Communication Demands of University Settings for Students Using Augmentative and Alternative Communication (AAC)
Lynne M. Atanasoff, David McNaughton, Pamela S. Wolfe and Janice Light
The Pennsylvania State University
Seven college students who use augmentative and alternative communication (AAC) participated in a written survey to describe their communication experiences in college. Participants reported the use of face-to-face, written, and distance communication techniques to communicate with both peers and instructors. Although participants reported that they were generally successful in communicating on a variety of topics with a wide variety of methods, those individuals who used e-mail rated this the most effective way of being understood by others. Results of this survey are used to discuss strategies for successful participation by AAC users in university settings, as well as directions for future research.
Success in college course work requires the integrated use in a variety of communication skills (Baker & Lombardi, 1985; Norton & Hartley, 1986). Not only must students be able to communicate basic ideas and arguments, they must be ready to participate in communication activities that pose significantly distinct demands from the challenges of high school (Carson, Chase & Gibons, 1992). Within the college setting, for example, the ability to contribute personal interpretations of course materials to class discussions, to take accurate notes without instructor "cue," and to create written work that adheres to the conventions of a particular academic discipline take on a special importance (Carson et al., 1992; McCarthy, 1987).
In addition to the use of communications skills to acquire and demonstrate knowledge, certain college level courses may focus exclusively on the development and use of communication skills. Many 4-year postsecondary programs include a public speaking course in which the actual ability to communicate effectively, above and beyond the content of the presentation, is assessed (Johnson & Szczupakiewicz, 1987; Lyons, 1989). Further, postsecondary education also often provides important opportunities for social interaction. For many individuals, college is a time for interacting with peers and the creation of life-long friendships (Liebert, Lutsky, & Gottlieb, 1990).
For most students in postsecondary settings, the use of speech, and of commonly available writing tools such as pencil and paper or work processing technology, provide appropriate means for meeting the academic and social demands of college. For a small number of students with severe physical disabilities, however, the communication demands of college may pose uncommon challenges (Schutz-Muehling & Beukelman 1990; Shell, Horn & Severs, 1988).
Augmentative and Alternative Communication
There were approximately 2 million Americans whose speech is inadequate to meet their communication needs (ASJA, 1991). Some of these individuals make use of augmentative and alternative communication (AAC) techniques (e.g., pointing to words and alphabet letters on a communication board, typing out messages to be spoken aloud by a computer-based device) to communicate with others.
The use of these communication techniques poses special challenges to successful interaction. Persons who use AAC have been found to have varied communication skills, and interactions involving AAC users may differ markedly from conversations in which natural speech is used. AAC users typically play a respondent role in the conversation, experience limited opportunities to initiate, and are frequently confronted by communication breakdowns (Glennen, Sharp-Bittner, & Tullos, 1991). Perhaps the most noticeable difference is in the area of communication rate. The conversational speaking rate of non-disabled natural speakers is approximately 150-200 words per minute (Beukelman & Mirenda, 1992; Goldman-Eisler, 1986). The rate for many AAC users is much less, often as slow as 2-8 words per minute (Beukelman & Mirenda, 1992; Foulds, 1987). Clearly such reduced rates of communication differ markedly from the lively and rapid communicative exchanges typically observed in college classrooms.
To date only a small percentage of individuals with severe disabilities have sought access to higher education (Blackorby & Wagner, 1996). The autobiographical writings of some of these successful pioneers, however, provide evidence that individuals with severe disabilities have sought access to higher education (Blackorby & Wagner, 1996). The autobiographical writings of some of these successful pioneers, however, provide evidence that individuals with severe physical disabilities who use AAC can successfully complete university (Creech, 1993; Rush, 1986; Williams, 1993). For full participation in postsecondary learning, Blackstone (1989a) has suggested that students who use AAC must have ways to communicate successfully with classmates and teachers in a wide variety of activities and settings. At present, however it is not clear what unique barriers are encountered in using AAC in a postsecondary environment, and how these have been overcome by AAC users in these settings (Huer, 1991; Shell, Horn & Severs, 1988). Beyond the communication demands faced by all students in a postsecondary setting, Lowe and Hollman (1994) have suggested that there may be special demands placed upon AAC users including the demands of overcoming attitudinal barriers present in postsecondary settings (e.g., communicating with personal care workers). Students with physical disabilities may require AAC support to complete writing assignments (Schultz-Muehling & Beukelman, 1990), and the necessary technology and services may not always be available (Horn & Shell, 1990).
The purpose of this study was to learn directly from the experiences of successful college students who use AAC, so that future students (and the service providers with whom they work) can better anticipate and respond to the demands of postsecondary education. Specifically, the data reported are intended to address the following questions (a) what are the communication demands of the postsecondary environment as reported by students who have cerebral palsy and use AAC, (b) how are these communications demands met, and (c) how effective are the reported communication methods in meeting these communication demands?
The participants of this study were students who (a) did not use speech as the primary method to meet their daily communication needs (e.g., speech could not be understood by an unfamiliar partner, not including persons who stuttered or who previously had a laryngectomy); (b) used AAC (e.g., communication board, adapted computer equipment, gestures, paper and pencil, photographs, printed words, electronic device, etc.); (c) had cerebral palsy; (d) had no uncorrected sensory deficits (e.g., hearing and vision assessed as being within normal limits); (e) were enrolled in a 4-year university of college in Pennsylvania in Spring semester, 1996.
As the first step in the recruitment process, personnel at disability services offices, Central Instructional Support Center, and Augmentative Communication Empowerment Support (ACES) were asked to forward a letter (written by the first author) to potential participants. The letter outlined the purpose of the study, monetary reimbursement, and the participant's role. Interested participants were asked to complete a brief form that was returned to the investigator in a self-addressed stamped envelope. On the return form, participants were asked to indicate the questionnaire format they wanted to receive. For participants who requested a copy to be completed by hand, an extra page was added to gather information on the individual who had completed the form (i.e., interpreter), the relationship that the interpreter had to the participant (e.g., family, professional, personal care provider, friend, significant other, or other), and the length of time the interpreter had known the participant.
To identify participants who met the criteria, a number of strategies were used. First, the disability services at selected postsecondary institutions in Pennsylvania were contacted. The schools included were those that were listed in Peterson's National College Databank: The College Book of Lists (1993) as accredited four-year colleges or universities (n = 96). Second, the personnel at the Central Instructional Support Center, a statewide educational agency serving school-aged students who use assistive technology, was contacted to assist in identifying students known to the agency who upon graduation had anticipated attending college in Pennsylvania. Third, Augmentative Communication Empowerment Supports (ACES), a program for adults with physical and speech disabilities, was contacted to assist in the identification of individuals who were currently enrolled in college. Finally, a notice was posted that briefly described the investigation on the Augmentative Communication On-Line Users Group listserv.1
A survey was developed based on relevant literature in postsecondary education for persons with disabilities (e.g., Fitchen, Amsel, Bourdon, & Creti, 1988; Fichen, Goodrick, Tagalakis, Amsel, & Libmann, 1990) and AAC (Huer, 1991; Schutz-Muehling & Beukelman, 1990; Shell, Horn, & Severs, 1988). Following preliminary development, the instrument was field tested in a pilot test. For the pilot study, 3 college graduates and 2 professionals with expertise in AAC provided feedback on the content appropriateness, lengthiness, and readability of the instrument. The experts included in the pilot test were (a) two persons who had cerebral palsy and who used AAC, both with a graduate level education; (b) one person who had cerebral palsy, had a bachelor's level education, and used AAC who was currently employed in his college field of study; and (c) two professionals with expertise in speech language pathology and AAC.
The questionnaire2 was used to gather demographic information from the respondents as well as information on the perceived communication demands, and effective techniques for participation, in the college environment. To measure communication demands, participants were asked to complete checklist and multiple choice formats. The participants had the option to write their responses using one of three formats: (a) a handwritten copy for the participant of an interpreter to complete, (b) a copy on a computer disc for the participant to complete, or (c) a copy through e-mail for the participant to complete. For this study, 4 of 7 participants completed hand written copies. Three of the 4 participants indicated that they received assistance from a transcriber to complete the written responses. Two of the three who received assistance reported that the transcriber was a parent; one received assistance from a personal care provider who reported knowing the participant for less than one year. Of the remaining participants, two completed the questionnaire using an e-mail formant while one used a computer disc.
Regardless of the questionnaire format, the instructions for completing the questionnaire were the same. Directions specified that participants either mark the most applicable response (20 items) or all applicable responses (20 items). For the later, an "other" category was included so as not to limit participants' responses to the provided options. The instrument also included open-ended questions. Directions requested that students answer the open-ended question as completely as they could, using at least three to five sentences per answer.
Results and Discussion
Descriptive statistics were used to summarize responses from the checklist and multiple choice type questions. Participant responses are discussed under three categories: (a) demographics and educational background of the participants, (b) content, function, and modes of communication in college, and (c) supports and barriers to communication.
Demographics and Educational Background of the Participants
There were 20 students from 10 different colleges or universities initially nominated for inclusion by cooperating personnel. A total of 13 of the 20 students who were nominated (65%), responded to the recruitment letter. However, two students who responded to the recruitment letter were excluded because one was scheduled to graduate before distribution of the questionnaire, and the other did not have cerebral palsy. Therefore, 11 of a total of 18 students met the sample criterion and responded to the recruitment letter (61 %). The low response rate may be due to the fact that recruitment letters were mailed at the end of the semesters at the various schools.
Of the 18 students who met the participation criteria, a total of 7 completed the questionnaire (39%). Follow up letters and phone calls were made to persons who returned forms indicating interest in the project but who did not return completed questionnaires (n = 4). The low questionnaire completion rate maybe due to the length of the entire questionnaire. The first author learned from three participants that the responses took more time than estimated in the recruitment letter to complete.
The 7 participants represented six different colleges or universities. Table I presents the demographic characteristics for the 7 participants. Four participants ranged in age from 18 to 48 years old. All individuals had cerebral palsy.
All seven participants had at least a high school diploma or a Graduate Equivalent Degree (GED)3. Of the participants who graduated from high school (n = 6), five reported receiving a range of services related to their disability that began between kindergarten and third grade. One person started receiving services between fourth and eighth grade. The most frequently received services were physical therapy (6 of 6), speech and language therapy (5 of 6), and occupational therapy (4 of 6). Of the respondents who answered the question on their use of disability services in college (n = 6), all reported that they received services related to their disability in college.
Four of the 7 participants entered a 4-year college or a university immediately following high school. The age at which these four participants graduated from high school ranged in years from 17-21. The remaining three participants were over 40 years old, and had entered a 2-year college prior to enrolling in a 4-year college or university. Two of the 3 who were over 40 years old reported graduating at age 18, while 1 person did not receive a high school education.
When asked to evaluate the academic rigor of their high school program, 3 of the 4 younger participants rated their overall level of academic competitiveness (in comparison to peers) as "very competitive," while one reported being "somewhat competitive." One of the older participants, Larry, reported being "competitive." His experience was substantially different from those of the other two older students. The other two, who were out of high school age before the passage of The Education of All Handicapped Children Act of 1975 (PL 94-142), reported less positive experiences. One person wrote, "did not go to high school." A second person, Judy, noted being very successful in a noncompetitive classroom that was below her capabilities. She described high school by writing:
The school was a special school for handicapped people. One room class limited to person with least potential. Teacher had divergent students had to cater to the lowest denomunator (sic).
Content, Function, and Modes of Communication in College
Participants reported communication exchanges involving face to face communication, written communication and distance communications technologies (telephone, e-mail).
Face To Face Communication
All participants reported having to answer questions in class, as well as participate in small group discussions (e.g., during class the student had to meet in a group and discuss a topic, the student had to participate in a group project for class). Six of the seven reported a need to make speeches and presentations. Five of seven were required to start, maintain, or develop discussion with classmates (e.g., the student had to lead a discussion on an assigned reading the entire class completed). Interestingly, one person reported being required to complete a final oral examination using face-to-face communication.
Hence, the experiences of the participants in this study appear to reflect the experiences of non-disabled students. In today's colleges and universities, instructors frequently implement educational methods that rely on small group discussion (Steams, 1994), and expect that students will be able to both answer questions as raised by the instructor, and initiate the asking of questions on any material or assignment that is unclear (Carson, Chase, Gibons, & Hargrove, 1992).
As well as participating in classroom interactions with peers and instructors, participants reported a variety of reasons for initiating contact with instructors (see Table 2). Six of seven students in this study reported a need to establish contact with instructors at the start of a course, ask for accommodations, schedule and appointment, inform instructors about the impact of a disability on coursework, and discuss solutions to problems. The current findings suggest that college students who use AAC should be prepared to initiate contact with college or university professors to communicate academic consideration and various accommodations.
The participants reported using a wide variety of augmentative communication techniques for face-to-face communication (see Table 3), including dedicated communication device (n = 5), natural speech and speech approximations (n = 3), and facial expressions (n = 3). Once participant also used an interpreter (i.e., a familiar partner repeated the message produced by the AAC user to assist unfamiliar partners).
Most students were pleased with their ability to communicate in face-to-face situations (see Table 3). Five of the seven students described their communication as "easily understood," while one rated himself somewhat higher ("very easily understood") and one somewhat lower ("somewhat easily understood").
It is of interest to note that in response to an open-ended question about the "challenges" of communicating in a college environment, four of the seven students made explicit reference to issues of intelligibility, while one made a reference to their reduced rate of communication. Sometimes these challenges led to a breakdown in communication.
My main challenge when trying to communicate is that when people don't understand me they won't ask me to repeat things because they are afraid of hurting my feelings. I can always tell because they either say "oh" or ignore me altogether (Fiona).
I have a hard time keeping the person's attention until I finish what I have to say. They usually don't hang around to (sic) long for me to complete my conversation (Isaac).
In response to a question about strategies used to compensate or make communication easier, participants discussed the use of a variety of strategies, including three related to clarification and communication rate acceleration: using pre-programmed vocabulary in their computer-based device (n = 4), repeating their message (n = 2), and using alternate modes (e.g., directing communication partners to look at the screen on their computer-based device if the computer-generated speech is not understood (n = 2). Participants also reported the use of two additional strategies for dealing with issues more complicated than basic intelligibility. In order to manage turns within a conversation, Isaac reported using a "Place-holding" strategy:
Sometimes I will tell them "I have an idea about that, give me a minute to put it together" or "Hang in there a minute, I need to spell a few words.
As a way to introduce partners to his use of his AAC system, Larry made use of a "social conversation" strategy to introduce partners to his system and reduce partners' anxieties about speaking with an individual who uses AAC:
In order to make them feel comfortable when they see me with a communicator, I usually try to start a conversation with them. I may also say "Good Morning/Good Afternoon" or say "How's it going". Or, I may after greeting them tell them a joke that I heard (this generally loosens everyone up).
Participants offered a number of ideas as to how communication partners might interact more effectively with AAC users. Fiona's contribution provides an effective summary for the responses of the group:
The biggest thing people can do is to be honest when they don't understand me. It is extremely frustrating for me when people pretend to understand me. The other thing people can do is try to be patient and concentrate on what is being said.
Findings would suggest that students should be prepared to initiate interactions with instructors and peers to discuss course materials and assignment expectations, and be prepared to provide introductions that explain how communication partners can best understand the individual's use of the AAC system.
Participants reported a wide variety of writing demands in the college environment, including a need to write both to acquire knowledge (notetaking) and to display knowledge (essays and tests). Table 4 illustrates the data provided by participants on the writing demands they experienced in college.
All participants (n = 7) took class notes in college, using a variety of techniques. While all participants made use of a notetaker, three also used a tape recorder, three used their AAC systems to record information, three received outlines or notes from their instructor, and one also took his or her own notes with pencil and paper.
It appears that even when provided with a hard copy of class notes by a notetaker, participants still chose to be involved in the notetaking process; of the 7 participants, 6 used note takes in conjunction with AAC system notetaking and/or audiotaping. Of the 7 people who participated, 5 specified the content of what they wrote (i.e., what was different from what the notetakers wrote). The content of class notes taken by persons using AAC included key words (n = 2), key phrases (n = 2), questions (n =1), and references (n = 2). It has been suggested that not only the outcome of written notes, but also the process of taking notes affects learning (Einstein, Morris, & Smith, 1985). For example, the amount and type of information included in notes are related to learning, academic performance, and information recall (Baker & Lombardi, 1985; Einstein, Morris, & Smith, 1985). Participants may have elected to participate, if only minimally, in the belief that notetaking would have a positive impact on learning.
For the current study, all participants had short written assignments, class tests, and reports or papers in college. A similar range of writing requirements were found by Schultz-Muehling and Beukelman (1990) for a female graduate student who used AAC for writing. Although most of the writing activities involved the production of written text, a number of participants made reference to the expectation that they produce mathematical calculations (n = 4), as well as graphs and charts (n = 2). As noted by Michael Williams (an AAC user but not a participant in this study) writing activities involving more than the production of written text may pose special challenges for those who are unable to write using a pencil and paper, and who must rely upon technology:
When push comes to shove, math is a paper and pencil enterprise in which the pencil acts like a camera hooked into your mind ... you just can't do this on a typewriter or computer. All your time is focused on how to write out a problem rather than solve it. (posting to ACOLUG listserv, 2/8/97)
As completion of at least an introductory level math class is now a degree requirement at many colleges and universities (Chamber, 1994), special attention to this problem, by both educators and device manufacturers, is needed.
The participants described a wide variety of methods used for written communication (see Table 4). Nonetheless, students' self-rating of effectiveness was somewhat lower for class-related writing (e.g., short written assignments, reports, papers) than for face-to-face communication. While most individuals again felt that they were easily understood (n = 4) (i.e., occasional difficulty writing in a reasonable amount of time), one participant reported that he or she was only "somewhat easily understood" (i.e., some difficulty writing in a reasonable amount of time), and one reported that he or she was "not easily understood" (i.e., routine trouble writing in a reasonable about of time).
For individuals with severe physical disabilities, the transportation demands of colleges and universities may pose specific challenges. For many of the individuals in this study, distance communication technologies, including the telephone and e-mail, played important roles in supporting academic and social interactions.
Participants used the telephone most frequently for information about classes (n = 6). However, participants also used telephones for social activities (n = 5), registration information (n = 3), and contacting family or friends (n = 1). Participants used a range of approaches to operate a telephone and communicate using telephone lines (see Table 5).
Six of 7 participants reported that others understood their communication by telephone "easily" or "somewhat easily." A closer analysis of the data revealed that participants who communicated only using natural speech (e.g., words or word approximations) rated themselves as "easy to understand" and that participants using voice output rated themselves as "easy," "somewhat easy," or "not very easy to understand." Four of 5 participants used voice output systems that were rated as highly intelligible in sentence identification tasks (81 -97%) and word identification tasks (60-84%) (Mirenda & Beukelman, 1987). However, the participants rated their ability to be understood in the middle to low end of the range of options. It is possible that there was a decrease in voice output intelligibility over the telephone (Spiegel, Altom, & Macchi, 1990). Likewise, ratings may have been influenced by other unknown variables (difficulty in creating syntactically correct sentences, the loss of the use of facial expression and gesture as modes of communication).
The opportunity to converse with others using e-mail has opened up an important new social opportunity for many individuals who use technology to communicate (Blackstone, 1989b; Mathy, 1996). Though there were 7 participants, only 5 used e-mail in college. Four of 5 participants who reported using e-mail did so to correspond with friends, and to converse about academic topics (one participant who used e-mail declined to answer the content of the messages communicated through e-mail). They accessed e-mail without outside assistance. Table 6 provides information on participants' use of electronic mail.
Although e-mail was available on all campuses where the participants attended college, 2 participants stated that they did not use e-mail. Of the two, one preferred not to use e-mail while the other was upgrading a dedicated communication device to access electronic mail. All 5 participants who used e-mail rated the ability of others to understand their e-mail messages as "very easy." For no other rating (face-to-face, written, or telephone) did all participants select the highest rating option of effectiveness. Hence, it appears that the participants who used e-mail considered this the most effective way of having their messages understood.
E-mail provides a unique opportunity for students with disabilities to communicate in an environment where rate of communication does not matter. A message prepared off-line can then be downloaded to the computer. Though e-mail should not substitute for all types of communication, e-mail communication may have special applications for students with severe disabilities (MacKinnon, King, Cathers, & Scott, 1996).
Summary and Future Research Directions
This study provides some initial information on the communication demands of 4-year colleges as reported by 7 persons who have severe physical disabilities, use AAC, and attend college in Pennsylvania. Given the size and geographic concentration of the sample, care should be taken in generalizing these findings to other types of postsecondary settings, other regions, or other disability groups.
Further, participants were asked to report on past experiences. Attempts were made in the structuring of the questionnaire to facilitate recall. However, recalled information about the past can be less reliable or complete than questions about the present (Ericsson & Simon, 1993). Likewise, data were based on self-report. Although it was valuable to learn directly from the participants, it is important for readers to remember the underlying assumption that the self-reports were accurate when interpreting the data.
Even though some implications may be made from the current data, no strong conclusions may be reached about critical variables that contribute to successful communication for persons using AAC in college. Future research could include (a) investigation of the college experiences from others' perspectives (e.g., other segments of the AAC population who are in college [e.g., persons who experienced spinal cord injuries, head injuries, strokes] service providers, faculty, family members); (b) investigation of the participation of persons who use AAC mother postsecondary settings (e.g., community colleges, vocational schools); (c) longitudinal evaluation of the affects of providing AAC-specific services to students; (d) investigation of the participation in postsecondary educational settings from a national perspective; and (e) longitudinal evaluation of the affects of a college education for persons who use AAC (e.g., employment, social network, community involvement).
Despite the limitations of the current study, the results provide important information for several reasons. This study provides insight into the communication demands experienced by individuals with severe physical disabilities and the strategies used to meet those challenges. The following skills were identified as contributing to successful college experiences: (a) to introduce self and use of system, including guidelines for successful interaction, to faculty and classmates; (b) to discuss academic expectations with instructors and peers; (c) to participate fully in the face-to-face and written communication demands of college level coursework; and (d) to make effective use of distance communication technologies, which was identified as especially important for the role that it played in supporting social interaction with peers and family members.
It is interesting to note that many of the successful strategies identified here may be common to other communication settings. Based on an extensive review of the research on the communicative interaction patterns of AAC users, Light (1988) suggested that persons judged to be competent communicators using AAC demonstrate the following skills: (a) portray a positive self-image to their commuinication partners; (b) show an interest in others and draw others into interactions; (c) actively participate and take turns in a conversation; (d) are responsive to their communication partners and negotiate shared topics; and (e) put their partners at ease with the AAC system, often by using humor as well as predictable readable signals. Many of these same skills were suggested by participants in this study as contributing to successful communication at a college level.
The identification of important communication skills for AAC users should not imply that they alone bear the responsibility for successful interaction. Respondents suggested the need for their communication partners to slow down, listen carefully, and give honest feedback as to their understanding of the AAC user's message.
Concerted efforts are necessary to ensure that the successes realized by the participants in this study are achieved by many more individuals who use AAC. The efforts of both students with severe disabilities and their service providers should be directed towards ensuring that individuals with disabilities have access to the technology, training, and ongoing support necessary for effective participation in college classrooms using AAC systems. Future research efforts should examine service delivery models that effectively meet the needs of individuals with severe disabilities at postsecondary settings (e.g., effective high school to college transition services), as well as the information needs of disability support service providers and college faculty (e.g., relevant training as a student enters college). Through the combined efforts of key participants, the opportunity enjoyed by only a handful of students with severe disabilities today may be extended to a larger group of individuals in the future.
1Persons who subscribe to ACOLUG discussion group are predominately individuals who use AAC, family members of persons using AAC, or related professionals.
2The data in this article represent only a portion of the entire questionnaire. Data not reported include responses to 12 open-ended questions, responses to which are to extensive for adequate description in this article. For a copy of the entire questionnaire, please contact the first author.
3A Graduate Equivalent Degree (GED) is a credential that is of equal value to a diploma granted to students upon completing a high school or secondary school education.
someone talks on behalf of student, uses voice output of liberatorTM, speakerphone
not very easily understood
pen or pencil, uses a liberatorTM, grid on the telephone
someone talks on behalf of student, uses voice output of liberatorTM, speakerphone
finger or thumb
uses voice output of vois 160TM
finger or thumb
uses voice output of liberatorTM
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This paper is based on the master's thesis of the first author. Some people who were particularly helpful in developing the study include Michael Williams, Rick Creech, John Povall, Janice Chadsey-Rusch, Barb Roberts, and Diane Bryan. Likewise, the help of professionals from the various college and university disability service offices is greatly appreciated.
Correspondence concerning this article should be addressed to Lynne M. Atanasoff, Department of Counselor Education, Counseling Psychology and Rehabilitation Services, The Pennsylvania State University, 327 CEDAR Building, University Park, Pennsylvania 16802. Electronic mail may be sent via Internet to Ima100@psu.edu.
About the Authors
Lynne M. Atanasoff, Department of Educational and School Psychology and Special Education (now at Department of Counselor Education), Counseling Psychology and Rehabilitation Services The Pennsylvania State University.
David McNaughton, Department of Educational and School Psychology and Special Education at The Pennsylvania State University.
Pamela S. Wolfe, Department of Educational and School Psychology and Special Education at The Pennsylvania State University.
Janice Light, Department of Communication Disorders at The Pennsylvania State University.