AAC Options for People with Speech/Language Difficulties Following a Stroke Monique Fourcaudot, SLP Loralee MacLean, SLP Toronto Rehab AAC Clinic March 30, 2010
Overview What is AAC and who can benefit? Range of AAC options What you can do Training AAC use Customization How to access services in Ontario Questions Presentation is designed to be interactive: 2:30pm-3:10pm: powerpoint presentation detailing educational objectives (total time:40 min) 3:10pm-3:50pm: “hands-on” rotation of stations (total time: 40 min) -3-4 stations will be set-up with various AAC technology -groups of OTAs and PTAs will be able to spend ~10-15min at each station to get hands-on experience with the AAC technology 3:50pm-4:00pm: question & answer period
What is AAC? AAC = Augmentative & Alternative Communication For face to face communication… It is the use of facial expressions, gestures, objects, pictures, symbols, sign language, written words and/or communication technology to augment speech, or to provide an alternative means of communication when speech is not possible or functional
Who is a candidate for technology? Almost anyone whose speech/language is non-functional Motivated to communicate Accepting of alternative methods to communicate Receptive language strong enough to follow one step commands
Communication post Stroke Aphasia Non-fluent aphasia Fluent aphasia Apraxia of Speech With or without aphasia Dysarthria Voice impairment
AAC and Aphasia Partner dependent communicators Emerging Contextual choice Transitional Independent communicators Stored message Generative message Specific need
Other Considerations…. Language Residual speech Cognition Vision Hearing client and/or their communication partner Physical Use of hands & quality of movement Ambulation
AAC and Natural Speech AAC is not all or none AAC can be used as repair if speech not understood AAC use can promote increase in speech with more successful communication opportunities
TYPES OF AAC: No Tech Options Low Tech AAC Options High Tech AAC Options Face-to-Face Communication
No Tech Options Pen and paper Write /erase boards Supported conversation Gestures, facial expressions, body language Life history books
Communication Books
Low Tech AAC Options Voice Amplifiers Chattervox Spokeman Addvox Electolarynx
Low Tech AAC Options Alerting / Signaling Systems Switch & Buzzer Baby monitors Call bells
Low Tech AAC Options TTY – Text Telephones Telephone communication for clients with impaired speech Also used by people with hearing impairments
Low Tech AAC Options Small hand held spelling device iPod touch with speaking apps Netbook with speaking software Keyboard Communicator KC200
TYPES OF AAC: High Tech AAC Options Face-to-Face Communication
Text to Speech Devices
Word Prediction
Abbreviation expansion Able to save frequently used phrases using a 1-2 letter code For example: hh=hello, how are you?
Devices with Static Displays
Devices with Dynamic Displays
Word and Pictures
Virtual
Visual Scene
Category
Word-based
Spelling for Scanners
What you can do? Identify people who could benefit from AAC MCST-A (screening tool for people with Aphasia) Prescribe low tech devices – if you are an IA Make communication books (important to customize!!!) Refer to AAC Clinics for high tech AAC options Support AAC use in community Train clients to use AAC
Training an AAC System Operational competency Linguistic competency on/off, charging, navigating Linguistic competency Recognizing symbol sets, reading, manipulating linguistic codes Social competency pragmatics – initiation, turn taking, etc Strategic competency limitations of system and how to use adaptive strategies to repair, using multimodal communication, etc)
Customization of AAC including communication books Vocabulary collection Category based Situational based Needs to fit client’s abilities and communication needs Real pictures Second language Number of items/page
Why customize? Better outcomes Relevant to client Motivating Compensate for deficits and maximize strengths
Role of AAC Facilitator Setup Charging Cueing / Reminders Training communication partners Mounting Device troubleshooting Shipping and receiving equipment
Other AAC Clinics in Ontario More than 26 AAC Clinics in Ontario See children / adults May have diagnostic or geographic criteria To find an AAC Clinic in your area – call the Assistive Devices Program (Communication Aids)
Toronto Rehab AAC Clinic Interprofessional team SLPs, OT, CDA and Technologist We see adults with acquired conditions Stable / progressive conditions Face-to-face communication Adapted computer access for writing aids No geographic boundary
How to refer to our AAC Clinic Call Toronto Rehab AAC Clinic 416-597-3028 Find application on Toronto Rehab website: www.torontorehab.on.ca
Q & A