1. Augmentative Communication Evaluations Simplified: ACES Tools & Resources
Debby McBride, MS, CCC-SLP
Presented by AAC TechConnect Inc.
Lisa Bardach, MS, CCC-SLP
Libby Rush, MS, CCC-SLP
Tanya Curtis, MS, CCC-SLP
700+ participants in other workshops
(contributions in content & resources)

4. To give people their VOICE Because we all have something to say!
Purpose
To give people their VOICE
Because we all have something to say!

5. What role do you play in giving people their voice?

6. What does Augmentative/Alternative Communication mean to you?

7. What is augmentative /alternative (AAC) communication?
Refers to the incorporation of techniques that can be used to help individuals with disabilities in general, as well as to very specialized technologies designed specifically for individuals with significant and severe disabilities. These techniques include, for example, the use of communication symbols, aids, strategies, skills, and devices designed to assist disabled individuals. (Sarah Blackstone; 1986)
What is augmentative /alternative communication?
ASHA??

8. AAC communication includes
Nonverbal
Vocalizations
* Low-tech or no-tech
* Lite-tech
* High-tech

9. Goals include: Your goals for this workshop
Write 3 ( on the back of your evaluation form) *

10. Goals include: Explain the process of obtaining an AAC tool/device
Describe tools/techniques used to determine the AAC candidate’s skill
Complete many of the components with templates provided for gathering, compiling and reporting the results.
Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)
Identify local resources and consultants for trials, support, and funding assistance for AAC devices.

11. Schedule Today – Tomorrow Looking at the “Communicator”
Using a “Toolkit” for Evaluation
Lunch
Matching persons to devices / communication tools
Trialing the toolkit
Tomorrow
Case studies – ours
Case studeis - yours
Decision-making process for appropriate devices
Trialing the appropriate device(s)
Using your local resources
Funding

12. A Systematic Approach for AAC Evaluations
ACES Module
Augmentative
Communication
Evaluation
Simplified

13. ACES Module examples
The Person: Skills & Features to Consider for Assistive Technology
The Person: Skills & Features to Consider for Assistive Technology
Y/N response
Method?
Answers ?’s:
Simple/Complex
Follow Directions:
Follows Conversation?
Understands Humor?
Receptive Language / Cognition
Memory/new learning
Attention
Categorization/Assoc.
Generalization
Vision Skills
Modifications
W/in Functional Limits (WFL)
Tactile
Symbol modifications
Glasses
Auditory scan/fishing
Color
Cortically Blind
Zoom magnification
Contrast
Font size: _____
Neglect/Field Cut
Other:
Y/N response
Method?
Answers ?’s:
Simple/Complex
Follow Directions:
Follows Conversation?
Understands Humor?
Receptive Language / Cognition
Memory/new learning
Attention
Categorization/Assoc.
Generalization
Vision Skills
Modifications
W/in Functional Limits (WFL)
Tactile
Symbol modifications
Glasses
Auditory scan/fishing
Color
Cortically Blind
Zoom magnification
Contrast
Font size: _____
Neglect/Field Cut
Other:
words
sentences
complex
pictures
objects
Current Communication Skills
Facial/body language
Speech
Board / Book
Point to/take/look at
Gestures / Signs
Device:
Vocal / verbalizations
Read:
Recognize
Write:
words
sentences
complex
pictures
objects
Current Communication Skills
Facial/body language
Speech
Board / Book
Point to/take/look at
Gestures / Signs
Device:
Vocal / verbalizations
Read:
Recognize
Write:
WFL
C P
Volume Access
C P
HOH*
Voice type/quality
H/A*
Headphones
Deaf
Silent Mode
C = Communicator
P = Partner
Skills
Hearing
Modifications
*HOH = Hard of Hearing
*H/A = Hearing Aid
WFL
C P
Volume Access
C P
HOH*
Voice type/quality
H/A*
Headphones
Deaf
Silent Mode
C = Communicator
P = Partner
Skills
Hearing
Modifications
*HOH = Hard of Hearing
*H/A = Hearing Aid
Fine Motor Skills
Points: Left/Right hand Finger/Knuckle
Writes:
Tremor:
Gross Motor
Ambulatory walker cane
Paralysis/Plegia:
Degenerative? Locked in?
Weight/size restrictions:
Wheelchair: manual/power
Type of transfer:
Limited (Describe):
Balance Issues:
Positioning:
WFL
Fine Motor Skills
Points: Left/Right hand Finger/Knuckle
Writes:
Tremor:
Gross Motor
Ambulatory walker cane
Paralysis/Plegia:
Degenerative? Locked in?
Weight/size restrictions:
Wheelchair: manual/power
Type of transfer:
Limited (Describe):
Balance Issues:
Positioning:
WFL
Visual
Auditory
Linear
Row Column
Group
Step
Inverse
Auto
Zoom
w/c
Mount:
Carry case
other
Trackball
Mouse
Joystick
Headmouse
Access Modifications (Mark access site)
Direct select: pointer stylus
Finger/Knuckle:
Keyguard
Size?
Headpointer
Eye Gaze
Scanning
# of switches:
MorseCode
Use w/c
controls
Switch Type
Switch Mount
Scanning Options
Other:
Visual
Auditory
Linear
Row Column
Group
Step
Inverse
Auto
Zoom
w/c
Mount:
Carry case
other
Trackball
Mouse
Joystick
Headmouse
Access Modifications (Mark access site)
Direct select: pointer stylus
Finger/Knuckle:
Keyguard
Size?
Headpointer
Eye Gaze
Scanning
# of switches:
MorseCode
Use w/c
controls
Switch Type
Switch Mount
Scanning Options
Other:
Device Location/Positioning:
Device Location/Positioning: ?
Left, Midline, Right,
High, Midpoint, Low ?
Switch
Circle switch site
Left, Midline, Right,
High, Midpoint, Low
Switch
Circle switch site L- L_ R- R_ L- L_ R- R_
Copyright © 2010 AAC TechConnect, Inc.
Copyright © 2010 AAC TechConnect, Inc.

14. Tools and Resources you will leave with:
ACES Module (handouts & on CD)
Evaluation Toolkit List
The Persons (form)
AAC Device Features (form)
Case History & Eval Summary (form)
Device Decision Making (form)
Resources on CD
Handouts (including the above)
AAC device flyers
Templates (report, summary forms, etc.)
Other resources (website lists, vendors lists, etc.)
Websites: free resources

15. Challenges you have? Why…*

16. AAC Evaluations - Challenges
Availability of systematic assessment protocols
Acquire premade materials/resources (vocabulary, overlays, etc)
Not organized / equipment available when needed / working when needed
Training ???
Knowledge???
Experience???
Keeping up with technology
Overwhelming ? ? ?

17. Process – Beginning to end
Person
Referral
Gathering information
Deciding on skills to assess
Choosing the “toolkit items” used
Evaluating the individual's skills (sensory, physical, language, communication functions/needs, etc.)
Summarizing individual’s skills

18. Process continued Communication Tools / Devices
Matching skills to communication tools
(feature - matching)
Voice / no voice
Trialing communication tools / voice output devices
Making recommendations
Writing appropriate documentation
Completing funding paperwork as needed
Use of your equipment reps

20. Evaluation Who are they? What do they want to say?
Where do they want to say it?
How do they want to say it?
What are their current skills?
What technology can bridge the gap?

21. Feature Matching –
Determine what the individual needs, then find the technology with the requisite features and match the technology to communicator.
SDT

23. Level of communicator
Emerging
Context/Partner Dependent
Independent

24. Emerging
No RELIABLE means of EXPRESSIVE communication through SYMBOLIC language
Have some functional non-verbal communication (gestures, vocalizations, other nonsymbolic communication)
Able to attend, even briefly, to individuals, conversations, pictures, or symbols
Yes/no (acceptance/rejection) depicted with body language; i.e. no reliable yes/no for more complex communication

25. Context- or Partner-Dependent
Has SYMBOLIC communication that is RELIABLE
but limited to particular CONTEXTS or PARTNERS
Rely on partners to provide limited response set
Need frequent instruction and cueing
Difficulty with initiation
May only be functional in particular settings
Wide range with regard to # of partners and # of settings

26. Independent (Generative)
Can communicate ANYTHING on ANY TOPIC to ANYONE in ANY CONTEXT
Locate, select, and convey messages on their own
Can interact with familiar / unfamiliar partners equally well
Can sequence symbols or letters to generate novel messages

27. Access / modification Direct select: keyguard, pointer, stylus
Headpointer / headmouse
Eye gaze
Joystick, mouse, trackball
Morse code
Scanning
Wheelchair controls (caution)

28. Switch access Circle for location of switch Type of switch
Mount / attachment
How many switches?

29. Scanning options Auditory / visual Linear / row-column / group
Step / inverse / auto
Other

30. Who is your person?

31. break

32. Evaluation -
What’s in your toolkit?
What do you currently use?

33. Toolkit List

34. Gathering your Toolkit
Help you organize what you have - toolkit list
Help you decide what to add to your resources
Give you additional ideas for premade materials / resources
Give you additional resources you can access: CD
AAC TechConnect- web

35. The Evaluation Toolkit

36. The Evaluation Toolkit

37. Low-tech physical access components
Keyguard
Pointing light
Partner Assisted Scanning
Eye gaze
PECS
Positioning (motor – visual)

38. Miscellaneous items

39. Augmentative Resources

40. Switches & accessories
Variety of switches
Switch interface
Switch mount

41. Array of Switches
                                      
                              

42. Switch Mounting System

43. TOOLKIT #1continued – “Lite – Tech” components
Battery adaptor
Array of Switches
Switch Interface
Switch activated devices (toy or fan or vibrating Pillow)
Switch Mounting system
Battery adapter ?

44. Cause-effect items

45. Switch Activated Devices

46. Battery Adapter

47. Switch Interface

48. The Evaluation Toolkit

49. Voice output – does it make a difference ? ? ?
Single message sequential communicator
Multiple message communicators
(progressive message key setups)
Consider ones with levels

50. Simple voice output – w/ sequencing capabilities
Single message communicators
(Sequencers, Step-by-Step, etc.)

51. Single message communicators
Replays one message at a time
Recorded speech
Some can do multiple messages (repeats different message each time you select it)
Some can do different levels / situations

52. Progressive Communicator - Digitized device(s)
Start simple – 2 pictures
Add more pictures
Has levels
Direct select
Recorded speech (voice)
Uses overlays

53. Static Display Progressive Communicator

54. Simpler voice output devices
Digitized Devices & Accessories

55. Others in your closet Macaw Message Mates ChatBox
Others? Any of these?

56. Digitized Devices (examples only – not all inclusive)

57. The Evaluation Toolkit

58. Toolkit #3 - “Higher Tech”
Laptop or tablet computer
(convertible laptop optimal)
Add communication software
Emulate devices (large, medium, small)
Accessories
Touch Screen (not just with pen)
Switch interface
Make small, med. And large overlay

59. Laptop Computer, Touch Screen and AAC Software

60. I “stuff” (iPad, iPod, iTouch, etc.) . ..
Droid, Slate, etc

61. Communication Software
Emulate the devices
3rd party software which does the following:
Make various configuration of overlays
Able to link them together to evaluate navigation
Can do scanning of all types
Spelling (word prediction) - optimal

62. Software for purchase Tobii Communicator (Tobii ATI) - $599 -
SayIt! Sam Software (Words +)-$1395
Speaking Dynamically Pro (Mayer Johnson)-
The Grid (Sensory software)
Mind Express (Words+)
others
Boardmaker Plus (Mayer Johnson)
Overboard (Gus)

63. Free manufacturer software/ demos you can get . . .
Series 5 Semesterware (DynaVox)
PASS software (Prentke Romich)
SayIt! Sam (Words+)
E Z Keys (Words+)
Mind Express (Words + - coming)
Others?

64. Questions?

65. What do you think you may
What do you have? or
What do you think you may
need / want?

66. Time for lunch!

67. ACES Module: Your Tools & Resources
Toolkit components: communication tools
to have at your fingertips (in the bag)
Premade evaluation materials / resources
(in the book)
Templates / resources to complete paperwork
(on CD and on the web)
Resources to make decisions on devices
(On web)

68. Premade resources - ideas

69. Evaluation Materials/Resources
Materials include:
Objects
Pictures
Premade overlays / pages
Low tech (communication boards)
Lite tech (overlays for digitized devices)
High tech (pages for dynamic display options)

70. Symbols Objects Photos COPPS Pictures Overlays Visual scenes Alphabet
boards
Make one example of each of these to show from the kit

71. Symbols and premade materials
Make your own
Purchase other resources
Examples of Toolkit Notebook
CD coming with PCS boards on it –
Fall 2010

72. Pre-made pictures/overlays
What do you use?
We use . . .
Examples include various sizes (size of message key and #’s of keys)
Various communication functions
Dynamic display (low tech example)
Sizes example

73. Object-COPPS-Photo

74. TALKING MY WAY
Talking My Wya

75. Object Symbol Resource

76. Photographs

77. PCS – Boardmaker (Mayer-Johnson)

78. SymbolStix - Symbolmate – News2U

79. Overboard by Gus

80. Attainment

81. The Test of Aided-Communication Performance (TASP)
by Joan Bruno, Ph.D., CCC-SLP
A tool for the assessment of symbol-based communication skills.
Includes subtests on symbol size and number, grammatical encoding, categorization and syntactic performance.
Results may help determine AAC intervention strategies and goals.
Provides starting point for designing communication boards or selecting a page for an AAC device.

82. Alphabet boards Alphabet/Spelling Alphabet boards
Keyboard arrangements
ABC
QWERTY
Frequency of occurrence
Grammar based boards

83. The Device: Features to Consider

84. Symbols Objects COPPS Photos Pictures Words Letters Media
(video clips, etc.)

85. Language Representation
Single meaning pictures
Multi-meaning pictures (Unity)
Alphabet / spelling
Use of core words
Visual scenes
Phrase-based
Grammar-based boards

86. Single meaning pictures

87. Semantic Compaction (Unity)
Multi-meaning pictures
Less key strokes (in sequencing) – faster
Motor memory
Icon prediction
Activity row – picture prediction

88. Semantic Compaction-example

89. Visual scenes

90. Phrase Based

91. Premade vocabulary considerations
Language representation
Progression (easy to more complex)
Individualizing
Smaller vs. larger vocabulary needs
Ease of navigation
Ease of learning (for user and communication partners)

92. Grammar - Based / Core Words

93. Grammar Based Software
WordPower
(Most manufacturers)
Picture Word Power
Wordcore (PRC - Pics)
Gateway (Dynavox - Pics & words)
Tobii Communicator (Sono Key- words/Sono Lexis-pics)
SpeechPro (Gus-words)
AlphaCore (Dynavox-Pics & words) 93

94. Alphabet/spelling Keyboard arrangements ABC QWERTY
Frequency of occurrence

95. Message formulation Single key messages Routine phrases
Novel sentences
Novel thoughts / ideas
Spelling

96. Message formulation:
Gateway -
Unity –
Picture WordPower –

97. Navigation / page changes
Who is changing: facilitator or communicator (can limit access)
Static display - # of pages
Dynamic display - # of pages
# of levels down

98. Message Key # of keys Size of keys Varies Actions required Click
Zoom/enlarge
Color changes
Hold time
Auditory “fishing” (technique)

99. Screen size Small (handheld size)
Small – medium (Xpress, Springboard Lite, Alt-Chat)
Medium
Large
Issues: visual, motor, navigation requirements (memory)

100. Message display Words Pictures Speak each word / sentence
Speak on demand / punctuation
Highlight each word as it speaks
Silent mode

101. Rate enhancement Pre-store messages
Prediction (word, letter, picture, symbol, character, phrase) **
Abbreviation – expansion
Pre-made vocabulary options
Grammar-based boards **
Word morphology (word endings, verb tenses, etc.)

102. 102

103. 103

104. Picture prediction – activity row

105. Refer to AAC Feature Chart for
Voice/speech
Device functions/access
Keyboard
Type of Device
Devices to trial

107. Toolkit Time . . .

108. Handheld size

109. Small - intermediate

110. Medium size

111. Large size

112. Try it on . . .

113. Types of devices to consider
Dynamic display
Integrated systems
Text – to – speech
Digitized
Simpler digitized
Single message communicators

114. Dynamic Display Multiple pages “Navigate between pages”
Variety of symbols available
Both types of speech (digitized & synthesized)
Possible to use generative language
Offers more options for alternative access

116. Integrated System Multiple pages “Navigate between pages”
Variety of symbols available
Both types of speech (digitized & synthesized)
Includes computer components

117. Digitized Simpler communication needs Recorded voice Use of pictures
Multi lingual
Most of them have:
Paper overlays that are changed
Also called “static display”

118. Digitized Devices (examples only – not all inclusive)

119. Text to Speech Mainly spelling (keyboard and some have scanning)
Most have built-in keyboards
Mostly synthesized speech, though few have digitized speech

120. Text-to-Speech (examples only – not all inclusive)

121. Let’s Review what we have so far:
The Person (ACES Module)
AAC Device Features (AAC Module)
Toolkit List (AAC Module)
Gather information (Case history & Summary Evaluation in ACES Module)
Record evaluation results (form above & Assessment summary in Templates)
Device Decision-Making (AAC Module)
Device Assistant – 30 day trial from AAC TechConnect
Write report (Templates)
Funding (work with vendor)

122. Device Selection Which Device to Choose ? ? ? ? Low tech Lite tech
High tech
Combination

124. How do you proceed?
Know user’s skills
now what?

125. Device Selection Options
Catalogues
AAC TechConnect – contact manufacturers
Manufacturer websites
Go to individual ones – AAC TechConnect has list
AAC TechConnect – free resources
Pictures (thumbnails of 100+ devices)
Free flyers

126.
Website which gives the following free information on ONE site
What’s New
Manufacturers
Product information
126

129. Clinical Tools From AAC TechConnect
The ACES Device Assistant – project of AAC-RERC
The Resource for Lite Tech Low Cost AAC Chart (by Libby Rush & Mary Joan McClure)

132. 132

133. Demo – AAC TechConnect
Free trial

134. 134

135. Clinical Online Tools from
Lite Tech Low Cost Chart
AAC TechConnect
$14.95 (online with credit card)
Device Assistant
Free trial – 14 days
Fee – for – service after that

136. Trialing equipment Loan equipment AT centers Vendors – local resources
Manufacturers
Rental options

138. Do you . . . Have some new strategies to try?
Have some things in your closet you will dig out for use?

139. Questions? ? ?

140. Review goals
Suggestions for next time?
Please put on your eval form.

141. Did we: Explain the process of obtaining an AAC tool/device
Describe tools/techniques used to determine the AAC candidate’s skills
Complete many of the components with templates provided for gathering, compiling and reporting the results.
Identify components on AAC devices such as common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)
Identify local resources and consultants for trials, support, and funding assistance for AAC devices.

142. THANK YOU
for helping others
To get
The best choice
For the best voice

143. Debby McBride, MS, CCC-SLP 866.4U.AAC.RX info@aacTechConnect.com
Contact us at:
Debby McBride, MS, CCC-SLP
866.4U.AAC.RX
866/ or 303/