This pilot project will determine whether Augmentative and Alternative Communication (AAC) devices improve the conversation of adults with moderate dementia. Clinical researchers have not conducted a systematic investigation of the effectiveness of AAC devices for this population, manipulating the components of AAC devices that might improve conversation for persons with dementia. Four hypotheses are generated. (1) Access to AAC devices in general will improve the conversations of individuals with moderate dementia. (2) The enhancement of conversation associated with AAC device use results from manipulation of 2 specific AAC variables: input and output mode. AAC input refers to the symbols in AAC devices (printed labels, 2-dimensional pictures, or 3-dimensional objects). AAC output refers to the presence or absence of digitized speech with the symbols. (3) The severity of language impairment displayed by persons with moderate dementia interacts with input and output mode. The more concrete input modes with voice output will improve conversation more for those with severe language impairment. (4) Familiar, untrained caregivers will find that the use of AAC devices improves functional conversation with individuals with moderate dementia. Participants are 60 adults with moderate dementia as defined by a CDR score of 2, MMSE between 5-15, and enrollment in the Oregon Alzheimer's Disease Center. The FLCI is the language severity measure. In Study 1, participants engage in 5 conversations with and without AAC devices that incorporate randomly assigned combinations of input and output mode. Participants' expressive behaviors are coded from videotapes to characterize rate and conversational content (Bourgeois, 2001). For Study 1 (Hypotheses 1-3), the main effect of AAC device use is evaluated using paired t-tests. The relative effects of input and output modes and their relationships to language severity are analyzed using a regression model. In Study 2 (Hypothesis 4), familiar untrained caregivers engage in conversations with subjects with or without an AAC device and rate the functional outcome of the conversations. Results will be used to generate an R01 application to determine more precisely the features of AAC that enhance functional communication for individuals with different severity levels of dementia in a longitudinal design measuring clinical outcomes over time.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Language and Communication Study Section (LCOM)
Program Officer
Ansel, Beth
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Oregon Health and Science University
Schools of Medicine
United States
Zip Code
Fried-Oken, Melanie; Daniels, Darlene; Ettinger, Olivia et al. (2015) What's on Your Mind? Conversation Topics Chosen by People With Degenerative Cognitive-Linguistic Disorders for Communication Boards. Am J Speech Lang Pathol 24:272-80
Fried-Oken, Melanie; Rowland, Charity; Daniels, Darlene et al. (2012) AAC to support conversation in persons with moderate Alzheimer's disease. Augment Altern Commun 28:219-31
Gibbons, Chris; Oken, Barry; Fried-Oken, Melanie (2012) Augmented input reveals word deafness in a man with frontotemporal dementia. Behav Neurol 25:151-4
Fried-Oken, Melanie; Beukelman, David R; Hux, Karen (2011) Current and future AAC research considerations for adults with acquired cognitive and communication impairments. Assist Technol 24:56-66
Fried-Oken, Melanie; Rowland, Charity; Baker, Glory et al. (2009) The Effect of Voice Output on the AAC-Supported Conversations of Persons with Alzheimer's Disease. ACM Trans Access Comput 1:15