RIGA Alternative/augmentative communication – key strategy for participation Andra Greitane, MD...

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Alternative/augmentative communication – key strategy for

participation Andra Greitane, MD

Rehabilitation center “Mes esam lidzas”

Riga, Latvia

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

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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

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Purposes of Communication are:•To fulfill needs and wants•To transfer information •To develop social closeness•To maintain social etiquette•To learn

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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

JusticeCommunication Sciences and Disorders: An

Introduction

• 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.

JusticeCommunication Sciences and Disorders: An Introduction

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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)

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The individual’s functional capacity in different environments and knowledge of the health condition suggests appropriate interventions

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• 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

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

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AAC is:• a visual language,•visual supports to language, •orientation to time and place, •supports to learning

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The individual’s functional capacity in different environments and knowledge of the health condition suggests appropriate interventions

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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

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“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

Interactions between the components of ICF

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Oregon Health and Science University has developed an On-line interactive ICF-CY for AAC ProfileSurvey: identify participation restrictions, communication limitations, functional reasons for them, and environmental facilitators and barriers Report: prioritize identified items to facilitate IEP goal development process

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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)

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)

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Results II - Rehabilitation Problem Solving Form

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Methods and materials

ICF Categorical profile

RPS - Form

GMFM GMFCS MACS CFCSPEDI Viking scale

Results I - ICF Categorical profile

Date 20.05.2015. 0 1 2 3 4

ICF codes

d3 COMMUNICATION

d310 Communicating with-- receiving -- spoken messages CFCS Level I X

d330 Speaking Viking scale Level I X d4 MOBILITY d410 Changing body positions GMFM X X d4153 Maintaining sitting position GMFM X X X d4154 Maintaining standing position GMFM X X X X X

d440 Fine hand use MACS Level III X X X

d4550 Crowling GMFM X X X X

d465 Moving around using equipment GMFCS- Level IV X X X X d5 SELFCARE d510 Washing onesef PEDI X X X d530 Toileting PEDI X X d540 Dressing PEDI X X X d550 Eating PEDI X X X

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.

Conclusions

RIGA Alternative/augmentative communication – key strategy for participation Andra Greitane, MD...

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