. Responsivecommunication partners noticemovements that are entirelymissed by the general public, oreven those who know the personbut are not as “tuned in.” AACclinicians and teachers who arefocused on teaching someone touse AAC may inadvertentlydisregard the person’s meaningfuluse of gestures.

• Videotaping the person duringinteractions with primary part-ners. Sometimes it is easier to seegestures as a component of anoverall AAC intervention afterwatching a videotape. Videos canhelp primary partners and serviceproviders reach consensus aboutthe importance of their owninput, as well as their ability to

Continued on page 12

12

Intervention, Continued from page 11

understand and respond to thecommunication gestures of anaugmented communicator.

• When necessary, replacingidiosyncratic gestures. While it iscritical to understand the intendedmeaning of an individual’sidiosyncratic gestures, cliniciansmay need to reshape thesebehaviors to be more conventionalor more socially acceptable.Guidelines for replacing existingbehaviors include: (1) make surethe new form has the samecommunicative function as theoriginal behavior and (2) makesure the new communicationbehavior is more efficient thatthan the original behavior withregard to ease of production andreadability by partners.29

SummaryGestures are an important form

of communication output foreveryone who relies on AAC,regardless of age, motor ability, ordevelopmental level. They conveyinformation and regulate interactionand are always available. Even themost physically involved augmentedcommunicators use gestures,including pointing and head shakesin conjunction with graphic symbolsand AAC devices. Yet gestures arerarely highlighted in our trainingprotocols or mentioned in ourliterature. This section providedsome ideas that may help clinicians,teachers and family members tosupport the use of gestures as onecomponent of an individual’s multi-modal communication system.

HOT off the press!Beneath the Surface: Creative Expressions of

Augmented Communicators

Edited by ACI’s Michael B. Williams & Carole KrezmanThis anthology contains the creative works of 51 augmented communicatorsfrom 12 countries. Through art, poetry and prose, the authors, and artistsexpress their views and dreams of love, life, war and everyday experiences.Useful to clinicians, educators, manufacturers and their representatives,augmented communicators and their family and friends. It demonstrates thepositive outcomes of the field and will make a thoughtful gift.

$23 US ($18 for members of ISAAC) plus postage and handling charge. Multiple copyrates are available. Contact: ISAAC, 49 The Donway West, Suite 308. Toronto, ON McC3M9 Canada. 416-385-0351 (phone); 416-385-0352 (FAX); secretariat@isaac-online.org;www.isaac-online.org

Websites on gestures

http://allsands.com/Kids/Education/babysignlangua_rql_gn.htm

This webpage describes the popularphenomenon of “Baby Signing” fromthe perspective of a mother with ahearing impairment. She describes herpositive experience with her son usingthis approach.

http://www.babysigns.com/

Researchers Linda Acredolo and SusanGoodwyn describe their approach ofencouraging symbolic gesturing inyoung children. The site highlights theirpopular book, Baby Signs. You candownload pictures of children usinggestures.

http://www.sigmaxi.org/Amsci/articles/99articles/corballis.html

A lengthy article describing the role ofgesture in the evolution of language. Itintegrates infomation from diverseresearch areas: the neurology oflanguage, the sophistication and cross-cultural nature of sign languages andthe ability of apes to communicate withsigns. It links to other websites.

http://www.ccp.uchicago.edu/faculty/David_Mcneill

David McNeill is aleading researcher ingesture at the University

of Chicago. His websitedescribes research that involves thegesture-language interface. It listsrelevant publications and presentations.

http://www.ccp.uchicago.edu/faculty/Susan_Goldin-Meadow/

Susan Goldin-Meadow’s researchexamines non verbal communication,specifically gestures. The site summa-rizes current and past research andprovides links to descriptions of currentresearch, publications and other usefulgestural research sites.

http://more.abcnews.go.com/sections/living/null/deafkids0115.html

How Deaf Kids Learn to 'Talk' - It's inthe Hands. This ABC News webpage isfun and easy to understand. It summa-rizes research on how deaf childrengesture and sign and has links to videofootage from studies conducted at theUniversity of Chicago.

http://zen.sunderland.ac.uk/%7Ehb5jma/1stbersn.htm

This site links to a number of differentsites on nonverbal communication,nonverbal behaviour, gesture, posture,and related areas. It is useful forresearchers and others. Note: Some ofthe links do not work.

13

Year 2 UpdateAs Year two of the AAC-RERCproject nears an end, researchers anddevelopers at lead institutions arereporting exciting progress. Thisissue updates the progress of theAAC Rehabilitation EngineeringResearch “Center.” Check out theirwebsite at www.aac-rerc.com to stayup-to-date.

Research ProjectsAttitudes of AAC Users, Peers, andIntervention Professionals towardAAC Technology and its Use byElderly Persons

Lead institution: University of Nebraska,Lincoln, Principal investigator: Dr. DavidBeukelman

Purpose: To investigate the attitudinalbarriers of elderly persons withdifferent types of severe communica-tion disorders and their communicationpartners toward AAC technology and todocument any differences in theseattitudes for people whose communica-tion disorders are secondary to stroke,amyotrophic lateral sclerosis (ALS) andParkinson’s disease.

Progress. Researchers have completeda project that compared the attitudes ofAAC users with ALS, their familymembers or caregivers, and peerstoward the communication that isproduced using speech that is impaired(dysarthric), low-tech communicationbooks, and high-tech AAC devices. Ingeneral, all groups preferred high-techAAC devices over both low-techoptions and dysarthric speech. Theyalso preferred low-tech options overdysarthric speech. Overall, the attitudesof AAC users with ALS, their spousesor caregivers, and their peers weresimilar.

In a second project, researcherscompared the attitudes toward a story-telling task among AAC users withALS, their spouses/caregivers andpeers. The stories were presented underthree conditions: (1) word-by-word, (2)sentence-by-sentence and (3) entire

narrative. Stories werepresented using an AACdevice with EZ Keysoftware (Words +, Inc.).All participants re-

sponded similarly. Thefull narrative presentation

was preferred over the sentence-by-sentence and word-by-word presenta-tion modes. Sentence-by-sentencepresentation was preferred over theword-by-word presentation mode.

A third project compared the prefer-ences of caregivers/family members,speech-language pathologists and peersfor storytelling. The storyteller was aman with moderate aphasia using (1)natural speech, (2) a low technologynotebook, and (3) an AAC device withdigitized speech output. Results showthat caregivers/family members,speech-language pathologists and peersresponded differently. Family membersand speech language pathologistspreferred natural speech over either thelow-tech or high-tech options. Peerspreferred the digitized speech modeover the natural speech and low-techcommunication book option.

Underway is a fourth project thatcompares storytelling by persons withmild, moderate, and severe aphasiausing natural speech, a low techcommunication book, or a digitizedAAC device. Participants in this studyare persons with aphasia and theirpeers.

The Study of Organizational Strate-gies for Adult AAC UsersUniversity of Nebraska, Lincoln, Dr. David

Beukelman

Purpose: 1) To determine the organiza-tional capabilities/preferences of threegroups of adult AAC users withacquired impairments and a group ofadults without disability; 2) to comparethe similarities and differences inorganizational preference among thesegroups and 3) to determine if organiza-tional capabilities/preferences on non-AAC tasks is predictive of performanceduring communicative interchangesusing AAC systems.

Progress: In the first project, partici-pants engage in confrontationalmessage storage and retrieval tasksusing experimenter determined andself-determined organizationalstrategies. The second project examinesthe relationship between communica-tive performance in context and

organization capabilities/preferences ofpersons using dynamic display AACsystems organized according to thestrategies studied in the first project. Acomputer-based interface, developedfor the project, utilizes a dynamicscreen strategy and allows for thepresentation of orthographic and iconicinformation using various organizationstrategies. Currently, 15 elderly adults(over 70 years of age) withoutdisabilities have participated. Theiraccuracy, rate and preference for threedifferent organizational strategies(semantic, location and theme) will becompared to other groups. Researchersare currently investigating the perfor-mance of people with traumatic braininjuries (TBI) using the researchprotocol.

Improving AAC Technologies forYoung Children with SignificantCommunication DisordersPennsylvania State University, Dr. Janice Light

Purpose: To evaluate the learningdemands of different approaches tolanguage representation, presentation,organization, and/or selection in AACtechnologies for toddlers and youngchildren; and determine empiricallybased, developmentally sound designspecifications for improved AACtechnologies and instructional protocolsfor young children with significantcommunication disabilities.

Progress: The project involves twodistinct phases. The first phaseaddresses how to organize and presentlanguage concepts in AAC technologiesto minimize the learning demands andmaximize communication power foryoung children. A major research studywas undertaken to investigate thelearning curves and functionalperformance of typically developingchildren ages 2, 3, 4 and 5, usingdifferent assistive technologies. Resultssuggest that young children withoutdisabilities have difficulty learning touse AAC devices as they are currentlydesigned. These findings have obviousimplications for children who rely onAAC. For more specifics, see theprevious issue of ACN (volume 12, #6)which focuses on the use of AAC inearly childhood.

The second phase of the project willconsider how to design selectiontechniques for AAC technologies tominimize the learning demands andmaximize accuracy and efficiency for

Continued on page 14

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AAC-RERC, Continued from page 13

young children. Initial planning for thatproject is underway.

Evaluating and Enhancing Commu-nication Rate, Efficiency andEffectivenessUniversity of New York at Buffalo, Dr. Jeff

Higginbotham

Purpose: To study factors related to thecommunication rate of current AACtechnologies and its impact oncommunicative effectiveness.

Progress: The Communication andAssistive Device Laboratory is engagedin three interrelated areas of researchand development.

Technology Development. In collabora-tion with Enkidu Research, Inc.,researchers are developing a suite ofsoftware tools to document and analyzecommunication performance. Thespecifications for a format forcommunication device logfiles arecomplete. The beta version of ananalysis program to analyze logfile datais complete. An AAC device simulatorto facilitate communication perfor-mance research is due in the Fall 2000.Work on software to facilitate transcrip-tion, coding and analysis of interactivecommunication is in progress. A hand-held computer system to facilitatedirect observation of communication isin the planning phase.

Communication Rate Research. Todevelop technologies that will over-come the current communication raterestrictions of AAC devices, it isnecessary to specify what restrictionscurrently exist and what speedsaugmented speakers need to achieve tosustain non-problematic socialinteractions. Researchers are develop-ing transcription techniques to analyzeinteractive communication rates,including a propositional analysisprotocol (in progress). They currentlyare running subjects to determine theeffect of communication rate on listenercomprehension of synthetic speechdiscourse. They are analyzing the datathey collected regarding the productionand error rates involved with learningto use four different scanning tech-niques.

Communication Performance Assess-ment Information Dissemination.Withinput from other AAC-RERC partners,researchers are developing a website thatlinks to the AAC-RERC website and

offers a variety of resources dealing withcommunication performance assessmentin AAC. Included are:

• Ethical issues related to assessment andautomated data logging (e.g., surveillance &privacy, legal implications).

• Resources to facilitate the observation andanalysis of AAC device and interactivecommunication.

• Information about RERC research oncommunication performance.

Improving Employment Outcomesfor Individuals who require AACPennsylvania State University, Dr. David

McNaughton

Purpose: To acquire detailed informa-tion on existing barriers to employmentfaced by individuals who require AACand to identify strategies to overcomethose barriers.

Progress: Two major studies areunderway.

The Employment and ALS project.Researchers conducted a 6-week longfocus group discussion on the WorldWide Web (WWW) to investigate theemployment experiences of fiveaugmented communications with ALS.A moderator presented specificquestions designed to gather informationabout the benefits and reasons forcontinuing employment, the negativeimpacts of employment, the barriers tocontinued employment, the necessarysupports required for successfulemployment and specific strategies andrecommendations that may overcomebarriers to employment. Key factors tothe participants’ ability to continueemployment were: (1) the nature ofemployment activities, (2) availability ofsupports for employment activities and(3) access to appropriate communicationsystems. Other important factors werethe participants’ personal incentives forovercoming barriers to employment andtheir self-determination.

The Employment and Cerebral Palsy(CP) project. Researchers recentlycompleted a focus group discussion onthe WWW to investigate the employ-ment experiences of 24 individuals withCP who require AAC. Participantsincluded individuals in full-timepositions in community-based employ-ment, as well as individuals who workpart-time, work for a company fromtheir home or are self-employed. Thefocus group discussions took place overapproximately eight weeks. Factorsconsidered important to obtaining andmaintaining employment were: (1)

appropriate training and experience, (2)the support of friends and familymembers and (3) effective and efficientAAC technology. Factors cited assignificant barriers to employmentincluded: (1) employer attitudes, (2) lackof appropriate educational experiencesand (3) difficulty in obtaining effectiveand efficient AAC systems. Participantsspecifically described ways AACtechnology could better meet thedemands of the workplace. They saidthey needed technology that was faster,more reliable and easier to learn.Researchers will soon be peaking withemployers of AAC users, vocationalrehabilitation councilors and parents/family members.

In Phase 2 (December 2000) researcherswill communicate with AAC users whoare seeking employment, and assist themin finding important informationresources related to employment.

Advanced ACETS (AugmentativeCommunication & EmploymentTechnology Supports)Temple University, Dr. Diane Bryen

Purpose: To increase employmentopportunities for selected graduates ofACES and other individuals who useaugmented communication bydeveloping, implementing, evaluating,replicating, and disseminating theresults of Advanced ACETS.

Progress: Participants in ACETS 99 arecurrently involved in follow upactivities. Bi-weekly contact occurswith each member face-to-face, byphone or email. Monthly timesheetstrack their progress. A full-daytechnical workshop in March onwebpage development resulted in fiveof the six participants putting up awebpage that includes their resume.One participant has a part time job in abookstore. Recruitment is underway forACETS 2000, scheduled for October21-29, 2000.

For additional information, contactKevin Caves, AAC-RERC, Box3888, Duke University MedicalCenter, Durham, NC 27710. 919-681-9983 (voice); FAX: 919-681-9984; www.aac-rerc.com

The AAC-RERC section is partially funded bythe National Institute on Disability andRehabilitation Research under grant numberH133E9 0026. The opinions are those of thegrantee and do not necessarily reflect those ofthe U.S. Department of Education.

15

Augmentative CommunicationNews (ISSN #0897-9278) is pub-lished bi-monthly. Copyright 2000 byAugmentative Communication, Inc. 1Surf Way, Suite 237, Monterey, CA93940. Reproduce only with writtenconsent.Author: Sarah W. BlackstoneTechnical Editor: Carole KrezmanManaging Editor: Harvey PressmanOne Year Subscription: Personalcheck U.S. & Canada = $50 U.S.;Overseas = $62 U.S.Institutions, libraries, schools,hospitals, etc.: U.S. & Canada=$75U.S.; Overseas = $88 U.S. Single rate/double issue = $20.Special rates for consumers and full-time students. Periodicals Postagerate paid at Monterey, CA. POST-MASTER send address changes toAugmentative Communication, Inc.1 Surf Way, Suite 237, Monterey, CA93940. Voice: 831-649-3050. Fax:831- 646-5428. sarahblack@aol.com;www.augcominc.com

Co-AuthorsMary Hunt Berg, Ph.D., CC-SLP, PrivatePractice, 183 Calle La Mesa, Moraga, CA94556. Phone/Fax 925-299-8791.huntberg@aol.com

Filip Loncke, Ph.D. International ProgramCoordination Fracaritatis, 43 JozefGuislainstraat, 9000 Gent, Belgium, Phone +329 216 35 85. Fax +32 9 216 35 51.ftl4n@virginia.edu

References1 Goldin-Meadow, S. (2000). Beyond words:

The importance of gesture to researchers andlearners. Child Development, 71, 231-239.

2 Iverson, J. M. & Thal, D. J. (1998). Commu-nicative Transitions: There’s more to the handthan meets the eye. In A. Wetherby, S.Warren, & J. Reichle (Eds.), Transitions inprelinguisitic communication. (pp.59-86).Baltimore: Paul H. Brookes.

3 Kendon, A. (1988). How gestures can becomelike words. In F. Poyatos (Eds.), Cross-cultural perspectives in nonverbal communi-cation. Toronto: Hogrefe.

4 Loncke, F. & Bos, H. (1997). Unaided AACsymbols. In L. Lloyd, D. Fuller & H.Arvidson (Eds.), Augmentative and alterna-tive communication: A handbook ofprinciples and practices (pp. 80-106).Needham Heights, MA: Allyn Bacon.

5 McNeill, D. (1992). Hand and mind. Whatgestures reveal about thought. Chicago:University of Chicago Press.

6 Kublin, K, Wetherby, A., Crais, E. & Prizant,B. (1998). Prelinguistic dynamic assessment.In A, Wetherby, S. Warren, & J. Reichle.(Eds.), Transitions in prelinguistic communi-cation. (pp 285-312.) Baltimore: Paul H.Brookes.

7 Volterra, V. & Erting, C. (1994). From Gestureto Language in Hearing and Deaf Children.Washington, DC: Gallaudet University Press.

8 Iverson, J., & Goldin-Meadow, S. (1997).What’s gesture got to do with it? Gesture incongenitally blind children. DevelopmentalPsychology, 33, 453-467.

9 Wang, X., Mylander, C., & Goldin-Meadow, S.(1995). The resilience of language: mother-child interaction and its effect on the gesturesystems of Chinese and American children. InK. Emmerey & J. Reilly (Eds.), Language,Gesture and Space (pp. 411-433). Hillsdale,NJ: Erlbaum.

10 Brenda Schick. (January, 2000). Personalcommunication.

11 Thal, D. J., & Bates, E. (1988). Language andgesture in late talkers. Journal of Speech andHearing Research, 31, 115-123.

12 Wetherby, A., Reichle, J. & Pierce, P. (1998).The transition to symbolic communication.In A. Wetherby, S. Warren & J. Reichle(Eds.), Transitions in Prelinguisitic Communi-cation. (pp.197-230). Baltimore: Paul H.Brookes.

13 Acredolo, L. P., & Goodwin, S. W. (1998).Baby Signs. Chicago: Contemporary Books.

14 Abrahamsen, A. (in press). Explorations ofenhanced gestural input to children in thebimodal period. In H. Lane & K. Emmorey(Eds.), The signs of language revisited: Ananthology to honor Ursula Bellugi andEdward Klima. Hillsdale, NJ: Erlbaum.

15 Goodwyn, S. & Acredolo, L. (1998).Encouraging symbolic gestures: A newperspective on the relationship betweengesture and speech. In J. Iverson & S.Goldin-Meadow, S. (Eds.), The nature andfunctions of gesture in children’s communica-tion. New Directions for Child Development,No. 79. (pp. 61-73). Jossey-Bass.

16 DeLoache, J.S., Pierroutsakos, S.L., &Troseth, G. L. (1997). The three R’s ofpictorial competence. In R. Vasta (Ed),Annals of Child Development, 12, 1-48.

17 Caselli, M.C. & Volterra, V. (1994). Fromcommunication to language in hearing anddeaf children . In V. Volterra & C. Erting(Eds.), From gesture to language in hearingand deaf children. (pp. 263-277). Washing-ton, DC: Gallaudet University Press.

18 Loncke, F. (1993). Multimodality: atheoretical argument for multimediainteractive learning. In B. Elsendoorn & F.Coninx (Eds.), Interactive learning technol-ogy for the deaf (pp. 31 - 42). Berlin:Springer Verlag.

19 Rowland, C. and Schweigert, P. (2000).(2000). Tangible symbols, tangible outcomes.Augmentative and Alternative Communica-tion. 16:2, 61-78.

20 Skelly, M. (1979). AmeriInd gestural codebased on universal American Indian handtalk. Amsterdam: Elsevier/North Holland.

21 Van Uden, A. (1977). A world of language fordeaf children. Lisse: Swets & Zeitlinger.

22 Hetzroni, R. & Harris, O. 1996. Culturalaspects in the development of AAC users.Augmentative and Alternative Communica-tion. 12, 52-58.

23 Fenson, L., Dale, P., Resnick, J., Thal, D.,Bates, E., Hartung, J., Pethick, S. & Reilly, J.(1993). The technical manual for theMacarthur communicative developmentinventories. San Diego: Singular PublishingGroup, Inc.

24 Blackstone, S. and Hunt-Berg, M. TrainingPartners to Facilitate Interaction withStudents using Augmentative CommunicationSystems in Public Schools. Paper presentedat RESNA/United States Society forAugmentative and Alternative CommunicationConference, Kansas City, July 1991.

25 Loncke, F. & Snell, M. (2000, August). Aprocedure for dynamic assessment ofnonsymbolic and prelinguistic communica-tion. Paper presented at the 9th BiennialConference of the International Society forAugmentative and Alternative Communica-tion, Washington, DC.

26 MacWhinney, B. (2000). The CHILDESProject:Computational Tools for AnalyzingTalk. Hillsdale, NJ: Erlbaum.

27 Dan Slobin, Department of Psychology, 3210Tolman #1650, University of California,Berkeley, CA 94720 USA

28 Wetherby, A. & Prizant, B. (1993). Communi-cation and symbolic behavior scales.Chicago: Applied Symbolix.

29 Reichle, J., Halle, J. W. & Drasgow, E. (1998).Implementing Augmentative communicationsystems. In A. Wetherby, S, Warren, & J.Reichle, (Eds.). Transitions in PrelinguisticCommunication (pp. 417-436) Baltimore:Paul H. Brookes.

30 Blackstone, S. & Hunt-Berg, M. Augmenta-tive Communication News. 10: 1 and 2. Also,go to www.augcominc.com/presentations/lang_learn_aac/index.htm

31 Gershkoff-Stowe, L. & Goldin-Meadow, S. (inpress). The role of a communication partnerin the creation of a gestural language system.Proceedings of the 22nd Annual BostonLanguage Conference on Language Develop-ment. Cascadilla Press.

32 Zukow-Goldring, P. (1996). Sensitivecaregivers foster the comprehension ofspeech: When gestures speak louder thanwords. Early Development and Parenting, 5(4), 195-211.

Continued on page 16

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Periodicals

Augmentative Communication News1 Surf Way, #237Monterey, CA 93940

Address Service Requested.

References (continued)33

Heller, K., Alberto, P. & Romski, M. (1995).Effect of object and movement cues onreceptive communication by preschool childrenwith mental retardation. American Journal ofMental Retardation. 99, 510-521.

Additional sourcesMaterial that served as background for thisissue has been presented at two conferences.

Hunt Berg, M., Loncke, F. & Blackstone, S.(August 2000). More than words and symbols:Incorporating gesture in AAC. Paper at the 9thBiennial Conference of the InternationalSociety for Augmentative and AlternativeCommunication, Washington, DC.

Hunt Berg, M. (February 5, 2000). Promotingthe use of gestures in AAC users. ISAACSeminar, San Francisco.

Loncke, F. (February 5, 2000). Structuringnonsymbolic interaction. ISAAC Seminar, SanFrancisco.

Blackstone, S. (February, 2000). Two to Tango:AAC users and their communication partners.ISAAC Seminar, San Francisco.

Berkeley AAC Study GroupThe following people participated in the StudyGroup’s discussions on gestures over the pastyear. Thanks to all for their unique contribu-tions.

Mary Hunt Berg, Private Practice, Moraga, CA.

Naomi Dayton, Private Practice, Alamo, CA.

Elisa Kingsbury, The Bridge School, Hillsboro,CA.

Nicole Liborin, The Cerebral Palsy Center,Oakland, CA.

Filip Loncke, International Program Coordina-tion Fracaritatis, Brussels, Belgium.

Gloria Soto, San Francisco State University,San Francisco, CA.

Mary Wrenn, Berkeley Unified School District,Berkeley, CA.