Class 2 Flashcards
who are we assessing:
have no ? be at risk for ? have ? but not sufficient to have speech that is functional in most contexts but not? have speech that is temporarily
access to natural speech developing intelligible speech some speech/meet all needs functional in some specific contexts inadequate to meet communication needs but is expected to improve or recover
What role will AAC fulfill for the individual?
- establish a basic means of
- improve
- alleviate
- equalize
- promote
- clarify
- facilitate
- enhance
- increase
- reduce ?
communication functional communication frustration comprehension and production -language development -educational/vocational opportunities -participation in society -challenging behaviors
How do we assess communication in individuals with CCN?
- there are very few ?
- assessment tools will need to be ? of an individuals true capabilities
commercially available or standardized assessment tools designed specifically for use with individuals who have CCN
adapted if we wish to obtain valid representation
The goal of an AAC assessment is to elicit .. and … behaviors that accurately demonstrate the AAC user’s
valid and representative
communication potential
AAC assessment is an ? what and what are required? even after an AAC system has been selected
ongoing process / ongoing evaluation and decision making
AAC assessment is ? it requires a team of individuals including ?
individuals with CCN are ? assessment tools need to be adapted to obtain a?
participation in real life ?
complex/ the individual who relied on AAC remember: nothing about us without us
complex/valid rep. of an individual’s true capabilities
matters
major transition in AAC testing from the Candidacy model to the ?
1970s, 1980s to participation model (1998)
Candidacy or readiness model:
historically significant - used in ? NOT
approach: evaluate individuals readiness for AAC based on?
individuals were often perceived as ? therefore,
result: individuals were
BUT we know that communication is a basic ? and no one is ?
1970s and 1980s / best practice and should not be used
formal testing, medical diagnosis or previous intervention performance
“too” something/ not a good candidate for AAC
excluded from AAC support
human right/too anything to be given access and support to communication
Participation model:
a systemic process for implementing AAC through ?
based on the ? who are the same ?
focuses on the need to design intervention based on ?
.. and… by ASHA
ongoing assessment and intervention
functional participation requirements of peers without disabilities / chronological age as the individual with CCN
what is needed for functional participation in real life
evidence-based and endorsed
The participation model 3 components:
- participation?
- … and ….
- the individual’s
patterns and communication needs
environmental supports and opportunity barriers
- policy
- practice
- attitude
- knowledge
- skill
capabilities -hearing/vision -motor -natural speech -language symbols -literacy -cognition
participation patterns:
activities in which the individual?
communication partners in each of these ?
step required to
level of
participates across different contexts
settings
complete a given activity
independence/support required to participate fully
step 1: assessment tools: - - - -
interviews
social networks inventory
communication needs survey
participation inventory
Interviews:
interview the ?
ask questions/gather data about: -the individuals - - - -current
individual, family, and current communication partners about their priorities for communication
- life experiences
- dreams or goals
- fears or worries
- strengths and unique gifts
- current unmet needs
Social network inventory:
what is a social network?
- the communication partners with whom
- critical to making an AAC system or support strategy ?
- provides the ? with his/her current and potential
- conduct structured ?
individual communicates
individualized for an individual’s specific needs
big picture/communication partners
interview with person in family or in social networks
Communication needs assessment or survey:
addresses ?
what is important to know
- a list of
- a list of
- a check next to ?
unmet needs an individual with CCN faces (can then be used for intervention planning)
- daily weekly monthly activities
- whom,when,why,how and about the individual. needs to communicate effectively
- needs that are met vs. unmet
AAC intervention will only be effective if the individual has the ?
opportunity and supports required to communicate and participate
step 2 goal:
identify the ?
requires us to ?
not assessing the ? examining the ?
supports available and any barriers that might limit opportunities to communicate
-take a close look at the individual’s environment
individual/environments in which the individual participates
Supports:
partner supports:
actions or strategies that allow an individual using AAC to?
example:
environmental supports: strategic arrangements of environments that allow and individual using AAC too ?
example:
communicate or participate at a desired or required level
- a parent uses extended conversational pause time to ensure that a child has an opportunity to take a turn to reinforce functional AAC use
communicate or participate at a desired or required level
-picture symbols are made available throughout preschool classroom
Barriers:
actors that may be ?
imposed by people other than ?
barriers can be related to: 1 2 3 4 5 6
barriers likely not ? but?
preventing the client from communicating or participating at a desired or required level
- policy
- practice
- attitude
- knowledge
- skill
intentional/need to be addressed for AAC to be successful
policy:
policies=
as future SLPs, it is critical to know which? to ?
often we are called on to be?
understanding the policies that support their rights helps us to become ?
legislated or regulated procedures
policies exist in our practice settings/support communication and participation rights of individuals with CCN
advocates for our clients, patients, and their families
supportive advocates and reduce barriers these individuals face
Practice barriers: practice= often driven by the? classic example of practice barrier for individuals who rely on AAC: -school districts may ?
the tension between policy vs. practice reflects the tension between ?
changing practice barriers requires ? and sometimes?
what is conventional or typically done in a given context
culture of a specific setting and not by written policies or legislation
- restrict the use of district funded AAC equipment outside of the school setting
what is written and what is done
advocacy/legal action
Attitudes:
how we ? and what we? determines how we act towards individuals with disabilities and/or CCN
think/believe/
attitudes can be ? but they are often?
how do we change attitudes?
-direct
-exposure to messages that ?
active ?
implicit or explicit/malleable
- experiences with people who have disabilities
- highlight how people without disabilities are similar
- role play to experience what it might be like to have a disability
Knowledge and skills:
KNOWLEDGE: WHAT WE ? HOW MUCH INFO WE HAVE ABOUT ? AAC?
skill: the strategies necessary to
understand/individuals with CCN/intervention options/technologies and instructional strategies
interact effectively
Positive supports =
barriers: areas to ?
resources for individuals. with CCN
address through intervention to ensure comm. opportunities for individuals with CCN
Goal of step 3:
focus on what the individual is ? NOT a ?
purpose is to inform ? NOT to determine
areas assessed: a b c d e f g
capable of doing (not a deficits based approach to assessment)
intervention planning (not to determine candidacy for services)
sensory/perceptual motor natural speech language symbols literacy cognition
Sensory perceptual skills: hearing
- individuals with CCN are at risk for ?
- impairments in these domains can make receiving input much more ?
hearing impairments can affect individuals with CCN in 2 ways:
- receiving
- processing
audiologist and or ENT should be part of the AAC ?
vision and or hearing impairments
difficult - including digitized or synthesized speech produced from an AAC device
- auditory signal
- -meaning of what is heard
assessment team if hearing impairments are documented or expected
Adapting assessments: hearing
adaptations that may be required when assessing individuals with CCN who also have hearing impairment:
- reduce
- provide
- augment
- model to demonstrate
- background noise
- amplification when appropriate
- oral directions with visual supports
- what the task requires
sensory/perceptual skills: vision
ways in which vision can be impaired for individuals with CCN:
- visual
- visual
- ocular
- .. sensitivity
- color
- cortical ?
acuity fields motor functioning light/color -perception -visual impairment (CVI)
adapting assessments: vision
-size:
-spacing:
-position:
within
lighting:
enlarge pictures, text
reduce visual clutter
appropriate distance from the individual, but within visual field
bright enough to see, but without reduce glare
Motor abilities:
individuals with CCN will vary in terms of the ? and how that affects ?
as a member of an AAC assessment team we need to understand the ?
you should be familiar with the following terms:
- tone
- strength
- reflex?
- .. and…
level and type of motor impairment/ range and efficiency of movements required to use AAC supports and systems
individuals motor capabilities and how those abilities affect function
- hyper and hypo
- strength (weakness , fatigue)
- patterns (ATNR, STNR, rooting)
- flexion, extension
Seating and positioning; goals -inhibit -minimize maximize -maximize
reflex patterns
any fixed positions
function
comfort
Seating and positioning considerations: consider performance in ? -seating and positioning must meet multiple goals -provide -ensure -promote -allow for
seating and positioning should allow for .. and…
multiple positions is required in daily life
- security
- safety
- functional activity
- for rest
flexibility and adaptability
assessment strategies: seating and positioning
-list
-identify… and .. within each position
-identify
-observe ? which become ?
-analyze position of ?
ALWAYYS solicit individuals ?
understand ? needed to achieve optimal positioning
-aka ?
positions throughout day
- communication needs and other functional needs
- optimal positions
- sub-optimal positions /priorities for intervention in OT PT
- pelvis,k trunk, shoulders, arms, legs and feet
- input
- supports and adaptations (foam inserts, customized seating, harnesses)
Natural speech: assess functional intelligibility
- collect several samples of the individual ?
- ensure they are ?
analyze at least ? per sample
-calculate word intelligibility - which is ?
calculate general message intelligibility which is ?
communicating with others in natural environment in typical situations
- representative of individual’s speech production
- 100 spoken words
words understood correctly by partner divided by # of words communicated
of messages understood correctly by partner divided by # of messages communicated
natural speech: assess use of clarification strategies
adjustments to following increase intelligibility: -proper - - -modifications of -est. -use of -use of -use of
positioning pacing repetition content (vocab) topic prior to specific message gestures or pantomime writing drawing
parallel programming:
maximizing natural speech function through ? while also ?
traditional speech therapy and clarification strategies/ augmenting natural speech via AAC to enhance comm.
Language: some individuals with CCN have
- intact ? but impaired ?
- challenges with both
goal: obtain a clear picture of what kind of ? NOT to assign ?
comprehension/production
-comprehension and production
spoken language input the individual understands and where breakdowns occur / score or developmental age
receptive language: does the individual understand -single words -various ? -grammatical - -techniques to ?
substantive and relational words -sentence structures -morphemes -pragmatics augment comprehension
assessment strategies: receptive language
family and or ?
-probe to obtain
direct? -record and collect data on 1 2 3
identify:
any evidence of
areas that may require
caregiver report
-specifics: ask for examples
observation in natural environment/daily interactions
- context
- what partner says
- what individual says
comprehension in context
further investigation
standardized, norm-referenced tests can be used to probe?
examples:
make sure items are ?
make sure the test does not require
specific areas of comprehension
PPVT, TACL, SICD, reynell developmental language scales
relevant, meaningful, and functional to the individual
unrelated skills to achieve success
informal, functional assessment procedures to probe?
- use
- probe full range of ?
- provide
- probe each form at various levels of
- ensure individual has
- record
- calculate
specific areas of interest
-relevant, meaningful questions
-question forms
-numerous trials with each form
-complexity
-means to respond
-individuals response
% correct, identify areas to address in treatment
assessment of augmented input can be used to probe?
-identify ?
-
-
techniques that might support comprehension
-vocabulary, types of sentence structures, level of syntactic complexity understood via speech alone
- augmented input on comprehension
- gestures + speech
- pictures + speech
- written words + speech
assessment strategies expressive language: interview direct ... -sample ? -transcribe -analyze for ?
informal?
ensure the elicitation context provides the opportunity for the ? requires the ? is ? and is ?
individual and or caregivers
- observation in natural environments
- communication in daily interactions with typical communication partners
- the sample
- language skills noted on previous slide
elicitation to target specific language structures/behaviors
-targeted language form/skill/ meaningful and motivating/chronologically age appropriate
symbol assessment: goal
generate a list of ?
identify symbols that show the ?
aided and unaided AAC symbols that the individual understands now
potential to be learned
assessment strategies: symbols
identify ? form your receptive language assessment
identify a range of ?
determine which AAC symbols to ?
choose ? that are meaningful to the individual
consider the ?
consider the array ? and the array ?
choose your ? carefully
… before you test
test the individuals ?
vocabulary
target concepts
assess
representations (line drawing, written words, combo)
size of the symbol based on motor and visual skills
size/layout
foils
teach
understanding of the symbols
assessment strategies symbols continued:
.. task
.. format
… format
… matching task
… format
receptive language task
-present 2 or more symbols and say show me X
yes/no
request format” provide individual with opportunity to initiate request
visual matching task: present actual object
ask individual to match the symbol to the object
question/answer format
- engage individual in convo and ask questions
- avoid test questions
literacy =
communicate ?
for individuals with developmental disorders assess the ?
for individuals with acquired disorders who have a history of literacy, assess
common code
-anything to anyone at anytime
range of literacy skills to get a picture of where they are functioning as literacy learners
residual reading and spelling skills
goals of literacy assessment:
to determine ?
to determine comprehension of
to determine?
to determine ?
reading comprehension of written words
-written sentences and texts
spelling skills
-written expression in sentences and texts
assessment strategies: literacy
standardized assessments (if?)
examples:
criterion? reading -.. correspondence -sound -phoneme -reading
available
-woodcock johnson, gray reading
- letter sound correspondence
- sound blending
- phoneme segmentation
- reading comprehension
-speed, accuracy, fatigue
cognitive linguistic organization:
understanding how a person ?
thinks and organizes language in their brain
schematic:
vocabulary grouped based on ?
an event or activity
taxonomic or categorical
vocabulary arranged by
hierarchal categories: food , places, people
semantic/syntactic:
displays are organized via?
symbols are ?
part of speech and spoken word order
-color-coded by part of speech or grammatical categories
others:
alphabetical
frequency of use
idiosyncratic:
pages follow alphabetical order
frequently used items in locations fastest and easiest to select
anything goes
assessment strategies: cognitive linguistic
getting started:
identify a list of
identify a range of ?
choose representations that are
check in with ?
important and relative vocab
target concepts
appropriate for these concepts
individual
assessment tasks: cognitive linguistic
S
- ask the individual to?
analyze the way the individual ?
A
-present ?
present ?
ask the individual too ?
T:
develop?
teach?
assess?
sorting:
- sort representations
- sorts and see which org. strategies emerge
- target item to individual
- several other items
- select item that goes with the target
trial systems using different organization
- use of systems
- best fit based on speed proficiency and accuracy
