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AAC- Yikes! You Want Me To Do What? June Maranville MSP, CCC-SLP Palmetto Language & Speech Center, LLC Website:

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Presentation on theme: "AAC- Yikes! You Want Me To Do What? June Maranville MSP, CCC-SLP Palmetto Language & Speech Center, LLC Website:"— Presentation transcript:

1 AAC- Yikes! You Want Me To Do What? June Maranville MSP, CCC-SLP Palmetto Language & Speech Center, LLC Email: Website:

2 I dont even know what I dont know The only disability in life is a bad attitude. - Scott Hamilton

3 ALL Individuals Can and Do Communicate! -National Joint Commission for the Communication Needs of Persons with Severe Disabilities. (1992) 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

4 Weve come a long way, baby. Who remembers… O Cut and paste pictures from notebooks O Hand coloring each picture O Glue with no Velcro! O No Boardmaker O Contact paper instead of lamination O Heavy-bulky systems that took weeks to program

5 Present Day Where are we now? O Boardmaker O Lamination O Velcro O Over 200 Apps for high-tech devices O AAC App Comparison Chart (SCATP) O O Light weight, durable, intuitive systems

6 What has not changed? O As professionals, practice due diligence when choosing AAC for client. O Team Approach O Client and caregiver as active participants O Best fit- low/medium/high tech O Feature matching O a process that involves matching the skills of the AAC user with the features of the given AAC systems.

7 What is Augmentative and Alternative Communication (AAC)? O AAC involves attempts to study and when necessary compensate for, temporarily or permanently, the impairments, activity limitations, and participation restrictions of individuals with severe disorders of speech- language production and/or comprehension. These may include spoken and written modes of communication. (ASHA 2005)

8 AAC is the bridge that enables children with severe communication difficulties to learn higher-level language skills and to interact with individuals outside the family. ~ Page and Quattlebaum (2012) Handbook of Children with Special Healthcare Needs

9 The Goal of AAC O Empower AAC user to O express wants and needs O exchange information O develop social closeness with others O engage in social etiquette routines. O MULTIMODAL approach most effective in order to be able to communicate for different purposes in a variety of contexts. (ASHA, 1991)

10 Multimodal Communication O Objects O Signs O Gestures O Facial Expressions O Pictures O Speech O Nurture residual speech O Written Word O Symbols O Voice output devices

11 Feature Matching O Which system is the best match to fit users abilities, needs and skills? O Dx does not determine need for specific device O Consider: O Current Skill Level O ADLs and associated wants/needs O Current Communication system/strategies O Future Communication needs O System growth with development and skills O Degenerative/Deteriorating skills

12 Feature Matching Cont. O Objective / Feature / Selection Criteria O Shared symbol system O Development of language system O Construction of messages to interact with others O Meaningful Vocabulary O O Access to communication symbols O Access to communication device ~Page and Quattlebaum (2012) Handbook of Children with Special Health Care Needs

13 Is it a good fit? O Would you ever get the gift box before you purchased the gift? ~ Dr. Carol Page O No! ~ Lets not do it with AAC either. O Evade flavor of the month devices based on marketing, promotion and popularity. O AbleData: AAC products and features AbleData: AAC products and features

14 Why Assess? O Will use of AAC… O Maximize clients abilities and decrease challenges of disabilities O Help improve condition or prevent from getting worse. O Help person function in their environment O Help improve independence O How will team find the best fit? O Is a formal assessment needed and required by funding source? O Is use of AAC a medical necessity?

15 Medical Necessity O Medicare defines as O Service or supplies that are needed for the diagnosis or treatment of medical condition and must meet best practice standards. O Buzz words O Correct deficits O Ameliorate deficits - to make better or tolerable O Palliate- to make less severe or unpleasant without removing the cause. O Letter of medical necessity and physician order with high- tech AAC purchases

16 Who can assess formally? O Licensed and credentialed in related field O PT, OT, SLP, Rehab Engineer O AT specialization certification O Other Team membersas warranted O Vision specialist O Nurse O Psychologist O Educators O Hearing specialist

17 Who pays for AAC? Funding sources consider AAC dedicated communication devices O Private Pay O Babynet (0-3) O IFSP Team, parents and professionals O Schools (3-21) FAPE O Private insurance- appeal if denied O CRS O Medicaid O Medicare O VA O Vocational Rehab O Community O Service organizations O Church and local charities

18 Who really pays for AAC? We all do!

19 Components of Successful Assessment O Team Assimilation O Medical Information O History O Functional Goals O Technology that has been tried in the past and results O Clear communication among team members O Trials with AAC O Time is your best friend!

20 Assessment Help O There are no standardized AT assessments. O Ecological Inventory ~ Nalty and Quattlebaum (1998) Ecological Inventory O Joy Zabala SETT Framework Joy Zabala SETT Framework O Its not about technology or device O Its about matching O The Student O The Environment O The Task O The best Tool O Communication Matrix Communication Matrix O Every Move Counts, Clicks and Chats Every Move Counts, Clicks and Chats

21 Trials with AAC O Low-tech O Examples: Communication boards, booklets. O Can start immediately O Boardmaker is your friend! O Backup system-as needed if high-tech device malfunctions

22 Trials with AAC O Mid-tech O Examples: BigMack, iTalk 2, Go talk series. O Typically requires a battery to operate. O Human voices recorded on device

23 Trials with AAC O High-tech O Examples: Dynavox, Prentke Romich, Tobii- SGDs O Increase vocabulary opportunities O Digitized, synthesized speech O iPads and Tablets

24 Purpose of Trials O What works. O What does not work. O Show evidence of optimal fit for individual communication need. O System not to be used or recommended just because only one tried, most popular, or most promoted.

25 AAC Intervention O If were using pictures do we call it AAC? O AAC vs. other types of learning activities

26 Picture Identification vs. Functional Communication O Picture ID- END O Receptive Skills and Knowledge O Touch the ____ O Teaching Format-Get response O Match, sort, reinforce O Academic Achievement

27 Picture Identification vs. Functional Communication O Functional AAC Communication- MEANS to END O Demonstrates desire to engage with communication partner to share wants, needs and ideas. O Nurtures social interactions O Empowers O Beyond Requesting Powerpoint Beyond Requesting Powerpoint

28 Message Sets O Vocabulary linked to social/emotional development O Feelings O Decrease behavioral problems with appropriate vocabulary selection O Vocabulary Selection O Provides means to interact O Motivating vocabulary imperative O Consider users interest first O Variety of word types

29 Core Vocabulary O Typical Peer 5-minute Conversation Sample O More than Nouns O Rich language experiences O Increase message set expansion O Generalizes across communication settings O Teaches rules of Syntax O Language to Literacy Expansion O juice, want juice, no juice, more juice, write or type juice –Page and Quattlebaum 2012 O Quick Hits/Urgent messages O One Icon to represent message O Example: I need help I feel sick

30 Prognostic Indicators O Extrinsic Factors O Skin in the game O Buy into use O Switch gears from basic needs to anticipating needs O Co-treating O Chain of cues O Model, model, model! O Enable vs. Empower O 15x per day O Intrinsic Factors O Knowledge is power O User grasps that power is in communication O Motivation O Example: Music variety O Active participant O Engage 15x per day using AAC device O Present and Possible Changes O Medical condition status O Plan implement ahead of time O Monitor and adjust to assess wants/needs O Dynamic and ever-changing process O ~ Page and Quattlebaum (2012)

31 Parent/Caregiver Roles O Active participants O Ongoing programming O Vocabulary selection O Facilitate carryover of device to all settings O Model use of device with motivating activity for user O Troubleshoot problems O Recognize when message sets changes needed O Attend training

32 Carryover O Functional O Motivating O Means-End O Efficient O Effective O Interactive O All Environments O At least 15 opportunities per day O Update AAC system when change occurs O Transition Strategies for Adolescents and Young Adults Who Use AAC Transition Strategies for Adolescents and Young Adults Who Use AAC

33 Resources O SC Assistive Technology Program SC Assistive Technology Program O Apps that make life easier O Apps comparison chart. O SC Equipment Distribution Program SC Equipment Distribution Program O SC Vocational Rehabilitation SC Vocational Rehabilitation

34 Resources Cont. O CRS- Children's Rehab Services CRS- Children's Rehab Services O SCATP- Device Loan Program SCATP- Device Loan Program O SC Independent Living Program SC Independent Living Program O CDR- Centers for Disabilities Resource Library CDR- Centers for Disabilities Resource Library O Loaner programs through vendors. O Key Technologies Key Technologies O Dynavox Dynavox O Tobii Tobii O Prentke Romich Prentke Romich

35 Prize Time! Q and A

36 Wrap it Up! When you know better, you do better ~ Maya Angelou O Use the resources O Celebrate great resources in your backyard O Dont be afraid to ask for help O Enjoy the journey and be inspired! O Heart of the Ravens! Superbowl 2013 Champs! O

37 Bibliography Works Cited AAC and Speech Devices from PRC. N.p., n.d. Web.. "AAC Messaging and Vocabulary." AAC References. N.p., n.d. Web.. "AbleData: Products." AbleData: Products. N.p., n.d. Web.. "Apps That Make Life Easier." Apps That Make Life Easier. South Carolina Assistive Technology Program, 7 Jan. 2013. Web. ASHA. "Goal of AAC." (1991): n. pag. Print. "Augmentative and Alternative Communication (AAC)." American Speech-Language-Hearing Association. N.p., 2005. Web.. "Beyond Requesting." Beyond Requesting. N.p., n.d. Web.. CDR Library, School of Medicine Library, University of South Carolina. N.p., n.d. Web.. "Communication Assessment for Parents & Professionals." Communication Matrix. N.p., n.d. Web.

38 Bibliography Cont. DynaVox: Communication Devices – Speech Devices. N.p., n.d. Web.. "EMC, Inc. Home." EMC, Inc. Home. N.p., n.d. Web.. ESPN. ESPN Internet Ventures, n.d. Web.. "Independent Living." South Carolina Department of Social Services. N.p., n.d. Web.. Key Techonologies. N.p., n.d. Web.. Nalty, L., and P. Quattlebaum. "A Practical Guide to Augmentative and Alternative Communication: Assessment and Intervention Strategies." Greenville:Super Duper (1998): n. pag. Abstract. Severe Communication Disorders (2012): 32. Print. National Joint Commission for the Communication Needs of Persons with Severe Disabilities. Guide-lines for Meeting the Communication Needs of Persons with Severe Disabilities (1992): n. pag. Print. Page, C. A., and P. D. Quattlebaum. "Severe Communication Disorders." Ed. D. Hollar. Handbook of Children with Special Health Care Needs (2012): 23-46. Print.

39 Bibliography Cont. SCATP Device Loan Program. N.p., n.d. Web.. "SCATP." South Carolina Assistive Technology Program (SCATP). N.p., n.d. Web.. "Sharing the SETT Framework." Joy Zabala SETT Framework. N.p., 2005. Web. South Carolina Department of Health and Environmental Control. N.p., n.d. Web.. "South Carolina Equipment Distribution Program." SCEDP. N.p., n.d. Web.. South Carolina Vocational Rehabilitation Department (SCVRD). N.p., n.d. Web.. Tobii Technology Global. N.p., n.d. Web.. "Transition Strategies for Adolescents and Young Adults Who Use AAC." ASHA Online Store Details. N.p., n.d. Web..

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