Final knowledge checks/midterm questions

What key communication skills are important to successful patient-provider communication for people with developmental disabilities? How can intervention support the use of these skills?

They key communication skills that are important to successful patient-provider communication are: Introducing oneself and one's communication system Making use of appropriate communication strategies, such as pre-prepared messages Making use of appropriate vocabulary and language to communicate concerns and needs, ensuring that previous health care and current health concerns are understood by the health professional Intervention: for people who use AAC in hospital settings can address the staff's recognition of a patient's individual AAC system and the staff's provision of general communication supports (e.g., offering choices) for all individuals, including children, A health passport containing relevant medical history (e.g., age, current medications, past medical procedures) can be developed for use during intake; other messages can be prepared in advance to address specific concerns, and AAC systems can be programmed to include words related to health care, body parts, and sexuality.

CAS cause

Though a definitive cause of CAS has not been identified, there are several possibilities: Neurological conditionsstrokeinfectionTBI Genetic disorderOccurs frequently with galactosemia

List and describe 3 examples of low-tech aids created for COVID-19.

1) CO-VIDSPEAK for those wanting to communicate with individuals that aren't near by 2) Voxello printable for letter boards, pain scale, single/phrase-based messages 3) Phrase-Based Partner Assisted Communication Aid

List and describe 4 communication aids or strategies that can be implemented in the ICU.

1) Establishing a yes/no communication response system if the individual is unable to produce speech output or shake their head (yes/no eye signals) 2) comprehension & attention strategies (call by name first, reduce information, "lock eyes", use augmented input) 3) Ot & nurses working together for a call system 4) The use of communication boards

SGD funding requirements

A medical prescription A letter of support from an OT or PT a price quote from the manufacturer

Communication Impairments and cerebral palsy

Articulation disorders and impaired speech intelligibilityrestricted movement of oral-facial musclespoor respiratory controllaryngeal and velopharyngeal dysfunction Language delays

What is the goal of intervention for beginning communicators who are preintentional?

Beginning communicators who are preintentional do not yet understand that they can impact others by communication. Beginning communicators who are preintentional may focus on building intentionality.

Data gathered in the assessment phase should include

Vision Hearing Fine motor skills Gross motor skills Cognition

Contextual-choice AAC communicators

Can indicate basic needs; demonstrate recognition of surroundings and awareness of some conversations initiated/maintained by others

most common CP

Spastic cerebral palsy

What is the goal of Early Phase AAC intervention for someone with brainstem stroke?

The Early Phase AAC intervention for an individual with a brainstem stroke involves incorporating yes/no questions for the individual to answer as well as a call system. Yes/no question can reduce fatigue and frustrations and the communication partner needs have adequate training. After the yes/no question method is established, the individual can also use low-tech systems depending on where the patients at in regards to their communication, motor abilities, vision, hearing, etc.

Who are relevant stakeholders on the AAC "team"?

The individual who uses AAC, the individual's communication partner(s), Rehab professionals (OT, PT, SLP)

T/F In Florida, AAC devices belong to the school, so devices need to stay with the current school when a student moves to a different school district.

F

T/F AAC is a "last resort" in speech-language intervention.

False

ASD possible causes

Genes Higher risk when a sibling has ASD Higher risk with certain genetic or chromosomal conditions (e.g., fragile X syndrome) Certain drugs during pregnancy (e.g., thalidomide) have been linked with a higher risk for ASD Children born to older parents are at a greater risk for ASD

CAS characteristics

Inconsistent errors on consonants and vowels in repeated productions of syllables and words Lengthened and disrupted coarticulatory transitions between sounds and syllables Inappropriate prosody. AAC used when the individual is not understood (augmentative strategy)

Communication challenges/strengths downs

challenges: Delayed language Delayed speech development Articulation difficulties resulting in poor intelligibility Conductive hearing loss associated with anatomical differences strengths: Typically understand more than are able to express Strengths in vocabulary (semantics) and social aspects of language ( pragmatics)

Generative AAC communicators

demonstrate some ability to convey novel info; can use symbols

T/F

false

Emerging AAC communicators

profound cognitive linguistic disorder, trouble with symbols/speaking

List five general functions of AAC (low-tech and high-tech) for people with aphasia or apraxia of speech.

1) Building upon an individuals comprehension (such as someone that experiences auditory comprehension impairments) 2) It allows the individual to express needs, wants, or other information 3) A word of phrase bank for multiple topics4) Helps to communicate through spoken language and written5) Allows for more independence for some individuals

Why is it useful to identify the communication needs of patients in a medical unit as part of an AAC intervention?

1. Accurate, effective, two-way communication between patients and health care providers is critical in providing quality health care and ensuring patient safety. 2. Patients needs to communicate regularly, with a wide range of familiar and unfamiliar communication partners, about many complex subjects. 3. A number of medical conditions can result in impaired communication abilities. 4. Side effects of medical interventions can also result in CCN. 5. Patients may have difficulty communicating for nonmedical reasons. Specific considerations for communication varies for each patient and a patient may be dealing with one issue or with a combination of issues. It is crucial to assess specific communication needs as part of AAC intervention.

How would you design an intervention program to teach communication partners how to alter their communication style to converse with a person who is a contextual-choice AAC communicator?

1. Actively use strategies to support the communicator with comprehension and expression; 2. Attend carefully to the communicator's messages, respond to and interpret communication attempts, make sure the communicator confirms their understanding of what the partner says. Partner strategies include written-choice conversational strategy, use of tagged yes/no, augmented comprehension strategies, and responding to all communication efforts. Communicator strategies include pointing to answer questions, answering tagged yes/no, pointing to partner/items of interest to express interest, and attending to partner communication and confirming understanding.

What are five key participation domains for all individuals, including people with complex communication needs? For one of these domains, describe a challenge that is commonly experienced by people with complex communication needs, and suggest adaptations and interventions that would help to address the challenge.

1. Education, 2. Employment and volunteer activities, 3. Assisted and independent living, 4. Health care, and 5. Community participation.

Describe at least two characteristics of each of the six AAC-Aphasia Communicator Categories and state where they fall on the continuum of support.

1. Emerging: very limited ability to communicate purposefully, even through basic nonspoken signals; 2. Contextual-choice: Can indicate basic needs, demonstrate recognition of surroundings and awareness of some conversations initiated/maintained by others; 3. Transitional: demonstrate ability to use AAC symbols and supports to help them communicate; 4. Stored-message: have enough executive function and initiation ability to learn to consistently access entire messages in specific contexts without prompting; 5. Generative: Demonstrate some ability to convey novel information, can formulate messages and combine aided and unaided supports; 6. Specific-need: do not need aided AAC as primary means of communication and have sufficient speech and gestures to meet many communication needs.

What speech characteristic of an individual with amyotrophic lateral sclerosis best predicts the need for an AAC assessment to take place in a timely manner? Does a diagnosis of spinal versus bulbar amyotrophic lateral sclerosis affect the usefulness of that predictor?

An individual with ALS has a reduced speech rate that should be monitored in order to determine when AAC may be used. This impacts their speech intelligibility as well. An individual wit ha diagnosis of spinal ALS may not have that reduced speech rate, so AAC may not be needed. However, their motor abilities may still be impacted. AAC assessment should happen when intelligibility is below 90%

Select Communication Partners' Less-Than-Ideal Behaviors that might interfere with communication during storybook reading?

Asking predominantly yes/no questions Taking the majority of conversational turns Focusing disproportionately on the technology

What is alphabet supplementation and how can it assist an individual with TBI?

Alphabet supplementation involves the individual selecting the first letter of a word on an alphabet board/AAC device in conjunction with stating the word. This may be utilized throughout conversational interactions and can help aid in speech intelligibility. Word retrieval in restricted to the word that being with the original letter identified.

What is functional communication training? Why is it important?

Functional communication training (FCT) is an intervention designed to reduce challenging behaviors by teaching functionally equivalent, socially appropriate communication skills to replace the challenging behaviors.

developmental disabilities causes

Genetics Complications during birth Diseases or Infections Exposure to diseases or toxins Parental behaviors during pregnancy (smoking/drinking)

What is the central goal of AAC intervention?

Learn their native language Establish and maintain their social roles Communicate accurately to guide their personal and medical care Meet their personal needs Participate and be included in different communication settings

Causes of CP

many are unknown changes in blood flow, maternal infections, intrauterine stroke, injury or genetics may play a role.

Is PECS a picture system?

no, its a teaching strategy. USED FOR ASD

What is meant by the term beginning communicator? To whom does this description refer?

A beginning communicator is someone who is at the early stages of communication development and is learning the skills needed to participate in daily life. Beginning communicators can also be at any of the following stages: preintentional, intentional but presymbolic, early symbolic development, or learning to combine symbols

Which of the following is true about Just-In-Time programming?

Just-In-Time programming works well with young children using visual scene displays.

T/F Teaching use of objects and/or photos to communicate choices about familiar routines or social activities would be appropriate for an emerging AAC communicator.

T

Goal Attainment Scaling is one tool that can be used to measure which of the following types of AAC Intervention outcomes?

functional communication and participation

Is brain-computer interface currently an AAC option that is often recommended for individuals with locked-in syndrome?

no, doesnt support day to day communication

specific need AAC communicator

written communication in situations requiring greater specificity, clarity, or efficiency Correct Answer Does not rely on AAC as his or her primary mode of communication

Key elements in providing a high-quality inclusive educational experience are

Collaborative teaming involving education professionals (e.g., general and special education teachers, speech- language pathologists), the parents, and the student, as well as members of the AAC team Comprehensive and individualized planning that reflects the individual's strengths, challenges, and interests and identifies overall desired outcomes and related instructional goals High- quality instruction with attention to universal design for learning, curriculum accommodations, system-atic instruction, and assistive technology Fostering of membership and relationships with same-age peers

T/F AAC systems for children with developmental disabilities, who are beginning communicators, should include mostly nouns; because they are easy to represent in pictures.

F

emergent literacy skills start by determining

Identifies most of the letters of the alphabet, most of the time Is interested and engaged during shared reading Has a means of communication and interaction Understands that print has meaning

T/F Language modeling techniques have been found useful in supporting the use of multisymbol utterances by people with CCCN

True

contextual choice AAC communicator

Can indicate basic needs; demonstrate recognition of surroundings and awareness of some conversations initiated/maintained by others

What is the the most common lifelong motor disability and how many people does it impact?

Cerebral Palsy (CP); more than 17,000,000 people around the world.

AAC intervention

Communication for all individuals should be multimodal. AAC systems should be customized to meet individual needs.

Transitional AAC communicators

Demonstrate ability to use AAC symbols and supports to help them communicate (e.g., through gestures, drawings, notebooks, speech-generating technologies)

What types of data might be collected during trials of AAC systems? Why is it important to collect data on the preferences of the individual with CCN, family members, and other important communication partners?

During trials of AAC systems, the data that is collected may focus on how easy the device is to use, the size of the device, how much the individual is participating and what their thoughts are about the device, and how well the device supports their functional communication and intervention goals. It's important to collect data on the preferences of the individual with CCN because if they do not like the device, the likelihood that they'll use it is minimal compared to an AAC system that they enjoy. It's important to collect data on the preferences for the family members because they're going to be the ones helping the individual to use the device and learn it. Therefore, if the family members do not like the device, this in turn can affect the intervention outcomes and the individuals success. Also, it's important to collect data on the preferences of the communication partners because they're around the individual and need to understand the device as well. If the individual with CCN, the family members, and other communication partners like the selected device in the end, this may help with achieving intervention goals and having the most effective impact on the individual.

How do the goals of Early Phase, Middle Phase, and Late Phase AAC intervention for amyotrophic lateral sclerosis differ?

Early Phase is centered on monitoring, preparation, and support from diagnosis through initial referral for an AAC assessment. Middle Phase is centered on assessment, recommendations, and implementation from the time of referral until AAC supports are selected, purchased, and initial instruction is completed. In this phase, a full AAC evaluation takes place.

T/F An individual who is unable to speak following a severe TBI will be unlikely to recover functional speech.

F

T/F For individuals with CCN, communicative competence is not learned; it is innate.

F

T/F For young children, there is a representational hierarchy of symbols that start with real objects, to photographs, to line drawings, to more abstract representations and then to written words.

F

T/F Individuals with Guillain-Barré Syndrome usually require long term AAC support.

F

T/F People who use AAC typically rely upon a single mode of communication.

F

T/F Requesting should only be targeted once a beginning communicator has solidly moved into the symbolic communication stage.

False

T/F Spacing and arrangement of symbols on a communication display is usually the same for most people with minor modifications.

False

T/F A fixed or static display refers to a communication device that is fixed to a wheelchair.

False, a fixed display refers to any AAC display in which the symbols and representations are fixed in a particular location.

T/F Scanning is an easier method of access than head or eye tracking, because the cognitive load is reduced.

False, the cognitive load associated with scanning is considerable, the learning requirements are extensive, and the rate of communication is slow.

What are the five key components of effective literacy instruction for individuals with complex communication needs? For one of these components, describe a challenge commonly experienced by individuals with complex communication needs, and suggest adaptations that would help to address the challenge.

Five key components are as follows: 1. Allocate sufficient time for instruction. 2. Use appropriate and effective instructional techniques to teach skills known to support successful acquisition of conventional reading and writing. 3. Provide appropriate adaptations to ensure the active participation of individuals with speech, motor, and/or sensory/perceptual impairments. 4. Build positive rapport and ensure learner motivation. 5. Monitor the literacy learner's progress and adjust as necessary to maximize outcomes. Many individuals with complex communication needs have motor impairments that can present challenges for their participation in literacy activities. These challenges can be addressed through appropriate seating and positioning based on input from occupational and/or physical therapists, alternative access techniques, such as eye pointing, scanning, and partner- assisted scanning; it is important to take care that the technique selected does not impose too many additional cognitive demands.

A patient who cannot speak or write can only communicate using her eyes. However, her spouse has difficulty interpreting her eye pointing, so you decide to teach him eye linking. How would you introduce this strategy to him?

I would first summarize the steps, then model, with him playing the role of patient and me playing the role of communication partner. 1. Use a transparent communication board, sitting opposite each other on either side of the board. 2. Have him look at the desired message. 3. As the communication partner, move the board until my eyes are "linked" directly across from his. At this point, the intended message lies between us. Once he understands how this works, I would use activities to scaffold his learning to use eye-linking to communicate with his wife.

Why is it important to assess the participation patterns and unmet communication needs of an individual? How can this be accomplished?

It's important to assess the participation patterns and unmet communication needs of an individual in order to gauge an understanding as to where they're at today, and the goals for tomorrow. Also, this is an important component for feature matching. Understanding the participation patters of the individual allow us to see their strengths and areas that may need additional support for communication purposes. The participation patterns can provide detailed information as to who the child interacts with the most, which in turn can help to decide target vocabulary words. The context also allow us to see the native language that is spoken at home and for the AAC device. The participation patters also allow us to see what activities the individual may enjoy and how to best elicit the use of the AAC device in the future. The participation patterns and unmet communication needs can be found through interviews with family members, through the social network inventory, the participation inventory, and the communication needs survey. The family can provide helpful information about the routines the individual goes through daily, as well as essential and developmental vocabulary.

Describe the knowledge and skills that individuals typically acquire during the emergent literacy stage of development. What are some of the challenges in providing emergent literacy experiences for individuals with complex communication needs? Describe some interventions that have been demonstrated to have a positive impact in supporting the participation of individuals with complex communication needs in emergent literacy activities.

Knowledge and skills acquired during this stage include: Language skills— semantic, syntactic, morphological, and narrative skills that will later be used to understand and produce written texts; Understanding of how spoken and written language are connected and how print represents spoken language; Conventions of print— how to hold a book, where to start reading, how to read from left to right, and so on. Challenges to fostering emergent literacy development in people who rely on AAC include: Limited opportunities to choose books for storybook reading experiences•; Limited opportunities to participate in story reading activities, especially repeated readings, and to build competence in comprehending, making inferences, making predictions, and retelling stories; Tendency of parents and teacher to dominate the interaction; Limited access to AAC during reading interactions. Interventions that can support individuals with complex communication needs in participating in emergent literacy activities address two key areas: 1) providing access to AAC that includes appropriate vocabulary concepts during story reading and 2) teaching partners to use interaction strategies that promote effective communication by individuals who rely on AAC

LAMP for ASD

LAMP WFL is a program that was designed to meet the needs of individuals with ASD. This program uses Language Acquisition through Motor Planning (LAMP) to organize their vocabulary. LAMP is a therapeutic approach that has 5 key components: readiness to learn joint engagement consistent and unique motor plans auditory signals natural consequences

Which of the following is NOT true about AAC system development?

Low tech systems should always be used first

ASD team

Neurologist or neuropsychologist OT to address fine motor deficits, sensory impairments, and ADLs Behaviorist (ABA) to address maladaptive behaviors and ADLs Special education Vocational rehabilitation (depending on age) Other (music therapy, HIPPO therapy, support animal, etc.)

ASD charecteristics

Not pointing to objects to show interest Not attending to what others point to Not being interested in other people or having trouble relating Avoiding eye contact Having trouble understanding the feelings of others or themselves Prefer not to be held or cuddled Appears to be unaware of when people are speaking to them Be very interested in people but not know how to talk or relate to them Repeating words that are said to them Inability to express needs Lack of pretend plan Repetitive actions Lack of adapting to change in routines Unusual reactions to sensory input (smell, taste, look, feel, or sound) Loss of speech in the early years

What is the primary goal and focus of intervention for individuals with Traumatic Brain Injury (TBI)?

One of the main goals of intervention in TBI is to achieve functional communication related to independent function in day to day activities. To provide patient-provider communication

Which of the following are intervention approaches for a student with limited fluency in decoding and sight word recognition skills?

Repeated readings of texts at the individual's independent reading level, Reading along with audio recordings or multimedia presentations of texts, Paired readings in which fluent readers read aloud with less fluent readers

Vision impairment

Some individuals who require AAC may experience blind spots in their vision, resulting in difficulty seeing items on the side or below Strabismus refers to when the direction of eyes is not coordinated. Use of color and contrast may be used on AAC systems to aid in discrimination of representations on an AAC display.

How do stored-message and generative AAC communicators differ? How would this difference influence your selection of a low-tech or high-tech communication strategy?

Stored-message AAC communicator: has the ability to select messages within their AAC system. These individuals use their AAC system in addition to their speech or as a replacement with no prompting in familiar situations. These individuals may need a high-tech system due to the fact that messages are needed to be stored in the device. Generative AAC communicator: Some novel information is able to be communicated that's not stored on the device. These individuals have aphasia and may speak or write. Some complex utterances may be stated. May use a lower tech system since there's some spontaneous speech present. When a communication break down happens, then the AAC device can be used.

T/F AAC systems should have developmentally appropriate representation of vocabulary and an easily learned organizational structure.

T

T/F Alternative access techniques provide people with physical and cognitive disabilities with a way to read, write, and communicate.

T

T/F Rate enhancement techniques that give individuals who use AAC access to a large vocabulary of symbols are encoding techniques and linguistic prediction techniques.

T

Describe the key principles of the Anchor Read Apply approach.

The anchor step involves building background knowledge or activating it in a certain setting. It involves setting a purpose for the reading. The read phase consists of reading the story and possibly occasionally reminding the individual the purpose. Then, students apply what they know by completing a task.

Put the CROWD in the CAR shared reading

The targeted skills first involve the CAR (Comment, Ask a question, and Respond by adding a little bit more). Once the partner is comfortable with these skills, they next tackle adding the CROWD (leave a blank at the end of a sentence so students can fill it in for Completion, have them Recall what happened in the story, use Open-ended questions and Wh-questions, and finally, decrease the Distance between them and the story by helping to relate the book to personal experiences).

CP impacting movement

The way CP impacts coordination, balance and movement have names like Spasticity (stiffness), Hypotonia (low tone), Dystonia (fluctuating tone), Athetosis and Chorea (extra, abnormal movements).

down syndrome types

Trisomy 21 = cell division error. three copies of chromosome 21 instead of the usual two. most common Mosaicism = some containing the usual 46 chromosomes and some containing 47. Those cells with 47 chromosomes contain an extra chromosome 21. least common. Translocation = total number of chromosomes in the cells remains 46; however, an additional full or partial copy of chromosome 21 attaches to another chromosome.

What are visual schedules and how can they be used?

Visual schedules use symbols to show the most important things that a person does throughout their day. They can be used by to show an easy transition between activities or for individuals that need high predictability.

The domains of knowledge and skills necessary for learning to write include

World knowledge and experience to generate ideas for writing Narrative skills Phoneme segmentation skills to break down words into their component sounds knowledge of how to spell irregular, frequently occurring words learned as sight words Skills in handwriting, keyboarding, or other access techniques to produce text

Predictable Chart Writing

approach writing at an emergent level. Write the chartTopic for writing this week is introducedStudents brainstorm items for the chartTeacher leads the class in writing the chart Reread the sentencesRead the chart as a classStudents read using inner voiceDiscuss reading, writing conventions, etc. Work with cutup sentencesReread the chart out loud and using inner voiceGive students their sentence stripsStudents read the individual sentence stripsCut up the sentence strip into words and reposition words, rereading as the write it Be the sentenceUse single message devices with each word of the sentence on itHave students order themselves to "be the sentence" Make the bookCreate light-tech books using sentence strips

Individuals who are Intentional but Presymbolic

communication is for two primary purposes: To express needs & wants and regulate the behavior of others To interact socially and develop social closeness

T/F Laptop computers, desktop computers or other devices that are not dedicated SGDs, but can be used for communication, are usually covered for funding because they meet the definition of durable medical equipment (DME).

false

Stored-message AAC communicators

have enough executive function to access messages in specific contexts

How frequently do nursing staff in acute care medical settings interact with patients who have AAC needs? What are the implications?

he nursing staff usually does not have much training when it comes to interacting with individuals that have AAC needs, however, they are frequently exposed to patients that have AAC needs. It's important to work with the nursing staff to develop a communication system that they can understand as the communication partner. These systems may be yes/no signals with a binary code or through natural communication strategies.

intellectual disability determined by

impact on adaptive functioning in three domains: Conceptual Domain (Language skillsReading skillsWriting skillsMath skillsReasoningKnowledgeMemory) Social Domain (EmpathySocial judgementInterpersonal communication skills) Practical Domain (Personal care Job responsibilitiesMoney managementRecreationOrganizing school and work tasks)

CP intervention collaborating

individual and their family, professional team you work with may include a physical therapist, occupational therapist, educators, vision expert, audiologist, interdisciplinary team; you will look at ways that you can make environmental adaptations, enable AAC access and use assistive tech. Consider planning for adulthood. DownsAn AAC system that accommodates the changing and complex needs of interpersonal, academic and employment needs is critical for true participation.

Down syndrome physical traits

low muscle tone, small stature, an upward slant to the eyes, and a single deep crease across the center of the palm. Most common chromosome disorder

Which of the following are examples of relational practices within a family-centered approach to intervention?

maintaining effective communication, demonstrating compassion, empathy, and respect, active listening

Explicit instruction is often combined with __________________ teaching to promote generalization of skills to the natural environment. Select all that apply.

milieu and incidental

Language code

must be learned including symbol representation and organization semantic, syntactic and morphological aspects

The Graphic Symbol Utterance and Sentence Development Framework

sentence-focused framework for children who rely on speech as they progress from early word productions to adultlike sentences. phase 1: Children learn to use graphic symbols with communicative intent, phase 2: as children progress to Early Symbol Combinations, they begin to combine symbols to express a variety of semantic relations with emerging word order accuracy. phase 3: Childlike Sentences are produced with more grammatical intent phase 4: adult like sentences

Components of Supported Conversation for Adults With Aphasia (SCA™) include

spoken and written key words, Body language and gestures Hand drawings Detailed pictographs

AAC systems should be personalized and should be reflective of:

the clients skills, knowledge and interests

T/F Alphabet boards, word boards, picture boards, white boards, magic slates, plexiglass eye gaze board or a text-to-speech typing system ALL may be appropriate for use with individuals in either intensive care units or long term acute care hospital units.

true

T/F Children do not have a certain set of prerequisite skills to be able to benefit from AAC.

true

T/F Speech rate of people with ALS is a good indicator as to when AAC options should be explored.

true

T/F Spell checkers and on-screen dictionaries are tools that can be used with individuals with spelling and vocabulary limitations.

true

Which of the following is not evidence of intentionality?

verbal approximation of the target word