ࡱ> MQ( '( F 2olli@purdue.edu/ 00DArialgsRotLv 0( 0"DTimes New Romanv 0( 0 DWingdingsRomanv 0( 00DTahomagsRomanv 0( 0" `0.  @n?" dd@  @@``    q****21// ..5    HH,,  )*     !# 0AA@8!-".R ʚ;k8ʚ;g4KdKdv 0ppp@  <4dddd 0L<4BdBd 0Lg4EdEdv 0p@ pp<4!d!d` 0Lt0___PPT10 ___PPT9  ( ? %O  =W?)IAugmentative and alternative communication (AAC) for children with autismJJ(IPreliminary results of a meta-analysis Oliver Wendt, M.A. Ralf W. Schlosser, Ph.D. Lyle L. Lloyd, Ph.D. AAMR, Philadelphia, June 2004>&(A'`*AAC and autismAutism includes qualitative impairment in verbal and nonverbal communication  delay in, or lack of the development of spoken language (American Psychiatric Association, 2000) ~50% of children with autism are functionally non-verbal, no sufficient natural speech or hand writing to meet their daily communication needs (Wing & Attwood, 1987; Light, Roberts, DiMarco, & Greiner, 1998) Barriers to full participation and inclusion in education, independent living, and leisure activities (Beukelman & Mirenda, 1998)BMZcZRZMcR>fz 2 AAC and autism (cont.)rAugmentative and alternative communication (AAC): supplementation or replacement of natural speech and/or writing using aided and/or unaided symbols (Lloyd, Fuller, & Arvidson, 1997) AAC strategies particularly used in autism: Sign language Pictographic symbols sets/systems High technology speech generating devices (SGDs) for synthesized and/or digitized speech outputNZZxW> l1+Evidence-based practice in AACPractitioners face difficult task selecting a suitable approach Evidence-based practice (EBP): Using research outcomes as a major basis for clinical and educational decisions (Lloyd, 2001) Integration of best and current research evidence with clinical/educational expertise and relevant stakeholder perspectives to facilitate decisions about assessment and intervention (Schlosser, 2003) *_Z'Z_'3 &Evidence-based practice in AAC (cont.)Need to evaluate intervention approaches such as AAC for autism Increased need for accountability Funding agencies Parents Does AAC produce a significant effect? Federal government promoting EBP through  No Child Left Behind Act (NCLB)  educators base school programs and teaching practices on  scientifically based research  Improving servicesnbZZ'ZKZnZb'K n4 "Current evidence for AAC in autismsAAC applications common for children with autism have limited empirical support Urgent need to establish the effectiveness empirically (Mirenda, 2001, 2003) Previous research has not documented the relative effectiveness of AAC interventions (Mirenda, 2001; Prizant & Rubin, 1999) Still controversial which AAC strategies are most effective with different types of autism6PMPM>dk, ObjectivesEvaluation of existing experimental intervention research Review the evidence for the effectiveness of AAC in autism Conduct a quantitative review and synthesis of the research literature Effectiveness measures Quantitative evaluation of study outcomes and study characteristics&[[5 Objectives (cont.)What AAC interventions (e.g., aided, unaided, partner training, etc.) are effective in terms of behavior change, generalization, and maintenance in individuals with autism? What AAC interventions are effective in yielding specific outcomes (e.g., language acquisition, functional communication, participation, etc.)? Which AAC interventions are more effective than others in general and in yielding specific outcomes? Find research gaps and methodological gapsl6 Methods9Meta-analysis of intervention studies Statistical reviewing technique providing a quantitative summary of findings across an entire body of research (Cooper & Hedges, 1994): Problem Formulation Data Collection (Retrieval of research literature) Data Evaluation Analysis and Interpretation Dissemination of Results@&l&7Data CollectionRetrieval of intervention studies through comprehensive literature search including Computerized database searches covering Cumulative Index to Nursing and Allied Health Literature (CINAHL) Dissertation Abstracts International Educational Resources Information Center (ERIC) Language and Linguistics Behavior Abstracts (LLBA) PsychINFO Handsearches in (a) bibliography  AAC Theses and Dissertations , and (b) 40 professional journals Ancestry searchesVT(uT(u,F  i8Inclusion of studiesSelection criteria for experiments/data series to be included in meta-analysis: Intervention must pertain to AAC Intervention target must include individuals with autism spectrum disorders (ASD) Experiment employs single-subject or group design Experiment needs to be written as an article in a refereed journal, documents available through ERIC, or unpublished MS/doctoral theses Dated between 1976 and 20040PZIlZPI-$Data evaluation/preliminary findingsMethodological issues Evidence pertaining to aided AAC strategies (e.g., SGDs, symbol sets/systems) Evidence pertaining to unaided AAC strategies (e.g., manual signs)IZ;Methodological issuesLiterature search revealed a total of 263 publications related to AAC & autism Empirical studies: 127 qualitative designs (case studies): 6 group designs: 12 longitudinal designs: 3 (2 descr./1 experim.) single-subject designs: 77 design flawed, etc. : 29>ff7>+Evidence pertaining to aided AAC strategies Speech-generating devices (SGDs) Portable, computerized devices producing synthetic or digitized speech output when activated Graphic symbols are used to represent messages, activated by finger, switch, headstick, etc. selecting a symbol from the display Total of N=6 studies (5 single subject, 1 group design) Potentially effective, outcomes suggest that feedback through synthesized speech increases communicative interactions Also successful in conjunction with Functional Communication Training to reduce problem behavior0!PP!, :?+Evidence pertaining to aided AAC strategiesYPicture Exchange Communication System (PECS) Structured behavioral intervention program to teach use of visual-graphic symbols for communication Teaches to make requests by handing/ exchanging symbols for desired items Total of N=7 studies (all single subject designs) Potential effect, increases in verbal speech reported, but study limitations(----@+Evidence pertaining to aided AAC strategiesFunctional Communication Training (FCT) Set of procedures to replace problem behavior by teaching functionally equivalent communication skills as alternatives Variety of AAC strategies taught including, e.g., gestures, manual signs, symbols sets, use of electronic devices Total of N=13 studies (all single subject designs) May provide convincing evidence, overall positive outcomes are reported re: substantial reduction of challenging behaviors,((<. Evidence pertaining to unaided AAC strategies//#Manual signs First form of AAC applied in autism, used for 30 yrs. Better choice than vocalization because easier to prompt an action than vocalization Involves more iconic representation than spoken language Total of 27 experimental studies 18 single-subject studies, 9 group studies Variable success reported, variable degrees of maintenance and generalization, development of vocalization in varying degrees Enough evidence to suggest it is a viable communication optionn PP+PP + . Further stepsDetermining effectiveness measures Glass effect size (ES) for group designs Percentage of non-overlapping data (PND) for single-subject designs Coding in detail (age, sex, type of autism, speech/language characteristics, etc.) Establishing inter-rater reliability on study selection on study coding Further analyzing and interpretation of the data V#ZnZZZ#n9Further steps (cont.)Further analyzing and interpretation of the data Criteria for interpreting outcome measures Group studies (ES range -3.00 to +3.00): ES of .20  .50: important ES > .50: major difference (Glass et al., 1981) Single subject studies (PND range 0-100%) PND < 50% reflects unreliable treatment PND 50%-70% questionable effectiveness PND 70%-90% fairly effective PND > 90% highly effectiveb1TK*1TK* /AcknowledgementsSupport provided through Research Grant from the Purdue Research Foundation Research Grant from the Purdue - Clifford Kinley Trust Fund Research Scholarship of the Autism Society of America Sigma Xi Grant-In-Aid-of-Researchvd0 References'American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.: text revision). Washington, DC. Beukelman, D. R., & Mirenda, P. (1998). Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd ed.). Baltimore, MD: Brookes. Cooper, H. M., & Hedges, L. V. (1994). The handbook of research synthesis. New York, NY: Russell Sage Foundation. Light, J. C., Roberts, B., Dimarco, R., & Greiner, N. (1998). Augmentative and alternative communication to support receptive and expressive communication for people with autism. Journal of Communication Disorders, 31, 153-180. Lloyd, L. L. (2001, March). Evidence based practice. Why and what with an emphasis on research issues. Paper presented at the Early Childhood Intervention Research Seminar, University of Pretoria, South Africa. Lloyd, L. L., Fuller, D. R., & Arvidson, H. H. (Eds.) (1997). Augmentative and alternative communication: A handbook of principles and practices. Needham Heights, MA: Allyn & Bacon.(Z*6RoK%'&LS%b  / AReferences (cont.)Mirenda, P. (2001). Autism, augmentative communication, and assistive technology: What do we really know? Focus on Autism and Other Developmental Disabilities, 16, 141-151. Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids. Language, Speech, and Hearing Services in Schools, 34, 203-216. Prizant, B. M., & Rubin, E. (1999). Contemporary issues in interventions for autism spectrum disorders: A commentary. Journal of the Association for Persons with Severe Handicaps, 24, 199-208. Schlosser, R. W. (2003). The efficacy of augmentative and alternative communication: Toward evidence-based practice. San Diego, CA: Academic Press. Wing, L., & Attwood, A. (1987). Syndromes of autism and atypical development. In D. J. Cohen & A. M. Donnellan (Eds.), Handbook of autism and pervasive developmental disorders (pp. 3-19). New York, NY: Wiley.Zj96A#[8"H c1Contact Oliver Wendt Purdue AAC Program Department of Educational Studies 1446 BRNG, Purdue University West Lafayette, IN 47907-2098 Phone: 765-494-0090 Fax: 765-496-1228 E-mail: olli@purdue.edu http://www.edst.purdue.edu/aacZ, !0 ` Ot{h______` M <ff33̙3` +ffO=ff̙H7` fff3f̙` Tff33ff` 0Ky{kOz` )R{f` GiIfff̙fR` ̙|̙3f` 3ff~>?" dd@'?lFd@  nK'o`P( n?" dd@   @@``PT     o (`0p>> '((  ZB  c $D"`   6( "M }  X Click to edit Master title style!!  (  0 "; `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!    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3ff~YQ___PPT101..g@x)+ D' = @B DD' = @BA?%,( < +O%,( < +D' =%(%(D ' =%(D' =ABBB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*|%(D' =+4 8?bCB#ppt_x-.2BCB#ppt_xB*Y3>B ppt_x<*|D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*|D' =-6Bwipe(right)*q3=-B%gradientSize: 0.1<*|D ' =%(DD ' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*|P%(D' =-g6B fade*<3<*|PD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*|PD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*|PDr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*|P%(D' =-g6B fade*<3<*|PD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*|PD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*|PD"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*|%(D' =-g6B fade*<3<*|D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*|D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*|D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*|t%(D' =-g6B fade*<3<*|tD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*|tD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*|t+p+0+| ++0+| +/" -> \|(  \ \ S M }<$0    \ S ; `<$0  H \ 0޽h ? 3ff~___PPT10..t?,+ˠD' = @B D' = @BA?%,( < +O%,( < +D' =%(%(D ' =%(D' =ABBB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*\%(D' =+4 8?bCB#ppt_x-.2BCB#ppt_xB*Y3>B ppt_x<*\D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*\D' =-6Bwipe(right)*q3=-B%gradientSize: 0.1<*\D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*\:%(D' =-g6B fade*<3<*\:D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*\:D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*\:D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*\:u%(D' =-g6B fade*<3<*\:uD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*\:uD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*\:uD' =%(D ' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*\u%(D' =-g6B fade*<3<*\uD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*\uD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*\uDr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*\%(D' =-g6B fade*<3<*\D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*\D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*\Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*\%(D' =-g6B fade*<3<*\D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*\D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*\+p+0+\w ++0+\w + -> (    c $<#CM }<$0  C   c $(C; `<$0 C "h_H  0޽h ? 3ff~ ___PPT10..t?,+ˠD9' = @B D' = @BA?%,( < +O%,( < +D' =%(%(D ' =%(D' =ABBB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?bCB#ppt_x-.2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D' =-6Bwipe(right)*q3=-B%gradientSize: 0.1<*D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-g6B fade*<3<*D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*=%(D' =-g6B fade*<3<*=D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*=D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*=D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*=%(D' =-g6B fade*<3<*=D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*=D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*=D"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-g6B fade*<3<*D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*+p+0+w ++0+w +) -> (    S MCM }<$0  C   S PSC; `<$0 C "h_H  0޽h ? 3ff~g'_'___PPT10?'..j@B+ D&' = @B DR&' = @BA?%,( < +O%,( < +D' =%(%(D ' =%(D' =ABBB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?bCB#ppt_x-.2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D' =-6Bwipe(right)*q3=-B%gradientSize: 0.1<*D' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*&%(D' =-g6B fade*<3<*&D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*&D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*&Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*&%(D' =-g6B fade*<3<*&D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*&D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*&Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-g6B fade*<3<*D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-g6B fade*<3<*D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-g6B fade*<3<*D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*!%(D' =-g6B fade*<3<*!D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*!D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*!Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*!:%(D' =-g6B fade*<3<*!:D' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*!:D' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*!:+p+0+w ++0+w +d -> r(  x  c $l\CM }  C   c $PW^; ` <$D0 C "h_H  0޽h ? 3ff~ ___PPT10..j@B+YD' = @B Dm' = @BA?%,( < +O%,( < +D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*T%(D ' =%(D ' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*T|%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*|%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*F%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*FP%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*P%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(+ -> f(  r  S xCM }  C   S }C; ` <$D0 C "h_H  0޽h ? 3ff~___PPT10..A5+YDn' = @B D)' = @BA?%,( < +O%,( < +D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*P%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*Pq%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*q%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*}%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*}%(+; -> d|(  d d S CM }<$0  C  d S dC; `<$0 C H d 0޽h ? 3ff~___PPT10..u?pp;+ˠD' = @B D' = @BA?%,( < +O%,( < +D' =%(%(D ' =%(D' =ABBB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*d%(D' =+4 8?bCB#ppt_x-.2BCB#ppt_xB*Y3>B ppt_x<*dD' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*dD' =-6Bwipe(right)*q3=-B%gradientSize: 0.1<*dD"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*d%(D' =-g6B fade*<3<*dD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*dD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*dD"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*dd%(D' =-g6B fade*<3<*ddD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*ddD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*ddD"' =%(D' =%(Dr' =AB,BB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*dd%(D' =-g6B fade*<3<*ddD' =+4 8?\CB#ppt_xBCB#ppt_xB*Y3>B ppt_x<*ddD' =+4 8?dCB#ppt_y+.05BCB#ppt_yB*Y3>B ppt_y<*dd+p+0+dh ++0+dh +F -> \(  x  c $(CM }  C   c $C; <$D0 C H  0޽h ? 3ff~ ___PPT10..A+YD' = @B De' = @BA?%,( < +O%,( < +D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*O%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*Of%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*f%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(D4' =%(D' =%(D' =4@BBBB%(D' =1:Bvisible*o3>+B#style.visibility<*%(+( ->  |(    S CM }<$0  C   S C; `<$0 C H  0޽h ? 3ff~]&U&___PPT105&..AXq+ˠD%' = @B DH%' = @BA?%,( < +O%,( < +D' =%(%(D ' =%(D' =ABBB@B0B%(D' =1:Bvisible*o3>+B#style.visibility<*%(D' =+4 8?bCB#ppt_x-.2BCB#ppt_xB*Y3>B ppt_x<*D' =+4 8?\CB#ppt_yBCB#ppt_yB*Y3>B ppt_y<*D' =-6Bwipe(right)*q3=-B%gradientSize: 0.1<*D"' =%(D' =%(Dr' =AB,B