Environmental factors influencing choice of spelling and graphic symbols in communicative interactions of adolescents who use communication aids.

This exploratory interpretative qualitative study aimed to investigate environmental factors influencing "in the moment" decisions about use of graphic symbols or spelling in face-to-face communicative interactions, by adolescents who use communication aids and are learning how to spell. The participants were six adolescents (who used speech generating devices) and their mothers. Data collection consisted of seven to eight communicative interactions between adolescents and their mothers and follow up interviews with the participants. Each dyad took part in three Zoom sessions. Researchers identified the communication mode shifts between graphic symbols and spelling during interactions and subsequently discussed with participants the reasons for these shifts. The interview data were analyzed using Charmaz's constructivist grounded theory approach to coding. The analysis revealed three themes explaining environmental factors relevant to choosing spelling or graphic symbols in communicative interactions, which were: (a) features of the communication aid; (b) communication partner's skills and their knowledge of the shared experience; and (c) opportunities to practice and use spelling. The findings provide insights into the importance of providing opportunities to practice and use spelling, communication partner's skills and knowledge of shared experience and communication aid technology design which can help to facilitate spelling during communicative interactions.