AAC Flashcards
communication examples
- body language
- eye contact
- gestures
- symbols
- written language
- multimedia
- braille
AAC definition
a set of tools and strategies that an individual uses to solve everyday communication challenges
types of AAC users
- expressive language group
- supportive language group
- alternative group
expressive language group
- comprehension
- typically motor impairment
- permanent AAC
- expressive language difficulty
supportive language group
- expected to develop speech
- promote language development
- support unclear speech
- severe articulatory disorders and learning disability
- output and sometimes input difficulties
alternative group
- input and output difficulties
- little speech comprehension
- AAC replaces speech
- learning disabilities, autism
why do people uses AAC
- speech is not meeting communication needs
- developmental disabilities (CP, ASD, intellectual disability)
- acquired disability (TBI, stroke), MND)
what level of speech requires alternative communication
little or no speech
what level of speech requires augmentative communication
unreliable speech
AAC system definition
- an integrated group of components used to enhance communication
- symbols, aids, strategies, and techniques
AAC symbol definition
- visual, auditory, and/or tactile representation of conventional concept
- photos, objects, words
AAC aid definition
- physical object or device used to transmit or receive messages
- communication book, board, chart
AAC strategy definition
specific way of using AAC aids, symbols, and/or techniques more effectively
AAC technique definition
- method of transmitting messages
- signing
types of AAC
- aided
- unaided
levels of AAC tech
- no tech
- low/light tech
- mid tech
- high tech
types of unaided (low tech) AAC
- eye pointing
- facial expressions
- gesture
- manual sign
- pointing
types of low/light AAC tech
- communication board
- book
- alphabet board
- communication passport
types of of mid AAC tech
- big mac (single message)
- step by step (sequenced message)
- static device (static device)
what constitutes mid tech
battery operated
high AAC tech
- computer-based voice output communication aids (VOCAs)
- dynamic display
- software packages
access methods
- direct access (finger, knuckle, etc.)
- switch
- eye gaze
- two switch scanning
- row/column scanning
symbol types
- photographs
- picture communication symbols
- widget symbols
- symbolstix
- bisssymbols
what to consider when choosing a symbol set
- what is available
- how pictorial
- how flexible
- how visually complex
- environment
- needs of the individual
when would technology not be suitable
- in the bath
- if broken
- left behind
4 competencies (Light, 1989)
- linguistic
- operational
- social
- strategic
pros of early AAC introduction
- potential for development of communication
- less associated with failure
- less time for negative attitudes to develop
- proactive approach to intervention
pros of later AAC introduction
- allows time for all to grow accustomed
- allow time for skill development necessary for effective use
- allows carers to put more input
- allow more space for harnessing cooperation
cons of AAC
- not typical systems of communication
- may not be readily reinforced
- may be hesitant to accept use of an augmentative system (some believe it represents giving up on vocal language)
- some unable to receive the message
- some not willing to take time to receive messages or converse
- expensive (buy equipment and train people to teach and receive messages)
- complex to develop effective system
- competing demands (motor, cognitive)
pros of AAC
- simultaneous inputs (auditory and visual)
- enhances speech and/or language development
- entries are available for longer time
- speech can be slowed more than vocal language with less distortion
- amenable to physically prompting
cons of aided AAC
- more vocab, harder to remember where everything is
- leaving something behind
- broken AAC
- rely on someone else
- environmental disruptions (sunlight affects eye-gaze systems)
cons of unaided AAC
- physical disadvantages
- limited vocabulary
- translation problems
important considerations for AAC users in the future
make sure you don’t limit someone based on their possible future abilities (don’t give a pointing board to someone with MND, will lose ability to point)
goal of assessment
- enable individual to be communicatively competent to meet today’s needs and future needs
- more autonomy/independence
principles of assessment
- not a finite process
- team approach
- focus on participation not impairment
- AAC is the start, not the goal of intervention
- identify and build on existing communication skills
- technology does not make a competent communicator
3 Cs
- client abilities and needs
- context of communication partners and opportunities
- communication code options
potential MDT
- AAC user
- family/carer
- SLT
- OT
- PT
- doctor
- psychologist
- teacher
- social worker
- orthotist
- AAC supplier
is it important to find and stick with one AAC supplier
no, keep a broad view and have many relationships with different suppliers
participation model
- identify participation contexts
- conduct activity inventory
- assess peer participation
- assess target individual participation
- identify participation barriers
participation barriers
- policies
- practices
- attitudes
- knowledge
- skills
how to overcome policy barrier
can’t change policy, change system
practice barrier example
putting AAC away after conversation rather than keeping it out in case it needs to be used again
when to address attitude barriers
- always!!
- you never know if there is something going on behind closed doors, allow the conversation to happen
how to overcome knowledge barriers
educate communication partners
how to overcome participation challenges
- identify barriers to direct intervention
- acknowledge levels of barriers
- go outside of clinical situation
- advocacy
participation evaluation tools
- communication logs (why)
- communication diaries (who and where)
- case histories
- observe across environments
- AAC Profile
capability profile componenets
- motor
- cognitive
- linguistic
- literacy
- sensory perceptual
profiles to assess for potential to use AAC
- capability profile
- operational requirements profile
- constraints profile
capability profile assessment purpose
assess individual performance level in relation to critical areas pertaining to AAC intervention
motor considerations
direct or indirect access
literacy considerations
- text based system?
- potential for text to become functional
cognitive considerations
- what kind of symbols?
- how many? (push to give many symbols even with cognitive deficits)
sensory considerations
- size
- spacing
- colors
- contrast
linguistic considerations
- what kind of language (catch a bus, ball, etc.)
- what kind of layout
predictive assessment
- extension of criteria based assessment
- incorporate trial periods
- carefully selected task to provide key information
- knowledge team in relation to AAC system features and learning requirements
what assessment is used for cognitive ability
symbol assessment
what assessment is used for language abilities
literacy assessment
what to assess during AAC assessment
- physical abilities
- sensory abilities
- visual-perceptual abilities
- sensory
- communication partner
- AAC user abilities
motor demands to consider
- access
- positioning (muscle tone, vision, sensory, environment, range of movement)
- selection
types of positioning to consider
- head control
- breath support
- hand function
- eye contact
- visual skills
90 90 90 position
types of access
- direct
- indirect
direct access definition
user selects a specific target by themselves
indirect access definition and example
- user needs help from someone to select a specific target
- scanning
scanning
- items in the selection set are presented sequentially over time
- user makes a selection indirectly (ex: switches)
pros of eye-gaze
- offers new opportunities for those with more challenging access
- can be an efficient access method
cons of eye-gaze
- demanding
- impact on social communication
areas of visual impairment
- visual acuity
- visual field deficit or loss
- occulomotor problems
- visual stability
- visual perceptual difficulties
visual acuity
affects size of symbols
visual field deficit or loss
device position
occulomotor problems
difficulties fixating, shifting, or focusing
visual stability
difficulty over a period of time
visual perceptual difficulties
difficulties in perception, discrimination, closure, and memory
vision assessment purpose
- what distance should symbols be placed
- what size
- field of vision compromised
- tracking ability (vertically, horizontally, diagonally)
- identify line drawings
- cross the midline
- how much detail can they handle
vision obstacle strategies
- color and contrast
- limit colors
- space and arrangement
- voice output or auditory feedback
- enlarge symbols
auditory scan systems pros
- partner assisted scanning
- allows development of a communication system
- reduces visual effort
- uses a sensory area of strength
communication partners pros
- able to assist in system use
- help with hearing, cognitive/literacy skills, attitude deficits
language versus communication
- language is receptive
- communication is expressive
symbol hierarchy
- real objects
- toy/miniature objects
- photograph
- color picture
- line drawing
- written word
aim of symbol sets and systems
identify the kind of symbols that might meet client’s communication needs
symbol assessment
- familiar objects
- symbol-object matching
- ability to communicate with symbols
- ability to use symbols to make requests
- advanced symbol use
- Symbol Categorization and Association Assessment
Index of Augmented Speech Comprehensibility in Children
- intelligibility v comprehensibility
- single word/short phrases elicited
- familiar and unfamiliar listeners
- with/without semantic context
- where appropriate, first letter cues
