Beyond the SGD: Sisters Co-constructing Meaning with Unaided AAC

Abstract

Aim 

Communication is a shared, co-constructed act between two or more people. Individuals who cannot rely on speech alone to be heard and understood often use aided augmentative and alternative communication (AAC) as one component of multimodal communication. Despite the potential impact of aided AAC, many AAC users demonstrate or express preferences for unaided forms of AAC, such as gestures, body movements, vocalizations, and facial expressions (e.g., Williams et al., 2023). However, the presence of a speech-generating device (SGD) may lead communication partners to attend primarily to device output while overlooking unaided forms of communication.

Siblings are unique lifelong communication partners who often develop a shared, intuitive sibling culture through years of shared experiences and interactions. Although sibling relationships have been studied across the lifespan, limited research has examined interactions between adult siblings when one person cannot rely on speech alone to be heard and understood. The aim of this study was to begin to address this gap by examining how one adult sibling dyad used multimodal communication to co-construct meaning during interaction.

Method 

This qualitative single case study examined AAC-mediated interactions between Sadie (pseudonym), an adult with an intellectual and developmental disability (IDD), and her sister, Laura (pseudonym), a speech-language pathologist. The sibling dyad completed two structured interaction tasks in Laura’s home: a communication preferences survey and an extended discourse task focused on a shared personal experience.

Interactions and SGD use were video recorded and synchronized using a picture-in-picture format that allowed simultaneous viewing of participant interaction and device activity. Analysis followed an inductive whole-to-part approach (Erickson, 2006) with detailed transcription and microanalysis informed by talk-in-interaction methods (Higginbotham, 2009). Transcriptions captured speech, SGD output, vocalizations, eye gaze, body movements, facial expressions, and other forms of unaided communication, emphasizing the importance of multimodality and collaboration in real-time interactions.

Results 

Across the two interaction tasks, 76 segments were identified in which Sadie and Laura co-constructed meaning through a highly individualized form of partner-assisted scanning (PAS), which they referred to as “using our hands.” The dyad integrated PAS with various forms of unaided AAC and SGD use. The sisters drew upon shared experiences and used PAS to clarify, expand, and negotiate meaning throughout their interactions. Although this deep, shared familiarity often supported efficient collaborative meaning making, findings also suggested that familiarity may influence how communicative acts are interpreted, highlighting the potential for asymmetry between partners.

Detailed microanalysis illustrates how the dyad coordinated multimodal communication use. Analysis revealed that Sadie’s SGD use represented only a portion of the interaction and that unaided AAC played a substantial role across both tasks. Rather than relying on a single modality, the dyad flexibly combined and coordinated unaided AAC, PAS, and SGD use with Sadie often initiating a topic using her SGD and then working with Laura to draw upon shared experiences to establish meaning through PAS and embodied cues. In other moments, Laura controlled the interaction using PAS independently of the SGD. The sisters explicitly indicated the goal of reducing effort or resolving ambiguity, but in some occasions the impact may have resulted in asymmetry of content and control. Notably, Laura continued to attend to Sadie’s unaided communication even when Sadie was engaged with her SGD, integrating information across communication modes rather than focusing exclusively on device output.

Conclusion 

Findings underscore the important role familiar communication partners can play in supporting individualized, multimodal co-construction. Shared experiences and familiarity shaped how the sisters clarified, expanded, and negotiated meaning throughout their interactions. At the same time, findings highlighted the need to critically consider issues of asymmetry and communication partner assumptions, even within highly familiar relationships.

Communication partners should be encouraged to recognize and respond to unaided communication alongside aided AAC, while also creating opportunities for ongoing collaboration across communication modalities. Although familiarity may support efficient communication, communication partners must remain attentive to potential asymmetries by creating intentional space and opportunities for AAC users to shape, redirect, and influence the direction and focus of interactions. This study contributes to the AAC literature by demonstrating how one adult sibling dyad combined unaided AAC, partner-assisted scanning, and SGD use to support meaningful communication and co-construct meaning beyond the device alone. Findings challenge traditional sender-receiver models of communication and highlight the important responsibility of communication partners to shift interactions toward collaborative meaning-making across communication modalities.

References 

Erickson (2006)
Higginbotham (2009)
Williams et al. (2023)