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
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