Augmentative and Alternative Communication, 2015; 31(2): 137–147 © 2015 International Society for Augmentative and Alternative Communication ISSN 0743-4618 print/ISSN 1477-3848 online DOI: 10.3109/07434618.2015.1008569

RESEARCH ARTICLE

Influence of message error type on Korean adults’ attitudes toward an individual who uses augmentative and alternative communication JAE RI KIM1, YOUNG TAE KIM1, HYUN JUNG LEE1 & EUN HYE PARK2 1

Department of Communication Disorders, and 2Department of Special Education, Ewha Womans University, Seoul, Korea

Abstract The aim of this study was to investigate the influence of types of message errors on the attitudes of Korean adults toward a person who uses AAC. The attitudes of 72 adults who speak native Korean were examined through attitude questionnaires completed after viewing videotaped conversations between a boy with cerebral palsy and an adult without disabilities. Each interaction video involved a message with one of six error types, including various types of syntactic, semantic, and pragmatic errors. The participants provided information on their attitude towards the person who used AAC, and ranked their preferences among the six messages. The results provide evidence that attitudes towards the individual using AAC were most positive (in comparison with other conditions) when a pragmatic error was observed. Messages containing a syntactic error were ranked most favorably. Spearman’s correlation analyses revealed some relationship between attitudes rating and preferences ranking. Our results provide evidence that specific language and cultural contexts may play an important role in shaping attitudes toward those who use AAC.

Keywords: Augmentative and alternative communication (AAC); Attitudes; Adults

Introduction

Hoag et al., 2008; McCarthy & Light, 2005; McCoy, Bedrosian, Hoag, & Johnson, 2007; Sperber & Wilson, 1995). An attitude is “an idea charged with emotion which predisposed a class of actions to a particular class of social situations” (Triandis, 1971, p. 2). That is, attitudes are learned dispositions that direct feelings, thoughts, and actions (Byron & Dieppe, 2000; Carter & Markham, 2001). Previous studies have found that negative attitudes toward individuals with disabilities can interfere with their ability to fully participate in society throughout their lives (Hergenrather, Rhodes, & McDaniel, 2005). For example, negative attitudes toward people with disabilities have been found to be significantly correlated with their self-esteem, their personal perception of their disability, and their utilization of vocational and rehabilitation services (Hergenrather & Rhodes, 2007; Mullins, Roessler, Schriner, Brown, & Bellini, 1997). Given that speakers who utilize AAC have complex communication needs as well as physical and/or intellectual disabilities, understanding their partners’ attitudes is deemed important for successful interaction (Beck, Thomson, Kosuwan, & Prochnow, 2010). Indeed, if

Successful conversation depends on the rapid and effective production of relevant utterances during live interaction. However, maintaining a conversation can be challenging for those who use augmentative and alternative communication systems (AAC) because even the most flexible AAC systems impose limitations on interactions between individuals (Light & McNaughton, 2014). For example, an utterance-based approach can, in principle, increase the rate of conversation because the system pre-stores a large number of sentences in the AAC device and retrieves them later when they are needed during a live conversation (Baker, 1982; Higginbotham & Wilkins, 1999; Langer & Hickey, 1998; Todman & Alm, 2003; Todman, Alm, Higginbotham, & File, 2008). However, due to the difficulty anticipating the exact message needed (Hoag, Bedrosian, McCoy, & Johnson, 2008), the available pre-stored message might deviate from the intended sentence. This deviation from the ideal messages could contribute to the negative attitude of communication partners, especially in the lived experiences reported by individuals who use AAC (Bedrosian, Hoag, & McCoy, 2003; Hoag et al., 2004;

Correspondence: Young Tae Kim, Department of Communication Disorders, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, Korea. E-mail: [email protected] (Received 22 March 2014; revised 14 December 2014; accepted 12 January 2015)

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communication partners have negative feelings about the individual who uses AAC, the interaction is less likely to be successful. Furthermore, the development of negative attitudes toward individuals with AAC might create barriers that interfere with the formation of meaningful social relationships (McCarthy, Light, & McNaughton, 2002), as well as causing difficulties in academic, vocational, and societal participation (Beukelman & Mirenda, 2012; McNaughton, Light, & Arnold, 2002; McNaughton, Light, & Groszyk, 2001; Popich & Alant, 1997). Thus, understanding the attitudes of those who communicate with individuals who use AAC can help to support more positive and effective interactions. Also, a greater understanding regarding how to influence and change societal attitudes toward people who use AAC would help clinicians to direct their clinical expertise and resources toward providing more positive outcomes for their clients. There are many factors, such as age, gender, previous experience, and culture, which can influence an individual’s attitude toward a person with disabilities and/or those who use AAC. Studies examining the perception of the general population regarding those with disabilities revealed that, in general, older individuals have more favorable attitudes toward those with disabilities than do younger individuals (Ten Klooster, Dannenberg, Taal, Burger, & Rasker, 2009; Weiserbs & Gottlieb, 1995). Some studies reported that females have more positive attitudes than males when facing individuals with disabilities (Mitchell, Hayes, Gordon, & Wallis, 1984; Paris, 1993) and individuals using AAC (Beck & Dennis, 1996; Beck, Bock, Thompson, & Kosuwan, 2002; Beck, Fritz, Keller, & Dennis, 2000; Beck, Kingsbury, Neff, & Dennis, 2000; Blockberger, Armstrong, O’Connor, & Freeman, 1993). However, other research indicated no differences between female and male attitudes (Bedrosian et al., 2003; Ringlaben & Price, 1981; Stephens & Braun, 1980). Previous experience dealing with individuals who have disabilities may also exert an influence on attitudes. Individuals who have experience with people with disabilities tend to have more positive attitudes than those without experience (Ten Klooster et al., 2009). Unfamiliar listeners rated a person who used AAC less positively than did speech-language pathologists who are presumed to have more experience (Bedrosian, Hoag, Calculator, & Molineux, 1992). In addition, children who attended inclusive schools reported more positive attitudes than those in non-inclusive schools (Beck & Dennis, 1996; Beck, Kingsbury et al., 2000). However, no difference was found in teacher attitudes between schools serving only children with disabilities and inclusive schools (Dada & Alant, 2002). Cultural factors can also influence an individual’s attitude toward people with disabilities (Tervo, Azuma, Palmer, & Redinius, 2002). For instance, Westbrook, Legge, and Pennay (1993) examined the attitudes of 665 health practitioners from six different cultures.

Results revealed that Germans scored higher on social distance ratings, followed by Anglo Australians, Italians, Chinese, Greeks, and Arabs, respectively. The authors suggested that the attitudes toward people with disabilities are more negative in collectivistic societies (China, Greece, Italian, and Arabic) than in individualistic societies (Germany and Australia). Another study, which made a cross-cultural comparison of the United States, Greece, and Denmark, also demonstrated Americans to have the most positive attitude toward people with disabilities, while Greeks were the least positive (Zaromatidis, Papadaki, & Gilde, 1999). A recent study by Grames and Leverentz (2010), however, showed different results. The authors investigated the attitudes of American college students compared with Chinese international college students in the United States. The results showed that the Chinese students reported more positive attitudes toward people with disabilities than did American students. While there have been a number of studies examining general attitudes towards persons with disabilities, we have a more limited understanding of specific factors associated with attitudes, especially with respect to the use of AAC by persons with complex communication needs. There is some initial evidence that the type of errors produced by a person who uses AAC may influence a partner’s attitude toward people who use AAC. A small number of studies have investigated the influence of the types of errors in messages on partners’ attitudes toward those who use AAC. For example, Bedrosian et al. tested the effects of AAC messages containing errors on the attitudes of salesclerks toward adults using AAC (Bedrosian et al., 2003; Hoag et al., 2004; 2008; McCoy et al., 2007). In each experiment, 96 salesclerks viewed scripted, videotaped message error situations in the context of a bookstore interaction; they also completed a questionnaire designed to assess their attitudes toward customers who used AAC. The results showed that situations involving slowly delivered relevant messages were rated more positively than situations in which the messages were quickly delivered but only partly relevant (Bedrosian et al., 2003); situations involving slowly delivered messages with adequate information were rated more positively than quickly delivered messages with inadequate information (Hoag et al., 2004); and situations involving quickly delivered messages with repetition were rated more positively than the slowly delivered, non-repetitive messages (McCoy et al., 2007). The researchers also examined the hierarchy across these three conversational rule violations when latency remained consistently short (Hoag et al., 2008). The results showed the highest rating for the pre-stored message with repetition, followed by the message with excessive information. The message with inadequate information was next, followed in the last place by the message with partly relevant information. The researchers interpreted the results based on the work of Sperber and Wilson (Sperber & Wilson, 1995; Wilson & Sperber, 2004, 2012), who proposed that relevance supersedes Augmentative and Alternative Communication

Influence of AAC Message Error all other considerations when processing information. Bedrosian et al. (2003) suggested that the less positive attitude toward the speaker is related to the greater processing effort required by the listener to retrieve meaningful and relevant information from partly relevant messages. While a variety of factors can impact a listener’s ability to retrieve meaningful and relevant information from messages, the presence of errors in the message can play a key role. Lyons (1977) defined two criteria for determining errors: grammaticality and acceptability. An utterance is grammatically correct when it is linguistically well formed. In contrast, acceptability involves a pragmatic element in addition to linguistic considerations. Bedrosian and her colleagues (Bedrosian et al., 2003; Hoag et al., 2004, 2008; McCoy et al., 2007) investigated the effects of utterances, which are grammatically correct, but not acceptable in the conversational context (e.g., a pragmatic error). However, since most of the current AAC devices can be combined with both wholeutterance and word-construction approaches, various types of message errors including grammatically incorrect sentences need to be carefully considered. Errors produced by an individual who uses AAC could be classified as follows: (a) the grammar of a message may not be used correctly (syntactic error), (b) the message content conveyed may not be relevant to the topic (flow) of an ongoing conversation (semantic error), or (c) the usage of a message may not be socially appropriate (pragmatic error). Any one of these errors can have a significant impact on the effectiveness of communication, as well as on the perceived competence of the individuals who use AAC. Many individuals who use AAC have been observed to experience difficulties using syntactic structures of language (Kelford Smith, Thurston, Light, Parnes, & O’Keefe, 1989). Incomplete syntax (e.g., Soto & Toro-Zambrana, 1995; van Balkom & Wele DonkerGimbrere, 1996), improper word order (e.g., Smith & Grove, 1999, 2003; Trudeau, Morford, & Sutton, 2010), and omission of function words (e.g., articles and prepositions; Soto & Toro-Zambrana, 1995; van Balkom & Wele Donker-Gimbrere, 1996) can make a speaker’s message obscure, which has a significant impact on communicative effectiveness. Semantically, a wide variety of words are needed to create syntactically accurate sentences. However, an individual who uses AAC’s external lexicon (i.e., the words on his or her communication display) may not accurately reflect his or her internal lexicon (i.e., difficulties in creating semantically correct sentences; Smith & Grove, 1999, 2003; Sutton, 1999). For example, young children who use AAC might experience delays in semantics because they cannot select their own lexicons to be displayed on AAC displays, and rely on adults to make those selections (Beukelman & Mirenda, 2012). The discrepancy between internal and external lexicons could also sacrifice the precision of conversational messages. © 2015 International Society for Augmentative and Alternative Communication

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Pragmatics involve communication skills such as using language for different purposes, changing language according to the needs of a listener or situation, and following rules for conversations (American Speech-Language Hearing Association [ASHA], 2014). For example, Bedrosian et al. (2003) coined the term floor holder to describe the explanatory message at the beginning of a conversation (e.g., “Please give me a minute while I construct my message”). This introductory message lets the communication partner know that the speaker uses AAC, and that the following speech may sound different. The results showed that messages preceded by a conversational floor holder are more favorably received than those without a preceding floor holder (Bedrosian et al., 2003; Hanson & Sundheimer, 2009; Hoag et al., 2004; McCoy et al., 2007). The authors interpreted these results as supporting the theory that such floor holders publicly acknowledge that there will be a violation of the speed of message delivery, and act as an anticipatory repair strategy. While there are a small number of studies that address the impact of semantic and pragmatic errors, few studies have been conducted regarding listeners’ preference toward different types of grammatical errors. Furthermore, because the majority of research on attitudes toward people with disabilities has focused on populations based in the Western culture, a considerable problem might occur when trying to generalize the results to non-Western countries (Wang, Chan, Thomas, Lin, & Larson, 1997). Evaluation of the effects of various types of message errors by an individual who uses AAC in non-English based languages would help to develop a more robust theoretical framework to explain the relationship between communication partners’ attitudes toward individuals who use AAC, and the types of message errors which may be produced. Thus, in the current study, the effects of various types of message errors on attitudes toward individuals who use AAC were examined in the Korean1 context. In Korea, the use of AAC has been limited due to insufficient information and low accessibility. For example, although the number of the students with disabilities receiving services in inclusive school settings has continued to grow (e.g., 65.2% in 2007 to 70.5% in 2013; Korea Ministry of Education, 2013), they still face limitations to effective AAC service delivery systems to assist in education. There have been a few studies on the attitudes and experiences of Koreans with individuals using AAC. For example, Han and Lee (2012) investigated the attitudes of 7- and 9-year-old children toward a peer with cerebral palsy who communicates though AAC. Results provide evidence that the attitudes of the participants were generally negative. The authors hypothesized this to be because Koreans do not yet have much experience with individuals who use AAC (Lee, Yim, Kim, & Park, 2013). Consistent with the results of that study, Korean university students who had previous experience with people with disabilities were found to have more

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positive attitudes than those without experience (Kim & Nam, 2005). In Korea, Korean is the only official language, as well as the dominant and educational language. Syntactically, as an agglutinative language (Lee & Ramsey, 2000; Sohn, 2001), the functions and meanings of nouns and verbs in Korean sentences are determined by the particles and verb endings that are attached to them. Thus, a small change in the particles or verb endings might result in a sentence with a completely different meaning. In addition, the Korean language utilizes an extensive system of honorifics (e.g., /jo/ ending) to reflect social relationships between the speaker and listeners. For example, it is considered rude if a child were to address an adult without using honorific expressions during their initial meeting. In order to explore the effects of types of message errors on the attitudes of Korean adults toward individuals who use AAC across different aspects of language (i.e., syntactic, semantic, and pragmatic components), the following research questions were proposed: (a) Are participants’ attitudes toward an individual who uses AAC more positive when the messages used have syntactic errors, semantic errors, or pragmatic errors?, (b) Which of these message errors employed by an individual who uses AAC do the participants rank less favorably?, and (c) Are there gender differences in how the participants rate the six error conditions? Our hypotheses were as follows: (a) Participants would have the most negative attitudes for an individual who has used messages with semantic errors, followed by messages with syntactic or pragmatic errors (Bedrosian et al., 2003; Grice, 1975; Hoag et al., 2004; McCoy et al., 2007; Sperber & Wilson, 1995), (b) The preference rankings of message errors would reflect the attitude ratings, and (c) Females would report more positive attitudes than males (Beck et al., 2002; Beck, Fritz et al., 2000; Blockberger et al., 1993).

Method Participants A total of 72 (36 male and 36 female) native Koreanspeaking adults participated in the study. Participants were required to complete written questionnaires after watching conversational videos portraying an interaction between a 10-year-old boy with cerebral palsy and an adult without disabilities. The female and male adults were chosen by the first author of the study, and both were in their 30s. A 10-year-old boy was selected in order to explore the effects of the absence-of-anhonorific-expression error, which would be obvious in situations where a child talks to an adult. Participants were recruited by advertisements placed around a university campus in Seoul, Korea. Those who were interested in participating contacted the first author of the study. The study was then explained to the potential participants, and signed consent forms were

obtained from those willing to participate. The participants were administered a questionnaire ensuring that they met the following criteria: (a) aged 19 or older, (b) no problems in speech production and comprehension in Korean, (c) functional hearing and vision, and (d) no previous experience in conversing with those who use AAC. All participants lived in Seoul, Korea; they were all ethnically Korean and spoke Korean as their native primary language. They also had a minimum of a high school education. The age of the male participants ranged from 19–59 years (M ⫽ 29.3, SD ⫽ 9.87); the age of the female participants ranged from 21–57 years (M ⫽ 26.5, SD ⫽ 6.54). Of the male participants, 27.78% (10 out of 36) had more than one year of previous experience with people with disabilities, whereas only 13.89% (5 out of 36) of the female participants had such experience. The demographic characteristics of the participants are provided in Table I. Error Conditions In the current study, the target message was “Could you please help me? Where is the nearest subway station on line 4?” As described in the introduction, the message error types were classified into three categories: syntactic errors (particle and verb-ending errors), semantic errors (subject part and predicate part errors), and pragmatic errors (absence of a floor holder and an honorific expression). Thus, manipulation of the message resulted in six error conditions: (a) wrong choice of a particle (/ka/ instead of /i/, which are both nominative particles in Korean marking the subject of one or more of the following verb or adjective phrases: the only difference is that /ka/ is used only after vowels, while /i/ is used after consonants) as a particle error, (b) wrong choice of a verb ending (declarative /-nida/ instead of interrogative /-nika/) as a verb-ending error, (c) wrong choice of a noun (“taxi” instead of “subway station”) as a subject error, (d) wrong choice of an interrogative (“how much” instead of “where”) as a predicate error, (e) the effect of missing the honorific ending (absenceof-an-honorific-expression error), and (f) the effect of missing a floor holder (absence-of-a-floor-holder error; see Table II). Since the six message error conditions were operationally defined for the current experiment, each message error

Table I. Characteristics of Participants by Gender.

Female (n ⫽ 36)

Male (n ⫽ 36)

Overall (n ⫽ 72)

20–29 30–39 40–59 ⱖ 1 year

24(67%) 8(22%) 4(11%) 10(28%)

31(86%) 4(11%) 1(3%) 8(22%)

55(76%) 12(17%) 5(7%) 18(25%)

⬍ 1 year

26(72%)

28(78%)

54(75%)

Characteristics Age range (years)

Prior experience with people with disabilities

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Influence of AAC Message Error

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Table II. Types of Error Messages.

Error types Particle errors

Wrong choice of the normative particle (/ka/ instead of /i/ )

Verb-ending error

Wrong choice of a final ending (declarative instead of interrogative)

Subject error

Wrong choice of the noun (“taxi” instead of “subway station”)

(Could you please help me? Where are the nearest subway station on Line # 4?) Syntactic errors

(Could you please help me? The nearest subway station on line # 4 is where.)

(Could you please help me? Where is the nearest taxi on line # 4?) Semantic errors

Predicate errors

Wrong choice of the interrogative (“how much” instead of “where”)

Absence of floor holder

Missing a floor holder

(Could you please help me? How much is the nearist subway station on line # 4?)

Pragmatic errors

(Where is the nearest subway station on line # 4?) Absence of an honorific expression

Missing a honorific expression

(Could you please help me? Where is the nearest subway station on line # 4?)

was tested for the ability to be identified in its current context. Eight graduate students majoring in communication disorders completed a questionnaire by matching each of the six messages into the corresponding error types. All the students were Korean, and spoke Korean as their native and primary language. As a result, only one student did not identify errors in the messages with a subject error, verb-ending error, and absence of a floor holder (87.5% in each message error type). All students accurately identified the intended error in the other three error types. The sentences were then corrected based on these results and other comments. The final version of the error conditions is presented in Table II.

help me?” via KidsVoice, the adult stops in front of him (except in the absence-of-a-floor-holder condition, where the target sentence was directly produced). Each video was ended after the child produced the target sentence with an error. Each video was 15 s in length (except for the absence-of-a-floor-holder condition, which was 10 s). In the experimental conditions, the female participants watched only the videos with a female communication partner, while the male participants watched only the videos with a male communication partner. This arrangement was designed to encourage the participants to project themselves in the role of the adult (Bedrosian et al., 2003; Hoag et al., 2004).

Conversational Scripts The setting for the videotaped conversation was on a busy street corner near a subway station. This setting was chosen in order to provide a public setting where an individual who uses AAC might seek help from strangers who are likely to be unfamiliar with them and their communication style (AAC). Three people were cast in the video: a school-aged child with cerebral palsy, and an adult male and female without disabilities. The boy communicated via a KidsVoiceTM2 AAC device (2006, UBQ, Co.), using direct selection with the index finger. The content of each script was the same across conditions, except for the last sentence in which the error occurred. In the opening scene of each script, an adult was passing by a child in a wheelchair. When the child asks, “Could you please © 2015 International Society for Augmentative and Alternative Communication

Questionnaire The attitude questionnaire used in Bedrosian et al. (2003) was adopted and translated into Korean. Among the 38 total items, those that were repetitive or exclusive to the original experiment settings were excluded. The final questionnaire was shortened to 18 items (see the Appendix to be found online at http://informa healthcare.com/doi/abs/10.3109/07434618.2015. 1008569). The survey addressed three different areas: a descriptive component, including six items describing the beliefs about and perceptions of the person who uses AAC; an affective component, including six items reflecting the feelings about the person who uses AAC; and a behavioral component, including six items reflecting the predicted actions toward the person who uses

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AAC in a particular situation. The three components were each presented separately. Each item was rated on a 5-point scale, ranging from 1 (strongly disagree) to 5 (strongly agree). In the final part of the questionnaire, the participants were asked to rank their preferences among the six delivered messages from 1 (most preferred) to 6 (least preferred). The participants were asked to mark a 1 beside the most preferred messages, a 2 beside the second-most preferred, and so forth, in descending order. Internal consistency was evaluated using Cronbach’s alpha. Each of the three components and the overall scores demonstrated adequate internal consistency by achieving values of Cronbach’s alpha higher than 0.70 (Nunnally, 1978): Cronbach’s alpha ⫽ 0.743 for the descriptive component; Cronbach’s alpha ⫽ 0.822 for the affective component; Cronbach’s alpha ⫽ 0.730 for the behavioral component; and Cronbach’s alpha ⫽ 0.856 for the overall scores). Procedures The experiment was conducted by Korean adults, with instructions delivered to the participants in Korean. In a quiet room, each participant viewed the scripted and videotaped street conversations, and completed an attitude questionnaire after each video. Each interaction video involved a message including one of the six error types. The participants completed one questionnaire for each of the videos. In order to minimize immediate sequential effects, the order in which the six messages were viewed was counterbalanced, using a Williams’ square (Kuehl & Kuehl, 1994; Williams, 1949). This resulted in six orders of the error conditions: 126354, 231465, 342516, 453621, 564132, and 615243. For example, participants assigned to the order 126354 saw condition 1 first, followed by conditions 2, 6, 3, 5, and 4. There were 12 participants per sequence. Participants were randomly assigned to sequences. After viewing all six conditions, the participants were asked to rank their preferences among the six messages. For this reason, they viewed the six scripted conditions in a single session with short breaks between the videos. The entire session lasted approximately 60 min.

Data Analysis First, the attitude rating was examined. This included participant responses to the 18 survey statements designed to assess the different aspects of attitude on a 5-point scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The mean attitude ratings of the participants served as the dependent variable (i.e., providing possible scores ranging from 1–5). Participant responses to negatively-stated items were recorded in reverse, for the purpose of data analysis. That is, for negatively-stated items, the score 1 was coded as a score of 5, and vice versa. Because the means were calculated as a composite average of the items in a section (and not individual 5-point-scale responses), it was reasonable to treat them as having approximately normal distributions due to the Central Limit Theorem (Traylor, 1983). Q-Q plot analysis confirmed the normal distribution of the composite scores, justifying the use of parametric analysis. A two-way mixed ANOVA was then conducted to compare the attitude ratings across gender (between-subject variable) and error types (within-subject variable). Second, participant preferences were indicated by rank ordering of the six error conditions from 1 to 6: 1 being the most preferred error condition, with 6 being the least preferred error condition.

Results Attitude Ratings A two-way mixed ANOVA revealed a statistically significant main effect for error types, F(5,350) ⫽ 32.763, p ⬍ .001. Neither a gender effect nor an interaction effect was observed. The mean attitude ratings (a possible maximum score of 5) towards the person with a disability and the results of Bonferroni post-hoc analysis are presented in Figure 1. Attitudes were most positive when the person who used AAC used the message without a floor holder, followed by the message with a particle error. The message without an honorific expression was next, followed by the

Figure 1. Overall mean scores by error types. Note: Error bars represent standard errors of means. Arrows indicate a significant difference between error types (p ⬍ .001). Augmentative and Alternative Communication

Influence of AAC Message Error message with a verb-ending error. The messages with semantic errors were rated the lowest, indicating the least positive attitudes. Preference Rankings The participant rankings of preferences were then examined. A total of 72 rank orderings were obtained. The frequencies of the preference rankings for each type of error are presented in Table III. The data indicated that the absence of an honorific expression was most frequently identified as the least preferred error type. When asked to rank the six error types, 50% of the participants ranked the absence of an honorific expression as the least favorable error, and 62% ranked the presence of a particle error as the most favorable error. In order to gain a better understanding of error rankings, we calculated the number of times that an error was ranked in the first three (most favorable) positions. Based on this analysis, participants ranked the errors in the following manner (from most to least favorable): messages with a particle error, the absence of a floor holder, a verb-ending error, the absence of an honorific expression, a predicate error and a subject error. A Spearman’s rank-order correlation was run to determine the relationship between attitude ratings and preference rankings. Before the analysis, the data were ranked. The attitude rating with the largest value (i.e., largest number) was labelled 1 and the preference ranking with the highest value (i.e., smallest number) was labelled 1. For the 72 correlations, 11 (15.28%) were above .80, 26 (36.11%) were between .50 and .79, and 35 (48.61%) were below .49. One of the factors that may have impacted the correlation between preference rankings and attitude ratings was the scores obtained for the absence of an honorific expression. This error was most frequently identified as the least preferred error type; however, it was more highly rated with respect to attitudes. Therefore, a Spearman’s rank-order correlation was run which excluded the absence of an honorific expression condition. For the 72 correlations with absence of an honorific expression excluded, 22 (30.55%) were above .80, 21 (29.17%) were between .50 and .79, and 29 (40.28%) were below .49.

Discussion In the present study, the influence of types of message errors on the attitudes of Korean adults toward a person who uses AAC was investigated. Three hypotheses were explored: (a) a hierarchy of attitudes would exist according to message error types, (b) the preference rankings of message error types would reflect the obtained hierarchy, and (c) gender differences might be found in the attitudes. Attitude Ratings The first hypothesis examined whether there would be a hierarchy of attitudes according to the message error types. As mentioned previously, participants showed the most negative attitudes toward messages with semantic errors, that is, when the individual with AAC selected the wrong subject noun (i.e., “taxi” instead of “subway station”) or the wrong interrogative (i.e., “how much” instead of “where”). These results suggest that whether the message was semantically understandable or not was the biggest element influencing the attitudes of the study participants toward a person who uses AAC. These results are consistent with those of the previous studies, where messages with only partly relevant information were rated the lowest among various messages with conversational rule violations (Bedrosian et al., 2003; Carlson, 1981; Hoag et al., 2008; Kim, Park, & Min, 2003). Moreover, messages with incorrect content words would require an additional investment of time and effort for the listeners to understand relevant information, which may result in negative impressions about the person who uses AAC (Sperber & Wilson, 1995; Wilson & Sperber, 2004, 2012). Consistent with these findings, the message with a verb-ending error was rated lower than the message with a particle error in the same syntactic error category. Given that verb endings express not only grammatical marks but also subtle semantic meanings (Lee & Ramsey, 2000), these results may be explained by the semantic discrepancy involved in each condition (McCoy et al., 2007). That is, stating a declarative sentence (i.e., “the nearest subway station on line 4 is where”) in a situation where you need to ask something (i.e., “where is the nearest subway station on line 4?”) brought not only a

Table III. Frequencies and Percentage of Rankings of Error Condition.

Syntactic error

The most Second Third Fourth Fifth The least

Semantic error

Pragmatic error

Particle error

Verb-ending error

Subject error

Predicate errors

Absence of a floor holder

Absence of an honorific expression

45 (62%) 19 (26%) 4 (6%) 2 (3%) 1 (1%) 1 (1%)

4 (6%) 21 (29%) 26 (36%) 10 (14%) 8 (11%) 3 (4%)

1 (1%) 5 (7%) 4 (6%) 17 (24%) 28 (39%) 17 (24%)

0 1 (1%) 9 (13%) 26 (36%) 22 (31%) 14 (19%)

20 (28%) 20 (28%) 15 (21%) 8 (11%) 8 (11%) 1 (1%)

2 (3%) 6 (8%) 14 (19%) 9 (13%) 5 (7%) 36 (50%)

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syntactic difference, but also a semantic/meaning difference to some extent.The semantic breakdown might have produced confusion for the participants in an attempt to relate the partly relevant message to the context of the interaction (Bedrosian et al., 2003; Hoag et al., 2008; McCoy et al., 2007; Nam, 2011; Sperber & Wilson 1995; Wilson & Sperber, 2004, 2012). In contrast, the same response effort may not be required in conditions involving the message with a particle error (i.e., /ka/ instead of /i/). In the experiment, /i/ was switched to /ka/, which are both nominative particles marking the subject of one or more of the following verb or adjective phrases in Korean. Since the error caused little change in the meaning of the message, the communication partners may be able to interpret what they thought the student wanted without additional effort. However, the level of the attitudes toward the message could differ even in the same particle-change error condition. For example, while the particle change between /i/ and /ka/ caused no substantive change in the meaning of the sentences used in this study, a change from a nominative particle, /i/, to an accusative particle, /r ul/, (“John eats” to “eat John”) might result in a completely different meaning. Thus, further research is needed to identify the extent to which different degrees of changes might affect the level of attitudes. Overall, the mean scores of participant attitudes were generally positive. These findings are contrary to those of the previous studies on Korean children and adults, where the participants generally expressed negative attitudes (Han & Lee, 2012; Kim & Nam, 2005). This might be explained by the age discrepancy between the participants and the person who has used AAC. The participants in the study were adults viewing a child, not someone from their age group. Given that older individuals tend to have more positive attitudes toward people with disabilities than younger individuals (Ten Klooster et al., 2009; Weiserbs & Gottlieb, 1995), the Korean adults might have rated the child who has used AAC more positively than expected, despite their limited experience with those who use AAC (Lee et al., 2013). Another possible explanation is the use of selfreported attitudes. Previous studies showed that the measured attitudes of persons towards individuals who use AAC were generally higher than the lived experiences of persons who use AAC (McCarthy & Light, 2005). Future research should include measures that can be generalized to actual behavior in different settings. Preference Rankings Our second research goal was to investigate whether the preference rankings of message error types would support the obtained hierarchy of attitudes. There appeared to be some relationship between attitude ratings and preference rankings. Spearman correlation analyses revealed that over half of the ratings (37 of 72) showed a moderate to strong correlation (rs ⱖ .80) between attitude ratings and preference rankings. When the absence

of an honorific expression condition was excluded, 43 out of 72 showed moderate to strong correlations between attitude ratings and preference rankings. Interestingly, the absence of an honorific expression was most frequently identified as the least preferred error type. Unlike English, the Korean language has a complicated system of honorifics in various verb forms as well as noun forms, and every single verb has several conjugations that reflect the social relationships between the speaker and listeners.The results of the current study showed that in a conversation using a speech generating device, the use of an appropriate honorific form was still one of the most important factors that can influence an individual’s feeling toward people who use AAC. Gender Differences Although the research methodology allowed for the exploration of gender differences, the results indicated no effect of gender among the participants. These findings are contrary to those of a number of studies where female children and adults were found to have more positive attitudes toward people with disabilities than their male counterparts (Beck et al., 2002; Beck, Fritz et al., 2000; Blockberger et al., 1993). However, some studies have also come to a similar conclusion, stating a lack of differences in attitudes with respect to gender (Bedrosian et al., 2003; Hoag et al., 2004; McCoy et al., 2007). Future research should investigate the effect of gender differences further. Limitations This study has several limitations as well. First, it must be acknowledged that the current investigation was limited by its experimental nature involving an attitude questionnaire (Hoag et al., 2004). Even though a previous study indicated no statistically significant differences in the attitudes formed from participating in a live conversation and from viewing an interaction via video (O’Keefe, 1992), the participants who provided the ratings were third-party participants as opposed to first-party conversational partners (Hoag et al., 2004; Wiemann, 1977). Additionally, the questionnaire used in the experiment may not measure global attitudes of the participants toward individuals who use AAC: rather, it measured their attitudes toward a particular speaker in a very specific situation. Future research should refine the scale and include measures of test-retest reliability, while also including more clearly described groups of participants to allow analysis of the influence of factors such as age and familiarity on attitudes toward error types. Implications Despite these limitations, the current study has important clinical and technological implications. Taken in the context of results from the previous research, this study concludes that some message errors may produce more positive (or less negative) reactions than others, and Augmentative and Alternative Communication

Influence of AAC Message Error that effective message strategies for errors could differ in specific language and cultural contexts. Indeed, the study’s finding that semantic violations were rated less positively than other types of errors has implications for the development of future technology to support AAC systems. As a matter of fact, AAC systems are essentially semantic systems that include sets of symbols to convey concepts (Light & McNaughton, 2014). Thus, developers and practitioners should not only collect vocabulary used with high frequency and then allocate the vocabulary appropriately (Baker, 1982; Higginbotham & Wilkins, 1999; Langer & Hickey, 1998; Todman & Alm, 2003; Todman et al., 2008) but also reduce operational demands (Light & McNaughton, 2014). The design of AAC systems should be focused to enable the individuals who use AAC to navigate and operate the systems accurately and efficiently. At the same time, individuals who use AAC also should learn the syntactic aspects required to express meaning (Blockberger & Sutton, 2003; Light & McNaughton, 2014). For example, in the Korean context, grammatical markers should be laid out appropriately, which can change the meaning of the sentence. The users should be allowed to quickly and easily edit pre-stored messages or construct the words (e.g., choosing an appropriate interrogative pronoun or changing verb endings) that are most relevant to the context in which they are used. Moreover, with the advent of technology, techniques such as an automatic correction might be used to reduce the syntactic errors to effectively convey meaning. Last but not least, a practical implication of this experiment is the need for considering the effects of culture. The current study results showed that people who use AAC to construct their messages in the Korean language might need quick and effective support for conversational control strategies, such as the use of honorific expressions. The finding that the conditions using honorific expressions achieved higher rankings supports the prediction that the use of such message strategies would reflect positively on the person who uses AAC. How well a communicator can do this is likely to have an effect on how others perceive him or her, especially within cultural contexts like in Korea, where proper/ improper honorifics can serve as a vital factor for judging language ability.

Conclusion The present study investigated the influence of types of message errors on the attitudes of Korean adults toward a person who uses AAC. Overall, the mean scores of participant attitudes were generally positive. Consistent with previous findings, whether the message was semantically understandable or not was the biggest element influencing the attitudes of the Korean adults toward a person who uses AAC. Our results also demonstrated that distinctive features of Korean language were of © 2015 International Society for Augmentative and Alternative Communication

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importance to listeners. Future research should investigate whether the differences in language errors would actually result in a change in the observed behavior of listeners.

Acknowledgements None.

Notes 1. This is a discussion of data collected in the Republic of Korea. 2. KidsVoice is a product of Ubiquitous Education (UBQ) Co. Ltd, Sungnam-Si, Geyonggi-do, Korea. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This research was supported by the Development Center to Support QoLT Industry and Infrastructures [100036459] and was funded by the Ministry of Knowledge and Economy/Korea Evaluation Institute of Industrial Technology (MKE/KEIT), Korea.

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