Augmentative and Alternative Communication Devices as ...
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Augmentative and Alternative Communication Devices as Employment Supports January 26, 2015 Megan Case, MA, CCC-SLP Speech-Language Pathologist for the Assistive Technology Center
Transcript of Augmentative and Alternative Communication Devices as ...
Augmentative and Alternative Communication Devices as Employment
Supports
January 26, 2015
Megan Case, MA, CCC-SLP Speech-Language Pathologist for the Assistive
Technology Center
2
Month Trainings available at Ohioemploymentfirst.org
website June 30, 2014 Task analysis for job coaches
July 21, 2014 Worksite Analysis for job coaches
August 28, 2014 Tablet Computers and Smartphones as workplace supports
September 23, 2014 The Role of the Occupational Therapist in supporting
employment
October 27, 2014 The Role of Rehab Engineering and the Assistive Technology
Center in supporting employment
November 20, 2014 Video Resumes and Professional Portfolios: Presenting Job
Seekers in the best light
January 26, 2015 Augmentative Communication Devices as employment supports.
February 26, 2015 Employment supports for those with IDD and Autism.
March 16, 2015 Employment supports for those with Physical or Sensory
involvement.
April 28, 2015 The Job Matching Process
Previous Presentations: Ohioemploymentfirst.org
Objectives Explore the different options of AAC devices that are
available to help individuals with communication difficulties communicate with a wider variety of individuals
Emphasize the importance of communication as an essential skill to obtain and maintain employment
Review how using an AAC device can aid individuals with obtaining employment
Explain how AAC devices allow individuals with communication difficulties to increase their functional independence and more effectively and efficiently interact with co-workers, supervisors, and customers and decrease the need for additional support personnel in the workplace.
Assistive Technology
Services, devices, strategies and practices that are conceived and applied to increase, maintain or improve functional capabilities of individuals with disabilities.
Service Device
Strategy Practice
AT
Cook and Polgar (2008)
322246615002391
HAAT Model
What is AAC?
Augmentative
Alternative
All forms of communication other than verbal communication that are used to express thoughts, needs, wants, and ideas.
Other names: Speech Generating Device (SGD), Augmentative Communication Device (ACD)
AAC
System
Method
Device
Why and When to Use AAC
• Enhance Speech Intelligibility
• Supplement Verbal Speech Production
• Supplement Written Communication
• Replace Nonfunctioning Speech System
• Provide Audible Voice Output
Why and When to Use AAC
When difficulty experienced conveying a message in a face-to-face communication situation such that they are failing or experiencing a high degree of frustration and when other ways of improving this have been tried….
May be main way of communicating, part of total communication strategy or used only in certain situations….
Interaction of AAC and ECD
Comprehensive Evaluation
• Pertinent Medical Background
• Communication/Speech and Language Status and Limitations
• Communication Needs Assessment
• Communication System Suitability
• Cognitive Status
• Postural and Mobility Status
• Sensory Status
• Access Capability
• Device Trial
• Mounts
• Use and Learning of SGD Selected
• Treatment Plan and Follow Up
Who is Involved?
Patient
Family/Caregivers
Educators
Vocational Rehab/OOD
Case Managers
Speech-Language Pathologist
Occupational Therapist
Physical Therapist
Rehab Engineer
Physician
Vendor/Manufacturer
What is Out There?
Features to consider when selecting a device:
Low Tech to High Tech
Dedicated vs. Integrated
Speech Output
Display
Rate Enhancement
Access Method
Portability
Low Tech vs. High Tech
Low Tech = Non Electronic
Writing, gestures, facial expression, sign language, letter board, picture board
Low Tech to High Tech
Mid Tech Requires source of power
Recordable device (digitized speech)
Paper “overlays” with static display
1-128+ buttons/messages
Can hold multiple pages (levels) of recordings & pictures
Low Tech to High Tech
High Tech = Electronic
Rechargeable power source
Speech Generating Device
Can produce synthesized speech
Some also allow for recorded speech
Dynamic Display
Computer features
environmental controls
computer access
Most require programming
Require training, support, and maintenance
Dedicated vs. Integrated
Dedicated means the device is used only for communication
Integrated means the device is built on PC format with other computer applications
Speech Output
Digitized Speech http://depts.washington.edu/augcomm/original_modules/module_equipt/equipt_features_output.htm
Synthesized Speech http://www.nextup.com/
Rate Enhancement
Purpose: To Accelerate Message Production
Message Encoding/Abbreviation Expansion
Salient Letter, Category, Numeric
Prediction
Letter, word, phrase, and grammar
http://www.youtube.com/watch?v=5_KEjkONjR8
Message Storage
Store an entire message under one button (e.g. TT)
Access Method
Direct Selection Use of fingers
May involve use of keygaurd
Assisted Direct Use of an external device that is controlled by a part of the body
Wooden pointer/stick, laser pointer, mouth stick, head pointer
Indirect Selection Use of a separate device that is not part of the body
Switch
Scanning
Switch for Scanning
The device highlights messages according to a set pattern and the user activates a switch to select the message
Varies by pattern, selection technique, and speed
Patterns include linear, row-column, and group-row-column
Selection techniques include automatic, directed, and step
Visual vs auditory
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Switches
Switch Types
Considerations:
Location- The most effective site may not allow for mobility
Should be easily activated
Need appropriate timing
Variables:
Type of feedback
Size
Weight
Pressure needed to activate
Moisture resistance
Alternative Access
Headmouse
Eye Gaze
Portibility
Size
Weight
Carrying Cases
Mounts
Smartphone and Tablets
Portable, generic, easily-available devices Music/game players
Smart phones
Tablet computers
Run Communication Apps (software)
Tablet Phenomenon
Benefits:
Universal design
Portability
Ease of availability and purchase
Cost considerations
What’s not being said:
Trials versus required purchase
Skipping comprehensive assessment
Portability
What is the Best System to Use?
There is no “best” type of AAC system.
Each has its own pros and cons
Goal is FEATURE MATCHING- to identify the most suitable system for an individual depending on their personal preference as well as on their abilities and needs.
AAC and Employment
Discuss 3 key components for obtaining and maintaining employment:
developing employee knowledge and skills that are valued in the workplace
identifying jobs that are a good match for the skills and interests of individuals who use AAC
ensuring that needed supports are available to maintain employment success
Employment support teams
Job carving
McNaughton, D., and Arnold, A.
AAC and Employment
Bryen et al. Communicate effectively in the workplace - KEY skill
Involves more than discussing work-related activities.
Storey and Provost
Benefits of providing communication skills instruction and communication books featuring social vocabulary
Breaks/social meals included core vocabulary as well as work site specific fringe
AAC device had substantially helped in many major life activities, including maintaining a source of income.
AAC and Employment
Effective use of assistive technology in work setting requires more than just access to a device!
Organized instruction and opportunities for meaningful practice are also needed
Committed Employer - Need for increased effort at the beginning of the employment process as well as ongoing needs for assistance with work activities and ADLs in the workplace
“Extensive, intensive teaching during implementation is the key to success” (Horton, Horton, & Meyers, 2001)
Who funds these services?
Medical Model MD referral
Bill for services based on LCD codes
Submit to insurance for approval
OOD referral, DD services, waiver services
Must have prior authorization
Private Payment model When above not available, services provided on
discounted rate
Consumer agrees upon services and signs an agreement
Additional Resources
Low Tech AAC www.speakingofspeech.com/AugCom_Materials.html
Alphabet Boards
http://www.spectronics.com.au/blog/tools-and-resources/free-downloadable-alphabet-boards-for-people-using-aac/
Make your own communication board
http://connectability.ca/visuals-engine/
Additional Resources
ATIA (Assistive Technology Industry Association) www.atia.org
Sample AAC Vendors
Forbes Rehab Services (www.frs-solutions.com)
Prentke Romich (www.prentrom.com)
Saltillo (www.saltillo.com)
Tobii DynaVox (www.tobiidynavox.com)
Questions?????
Thank you!!!!!
Tablet Phenomenon
What is Not Available? Training on App
Technical support
Limited alternative access
Limited speaker volume control
App for monitoring use
Performance measurement
Outcomes measurement
State Centers
Assistive Technology of Ohio
www.atohio.org
Assistive Technology of Ohio Device Lending Library
www.atohio.org/devices.html
Assistive Technology Trading Post
www.atohiotradingpost.org/home.php
Autism Society of Ohio
www.autismohio.org
