double hit to get into the first row, on the second sequence. For Douglas, his select switch was the switch in his scanning array that he used least often; therefore, it was not as natural of a motor sequence (although learnable). So, it was not necessarily detri- mental to give up this conceivably easier to access row for fringe vocabulary, and it was possibly advantageous. Moving down the rows, they were then sorted by types of words/parts of speech. This pattern remained consistent through- out the device. Much like when finding the main verb in a Min- Speak® based program at the Action Man location, verbs are al- ways found in the green or third row of Douglas’ language system (see Figure 2). This pattern carries through for all word types – nouns, pronouns/people words, actions, phrases and adjectives/ describing words. Giving these consistent patterns allows for au- tomaticity to happen in motor planning, increasing efficiency of expression. (Van Tatenhove, n.d.). Related to motor planning is real estate (or the value of the lo- cation of single button) of the language system. In direct selection systems real estate is not as important of a factor as one button is not necessarily easier to access than another; albeit direct selec- tion can have its own set of access difficulties depending on the user. Real estate was critical when arranging Douglas’ language system. Scanning already has efficiency working against it, there- fore we needed to consider where and how we were going to lay out language in conjunction with frequency of word use. For Douglas’ system we used frequency of word use and fine-tuned our arrangement with word importance to Douglas. For exam- ple, “eat” and “drink” are frequently used core words. Eating and drinking is not a big part of Douglas’ life. While he certainly still has things to say with these words, it did not warrant them being more easily accessible than other, more relatable words. When thinking about real estate in a language system de- signed for scanning, we did not determine linearly, but by number of switch hits (moving and selecting) it would take Douglas to get to a single word. These hit numbers will differ for single- and two- switch scanners, but relationally will give the same information, when also considering the auditory information and wait time single-switch scanners will still have. For example, in Douglas’ lan- guage system, “touch” (see Figures 1 and 2) is a two-hit sequence in MinSpeak® terms, but takes seven switch hits (five moves and two selects) to navigate to. You will see that the number of se- lections, remains consistent with the Unity® and MinSpeak® hit patterns, two selects is the same as a two-hit sequence. Instead of counting hits for each word, we looked at the grid of icons as a (partial) pyramid, tilted on its base, with dimensionality added as Douglas progressed into sequential screens. The first button in the first row takes the least amount of switch hits (two) to ac- cess. The second button in the first row and the first button in the second row take the next, least amount of switch hits (three) to access. The third button in first row, second button in the second row, and first button in the third row take the next least amount of switch hits (four) to access; and so on. While the system could not
be organized on a purely one-to-one ratio with frequency of word use to least amount of hits, due to the already established motor pattern “categories” (yellow, green, blue, orange row, etc.); the real estate pyramid guided us in where to place our multi-meaning icons within their motor pattern “category.” The “eat” and “drink” examples I mentioned earlier come in to play here. “Eat” and “drink” and the vocabulary within their icon symbol were mostly related to eating and drinking; and because we decided this set of vocabulary was not essential to have near the top of the pyramid, quicker to access, we moved them towards the base, giving oth- er more highly sought after words better real estate. Additionally, because they were towards the base of the pyramid, they had less language content inside of them, versus icons closer to the top, were filled with more language. See Figure 3. Lastly, we did add (mostly core) phrases into Douglas’ lan- guage system. Important to note, is that the phrases we chose were likely word combinations and could be combined with oth- er core words, still maintaining the generative natures of Douglas’ language system. They were not necessarily a singular unit. We wanted to offer Douglas the same efficiency tool that Unity® of- fers with pronoun/verb combinations (i.e.,“I want”,“you need”,“we like”, etc.). Due to the high frequency of uses for the words in these combinations, it made sense to combine them into a single motor pattern instead of always having to use two motor patterns. We offered these phrases both in statement and question phrases, in a similar location pattern to Unity®. The statement phrases live in the pronoun icon with which they are associated. The question phrases live in the icon symbol of the verb with which they are associated. Since these phrases did not take up all of our fourth row (or blue row) real estate within the language system, we were able to create other phrases that we determined would be ideal for Douglas to say efficiently, adding a social and pragmatic lan- guage component within the language system, such as “pay at- tention,” or “not cool.” Morphological and Syntactical Considerations Another important consideration for Douglas’ language sys- tem was understanding that when it took at minimum two hits to say any single word and up to 20+ switch hits (for a two-step scanner) to say to a single word (in a core language based sys- tem), we needed to take into consideration our desire for Douglas to use correct syntax and how this affected his efficiency. Was it important for us that Douglas used correct syntax or more im- portant for him to be able to get his expressions across more ef- ficiently with one, two or three words that were not necessarily grammatically“correct”nor in the syntactically correct word order, but had meaningful context and were novel, generative and au- tonomous? We went for novel, generative and autonomous. It is not to say that his language system could not grow and become more grammatically complex as he grew in his automaticity, but we knew that quick access to rich content words was crucial for him to be generative in his language use and overcome ineffi-
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