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Rehabilitation center “Mes esam lidzas”

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1 Rehabilitation center “Mes esam lidzas”
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Alternative/augmentative communication – key strategy for participation Andra Greitane, MD Rehabilitation center “Mes esam lidzas” Riga, Latvia RIGA RIGA

2 Communication is a human right and fundamental freedom.
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Communication is a human right and fundamental freedom. The ability to communicate is fundamental to basic Quality of Life, yet for many people (1-1.5 % of whole population) effective communication is difficult because of: a physical impairment, language disorder or learning disability RIGA RIGA

3 Purposes of Communication are:
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Purposes of Communication are: To fulfill needs and wants To transfer information To develop social closeness To maintain social etiquette To learn RIGA RIGA

4 Complex Communication Needs (CCN) occur:
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Complex Communication Needs (CCN) occur: When individuals cannot meet their daily communication needs through the current method of communication Result from variety of physical, sensory, and environmental causes which restrict independent functioning in society Justice Communication Sciences and Disorders: An Introduction RIGA RIGA

5 The individual with CCN can no longer or never could communicate in conventional ways,
CCN assessment focus on identifying what is important for each person to meet his/her own goals of communication. Justice Communication Sciences and Disorders: An Introduction 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

6 Intellectual impairment Motor neuron desease Traumatic brain injury
Individuals with CCN may have difficulty communicating related to a variety of different health conditions: Cerebral palsy Autism Intellectual impairment Motor neuron desease Traumatic brain injury Stroke Sensory impairments (hearing, vision) 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

7 The individual’s functional capacity in different environments and knowledge of the health condition suggests appropriate interventions 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

8 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
Area of clinical practice that supports and meets communication needs is augmentative and alternative communication (AAC) AAC uses symbols, aids, strategies, and techniques to improve success and effectiveness of communication RIGA RIGA

9 AAC involves attempts to study and when necessary compensate for temporary or permanent impairments, activity limitations and participation restrictions of persons with severe disorders of speech- production and/or comprehension. American Speech-Language-Hearing Association 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

10 visual supports to language, orientation to time and place,
AAC is: a visual language, visual supports to language, orientation to time and place, supports to learning 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

11 The individual’s functional capacity in different environments and knowledge of the health condition suggests appropriate interventions 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

12 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
ICF: International Classification of Functioning, Disability and Health (Child & Youth version) Developed by the World Health Organization (WHO) to complement the ICD (International Classification of Disease) Designed to describe the functional status of individuals in a standardized manner AAC Volume 28, Number 1 (March 2012) Special Issue: AAC and ICF: A Good Fit to Emphasize Outcomes RIGA RIGA

13 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
“The ICF fits our international AAC community like an old shoe that we have been wearing for many years.” Fried-Oken and Granlund (2012) Volume 28, Number 1 (March 2012) Special Issue: AAC and ICF: A Good Fit to Emphasize Outcomes RIGA RIGA

14 Interactions between the components of ICF
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

15 Oregon Health and Science University has developed an
On-line interactive ICF-CY for AAC Profile Survey: identify participation restrictions, communication limitations, functional reasons for them, and environmental facilitators and barriers Report: prioritize identified items to facilitate IEP goal development process 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine RIGA RIGA

16 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
RIGA RIGA

17 Objectives of the study
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Objectives of the study to explore and analyze functioning, activities and participation of a 8 years old boy with Spastic Bilateral Cerebral Palsy (CP) using: ICF-CY Model (WHO, 2007) 1.wmv RIGA RIGA

18 Objectives of the study
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Objectives of the study to explore and analyze functioning, activities and participation of a 8 years old boy with Spastic Bilateral Cerebral Palsy (CP) using: ICF-CY Model (WHO, 2007) 2.mp4 RIGA RIGA

19 Results II - Rehabilitation Problem Solving Form
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Results II - Rehabilitation Problem Solving Form RIGA RIGA

20 Results II - Rehabilitation Problem Solving Form
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Results II - Rehabilitation Problem Solving Form RIGA RIGA

21 Results II - Rehabilitation Problem Solving Form
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Results II - Rehabilitation Problem Solving Form RIGA RIGA

22 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
RIGA RIGA

23 ICF Categorical profile
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Methods and materials RPS - Form ICF Categorical profile GMFM GMFCS MACS PEDI CFCS Viking scale RIGA RIGA

24 Results I - ICF Categorical profile
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Results I - ICF Categorical profile Date 1 2 3 4 ICF codes d3 COMMUNICATION d310 Communicating with-- receiving -- spoken messages CFCS Level I X d330 Speaking Viking scale Level I d4 MOBILITY d410 Changing body positions GMFM  X d4153 Maintaining sitting position GMFM d4154 Maintaining standing position GMFM d440 Fine hand use MACS Level III d4550 Crowling GMFM d465 Moving around using equipment GMFCS- Level IV d5 SELFCARE d510 Washing onesef PEDI d530 Toileting PEDI d540 Dressing PEDI d550 Eating PEDI RIGA RIGA

25 Results II - Rehabilitation Problem Solving Form
4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine Results II - Rehabilitation Problem Solving Form RIGA RIGA

26 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
Conclusions The use of ICF principles and definitions help to perform a wholistic assessment of functions, activities, associated disabilities of children with Cerebral Palsy. The visualization of target problems as well as the target mediators in RPS-Form helps to define practical, meaningful, measurable and attainable therapy goals as well as plan the most appropriate interventions for Cerebral Palsy children. RIGA RIGA

27 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
Conclusions The use of ICF principles and definitions help to perform a wholistic assessment of functions, activities, associated disabilities of children with Cerebral Palsy. The visualization of target problems as well as the target mediators in RPS-Form helps to define practical, meaningful, measurable and attainable therapy goals as well as plan the most appropriate interventions for Cerebral Palsy children. RIGA RIGA

28 4th Baltic & North Sea Conference on Physical and Rehabilitation Medicine
Conclusions The use of ICF principles and definitions help to perform a wholistic assessment of functions, activities, associated disabilities of children with Cerebral Palsy. The visualization of target problems as well as the target mediators in RPS-Form helps to define practical, meaningful, measurable and attainable therapy goals as well as plan the most appropriate interventions for Cerebral Palsy children. RIGA RIGA

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