More than Words:AUGMENTATIVE AND ALTERNATIVE COMMUNICATION

PATRICIA OURAND, MS, CCC-SLPSPEECH-LANGUAGE PATHOLOGIST

ASSOCIATED SPEECH & LANGUAGE SERVICES, INC. BALTIMORE, MD

WWW.ASLSINC.COMPOURAND@ASLSINC.COM

The Big PictureThe Power of Communication

"If all my possessions were taken from me with one exception, I would choose to keep the power of communication, for by it I would soon regain all the rest“

— Daniel Webster

Communication

• Identify, demonstrate, and discuss strategies that facilitate communication nonverbally, using expressions, gestures, symbols, photographs and/or illustrations, and text, among others 

RFS’s copy of a B, which he is able to see clearly, and an 8, which he sees only as a jumble of lines with color in

the background

Case Study:• RFS is a 61-year-old geological engineer with a

progressive neurological disease

• In October 2010 he suddenly found himself unable to perceive Arabic digits, such as 4 or 8

• Since that time, he sees digits only as uninterpretable jumbles of lines (which he calls ‘spaghetti’)

• RFS can perceive most, but not all letters normally

•  He has been diagnosed with Alphanumeric Visual Awareness Disorder (AVAD)

Visual Strategies• Newly devised digit

character set• Calculator app using new

characters

Imagine …• your power of speech never works well for you.

• you are nearly always misunderstood, not heard, not noticed, not considered part of a conversation.

• you are often ignored because you can’t do this simple thing (i.e., speak) that everyone else around you seems to do so well and so fast.

• when you try to write a note to a friend or a term paper for a class, you can’t, either because you don’t know how or because your hands and arms won’t perform the writing and typing movements that everyone else does so effortlessly.

This discussion is about how people communicate. • It’s about how we can augment, support, and often

compensate for communication abilities that have not developed functionally or that are lost at some point in an individual’s life due to injury, illness, or some other acquired disorder.

• How we augment spoken and/or written communication and how we use alternative methods to get the message through will be discussed throughout this discussion.

AAC within the realm of: Assistive Technology (AT)

• Augmentative and Alternative Communication (AAC)

• Adapted Computer Access

• Devices to Assist Listening and Seeing

• Environmental Control and Manipulation

• Adapted Play and Recreation

• Wheeled and Powered Mobility

• Seating and Positioning

• Prosthetics

• Rehabilitation Robotics

• Integration of Technologies Church & Glennen (1992), King (1999), Cook & Hussey (2002), Scherer (2003)

Talking or “saying” is communication SOME PEOPLE USE THEIR SPEECH TO TALK.

OTHER PEOPLE USE GESTURES, OBJECTS,

PICTURES AND/OR ELECTRONIC DEVICES TO

TALK.

The Dance

• To communicate one person must “say” something by using: any combination of speech, gestures, writing, pictures, and/or objects.

AND

• To communicate at least one person must “understand” what is meant by the: speech, gestures, writing, pictures, and/or objects.

Communication across environments and over timeLOCATION, LANGUAGE, ABILITIES, LITERACY LEVELS, AND CULTURE

Barriers to information access: • language that is too complex

• text that is not accessible

• lack of availability of alternative languages and formats (e.g., Braille, large print, audio, and electronic formats)

• use of disabling language

• the physical inaccessibility of various hard copy formats (Newel 1994)

Goals of AAC

• provide a temporary means of communication

Temporary

• provide a long-term means of communication

Long-term • facilitate the

development of natural, spoken communicationTherapeu

tic

• provide a temporary means of communication

Temporary

• Communication is central to human life.

• Everyone communicates ...

Additional Goals• availability of written communication across multiple

formats and environments

• control of the environment using speech, writing, and/or other gestural movements

• concept and skill development, maintenance, or re-development

Recommendations addressing some written communication barriers:1. Simplify language and terminology

2. Include alternative formats

3. Print should be a font size larger than 12

4. Use full name / words / word combinations instead of acronyms

5. Incorporate colors that provide contrast between the text and the background

6. Use photos, graphics, and pictures that make document interesting and enhance accessibility to the text-based message

Health LiteracyLiteracy in these terms refers to the ability of the

individual and his or her family to obtain, process, and understand the basic information and services necessary to make adequate and appropriate decisions about care.

It has been noted that individuals with speech-language and hearing disorders are at risk for poor health literacy.

Communication, while basic, is also a complex, multifaceted, multi-modal process shared among humans and others.

Volkmann (2002) noted, if you have a heartbeat, you communicate.

Paramedic & EMS Symbol Board

LINKS AND BRIEF DESCRIPTIONS TO USEFUL WEB SITES FOR PEOPLE WITH DISABILITIES AND FUNCTIONAL LIMITATIONS

http://www.patientprovidercommunication.org/useful_information.htm

Communication: the way in which we share information with others through language. Although we all like to think we're saying exactly what we mean, that's not always the case, especially when we're talking to someone who uses a communication style very different from our own.

© 2011 SHERRIE BOURG CARTER

Communication is more than “talking”IT ENCOMPASSES A HOST OF ENVIRONMENTS, TECHNOLOGIES, AND STRATEGIES. NEW KNOWLEDGE COMING FORWARD WILL ASSIST WITH THE IDENTIFICATION OF NEW AND ADDITIONAL AAC TECHNOLOGIES, STAKEHOLDERS, AND FINDERS.

American Speech-Language-Hearing Association (ASHA)HEALTH LITERACY RESOURCES