Communication problems experienced following a brain injury or stroke not only impact a person’s ability to participate in their desired social and vocational roles but may also impact their ability to participate in decision-making about their care, participate in therapy and receive counseling and education. Many technologies exist, including Augmentative and Alternative Communication (AAC), which can help increase communication and life participation following a brain injury or stroke. This article will define and describe a variety of AAC technologies and interventions for people with communication problems following acquired brain injury as well as discuss assessment, training and funding issues.
We describe a brief pilot study undertaken to investigate the potential benefit(s) of using a SenseCam in aphasia therapy. Five post-stroke persons with aphasia and their caregivers agreed to participate. Each person with aphasia wore the SenseCam for 1 day during the daytime. Slide shows and printed images were created from the images obtained and presented at a (videotaped) weekly group conversation session. Therapists’ observations, reflections, and opinions were subsequently elicited in a group interview and online survey. Wearable, sensor-triggered automatic imaging devices offer potential advantages over both conventional cameras and generic pictures when used in aphasia therapy. We identified three advantages of a SenseCam over conventional imaging methods: Images can be acquired without the presence of the researcher, no action is required by the wearer for image acquisition and the continuous point of view is that of the wearer. Acquired images are of personal relevance to the wearer and may have greater efficacy for the person with aphasia in aiding conversation, and for the speech language therapist in setting functional language goals.
Assessing preferences for AAC options in communication interventions for individuals with developmental disabilities: A review of the literature
We synthesized studies that assessed preference for using different augmentative and alternative communication (AAC) options. Studies were identified via systematic searches of electronic databases, journals, and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) communication options assessed, (d) design, (e) communication skill(s) taught to the participant, (f) intervention procedures, (g) outcomes of the intervention and outcome of the preference assessment, (h) follow-up and generalization, and (i) reliability of data collection and treatment integrity. Seven studies, involving 12 participants, met the inclusion criteria. In these studies, individuals were taught to use either speech-generating devices (SGD), (b) picture exchange (PE) systems, and/or (c) manual signs. Assessments to identify preferences for using each AAC option were conducted in each study. Sixty-seven percent (n = 8) of participants demonstrated some degree (≥55%) of preference for using SGD compared to 33% (n = 4) of participants who demonstrated some degree (≥55%) of preference for PE. The results indicate that individuals with developmental disabilities often show a preference for different AAC options. Incorporating an assessment of such preferences might therefore enable individuals to exert some degree of self-determination with respect to AAC intervention.
Communication vulnerable patients in the pediatric ICU: Enhancing care through augmentative and alternative communication
Children in pediatric intensive care units (PICUs) may experience a broad range of motor, sensory, cognitive, and linguistic difficulties that make it difficult for them to communicate effectively. Being unable to communicate is emotionally frightening for children and can lead to an increase in sentinel events, medical errors and extended lengths of stay. Implementation of augmentative and alternative communication (AAC) tools and strategies can address the communication needs of children in the PICU by enabling them to communicate their wants, needs and feelings to healthcare providers and family members and participate in their own care more productively.<p><p>from the <a href=”Journal” _mce_href=”http://iospress.metapress.com/content/17214k076508n4k7/”><em>Journal”>http://iospress.metapress.com/content/17214k076508n4k7/”><em>Journal of Pediatric Rehabilitation Medicine</em></a></p>
This article introduces the roles of parents and rehabilitation professionals in the provision of communication supports for children who cannot meet their communication needs through natural speech alone, also referred to as individuals with complex communication needs (CCN). The authors present a personnel framework, introduce intervention models of augmentative and alternative communication (AAC) services, and address issues parents face in preparing to provide communication supports to children with CCN using AAC and assistive technology (AT).
<p><p>from the <a href=”Journal” _mce_href=”http://iospress.metapress.com/content/81k4698844061536/”><em>Journal”>http://iospress.metapress.com/content/81k4698844061536/”><em>Journal of Pediatric Rehabilitation Medicine</em></a></p>
Conclusions: The effects of parent-coached augmented language interventions generalize to children’s engagement in child–parent interactions outside the intervention context in ways that may facilitate additional language acquisition.
This Article does not have an abstract.
These findings suggest that low-tech VSDs have an impact on the manner and extent to which a person with aphasia and a communication partner contribute to conversational interactions involving information transfer.
Australian Speech-Language Pathologists’ Perceptions and Experiences of Augmentative and Alternative Communication in Early Childhood Intervention
Speech-language pathologists (SLPs) working in early childhood intervention are expected to have knowledge and skills across a number of areas and to engage in evidence-based practice. We explored the knowledge and perceptions of SLPs working with young children within Australian early childhood settings about augmentative and alternative communication (AAC), evidence-based practice, and barriers to such practice. Fourteen clinicians participated in group or individual interviews. Thematic analysis of the transcripts of these discussions revealed that they had a broad view of AAC and its benefits. Their reported assessment and intervention approaches reflected best practice as documented in the literature. The exception was in the implementation of family-centred practice. Although the participants involved families in their children’s intervention, many appeared to use a directive approach. There was also evidence of struggling with families’ negative attitudes about the use of AAC. A major barrier for these clinicians in implementing AAC and best practice was limited time in light of the many demands and expectations. Despite some frustration, these participants were passionate about their work and belief in the benefits of AAC for young children with varied communication difficulties. The results suggest that many expectations placed on clinicians within early childhood intervention settings may fail to take into account the everyday demands on their time, in a context of varied resources and support.
An important part of evidence-based practice is to identify the best and most current research evidence to guide clinical practice. The purpose of this paper is to propose the use of the 5-S model by Haynes (2006) as a principled approach for navigating evidence-based information sources related to interventions in augmentative and alternative communication (AAC). The 5-S model is a pyramid that is used from the top down, beginning with systems followed by summaries, synopses, syntheses, and studies. The 5-S model is described along with relevant evidence-based information sources in AAC, and subsequently illustrated with a case scenario. Following the 5-S model may enable practitioners to identify the best and most current research evidence.
The Use of Augmentative and Alternative Communication Methods with Infants and Toddlers with Disabilities: A Research Review
This review sought to determine the evidence base of augmentative and alternative communication (AAC) use with infants and toddlers with disabilities. The review identified 12 studies, involving 190 participants aged 36 months or younger. The majority of the studies investigated unaided AAC methods (e.g., gestures or sign language), with 42% of the studies also including aided AAC methods. Although all studies reported improvement in child communication following AAC intervention, in-depth analyses of study methodology indicated that only 7 out of 12 provided conclusive evidence. Implications for early intervention AAC practice and suggestions for future research are proposed.