CD 485 Computer Applications in Communication Disorders and Sciences

Augmentative and Alternate Communication (AAC) Devices for Communicatively Handicapped Individuals.

SECTION IV: IMPLEMENTNG Augmentative OR ALTERNATIVE Communication devices (from a presentation provided to the Computer Applications Course by Kirk Behnke, Training Coorinator for the Center on Disabilities, California State University, Northridge.

when a device has been selected for a child (or an adult) it is not enough to simply provide him/her with an aid, and expect that it’s benefits will be immediately recognized and appreciated by the user. This is a formula for disaster. Many expensive devices are left in the closet or end up to be used as paper-weights. Almost more important than the device itself is the service and support that is provided along with it. The Communication Interaction Chart below summarizes the important elements to be considered in developing this support: They include the Communication Partner, the Activity, the Environment and the Purpose.

1. The Communication Partner is a very important person, who may be a parent or spouse, or a teacher or a close adult friend of the user. This is a person who is not only a listener but is also knowledgeable (trained) in the operation of the communication device including the manipulation of its parameters to meet the specific needs of the user, in a particular environment, for a designated activity. This may include such critical functions as selecting the vocabulary that will be stored in the device. This, in turn, is tied directly into the selection of the communication target—e.g., whether the user is participating in circle time or telling a parent what he/she did in school today. The partner is also responsible for arranging the communication environment to facilitate the process. This might, for example, include placing pictures in strategic places. These pictures could be used for communication purposes or for cueing a user to follow certain procedures. This is called ECT or Environmental Communication Teaching.

A major function of the partner in ECT, particularly for beginning users, is to provide positive and constructive feedback by responding to the child’s communication initiations and then reinforcing these attempts. The following chart provides an example of a hierarchy of ways the Communication Partner can facilitate the user’s communication attempts.

After this, descriptive feedback can be used for reinforcement. This feedback, which is basically a reiteration of the user’s communication, serves three functions. 1) It immediately acknowledges that the communication was received; 2) It confirms that the communication was understood by the listener; and 3) It provides a bases of for providing a model for expanding the message (an important feature if language development is to be considered).

Other support services provided by the partner may include making and/or selecting the appropriate overlay; making or selecting the appropriate voice output; assisting in the interpreting the user’s responses (when needed).

2. The Activity must be structured along strict pragmatic parameters to facilitate communication and/or teach the user how to communicate. This includes a plan to initiate the communication, maintain it, and terminate it.

To initiate the activity the plan must include where the transition should be from the last activity; who begins it; and how is it begun (what is said or done). For example the teacher may read a story and ask the user a question at a certain point in the story. The user’s device would be programmed to give an appropriate response.

To maintain the activity the operations must be planned in terms of what they are and who must do them; and what must be said and who must say them. In the case above, the teacher will read a story and pause designated spots to ask the user to fill in an answer or to provide a refrain relevant to the story. For example the teacher says, “Goldilocks found a bowl of porridge…” and the user says the refrain, “ In a cozy cottage, in a deep woods in far away land.” Then the teacher proceeds saying, “Goldilocks found three chairs…” and the user repeats the refrain. The teacher proceeds etc., etc. etc.,

To terminate the activity consideration should be given to what actions will end the activity. Who will do this and when and what will they say. In the case of the example above, when the story is over the teacher might say, “Who is ready for juice?” The user could respond with a pre programmed phrase, “I am ready!”

A rather detailed plan, called an ABO (Activity-Based Objectives) should be developed, listing the objectives for each activity. This is helpful in underscoring the communication opportunities. This plan, should reflect the highest level of expectation that one has for the particular user (Let’s call him Cody), and will include any teaching displays or mnemonic devices that are needed. It will state what the student will do or say to complete the activity. Note in the example below, that typically only verbs such as “Ask, tell, or say, “ are used to describe the communication of the user.

3. The Environment sets the stage to hinder or facilitate communication. Hopefully with a little forethought it will do the latter. Of course, interesting activities and materials should be developed. These will change relative to the age, cognitive ability, experience and nature of the disability of the child. In true Piagarian tradition, small or inadequate amounts/portions of materials will provoke a need for communication. The same is true for planned sabotage of an activity, or inclusion of something the child does not like very much. Novel elements are also excellent attention getters and conversation pieces.

The materials for activities should be selected that require some assistance, so that communication between the teacher (partner) and user is needed to complete the task.

The environment can be set up with special considerations for a disabled communicator. For example, a picture sequences of tasks, daily routines, and schedules for a child can be displayed along with mnemonic devices, which cue the child in what to say at each point. Of particular importance are considerations related to the child’s assistive devices that increase their effectiveness and usefulness. Communication Devices, for example, can be placed strategically in terms of the user's convenience, and the nature of the task being attempted.

This may require special furniture or mounting equipment. There are table mounts, ambulatory carts, wheelchair mounts, bed mounts, built-in carry systems and carry bags to mention a few. Some mounts are interchangeable so that the device can be moved to suit the needs of the situation.

You can use a Google Search to find more information about wheelchair and wheelchair mounts.

4. 4. The Purpose of an assistive device is generally the same in all situations:

To facilitate meaningful participation in daily life activities. The important idea to keep in mind is “functionality.” The device should be doing something that fulfils this purpose.

In the light of all these criteria, we will now look at some specific augmentative and alternative devices. Roughly, they can be divided into high-tech and low-tech devices. I am considering low-tech devices to be those that you don’t have to plug into a wall socket (a non computer device). If it has a “chip” it is a computer of some kind and a high tech device.

(Thank you Kirk Behnke!)