title: Attitude and key word signing usage in support staff.
abstract: BACKGROUND
  Support staff may diverge in their use of augmentative and alternative communication (AAC) and key word signing (KWS). AAC use is determined by multiple personal and environmental factors. In this study, the relation between KWS attitudes and usage was examined in support staff.
  
  
  METHODS
  Twelve adults with an intellectual disability who use KWS were each filmed during a dyadic interaction with two professionals from their service: one had received first-hand (1HT) and the other second-hand KWS training (2HT). Each communication partner participated with only one client. The professionals' sign usage was coded, and their attitude towards KWS was measured using a survey and single-category Implicit Association Test (IAT).
  
  
  RESULTS
  1HT produced more signed utterances and distinct signs than 2HT, and this increase had a positive, linear relation to IAT scores. Explicit attitude did not correlate with KWS usage, but did significantly correlate with the discrepancy between intention and KWS usage.
  
  
  CONCLUSIONS
  The train-the-trainer system may not reach its full potential as 2HT knew fewer distinct signs and consequently produced fewer signed utterances than 1HT. In contrast to implicit attitude, no relation was found between explicit attitude and KWS usage. Though the survey may provide valuable information, it may not fully capture the complex influences that shape AAC usage.
authors.affiliation: KU Leuven, Faculty of Medicine, Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ORL), Herestraat 49 box 721, BE-3000 Leuven, Belgium. Electronic address: Ellen.Rombouts@kuleuven.be.
authors.forename: Ellen
authors.initials: E
authors.lastname: Rombouts
authors.affiliation: KU Leuven, Faculty of Psychology and Educational Sciences, Parenting and Special Education Research Group, L. Vanderkelenstraat 32 box 3765, BE-3000 Leuven, Belgium.
authors.forename: Bea
authors.initials: B
authors.lastname: Maes
authors.affiliation: KU Leuven, Faculty of Medicine, Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ORL), Herestraat 49 box 721, BE-3000 Leuven, Belgium; University Hospitals Leuven, Campus St.-Rafaël Department of ENT, Head & Neck Surgery, MUCLA Herestraat 49, BE-3000 Leuven, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Zink
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003143:Communication Devices for People with Disabilities; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008607:Intellectual Disability / Q000534:rehabilitation*; D008875:Middle Aged; D011247:Pregnancy; D012813:Sign Language; D000070260:Teacher Training; D055815:Young Adult
keywords: Attitude; Augmentative alternative communication; Direct support staff; Key word signing