Augmentative Communication Evaluations Simplified: ACES Tools & Resources

Debby McBride, MS, CCC-SLPPresented by AAC TechConnect Inc.

Lisa Bardach, MS, CCC-SLPLibby Rush, MS, CCC-SLP

Tanya Curtis, MS, CCC-SLP700+ participants in other workshops

(contributions in content & resources)

Purpose

To give people their VOICE

Because we all have something to say!

What role do you play in giving people their voice?

What does Augmentative/Alternative Communication mean to

you?

What is augmentative /alternative (AAC) communication?

Refers to the incorporation of techniques that can be used to help individuals with disabilities in general, as well as to very specialized technologies designed specifically for individuals with significant and severe disabilities. These techniques include, for example, the use of communication symbols, aids, strategies, skills, and devices designed to assist disabled individuals. (Sarah Blackstone; 1986)

AAC communication includes Nonverbal

Vocalizations

* Low-tech or no-tech

* Lite-tech

* High-tech

Goals include:

Your goals for this workshop

Write 3 ( on the back of your evaluation form)

*

Goals include: Explain the process of obtaining an AAC tool/device

Describe tools/techniques used to determine the AAC candidate’s skill

Complete many of the components with templates provided for gathering, compiling and reporting the results.

Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)

Identify local resources and consultants for trials, support, and funding assistance for AAC devices.

Schedule Today –

Looking at the “Communicator” Using a “Toolkit” for Evaluation Lunch Matching persons to devices / communication tools Trialing the toolkit

Tomorrow Case studies – ours Case studeis - yours Decision-making process for appropriate devices

Trialing the appropriate device(s) Using your local resources Funding

A Systematic Approach for AAC Evaluations

ACES Module Augmentative

Communication

EvaluationSimplified

ACES Module examples

Tools and Resourcesyou will leave with: ACES Module (handouts & on CD)

Evaluation Toolkit List The Persons (form) AAC Device Features (form) Case History & Eval Summary (form) Device Decision Making (form)

Resources on CD Handouts (including the above) AAC device flyers Templates (report, summary forms, etc.) Other resources (website lists, vendors lists, etc.)

Websites: free resources

Challenges you have? Why…

*

AAC Evaluations - Challenges

Availability of systematic assessment protocols Acquire premade materials/resources

(vocabulary, overlays, etc) Not organized / equipment available when

needed / working when needed Training ??? Knowledge??? Experience??? Keeping up with technology Overwhelming ? ? ?

Process – Beginning to end

Person Referral Gathering information Deciding on skills to assess Choosing the “toolkit items” used Evaluating the individual's skills (sensory, physical, language, communication functions/needs, etc.)

Summarizing individual’s skills

Process continued

Communication Tools / Devices Matching skills to communication tools (feature - matching)

Voice / no voice Trialing communication tools / voice output

devices Making recommendations Writing appropriate documentation Completing funding paperwork as needed Use of your equipment reps

Evaluation

Who are they? What do they want to say? Where do they want to say it? How do they want to say it? What are their current skills? What technology can bridge the gap?

Feature Matching –

Determine what the individual needs, then find the technology with the requisite features and match the technology to communicator.

SDT

Level of communicator

Emerging

Context/Partner Dependent

Independent

EmergingNo RELIABLE means of EXPRESSIVE

communication through SYMBOLIC language

Have some functional non-verbal communication (gestures, vocalizations, other nonsymbolic communication)

Able to attend, even briefly, to individuals, conversations, pictures, or symbols

Yes/no (acceptance/rejection) depicted with body language; i.e. no reliable yes/no for more complex communication

Context- or Partner-Dependent

Has SYMBOLIC communication that is RELIABLE but limited to particular CONTEXTS or PARTNERS

Rely on partners to provide limited response set

Need frequent instruction and cueing

Difficulty with initiation

May only be functional in particular settings

Wide range with regard to # of partners and # of settings

Independent (Generative)

Can communicate ANYTHING on ANY TOPIC to ANYONE in ANY CONTEXT

Locate, select, and convey messages on their own

Can interact with familiar / unfamiliar partners equally well

Can sequence symbols or letters to generate novel messages

Access / modification

Direct select: keyguard, pointer, stylus

Headpointer / headmouse Eye gaze Joystick, mouse, trackball Morse code Scanning Wheelchair controls (caution)

Switch access

Circle for location of switch

Type of switch

Mount / attachment

How many switches?

Scanning options

Auditory / visual Linear / row-column / group Step / inverse / auto Other

Who is your person?

break

Evaluation -

What’s in your toolkit?

What do you currently use?

Toolkit List

Gathering your Toolkit

Help you organize what you have - toolkit list Help you decide what to add to your

resources Give you additional ideas for premade

materials / resources Give you additional resources you can access:

CD AAC TechConnect- web

The Evaluation Toolkit

The Evaluation Toolkit

Toolkit

Low-tech physical access components

Keyguard Pointing light Partner Assisted Scanning Eye gaze PECS Positioning (motor – visual)

Miscellaneous items

Augmentative Resources

Switches & accessories

Variety of switches

Switch interface

Switch mount

                                                                     

Array of Switches

Switch Mounting System

TOOLKIT #1continued – “Lite – Tech” components

Battery adaptor Array of Switches Switch Interface Switch activated devices (toy or

fan or vibrating Pillow) . . . . .

Switch Mounting system

Cause-effect items

Switch Activated Devices

Battery Adapter

Switch Interface

The Evaluation Toolkit

Toolkit

Voice output – does it make a difference ? ? ?

Single message sequential communicator

Multiple message communicators (progressive message key setups)

Consider ones with levels

Simple voice output –w/ sequencing capabilities

Single message communicators(Sequencers, Step-by-Step, etc.)

Single message communicators

Replays one message at a time Recorded speech Some can do multiple messages

(repeats different message each time you select it)

Some can do different levels / situations

Progressive Communicator- Digitized device(s)

Start simple – 2 pictures Add more pictures Has levels Direct select Recorded speech (voice) Uses overlays

Static Display Progressive Communicator

Simpler voice output devices

Digitized Devices & Accessories

Others in your closet

Macaw Message Mates ChatBox Others? Any of these?

Digitized Devices (examples only – not all inclusive)

The Evaluation Toolkit

Toolkit

Toolkit #3 - “Higher Tech” Laptop or tablet computer

(convertible laptop optimal)

Add communication software Emulate devices (large, medium, small)

Accessories Touch Screen (not just with pen) Switch interface

Laptop Computer, Touch Screen and AAC Software

I “stuff” (iPad, iPod, iTouch, etc.) . .. Droid, Slate, etc. . . . .

Communication Software Emulate the devices 3rd party software which does the

following: Make various configuration of

overlays Able to link them together to evaluate

navigation Can do scanning of all types Spelling (word prediction) - optimal

Software for purchase Tobii Communicator (Tobii ATI) - $599 - SayIt! Sam Software (Words +)-$1395 Speaking Dynamically Pro (Mayer

Johnson)- The Grid (Sensory software) Mind Express (Words+)

others Boardmaker Plus (Mayer Johnson) Overboard (Gus)

Free manufacturer software/ demosyou can get . . .

Series 5 Semesterware (DynaVox) PASS software (Prentke Romich) SayIt! Sam (Words+) E Z Keys (Words+) Mind Express (Words + - coming) Others?

Questions?

What do you have?

or

What do you think you may need / want?

Time for lunch!

ACES Module: Your Tools & Resources

Toolkit components: communication tools to have at your fingertips (in the bag)

Premade evaluation materials / resources(in the book)

Templates / resources to complete paperwork (on CD and on the web)

Resources to make decisions on devices(On web)

Premade resources - ideas

Evaluation Materials/Resources

Materials include: Objects Pictures Premade overlays / pages

Low tech (communication boards) Lite tech (overlays for digitized devices) High tech (pages for dynamic display

options)

Symbols Objects Photos COPPS Pictures Overlays Visual scenes Alphabet boards

Symbols and premade materials

Make your own

Purchase other resources

Examples of Toolkit Notebook CD coming with PCS boards on it – Fall 2010

Pre-made pictures/overlays

What do you use?We use . . . Examples include various sizes (size

of message key and #’s of keys) Various communication functions Dynamic display (low tech example) Sizes example

Object-COPPS-Photo

Talking My WyaTALKING MY WAY

Photographs

PCS – Boardmaker (Mayer-Johnson)

SymbolStix - Symbolmate – News2U

Overboard by Gus

Attainment

The Test of Aided-Communication Performance (TASP)

by Joan Bruno, Ph.D., CCC-SLP

A tool for the assessment of symbol-based communication skills.

Includes subtests on symbol size and number, grammatical encoding, categorization and syntactic performance.

Results may help determine AAC intervention strategies and goals.

Provides starting point for designing communication boards or selecting a page for an AAC device.

Alphabet boards

Alphabet/Spelling Alphabet boards Keyboard arrangements

ABC QWERTY Frequency of occurrence

Grammar based boards

The Device: Features to Consider

Symbols Objects COPPS Photos Pictures Words Letters Media (video clips, etc.)

Language Representation Single meaning pictures Multi-meaning pictures (Unity) Alphabet / spelling

Use of core words Visual scenes Phrase-based Grammar-based boards

Single meaning pictures

Semantic Compaction (Unity)

Multi-meaning pictures Less key strokes (in sequencing) –

faster Motor memory Icon prediction Activity row – picture prediction

Semantic Compaction-example

Visual scenes

Phrase Based

Premade vocabulary considerations

Language representation Progression (easy to more complex) Individualizing

Smaller vs. larger vocabulary needs Ease of navigation Ease of learning (for user and

communication partners)

Grammar - Based / Core Words

Grammar Based Software WordPower

(Most manufacturers)

Picture Word Power (Most manufacturers)

Wordcore (PRC - Pics)

Gateway (Dynavox - Pics & words)

Tobii Communicator (Sono Key- words/Sono Lexis-pics)

SpeechPro (Gus-words)

AlphaCore (Dynavox-Pics & words)

Alphabet/spelling

Keyboard arrangements ABC QWERTY Frequency of occurrence

Message formulation

Single key messages Routine phrases Novel sentences Novel thoughts / ideas Spelling

Message formulation:

Gateway - Unity – Picture WordPower –

Navigation / page changes

Who is changing: facilitator or communicator (can limit access)

Static display - # of pages Dynamic display - # of pages

# of levels down

Message Key # of keys Size of keys Varies Actions required

Click Zoom/enlarge Color changes Hold time Auditory “fishing” (technique)

Screen size

Small (handheld size) Small – medium (Xpress,

Springboard Lite, Alt-Chat) Medium Large Issues: visual, motor, navigation

requirements (memory)

Message display

Words Pictures Speak each word / sentence Speak on demand / punctuation Highlight each word as it speaks Silent mode

Rate enhancement Pre-store messages Prediction (word, letter, picture,

symbol, character, phrase) ** Abbreviation – expansion Pre-made vocabulary options Grammar-based boards ** Word morphology (word endings,

verb tenses, etc.)

Picture prediction – activity row

Refer to AAC Feature Chart for

Voice/speech Device functions/access Keyboard Type of Device Devices to trial

Toolkit Time . . .

Handheld size

Small - intermediate

Medium size

Large size

Try it on . . .

Types of devices to consider

Dynamic display Integrated systems Text – to – speech Digitized Simpler digitized Single message communicators

Dynamic Display

Multiple pages “Navigate between pages” Variety of symbols available Both types of speech (digitized &

synthesized) Possible to use generative language Offers more options for alternative

access

Integrated System

Multiple pages “Navigate between pages” Variety of symbols available Both types of speech (digitized &

synthesized) Includes computer components

Digitized Simpler communication needs Recorded voice Use of pictures Multi lingual

Most of them have: Paper overlays that are changed Also called “static display”

Digitized Devices (examples only – not all inclusive)

Text to Speech

Mainly spelling (keyboard and some have scanning)

Most have built-in keyboards Mostly synthesized speech, though

few have digitized speech

Text-to-Speech (examples only – not all inclusive)

Let’s Review what we have so far: The Person (ACES Module) AAC Device Features (AAC Module) Toolkit List (AAC Module) Gather information (Case history & Summary

Evaluation in ACES Module) Record evaluation results (form above &

Assessment summary in Templates) Device Decision-Making (AAC Module) Device Assistant – 30 day trial from AAC

TechConnect Write report (Templates) Funding (work with vendor)

Device Selection

Which Device to Choose ? ? ? ?

Low tech Lite tech High tech Combination

How do you proceed?

. . . . . Know user’s skills

. . . . .now what?

Device Selection Options

Catalogues AAC TechConnect – contact manufacturers

Manufacturer websites Go to individual ones – AAC TechConnect

has list AAC TechConnect – free resources

Pictures (thumbnails of 100+ devices) Free flyers

www.aacTechConnect.com

Website which gives the following free information on ONE site What’s New

Manufacturers

Product information

Clinical Tools

From AAC TechConnect

The ACES Device Assistant – project of AAC-RERC

The Resource for Lite Tech Low Cost AAC Chart (by Libby Rush & Mary Joan McClure)

Demo – AAC TechConnect

Free trial

Clinical Online Tools from

Lite Tech Low Cost Chart AAC TechConnect $14.95 (online with credit card)

Device Assistant Free trial – 14 days Fee – for – service after that

Trialing equipment

Loan equipment AT centers Vendors – local resources Manufacturers Rental options

Do you . . .

Have some new strategies to try?

Have some things in your closet you will dig out for use?

Questions? ? ?

Review goals

Suggestions for next time? Please put on your eval form.

Did we: Explain the process of obtaining an AAC

tool/device Describe tools/techniques used to determine the

AAC candidate’s skills Complete many of the components with

templates provided for gathering, compiling and reporting the results.

Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)

Identify local resources and consultants for trials, support, and funding assistance for AAC devices.

THANK YOU

for helping othersTo get

The best choice For the best voice

Contact us at:

Debby McBride, MS, CCC-SLP866.4U.AAC.RX

info@aacTechConnect.comwww.aacTechConnect.com

866/482-2279 or 303/674-8553