AAC
SERVICE DELIVERY SOFTWARE AND RESOURCES
Presenter(s)
Barry Romich, P.E.
AAC Institute
Telephone: (330) 262-1984 x211
Fax: (330) 263-4829
Email: bromich@aacinstitute.org
Presenter
Katya
Hill, Ph.D., CCC-SLP
Communication Science and Disorders
School of Health and Rehabilitation Sciences
Forbes Tower
University of Pittsburgh
Pittsburgh, PA 16444-0001
Pittsburgh, PA 15260
Telephone: (412) 383-6564
khill@shrs.pitt.edu
Children and adults who rely on AAC
(augmentative and alternative communication) receive services from speech-language
pathologists (SLPs), occupational therapists (OTs), physical therapists (PTs),
teachers, engineers, and other service providers. These professionals are
now expected to provide services in accordance with the principles of
evidence-based practice (EBP). (ASHA 2001)
Two types of evidence are used in EBP service
delivery: external evidence and personal evidence. External evidence is
comprised of research reports, case studies, and even informal anecdotal
evidence. However, evidence can be conflicting and thus sometimes needs
to be compared. Judgments must be made regarding the reliability,
validity, relevance, age, and other characteristics of evidence. A free
and easy to use source of evidence is the web site of the AAC Institute, a
not-for-profit charitable organization dedicated to the most effective
communication for people who use AAC. At the site, evidence is divided
into five levels and into categories according to single subject vs. group
research. The further distinction is made between studies in which
subjects were actual users of AAC and those studies in which the subjects
pretended to use AAC for the study. External evidence helps establish the
vision for the future that one needs to have when providing services.
The foundation of personal evidence goes beyond
the identification of the values and expectations of an individual and includes
a thorough appreciation of the person’s abilities and needs. The best
foundational personal evidence includes the collection and analysis of language
samples. Many AAC systems today have language activity monitoring (LAM)
(Hill & Romich 1999, 2001) as an internal
feature. LAM records the time and content of language events as they are
generated. However, language samples can be collected from any speech
output AAC system using U-LAM (Universal Language Activity Monitor) PC
software. Further, U-LAM provides for recording keyboard notations as
part of the time-ordered record. U-LAM is available for both PC and PocketPC.
Analysis of LAM data can result in the AAC
Performance Report, a set of seventeen quantitative summary measures of
communication performance. (Romich, et.al. 2003) The AAC Performance Report can be easily
generated using PeRT (Performance Report Tool)
software. The report appendices also include frequency and alphabetic
order word lists from the language sample.
Comparison of external and personal evidence can
be useful in determining the current status of communication performance for an
individual. Performance data provides the evidence for a critical
appraisal of the outcomes achieved among the AAC systems used during a trial
process. Therapy time is precious for people who use AAC.
Comparison of external and personal evidence can identify those areas
needing attention most and those not needing attention. Therapy plans can
then be developed accordingly.
Communication rate is important to people who
use AAC. One of the factors affecting communication rate is selection
rate, the speed of making selections on the AAC system. For most people,
direct pointing is the fastest way to access an AAC system. Selection
rate is one of the summary measures of the AAC Performance Report. By
measuring selection rate for different selection techniques, the technique that
produces the best results can be chosen objectively.
When the individual must access the system using
a single switch it is important that the switch be the most effective possible.
This means choosing the right switch, placing or mounting it properly, and
training in its use. (King 1999)
Single Switch Performance Test (SSPT) is a
clinical tool to facilitate the measurement of performance using a single
switch. (Liffick 2005) SSPT is software
to allow a PC to be used to practice switch use and collect switch use data.
SSPT measures three parameters: 1) time to activate the switch, 2) time
to release the switch, and 3) speed of repeated switch
activation. The opening screen allows the selection of background
information and also the specific test to be administered. Stimulus is
provided by the computer and can be visual and/or auditory. The switch is
connected to the computer using a modified mouse with a jack in parallel with
the mouse button switch. This program is a free download from the AAC Institute
web site.
Many people who use AAC also use their AAC
systems for computer access. Reasons include physical access issues and
the availability of more powerful language representation methods. In the
past, computer and operating system manufacturers included a feature called
Serial Keys to allow data entering the serial port to emulate the keyboard and
mouse. Macintosh OSX no longer offers this feature. Serial Keys
began to deteriorate in Windows98. AAC Institute now offers AAC Keys for
both platforms as a free download. (Donations are appreciated and
contribute to ongoing initiatives.)
These and other resources are available free,
with a donation, or at low cost (<$100) from AAC Institute. Use of
these resources can result in optimized communication performance for people
who use AAC. This in turn can lead to the best life experience possible
for this population.
References
American Speech-Language-Hearing Association
(ASHA). (2001). Scope of Practice.
Hill, K., & Romich
B. (1999). AAC
language activity monitoring and analysis for clinical intervention and
research outcomes. In Proceedings of the C-SUN
Conference.
Hill, K., & Romich,
B. (2001). A Language
Activity Monitor to support AAC evidence-based practice. Assistive
Technology, 13, 12-22.
King, T. (1999). Assistive technology:
essential human factors.
Liffick,
B., Romich, B., Hill, K. (2005) “ A
Single Switch Performance Evaluation Tool." Proceedings
of HCI International 2005 Conference.
Romich, B., Hill, K., Seagull, A., Ahmad, N., Strecker, J., & Gotla, K
(2003). AAC performance report tool. In
Proceedings of the RESNA 2001 Annual Conference [CD-ROM].
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