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Augmentative Communication Evaluations Simplified: ACES Tools & Resources
Debby McBride, MS, CCC-SLPPresented by AAC TechConnect Inc.
Lisa Bardach, MS, CCC-SLPLibby Rush, MS, CCC-SLP
Tanya Curtis, MS, CCC-SLP700+ participants in other workshops
(contributions in content & resources)
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Purpose
To give people their VOICE
Because we all have something to say!
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What role do you play in giving people their voice?
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What does Augmentative/Alternative Communication mean to
you?
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What is augmentative /alternative (AAC) communication?
Refers to the incorporation of techniques that can be used to help individuals with disabilities in general, as well as to very specialized technologies designed specifically for individuals with significant and severe disabilities. These techniques include, for example, the use of communication symbols, aids, strategies, skills, and devices designed to assist disabled individuals. (Sarah Blackstone; 1986)
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AAC communication includes Nonverbal
Vocalizations
* Low-tech or no-tech
* Lite-tech
* High-tech
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Goals include:
Your goals for this workshop
Write 3 ( on the back of your evaluation form)
*
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Goals include: Explain the process of obtaining an AAC tool/device
Describe tools/techniques used to determine the AAC candidate’s skill
Complete many of the components with templates provided for gathering, compiling and reporting the results.
Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)
Identify local resources and consultants for trials, support, and funding assistance for AAC devices.
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Schedule Today –
Looking at the “Communicator” Using a “Toolkit” for Evaluation Lunch Matching persons to devices / communication tools Trialing the toolkit
Tomorrow Case studies – ours Case studeis - yours Decision-making process for appropriate devices
Trialing the appropriate device(s) Using your local resources Funding
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A Systematic Approach for AAC Evaluations
ACES Module Augmentative
Communication
EvaluationSimplified
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ACES Module examples
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Tools and Resourcesyou will leave with: ACES Module (handouts & on CD)
Evaluation Toolkit List The Persons (form) AAC Device Features (form) Case History & Eval Summary (form) Device Decision Making (form)
Resources on CD Handouts (including the above) AAC device flyers Templates (report, summary forms, etc.) Other resources (website lists, vendors lists, etc.)
Websites: free resources
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Challenges you have? Why…
*
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AAC Evaluations - Challenges
Availability of systematic assessment protocols Acquire premade materials/resources
(vocabulary, overlays, etc) Not organized / equipment available when
needed / working when needed Training ??? Knowledge??? Experience??? Keeping up with technology Overwhelming ? ? ?
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Process – Beginning to end
Person Referral Gathering information Deciding on skills to assess Choosing the “toolkit items” used Evaluating the individual's skills (sensory, physical, language, communication functions/needs, etc.)
Summarizing individual’s skills
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Process continued
Communication Tools / Devices Matching skills to communication tools (feature - matching)
Voice / no voice Trialing communication tools / voice output
devices Making recommendations Writing appropriate documentation Completing funding paperwork as needed Use of your equipment reps
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Evaluation
Who are they? What do they want to say? Where do they want to say it? How do they want to say it? What are their current skills? What technology can bridge the gap?
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Feature Matching –
Determine what the individual needs, then find the technology with the requisite features and match the technology to communicator.
SDT
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Level of communicator
Emerging
Context/Partner Dependent
Independent
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EmergingNo RELIABLE means of EXPRESSIVE
communication through SYMBOLIC language
Have some functional non-verbal communication (gestures, vocalizations, other nonsymbolic communication)
Able to attend, even briefly, to individuals, conversations, pictures, or symbols
Yes/no (acceptance/rejection) depicted with body language; i.e. no reliable yes/no for more complex communication
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Context- or Partner-Dependent
Has SYMBOLIC communication that is RELIABLE but limited to particular CONTEXTS or PARTNERS
Rely on partners to provide limited response set
Need frequent instruction and cueing
Difficulty with initiation
May only be functional in particular settings
Wide range with regard to # of partners and # of settings
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Independent (Generative)
Can communicate ANYTHING on ANY TOPIC to ANYONE in ANY CONTEXT
Locate, select, and convey messages on their own
Can interact with familiar / unfamiliar partners equally well
Can sequence symbols or letters to generate novel messages
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Access / modification
Direct select: keyguard, pointer, stylus
Headpointer / headmouse Eye gaze Joystick, mouse, trackball Morse code Scanning Wheelchair controls (caution)
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Switch access
Circle for location of switch
Type of switch
Mount / attachment
How many switches?
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Scanning options
Auditory / visual Linear / row-column / group Step / inverse / auto Other
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Who is your person?
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break
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Evaluation -
What’s in your toolkit?
What do you currently use?
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Toolkit List
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Gathering your Toolkit
Help you organize what you have - toolkit list Help you decide what to add to your
resources Give you additional ideas for premade
materials / resources Give you additional resources you can access:
CD AAC TechConnect- web
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The Evaluation Toolkit
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The Evaluation Toolkit
Toolkit
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Low-tech physical access components
Keyguard Pointing light Partner Assisted Scanning Eye gaze PECS Positioning (motor – visual)
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Miscellaneous items
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Augmentative Resources
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Switches & accessories
Variety of switches
Switch interface
Switch mount
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Array of Switches
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Switch Mounting System
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TOOLKIT #1continued – “Lite – Tech” components
Battery adaptor Array of Switches Switch Interface Switch activated devices (toy or
fan or vibrating Pillow) . . . . .
Switch Mounting system
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Cause-effect items
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Switch Activated Devices
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Battery Adapter
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Switch Interface
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The Evaluation Toolkit
Toolkit
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Voice output – does it make a difference ? ? ?
Single message sequential communicator
Multiple message communicators (progressive message key setups)
Consider ones with levels
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Simple voice output –w/ sequencing capabilities
Single message communicators(Sequencers, Step-by-Step, etc.)
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Single message communicators
Replays one message at a time Recorded speech Some can do multiple messages
(repeats different message each time you select it)
Some can do different levels / situations
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Progressive Communicator- Digitized device(s)
Start simple – 2 pictures Add more pictures Has levels Direct select Recorded speech (voice) Uses overlays
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Static Display Progressive Communicator
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Simpler voice output devices
Digitized Devices & Accessories
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Others in your closet
Macaw Message Mates ChatBox Others? Any of these?
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Digitized Devices (examples only – not all inclusive)
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The Evaluation Toolkit
Toolkit
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Toolkit #3 - “Higher Tech” Laptop or tablet computer
(convertible laptop optimal)
Add communication software Emulate devices (large, medium, small)
Accessories Touch Screen (not just with pen) Switch interface
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Laptop Computer, Touch Screen and AAC Software
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I “stuff” (iPad, iPod, iTouch, etc.) . .. Droid, Slate, etc. . . . .
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Communication Software Emulate the devices 3rd party software which does the
following: Make various configuration of
overlays Able to link them together to evaluate
navigation Can do scanning of all types Spelling (word prediction) - optimal
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Software for purchase Tobii Communicator (Tobii ATI) - $599 - SayIt! Sam Software (Words +)-$1395 Speaking Dynamically Pro (Mayer
Johnson)- The Grid (Sensory software) Mind Express (Words+)
others Boardmaker Plus (Mayer Johnson) Overboard (Gus)
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Free manufacturer software/ demosyou can get . . .
Series 5 Semesterware (DynaVox) PASS software (Prentke Romich) SayIt! Sam (Words+) E Z Keys (Words+) Mind Express (Words + - coming) Others?
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Questions?
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What do you have?
or
What do you think you may need / want?
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Time for lunch!
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ACES Module: Your Tools & Resources
Toolkit components: communication tools to have at your fingertips (in the bag)
Premade evaluation materials / resources(in the book)
Templates / resources to complete paperwork (on CD and on the web)
Resources to make decisions on devices(On web)
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Premade resources - ideas
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Evaluation Materials/Resources
Materials include: Objects Pictures Premade overlays / pages
Low tech (communication boards) Lite tech (overlays for digitized devices) High tech (pages for dynamic display
options)
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Symbols Objects Photos COPPS Pictures Overlays Visual scenes Alphabet boards
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Symbols and premade materials
Make your own
Purchase other resources
Examples of Toolkit Notebook CD coming with PCS boards on it – Fall 2010
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Pre-made pictures/overlays
What do you use?We use . . . Examples include various sizes (size
of message key and #’s of keys) Various communication functions Dynamic display (low tech example) Sizes example
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Object-COPPS-Photo
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Talking My WyaTALKING MY WAY
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Photographs
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PCS – Boardmaker (Mayer-Johnson)
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SymbolStix - Symbolmate – News2U
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Overboard by Gus
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Attainment
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The Test of Aided-Communication Performance (TASP)
by Joan Bruno, Ph.D., CCC-SLP
A tool for the assessment of symbol-based communication skills.
Includes subtests on symbol size and number, grammatical encoding, categorization and syntactic performance.
Results may help determine AAC intervention strategies and goals.
Provides starting point for designing communication boards or selecting a page for an AAC device.
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Alphabet boards
Alphabet/Spelling Alphabet boards Keyboard arrangements
ABC QWERTY Frequency of occurrence
Grammar based boards
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The Device: Features to Consider
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Symbols Objects COPPS Photos Pictures Words Letters Media (video clips, etc.)
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Language Representation Single meaning pictures Multi-meaning pictures (Unity) Alphabet / spelling
Use of core words Visual scenes Phrase-based Grammar-based boards
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Single meaning pictures
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Semantic Compaction (Unity)
Multi-meaning pictures Less key strokes (in sequencing) –
faster Motor memory Icon prediction Activity row – picture prediction
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Semantic Compaction-example
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Visual scenes
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Phrase Based
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Premade vocabulary considerations
Language representation Progression (easy to more complex) Individualizing
Smaller vs. larger vocabulary needs Ease of navigation Ease of learning (for user and
communication partners)
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Grammar - Based / Core Words
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Grammar Based Software WordPower
(Most manufacturers)
Picture Word Power (Most manufacturers)
Wordcore (PRC - Pics)
Gateway (Dynavox - Pics & words)
Tobii Communicator (Sono Key- words/Sono Lexis-pics)
SpeechPro (Gus-words)
AlphaCore (Dynavox-Pics & words)
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Alphabet/spelling
Keyboard arrangements ABC QWERTY Frequency of occurrence
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Message formulation
Single key messages Routine phrases Novel sentences Novel thoughts / ideas Spelling
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Message formulation:
Gateway - Unity – Picture WordPower –
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Navigation / page changes
Who is changing: facilitator or communicator (can limit access)
Static display - # of pages Dynamic display - # of pages
# of levels down
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Message Key # of keys Size of keys Varies Actions required
Click Zoom/enlarge Color changes Hold time Auditory “fishing” (technique)
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Screen size
Small (handheld size) Small – medium (Xpress,
Springboard Lite, Alt-Chat) Medium Large Issues: visual, motor, navigation
requirements (memory)
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Message display
Words Pictures Speak each word / sentence Speak on demand / punctuation Highlight each word as it speaks Silent mode
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Rate enhancement Pre-store messages Prediction (word, letter, picture,
symbol, character, phrase) ** Abbreviation – expansion Pre-made vocabulary options Grammar-based boards ** Word morphology (word endings,
verb tenses, etc.)
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Picture prediction – activity row
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Refer to AAC Feature Chart for
Voice/speech Device functions/access Keyboard Type of Device Devices to trial
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Toolkit Time . . .
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Handheld size
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Small - intermediate
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Medium size
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Large size
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Try it on . . .
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Types of devices to consider
Dynamic display Integrated systems Text – to – speech Digitized Simpler digitized Single message communicators
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Dynamic Display
Multiple pages “Navigate between pages” Variety of symbols available Both types of speech (digitized &
synthesized) Possible to use generative language Offers more options for alternative
access
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Integrated System
Multiple pages “Navigate between pages” Variety of symbols available Both types of speech (digitized &
synthesized) Includes computer components
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Digitized Simpler communication needs Recorded voice Use of pictures Multi lingual
Most of them have: Paper overlays that are changed Also called “static display”
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Digitized Devices (examples only – not all inclusive)
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Text to Speech
Mainly spelling (keyboard and some have scanning)
Most have built-in keyboards Mostly synthesized speech, though
few have digitized speech
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Text-to-Speech (examples only – not all inclusive)
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Let’s Review what we have so far: The Person (ACES Module) AAC Device Features (AAC Module) Toolkit List (AAC Module) Gather information (Case history & Summary
Evaluation in ACES Module) Record evaluation results (form above &
Assessment summary in Templates) Device Decision-Making (AAC Module) Device Assistant – 30 day trial from AAC
TechConnect Write report (Templates) Funding (work with vendor)
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Device Selection
Which Device to Choose ? ? ? ?
Low tech Lite tech High tech Combination
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How do you proceed?
. . . . . Know user’s skills
. . . . .now what?
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Device Selection Options
Catalogues AAC TechConnect – contact manufacturers
Manufacturer websites Go to individual ones – AAC TechConnect
has list AAC TechConnect – free resources
Pictures (thumbnails of 100+ devices) Free flyers
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www.aacTechConnect.com
Website which gives the following free information on ONE site What’s New
Manufacturers
Product information
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Clinical Tools
From AAC TechConnect
The ACES Device Assistant – project of AAC-RERC
The Resource for Lite Tech Low Cost AAC Chart (by Libby Rush & Mary Joan McClure)
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Demo – AAC TechConnect
Free trial
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Clinical Online Tools from
Lite Tech Low Cost Chart AAC TechConnect $14.95 (online with credit card)
Device Assistant Free trial – 14 days Fee – for – service after that
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Trialing equipment
Loan equipment AT centers Vendors – local resources Manufacturers Rental options
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Do you . . .
Have some new strategies to try?
Have some things in your closet you will dig out for use?
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Questions? ? ?
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Review goals
Suggestions for next time? Please put on your eval form.
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Did we: Explain the process of obtaining an AAC
tool/device Describe tools/techniques used to determine the
AAC candidate’s skills Complete many of the components with
templates provided for gathering, compiling and reporting the results.
Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)
Identify local resources and consultants for trials, support, and funding assistance for AAC devices.
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THANK YOU
for helping othersTo get
The best choice For the best voice
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Contact us at:
Debby McBride, MS, CCC-SLP866.4U.AAC.RX
866/482-2279 or 303/674-8553