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Assistive Technology for People with Communication Impairments. Melanie Fried-Oken, Ph.D., CCC/Sp Director, Assistive Technology Program Professor, Neurology, Biomedical Engineering, Otolaryngology & Pediatrics Oregon Health & Sciences University Portland, Oregon [email protected]

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assistive technology for people with communication impairments

Assistive Technology for People with Communication Impairments

Melanie Fried-Oken, Ph.D., CCC/Sp

Director, Assistive Technology Program

Professor, Neurology, Biomedical Engineering, Otolaryngology & Pediatrics

Oregon Health & Sciences University

Portland, Oregon

[email protected]

lecture objectives
Lecture Objectives
  • Understand the WHO International Classification of Functioning model for disability;
  • Present information on current assistive technology related to employment;
  • Describe augmentative and alternative communication equipment and practice.
a model of illness and health
A model of illness and health
  • Need a way to describe illness or (PC) health&wellness.
  • Need a model to understand relationship between illness and interventions.
the who international classification of functioning icf model of illness
The WHO International Classification of Functioning (ICF) model of illness
  • WHO ICIDH: International ClassificationofImpairments, Disabilities, andHandicaps
  • Developed in 1970s
  • Published first in 1980
  • revised 1995-99; now ICF
slide5

WHO ICF Model of illness

Four Levels

Three Contexts

Organ(pathology)

Personal

Person(impairment))

Physical

Person in environment

Behavior (activities)

Social

Person in society

Social position (Participation)

Well-being

slide6

WHO ICF

20 y.o. wm with cerebral palsy

Lesions in the basal ganglia

Organ (pathology)

Person (impairment)

Spastic dysarthria 2° cerebral palsy

Person in environment

Behavior (activities)

Reduced intelligibility

Norman talks less; he eats alone at work, he has no friends; cannot use telephone well; he does not participate in workplace activities because people don’t understand him.

Person in society

Social position (Participation)

slide7

Introduce speech generating device

Person in environment

Behavior (activities)

Synthetic speech offers 100% intelligibility

Person in society

Social position (Participation)

Norman talks more and is really funny…he tells great jokes at lunch and has friends whom he eats with; he uses the telephone for work; now participates in workplace conversations.

what is assistive technology
WHAT IS ASSISTIVE TECHNOLOGY?

Devices, software, tools, and services that allow people who have physical and/or cognitive limitations to do tasks that would otherwise be significantly difficult for them to do.

  • Rick Creech, Augmented speaker and Resources Coordinator, PA Department of Education
tech act
Tech Act:
  • Technology-Related Assistance for Persons with Disabilities Act of 1998:
  • Assistive technology is “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 people with disabilities” [P.L. 100-407, 29 U.S.C. 2201, §3(1)].
a device
A Device:
  • Any item, piece of equipment, or system that increases, maintains, or improves the functional capabilities of people with disabilities.
  • A.T. devices help people function longer and better.
a service
A Service:

Assistive Technology without training is not assistive.

- Rick Creech, A.T. user and advocate

what is aac
WHAT IS AAC?

Augmentative and Alternative Communication refers to any strategy, technique or tool that enhances, replaces, augments or supplements an individual’s communication capabilities.

augmentative communication approaches
Speech

Vocalization

Gestures

Eye gaze

Body language

Sign language

Paper and pencil

Communication books

Communication boards and cards

Speaking computers

Talking typewriters

Voice output communication aids

Augmentative Communication Approaches
aac goals
AAC GOALS
  • Temporary means of communication
  • Lifelong means of communication
  • Means to facilitate re-development of communication
who is an aac user
WHO IS AN AAC USER?

Anyone whose communication is adversely affected by an impairment in speech, language, cognition, and/or physical abilities.

slide18

“Communication competence and the control it brings insures that patients will maintain the ability to guide, direct, and influence the management of medical and personal aspects of their lives.”

Yorkston, Miller, Strand, 1996

an expressive communication disorder

AN EXPRESSIVE COMMUNICATION DISORDER

A PERMANENT OR TEMPORARY INABILITY TO EXPRESS ONESELF WITH GESTURAL, SPOKEN OR WRITTEN MEANS BECAUSE OF PHYSICAL, COGNITIVE, &/OR LANGUAGE IMPAIRMENTS

BEUKELMAN & GARRET, 1988

physical impairments
PHYSICAL IMPAIRMENTS
  • Amyotrophic Lateral Sclerosis
  • Friedrich’s Ataxia
  • Brainstem Stroke (locked in syndrome)
  • Respiratory Insufficiency (intubation/ventilator dependency)
  • Spinal Cord Injury
  • Cerebral Palsy
physical and cognitive impairments
PHYSICAL AND COGNITIVE IMPAIRMENTS
  • Huntington’s Disease
  • Multiple Sclerosis
  • Closed Head Injury
  • Parkinson’s Disease
language impairments
LANGUAGE IMPAIRMENTS
  • Aphasia (usually Broca’s, anterior, or expressive aphasia)
  • Mental retardation/developmental disability
what is the aac evaluation
What is the AAC evaluation?
  • Needs and environmental assessment
    • Communication partners
    • Communication locations
    • Communication modes
    • Message needs
4 purposes of communication
4 purposes of communication
  • Express needs and wants
  • Information exchange
  • Social closeness
  • Social etiquette
the aac evaluation cont d
The AAC Evaluation cont’d
  • Language abilities
    • Language comprehension
    • Language production (vocabulary, grammar, morphology)
    • Spelling and writing abilities
    • Mechanics of writing
    • Speech function
  • Speech function
electronic devices
Electronic Devices
  • Speech generating devices (SGDs)
    • Synthesized speech output
    • Digitized speech output
  • Computers
    • Dedicated versus integrated devices
    • Adapted keyboards
    • Touch screens
    • Track balls and joysticks
4 components of sgd to consider
4 components of SGD to consider:
  • Processor
  • Interface or access method
  • Language system (or symbolic representation used for concepts)
  • Output
purpose of computer access
Purpose of computer access
  • Written communication (word processing)
  • Emailing
  • Vocation/employment
  • Telecommuting
  • Internet surfing
  • Telephoning
written communication options
Written communication options
  • Keyboard modifications
  • On screen keyboards
    • mouse access
    • head mouse access
    • single switch access
  • Rate enhancement techniques:
    • word prediction
    • abbreviated expansions (macros)
working while locked in
Working while locked in

Brain-computer interface

Cyber link

morse code
Morse Code
  • 2 switch option
slide46
Orthography
    • Spelling
    • Typing
    • Words & phrases
rate enhancement techniques
Rate enhancement techniques
  • Generating text with these techniques is

S…L…O…W…

Two techniques to enhance rate of production:

  • Word prediction
  • Abbreviated expansion
abbreviated expansions macros
abbreviated expansions (macros)
  • AAC = Augmentative and Alternative Communication
  • 3S = 3 spades
  • 3C = 3 clubs
  • 3H = 3 hearts
  • 3D = 3 diamonds
attention getting devices
Attention Getting Devices
  • Bicycle horns
  • Cow Bells
  • Battery Powered Doorbell
telephone options

Ameriphone XL25s Amplified Telephone with Outgoing Amplificationproduct #: 76563.000

The XL25s™ amplified corded phone, by Clarity®, features Clarity® Power™ technology to make words not only louder, but also clearer and easier to understand. The XL25s™ provides up to 18 decibels of outgoing voice amplification, making it an ideal solution for those with low speech or a mild-to-moderate hearing loss. $99.00

Telephone Options

Available through

PUC TDAP: Telecommunication

Device Access

Program

[email protected]

TTY and

Oregon Relay System

Speakerphone with SGD (available through PUC TDAP)

voice amplification options
Voice Amplification Options

Microphone

attachments

ChatterVox voice amplifier

JustAMP or JusTalk

JustMED, Inc.

503-524-4223

Voicette and Mini-Vox from Luminaud

hard copy print out
Hard copy print out

Mayer-Johnson Writing with Symbols

lcd screens
LCD screens

Saltillo Chat PC-M3

Assistive Technology, Inc LINK, Mercury

digitized speech devices

Bluebird

MightyMo/MiniMo

Digitized Speech Devices

Macaw Family (9 +minutes)

Chat Box

speech output
Speech Output

Synthetic speech

Dynavox VMax

PRC Pathfinder

Lightwriter SL40

talking computer
“Talking computer”
  • Next Up Talker
  • Many voices
  • Download program from Internet for $99
  • Speaks out everything written on screen
  • www.talkforme.com
talking typewriters

“Talking Typewriters”

DynaWrite

Lightwriter SL35

Proloquo2go

speech recognition
Speech recognition
  • Dragon-Naturally Speaking
  • Must have consistent speech production
  • Mild-moderate dysarthria is adequate for controlling computer with speech input.
the dilemma what comes first the a t or the job

Assistive

Technology

The Dilemma: What comes first? The A.T. or the job?

Employment Opportunities

The vicious cycle

Worksite

Participation

Assistive

Technology

who are employed aac users
Who are employed AAC users?

Stephen Hawkings, physicist

Michael Williams, author and journalist

Andy Owens, Inventory specialist at Powell’s Books

India Ochs, Civil Rights Attorney

don t be left in the middle of the lake without any paddles
Don’t be left in the middle of the lake without any paddles!

AAC offers you the tools to enter, continue or return to the workforce.

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