AAC Options for People with Speech/Language Difficulties

Following a Stroke

Monique Fourcaudot, SLPLoralee MacLean, SLPToronto 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

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 With or without aphasia

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 OptionsHigh 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

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