The Critical Need for Knowledge and Usage of AT and AAC Among Speech-Language Pathologists

1. The Critical Need for Knowledge and Usage of AT and AAC AmongSpeech-Language Pathologists David Dikter, CEO, ATIA ddikter@atia.org Amy Goldman, MS, CCC-SP/L Temple University Amy.goldman@temple.edu

2. Background • Poor AAC preparation of SLPs a recurring theme at ATIA “Town Hall Meetings” ; ATIA AAC SIG decided to initiate a formal survey to examine extent of this issue • ATIA study addresses “aided” vs. “unaided” AAC (e.g. ASL). • Purpose: Assess SLPs’ preparation, knowledge, and use of AT and AAC in communication intervention; identify strategies for improving SLP AAC and AT-related competencies

3. Survey Details Survey Monkey –launched October, 2011. Promoted through ASHA SIGS 12 (AAC) and 16 (School-based Issues) as well as QIAT listserv. N= 549 SLPs (US) Respondents represent a range of practice settings, area of focus/expertise, and length of time in practice. Respondents received no incentives.

4. Highlights • Majority of SLPs surveyed admit lacking knowledge, direct experience, and competence in AT and AAC. • Confusion regarding the nature and uses of AT and AAC, and their roles in language and literacy intervention. • Perception that many professional peers who provide AT and AAC services are unqualified to do so. • Respondents believe that AT and AAC are interesting and worthwhile fields of knowledge. • To remediate knowledge gaps, SLPs favor a mix of pre-service curriculum modifications, more continuing education opportunities, and increased mentorship.

5. Inadequate Pre-service Preparation • Lack of AAC content integrated into other courses • Lack of AAC clinical opportunities • Lack of faculty who are well versed in AAC • No time in program to offer a required, dedicated AAC course • Only 21% of respondents feel that they were adequately prepared in AT by their pre-service training.

6. Increase Access to Continuing Education “What factors would increase the availability of SLPs with AT and AAC skills?” Respondents in aggregate and SLPs/Adult as a sub-group rank “More opportunities in continuing education in AT and AAC” as the number one factor

7. Mentoring • Lack of mentoring is a factor inhibiting knowledge today: • SLPs/Adult view mentoring by experienced AT and AAC professionals as an important way to become proficient in AT and AAC technologies and interventions. • SLPs/Child consider mentoring to be just about as important as on-the-job continuing education in achieving AT and AAC competence. • SLPs/Mixed have a much greater interest in becoming mentors (76%) than those who treat only children (43%).

8. In-Service vs. Pre-Service Mentoring Importance of Pre-Service vs. In-Service Mentorship on Developing AAC Knowledge and Skills • SLPs/Child are much more interested in being mentored (80%) than SLPs/Adult (50%). • SLPs/Adult who received their master’s degree after 1990 are also very interested in being mentored (81%). • SLPs/Child seem to be more interested in mentoring as a pre-service opportunity while SLPs/Adult seem to favor mentoring while in practice. • Why? Many SLPs/Child move directly from degree programs to school settings where they are plunged into AT and AAC treatment issues right away and may feel the need for earlier mentoring on the topic more urgently.

9. Technology: Challenges and Opportunities • SLPs mentioned technological advances with both positive and negative connotations. • For some longer-practicing SLPs, technology is viewed as a frustrating obstacle. “It is hard to keep up with all of it [AT and AAC technology] when you are working with the children and dealing with the day to day needs and requirements” “Technology is changing so fast that the lessons I received in school no longer exist.”

10. The Desire for More Training

11. What factors would increase the availability of SLPs with AAC skills?

12. Conclusions • There are not enough AT and AAC competent SLPs. • Most SLPs didn’t learn AT and AAC in school • School districts are decreasing or eliminating budgets for “expert” SLPs who provide AT and AAC , and less $ for continuing education • There are other factors that may interfere with appropriate intervention practices, e.g. ability to improve interactions and opportunities in the classroom

13. Recommendations • Effect modifications in graduate school curricula • AT and AAC content needs to be integrated into courses that deal with standard treatment modalities, e.g. when apraxia, aphasia, voice disorders, neurological impairments, and other relevant disabilities are addressed. • Improve knowledge and awareness of graduate faculty – a “train the trainer” type of approach to improve AT and AAC content in graduate coursework. • Require specific coursework and/or practica in AT and AAC. • Provide more elective coursework opportunities in AT and AAC in undergraduate and graduate programs.

14. Recommendations • Provide more continuing education and conference opportunities: • More robust, content-rich AT and AAC conference tracks. • Online/Webinar continuing education. • Online learning/resources must include intermediate – advanced level material. • Facilitate mentoring as a path to AT and AAC proficiency: • For AT and AAC as specialized topics. • For AT and AAC as tools that are part of speech and language intervention. • For technology-specific (e.g. AT and literacy) or disability-specific topics (AAC for individuals with acquired neurogenic disorders).

15. A complete copy of the White Paper is available at http://www.atia.org/i4a/pages/index.cfm?pageid=4327 (or go to www.atia.org and enter “ATIA SLP” in the search box)