1999 Conference Proceedings

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Nancy B. Robinson, Ph.D., CCC-SLP
California State University, Chico
Speech Pathology and Audiology Department
Chico, CA 95929-0350
ph: (530) 898-6848

With rapid changes in technology and telecommunication, professional training programs in speech-language pathology/audiology, special education, physical and occupational therapy, rehabilitation, and related fields are faced with the challenge to train professionals to assist people with disabilities to access technology more effectively. For individuals who are non-speaking or who have limited verbalexpression, increased professional expertise in augmentative and alternative communication (AAC) systems is needed. Access to AAC systems requires that individuals with disabilities not only can acquire needed equipment but that professionals are available to identify and develop appropriate systems. Due to their specialized knowledge in communication disorders and linguistic development, speech-language pathologists are increasingly called on as members of the professional team to develop and authorize purchase of AAC devices. However, the knowledge and skill required to design appropriate AAC systems for individuals requires more training than is currently provided in many pre-professional training programs.

Augmentative and Alternative Communication (AAC) is taught in many forms in professional training programs, including stand-alone courses, as a subcomponent of assistive technology courses, and as special features within courses offered in departments of speech-language pathology, special education, and related fields. The rapidly changing field of assistive technology and specifically, AAC, clearly requires that students acquire a working knowledge of the range of devices available including dedicated devices; computer hardware and software; peripheral adaptations and switches; symbol sets and languages; multi-media equipment; and low-technology products. In addition to skills to use AAC devices, the application and design of appropriate systems with individuals requires critical thinking and problem solving skills. The case study method is often used in AAC teaching in order to provide students the opportunity to apply what they have learned regarding the range of available devices and equipment.

This presentation will focus on the development of new course at CSU Chico in Augmentative and Alternative Communication in the Speech Pathology and Audiology Program, to be offered in the Spring Semester, 1999. The course is planned to not only increase the knowledge of speech pathologists in AAC but to accomplish two additional goals: 1) develop problem-solving skills in the design and application of appropriate AAC systems based on the communicative and linguistic needs of individuals who are non-speaking or who have limited verbal expression; and 2) promote team work among speech-language pathologists and related services professionals in the design and application of AAC systems. The format of the course is designed to apply widely used types of AAC devices, computer hardware, software, media, and adaptive equipment through several case studies that include people in the surrounding community who currently use or require an AAC device.

The individuals who are identified to participate in the course were selected to represent a wide range of ages, abilities, and needs in the uses of AAC devices. In addition, family members and community professional team members are to be included in the case-study presentations and problem-solving approach to teaching employed in the course. The development of each case and the implementation within the course structure forms the core of the presentation and will proceed as follows:

The case study method applied in the course is referred to as "People-Focused Learning" and is based on several years of work that the author implemented with colleagues at the Center on Disability Studies at the University of Hawaii. In the Hawaii model, the curriculum approach was referred to as "Family-Focused Learning" and involved family members of children with disabilities who participated as "teaching" families in partnership with faculty in an interdisciplinary training program for health professionals (Tada, 1997). Through the use of videotaped interviews and meetings with the students, family members related their experiences in meeting the needs of a child with a disability.

The adaptation of the model to AAC required a shift to focus on individuals using AAC devices while also including family and team members, thus the "People-Focused Learning" approach. The PFL approach is essentially a problem-based curriculum model that promotes critical thinking and active learning among students with a central focus on the individual who uses an AAC system and the issues related to the design, development, and implementation of the system across a variety of daily environments and communicative partners. The PFL approach to teaching AAC requires extensive preparation and development prior to presentation in class sessions for faculty and the individuals involved. The interactive model and learning outcomes for students are considered effective, although further evaluation is needed. The process in the development and presentation of each case is described briefly in the following paragraph.

The design and implementation of the PFL process involves four phases, a) preparation of background material with the individual, family and team members; b) presentation of the individual's story; c) student presentations of research related to selected learning issues; and d) meeting with the individual, family and team members. Each phase requires ongoing interaction with the individual and support team in the community (including family members).

In the first phase, preparation of the individual's story requires discussion and meeting with the faculty member, individual, and support team to determine the current use or potential need for an AAC system. Individuals and support team members are interviewed to determine the issues that they wish to share with students, related to the use of AAC in their daily lives. After approximately two-three informal meetings, a videotaped interview is developed that highlights key issues and uses of AAC in natural environments. Video taped material is transcribed by the faculty member and edited prior to presentation in class, to assure that the individual and support team agree and determine the issues that are shared. Presentation of the individual's story includes video and written material that is discussed with students in an "opening session".

Faculty presents material initially and then provides a facilitative role for student discussion and learning. Students are provided opportunities to identify the major issues, strengths, and needs identified by the individual and support team regarding the AAC system. The faculty member guides the students to then define areas that require further research and resources in the design, further development or use of the individual's AAC system. For example, areas of student research are related to the needs expressed by the individual and may include evaluation of the appropriate linguistic level of the current AAC device or system, aspects of financing and payment for devices, communicative partners available to the individual, and family and support team roles.

Following an interval of approximately two weeks, students are required to present findings related to their selected learning issues related to the AAC system for a given individual. The format of student presentations includes a brief written description of the work completed, an oral presentation, and visual display of AAC materials (as appropriate). Faculty and fellow students provide feedback and discussion for each student and materials are revised accordingly. Following completion of revisions, materials are shared with the individual and support team members.

A final session involves meeting with the individual, family and support team members to discuss the results of students' research and resource identification. Feedback is invited in a "dialogue" format between students, the individual, family, and support team members regarding the feasibility of the students' research and suggestions. The role of the faculty in this session is to facilitate discussion between all participants in order to identify possible next steps regarding the ACC device and system for each individual involved. The effectiveness of the problem-based model as a teaching method for AAC, particularly in speech-language pathology will be shared and discussed with participants of this session. Evaluation data to be collected to date will include feedback from individuals, family members, professionals, and students.


Tada, W. (1997). MCH LEND Curriculum Development: Family-Focused Learning (FFL): An inquiry-based learning model using family stories. Center on Disability Studies, University of Hawaii. Unpublished manuscript.

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