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AAC Options for People with Speech/Language Difficulties Following a Stroke

Learn about Augmentative & Alternative Communication (AAC) options for people with speech/language difficulties following a stroke. Discover the range of AAC options available, how to access services in Ontario, and how to customize AAC to fit individual needs. Training and support for AAC use will also be discussed.

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AAC Options for People with Speech/Language Difficulties Following a Stroke

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  1. AAC Options for People with Speech/Language Difficulties Following a Stroke Monique Fourcaudot, SLP Loralee MacLean, SLP Toronto Rehab AAC Clinic March 30, 2010

  2. Overview • What is AAC and who can benefit? • Range of AAC options • What you can do • Training AAC use • Customization • How to access services in Ontario • Questions

  3. What is AAC? • AAC = Augmentative & Alternative Communication For face to face communication… • It is the use of facial expressions, gestures, objects, pictures, symbols, sign language, written words and/or communication technology to augment speech, or to provide an alternative means of communication when speech is not possible or functional

  4. Who is a candidate for technology? • Almost anyone whose speech/language is non-functional • Motivated to communicate • Accepting of alternative methods to communicate • Receptive language strong enough to follow one step commands

  5. Communication post Stroke • Aphasia • Non-fluent aphasia • Fluent aphasia • Apraxia of Speech • With or without aphasia • Dysarthria • With or without aphasia • Voice impairment

  6. AAC and Aphasia • Partner dependent communicators • Emerging • Contextual choice • Transitional • Independent communicators • Stored message • Generative message • Specific need

  7. Other Considerations…. • Language • Residual speech • Cognition • Vision • Hearing • client and/or their communication partner • Physical • Use of hands & quality of movement • Ambulation

  8. AAC and Natural Speech • AAC is not all or none • AAC can be used as repair if speech not understood • AAC use can promote increase in speech with more successful communication opportunities

  9. TYPES OF AAC:No Tech OptionsLow Tech AAC OptionsHigh Tech AAC OptionsFace-to-Face Communication

  10. No Tech Options • Pen and paper • Write /erase boards • Supported conversation • Gestures, facial expressions, body language • Life history books

  11. Communication Books

  12. Voice Amplifiers Chattervox Spokeman Addvox Electolarynx Low Tech AAC Options

  13. Alerting / Signaling Systems Switch & Buzzer Baby monitors Call bells Low Tech AAC Options

  14. Low Tech AAC Options TTY – Text Telephones • Telephone communication for clients with impaired speech • Also used by people with hearing impairments

  15. Low Tech AAC Options Small hand held spelling device • iPod touch with speaking apps • Netbook with speaking software • Keyboard Communicator KC200

  16. TYPES OF AAC:High Tech AAC OptionsFace-to-Face Communication

  17. Text to Speech Devices

  18. Word Prediction

  19. Abbreviation expansion • Able to save frequently used phrases using a 1-2 letter code • For example: hh=hello, how are you?

  20. Devices with Static Displays

  21. Devices with Dynamic Displays

  22. Word and Pictures

  23. Virtual

  24. Visual Scene

  25. Category

  26. Word-based

  27. Spelling for Scanners

  28. What you can do? • Identify people who could benefit from AAC • MCST-A (screening tool for people with Aphasia) • Prescribe low tech devices – if you are an IA • Make communication books (important to customize!!!) • Refer to AAC Clinics for high tech AAC options • Support AAC use in community • Train clients to use AAC

  29. Training an AAC System • Operational competency • on/off, charging, navigating • Linguistic competency • Recognizing symbol sets, reading, manipulating linguistic codes • Social competency • pragmatics – initiation, turn taking, etc • Strategic competency • limitations of system and how to use adaptive strategies to repair, using multimodal communication, etc)

  30. Customization of AAC including communication books • Vocabulary collection • Category based • Situational based • Needs to fit client’s abilities and communication needs • Real pictures • Second language • Number of items/page

  31. Why customize? • Better outcomes • Relevant to client • Motivating • Compensate for deficits and maximize strengths

  32. Role of AAC Facilitator • Setup • Charging • Cueing / Reminders • Training communication partners • Mounting • Device troubleshooting • Shipping and receiving equipment

  33. Other AAC Clinics in Ontario • More than 26 AAC Clinics in Ontario • See children / adults • May have diagnostic or geographic criteria • To find an AAC Clinic in your area – call the Assistive Devices Program (Communication Aids)

  34. Toronto Rehab AAC Clinic • Interprofessional team • SLPs, OT, CDA and Technologist • We see adults with acquired conditions • Stable / progressive conditions • Face-to-face communication • Adapted computer access for writing aids • No geographic boundary

  35. How to refer to our AAC Clinic • Call Toronto Rehab AAC Clinic • 416-597-3028 • Find application on Toronto Rehab website: • www.torontorehab.on.ca

  36. Q & A

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