Transcript Communication DEALL- An overview

Isphana Al Khatib, Premila Chandrasekaran, Tanuka Gupta and Deepika Gopalarao
Al Noor Training Centre for Children with Special Needs
Dubai
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Augmentative and Alternative Communication
Augmentative and Alternative Communication
(AAC) is an area of clinical practice that attempts
to compensate for the severe impairments in
communication that non-verbal individuals have
in meeting their daily communication needs.
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AAC and UNCRPD
Article 2
“Communication” includes languages, display of
text, Braille, tactile communication, large print,
accessible multimedia as well as written, audio,
plain-language, human-reader and augmentative
and alternative modes, means and formats of
communication, including accessible information
and communication technology
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Classification of AAC systems
Aided
Photographs
Communication
boards
Computerized
systems
Head pointers
Unaided
Gestures
Vocalizations
Sign Language
Makaton Signs
Partner-assisted
communication
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Partner-Assisted Communication
Communication is a two-way process
“Smart” partners
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Pragmatic Organization Dynamic Display
(PODD) as Partner-Assisted Communication
PODD is a multi-level communication book
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PODD- Key organizational features
 Vocabulary organization
 Pragmatic branch starters
 Taxonomic, topic and anecdote organizations
 Incorporating individual requirements
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PODD-Key partner-related features
 One single response
 Have limited physical control
 Flexibility in the pace and responsiveness
 To predict and use the system more efficiently.
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Aim of our Case Study
To study the effectiveness of use of late-onset
AAC/PODD intervention on the range of
communication
functions
and
social
interactions on a 17 year old student with
Cerebral Palsy
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Case History
 VK, a 17-year old adolescent with a diagnosis of
Spastic Quadriplegia
 Physical condition
 Hand function: severely restricted
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Case History
 VK’s hearing and vision are within the normal range
of functioning.
 Visually responsive and this sensory modality is one
of his strengths.
 Keen observer and responds well to people.
 Able to communicate yes/no
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Rationale for selection of PODD
The selection of PODD was determined by
 Severity of his physical challenges
 Pre requisite conditions of use of eye gaze
 Yes/no responses
 Sight words to access PODD
 Pragmatic organization of the tool i.e. PODD
 Social responsiveness
 Lack of funding required to procure the eye gaze
equipment aided the decision of the selection of
PODD.
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Methodology
Training
Post training
assessment
Methodology
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Preparation
 Consent letter to secure parental approval
 Multiple sources of data collection
 Trans-disciplinary assessment
o
o
Eye pointing is the main modality for communication.
Advanced receptive language
 An orientation on the use of AAC strategies to
parents
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Methodology-Baseline Assessment
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Baseline assessment- Physical Status
Seating: customized wheelchair which
can be reclined and has firm hip straps
to maintain appropriate seating posture
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Influences on PODD creation
Findings of two
assessment tools
Range of Communication
Function
Pragmatic Branch
Starters
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Creation of PODD
 Use of Boardmaker
 Scaffolding of PODD
 Different versions
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PODD
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PODD
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Steps in Training
 Duration of Training: 22 weeks
 Familiarization process: 2 weeks
 Routines
 Different communication partners
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Training record
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Pragmatic Profile: Communication Functions
FUNCTIONS
PRE-TRAINING
POST- TRAINING
COMMUNICATIVE FUNCTIONS
Attention Directing
Tugging at clothes or tapping
the person
Vocalizing and making noise
Giving information
Facial expression, responding
with yes/no cards
Using the PODD to respond to
queries
Requesting for information
Facial expression
Initiates communication using
PODD
Expression of emotion
Limited facial expression
Indicating feeling and emotions
using PODD
RESPONSE TO
COMMUNCIATION
Gaining attention
Touching him
Calling out his name
INTERACTION AND
CONVERSATION
Interest in Interaction
Interacts only with adults he
knows well
Interacts with a range of adults
1)
1)
CONTEXTUAL VARIATION
1. Person
2. Topic
2)
Parent, teacher, other
member of the family
Limited
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Widened social circle of
communication
Varied
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Social Networks Inventory: Social Interaction
FUNCTIONS
PRE-TRAINING
READING
Limited ability to scan
words (30-35 words)
COGNITION
Extremely limited span
of attention during
interaction (5 minutes)
MODES OF EXPRESSION
Facial expression/body
language
POST- TRAINING
Increase in number of
words scanned in sight
reading (70-90 words)
Increase in span of
attention during
interaction (15-20
minutes)
Increased vocalizations,
increase in the range of
appropriate facial
expression
Additionally there has been a significant increase in the frequency, effectiveness
and efficiency in the use of the non-electronic communication board/PODD
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Circles of Communication Partners
Pre-Training
Life Partners/Family
Post-Training
Life
Partners/Family
Acquaintances
Paid Partners/teachers
and therapists
Paid
Partners/teachers
and therapists
Unfamiliar
partners
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Observations
Observations indicate an enhancement in
 Frequency and quality of communication
 Communication repertoire
 Initiation of communication with adults
 Frequency of requesting, describing and
commenting
 Emotional maturity
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Conclusion
These observations indicate that despite lateonset intervention, improvements in functional
communication and social interaction can be
brought about by the use of partner-assisted
communication strategies such as PODD.
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Implications for further research
 Use of PODD on different clinical populations
 Longitudinal studies on larger number of cases to
study the effectiveness of PODD
 Examining the effectiveness of PODD on specific
aspects of communication and literacy
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References
 Allaire, J.H., Gressard, R. P., Blackman, J. A., &Hostler, S. L.(1991). Children with severe
speech impairments: Caregiver survey of AAC use. Augmentative and Alternative
Communication, 7, 248 – 255.
 Blackstone, S. (1995). AAC outcomes. Augmentative Communication News, 8(1).
 Calculator, S. N. (1988). Evaluating the effectiveness of AAC programs for persons with
severe handicaps. Augmentative and Alternative Communication, 4, 177 – 179.
 Culp, D. M., Ambrosi, D. M., Berniger, T. M., & Mitchell, J. O. (1986). Augmentative
communication aide use – A follow-up study. Augmentative and Alternative
Communication, 2, 19 – 24.
 Goossens’, C. (1989). Aided communication intervention before assessment: A case study
of a child with cerebral palsy. Augmentative and Alternative Communication, 5, 14 – 26.
 Kraat, A., & Brune, P. (1997, November). Getting from here to there: Lessons from ‘Miles’.
Paper presented at the American Speech Language Hearing Association, Boston, MA.
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References

Porter, G. and Kirkland, J. (1995) Integrating Augmentative and Alternative Communication into
Group Programs: Utilising the Principles of Conductive Education. Melb: Spastic Society of Victoria

Porter, G., Kirkland, J. & Dunne, L. (1996) Developing Functional use of AAC within holistic group
programs. Paper presented at the ISAAC conference: Vancouver, Canada.

Porter, G. (1997) Observational assessment forms (printed in, Department of Education. (2001).
Students with physical impairment: Augmentative and alternative communication. Brisbane, QLD:
Author

Porter, G., Kirkland, J. & Dunne, L. (1998) Multi-level communication books. Poster presented at the
ISAAC conference: Dublin, Ireland.

Porter, G. (2000) Low-Tech Dynamic Displays: User friendly Multi-level communication books. Paper
presented at the ISAAC conference: Washington, USA.

Porter, G. (2000) Ideas for the design of low- tech dynamic displays: User friendly, multi-level
communication books. (Printed in Department of Education (2001) Students with physical
impairment: Augmentative and alternative communication. Brisbane, QLD: Author.)
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