PROMOTING FUNCTIONAL INDEPENDENCE THROUGH USE OF AAC

1. Promoting Functional Independence Through Use of AAC MeLea Mihok, MS/CCC-SLP Craig Hospital, Tailor Made Rehab Karen Sims, MS/CCC-SLP Craig Hospital

2. Review of Terminology

4. Review of Terminology cont. High Tech Augmentative Alternative Communication (AAC) Any form of AAC that involves technology Speech Generating Devices Dynavox lightWRITER TextSpeak Message Mate Smartphones Proloquo2go

5. Review of Terminology cont. Dynamic Display Interactive software on high tech AAC devices Functional Independence The client�s ability to learn and use AAC within the therapy setting and in everyday life, decreasing their dependence on care givers.

6. Review of Assessment Procedures

7. Review of Assessment Procedures In order to determine which patients are appropriate, it is important to evaluate: Receptive Language Auditory Comprehension Reading Comprehension Expressive Language Vocalizations Written Language Non-verbal Expressive Modalities Gestures, eye-blinks, head nods, consistent movement Ability to mouth words Sound production

8. Review of Assessment Procedures cont. In order to determine which patients are appropriate, it is important to evaluate: Cognitive Status Awake/Alert Communicative Intent Understanding of Cause and Effect Motivation Ability to Initiate Memory Working Memory (basic ability to hold onto thoughts while trying to communicate) Long-term Memory (ability to utilize dynamic display)

9. Review of Assessment Procedures cont. In order to determine which patients are appropriate, it is important to evaluate: Vision Has the client received a vision evaluation by an OD or OT? Hearing Has the client received a basic hearing screening? Sensory and Motor What accommodations are necessary for the patient to utilize AAC?

10. Review of Assessment Procedures cont. In order to determine which patients are appropriate, it is important to evaluate: Access Method Client or partner-based? If patient-based, which access methods provide the most independence? Current Communication Needs Is client able to establish topic? Will a low-tech device work?

11. Review of Assessment Procedures cont. In order to determine which patients are appropriate, it is important to evaluate: Client�s exposure to technology Client and family interest in using adaptive technology Level of family comfort with technology Trainable family or caregivers

12. Selection of Appropriate AAC

13. Selection of Appropriate AAC Low-Tech AAC Many individuals appropriate, even in multiple settings Even with a high tech system, a client will need a low tech system High-Tech AAC Emergent Context Dependent Independent

14. Selection of Appropriate AAC cont. Know when to reevaluate and upgrade client to a new or different device Once client begins to improve and fully utilize their form of AAC, continue evaluating all components detailed in earlier slides Teach family how to watch for positive changes and advances with the client�s ability to utilize AAC Adapt AAC as necessary

15. Functional Use of AAC

16. Functional Use of AAC AAC must be client-specific High frequency choices and ability to generate novel utterances Know client�s interests and vocational history Spend time creating activities that will interest client during therapy

17. Functional Use of AAC cont. Make sure that client is familiar with their communication device Train all staff that interact with client on the use of AAC Provide written and verbal instructions Practice �role-playing� with main caregivers Demonstrating set up, use, trouble-shooting, and shutdown of AAC Make sure that AAC components are readily available to/with client at all times

18. Functional Use of AAC cont. Create opportunities within and outside of traditional treatment settings for the client to practice using AAC To communicate wants and needs To direct their care To initiate conversation with family, friends, doctors, therapists, staff, and general public To problem-solve and communicate solutions

19. Functional Treatment Activities

20. Functional Treatment Activities Have client direct staff for set-up of AAC Using low tech AAC Practice communicating needs during ADL routine Initiation of conversation with familiar and unfamiliar staff Use of AAC to stay connected to social network Via assisted phone calls and computer use

21. Functional Treatment Activities cont. Use of AAC during family interactions Client participation in MD appointments, conferences, and decision making Outings to locations of interest to client Stores Sporting events Parks Investigation of educational or employment opportunities

22. Functional Independence

23. Functional Independence with AAC Achieved by making AAC an invaluable tool: Help clients and families think of AAC as a tool, not a hassle or something �too complicated� Be creative with low-tech AAC Simplify use of high-tech AAC Be available as a resource and advocate for your client and AAC

24. Questions? Questions? Comments? Feedback?

25. Thank you Electronic copies of these slides are available at: www.tailormaderehab.com If there are further questions or comments, please feel free to contact us at: melea@tailormaderehab.com ksims@craighospital.org