Transcript Augmentative Communication Evaluations Simplified: ACES Tools

AAC for Persons With
Complex Communication Needs
Part I: Emerging Communicators/
Developing Communication Intent
Debby McBride Ligon, MS, CCC-SLP
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Goals:
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Discuss Continuum of Communication towards Independence
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Describe Emerging Communicators
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Learn about AAC resources for your use that will be included on the
PPHC website.
Review AAC Communicator Profile for referrals/evaluations (website).
Review University of Washington Resources and Communication
Matrix - online resources
Examples of AAC recommendations from patient referrals
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http://depts.washington.edu/augcomm/index.htm
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Communication is not "independent" if..
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utterances can only be understood by some people, or...
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other people have to preprogram all vocabulary in a device, or...
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he cannot spell well enough to compose novel utterances, or...
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she is given no opportunity to communicate what she wants to say,
or...
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his communication system doesn't match his motor skills making it
difficult to control, or...
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her communication system doesn't match her communication
needs, or...
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there are partners who influence communication through cueing, or...
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he has hidden vision impairments making it hard to see the symbols,
or...
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she has a hidden hearing impairment making it difficult to hear what
is said, or...
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he has been given insufficient training and time to learn to use his
AAC system, or...
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she has no access to a communication system at times, or...
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he cannot see the display on his system in some light conditions, or...
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no one believes she has anything worth listening to....etc.
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Emerging Communicator: No RELIABLE
means of EXPRESSIVE communication
through SYMBOLIC language
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Have some functional non-verbal communication
(gestures, vocalizations, other nonsymbolic
communication).
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Increase attention and/or desire to interact with
environment/others.
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Able to attend, even briefly, to individuals,
conversations, pictures, or symbols.
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Yes/no (acceptance/rejection) depicted with body
language; i.e. no reliable yes/no for more complex
communication.
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Other Emerging
Communicators
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Have interest / motivation
Limited by motor
Limited by vision / hearing (may be
unknown
Have to rely on non-symbolic (facial,
body language, intonation, etc.)
Given AAC tools/strategies – have lots
to say
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AAC Glossary- on website
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Build skills for communication
Attention
Access
Interaction
Symbols
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Current communication skills
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Vision Skills/Modifications
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Hearing Abilities/Modifications
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AAC Communicator Profile
for Evaluations & Referrals
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On PPHC website
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In referral packet
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Can be used by itself for your own
evaluations
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Determining the FUN in
FUNctional
Likes / Dislikes checklist
- Available on website
- More info online
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http://depts.washington.edu/augcomm/01_vocab/vocab2_emerging.htm
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Popular AAC Apps (pictures)
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Analysis of Inappropriate
Behaviors
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Some individuals have problem behaviors, such as tantrums,
kicking, scratching, damaging property or self-injurious
behaviors. There is considerable evidence that some of this
behavior can be replaced with functionally equivalent alternative
communication. Studies have identified specific communicative
functions that are crucial for many individuals with problem
behaviors.
According to Lloyd et al (1997), these are:
· getting attention
· getting or keeping objects or actions
· getting pleasant sensory input (e.g. sounds, etc.)
· escaping from an unpleasant task, sensation, demand
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The communication matrix is an
assessment tool designed to pinpoint
exactly how an individual
is communicating and to provide a
framework for determining logical
communication goals.
https://www.communicationmatrix.org/
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Communication Matrix - start
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Communication Matrix – re eval
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Example of summary of
communication content
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Free online profile
for therapists & parents
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Pictures / video examples
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Communication Matrix Questions
& Answers (on PPHC website)
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Design and Organization of
the Communication Matrix
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4 Reasons to communicate
24 specific message examples to
communicate developmentally
7 Levels of communication
9 categories of communication
behaviors
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4 Reasons to communicate &
24 specific messages
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9 categories of communicative
behavior
* Body Movements
* Early Sounds
* Facial Expressions
* Visual (Look at)
* Simple Gestures
* Simple Gestures
* Conventional Gestures & Vocalizations
* Concrete Symbols (includes AAC Tools)
* Abstract Symbols ( “ )
* Language
(“)
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7 Levels of Communication
Level I: Pre-intentional Behavior
 Level II: Intentional Behavior
Intentional Behavior Begins Here
 Level III: Unconventional Behavior
 Level IV: Conventional Communication
Symbolic Communication Starts Here
 Level V: Concrete Symbols
 Level VI: Abstract Symbols
 Level Vii: Language
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Handout on website: Design and Organization of the
Communication Matrix
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YouTube
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https://www.youtube.com/watch?v=5Jr
2pW3CzfY
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Case examples
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BCH
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Decide on preferred item(s)
Touch/reach for preferred item (s)
Move around; change sides; up/down
Use food labels – put on eyegaze board
Add non-preferred item (by itself – in a
choice) – watch for PROTEST – turn
away/push away.
Ask for help – put item in box- hand over
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to person for assistance
EG
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Physically challenged
Vision questionable
Non-symbolic (facial, body language,
Therapist introduce symbolic
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Use single message communicator for YES/NO
Offer choices with partner assisted auditory
scanning
Observed to follow direction (blow kisses),
follow conversation
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Communication goals – guided by
AAC Communicator Profile
(PPHC website)
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Look at Functions
Look at Behaviors
Decide which functions to expand
Decide what Non-symbolic ways to do
that (listed above)
Introduce symbolic as appropriate
Include AAC tools/strategies as
appropriate
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Hope you: > > >>
 Learned about some new resources . . .
 Have some fresh ideas . . .
And
 New / different perspectives . . . .
On Developing Skills for Emerging
Communicators
See PPHC website – under Employee Login
for these and other
AAC forms & resources
Including:
 Other AAC Training Sessions
 AAC Referral Packet
 Interest in participatin on an AAC Team
(if available).
Debby McBride Ligon
[email protected]
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