Transcript Day1of2. 12.09.TX2003F

Augmentative
Communication
Evaluations
Simplified:
ACES Tools & Resources
Debby McBride, MS, CCC-SLP
Presented by AAC TechConnect Inc.
Lisa Bardach, MS, CCC-SLP
Tanya Curtis, MS, CCC-SLP
Libby Rush, MS, CCC-SLP
(contributions in content & resources)
Purpose
To give people their VOICE
Because we all have something
to say!
What role do you play in giving
people their voice?
What does
Augmentative/Alternative
Communication mean to you?
What is augmentative /alternative
(AAC) communication?

Refers to the incorporation of techniques that can
be used to help individuals with disabilities in
general, as well as to very specialized technologies
designed specifically for individuals with significant
and severe disabilities. These techniques include,
for example, the use of communication symbols,
aids, strategies, skills, and devices designed to
assist disabled individuals. (Sarah Blackstone;
1986)
AAC communication includes

Nonverbal
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Vocalizations
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* Low-tech or no-tech
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* Lite-tech
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* High-tech
Goals include:
Your goals for this workshop
Write 3 ( on the back of your evaluation form)
*
Goals include:
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Explain the process of obtaining an AAC tool/device
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Describe tools/techniques used to determine the AAC candidate’s skill
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Complete many of the components with templates provided for
gathering, compiling and reporting the results.
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Identify components on AAC devices such as common features and
categories of devices (i.e. dynamic display, digitized, integrated, etc.)

Identify local resources and consultants for trials, support, and
funding assistance for AAC devices.
A Systematic Approach for
AAC Evaluations
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ACES Module
Augmentative
Communication
Evaluation
Simplified
Toolkit List
Forms for summarizing evaluation information
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Individual skills
Device Features
ACES Module examples
Tools and Resources
you will leave with:
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ACES Module (handouts & on CD)
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A Toolkit List
The Communicator
Device Features
Other Considerations
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Resources on CD
Handouts (including the above)
AAC device flyers
Templates
Other resources
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Websites: free resources
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Challenges you have? Why…
*
AAC Evaluations - Challenges
Availability of systematic assessment protocols
Acquire premade materials/resources (vocabulary,
overlays, etc)
Not organized / equipment available when needed /
working when needed
Training ???
Knowledge???
Experience???
Keeping up with technology
Overwhelming ? ? ?
Process – Beginning to end
Person
 Referral
 Gathering information
 Deciding on skills to assess
 Choosing the “toolkit items” used
 Evaluating the individual's skills
(sensory, physical, language,
communication functions/needs, etc.)
 Summarizing individual’s skills
Process continued
Communication Tools / Devices
 Matching skills to communication tools
(feature - matching)
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Voice / no voice
Trialing communication tools / voice output devices
Making recommendations
Writing appropriate documentation
Completing funding paperwork as needed
Use of your equipment reps
Evaluation
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Who are they?
What do they want to say?
Where do they want to say it?
How do they want to say it?
What are their current skills?
What technology can bridge the gap?
Feature Matching –
SDT
Determine what the individual needs, then
find the technology with the requisite
features and match the technology to
communicator.
The Communicator
The Communicator
Level of communicator
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Emerging
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Context/Partner Dependent
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Independent
Emerging
No RELIABLE means of EXPRESSIVE
communication through SYMBOLIC language
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Have some functional non-verbal communication
(gestures, vocalizations, other nonsymbolic
communication)
Able to attend, even briefly, to individuals,
conversations, pictures, or symbols
Yes/no (acceptance/rejection) depicted with body
language; i.e. no reliable yes/no for more complex
communication
Context- or Partner-Dependent
Has SYMBOLIC communication that is RELIABLE
but limited to particular CONTEXTS or PARTNERS
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Rely on partners to provide limited response set
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Need frequent instruction and cueing
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Difficulty with initiation
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May only be functional in particular settings
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Wide range with regard to # of partners and # of
settings
Independent (Generative)
Can communicate ANYTHING on ANY TOPIC
to ANYONE in ANY CONTEXT
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Locate, select, and convey messages on their own
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Can interact with familiar / unfamiliar partners equally well
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Can sequence symbols or letters to generate novel
messages
Scanning options
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Auditory / visual
Linear / row-column / group
Step / inverse / auto
Other
Who is your person?
Video
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Questions ? ? ? ? ?
Evaluation What’s in your toolkit?
What do you currently
use?
Toolkit List
Gathering your Toolkit
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Help you organize what you have - toolkit list
Help you decide what to add to your
resources
Give you additional ideas for premade
materials / resources
Give you additional resources you can access:
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CD
AAC TechConnect- web
The Evaluation Toolkit
Toolkit #1: Low-to Lite-tech Tools
Toolkit #2: Digitized devices
Toolkit #3: Computer & accessories to
emulate variety of communication
devices (evaluation ONLY)
Let look at some examples
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TOOLKIT #1 – “Lite – Tech”
components
Low-tech physical access
components
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Keyguard
Pointing light
Partner Assisted Scanning
Eye gaze
PECS
Positioning (motor – visual)
Miscellaneous items
Augmentative Resources
Switches & accessories
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Variety of switches
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Switch interface
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Switch mount
Switch Mounting System
TOOLKIT #1continued – “Lite –
Tech” components
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Battery adaptor
Array of Switches
Switch Interface
Switch activated devices (toy or
fan or vibrating Pillow) . . . . .
Switch Mounting system
Cause-effect items
Switch Activated Devices
Battery Adapter
Switch Interface
Switch Computer Application
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RJ Cooper
Linda Burkhart
Marblesoft/Simtech
Judy Lynn
Voice output – does it make a
difference ? ? ?
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Single message sequential
communicator
Multiple message communicators
(progressive message key setups)
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Consider ones with levels
Simple voice output –
w/ sequencing capabilities
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Single message communicators
(Sequencers, Step-by-Step, etc.)
Progressive Communicator
- Digitized device(s)
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Start simple – 2 pictures
Add more pictures
Has levels
Direct select
Recorded speech (voice)
Uses overlays
Static Display
Progressive Communicator
Simpler voice output devices
Digitized Devices & Accessories
Others in your closet
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Macaw
Message Mates
ChatBox
Others? Any of these?
Toolkit #3 - “Higher Tech”
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Laptop or tablet computer
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(convertible laptop optimal)
Add communication software
 Emulate devices (large, medium, small)
Accessories
 Touch Screen (not just with pen)
 Switch interface
Laptop Computer, Touch Screen and
AAC Software
Software
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Emulate the devices
3rd party software which does the
following:
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Make various configuration of overlays
Able to link them together to evaluate
navigation
Can do scanning of all types
Spelling (word prediction) - optimul
Software for purchase
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Tobii Communicator (Tobii ATI) - $599 SayIt! Sam Software (Words +)-$1395
Speaking Dynamically Pro (Mayer Johnson)The Grid (Sensory software)
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others
Boardmaker Plus (Mayer Johnson)
Overboard (Gus)
Free software/ demos
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Manufacturers (some examples)
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Series 5 Semesterware (DynaVox)
PASS software (Prentke Romich)
SayIt! Sam (Words+)
EZ keys (Words+)
Overboard (GUS)
Questions?
What do you have?
or
What do you think you may
need / want?
ACES Module:
Your Tools & Resources
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Toolkit components: communication tools to
have at your fingertips (in the bag)
Premade evaluation materials / resources
m( in the book)
Templates / resources to complete paperwork
(on CD and on the web)
Resources to make decisions on devices
( On web)
Evaluation
Materials/Resources
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Materials
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Objects
Pictures
Premade overlays / pages
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Low tech (communication boards)
Lite tech (overlays for digitized devices)
High tech (pages for dynamic display options)
No-tech symbols
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Objects
Photos
COPPS
Pictures
Overlays
Visual scenes
Alphabet
boards
Symbols and premade materials
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Make your own
Purchase other resources
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Examples of Evaluation Assistant
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Pre-made pics/overlays
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What do you use?
Examples include various sizes (size of
message key and #’s of keys)
Various communication functions
Dynamic display (low tech example)
Sizes example
Object-COPPS-Photo
Talking My Wya
TALKING
MY WAY
PCS – Boardmaker (Mayer-Johnson)
SymbolStix
Overboard by Gus
Attainment
The Test of Aided-Communication Performance
(TASP)
by Joan Bruno, Ph.D., CCC-SLP
A tool for the assessment of symbolbased communication skills.
Includes subtests on symbol size and
number, grammatical encoding,
categorization and syntactic
performance.
Results may help determine AAC
intervention strategies and goals.
Provides starting point for designing
communication boards or selecting a
page for an AAC device.
Alphabet boards
Alphabet/Spelling
 Alphabet boards
 Keyboard arrangements
ABC
 QWERTY
 Frequency of occurrence
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Grammar based boards
Premade Resources?
ACES Module:
Your Tools & Resources
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
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Toolkit components: communication tools to
have at your fingertips (in the bag)
Premade evaluation materials / resources
( in the book)
Templates / resources to complete paperwork
(on CD and on the web)
Resources to make decisions on devices
( On web)
The Device:
Features to Consider
Symbols
Objects
 COPPS
 Photos
 Pictures
 Words
 Letters
 Media
(video clips, etc.)
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Language Representation
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Single meaning pictures
Semantic Compaction
Alphabet / spelling
Visual scenes
Phrase-based
Grammar-based boards
Single meaning pictures
Semantic Compaction
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Multi-meaning pictures
Less key strokes (in sequencing) –
faster
Motor memory
Icon prediction
Activity row – picture prediction
Semantic Compaction
Alphabet boards
Alphabet/Spelling
 Alphabet boards
 Keyboard arrangements
ABC
 QWERTY
 Frequency of occurrence
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Visual scenes
Phrase Based
Grammar - Based
Navigation / page changes
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Facilitator/communicator changes pages
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Number of pages required (few-many)
Static display # of pages
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Dynamic display navigation skills
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Keyboard options
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Built – in keyboard (integrated)
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Onscreen keyboard – W+
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Plug-in keyboard (external)
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Convertible-style tablet
Voice / speech
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Synthesized (synthetic)
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Digitized
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Other language needed
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Pre-recorded
Spelling
Type of device
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Dynamic display (small/med/large)
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Integrated (dynamic display as computer)
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Text-to-speech (attached keyboard)
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Digitized (static display with overlays)
Types of devices to consider
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Dynamic display
Integrated systems
Text – to – speech
Digitized
Simpler digitized
Single message communicators
Dynamic Display
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Multiple pages
“Navigate between pages”
Variety of symbols available
Both types of speech (digitized &
synthesized)
Possible to use generative language
Offers more options for alternative
access
Dynamic Display
(examples only – not all inclusive)
Integrated System
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Multiple pages
“Navigate between pages”
Variety of symbols available
Both types of speech (digitized &
synthesized)
Includes computer components
Integrated Systems
(examples only – not all
inclusive)
Digitized
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Simpler communication needs
Recorded voice
Use of pictures
Multi lingual
Most of them have:
 Paper overlays that are changed
 Also called “static display”
Digitized Devices
(examples only – not all inclusive)
Text to Speech
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Mainly spelling (keyboard and some
have scanning)
Most have built-in keyboards
Mostly synthesized speech, though few
have digitized speech
Text-to-Speech
(examples only – not all inclusive)
Device functions / access
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Use access to on / off
User access to volume
User access to programming
ECU’s
Internet access / browsing
Computer applications
Camera
Phone
Text messaging
Email
Printer
Rate enhancement
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Pre-store messages
Prediction (word, letter, picture,
symbol, character, phrase) **
Abbreviation – expansion
Pre-made vocabulary options
Grammar-based boards **
Word morphology (word endings, verb
tenses, etc.)
Picture prediction – activity row
Message formulation
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Single key messages
Routine phrases
Novel sentences
Novel thoughts / ideas
Single meaning pictures
Core vocabulary
Message button
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# of keys per page
Size of keys
Need for variety (progressive)
Message feedback
Action
 Click (auditory)
 Color changes (visual)
 Zoom / enlarge (visual)
Button / selection method
features
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Touch enter / exit
Hold time
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Direct select
Headpointing
Eyegaze
Auditory “fishing”
Scanning
Message display
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Words
Pictures
Speak each word / sentence
Speak on demand / punctuation
Highlight each word as it speaks
Silent mode
Screen size / size of device
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Small – handheld size
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Small – medium 7” screen
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Medium - 8.4” screen
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Large – 10.4” + screen (mounted?)
Handheld size
Small - intermediate
Medium size
Large size
Try it on . . .
Premade vocabulary
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Language representation
Progression
Individualizing
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Smaller vs. larger vocabulary needs
Ease of navigation
Ease of learning (for user and
communication partners)
Grammar Based Software
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WordPower
(Most manufacturers)
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Picture Word Power
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(Most manufacturers)
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Wordcore (PRC)
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InterAAACT (Dynavox)
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SpeechPro (Gus)
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AlphaCore (Dynavox)
d
Quick fires
ACES Module
(templates provided )
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Gather information (Case history)
Record evaluation results (Assessment
summary)
Device decision-making (Device
assistant)
Write report (report)
Funding (work with vendor)
Pre-Assessment Preparation
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Obtaining previous reports,
evaluations and supplemental
information (on CD)
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Case History
Intake
Evaluation Notes
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Form to provide consistent means of
recording information during the
evaluation session
Use of form helps to promote an
organized method for keeping work
records
Mechanism to measure progress
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Assessment Summary
Intake form with notes
******
Video
Device Selection

Which Device to Choose ? ? ? ?
Additional Features to know
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Accessories required (list on CD)
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Medicare version required (Insurance)
website: www.aacfundinghelp.com (web list
on CD)
Cost
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Size / weight
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Etc.
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Decision-making
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Alphabet / Spelling
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Pictures / spelling
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Keyboard (Text to speech)
And/or onscreen keyboard (Dynamic
display - tablet style)
Dynamic display
Pictures / spelling with computer
components
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Integrated systems
Decision-making continued

Pictures only –
Static display (digitized) vs Dynamic display
vs integrated system
 Number of pictures
 Number of pages
 Types of pictures
 Changing levels (user vs. facilitator)
 Ease of programming
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Single message communicators
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Replays one message at a time
Recorded speech
Some can do multiple messages
(repeats different message each time
you select it)
Some can do different levels / situations
Single Message
No tech
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Use as primary communication
Secondary communication
Backup communication
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Evaluate benefits of voice output
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Individual
Communication partners
Motivation
Decision-Making &
Supporting Documentation
How do you proceed?
. . . . . Know user’s skills
. . . . .now what?
Funding
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www.aacfundinghelp.com
3rd party medical funding (Medicaid,
Medicare, Private Insurance)
Medicaid Available
Educational or Vocational
or Independent living
Private pay or donations
(Used equipment)
Work with your local device
representatives
Device Selection Options
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Catalogues
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Manufacturer websites
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AAC TechConnect – contact manufacturers
Go to individual ones – AAC TechConnect
has list
AAC TechConnect – free resources
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Pictures (thumbnails of 100+ devices)
Free flyers
www.aacTechConnect.com
www.aacTechConnect.com
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Low cost information resources
Lite Tech Low Cost Chart
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AAC TechConnect
$14.95 (online with credit card)
Device Assistant
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Free trial – 14 days
Fee – for – service after that
Trialing equipment
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Loan equipment
AT centers
Vendors – local resources
Manufacturers
Rental options
Explore Programming of the
device
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Try the actual programming – see how
it feels
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Edit button; make page; link pages
Communication partners need to feel
comfortable with the programming
Sales representatives can assist
Ask what support options include
(including on-line support)
Do you . . .
Have some new strategies to
try?
Have some things in your
closet you will dig out for
use?
Questions? ? ?
Review goals

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Suggestions for next time?
Please put on your eval form.
Did we:





Explain the process of obtaining an AAC tool/device
Describe tools/techniques used to determine the
AAC candidate’s skills
Complete many of the components with templates
provided for gathering, compiling and reporting the
results.
Identify components on AAC devices such as
common features and categories of devices (i.e.
dynamic display, digitized, integrated, etc.)
Identify local resources and consultants for trials,
support, and funding assistance for AAC devices.
THANK YOU
for helping others
To get
The best choice
For the best voice
Contact us at:
Debby McBride, MS, CCC-SLP
866.4U.AAC.RX
[email protected]
www.aacTechConnect.com
866/482-2279 or 303/674-8553