Augmentative and Augmentative and Alternative Alternative

CommunicationCommunication

Supporting Existing Speaking Skills

“The ability to communicate is the most powerful tool humans possess , it opens many doors; the inability to do

so, can close just as many”

(Tanchak & Sawyer, 1995, p 57).

Communications Group

Web Activity #3/3

Nancy Swan-Cendejas

Designing and implementing AAC systems for children is truly a team process.

Three common beliefs that must be held in order to participate in matching a person with a communication aid are:

Everyone can communicateEveryone can learnEveryone can participate

Rule 1: Be committed to the most effective communication system for the individual being served.

The AAC assessment may be the single most important event in the life of a person who relies on AAC. Where that person goes in life will be influenced by communication effectiveness.

Rule 2: Be committed to following your professional code of ethics.

All members of the team must not only agree, but also be motivated to provide the system and services that result in the highest level of personal achievement. In addition, the team must be working toward helping the child develop communicative competence which results in a spontaneous, interactive exchange of information, feelings, and thoughts. Parents should be asking team members how their educational plan and recommendations are going to help their child communicate effectively.

Rule 3: Be committed to involving the consumer and family in the service delivery process.

Parents may need to remind team members that the reason for all these procedures is because of their child. A Consumer-Centered Service Delivery model places the team members and processes in proper perspective. The consumer and family are the focal point and parents may even decide to request outside supports. Outcomes are influenced by the environment. Defining the roles and responsibilities of the individual team members in this model can have a positive influence on Rule 4.

Rule 4: Be committed to achieving the maximum outcomes for the individual.

Stakeholders are those with an interest in the outcomes of the process. Parents need to realize that because of different roles and responsibilities, some stakeholders are vested in achieving different outcomes. Clinicians and therapists tend to be more concerned with outcomes related to clinical results. Whereas, administrators will be more concerned with best use of staff time and cost effectiveness for service delivery. Consumers and family members have concerns connected to quality of life and satisfaction issues. Acknowledging differing interests can help teams reach a better understanding of contrasting positions and swifter resolutions to any disagreements.

Rule 5: Be committed to advocating for language. If the team agrees on the central goal of AAC as being the highest possible personal achievement, then language becomes the focus of assessment and intervention. Unfortunately, many AAC strategies and programs focus on modifying behaviors, such as providing for classroom vocabulary, rather than real communication. The technology is used to promote responses to environmental cues and the child is limited to activating scripted messages. The mastery of basic core vocabulary words should precede the introduction of vocabulary specific to daily activities and academic subjects.

Rule 6: Understand the merits of ALL language representation methods. The three commonly used language representation methods are single meaning pictures, spelling, and semantic compaction. The outcomes an individual who relies on AAC is able to achieve depend heavily on the language representation method(s) being used. Ease of use at first encounter may not be most effective in the long run.

Rule 7: Support the language representation method(s) for core and extended vocabulary access that best serve the interest of the individual.

Vocabulary selection and organization has been one of the most widely researched topics in AAC. Access to a vocabulary based on the notion of core and extended categories is more important than vocabulary frequency lists to support vocabulary selection. The vast majority (approximately 85%) of what we say in daily situations consists of a few hundred core words. Most of these core words are determiners, verbs, adjectives, prepositions, indefinite pronouns, etc., situation-specific nouns would be considered extended, or fringe vocabulary.

Rule 8: Advocate for the AAC system that supports the chosen language representation method(s).

Most individuals reaching the goal of AAC are using multiple language representation methods with the AAC system. Observation of their achievement indicates the use of semantic compaction for core vocabulary access and spelling for extended vocabulary words. Single meaning pictures appear to have limited use for when the individual only requires access to a small core vocabulary set or for access to extended vocabulary when the individual cannot spell.

Rule 9: Be committed to using AAC performance measurement to support clinical intervention.

The most useful and beneficial evidence on which to base decisions regarding educational and clinical AAC services is analyzed performance data (language samples taken from clinical and natural settings). This is done using automated language activity monitoring. This type of monitoring provides team members with detailed information from spontaneous language samples to measure changes in communicative performance. An objective, quantitative record of how the individual is using technology in different settings can provide the basis for clinical intervention.

Rule 10: If unable to adhere to any of these guidelines, be truthful about it to the individual, family, and advocates.

Provides an opportunity for any team member to express discomfort with what is being expected of him or her. It also provides for disclosure of being "between a rock and a hard place" relative to making recommendations that may be contrary to administrative directives, such as "Don't write that into the IEP, or the school will have to buy it."

Augmentative Communication; refers to any approach designed to enhance an individual's already existing speaking skills. The intervention is not designed to replace existing communication abilities, but rather to support them.

Alternative Communication; refers to those communication approaches that are an individual's primary means of communication.

"No tech" is the use of natural communication/interaction, such as eye gaze.

"Low tech" is the use of simple external materials to facilitate the communication process. Examples of this include communication boards and voice output communication aides

"High tech" is the use of computer-based devices that have a variety of capabilities. Many "high tech" devices use synthesized speech to generate speech production. Some examples of "high tech" devices include: the DynaMyte, AlphaTalker, and the McCaw.

Low Tech Boardmaker

There are a myriad of AAC products commercially available. It is critical to "question and try out everything" prior to selecting a device. The assessment process is just as important, if not more important, than the product itself. Matching a person with the proper device (high or low tech) is critical for the person's

success.

                                                             

LightWRITER

Explore some vendor sites to learn more about many of the devices commercially available. Please visit the AAC vendor links at the following website: http://aac.unl.edu This will take you to the homepage, and then look under "vendor links" (not "products.") These sites provide pictures of devices, text descriptions, and current prices. Many also include the weight, color available, and other detailed specifications. This is a good opportunity to find out more about specific aac (as well as other types of assistive technology) devices. I recommend that you visit the AbleNet and the Don Johnston sites first.

Continued

For communication aids to be successful, they need to be used across environments and to generalize to many different communication partners. Children need to be able to use a communication aid in their classroom. However, this experience is not always successful.

Despite the many types of aac devices available, there are reasons a chosen device will fail with a specific individual. These reasons typically fall into three categories: implementation strategies, vocabulary selection, and the mechanics of the device.

The device is too complicated It breaks easily It is not the child's/consumer's

choice Educational staff turn over Educational staff follow

through The manufacturer fails/does not

provide support Insufficient training to family,

school, etc.

Lack of peer "buy in"/understanding

Poor convenience/portability/weight

Student/situation changes Speed of communication is too

slow/too fast Vocabulary chosen does not

match child's personality/needs/wants/environment

Reasons for Failure

Fear/Assumptions Lack of time Ignorance Lack of follow through Safety of equipment

Programming needs Equipment glitches "Ownership of the

child/equipment" Lack of equipment

Classroom Related Problems

These issues, however, also can be successfully addressed. Helping the educational staff to be well trained and comfortable with an aac device, takes time, training and support.

Gus the Pocket Communicator

The child, not the type of technology (nor the funding), must always be the focus of the assessment. The technology must meet the child's wants and needs; the child must never "fit" any existing/convenient technology. The information gained from the assessment will dictate the type of technology the team should explore. Prior to trying different types of technology . Consider the following questions:

                     

1. What reasons does the learner have to communicate?2. How does the learner currently meet communication

obligations and opportunities?3. Which communicative intents and vocabulary should

be taught to enable the learner to meet communicative obligations and opportunities?

4. Which communication modes or modes (vocabulary, gestural, graphic) best match the learner's communication needs and abilities?

5. What decisions must be made for getting started in the graphic mode?

6. What decisions must be made for getting started in the gestural mode?