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Effect of late-onset AAC/PODD Intervention in a 17 year old student with Cerebral Palsy. Isphana Al Khatib, Premila Chandrasekaran, Tanuka Gupta and Deepika Gopalarao Al Noor Training Centre for Children with Special Needs Dubai. Augmentative and Alternative Communication.

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effect of late onset aac podd intervention in a 17 year old student with cerebral palsy

Effect of late-onset AAC/PODD Intervention in a 17 year old student with Cerebral Palsy

Isphana Al Khatib, Premila Chandrasekaran, Tanuka Gupta and Deepika Gopalarao

Al Noor Training Centre for Children with Special Needs

Dubai

Rehab 2010, Dubai

augmentative and alternative communication
Augmentative and Alternative Communication

Augmentative and Alternative Communication (AAC) is an area of clinical practice that attempts to compensate for the severe impairments in communication that non-verbal individuals have in meeting their daily communication needs.

Rehab 2010, Dubai

aac and uncrpd
AAC and UNCRPD

Article 2

“Communication” includes languages, display of text, Braille, tactile communication, large print, accessible multimedia as well as written, audio, plain-language, human-reader and augmentative and alternative modes, means and formats of communication, including accessible information and communication technology

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partner assisted communication
Partner-Assisted Communication

Communication is a two-way process

“Smart” partners

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slide6

Pragmatic Organization Dynamic Display (PODD) as Partner-Assisted Communication

PODD is a multi-level communication book

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podd key organizational features
PODD- Key organizational features
  • Vocabulary organization
  • Pragmatic branch starters
  • Taxonomic, topic and anecdote organizations
  • Incorporating individual requirements

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podd key partner related features
PODD-Key partner-related features
  • One single response
  • Have limited physical control
  • Flexibility in the pace and responsiveness
  • To predict and use the system more efficiently.

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aim of our case study
Aim of our Case Study

To study the effectiveness of use of late-onset AAC/PODD intervention on the range of communication functions and social interactions on a 17 year old student with Cerebral Palsy

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case history
Case History
  • VK, a 17-year old adolescent with a diagnosis of Spastic Quadriplegia
  • Physical condition
  • Hand function: severely restricted

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case history12
Case History
  • VK’s hearing and vision are within the normal range of functioning.
  • Visually responsive and this sensory modality is one of his strengths.
  • Keen observer and responds well to people.
  • Able to communicate yes/no

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rationale for selection of podd
Rationale for selection of PODD

The selection of PODD was determined by

  • Severity of his physical challenges
  • Pre requisite conditions of use of eye gaze
  • Yes/no responses
  • Sight words to access PODD
  • Pragmatic organization of the tool i.e. PODD
  • Social responsiveness
  • Lack of funding required to procure the eye gaze equipment aided the decision of the selection of PODD.

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methodology
Methodology

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preparation
Preparation
  • Consent letter to secure parental approval
  • Multiple sources of data collection
  • Trans-disciplinary assessment
      • Eye pointing is the main modality for communication.
      • Advanced receptive language
  • An orientation on the use of AAC strategies to parents

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baseline assessment physical status
Baseline assessment- Physical Status

Seating: customized wheelchair which can be reclined and has firm hip straps to maintain appropriate seating posture

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creation of podd
Creation of PODD
  • Use of Boardmaker
  • Scaffolding of PODD
  • Different versions

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slide20
PODD

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slide21
PODD

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steps in training
Steps in Training
  • Duration of Training: 22weeks
  • Familiarization process: 2 weeks
  • Routines
  • Different communication partners

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training record
Training record

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social networks inventory social interaction
Social Networks Inventory: Social Interaction

Additionally there has been a significant increase in the frequency, effectiveness and efficiency in the use of the non-electronic communication board/PODD

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circles of communication partners
Circles of Communication Partners

Pre-Training

Post-Training

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observations
Observations

Observations indicate an enhancement in

  • Frequency and quality of communication
  • Communication repertoire
  • Initiation of communication with adults
  • Frequency of requesting, describing and commenting
  • Emotional maturity

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conclusion
Conclusion

These observations indicate that despite late-onset intervention, improvements in functional communication and social interaction can be brought about by the use of partner-assisted communication strategies such as PODD.

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implications for further research
Implications for further research
  • Use of PODD on different clinical populations
  • Longitudinal studies on larger number of cases to study the effectiveness of PODD
  • Examining the effectiveness of PODD on specific aspects of communication and literacy

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references
References
  • Allaire, J.H., Gressard, R. P., Blackman, J. A., &Hostler, S. L.(1991). Children with severe speech impairments: Caregiver survey of AAC use. Augmentative and Alternative Communication, 7, 248 – 255.
  • Blackstone, S. (1995). AAC outcomes. Augmentative Communication News, 8(1).
  • Calculator, S. N. (1988). Evaluating the effectiveness of AAC programs for persons with severe handicaps. Augmentative and Alternative Communication, 4, 177 – 179.
  • Culp, D. M., Ambrosi, D. M., Berniger, T. M., & Mitchell, J. O. (1986). Augmentative communication aide use – A follow-up study. Augmentative and Alternative Communication, 2, 19 – 24.
  • Goossens’, C. (1989). Aided communication intervention before assessment: A case study of a child with cerebral palsy. Augmentative and Alternative Communication, 5, 14 – 26.
  • Kraat, A., & Brune, P. (1997, November). Getting from here to there: Lessons from ‘Miles’. Paper presented at the American Speech Language Hearing Association, Boston, MA. 

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references33
References
  • Porter, G. and Kirkland, J. (1995) Integrating Augmentative and Alternative Communication into Group Programs: Utilising the Principles of Conductive Education. Melb: Spastic Society of Victoria
  • Porter, G., Kirkland, J. & Dunne, L. (1996) Developing Functional use of AAC within holistic group programs. Paper presented at the ISAAC conference: Vancouver, Canada.
  • Porter, G. (1997) Observational assessment forms (printed in, Department of Education. (2001). Students with physical impairment: Augmentative and alternative communication. Brisbane, QLD: Author
  • Porter, G., Kirkland, J. & Dunne, L. (1998) Multi-level communication books. Poster presented at the ISAAC conference: Dublin, Ireland.
  • Porter, G. (2000) Low-Tech Dynamic Displays: User friendly Multi-level communication books. Paper presented at the ISAAC conference: Washington, USA.
  • Porter, G. (2000) Ideas for the design of low- tech dynamic displays: User friendly, multi-level communication books. (Printed in Department of Education (2001) Students with physical impairment: Augmentative and alternative communication. Brisbane, QLD: Author.)

Rehab 2010, Dubai