COMMUNICATION BOARD &

AMERICAN-INDIAN
GESTURAL CODE
Annie Loof and Kim Caron

AMERICAN-INDIAN GESTURAL CODE

Basic hand gestural code
Using action instead of words (pantomiming)
Easily comprehended

Was founded on the absence of a shared linguistic background

The gesture system was shaped:
By its origin in the need for basic communication
By its purpose of transcending different spoken languages

Simple gestures were used for clarity to limit the levels of symbolism
No need for rules or grammar!

Code, not a language!

OVERVIEW
EARLY PILOT STUDY
Included 20 patients who had aphasia
At the date of admission, no patients had any usable verbalization or effective
gestures.
During approximately 50 sessions:
18 patients were exposed to 50 gestures
1 patient was exposed to 40 gestures
1 patient was exposed to 30 gestures

A hierarchy was used to facilitate communication

Imitation of gesture to verbalization

Results: All patients achieved, to varying degrees, a repertoire of gestures and

practical use of it.

RATIONALE
Many patients who do not respond appropriately to auditory stimuli often interpret
accurately and respond appropriately to the codified gestures.
Patients can also profit from a program that emphasizes Amer-Ind Code as a mode
of communication by the patient as well as to the patient.
Madge Skelly
OUTPUT AND INPUT

CASE HISTORY
CH is a 62-year-old female
History of left CVA
Exhibits global aphasia
Extremely limited abilities across all modalities
Has no consistent, functional verbalizations or effective gestures
at this time
Primarily communicates through husband
Amer-Ind Gestural Code was modified to work in and out of
modalities.

THERAPY OVERVIEW
Goal: CH will use modified Amer-Ind Gestural Code for social situations.
Objective 1: Inform CH of functional gestures used in everyday situations
Task: CH will understand that many normally speaking adults use hand
gestures for normal communication under certain circumstances.

Normal, acceptable and truly useful

Traffic officer, camera operator, umpires
Gestures can be more effective than verbal speech (noisy situations)
Gestures are easily and quickly learned as an alternate method of communication

THERAPY OVERVIEW
Objective 2: Achieve gesture recognition
Task 1: CH will point to pictures of family members on the communication
board when clinician states the family members name.
Point to (auditory comprehension)

Task 2: CH will point to pictures of family members on the communication

board when presented with a corresponding gesture from the clinician.
Point to the family member that goes with the gesture I do. (gestural recognition)

Task 2: CH will point to pictures of family members on the communication board

when presented with a corresponding gesture from the clinicia n.

THERAPY OVERVIEW
Objective 3: Achieve gesture execution
Task: CH will imitate gestures presented by the clinician.
Do the gesture I do for (gestural execution)

THERAPY OVERVIEW
Objective 4: Achieve gesture retrieval
Task 1: CH will state the family members names when the clinician points
to a picture on the communication board.
Who is this? (verbal expression)

Task 2: CH will retrieve the corresponding gesture when the clinician

states the family members name.
Show me the gesture for (gestural retrieval and auditory comprehension)

Task 3: CH will retrieve the corresponding gesture and state the family
members name when the clinician points to a picture on the
communication board.
Im going to point to a picture on the communication board. I want you to do the
gesture and say the name. (gestural retrieval and verbal expression)

Task 2: CH will retrieve the corresponding gesture when the clinician states the
fa mily members na me.

Task 3: CH will retrieve the corresponding gesture and state the family
members na me when the clinicia n points to a picture on the communica tion
boa rd.

MULTI-MODALITIES
Auditory Comprehension
Verbal Expression
Gestural Recognition
Gestural Execution
Gestural Retrieval
Gestural Retrieval + Verbal Expression

FEEDBACK
Explicit comments (semantic) during teaching tasks
Clinician: What family member goes with this gesture?
CH: ZH
Clinician: Thats correct. ZH likes to play golf. ZH is your son.

If incorrect, clinician explained why her response was wrong.

Clinician: What family member goes with this gesture?
CH: JH
Clinician: Thats not right. JH is the attorney. Her gesture is this. ZH likes to play golf. ZH is
your son. This is the gesture for ZH.

SCORING AND DATA COLLECTION

Binary
Benefitted from oral-motor and phonemic cueing
Self-corrected on verbal perseverations
Goal: CH will use Amer-Ind Gestural Code for social situations.
Objective 1: Inform CH of functional gestures used in everyday situations
Results: No data was obtained.

SCORING AND DATA COLLECTION

Objective 2: Achieve gesture recognition
Task 1: CH will point to pictures of family members on the communication
board when clinician states the family members name.
Results: CH was able to accurately identify each family member 14 out of 14 trials
(100%)

Task 2: CH will point to pictures of family members on the communication

board when presented with a corresponding gesture from the clinician.
Results: CH was able to accurately identify each family member 22 out of 28 trials
(79%).

SCORING AND DATA COLLECTION

Objective 3: Achieve gesture execution
Task: CH will imitate gestures presented by the clinician.
Results: CH was able to imitate gestures presented by the clinician 12 out of 12 trials
(100%).

SCORING AND DATA COLLECTION

Objective 4: Achieve gesture retrieval
Task 1: CH will state the family members names when the clinician points to a
picture on the communication board.
Results: CH was able to accurately state each family member 17 out of 17 trials (100%).

Task 2: CH will retrieve the corresponding gesture when the clinician states the
family members name.
Results: CH was able to accurately retrieve the gesture with given a name of the family
member 11 out of 13 trials (85%).

Task 3: CH will retrieve the corresponding gesture and state the family
members name when the clinician points to a picture on the communication
board.
Results: CH was able to accurately retrieve the corresponding gesture 24 out of 29 trials
(83%). CH was able to accurately state the corresponding name 24 out of 29 trials (83%).

FUTURE PLANS
Continue modified Amer-Ind Gestural Code in therapy
Continue to work in and out of modalities
Review four gestures and names
Introduce more gestures for additional family members
Work toward use of gestures for conversation