Opening of the Conference: assoc. prof. Maurice Grinberg, ASSIST || Afshan Khan, UNICEF Regional Director For Europe and Central Asia || Maria Gaydarova, Deputy minister of Education and Science, Bulgaria |||| Nadya Klisurska-Zhekova, Deputy minister of Labor and Social Policy || Sophia Kalman, MD, PhD, DML || prof. Juan Bornman, ISAAC

Inclusion may be defined as supporting individuals with disabilities to be active participants in the life of mainstream nursery schools or schools, in spite of their functional limitations. Both segregation and inclusion are based on assumptions related to educational, relational, ethical and political issues, resulting in different approaches to the organization of education and training of children with disabilities, including children in need of augmentative and alternative communication (AAC). Inclusive education is a condition for learning and enculturation in a broad sense. Inclusion requires reciprocal communication but is also a context for communication and language development and use, including development and use of AAC. Inclusion affects the whole range of events and activities that are the foundation of meaning making in nursery school and school. Much of the meaning making is taking place within activities of the peer culture in and out of school. Children with disabilities may need some one-to-one training but support of participation in the class and in child-managed activities and events are core elements of inclusive practices.

Anna Krasteva is 10 years old and is from Tagovishte, Bulgaria. She has been using an eye-tracking system to communicate, to study, to play games for more than 4 years. Anna is extremely intelligent and persistently uses every free moment to study. Annie is a 3rd-year student at the one of the best school at her hometown. Using eye-gaze technology she can take part in all of the activities at school. She can read, write and do her homework on the computer. The eye-tracking technology she is using allows her also to communicate with her peers, to use Scratch for programming, and also to listen to her favourite songs, stories and films, as well as to use skype, viber, and to play games.

During the COVID-19 pandemic, CHAP conducted a study with children with complex communication needs about their experiences during the pandemic. Six children (5-13 years) were interviewed through a video-conferencing platform in December 2020. The interview guide was adapted based on the children’s communicative abilities and included augmentative and alternative communication support. General open questions were combined with probing questions, as well as some closed-choice questions. All interviews started with open-ended questions, even when the parent or personal assistant expressed that closed questions were the “easiest and most effective way” for some children to communicate. The interviews were conducted by a speech and language therapist, specialised in AAC. Through qualitative content analysis, two themes were identified: The child’s knowledge of Corona raises anxiety and fear; and Boring Corona makes the child even lonelier. This study demonstrates that children with complex communication needs can give insights to their unique life situations, given adequate support. The children had knowledge about the pandemic, missed their grandparents, and expressed existential concerns, much to the surprise of their parents.

AT and AAC interventions have many facets that require careful thinking, planning and implementation if we want these interventions to be successful. But what do we actually know about success in AT, beyond anecdotical evidence? And what are the challenges when it comes to raising outcomes and impact? The speaker will elaborate on some of the results of a European wide consultation that have been recently held, organised by AAATE and a group of experts in the framework of a global consultation promoted by the Global Alliance of Assistive Technology Organizations (GAATO).

Successful communication depends upon pragmatic skills like choosing the correct words at the right time. Children develop their pragmatic skills using their language, implying that aided communicators may be at a disadvantage if they are not in an environment where their language is used. Inclusive practices therefore both supports and is supported by the development of pragmatic skills. In the Becoming an aided communicator (BAC) project, pragmatic understanding was investigated. BAC is an international multi-center study including aided communicators with age-appropriate cognitive functioning. Type of pragmatic functions used and how relevant the children’s responses were was analyzed, in relation to mode of aided communication, the child’s verbal comprehension and communicative functioning, and the educational setting of the child.

UNICEF’s Regional office for Europe and Central Asia has been piloting a joint initiative to bring affordable Assistive Technology for Augmentative and Alternative Communication (AAC) in Croatia, Montenegro and Serbia. Bulgaria and North Macedonia joined the project in 2021. An open source mobile app, “Cboard” is being introduced by UNICEF and partners to support young children with complex communication needs who otherwise may be left out of early childhood education services. The tool promotes interaction, helps overcome speech impairments, develops language and steers these children towards an education and active social life right from their early years. An AAC tablet-based communicator – Cboard, which is available in over 30 languages, and accesses the Global symbols database of over 20,000 symbols – is being tested for effectiveness with children, professionals and parents. Cboard is an open-source, offline-compatible and freely available AAC application, designed for scalability and access to reach many more children in the future around the globe. In low-tech settings, the pictographic symbol sets can also be exported from Cboard and printed to support communication work with children using paper-based resources. Professionals including pre-school teachers, speech and language therapists, psychologists, occupational therapists and special educators are being trained to identify and support young children with speech, language, and communication related difficulties who could benefit from assistive technology. A robust training package developed for this purpose and delivered as a combination of face to face and on-line learning is readily available to support professionals from other countries.

Since 2016 UNICEF Bulgaria supports the introduction of augmentative and alternative communication (AAC) technologies in the system of pre-school and school education by stimulating the building of positive attitudes in society and among professionals about the possibilities of these technologies, but also increases the capacity of the professionals themselves for the systematic and sustainable introduction of AAC in support of children with special needs. At a time when Bulgaria is still adjusting inclusive education practices and policies, including first attempts to move from the medical to the social model of assessment and support for children with special needs and disabilities, it is extremely important to improve the understanding of the basic need for communication and interaction, as well as to raise awareness of approaches and means supporting this communication. A study of the attitudes, competencies and practices of professionals in Bulgaria will be presented and the main strands of support from UNICEF for the introduction of AAC will be presented, including support for the development of the legal framework, development of training packages for professionals and qualification programs, development of an interactive platform podkrepi.me to improve the quality of additional support for children with special needs, including through AAC, as well as adapting for Bulgaria free and accessible AAC resources and tools. Special attention will be paid to the role and tasks of the Regional Centres for supporting the process of inclusive education as supporting and sustainable units in the inclusive education system by presenting the experience of the center in Sofia city.

I would like to introduce the AAC-Modell Program in the framework of the MONTÁZS Project (EFOP 1.9.2.-VEKOP-16-2016-00001) called „Developping accessibility to special and public services for persons with disabilities”. The main goals were: setting up regional (6) AAC-centres in Hungary with complex services e.g. assessement of communication competency, providing trainings and support for the target group and their families, supporting professionals working with CCN persons in special and public organisations achiving these goals we had to train professionals on AAC-competencies creating special AAC-library with a wide range of equipements from low-tech to high-tech devices. In the second part of my presentation I would like to focus on the conlusions of the 4-year long period such as good practices, experiences, future plans. Beside being the coordinator I worked with CCN persons, families, professionals directly, which gave me different insight of the use of AAC.

The network of ICT Resource Centres for Special Needs in Portugal have the responsibility to assess students’ needs for assistive technology to access curriculum and learning, since 2007. They have an important role to train for the use of AT, since they are the AT prescribers of the Ministry of Education, belonging to a vaster system of national prescribers of assistive products. This network of 25 centres covers all portuguese schools and has been recognized as one of the organizational resources to support learning and inclusion in the recent Inclusive Education Law of 2018. Considering a general recommendation to explore free tools and resources, the ICT Resource Centres have produced many resources, such as the adaptation of children stories and other didactic materials into AAC symbols, as well as video tutorials about free software and videos on the use of AT by students. They have also produced many AT devices with recycled materials, such as sensory materials, switches, talking devices, makey makey and arduino projects.

A video presentation

Children learn through exploration and play, and gaming is one of the most motivational tools to promote development and growth – regardless of age and motor or cognitive ability; It holds the key to inclusion, participation, and ultimately independence while having loads of fun!

Our presentation focuses on the strategies we have been using in our school for including nonverbal students in online learning, so that they are not left out during the difficult time of pandemic. In our school, nonverbal students are taught to use no–tech or low-tech communication devices (communication books, boards or cards) due to the economic situation of families and school resources. Teachers use school resources to produce the support for AAC for each child.

With more than 15 mouse equivalents to choose from, Pretorian’s range is by far the broadest in the assistive technology space. But which should you choose for a particular client? Dave Gilbert discusses some of the ways in which each can be used and which are the best choices for particular conditions, particular situations and particular software, including AAC software such as Grid 3.

Since her birth, Anjela has been diagnosed with cerebral palsy, a fighter at heart, full of life and curiosity about the world around her, she does not allow this to break her. Her need to communicate freely with people led her to art, where, although confined to a wheelchair, she flies. She dances, plays, writes and creates. As she leads her silent fight for the people with special needs. The stories of her relatives and colleagues, reveal her strength and her work. They take turns with animated pieces, where we hear the computer voice with which she speaks to us today, while writing with her eyes on a computer. In them, the physical freedom of the animated Anjela takes her to all the places of her dreams. Title: ANJELA Director: VILMA KARTALSKA Production Company: RAIZA VILM PRODUCTIONS, PRIME PRODUCTIONS Country, year: BULGARIA, 2021

By interacting with others, children encounter and solve problems, communicate, and learn to consider others’ perspectives. Social understanding and pragmatic reasoning are skills that begin to develop during childhood interactions while children participate in social activities such as play, act in their physical environment, interact with others, and learn how to communicate social behaviour in accordance with the expectations of society. Children, who have severe motor and communication impairments, often lack opportunities to play and interact with peers due to limitations in their speech or movement. Social interactions are often restricted because these children are unable to control their environment through physical actions or communication. While using currently available augmentative and alternative communication (AAC) technologies (such as speech generating devices) can help, it is typically slow and time-consuming, especially for children and youth with severe physical disabilities. This lack of ability to communicate in real-time is particularly problematic in peer interactions. This presentation will discuss current research concerning the social participation of children with severe motor and communication impairments and emerging evidence on supportive strategies.

How do normative understandings of ‘voice’ mediate research with persons who communicate differently? Can researchers ‘give voice’ to participants who use AAC? Qualitative research is often reliant on idealized conceptions of voice as the singular possession of an autonomous individual. This framing grants authority to some accounts while raising concerns about the authenticity of those generated with participants who use AAC. In this presentation, I discuss these issues in the context of a study about inclusion with young people who use AAC. Drawing examples from the study and subsequent application in other areas, I demonstrate the value added through conceptualizing voice as dialogical. I suggest the implications of this work for research and practice more generally, highlighting the dialogical relation that is all our communication.

AAC is a relatively new field of intervention. Isolated interest in providing tools for communication for people without speech began to pop up in different countries during the 1960s. In the 1970s this interest grew and became more widespread. There were no personal computers, no Internet, no virtual communication at that time. Knowledge was spread through presentations at conferences, professional and personal visits around the globe, and word of mouth. Two non-speech conferences were held in Toronto in 1980 and 1982. In 1983 Prof. John Eulenberg hosted a historical meeting at the Artificial Language Laboratory in East Lansing Michigan. The term Augmentative and Alternative Communication was officially adopted and ISAAC (The International Society for Augmentative and Alternative Communication) was born. The Film Prelude to ISAAC was produced for the ISAAC Connect virtual Conference held in August, 2021, for the purpose of providing documentation regarding the beginnings of our field. This presentation will include a short introduction to this period of AAC history and the showing of the film Prelude to ISAAC.

Child abuse is a rampant global problem, affecting more than one billion children - half of world’s children (Hillis et al., 2016). A global review of published research showed that the prevalence of abuse (including sexual, physical and emotional abuse as well as neglect and exploitation) against children with disabilities was 21%, which is estimated to be 3-5 times higher than the abuse prevalence of peers without disabilities (Jones et al., 2012). Individuals with complex communication needs have a heightened risk. This presentation will unpack the risk factors, focussing on the perpetrators, professional persons across the criminal justice system (police and courts), persons with disability themselves as well as their families. Augmentative and alternative communication (AAC) can allow these individuals to exercise their own autonomy, to make decisions and share information thereby allowing them to access justice. A number of different court-based communication methods and strategies will be described with a focus on a recent South African case study.

PCS symbols, the largest symbol language in the world with over 40,000 symbols, are weaved throughout Tobii Dynavox software, Boardmaker and TD Snap, to encourage and enable inclusion, participation, and positive behavior for learners and their support network.

Honzík Přikryl is a 13-year-old student in 7th grade. He has cerebral palsy which impairs his movements and speaking. However, this hasn't stopped him from entering a public kindergarten at the age of 4 and continuing his education in elementary school. Honzík Přikryl uses an eye-tracking device and a specialized software for communication Grid 3. With the assistance of his AAC system, he can communicate with his family and friends.

Hospitalization of a patient who has lost the ability of speech & Language (Due to a stroke resulting with Aphasia) is frequently characterized by the loss of basic patient rights. Communication impaired patients are severely limited or totally cut off from an intelligent exchange of vital information and dialogue with their medical and caregiving team. The outcome of communication vulnerability for patients is often a sense of helplessness, anxiety, and depression, which many times has earlier roots in an inability to communicate with family members and relatives. Many patients who cannot write or spell are able to understand and convey messages by pointing at objects or images. Speech therapists that work in the hospital struggle with limited resources, specifically time, equipment and appropriate skills. It is challenging for them to create communication tools based on pictures and symbols and to provide suitable guidance for patient companions. There is a pressing need for a communication tool featuring pictures and symbols adapted for adult patients, which includes messages on topics that hospitalized patients want to talk about: urgent personal needs as well as assorted conversation topics. There was also a need for building a quick and effective guidance tool for family members and patient escorts who would facilitate the use of the communication tool. In a process that included gathering information from speech therapists in 28 hospitals, our team created communication boards for three different levels. These boards were translated into the four most common languages in Israel (Hebrew, English, Arabic and Russian). The lecture will demonstrate the boards that were created, the accompanying guide tools and the rationale that serves as the basis for their creation.

This study evaluates an Augmentative and Alterative Communication (AAC) implementation project in a school for students with Autism and Intellectual Disabilities. Assimilation of AAC in schools is essential for providing communication opportunities among the students. This process included providing knowledge and skills to the school staff. The study examined the teachers' attitudes, AAC-knowledge and practicable abilities. Data was collected by analyzing the outcomes of discussions and questionnaires. Teachers who participated in all modules had the highest sense of AAC competence. These teachers were also the leaders in implementing AAC. All the teachers reported high degree of satisfaction. This study provides an AAC intervention model for multi-disciplinary teams in schools. Validating the multi-dimensional intervention model is a starting point for implementing AAC in a variety of schools and within the community.

An introduction to Inclusive Technology and a brief overview of Cosmo; the award-winning, interactive therapy and inclusive training system and Skyle for iPad Pro; eye tracking technology. We are proud to offer an extensive selection of hardware, software, and online resources to support clients with complex needs. This presentation will focus on our most recent innovative resources!

Learning Adjustment in Pandemic times – Challenges for Students with Special Educational Needs and AAC users (Swedish context) Since March 11th of 2019, the pandemic multifaceted and created unprecedented challenges in everyday life of people and societies, particularly regarding issues of age, gender, ethnicity and disability. Provision of education caused major disruption across the globe. School closures worldwide in spring 2020, identified digital technologies, digital competences, new partnership in intersectional and transnational fields approaches as a central in education for rethinking the delivering of various forms of education, supporting provision of it as a basic human right. Sweden was one of the few countries that decided to keep preschools and compulsory schools open during the pandemic, recognizing the necessity of the Lockdown just for secondary/gymnasiums and higher education institutions. Municipalities got the right to coordinate physical and remote education for pre-school and compulsory schools in accordance with local pandemic conditions. The data around the pandemic effect on the students with special educational needs (SEN) and AAC users is rather limited and fragmented. Despite fragmented character of the data, most of the statistical and thematic reports emphasize that the pandemic disproportionally and negatively affected vulnerable groups of learners, such as a high level of school absence of students with SEN, poor health conditions among them, etc. The presentation will be based on analysis national Skolverket, SPSM (Specialskolmyndigheten), etc. reports.

During the last eighteen months the world learnt about new ideas, like home office, Е-learning, zoom conferences, quarantine obesity, mRNА vaccines, etc. From the beginning teachers and clinicians recognized that children and adolescents frequently fight fear, anxiety, and other mental health problems. The cause was the physical and social isolation, the loss of normal routines and restricted opportunities for stress release. AAC using children and adolescents also experience these problems, so it’s important that they have tools to deal with them. In the post-pandemic years inclusion might become the focus, partly because of its controversies. To follow smart technologies and robotics will become a challenge for AAC professionals, otherwise their students won’t be able to live with the new opportunities. Social justice will mean another controversial field: some will have the opportunities to use human and technical resources, some others not. Priorities of the post-pandemic efforts might not include people with disabilities and SCN. Inclusion means that we all have to share our only world, thus AAC professionals will have an important task to make sure that AAC using people and their families are not left behind while we all work for a more solidary, more sustainable post-pandemic world.