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A ugmentative C ommunication E valuations S implified: ACES Tools & Resources. Debby McBride, MS, CCC-SLP Presented by AAC TechConnect Inc. Lisa Bardach, MS, CCC-SLP Tanya Curtis, MS, CCC-SLP Libby Rush, MS, CCC-SLP (contributions in content & resources).

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a ugmentative c ommunication e valuations s implified aces tools resources

Augmentative Communication Evaluations Simplified: ACES Tools & Resources

Debby McBride, MS, CCC-SLP

Presented by AAC TechConnect Inc.

Lisa Bardach, MS, CCC-SLP

Tanya Curtis, MS, CCC-SLP

Libby Rush, MS, CCC-SLP

(contributions in content & resources)

purpose
Purpose

To give people their VOICE

Because we all have something to say!

what is augmentative alternative aac communication
What is augmentative /alternative (AAC) communication?
  • Refers to the incorporation of techniques that can be used to help individuals with disabilities in general, as well as to very specialized technologies designed specifically for individuals with significant and severe disabilities. These techniques include, for example, the use of communication symbols, aids, strategies, skills, and devices designed to assist disabled individuals. (Sarah Blackstone; 1986)
aac communication includes
AAC communication includes
  • Nonverbal
  • Vocalizations
  • * Low-tech or no-tech
  • * Lite-tech
  • * High-tech
goals include
Goals include:

Your goals for this workshop

Write 3 ( on the back of your evaluation form)

*

goals include1
Goals include:
  • Explain the process of obtaining an AAC tool/device
  • Describe tools/techniques used to determine the AAC candidate’s skill
  • Complete many of the components with templates provided for gathering, compiling and reporting the results.
  • Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)
  • Identify local resources and consultants for trials, support, and funding assistance for AAC devices.
a systematic approach for aac evaluations
A Systematic Approach for AAC Evaluations
  • ACES Module

Augmentative

Communication

Evaluation

Simplified

  • Toolkit List
  • Forms for summarizing evaluation information
    • Individual skills
    • Device Features
tools and resources you will leave with
Tools and Resourcesyou will leave with:
  • ACES Module (handouts & on CD)
    • A Toolkit List
    • The Communicator
    • Device Features
    • Other Considerations
    • Resources on CD
    • Handouts (including the above)
    • AAC device flyers
    • Templates
    • Other resources
    • Websites: free resources
aac evaluations challenges
AAC Evaluations - Challenges

Availability of systematic assessment protocols

Acquire premade materials/resources (vocabulary, overlays, etc)

Not organized / equipment available when needed / working when needed

Training ???

Knowledge???

Experience???

Keeping up with technology

Overwhelming ? ? ?

process beginning to end
Process – Beginning to end

Person

  • Referral
  • Gathering information
  • Deciding on skills to assess
  • Choosing the “toolkit items” used
  • Evaluating the individual's skills (sensory, physical, language, communication functions/needs, etc.)
  • Summarizing individual’s skills
process continued
Process continued

Communication Tools / Devices

  • Matching skills to communication tools

(feature - matching)

    • Voice / no voice
  • Trialing communication tools / voice output devices
  • Making recommendations
  • Writing appropriate documentation
  • Completing funding paperwork as needed
  • Use of your equipment reps
evaluation
Evaluation
  • Who are they?
  • What do they want to say?
  • Where do they want to say it?
  • How do they want to say it?
  • What are their current skills?
  • What technology can bridge the gap?
feature matching
Feature Matching –

Determine what the individual needs, then find the technology with the requisite features and match the technology to communicator.

SDT

level of communicator
Level of communicator
  • Emerging
  • Context/Partner Dependent
  • Independent
emerging
Emerging

No RELIABLE means of EXPRESSIVE communication through SYMBOLIC language

  • Have some functional non-verbal communication (gestures, vocalizations, other nonsymbolic communication)
  • Able to attend, even briefly, to individuals, conversations, pictures, or symbols
  • Yes/no (acceptance/rejection) depicted with body language; i.e. no reliable yes/no for more complex communication
context or partner dependent
Context- or Partner-Dependent

Has SYMBOLIC communication that is RELIABLE

but limited to particular CONTEXTS or PARTNERS

  • Rely on partners to provide limited response set
  • Need frequent instruction and cueing
  • Difficulty with initiation
  • May only be functional in particular settings
  • Wide range with regard to # of partners and # of settings
independent generative
Independent (Generative)

Can communicate ANYTHING on ANY TOPIC to ANYONE in ANY CONTEXT

  • Locate, select, and convey messages on their own
  • Can interact with familiar / unfamiliar partners equally well
  • Can sequence symbols or letters to generate novel messages
scanning options
Scanning options
  • Auditory / visual
  • Linear / row-column / group
  • Step / inverse / auto
  • Other
video
Video
  • Questions ? ? ? ? ?
evaluation1
Evaluation -

What’s in your toolkit?

What do you currently use?

gathering your toolkit
Gathering your Toolkit
  • Help you organize what you have - toolkit list
  • Help you decide what to add to your resources
  • Give you additional ideas for premade materials / resources
  • Give you additional resources you can access:
    • CD
    • AAC TechConnect- web
the evaluation toolkit
The Evaluation Toolkit

Toolkit #1: Low-to Lite-tech Tools

Toolkit #2: Digitized devices

Toolkit #3: Computer & accessories to emulate variety of communication devices (evaluation ONLY)

let look at some examples
Let look at some examples
  • TOOLKIT #1 – “Lite – Tech” components
low tech physical access components
Low-tech physical access components
  • Keyguard
  • Pointing light
  • Partner Assisted Scanning
  • Eye gaze
  • PECS
  • Positioning (motor – visual)
switches accessories
Switches & accessories
  • Variety of switches
  • Switch interface
  • Switch mount
toolkit 1continued lite tech components
TOOLKIT #1continued – “Lite – Tech” components
  • Battery adaptor
  • Array of Switches
  • Switch Interface
  • Switch activated devices (toy or fan or vibrating Pillow) . . . . .
  • Switch Mounting system
switch computer application
Switch Computer Application
  • RJ Cooper
  • Linda Burkhart
  • Marblesoft/Simtech
  • Judy Lynn
voice output does it make a difference
Voice output – does it make a difference ? ? ?
  • Single message sequential communicator
  • Multiple message communicators

(progressive message key setups)

  • Consider ones with levels
simple voice output w sequencing capabilities
Simple voice output –w/ sequencing capabilities
  • Single message communicators

(Sequencers, Step-by-Step, etc.)

progressive communicator digitized device s
Progressive Communicator- Digitized device(s)
  • Start simple – 2 pictures
  • Add more pictures
  • Has levels
  • Direct select
  • Recorded speech (voice)
  • Uses overlays
simpler voice output devices
Simpler voice output devices

Digitized Devices & Accessories

others in your closet
Others in your closet
  • Macaw
  • Message Mates
  • ChatBox
  • Others? Any of these?
toolkit 3 higher tech
Toolkit #3 - “Higher Tech”
  • Laptop or tablet computer
    • (convertible laptop optimal)
  • Add communication software
    • Emulate devices (large, medium, small)
  • Accessories
    • Touch Screen (not just with pen)
    • Switch interface
software
Software
  • Emulate the devices
  • 3rd party software which does the following:
    • Make various configuration of overlays
    • Able to link them together to evaluate navigation
    • Can do scanning of all types
    • Spelling (word prediction) - optimul
software for purchase
Software for purchase
  • Tobii Communicator (Tobii ATI) - $599 -
  • SayIt! Sam Software (Words +)-$1395
  • Speaking Dynamically Pro (Mayer Johnson)-
  • The Grid (Sensory software)
    • others
  • Boardmaker Plus (Mayer Johnson)
  • Overboard (Gus)
free software demos
Free software/ demos
  • Manufacturers (some examples)
    • Series 5 Semesterware (DynaVox)
    • PASS software (Prentke Romich)
    • SayIt! Sam (Words+)
    • EZ keys (Words+)
    • Overboard (GUS)
what do you have
What do you have?

or

What do you think you may

need / want?

aces module your tools resources
ACES Module: Your Tools & Resources
  • Toolkit components: communication tools to have at your fingertips (in the bag)
  • Premade evaluation materials / resources

m( in the book)

  • Templates / resources to complete paperwork

(on CD and on the web)

  • Resources to make decisions on devices

( On web)

evaluation materials resources
Evaluation Materials/Resources
  • Materials
    • Objects
    • Pictures
    • Premade overlays / pages
      • Low tech (communication boards)
      • Lite tech (overlays for digitized devices)
      • High tech (pages for dynamic display options)
no tech symbols
No-tech symbols
  • Objects
  • Photos
  • COPPS
  • Pictures
  • Overlays
  • Visual scenes
  • Alphabet

boards

symbols and premade materials
Symbols and premade materials
  • Make your own
  • Purchase other resources
  • Examples of Evaluation Assistant
pre made pics overlays
Pre-made pics/overlays
  • What do you use?
  • Examples include various sizes (size of message key and #’s of keys)
  • Various communication functions
  • Dynamic display (low tech example)
  • Sizes example
slide67

TALKING MY WAY

Talking My Wya

slide72

The Test of Aided-Communication Performance (TASP)

  • by Joan Bruno, Ph.D., CCC-SLP

A tool for the assessment of symbol-based communication skills.

Includes subtests on symbol size and number, grammatical encoding, categorization and syntactic performance.

Results may help determine AAC intervention strategies and goals.

Provides starting point for designing communication boards or selecting a page for an AAC device.

alphabet boards
Alphabet boards

Alphabet/Spelling

  • Alphabet boards
  • Keyboard arrangements
    • ABC
    • QWERTY
    • Frequency of occurrence
  • Grammar based boards
aces module your tools resources1
ACES Module: Your Tools & Resources
  • Toolkit components: communication tools to have at your fingertips (in the bag)
  • Premade evaluation materials / resources

( in the book)

  • Templates / resources to complete paperwork

(on CD and on the web)

  • Resources to make decisions on devices

( On web)

symbols
Symbols
  • Objects
  • COPPS
  • Photos
  • Pictures
  • Words
  • Letters
  • Media

(video clips, etc.)

language representation
Language Representation
  • Single meaning pictures
  • Semantic Compaction
  • Alphabet / spelling
  • Visual scenes
  • Phrase-based
  • Grammar-based boards
semantic compaction
Semantic Compaction
  • Multi-meaning pictures
  • Less key strokes (in sequencing) – faster
  • Motor memory
  • Icon prediction
  • Activity row – picture prediction
alphabet boards1
Alphabet boards

Alphabet/Spelling

  • Alphabet boards
  • Keyboard arrangements
    • ABC
    • QWERTY
    • Frequency of occurrence
navigation page changes
Navigation / page changes
  • Facilitator/communicator changes pages
  • Number of pages required (few-many)
  • Static display # of pages
  • Dynamic display navigation skills
keyboard options
Keyboard options
  • Built – in keyboard (integrated)
  • Onscreen keyboard – W+
  • Plug-in keyboard (external)
  • Convertible-style tablet
voice speech
Voice / speech
  • Synthesized (synthetic)
  • Digitized
  • Other language needed
    • Pre-recorded
    • Spelling
type of device
Type of device
  • Dynamic display (small/med/large)
  • Integrated (dynamic display as computer)
  • Text-to-speech (attached keyboard)
  • Digitized (static display with overlays)
types of devices to consider
Types of devices to consider
  • Dynamic display
  • Integrated systems
  • Text – to – speech
  • Digitized
  • Simpler digitized
  • Single message communicators
dynamic display
Dynamic Display
  • Multiple pages
  • “Navigate between pages”
  • Variety of symbols available
  • Both types of speech (digitized & synthesized)
  • Possible to use generative language
  • Offers more options for alternative access
integrated system
Integrated System
  • Multiple pages
  • “Navigate between pages”
  • Variety of symbols available
  • Both types of speech (digitized & synthesized)
  • Includes computer components
digitized
Digitized
  • Simpler communication needs
  • Recorded voice
  • Use of pictures
  • Multi lingual

Most of them have:

  • Paper overlays that are changed
  • Also called “static display”
text to speech
Text to Speech
  • Mainly spelling (keyboard and some have scanning)
  • Most have built-in keyboards
  • Mostly synthesized speech, though few have digitized speech
device functions access
Device functions / access
  • Use access to on / off
  • User access to volume
  • User access to programming
  • ECU’s
  • Internet access / browsing
  • Computer applications
  • Camera
  • Phone
  • Text messaging
  • Email
  • Printer
rate enhancement
Rate enhancement
  • Pre-store messages
  • Prediction (word, letter, picture, symbol, character, phrase) **
  • Abbreviation – expansion
  • Pre-made vocabulary options
  • Grammar-based boards **
  • Word morphology (word endings, verb tenses, etc.)
message formulation
Message formulation
  • Single key messages
  • Routine phrases
  • Novel sentences
  • Novel thoughts / ideas
message button
Message button
  • # of keys per page
  • Size of keys
  • Need for variety (progressive)
message feedback
Message feedback

Action

  • Click (auditory)
  • Color changes (visual)
  • Zoom / enlarge (visual)
button selection method features
Button / selection method features
  • Touch enter / exit
  • Hold time
    • Direct select
    • Headpointing
    • Eyegaze
  • Auditory “fishing”
  • Scanning
message display
Message display
  • Words
  • Pictures
  • Speak each word / sentence
  • Speak on demand / punctuation
  • Highlight each word as it speaks
  • Silent mode
screen size size of device
Screen size / size of device
  • Small – handheld size
  • Small – medium 7” screen
  • Medium - 8.4” screen
  • Large – 10.4” + screen (mounted?)
premade vocabulary
Premade vocabulary
  • Language representation
  • Progression
  • Individualizing
    • Smaller vs. larger vocabulary needs
  • Ease of navigation
  • Ease of learning (for user and communication partners)
grammar based software
Grammar Based Software
  • WordPower

(Most manufacturers)

  • Picture Word Power
    • (Most manufacturers)
  • Wordcore (PRC)
  • InterAAACT (Dynavox)
  • SpeechPro (Gus)
  • AlphaCore (Dynavox) d
aces module templates provided
ACES Module (templates provided )
  • Gather information (Case history)
  • Record evaluation results (Assessment summary)
  • Device decision-making (Device assistant)
  • Write report (report)
  • Funding (work with vendor)
pre assessment preparation
Pre-Assessment Preparation
  • Obtaining previous reports, evaluations and supplemental information (on CD)
    • Case History
    • Intake
evaluation notes
Evaluation Notes
  • Form to provide consistent means of recording information during the evaluation session
  • Use of form helps to promote an organized method for keeping work records
  • Mechanism to measure progress
    • Assessment Summary
    • Intake form with notes
    • * * * * * *
device selection
Device Selection
  • Which Device to Choose ? ? ? ?
additional features to know
Additional Features to know
  • Accessories required (list on CD)
  • Medicare version required (Insurance)

website: www.aacfundinghelp.com (web list on CD)

  • Cost
  • Size / weight
  • Etc.
decision making
Decision-making
  • Alphabet / Spelling
    • Keyboard (Text to speech)
    • And/or onscreen keyboard (Dynamic display - tablet style)
  • Pictures / spelling
    • Dynamic display
  • Pictures / spelling with computer components
    • Integrated systems
decision making continued
Decision-making continued
  • Pictures only –
    • Static display (digitized) vs Dynamic display

vs integrated system

      • Number of pictures
      • Number of pages
      • Types of pictures
      • Changing levels (user vs. facilitator)
      • Ease of programming
single message communicators
Single message communicators
  • Replays one message at a time
  • Recorded speech
  • Some can do multiple messages (repeats different message each time you select it)
  • Some can do different levels / situations
no tech
No tech
  • Use as primary communication
  • Secondary communication
  • Backup communication
  • Evaluate benefits of voice output
    • Individual
    • Communication partners
    • Motivation
how do you proceed
How do you proceed?

. . . . . Know user’s skills

. . . . .now what?

funding
Funding
  • www.aacfundinghelp.com
  • 3rd party medical funding (Medicaid, Medicare, Private Insurance)
  • Medicaid Available
  • Educational or Vocational

or Independent living

  • Private pay or donations

(Used equipment)

  • Work with your local device representatives
device selection options
Device Selection Options
  • Catalogues
    • AAC TechConnect – contact manufacturers
  • Manufacturer websites
    • Go to individual ones – AAC TechConnect has list
  • AAC TechConnect – free resources
    • Pictures (thumbnails of 100+ devices)
    • Free flyers
www aactechconnect com1
www.aacTechConnect.com
  • Low cost information resources
  • Lite Tech Low Cost Chart
    • AAC TechConnect
    • $14.95 (online with credit card)
  • Device Assistant
    • Free trial – 14 days
    • Fee – for – service after that
trialing equipment
Trialing equipment
  • Loan equipment
  • AT centers
  • Vendors – local resources
  • Manufacturers
  • Rental options
explore programming of the device
Explore Programming of the device
  • Try the actual programming – see how it feels
    • Edit button; make page; link pages
  • Communication partners need to feel comfortable with the programming
  • Sales representatives can assist
  • Ask what support options include (including on-line support)
do you
Do you . . .

Have some new strategies to try?

Have some things in your closet you will dig out for use?

review goals
Review goals
  • Suggestions for next time?
  • Please put on your eval form.
did we
Did we:
  • Explain the process of obtaining an AAC tool/device
  • Describe tools/techniques used to determine the AAC candidate’s skills
  • Complete many of the components with templates provided for gathering, compiling and reporting the results.
  • Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)
  • Identify local resources and consultants for trials, support, and funding assistance for AAC devices.
thank you
THANK YOU

for helping others

To get

The best choice

For the best voice

slide154
Contact us at:

Debby McBride, MS, CCC-SLP

866.4U.AAC.RXinfo@aacTechConnect.com

www.aacTechConnect.com866/482-2279 or 303/674-8553