Augmentative and Alternative Communication

Technology

Augmentative Communication Technology

• • • • Augmentative communication is an alternative way to help students with language disorders use expressive language or receptive language. Augmentative communication can be accomplished through assistive technology devices such as computers or hand held devices. Low technology such as picture communication systems can also be used as augmentative communication.

Augmentative communication is most often used with students and who have significant disabilities impacting language or those who do not have the ability to speak. Severe language disabilities may include:

• • • • • • • • • • • • Learning disabilities in listening comprehension; Learning disabilities in oral expression; Autism; Communication disorders; Developmental delays in communication; Apraxia; Auditory processing disorders; Traumatic brain injuries; Mental retardation; (The term mental retardation, although still used, is considered negative. Many parents and disability advocates prefer the term mental disability and "person first" language.) Deafness and hardness of hearing; Aphasia and Senior citizens with health issues or language disorders.

History

• • • • 1970s, legislation began requiring that all children received educational services. As a result, many children with disabilities entered the school system, compelling classroom teachers to find ways in which to assist communicative exchanges.

1980s, AAC became an area of professional specialization. Articles, newsletters, and textbooks on the matter were published as well as the first international conferences. In 1983 the International Society for Alternative and Augmentative Communication.(ISAAC) was founded 1992, the Communication Bill of Rights, stated that all individuals with severe communication disabilities have a right to use AAC devices at all times as well as a right to information and the opportunity to have and make choices.

Since the 1990s, there has been an increase in in-class and natural education techniques, as opposed to traditional pull-out methods, which has led professionals to seek ways for children with disabilities to participate more comprehensively and successfully in classroom activities.

History

• • • • 1950’s – first use of augmentative strategies with the deaf, its modern inception began in the 1950s.

– At this time, AAC devices were mainly implemented for those whose oral and laryngeal anatomy was damaged by surgical procedures such as laryngectimis and

glossectomies

– During the 1960s in the United States, as well as the deaf community's pursuit of the right to be educated using American Sign Language (ASL), helped increase public and governmental awareness of the issues related to AAC.

During the late 1960s, manual sign languages were used with individuals who had both hearing and cognitive impairments. AAC devices were also used with individuals where intelligible speech would likely never be possible, including those with severe dysarthria, cerebral palsy and amyotrophic lateral sclerosis. However, in most cases AAC strategies were only employed after traditional speech therapy had failed, as many felt hesitant to provide non-speech intervention to those who might be able to learn to communicate verbally.

AAC

• The methods of AAC will vary and be personalized to meet the needs of the individual. Many forms of AAC will have an assistive technology component which will come in both high tech or low tech strategies. You don't need special skills for understanding an individual who is using ACC as the processes are self-explanatory.

Process Methods

• 3 Methods –

A method to represent figures(objects, words, drawings, symbols, photographs, line drawings etc. )

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A method to select symbols (point directly or use a scanning device such as a head pointer )

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A method to transmit the Message (visual or auditory output)

Method 1: Method to represent Symbols

• Symbols are pictures or gestures that represent something. The symbols are pictures that represent words, letters for spelling, • Things that need be considered when using symbols are the student chronological age, cognitive , visual and physical skills.

• Other things that should be considered are the vocabulary and what words are most important for the students to learn. – How to participate in an conversation, initiation, change, get out of conversations.

– Things needed for school, asking questions, requesting information, social peer communication.

• These symbols can be low tech or high tech. Low teach are those that do not require batteries or electricity.

Method 2: Method to Select Symbols

• • • • There are two main methods for AAC users to select symbols.

1) A person may directly select a desired symbol from available symbols. This may be aided through the use of mechanical pointers, switches, light beams, prostheses; or unaided through the use of blinking, eye gaze, body movements, pointing, or symbol removal. 2) Individuals with limited mobility may use a scanning selection mode to speed up the selection process. In a scanning mode possible choices are offered in sequence, either one item at a time or in a row-column or block presentation Both of the above methods may use some type of input device (such as a switch, mouse or adapted keyboard) to assist the person in making their selection. Some methods/devices utilize levels or pages to divide possible vocabulary choices. To go from one level to another a person may use low tech means by going from page to page, or high tech means in which the level/page is switched electronically.

Method 3: Method to transmit the Message

• • AAC users may convey their message through visual and/or auditory output. With manual signs/gestures or communication boards the listener must watch the individual to interpret the message. Many electronic devices provide voice output (either computer generated or recorded) or a written display. AAC aids fall into three categories: – 1) Simple Systems include low tech aids and techniques, such as communication boards and gestural systems, 2) Dedicated Devices serve the purpose of communication only. 3) Multipurpose Systems are those that serve for more than just communication. They are designed to change functions easily, and serve educational, vocational, and/or recreational purposes. AAC devices range in complexity. They may include one symbol at a time that is available to the user, or may be more complex devices which use a sequence of icons to represent different concepts.

How are AAC assigned?

• • Comprehensive evaluation of a user's unique abilities and requirements is necessary in order to implement appropriate intervention and match the user with the most appropriate AAC device. AAC evaluations are conducted by specialized multidisciplinary teams consisting of a speech-language pathologist, occupational therapist, physiotherapist, social worker and a physician.

[ The assessment team conducts interviews with the user, family members, caregivers and/or teachers in order to obtain additional information about the user's behavior and skills in different settings. The team also assesses the user's motor abilities, communication skills, cognition and vision

ACC Assigned cont.…

• During the intervention process, the occupational therapist assists with the positioning and seating adaptations so that the individual can have the best access to the AAC system. An example would be when someone might need a key guard on the top of a keyboard or touch screen to keep from hitting the wrong button. The physiotherapist works on motor development training. The speech language pathologist's role is to teach the user and their communication partners how to use the AAC device. In selecting and adapting the AAC device for the user's individual needs, the speech-language pathologist's goal is to ensure that the AAC device can be used in different contexts and with different communication partners.

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Facts

Augmentative and alternative communication is generally slower than speech. Rate enhancement strategies increase the user's rate of output, and as a result enhance the efficiency of communication.

There are two main options for increasing the rate of communication for AAC devices: encoding and prediction.

Encoding – Encoding is a technique permitting an AAC user to produce an entire word, sentence or phrase using only one or two activations of their AAC system.

– "Iconic encoding" sequences of icons (picture symbols) are combined to produce words or phrases In numeric. – keyboard text-to-speech generating device Prediction – Prediction is a rate enhancement strategy in which the AAC device attempt to predict the letter, word or phrase being written by the user. The user can then select the correct prediction without needing to write the entire word. Word prediction software may determine the choices to be offered based on their frequency in language, association with other words, past choices of the user, or grammatical suitability.

– Examples of this in every day life are your cell phones.

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Teaching how to use AAC

Use the daily routine as a framework for planning for the use of AAC

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Think about the routine that the child will be using in your classroom. This will be the framework for what types of communication the child needs.

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Use messages that are motivating for the student

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When using messages that are motivating for the students, use messages of what the child will need and want to say. To get Ideas listen to conversation during play time, lunch time, and in class.

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Model the use of the devices/boards by pointing to the appropriate messages as you speak.

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Everyday experiences are linked to words by the teacher/ adults in a child's life. It is the teacher/ adult who models the use of oral language (“You want a block?") and also makes the words meaningful in the child’s life.

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The teacher will model how to use the board when speaking to the child.

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It will take time but with consistency the student will began to use the device as well.

Strategies

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Give cues (expectant pause, facial expression, gesture, body language, etc.) and plenty of wait time for student responses

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Allow students to response with facial expression, gestures or body language. This could be a wink, the direction that they look, finger tap, or anything that answers the question.

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Wait time should be between 10 and 15 seconds. This lets the student or child know that their response is important. Practice the prompt hierarchy

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A prompting hierarchy method of assisting students in learning a skill. The prompts are from least to most. Build empowerment, initiative, and ownership

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This is when you encourage the student about what the device will do for them

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You will then present the device and talk about the device with the students and give the students the device to keep with them at all times to show ownership of the device.

Strategies

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Provide immediate and consistent feedback to a student's communication attempts

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When the student began to use the device, provide feedback each time they use the device. This could be any feedback , even if it is to say “no, it is not time for play”.

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Set the stage for communication to occur (sabotage)

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This is when you set up your room or any situation that will influence communication.

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Keep devices/boards accessible and within easy reach

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It is good to keep the devices/boards in an area where they will be used the most.

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Use a symbol system according to the student's needs (objects, miniature objects, photos, drawings, product labels, or Picture Communication Symbols)

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You can use objects that can also help student to make choices.

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All Strategies are suggested from

http://prekese.dadeschools.net/AS/aac.html

ChatBox

Price $495.00

A beginning-level device that introduces a non-speaking person to electronic voice aids. ChatBox can be programmed for the appropriate vocabulary, voice and native tongue of the user. By organizing vocabulary around activities and situations, the communicator is provided with sufficient vocabulary for use at home, school, work or play. This newest model includes more than three times the memory of earlier models, plus additional battery life, higher quality speech and row/column scanning as an additional input technique. 495.00

The Tech/Speak

Online Price:

$1,095.00 – $1,610.00

• The Tech/Speak with Environmental Controls combines augmentative communication with the added functionality of environmental control, providing an added level of empowerment to the user. • Can control several electrical devices and/or light fixtures. Within each of four on-off combinations, up to eight devices can be programmed to activate simultaneously. • The device functions through radio frequency. This device has real voice audio reproduction.

EyeMax

Price $7800-$9000 Not including eye max accessory $ 7000

• • • •

Fully-functional, integrated augmentative and alternative (AAC) device and develop an eye tracking system that can be used to access its features. The Vmax is designed to withstand moisture, temperature and the impact of daily use, and provides an array of access methods to users of AAC. The EyeMax accessory is the newest addition to this variety of access methods for use with the Vmax. The EyeMax System’s size and wide range of positioning options allow a user to communicate while maintaining the field of view necessary to navigate a wheelchair and effectively interact with a communication partner.

DynaWrite

Price $5299-$5999 With warranty

• • • • The DynaWrite is one of several type-and-talk AAC devices from DynaVox. everyday computer-style keyboard and bright screen display that have users typing and talking within minutes of opening the box. Superior word prediction features, multiple voices, and optional scanning methods combine to make the DynaWrite suitable for individuals with a wide range of motor skills. DynaWrite can connect with your PC, enable you to talk on the phone, and act as a universal remote control for common household appliances.

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Sources Dynavox Website http://www.dynavoxtech.com/products/ Mimami Dade Preschool website http://prekese.dadeschools.net/AS/aac.html

http://www.circleofinclusion.org/english/augcomm/inde x.html

Augmentative Communication News (Copyright 2009) Newsletter Volume 21 number 4 Peters-Johnson, Cassandra Language, Speech, & Hearing Services in Schools; Jul95, Vol. 26 Issue 3, p295, 8p

http://web.ebscohost.com.spot.lib.auburn.edu/ehost/pdf?vid=7&hid=104&sid=16437026-aadd-4f0b-8e1a 035fbcc813bb%40sessionmgr10 Ann Logsdon Augmentative Communication - Augmentative

Communication Systems taken from website http://learningdisabilities.about.com/od/ac/g/augmentative.htm