Message Management: Vocabulary, Small Talk, and Storytelling

Excerpted from Chapter 2 of Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs, Third Edition, by David R. Beukelman, Ph.D., & Pat Mirenda, Ph.D.

Copyright © 2005 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Message management is the formulation, storage, and retrieval of messages in AAC applications (Stuart, Lasker, & Beukelman, 2000). You might consider how it would feel to be restricted to the words, phrases, and stories selected for you by someone else. Even if you could spell out all of your messages at a rate of about five to seven words per minute, you would still need complete phrases to communicate urgent messages, break into a conversation, engage in small talk, or tell a joke or a lengthy story. Obviously, the appropriateness of the messages stored in your augmentative and alternative communication (AAC) system would be very important to you. If you could pick a few people to select your messages for you, who would they be — people who know a lot about language or people who know a lot about you? What do you think?

AAC is about helping individuals who cannot speak well enough to meet their daily communication needs to interact with others. To that end, this book contains extensive information about symbols, communication boards, switches, displays, and speech output. However, because the central goal of AAC is to provide individuals with the opportunity and capability 1) to communicate messages so that they can interact in conversations; 2) to participate at home, in school, at work, and during recreational activities; 3) to learn their native language; 4) to establish and maintain their social roles (e.g., friend, student, spouse, mentor, and employee); and 5) to meet their personal needs, we designed this chapter to introduce the factors that influence message selection in AAC in such contexts. Because the message selection process in AAC is unique and is influenced by such a wide range of factors, this chapter provides an overview to supplement information that is included in Chapters 9–19, which cover specific interventions.

FACTORS THAT INFLUENCE AAC MESSAGE SELECTION

Because word selection and message formulation are such efficient processes for most typical speakers, people usually enter communication situations without giving much consideration beforehand to the words, phrases, and stories they will use. Of course, there are times when we plan our messages and even rehearse them, such as when we make marriage proposals, participate in employment interviews, and appear in court. However, message selection during natural speech interactions and written communication is usually so automatic that even most AAC specialists themselves have little experience selecting vocabulary items in advance of the acts of speaking or writing. Even interventionists who have regular contact with individuals who experience communication disorders such as stuttering, voice problems, articulation problems, and cleft palate rarely need to preselect messages to support conversational or written communication.

As we write this book, I have been assisting a close friend of mine to communicate effectively in a range of situations. He has amyotrophic lateral sclerosis and uses AAC technology. Each Tuesday evening, Tom and his wife invite members of their social and professional networks to drop by a local restaurant for "Time with Tom." They do not know who will attend or if they will visit with the usual 25–50 guests or the approximately 200 that appeared on his birthday. Of course, we have the usual "small talk" messages entered into his talking AAC device. Each week we prepare for this event by predicting the messages Tom will use and then programming pages of personal news, jokes, thoughts for the week, comments on events in the local and national news, and sports, as well as personal comments for specific individuals with special health, family or personal issues who might attend. Tom spells out novel messages as well, but with the crowd of changing guests, he doesn’t have much time to prepare complex, novel messages. (D. Beukelman, personal communication, August 2004)

In addition to the lack of experience with which most AAC facilitators (i.e., people who assume or are assigned responsibility for supporting an individual's communicative
efforts) approach message selection, a variety of other factors influence the types of messages used by different communicators. Differences in age, gender, and social role exert powerful influences on both natural speakers and those who rely on AAC. Children use different messages than adults. Older adults speak about different topics and use different small-talk phrases than younger adults. Men and women tend to talk about different topics. When those who rely on AAC and their facilitators represent different age, gender, and social cohorts, message selection becomes even more complicated.

In addition to generic differences in message use, individuals vary with regard to their message needs and preferences. The environments in which they live influence the ways in which they wish to communicate. Communication at home is different from that in nursing centers, community living facilities, schools, and hospitals. The type of disability experienced influences people's interactions with caregivers, medical staff, education personnel, and family. The messages included in AAC systems must reflect individual differences related to the names of family members, streets, stores, pets, and interests. Finally, differing life experiences leave individuals with different stories to tell.

For a person who experiences a disabling event or condition, the transition from being a nondisabled individual to one with a chronic disability is an evolutionary journey (Stuart et al., 2000). As one passes through the stages of awareness, loss, accommodation, and regaining of self, the need for unique vocabulary is necessary but (as of yet) poorly understood. In time, individuals with chronic disability often go on to mentor others and teach others about their journey. This also requires specialized vocabulary from that commonly available in most AAC systems.

Fortunately, the futures of individuals with lifelong disabilities are not nearly as limited as they once were (Mirenda, 1993). At one time, people with lifelong disabilities lived segregated lives at home or in institutions; thus, their communication needs were quite restricted and predictable. Since the 1970s, however, societal involvement of people with disabilities has increased dramatically. As people with disabilities are included more successfully in the educational, social, religious, recreational, volunteer, and vocational realms of our communities, their communication needs change dramatically (McNaughton, Light, & Arnold, 2002). As their opportunities and choices continue to increase, their communication needs expand. Unfortunately, as persons who rely on AAC become more involved in a variety of contexts and situations, their potential for victimization also increases. Bryen, Carey, and Frantz (2003) reported that nearly half of the individuals (ages 18–39 years) who rely on AAC and participated in their survey experienced some type of crime during their lifetime. These results support the need for vocabulary that is necessary to report victimization for legal and counseling purposes.

Changes in technology have also had an extensive impact on the communication patterns of individuals with severe communication disorders. Early in the development of the AAC field, the memory and display capabilities of AAC systems were so limited that these devices could store only relatively small message sets. With new electronic designs and inexpensive computer memory, the storage and computing capacity of electronic communication devices has expanded dramatically; many now have a nearly limitless capacity for message storage. Thus, AAC devices can now include an unrestricted number of messages including those related to small talk, scripts, and stories that earlier systems could not manage. In addition, with the advent of dynamic display devices (i.e., computer screens that change like the pages of a book and use lights to signal available message options), AAC facilitators can organize and symbolize huge message pools using strategies that do not rely solely on the memory capabilities of those who rely on AAC (see Chapter 3). Finally, the voice output options available in modern AAC devices are intelligible enough to allow AAC use in a wide range of social contexts. Together, these technological advances permit the use of message sets to support communication with strangers as well as with friends and before large or small groups as well as on a one-to-one basis.

As the 21st century begins, debates over the "best" way to manage messages in AAC devices continue . . . . [D]iscussions regarding the relative merits of word-based versus phrase-based message formulation [are] recurrent themes . . . .
Those who [support] word-based strategies [stress] the generative flexibility of this approach as compared with the phrase-based approach. Those who [support] phrase-based strategies [cite] improved communication rate and timing as compared with the word-based approach. AAC device designers have responded to this debate by developing a range of AAC products that utilize a variety of message management strategies . . . . It is our impression that these arguments changed little during the 1990s. Unfortunately, the debate focuses on the "best" way to design AAC devices rather than on approaches that adjust message management in response to specific concerns influencing AAC users as they participate in all avenues of life. (Stuart et al., 2000, pp. 25–26)

THE MESSAGES OF CONVERSATION

Most conversations have a rather predictable structure. Usually, a person initiates a conversation with a greeting followed by a segment of small talk. Some conversations then progress to an information-sharing segment, whereas others do not. The shared information can take a variety of forms, including stories (i.e., narratives), procedural descriptions, or content-specific conversations. Most conversations close with some wrap-up remarks and a final farewell. To provide the messages needed to support conversation, it is useful to select and organize messages with this conversational contour in mind.

Greetings

Greetings are essential to initiating social interactions. Greetings can be rather generic in that they do not usually convey specific information. Rather, they signal awareness of someone's presence, communicate the speaker's intention to be friendly, and often include a bid to start a conversation. Despite the apparent simplicity of greetings, however, AAC teams must have some awareness of the social status or ages of the individuals involved when selecting appropriate greetings. This awareness is generally communicated by the degree of formality used for the greeting. Usually, a younger person does not greet an older person or a person of higher status (e.g., an employer, a teacher) with an excessively informal or familiar message. However, at least in middle-class North American culture, it is permissible to use informal messages that may contain personal references (e.g., "Hey! Big guy!") or even mild profanity (e.g., "How ya doing, you old *&#?") with close friends or peers. Although specific greeting conventions may change from culture to culture, there is always a need for variety in this type of message. Thus, greeting messages should include a range of message options that are culturally sensitive so that individuals are able to signal their awareness of social conventions. In addition, the availability of a range of different messages discourages the overuse of the same greetings.

This week, pay attention to how you greet others. Notice that you use a variety
of different greetings. Try to determine whether you understand the social rules that you use. Pay careful attention to those around you, and note the age, familiarity, and gender of individuals who say things such as "Well, hello, dear!" "Hi there!" "Goodness gracious, it’s been a long time!" "Good morning!" and "What's up?"

Small Talk

Small talk is a type of conversational exchange used for initiating and maintaining conversational interactions. Small-talk scripts provide for the incremental sequence of social engagement and disengagement messages that seem necessary when people attempt to interact in a social setting. Some conversations may never progress past the small-talk stage, such as often occurs at cocktail parties. Often, however, it seems as though small talk is used as a transition between the greeting and the information-sharing stage, especially when the communication partners do not know each other well or do not possess a lot of shared information.

Adults who rely on AAC frequently report that social situations are very difficult for them. The following are remarks we have collected through the years:

"Dinner parties with my spouse kill me. Eating, talking, smiling, and small talk — it is too much to handle."

"My fiancée told me that she wouldn't go to a party with me again until I learned something about small talk!"

"I didn’t get serious about learning small talk until I was 45 years old. I thought it was a total waste of time. Why should I work so hard to say nothing of content? But I was wrong."

One type of small talk in particular can be quite effective for AAC use. We call it generic small talk or small talk that people can use with a variety of different conversational partners because it does not refer to specific shared information. Table 2.1 contains some examples of generic and specific small talk.

In an effort to determine the relative frequency and types of generic small talk used by speakers of various ages without disabilities, several groups of researchers at the University of Nebraska–Lincoln recorded everyday conversations using portable, voice-activated tape recorders. Nearly half of the utterances of preschool children (3–5 years of age) in both home and school settings were classified as generic small talk. For young adults (20–30 years of age), 39% of all utterances were generic small talk (Ball, Marvin, Beukelman, Lasker, & Rupp, 1997; King, Spoeneman, Stuart, & Beukelman, 1995; Lasker, Ball, Bringewatt, Stuart, & Marvin, 1996). Older men and women used somewhat less small talk than the young adults; 31% of the utterances of 65–74-year-olds and 26% of the utterances of 75–85-year-olds were small talk. These results confirm the extensive role of small talk in everyday communicative interactions for individuals across the age range. To interact in integrated social contexts, access to small talk and the ability to use it seems essential.

Overall, preschool children produced more utterances classified as confirmation/ negation messages (26%) than any other type of small talk. They used continuers and environmental control utterances with similar frequencies. This high level of use of environmental control phrases is highly unique to preschool children, because none of the adult groups used these phrases more than 1% of the time. The young children also commented quite frequently about internal and external evaluations. For all of the adult groups, continuers were the most commonly used type of generic small-talk utterance.

The messages used during small talk vary somewhat across the age span. Those who use AAC should have opportunities to select the messages that they prefer from detailed resource lists and other sources. Detailed information about small-talk use patterns is now available on the Barkley AAC Center's World Wide Web site.

Storytelling

For adults, storytelling is a rather common communication form. Older adults in particular use stories to entertain, teach, and establish social closeness with their peers. Storytelling remains an important communication form even for adults who are unable to speak. This is particularly true as older adults begin to focus more and more of their social time on acquaintances and friends rather than on families. As these individuals lose their spouses and move to retirement or care facilities, the need to socially connect with individuals their own age becomes important, and storytelling provides a vehicle for this.

In his very interesting book, Tell Me a Story: A New Look at Real and Artificial Memory, Schank (1990) discussed story formulation, refinement, and storage in detail. He pointed out that we use stories from a variety of sources. First-person stories are those that have occurred to the speaker personally. Second-person stories are those that a speaker has learned from others through listening or reading. It is permissible to tell a second-person story, as long as we give credit to the source. Official stories are those that are used to teach a lesson or explain a phenomenon and are frequently used by families, schools, and religious groups. Finally, fantasy stories are those that are "made up." Marvin and her colleagues studied the communication patterns of typically developing preschool children and found that, on average, 9% of what they talked about at home and 11% of their conversations at school involved some type of fantasy (Marvin, Beukelman, & Bilyeu, 1994).

As the memory capacity of electronic AAC devices has increased and the intelligibility of speech synthesis has improved, storytelling with AAC systems has become much more practical. AAC facilitators play an important role in storytelling by assisting people who use AAC to capture stories for this type of communication. First, the facilitator must understand the story that the individual wishes to include in his or her AAC system. This is critical because storytelling is very personal and must be individualized to reflect personal experiences (e.g., through first-person stories), interests (e.g., through second-person stories), and affiliations (e.g., through official stories). Next, the facilitator can help to program the AAC device by dividing the story into segments (usually of sentence length) that the device can release sequentially with synthetic speech to tell the story, one sentence at a time. Finally, opportunities to practice telling the story should be provided. As the number of stories included in an AAC system increases, AAC facilitators also need to assist by indexing them according to the main topics, key participants, or major life events they represent so that stories can be retrieved efficiently. Of course, facilitators can also use nonelectronic AAC strategies to store and retrieve stories. For example, a man with aphasia due to stroke used to tell the story of how he got his unusual name, Roderick, by guiding his communication partner through his communication book one segment at a time, indicating the line of the story that the partner should read aloud. Other individuals may tell stories using line-drawing symbols arranged in sequential order with the written story underneath each symbol.