AAC LANGUAGE SAMPLING YIELDS THE BEST RESULTS
Barry Romich, P.E.
Telephone: (330) 262-1984 x211
Fax: (330) 263-4829
Katya Hill, Ph.D., CCC-SLP
Communication Science and Disorders
School of Health and Rehabilitation Sciences
University of Pittsburgh
Pittsburgh, PA 16444-0001
Pittsburgh, PA 15260
Telephone: (412) 383-6564
The purposes of this presentation are 1) to raise awareness of the availability of new methods and tools for supporting AAC evidence-based practice and 2) to demonstrate the practicality of using these resources in routine clinical practice.
For children and adults who use AAC, their life experience is and will be a function of their ability to communicate. People who use AAC tell us that the two most important desires in their use of AAC are 1) saying exactly what they want to say and 2) saying it as fast as they can. The AAC service delivery process must honor these values.
The best results in AAC are obtained through evidence-based practice (EBP) and this is the expected method of service delivery today. (ASHA 2001) The components of EBP are 1) the knowledge and skills of the service provider, 2) external evidence, and 3) personal evidence. Knowledge and skills come from pre-service and in-service education as well as personal experience. Attending conferences such as this one can be an exceptional way to advance knowledge and skills.
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.
This presentation is focused on the remaining component of EBP, personal evidence. The foundation of personal evidence in AAC is the language sample. Speech-language pathologists (SLPs) know that the collection and analysis of language samples lead to the most effective therapy (Hill & Romich, 1999). However, until recently only about ten percent of SLPs actually did this. Prior to the development of new methods and tools, language sample collection and analysis was a labor-intensive activity and rarely done. Expectations have changed.
Today language samples can be collected efficiently and reliably from people who use AAC. Language activity monitoring (LAM) or an alternative logfile function is a feature in a growing number of AAC devices (Hill & Romich, 2001). When the feature is turned on, the AAC device records the content and time of each language activity that is generated. For older devices that do not have this feature built in, PC software allows a computer or PocketPC to be the language activity monitor. Regular periodic collection of language samples using automated methods provides information not otherwise available to the SLP providing AAC services. (Van Tatenhove, 2005)
This presentation includes a demonstration in which a person using AAC generates a language sample. The sample will be both recorded in the AAC device and recorded in the PC that is connected to the data projector. The audience will be the communication partner and participants will be able to watch the language sample collection appear on the screen.
Various language sampling protocols can used. Common protocols are conversation, interview, picture description, story retelling, and other activities that might be occurring in therapy. These are all controlled environment protocols. Natural environment language sampling also can be done and may offer a better representation of actual communication performance in the classroom or community.
After the language sample is collected, it can be analyzed. The AAC Performance Report is a set of seventeen quantitative summary measures of communication performance. Performance Report Tool (Pert) is software that facilitates the generation of this report. (Romich, et.al., 2003) In this presentation, the collected language sample will be analyzed using PeRT and session participants will see the ease and speed of performing this analysis.
Finally, the quantitative summary measures will be reviewed and discussion will focus on how to use the measures to guide AAC therapy and measure outcomes as a component of evidence-based practice (Hill, 2004).
Association (ASHA). (2001). Scope of Practice.
Hill, K. (2004). AAC evidence-based practice and language activity monitoring. Topics in Language Disorders: Language and Augmented Communication, 24, 18-30.
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.
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].
Van Tatenhove, G. (2005). Using Objective Data to Transition Across AAC Systems. Presentation at AAC Institute Third Annual International Symposium on AAC Evidence-Based Practice.