AAC

• Children whose speech is not functional for all communication needs and need/use AAC may be refereed to as :• Severe speech and physical impairment (SSPI)• Complex communication needs (CCN)• Nonverbal

A wide range of etiologies and severity

• Autism• ADD• Stroke, etc. • All host of reasons congenital or not

Types of Communicators• A life long continuum

• Emerging communication (non symbolic only)-> context –dependent communicators (symbolic and non-symbolic, limited vocabulary, limited partner -> independent communicators ( all topics, all partners, spelling possible)

(line continuum)

Will AAC stop the development of speech?• EI kids are not referred because we want to see if they

develop speech. • Whatever speech a child has, they are going to use and its

going to be hard to augment them using a device because it may be slow, may not have what they want to say, and vice/versa• We should use augmented devices earlier

What is ACC?

• The devices, displayed as well as techniques and strategies

Principal of assessment

• There is no standardized battery of tests that compromise an ACC assessment• We do things that are more observational or task

strategies that to see what the pt. needs & what assistance matches their needs

Assessment

• Participation + AAC feature + child & partners = ACC system + intervention

Partner Categories

• 1. family living w/ individual• 2. Close friends• 3. Acquaintances• 4. Paid people: paraprofessionals, therapists, etc• 5. Unfamiliar Partners

• Family & paid people are usually the big groups of people that interact with these ppl. We want to expand to the rest of the groups

Principle AAC assessment must involve a team

• Include specialists form many disciplines who ideally make collaborative recommendations regarding an intervention plan.

Funding source may determine who does the assessment• Funding• School district• Medical insurance

• Evaluation• At team• Independent evaluator

Participation Model (beukelman & Mirenda, 2005)

• We want kids to participate in a normal setting• Need to consider how they will participate in a

group, cafeteria, playground, etc.

Literacy & Learning

• If you cannot speak the reading and writing is affected• If you are stuck w/ a communication board that

some adult ahs chosen for you, that’s the only thing you can say. You’re like a prisoner of w/e that person chooses for you. • If you can spell, you can say w/e you want.

Identify communication needs

• Does the child’s current means of communication meet his needs?• How can we prepare the child to meet his future

needs?

Overall AAC system• Modes• Speech• Facial expressions• Gestures• Body postures• Communication book• AAC deice• Email• Computer• Alphabet board • Phone vocalizations

• (circle w/ each branching off)

Low (light) tech AAC

• A light to have kids spell out what they want to say.

High tech devices that produce synthesized speech• You type in what you want to say and it says it• Dynavox Maestro• Nova chat 7 (Saltillo)• Accent 1200• Large, 12’ display, • Advanced functionality and user friendly features

• All have dynamic display: going from screen to screen to screen. • Child has access to millions of words

iPad

• Don’t cost as much• The software is $200-300• Can be a communicative device• Insurance won’t pay for these because it’s considered

a “computer”

• There are AAC apps• There are no key guards on these things. Key guards

are made for the dedicated devices• It’s getting hard to choose btw. AAC & iPads

Selection Technique

• Scanning• Eye gaze• Direct Selection

• Selection technique can be variable• Not clear cut • Need to consider access & seating

Sensory/perceptual skills for the kid and his communicative partner

Positioning & seating• Degree of independent in mobility• Different seating for different environments

Portability

• Size & weight• Transport/ mount• Carrier case requirement• Battery time required

Feature Matching

• Capabilities + communication = needs device features