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Using the Toolkit. AAC Evaluations Simplified: Tools & Resources. Review. Name 1 new thing you learned yesterday Ideas Resources Equipment. Review process – so far. Person with complex communication needs (CCN) 1. Determine what you know about them
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Using the Toolkit AAC Evaluations Simplified: Tools & Resources
Review • Name 1 new thing you learned yesterday • Ideas • Resources • Equipment
Review process – so far Person with complex communication needs (CCN) 1. Determine what you know about them Case History / Case History Summary 2. Evaluate skills - with your toolkit 3. Summarize skills 4. Look at device features
Agenda • Evaluation Examples: 3 types of communicators • Work through your individuals with complex communication needs (CCN) • Feature matching • Device selection options and research • Trialing equipment • Vendor Presentations • Questions and Summary
Evaluation Examples • 3 types of communicators • Emerging • Context – dependent / situation dependent • Independent
Emerging No RELIABLE means of EXPRESSIVE communication through SYMBOLIC language • 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
Case Study #1 - RM • Age 23 • TBI at age 18 • Quadriplegic, no functional movement • Can turn head but unclear to what degree • Limited arousal/attention
Forms • Vocalization • Body movement • Facial expressions • Inconsistent eye contact • Blinks for yes/no (inconsistent) • Attends to family, friends, TV
Function • Make request • Make choices • Continue • Stop • Protest/reject • Help • Pain/discomfort
Toolkit items • Pictures (black/white, color) • Velcro Board • Eye gaze board • Switch • Switch mount • Single message voice output • Computer with switch interface and communication software
Outcome • Eye gaze f/2 • Single switch hits • Single message voice output • Partner-assisted scanning
Context- or Partner-Dependent Has SYMBOLIC communication that is RELIABLE but limited to particular CONTEXTS or PARTNERS • Rely on partners to provide limited response set • Need frequent instruction and cueing • Difficulty with initiation • May only be functional in particular settings • Wide range with regard to # of partners and # of settings
Case Study #2 - JM • TBI age 7 • Age 15 at evaluation • Power w/c, drives with left non-dominant hand • Can point to objects • Has Delta Talker but doesn’t really use it • Receptive vocabulary worse than most give credit for • Rarely initiates communication • Answers specific questions if he knows the sequence • Uses some signs
Functions • Make requests / choices • Indicate continue / stop • Greet and simple interactions • Answer questions • Make comments • Ask questions • Relate personal events • Participate in class • Communicate physical problems
Toolkit Items • Communication devices – • Dynamic display • Picture-based • Minspeak • Icon prediction • Keyguards
Outcome • Vantage • Small (can mount to w/c and not hit doors) • Dynamic display • All pages fit keyguard • Minspeak • Training seminar for school • Imitation to increase verbal speech • Learn to string icons together
Independent (Generative) Can communicate ANYTHING on ANY TOPIC to ANYONE in ANY CONTEXT • Locate, select, and convey messages on their own • Can interact with familiar / unfamiliar partners equally well • Can sequence symbols or letters to generate novel messages
Case Study #3 - LU Independent communicator • ALS • Computer literate • Physical access – degenerative • Verbal speech still good
Functions - all • Including computer access
Toolkit • Access • Headpointing • Eye gaze • Scanning – single / double switch • Language Representation method • Spelling • Word-based • Pre-stored messages • Conversation facilitation
Outcome • Intake form • V Max with EyeMax • AlphaCore • May use direct touch for now • Continued use of computer for written communication • MDA funding
Augmentative Communication Strategies for Adults with Acute or Chronic Medical Conditions Beukelman, Garrett, & Yorkston, eds. Paul H. Brookes Publishing Co.
Your turn • Decide on groups • Emerging communicators • Context – depending communicators • Independent communicators • Decide on 1 person the group will focus on • Get out your forms • Summary of Observations (CD) • The Communicator • The Device • Toolkit list
Your process 1) Look at known skills of person with CCN (complex communication needs) 2) Look at items in toolkit to continue assessment 3) Speculate on possible devices or communication tools which would meet communication needs
Summary Pertinent background • Medical, etc. • Hearing/Vision • Physical • Ambulatory • Access: direct select, scanning, switch placement, etc.
Known skills summary • Cognitive • Pragmatics/Behavioral • Receptive • Expressive • Current communication methods • Verbal Speech • Symbols used • Message Formulation
Functions – WHY are they communicating? • Attend to environment/others • Express wants/needs • Make requests / choices • Continue/stop • Request attention / help • Protest • Greet
Answer / ask questions • Direct actions of others • Initiate – maintain – end conversation • Make comments • Relate personal experiences/events • Repair communication breakdowns • Express novel thoughts / ideas
Communication Needs – WHO and WHERE • Communication partners “With WHOM are they communicating?” • Communication situations “ WHERE are they communicating?”
Toolkit items to use for evaluation • No – tech • Lite – tech • Digitized • High-tech • Access • Additional features
LOOK at FEATURES REQUIRED • No – Tech (no voice) vs. Higher Tech (voice output) • Input features to be addressed (on next slides) • Output features to be addressed ( on next slides)
INPUT FEATURES • Selection Technique; • Direct select (modifications?) • Scanning (type) • Switches (number, type, etc.) • Symbol features • Pictures (type – photos, drawings) • Alphabet
Input Features continued: • Use of multiple pages: • Understand navigation • How to change pages • Who changes pages . . . Etc. • Rate enhancement: • Prestore messages • Dynamic display required • Premade vocabulary • Word / phrase / character /grammatic prediction
OUTPUT FEATURES • Voice output • Synthesized • Digitized • Other languages • Text – to – speech • Visual display • Static display – or dynamic screen • Size of screen – small, med., large • Other considerations:
OUTPUT FEATURES (continued – quick review) • Message key characteristics • Message bar characteristics • Other device requirements (computer access, printer, telephone, etc.) • Accessories • Environmental controls • Accessories (mounts, carry bags, etc) • Device style: keyboard vs. tablet
How do you proceed? . . . . . Know user’s skills . . . . . . . . Know device features . . . . .now what?
Device Selection Options • Catalogues • AAC TechConnect – contact manufacturers • Manufacturer websites • Go to individual ones – AAC TechConnect has list • AAC TechConnect – free resources • Pictures (thumbnails of 85+ devices) • Free flyers • Vendors
Trialing equipment • Vendors – local resources • Manufacturers • Loan equipment • Rental options • ASHA – list of questions to ask manufacturers
Explore Programming of the device • Try the actual programming – see how it feels • Communication partners need to feel comfortable with the programming • Sales representatives can assist • Ask what support options include
Accessories (list on CD) • Carry bags • Keyguards • Access hardware (switches/head controlled device, joystick, etc.) • Mounting systems/componants • Extra power (if required) • Internet/computer access (hardware/software) • Environmental controls • Software to make overlays (for digitized devices) • Others?
Completing the paperwork • Gather • Summarize • Write report • Get quote / info from manufacturer • Complete funding paperwork (packets from each company)