1. Augmentative Communication Evaluations Simplified: ACES Tools & Resources
Debby McBride, MS, CCC-SLP
Presented by AAC TechConnect Inc.
Lisa Bardach, MS, CCC-SLP
Tanya Curtis, MS, CCC-SLP
Libby Rush, MS, CCC-SLP
(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 – Looking at the “Communicator”
Using a “Toolkit” for Evaluation
Lunch
Matching them to the devices / communication tools
Decision-making process for appropriate devices
Trialing the appropriate device(s)
Using your local resources
Local reps and distributors
Local loan banks
Local resources
Funding
CEU certificates

12. A Systematic Approach for AAC Evaluations
ACES Module
Augmentative
Communication
Evaluation
Simplified
Toolkit List
Forms for summarizing evaluation information
Individual skills
Device Features

13. ACES Module examples

14. Tools and Resources you will leave with:
ACES Module (handouts & on CD)
A Toolkit List
The Communicator
Device Features
Other Considerations
Resources on CD
Handouts (including the above)
AAC device flyers
Templates
Other resources
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

22. The Communicator

23. The Communicator

24. Level of communicator
Emerging
Context/Partner Dependent
Independent

25. 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

26. 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

27. 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

28. Vision Modifications Vision modifications Tactile Auditory cueing Zoom
Symbol modifications
Other

29. Hearing modifications
Volume access
Voice type/quality
Headphones
Other (including communication partners)
Silent mode

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

31. Current communication
Facial/body language
Point to / take / look at
Gestures / signs
Vocal / verbalizations
Board / book
Device
Other

32. Fine motor Fine motor Points Writes
Limited hand / finger use (describe)

33. Gross motor Ambulatory Wheelchair Walker Cane
Walk only with assistance
Mounting / carry case needs

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

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

36. Who is your person?

37. Video
Questions ? ? ? ? ?

38. break

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

40. Toolkit List

41. 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

42. The Evaluation Toolkit
Toolkit #1: Low-to Lite-tech Tools
Toolkit #2: Digitized devices
Toolkit #3: Computer & accessories to emulate variety of communication devices (evaluation ONLY)
Objects
Pictstures
Dusty pics

43. Let look at some examples
TOOLKIT #1 – “Lite – Tech” components

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

45. Miscellaneous items

46. Augmentative Resources

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

48. Array of Switches
                                      
                              

49. Switch Mounting System

50. 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 ?

51. Cause-effect items

52. Switch Activated Devices

53. Battery Adapter

54. Switch Interface

55. Switch Computer Application
RJ Cooper
Linda Burkhart
Marblesoft/Simtech
Judy Lynn

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

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

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

59. Static Display Progressive Communicator

60. Simpler voice output devices
Digitized Devices & Accessories

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

62. 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

63. Laptop Computer, Touch Screen and AAC Software

65. 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) - optimul

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

67. Free software/ demos Manufacturers (some examples)
Series 5 Semesterware (DynaVox)
PASS software (Prentke Romich)
SayIt! Sam (Words+)
EZ keys (Words+)
Overboard (GUS)

68. Point-N-Click
Click-N-Type
Etriloquist

70. Questions?

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

72. Time for lunch!

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

74. Premade resource

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

76. No-tech symbols Objects Photos COPPS Pictures Overlays Visual scenes
Alphabet
boards
Make one example of each of these to show from the kit

77. Symbols and premade materials
Make your own
Purchase other resources
Examples of Evaluation Assistant

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

79. Object-COPPS-Photo

81. TALKING MY WAY
Talking My Wya

82. PCS – Boardmaker (Mayer-Johnson)

83. SymbolStix

84. Overboard by Gus

85. Attainment

86. 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.

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

88. Examples from Medical book
For Medical settings – check with AAC TechConnect for more info

89. Premade Resources?

90. 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)

91. The Device: Features to Consider

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

93. Language Representation
Single meaning pictures
Semantic Compaction
Alphabet / spelling
Visual scenes
Phrase-based
Grammar-based boards

94. Single meaning pictures

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

96. Semantic Compaction

97. Alphabet boards Alphabet/Spelling Alphabet boards
Keyboard arrangements
ABC
QWERTY
Frequency of occurrence

98. Visual scenes

99. Phrase Based

100. Grammar - Based

101. Navigation / page changes
Facilitator/communicator changes pages
Number of pages required (few-many)
Static display # of pages
Dynamic display navigation skills

102. Keyboard options Built – in keyboard (integrated)
Onscreen keyboard – W+
Plug-in keyboard (external)
Convertible-style tablet

103. Voice / speech Synthesized (synthetic) Digitized Other language needed
Pre-recorded
Spelling

104. Type of device Dynamic display (small/med/large)
Integrated (dynamic display as computer)
Text-to-speech (attached keyboard)
Digitized (static display with overlays)

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

106. 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

107. Dynamic Display (examples only – not all inclusive)

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

109. Integrated Systems (examples only – not all inclusive)

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

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

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

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

114. Device functions / access
Use access to on / off
User access to volume
User access to programming
ECU’s
Internet access / browsing
Computer applications
Camera
Phone
Text messaging
Printer

115. 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.)

118. Picture prediction – activity row

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

120. Single meaning pictures

121. Core vocabulary

122. Message button # of keys per page Size of keys
Need for variety (progressive)

123. Message feedback Action Click (auditory) Color changes (visual)
Zoom / enlarge (visual)

124. Button / selection method features
Touch enter / exit
Hold time
Direct select
Headpointing
Eyegaze
Auditory “fishing”
Scanning

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

127. Screen size / size of device
Small – handheld size
Small – medium 7” screen
Medium ” screen
Large – 10.4” + screen (mounted?)

128. Handheld size

129. Small - intermediate

130. Medium size

131. Large size

132. Try it on . . .

133. Premade vocabulary Language representation Progression Individualizing
Smaller vs. larger vocabulary needs
Ease of navigation
Ease of learning (for user and communication partners)

134. Grammar Based Software
WordPower
(Most manufacturers)
Picture Word Power
Wordcore (PRC)
InterAAACT (Dynavox)
SpeechPro (Gus)
AlphaCore (Dynavox) d

136. Quick fires

140. ACES Module (templates provided )
Gather information (Case history)
Record evaluation results (Assessment summary)
Device decision-making (Device assistant)
Write report (report)
Funding (work with vendor)

141. Pre-Assessment Preparation
Obtaining previous reports, evaluations and supplemental information (on CD)
Case History
Intake

142. Evaluation Notes
Form to provide consistent means of recording information during the evaluation session
Use of form helps to promote an organized method for keeping work records
Mechanism to measure progress
Assessment Summary
Intake form with notes
* * * * * *

144. Video

145. Device Selection
Which Device to Choose ? ? ? ?

146. Additional Features to know
Accessories required (list on CD)
Medicare version required (Insurance)
website: (web list on CD)
Cost
Size / weight
Etc.

147. Decision-making Alphabet / Spelling Pictures / spelling
Keyboard (Text to speech)
And/or onscreen keyboard (Dynamic display - tablet style)
Pictures / spelling
Dynamic display
Pictures / spelling with computer components
Integrated systems

148. Decision-making continued
Pictures only –
Static display (digitized) vs Dynamic display
vs integrated system
Number of pictures
Number of pages
Types of pictures
Changing levels (user vs. facilitator)
Ease of programming

151. 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

152. Single Message

153. No tech Use as primary communication Secondary communication
Backup communication
Evaluate benefits of voice output
Individual
Communication partners
Motivation

154. Decision-Making & Supporting Documentation

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

157. Funding www.aacfundinghelp.com
3rd party medical funding (Medicaid, Medicare, Private Insurance)
Medicaid Available
Educational or Vocational
or Independent living
Private pay or donations
(Used equipment)
Work with your local device representatives

158. 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

161. www.aacTechConnect.com Low cost information resources
Lite Tech Low Cost Chart
AAC TechConnect
$14.95 (online with credit card)
Device Assistant
Free trial – 14 days
Fee – for – service after that

162. Lite Tech Low Cost Chart

163. Device Assistant – free info

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

165. Explore Programming of the device
Try the actual programming – see how it feels
Edit button; make page; link pages
Communication partners need to feel comfortable with the programming
Sales representatives can assist
Ask what support options include (including on-line support)

166. Accessories (on CD) Carry bags Keyguards
Access hardware (switches/head controlled device, joystick, etc.)
Mounting systems/components
Extra power (if required)
Internet/computer access (hardware/software)
Environmental controls
Software to make overlays (for digitized devices)
Others?

167. Completing the paperwork
Gather
Summarize
Write report
Get quote / info from manufacturer
Complete funding paperwork (packets or online resources from each company)

168. Free templates & Paperwork AssistantCD
Report Coach: aacfundinghelp.com
Dynavox – Funding Manager
PRC – Funding Submission Assistant
Templates on

169. Paperwork Assistant from AAC TechConnect (coming in Fall)

170. Knowledge about best practices
Evidence-based practice refers to an approach in which current, high-quality research evidence is integrated with practitioner expertise and client preferences and values into the process of making clinical decisions.
Web list I & web list II
To download handouts, go to
go to EVENTS - see materials listed there

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

172. Questions? ? ?

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

174. 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.

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

176. 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/