1. UGA Speech & Hearing Clinic AAC Consult Ben Satterfield, Ed.D. Center for AT Excellence Ben@C4ATX.com GA Tools for Life www.gatfl.gatech.edu www.gatfl.gatech.edu

2. Agenda Welcome & Introductions Client 1 - Adult female with dysarthria, MOID, with expressive language disorder Client 2 - Adult client (female) who is autistic and nonverbal. Client 3 – 47 yo. female stroke patient with non-fluent aphasia and apraxia of speech. Client 4 - Adult, male with Receptive & Expressive Language Disorder, Intellectual Disability, Cerebral Palsy Q & A Our Favorite AAC Resources

3. Client 1 Client: – adult female with dysarthria, – expressive language disorder – moderate intellectual disability Status: 1.using verbal communication and Dynavox 2.unsure if she uses it at home - does not use it at her day program. 3.verbal communication is highly unintelligible 4.Prefers to communicate verbally rather than use the Dynavox. 5.demonstrates knowledge of favorite pages such as games and music, 6.rarely independently navigates to other pages 7.readily identifies and matches pictures using the Dynavox and follows verbal directions

4. Client 1 1.Readily identifies and matches pictures using the Dynavox and follows verbal directions 2.Moderate motivation to the use the Dynavox in structured activities especially when her communication partner is also using an AAC device 3.On-site training for the caretakers at the client’s day program on how to use and troubleshoot the Dynavox 4.Limited to no improvement after the training session 5.Goals this semester target getting the client to independently choose the Dynavox in conversation 6.Client’s accurate navigation among Dynavox pages to participate in conversation and accurate use of icons on a variety of pages

5. Client 1 Questions Would you suggest adding a toolbar so that she always has access to icons such as “yes, no, my name is…, please, thank you”? If so, how can we do that? What are some treatment strategies that you find helpful for encouraging a client to use the Dynavox? Do you have any suggestions for getting the caregivers and/or family more involved in using the device?

6. Client 2 Adult client (female) who is autistic and nonverbal. Has both a receptive and expressive language disorder. She has used PECS and is now using mini iPad. She uses a mini-iPad to request. She lives with her family and is coming to clinic for maintenance of social skills. In session, we work on using appropriate touch to select icons She imitates the clinician's selection of appropriate icons. She has a particular interest in music.

7. Client 2 Any suggestions for promoting appropriate light touch of the iPad? Are there any iPad apps that you believe would benefit our client?

8. Client 3 Client is a 47-year-old female who uses AAC primarily for word-finding and grammatical sentence production. Her relevant past medical history includes a left-hemisphere stroke which resulted in non-fluent aphasia with some intact repetition and apraxia of speech. She has mixed expressive and receptive language deficits, although her comprehension (via a combination of auditory and reading) is relatively intact, given ample time to process short phrases. Her current device is a Dynavox Series V which has been programmed to match her preferences and goals for treatment. She has had this device since 2011, but she does not use the device at home, and therefore is still learning basics of navigation and programming.

9. Client 3 She is using single word icons and we are targeting subject+verb+object phrases. We are currently looking to update her device to be more portable, socially acceptable, and functional for everyday use. Some of the options we are testing out with her are the iPad applications Proloquo2go, Tobii Sono Flex, and TalkTablet. Ideally, she would have an application which could : – match her current Dynavox set-up – has typing/keyboard functions – with word-prediction and grammar inflection.

10. Client 4 Age: Adult, male Diagnosis: Receptive & Expressive Language Disorder, Intellectual Disability, Cerebral Palsy Current Status: – Client is in his second semester of therapy at UGA. – Client is currently using the device to answer "wh" questions and "comment" by selecting the appropriate icon when prompted by a picture, object or key phrase. – Client is demonstrating difficulty with navigating folders (i.e., opening the correct folder to then select a predetermined icon). – Client demonstrates an understanding that the icon must be selected in order for others to hear the device, but has occasional difficulty with getting the device to respond. It appears that he either presses too low on the icon or presses without the right amount of pressure. – He will try the same icon several times without success and will sometimes stop pressing the icon unless prompted by clinicians. – Client knows approximately half of his board's vocabulary and occasionally uses the device spontaneously to communicate..

11. Client 4 Device: Proloquo 2 Go iPad Application (using a 9-option grid, no scrolling) Objectives: – (1) Client will use app to comment in each page/folder of app. – (2) Client will respond to "Show me __" or "Point to __" in the "My Care" folder given a verbal prompt. – (3) Client will use the app to answer "wh" questions in each page/folder. – (4) Client will use "Tap to Talk" strategy to use the iPad (i.e., will press the icon until others hear it). – (5) Client will use the "Go Back to Home" strategy to use the iPad when given a verbal prompt (i.e., client will use the Home icon to return to the main page). – (6) Client will use the "Touch 'More' to Go to Folders" strategy to use the iPad given a verbal cue (i.e., client will use the more button to see the next page). – (7) Client will navigate folders on the iPad for each folder.

12. Client 4 Special Considerations: As aforementioned, client's motoric difficulties present a problem with getting the device to respond audibly to client's touch. In addition, client cannot turn on the device (from a sleeping state) because it requires a swiping motion. – Although Apple and Ablenet have been used as resources to try to solve this issue, – cannot figure out how to turn off this necessary swiping motion. Additionally, future objectives include: – targeting client's use of the "back" button to return to the previous page, – targeting the client's use of the power button once the swiping motion has been solved, and – targeting the client's use of the iPad to spontaneously communicate throughout his day.

13. Questions?

14. Our Favorite AAC Resources

15. Dynavox Resources Dynavox Implementation Toolkit: http://www.dynavoxtech.com/implementation-toolkit/ http://www.dynavoxtech.com/implementation-toolkit/ – Communication Partner Training Video Series w/ Study Guide Series 5 Page Editing software: http://www.dynavoxtech.com/support/downloads/Trial.aspx?id=87? http://www.dynavoxtech.com/support/downloads/Trial.aspx?id=87 Compass software/app: http://www.mydynavox.com/DynaVoxCompass#Overview http://www.mydynavox.com/DynaVoxCompass#Overview

16. PrAACtial AAC http://praacticalaac.org/

17. BridgingApps

18. BridgingApps Cont. program of Easter Seals Greater Houston that provides access to educational and therapeutic tools created by parents and therapists who began using the iPad with children who have special needs goal is to provide caregivers and professionals with the best resources for choosing apps www.bridgingapps.org custom-built App Search Tool allows users to access app reviews conducted by therapists and special education teachers and focuses on skill Real-time search in iTunes store

19. Webinar Updates & Schedule Liz Persaud