AAC Class

Hierarchy of Symbols

(most concrete) Physical communication, real objects, miniature real objects, true object based icons, photos, real drawings, line drawings, written word (least concrete)

In what order should AAC interventions be addressed?

1. Address immediate basic needs 2. Address complex communication needs 3. Address ongoing communication needs

Beukelman and Miranda, 2013, condenses the purposes of communication as having the ability to...

1. communicate needs/wants 2. transfer information 3. acquire social closeness 4. use social etiquette 5. communicate with onself

How many picture producers does core vocabulary produce?

10%

How many words make up 80% of the words spoken?

350 words. Make up the core words

What % of individuals with ASD do not talk before 8 years of age?

50%

How many messages can a mid-tech device have?

9-25 messages

Working Definition of Communication

A mutually understood message that is intentionally exchanged between at least two people.

Typically, individuals with ASD respond to...

A state of being

Sign Language

A structured visual gestural system employing manual gestures, facial expressions, and postures of the body for communication

What occurs when the AAC user has frequent negative encounters?

AAC user does not want to use the device. Counsel and advocate

What are the advantages/disadvantages of checklists and profiles?

ADV: Not required to follow strict administration guidelines offers information that may otherwise not be obtained based on research findings of communication development provides specific detailed information about level of communication breakdown DISADV: Many do not offer normative data Responses are more subjective reliability and validity of results are compromised

Communicator Knowledge

Ability to comprehend and utilize the AAC system

Goals that Matter Do's (Guidelines for Writing Goals That Have the Greatest Comm. Impact for the AAC User)

Address skills that make the communicator more independent and happier, teaches things that enable the communicator to be a more efficient learner, provide a strong foundation for further language development, positively influence how other people treat the communicator

Describe/Expand: Integrate perspectives, knowledge and skills of team members, especially the who have AAC needs, their families, and significant others, in developing functional and meaningful goals and objectives.

Allows for information gain on likes/dislikes/vocab, etc.

Section 504

Allows students who are not eligible for special education services under IDEA to receive accommodations

ADM

Alternative Diagnostic Method

AT Device

Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized that is used to increase, maintain, or improve functional capabilities of a child with a disability

No Tech

Any method of communication that does not involve the use of any technology and uses readily available materials. ex. paper, pencil, actual objects, alphabet board

Gestures

Any movement randomly assigned meaning and consistently used for specific desired messages and is learned by communication partners.

Orthography and Orthographic Symbols

Any process of utilizing letters of the alphabet to transcribe thoughts and ideas into words in print. (braille, fingerspelling, writing). Literacy based method. Challenge: time consuming

Vocal Approximations

Any vocalization that is consistently used for specific desired messages and is learned by the communication partner. Or gesture approximations

AAC (PPWPT Def.)

Anything that adds to our communication or anything that substitutes our verbal communication. Range (simple to complex)

Articulation: What to Document

Are phonetic sounds used> How many? What is intelligibility like? Describe vocal output. Describe effort needed for vocal output. Describe oral motor functioning

Examples of Informal Assessment Methods

Assess level of external awareness (sudden loud sound, sudden presentation of air, massage, fast, close movement to eyes) Determine how often and how long joint attention is used (tracking with desired items, object permanence, attention shifts) Determine how needs/wants are relayed (entire with items of interest out of reach, turn your back with desired item and see how they gain your attention)

Individuals with Disabilities Improvement Act

Assistive technology that supplements a skill that is lacking or replaces a skill that is not there

Attitude Barriers

Attitudes that restrict or prevent communication participation. Beliefs held by an individual. Culture of service delivery agency.

Implications for Therapy (Communicate with Oneself)

Be able to analyze their needs and report their thoughts. Respond to interventionist comments, questions, and requests with appropriate and insightful feedback, be able to provide ideas

What does this statement mean?: "symbols should support literacy, but should not require literacy to be used"

Can use symbols and pictures to support literacy, but the individual should not have to depend on literacy to allow for access and understanding to the symbols

Checklists/Profiles

Checklists and profiles are evaluative tools hat offer information retrieved in various ways such as, observation, interview, and direct assessment. They are not all norm referenced however, are usually based on the researched backed developmental process of communication abilities

Intervention Procedure for Phoneme Segmentation

Clinician says the word and asks students to identify sounds within the word using their AAC method, Also may give a group of words and ask student to identify the word that has a specific sound in it.

Intervention Procedure for Sound Blending in AAC Intervention

Clinician says the word by extending each phoneme for 1-2 seconds. The students then blends the phonemes hear using subvocal rehearsal and states the word using the AAC method

Intervention Procedures for Letter-Sound Correspondences

Clinicians say the sound and students use their AAC method to identify the letter

Transfer of Information

Comment, respond, question. Relaying messages to convert thoughts, idea, and information. More complex messages that are novel with much less predictability go vocabulary content

Core Vocabulary

Commonly used words that occur frequently

Percentages listed do not apply for all...

Communicative Settings (email, foreign speakers, etc)

Strategic Competence

Compensatory strategies used by people who rely on AAC to deal with functional limitations associated with AAC. (interacting with those unfamiliar to AAC, resolving communication breakdowns, compensation for slow speaking rates, repair strategies)

Describe/Expand: Acquire and maintain the knowledge and skills that are necessary to provide quality professional services

Constantly Changing

Symbolic Representation + Referent

Cup Icon and Thirsty

Overall Process of Decision Making (Tomorrow)

Decisions are made to address future communicative opportunities, needs, and constraints based on predicted health, academic, social, safety, and employment status. Broadening an individual's skill base in preparation for future AAC systems and/or communication needs Instruction on specific motor, symbol recognition, social pragmatic, or literacy skills

Overall Process of Decision Making (Today)

Decisions are made to address the immediate communication needs of the client during assessment. Accurate, efficient, non fatiguing. Match linguistic, cognitive, sensory, and motor abilities

Pragmatic Language: What to Document

Describe when and why expressive messages are used (request, respond, initiate, comment, question, maintain, reject, gain attention, greet, direct, describe, clarify)

Phonological Processing

Detection and manipulation of the sound structures of speech and mapping letters to sounds and sounds to letters. Intrinsic understanding of phonemes in a word

What is phase three of the AAC assessment?

Developing a comprehensive communication system that will allow the individual with CCN to communicate in a variety of settings (school, home, recreational)

Primary Iconicity

Direct Representation. Cup photo means cup

Transparent Iconicity

Direct Representation. Ex. Nouns

Informal Assessment and Observation

Document information gathered through probing, structured activities, interventions, and observations about communicative behaviors

Goals that Matter Don'ts

Don't address a skill just because the communicator missed it on a test/evaluation instrument, don't teach something just because it is part of a goal sequence that someone developed for a generic program, don't assume that because someone hasn't mastered early skills that later skills are out of the question.

Augmentative

Enhance current expressive methods

What does teach, interact - Don't Test mean?

Ensures understanding and support carryover, measure goals in natural communicative contexts with lots of opportunities for practice. Why?: When kids perceive communication as another demand or job, they are more likely to shut down or lack the motivation to communicate

No Child Left Behind (NCLB)

Establish rigorous academic content standards, develop and implement assessments to monitor progress towards standards, hold schools, school systems, and states accountable for the progress toward these standards for all students

Fatigue Reduction

Establishing a method of vocabulary selection that will reduce the occurrence of fatigue when using an AAC method ex. reducing the complexity of the message (telegraphic speech instead of full sentences). Reducing number of key strokes needed to generate messages. Changing selection method from direct select to scan or eye gaze

Timing Enhancement

Establishing a method to generate messages needing to be relayed fast to be appropriate ex. that really hurst, please stop. Wait a minute. Leave me alone.

Message Acceleration

Establishing a time saving access method to word or messages that are lengthy and/or occur frequently ex. address/phone number. Pledge of allegiance. I left my homework at home

What may AAC users that can express various functions have goals written for?

Express specific language skills such as vocab, tense plurals, MLU, etc

T.O.B.I.s

Foam Board. Photos cut out into actual shape and outline.

Referential Teaching Model

Focus is on memorization of terms and definitions. Gives little scope for creative thinking and participation by special learners

IDEA

Free and appropriate public education, least restrictive environment, individualized education program, access to general curriculum, inclusion in district/state assessments, alternate assessments, IEPs address participation/progress of students in general education curriculum

What should be included in a written report for AAC testing?

Full disclose of any deviation that is made when administering the test should be cited in the report even if it doesn't effect reliability or validity of results. If standardized tests are not used, a statement explaining "why" should be included Methods of evaluation should be cited in the report A detailed description of all areas of communication should be included

Purposes of Communication

Gain attention, request, reject, greet, comment, respond, question, direct, describe, clarify (Grounded Rocky Radioactive Gooey Controls Reach Quiet Dreamy Democratic Crosswalks)

Communicate Needs/Wants

Gain attention, request, reject. Expressing needs and wants to regulate the behavior of the listener towards an action-oriented response. The messages usually have a high degree of predictability and concreteness

Acquire Social Closeness

Gain attention. request. greet, comment, respond, question, clarify, describe. Establishing, maintaining, or developing social engagement (will you play with me?). Content of the messages is less important than the feelings of connectedness and intimacy achieved through interaction

Gestures Adv. and Disadv.

Generally known, varies on culture Limited, only gives global/general messages

Types of Unaided AAC

Gestures, Vocalizations/Vocal Approximations, Sign Language, Eye Gaze, Facial Expressions, Body Language, Proxemics, Writing

Use Social Etiquette

Greet., Conform to social conventions of politeness through interactions that are often brief and contain predictable vocabulary. (please, thank you, etc.). These messages are often brief and contain predictable vocabulary.

Needs Based Communication Overlay

Has specific nouns for objects in specific environments. Must be updated for new environments. Assume a multiplicity of overlays with special words on each page connected to a specific topic, environment, or activity. based on staff intuitions and are designed for specific needs

Mid-Tech

Have some amount go electrical power (usually battery powered), speech generation ability, and limited programming option with the ability to store messages. Cheap Talk, Go Talk 32- Location Device

Expressive Language: What to Document

How the student relays message and when (full sentences, telegraphic speech, one word responses, echolalia, gestures/nonverbal cues, eye gaze, intentionality)

When may a speech language limitation be eligible under IDEA?

If the impairment significantly affects his or her educational performance

Secondary Iconicity

Indirect representation. Cup photo means thirsty. Must be taught

Why may AAC users have limited comprehension, language, and communication development during literacy activities?

Individuals who read to them provide few opportunities for participation, focus is on reading, participation is limited to turning pages and pointing to pictures

What can fringe vocabulary be derived from?

Informants, vocabulary selection process, environmental or ecological inventories

Informants

Information about communicative needs from those familiar with the AAC user

What is phase two of the AAC assessment?

Initial Assessment and Intervention for Today. In addition to comm abilities, gather information to design and initial intervention to match existing needs and capabilities (cognition, physical abilities, language, sensory needs)

Examples of Literacy yBased Intervention Activities

Journal Cards, Lotto/Bingo Activities, Picture/Word Matching, Action Picture/Sentence Matching, Flip Sentence Strips, Story Starters

What are some challenges for the SLP and Literacy for AAC users?

Knowing which activities are most likely to result in literacy learning Understanding how to adapt the tasks to enable active participation

Descriptive Teaching Strategies

Label the objects in the environment descriptively (what do?), model by using descriptive talking, use systematic and explicit teaching

Components of Communicative Competence/What is Needed to Become a Competent AAC User

Linguistic, Operational, Social Competence, Strategic Competence

What should a short term goal for AAC consider?

Lists the objectives or steps to support the process for obtaining the long-term goal

Describe/Expand: Advocate with and for individuals who can already do benefit from AAC, their families, and significant others to address communication needs and ensuring rights to full communication access.

Main responsibility

Altering Standardized Tests

Make adjustments in the presentation of the test and/or stimulus items to allow the individual to access, understand, respond, and achieve results that accurately reflect communication abilities

What are some practice barriers to consider in the acute setting?

Medical teams are not referring patients for AAC services, personnel are not willing to do the additional work, SLPs and other professionals who are not familiar with types of AAC services.

What is the purpose of AAC in Acute Care?

Meet all patient needs, relay patient and staff feedback, improve quality of care and patient safety, meet accreditation requirements

Describe/Expand: Assess, intervene, and evaluate progress and outcomes associated with AAC interventions using principles of EBP

N/A

How many messages does a low-tech device have?

No more than 4

Types of AAC - Aided

No tech, low tech, mid tech, high tech

Unaided Symbols

Non-verbal behavior used to represent a message

What happens when communication needs are not met in the acute care setting?

Nurses have admitted to increased use of sedation and patients being less involved in their care

Alternative Diagnostic Methods

Obtaining diagnostic information about the levels of communication competency using methods or strategies other than or in addition to standardized tools

Knowledge and Skill Barriers

Occur when team members (client, school staff, family members, peers) have limited knowledge and understanding of the AAC method resulting in limited opportunities for communication.

Assessment

On-going process due to the dynamic changes that occur in individuals due to maturity, health changes, cognitive/language growth/decline, changes in communication needs, and equipment maintenance

Miscellaneous: What to Document

Other factors that impact communication (joint attention, motivation to communicate, likes and dislikes, how needs and wants are met, response to communication breakdowns, communication opportunities)

What are some factors to consider for AAC in acute care?

Patient issues should not interfere with the delivery of medical care. Communication services should be integrated into the overall care plan, provide AAC services upon referral from the medical team, consult with the medical team before and during AAC interventions, AAC interventions must require minimum training. Ongoing training physician education is needed. Specific instruction about AAC services usually occurs during service delivery

Why is AAC needed in the acute care setting?

Patients are unable to speak either temporarily or permanently due to medical conditions such as TBI, Stroke, Oral-Laryngeal Cancer, Myasthenia Gravis, Tracheostomy, Intubation

Proxemics

Personal Space. Distance between speaker and listener that shows familiarity of the two. As the distance changes, the intimacy changes.

What are the factors or barriers that may impact extent to which AAC is available or implemented?

Policy barriers, practice barriers, attitude barriers, knowledge and skill barriers

Communication Bill of Rights

Position of ASHA that communication is the essence of human life and that all people have the right to communicate to the fullest extend possible

Practice Barriers

Procedure or conventions that have become common in a family, school, or workplace but contradict official policies that allow for service provision. Assumptions: Parents assume AAC will eliminate all chances for verbal communication, School staff who resists changed needed for AAC use (I dont have time for that), AAC method use has limitations

Orthographic Processing

Processing and identification of letters and letter patterns

Purpose of AAC

Provide them with something that will allow them to relay messages effectively. Provide adaptive assistance to individuals whose gestural, spoken, and/or written comm is temporarily or permanently inadequate to meet their communication needs. Communicatively competent, meet current communication needs (work, school, leiusure), improves ability to learn, self esteem and confidence (I like that, please go away, shut up), means for self though and cognitive processes (thinking through language)

Resolution to Knowledge and Skill Barriers

Provide training, collaboration, mentoring, intervention activities to assist the facilitator when working with an individual using an AAC method

Adv. and Disadv. of Sign Language as AAC

Provides a comprehensive/rapid method of communication. A complex system requiring learned knowledge for speaker and listener Not always mutually understood.

What aspects of communication should be considered when developing AAC?

Purpose of communication, types of communication, types of AAC, client communication competencies

What is phase one of the AAC Assessment?

Referral Confirm the individual has CCN and AAC may help Make a referral to the appropriate resource Provide or secure info/documentation needed for funding

ASHA Definition of AAC

Refers to an area of research, clinical, and educational practice. Involves attempts to study and when necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of persons with severe disorders or speech-language production and/or comprehension, including spoken and written models of communication. Involves the use of multiple components or modes for communication.

Unaided AAC

Relaying messages only using parts of the body. No external materials or equpitment

For individuals in which English is not the primary language, what should AAC include?

Request interpreter, use translating device/app

Review Lab 1 From Class

Review it!! Look over her examples too

What should be considered when writing a measurable goal for AAC?

Same components as any other goal. must be measurable and have a baseline

Vocabulary Selection Process

Selecting words that have high interest, have potential for frequent use, reflect pertinent communication needs

Communicator Need

Self motivation, intentions, and reasons to communicate

Social Competence

Skills of social interaction such as initiating, maintaining, developing, and terminating communication interactions. (give and take turns, engage in a variety of coherent and cohesive interactions, interest in others and desire to comm)

What to consider when addressing social/emotional status?

Social emotional factors of both the patient and communication partners are strong determiners of success of intervention (motivation, support, willingness to try/willingness to learn new language patterns)

Symbol

Something that stands for or represents something else

High Tech

Sophisticated electronic device that makes use of computer technology and requires a considerable training for programming and use Prentke Romich, Dynavoc, Saltillo Nova Chat.

General Curriculum

State's academic content standards outlining the scope and sequence of skills students are to meet within and across grade levels in the academic domains of: language arts, math, science, and social studies

Educate America Act

States must have their own standards, though it does not say what the standards are. Encourages states to base standards off national standards

How is No-Tech Different from Un-Aided?

Still using materials, just not technology

Label + Referent

Table Icon and Table

Physical Comm.

Take you by the hand and shows you what they want

Describe/Expand: Implement multimodal approach to enhance effective communication that is culturally and linguistically appropriate.

Teach basic gestures (yes/no, come here)

Intervention Procedures for Decoding Skills

Teach the student to look at the letters in a given word. Use subvocal practice of the sounds and letters, blending them to determine the word. The student will identify the target word using the AAC method

Descriptive Teaching Model

Teaches the concept behind context specific vocabulary by using high frequency, reusable, common words (core vocabulary)

What is core vocabulary valuable for?

Teaching Literacy. Early words in literacy teaching are core words. Ex. sight words

Team Knowledge

Team's knowledge of AAC system and ability to assist and teach AAC to the communicator

Team Needs

Team's perception of the communicator's overall need to utilize additional methods of communication

Operational Competenece

Technical skills needed to operate AAC system. (keep vocab up to date, protect technology against breaking, secure necessary repairs, setting and positions, access method)

Iconicity

Technical term to describe he resemblance between a symbol and whatever it represents

How do they tell you this?

Tests for intentionality. Would they do it if the person/teacher was not there?

Communicate with Oneself

The ability to conduct an internal dialogue that allows a mental organization to be able to prioritize, organize, prepare, and effectively interact confidently with appropriate and engaging communication exchanges. INTERNAL DIALOUGE. Executive functioning, thinking, planing, rationale

Descriptive Talking

The act of describing/explaining/expanding when relaying messages (spontaneous or with modeling)

What does intentionally exchanged mean?

The expressive method was initiated for the sole purpose to share

What is the purpose of teaching literacy for AAC users?

The longer we wait, the longer it will take to achieve skills. It offers opportunities to build communication When other people see us teaching reading and writing, it changes their perception of the student in a positive way Mandates for us to address in the education curriculum

Translucent Symbols

The meaning may not be obvious, but a relationship can be made between a symbol and its meaning

Transparent Symbol

The meaning of the symbol can be readily guessed

Which organization sets standards for care?

The national healthcare accreditation agency. The Joint Commission on Accreditation of Health Care Organizations (JACHO). All organizations are required to follow these rules

What are some linguistic skills to assess/intervene on?

The patient's proficiency in expressive, receptive, and pragmatic areas of language

What should be considered when including levels of prompting in AAC goals?

The prompting hierarchy that will be used should be clearly identified and the goal should clearly specify the level of prompting allowed

When are alternative assessment methods used?

The student cannot adhere to administration guidelines delineated for administration which negatively effects the reliability and validity of the test The student cannot understand the consent presented at the individual's age level because content far exceeds cognitive abilities The test results achieved do not accurately reflect the individual's actual abilities.

Tangible Symbols

The use of real objects, miniature objects, artificially associated items, and textured symbols to relay messages

Literacy

The use of visual modes of communication, specifically reading and writing

Why may standardizes tests fail to generate needed evaluative information?

They accommodate speech only (Verbalizations), don't address earliest stages of communication in sufficient detail to show progress, may not probe for meaningful behaviors as a opposed to a mere production of behaviors, do not accommodate sensory or physical impairments, emphasize what the child can't do.

How should IEP goals be written in regards to the common core?

They should be written to accomplish the tasks that underlie achievement of standards. CC goals are gen ed standard and if an SLP uses them, it implies that the students do not need special ed.

What are some message preparation options for literate AAC users?

Time enhancement, message acceleration, fatigue reduction

Why are assessments administered in AAC?

To accommodate the changing lifestyle and capabilities of the individual. Both gaining and losing abilities. Monitoring for repair needs New Communication Needs Reassessing Abilities

What is the goal for vocabulary selection in non literate AAC users?

To facilitate efficient, functional communication in a variety of age-appropriate contexts. To expand the number of words and concepts the AAC user can communicate rather than teaching new words/concepts

Aided AAC

Tools/equipment are needed. Occurs in levels

What are the most common linguistic interventions?

Training new receptive and expressive communications strategies for patients and their communication partners, improving word finding, help with message construction and narratives

True or False: Core vocabulary is a statistical concept from modern corpus linguistics related to overall word frequency

True

True or False: Core vocabulary is consistent across clinical populations, activities, places, topics, and demographic groups

True

True or False: Core vocabulary is not the central focus of most AAC systems

True

True or False: Federal and State mandates that IEP goals align with academic content standards for the student's grade levels

True

True or False: If the speech-language impairment is augmented with a communication device so that it allows the student to perform at or near grade level, then the student is no eligible for special education under IDEA. Thes student may receive accommondations/modfications under section 504

True

True or False: If you changed anything in administrative guidelines of a standardized assessment, scores cannot be used as it hurts the reliability and validity of the test

True

True or False: Misunderstandings of messages occur more often if nonverbal are not seen or heard

True

True or False: Non-verbal supplement messages when unsure of what words mean

True

True or False: Peers often choose a book to be read usually choosing the same book repeatedly while parents of AAC users often choose a book o be read and tends to choose a different book each time

True

True or False: Sometimes intentionality must be taught

True

True or False: Storybook reading interactions differ between AAC users and typically developing peers

True

True or False: The most meaning is relayed through nonverbal ways of communication

True

True or False: We all use AAC everyday to help us get out pint across

True

True or False: When teaching literacy to AAC users, it is beneficial to provide the AAC method along with independent access to reading materials

True

True or False: core vocabulary contains few picture producers

True

True or False: SLPs or AAC specialists do not have the knowledge and training to assess and intervene in AL areas that impact communication competence

True (ex. cognition)

Linguistic Competence

Understanding receptive and expressive language skills of one's native language. Cannot have AAC without language skills. Why individuals need language therapy as well. Must have some symbolic understanding. Knowledge of language spoken by communication partners in order to receive messages (ASL, bilignuasim( Knowledge of the linguistic code unique to one's AAC system (symbol representations, method of message generation

Vocal Approximations Disadvantages

Unless meaning is taught, not mutually understood. Is also limiting in purposes of communication

Intervention Procedures for Sight Word Recognition

Use direct instruction with systematic prompting and prompt fading. Incorporate repeated opportunities for practice. Have a student match written words with the target word picture. Use a word wall.

Low Tech

Use of a fairly simple device containing few moving parts. Big Mac, voice amplifications. Limited messages for output

Alternative

Use of alternative method to replace a non-functional vocal tract

Tangible Symbol

Use two or three dimensional times to represent a message

Environmental or Ecological Inventories

Using the most critical words used while observing the AAC user and peers during activities

Vocabulary Maintenance

Vocab selection is an ongoing process. Remove words that are not used often and add words that are needed. Space on the device can be an issue. Prioritize

Context Processing

Vocabulary knowledge, syntactic/grammatical knowledge world knowledge to derive meaning from text or encode meaning

Coverage Vocabulary

Vocabulary required to communicate essential messages addressing the AAC users basic communication needs.

Developmental Vocabulary

Vocabulary selected for language and vocabulary growth rather than function. AAC user may not yet know the meaning, but that is okay. May include vocabulary for upcoming academic lesson or a novel event (field trip, party, circus)

Describe/Expand: Recognize and hold paramount the needs and interests of individuals who may benefit from AAC and assist them to communicate in ways they desire.

We aware and select vocabulary based on age/culture/gender/interests

Receptive Language: What to Document

What the student responds to and how (recognize and respond to their name, follow verbal directions and requests, respond to multi-step directions, understand nonverbal messages, follows rules and routines, has object permanence)

What can core vocabulary be derived from?

Word lists based on vocabulary-use patterns of other individuals who successfully use AAC systems, word lists based on the use patterns of the specific AAC user, Word lists base on the performance of natural speakers or writers in similar contexts

Fringe Vocabulary

Words that have specific meaning, often related to core vocabulary

Language Based Communication Overlay

Words that support communication in all enviornments

Communication Breakdown Percentages (Words, Tone, Nonverbal)

Words: 7% Tone: 38% Non-Verbal: 55%

Policy Barriers

Written laws, standards, or regulations that govern the contexts of access of AAC materials/equipment. ex. some laws state only in-school use of the device

Are core words present in all languages?

Yes

What should the AAC team prepare in advance?

a set of AAC materials for the acute care unit to be accessed as needed

What are some factors that influence the types of messages an AAC use may select?

age, gender, social role, medical condition, and culture

What is coverage vocabulary dependent on?

age, sex, medical conditions, communicative environments, social, and cognitive level of the AAC user

What types of contexts and situations should AAC methods allow the user to generate messages?

all. ex. greetings, small talk, story telling, prodcedural descriptions, content-specific conversations, wrap-up remarks and farewell statements

How do you select the level of abstraction for a tangible symbol?

allows the individual maximum comprehension

What are the three types of alternative assessment methods?

altering standardized tests, using checklists/profiles, using informal assessments/observations

What is the most common movement that is assigned meaning?

an eye blink

What should AAC methods selected be....

appropriate for communication needs, functional, easy to access, easy to use, easy to acquire. Should not be too complex and should not require a lot of training

If an individual is non-verbal or has limited mobility, what should be done?

assign meaning to any movements that the patient can consistently do and assign meaning to any vocalizations the patient can consistent produce

What are some AAC techniques that are valuable to help with cognitive limitations?

associate words with gesture, sign, symbol, device

How should vocabulary be chosen for non literate AAC users?

based on what is functional, vocabulary/messages represented using symbols, usually organized by context (environment or activity)

How to write functional AAC goals?

choose appropriate vocabulary and language skills, include level of prompting, write measurable goals, teach interact-don't test

Who is the goal of AAC interventions met in the acute care setting?

close family members need to be involved as we do not know the person and AAC may be used for direct communication or as therapy tool (Word finding)

How do you choose appropriate vocabulary and language skills?

consider the purpose of expressive language (initiate, comment, request, etc.) consider expressive language use (MLU, sentence structure) consider receptive language needs (morphological awareness) Select vocabulary and language structures that will help the student establish and maintain meaningful communicative interactions (core and fringe for various settings)

Vocabulary chosen for AAC users should allow them to interact in the following communicative settings:

conversations, relaying messages in various settings, in their native language, establishing and maintaining social roles...more on slide

Words from various semantic categories should be used in what type of vocabulary?

developmental

Descriptive Testing

formally assessing a student learning using descriptive questions

What is the number one reason for abandonment of an AAC device?

frustration due to lack of availability of ways to convey messages they want to convey

Describe/Expand: Facilitate individuals' uses of AAC to promote and maintain their quality of life.

functional communication, educational, and vocational access

Examples of unaided symbols

gestures, vocalizations, sign language

What should you prompt the student to do during explicit teaching?

give an attribute, give an action word, give a who idea, give a time idea, and give a place idea give a word that is similar, opposite, state something that goes with it, use a word that sounds like it, tell a letter it starts with

How should expressive communication needs be met?

identifying communication needs by completing a full AAC evaluation, providing and teaching AAC methods

Because users of AAC often have deficits in all aspects of language that negatively impacts literacy learning and narrative skills needed for literacy....

include interventions in therapy that are targeted to improve pragmatic, semantic, syntactic, and morphological skills

Meaning Processing

integration of orthographic, phonological, and contextual processing to build a coherent understanding of the meaning of the text or to encode meaning into coherent text

How to create motivation for AAC users learning literacy?

introduce materials students are interested in, immerse reading activities into fun actives, allow the student to choose materials/activities

What to consider when assessing motor skills?

is the strength, range, or speech or motor actions limited? Are voluntary complex actions or motor planning limited? What are alternative access modes?

What are the knowledge and skills required for writing?

knowledge and experience to have something to write about, narrative skills to develop a cohesive story, language skills, phoneme segmentation skills, knowledge of letter-sound correspondence, knowledge of spelling irregularly spelled words (sight words), skills in handwriting, keyboarding, or other methods of writing

What are some knowledge and skills required to support reading and writing skills?

language skills, phonological awareness skills, letter-sound correspondences, single word decoding, sight word recognition, application of decoding and sight word recognition, reading and understanding of text, single word spelling skills, sight word spelling skills

What are some tools that offer quick access in the acute setting?

magnifying class, clipboard/dry erase board, alphabet board, communication board, amplification system, electrolarynx, simple speech generating device, eye pointing displays, portable mounting system

What are the results of the AAC user's parent selecting the book?

may be less interested during the reading session become less responsive. AAC user does not benefit from the comprehension, inference, retelling, anticipate event, and pretend...

Translucent Iconicity

meaning is not obvious, but can be determined in context Ex. book for reading (high), book for English class (low)

What to consider when addressing cognitive abilities?

memory, word finding difficulties.

What are complex communication needs?

multiple or complex issues impacting the patients ability to relay or receive messages. Cognitive impairment, deaf, English is not the primary language, limited mobility

Opaque Iconicity

no relationship is perceived even when the meaning of the symbol is known ex. blisssymbolics

Can unaided symbols be guessed by unfamiliar individuals?

nope, they must be learned

What part of the working definition of communication is impaired if there is a receptive language disorder?

not mutually understood

How are nurses most valuable to the AAC plan?

nurses see the patient and their family members consistently making them valuable to the AAC plan. Coordination ofAAC interventions with medical care plan, document communication needs keep family members informed of changes in the AAC plan, advocate for the patient by encouraging doctors to request AAC services

How to build fluency in AAC users learning literacy?

opportunities for repeated readings of text at student's reading level, silent reading along with audio recording or visual presentation of text, silent reading during paired reading with a fluent reader

Who should participate in the AAC evaluation team?

parents/key family members, SLP, PT, PT, School personnel, employers, doctors

What are the requirements of JACHO?

patients have a right and a need for effective communication, encourage patient's active involvement in their care

How many messages Can a high tech device have?

pretty much the same amount fo messages that can be generated verbally

What happens when communication needs are met in the acute setting?

receive less sedation, transitioned quicker, have increased satisfaction with health care, feel more in control, generally do better

What does mutually understood mean?

receiving and understanding the intentional method

For a cognitive impairment, what should AAC include?

reduce complexity of utterances, yes/no questions, allow time for processing of information

For deafness, what should AAC include?

request a sign language interpreter, use paper/white board for writing

What are some teaching/interaction strategies that promote effective communication? Emergent Literacy

select appropriate books, introduce the topic of the book, introduce new vocabulary as needed, read the text of the book, use time delay/wait expectantly, ask appropriate questions, model use of AAC and speech, respond to communication attempts, encourage the learner to retell the story

What may beginning AAC users have goals written for?

show an increase in the number of communicative functions (initiating, responding, commenting, etc)

Where did LRE come from?

students used to be grouped by disability, not academic abilites

Semantic Categories to include in developmental vocabulary?

substantial words (people, places, things), relational words (big, little), generic verbs (give, get, make), specific verbs (eat, drink, sleep), emotional state words (happy, scared), affirmation/negation words (yes/no), recurrence/discontinuation words (more, all gone), proper names for people/personal pronouns, single adjectives (hot, dirty)/opposites

What are the four primary components of AAC?

symbols, aids, strategies, techniques

Descriptive Teaching

systematically using descriptive language in a lesson

Core words allow for...

talking instead of labeling

What four factors support the AAC system?

team, need, knowledge, communicator

Teaching students to speak descriptively is more important when...

the vocabulary of the curriculum gets more sophisticated. not every word can be stored on the device

What is the purpose of descriptive teaching?

to allow AAC users a method to really desired messages that is not represented in a user's pre-stored vocabulary

Why were federal and state legislation enacted?

to ensure student compare in the global society by creating rigorous educational standards and measuring progress

What do literacy skills allow for in regard to AAC?

to generate novel messages using speech output devices that offer spelling and word based programs

What is the goal of AAC interventions in the acute care setting?

to raise or maintain a person's quality of life.

What are the three measures of iconicity?

transparent, translucent, opaque

What are some access barriers to consider in the acute setting?

unable to participate in the initial screening, oral-motor capabilities, writing abilities, access constraints

What are some ways to teach writing skills for AAC users?

use story starters, sentence completion tasks (sentence starters), describe action pictures, answer questions

What can happen is the parents/teachers don't know which activities are most likely to result in literacy learning for AAC users and how to adapt literacy tasks to enable participation for AAC users?

user is not included in literacy activities

What are some ways to provide access to an AAC method for vocabulary leaning in emergent literacy>

using signs and gestures during a reading activity, using object to communicate choices and interactions, provide simple switched programmed with repeated story lines, use low tech boards with vocabulary for questions and commets

What are some communication limitation in the in-patient setting?

verbal output, reading/writing, hearing, language barriers, using a call system

What do you do if a member of the medical team is not willing to work around AAC?

work around them. They are not the only member on the team.

If you don't have an IEP, it is assumed that...

you have the ability to access general curriculum standards