1. AAC Options for People with Speech/Language Difficulties Following a Stroke
Monique Fourcaudot, SLP
Loralee MacLean, SLP
Toronto Rehab AAC Clinic
March 30, 2010

2. 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

3. 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

4. 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

5. Communication post Stroke
Aphasia
Non-fluent aphasia
Fluent aphasia
Apraxia of Speech
With or without aphasia
Dysarthria
Voice impairment

6. AAC and Aphasia Partner dependent communicators
Emerging
Contextual choice
Transitional
Independent communicators
Stored message
Generative message
Specific need

7. Other Considerations….
Language
Residual speech
Cognition
Vision
Hearing
client and/or their communication partner
Physical
Use of hands & quality of movement
Ambulation

8. 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

9. TYPES OF AAC: No Tech Options Low Tech AAC Options High Tech AAC Options Face-to-Face Communication

10. No Tech Options Pen and paper Write /erase boards
Supported conversation
Gestures, facial expressions, body language
Life history books

11. Communication Books

12. Low Tech AAC Options Voice Amplifiers Chattervox Spokeman Addvox
Electolarynx

13. Low Tech AAC Options Alerting / Signaling Systems Switch & Buzzer
Baby monitors
Call bells

14. Low Tech AAC Options TTY – Text Telephones
Telephone communication for clients with impaired speech
Also used by people with hearing impairments

15. Low Tech AAC Options Small hand held spelling device
iPod touch with speaking apps
Netbook with speaking software
Keyboard Communicator KC200

16. TYPES OF AAC: High Tech AAC Options Face-to-Face Communication

17. Text to Speech Devices

18. Word Prediction

19. Abbreviation expansion
Able to save frequently used phrases using a 1-2 letter code
For example: hh=hello, how are you?

20. Devices with Static Displays

21. Devices with Dynamic Displays

22. Word and Pictures

23. Virtual

24. Visual Scene

25. Category

26. Word-based

27. Spelling for Scanners

28. 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

29. 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)

30. 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

31. Why customize? Better outcomes Relevant to client Motivating
Compensate for deficits and maximize strengths

32. Role of AAC Facilitator
Setup
Charging
Cueing / Reminders
Training communication partners
Mounting
Device troubleshooting
Shipping and receiving equipment

33. 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)

34. 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

35. How to refer to our AAC Clinic
Call Toronto Rehab AAC Clinic
Find application on Toronto Rehab website:

36. Q & A