Use of iphone AAC Software for Brain Injury and Stroke Patients

Transcription

1 Use of iphone AAC Software for Brain Injury and Stroke Patients Katherine Knarr, B.S. Miriam Leuin, B.A. Daniel Zarakov, B.A Katelynn Kapki, B.S. Wendy Quach, Ph.D., CCC-SLP

2 Objectives To identify patients who would benefit from AAC devices To identify barriers to using AAC devices To gain knowledge in use of mobile technology with patients 2

3 Different Communication Modalities Think about your communication today What ways did you use to communicate? 3

4 What is augmentative and alternative communication (AAC)? A set of procedures and processes by which an individual's communication skills (i.e., production as well as comprehension) can be maximized for functional and effective communication. The field or area of clinical, educational, and research practice to improve, temporarily or permanently, the communication skills of individuals with little or no functional speech and/or writing. (American Speech-Language-Hearing Association, 2002) 4

5 What is AAC? ASHA emphasizes the importance of multimodal AAC interventions, meaning that the individual s full communication capabilities, including any residual speech or vocalizations, gestures, signs, and aided communication should be utilized (ASHA, 1991, as cited in Beukelman & Mirenda, 2000) 5

6 Categories of AAC Systems No tech similar to unaided, does not involve the use of technology Low tech supplements speech, but does not require batteries High tech requires batteries Dedicated functions only as an AAC system Non-dedicated has other functions in addition to AAC 6

7 Main Components of AAC Devices 1) Access method: Direct selection: individual chooses and selects targets on their own Scanning: requires a switch. The individual accesses a switch, which accesses the device. 2) Symbols: Aided: anything supplemental, including a physical device/object, symbols and/or signs Unaided: anything that does not require an extra piece of equipment (gestures, body language, facial expressions) 7

8 Main Components of AAC Devices (continued) 3) User display: Static: symbols are fixed in a particular place Dynamic: selections change as individual symbols are activated 4) Output: Digitized: an individual can record his/her own voice Synthesized: computer-generated 5) Feedback: Tactile Auditory Visual 8

9 9 AAC Devices (Static)

10 10 AAC Devices (Dynamic)

11 People who might Benefit from AAC Anyone who is unable to communicate efficiently with natural speech Includes individuals with: Traumatic Brain Injury Stroke related speech and language disorders Aphasia Apraxia of Speech Degenerative Disorders Amyotrophic Lateral Sclerosis (ALS) Huntington Disease Parkinson s Disease 11

12 12 Many people with these conditions have lost or will progressively lose speech skills How can AAC help? Supplements existing speech Replaces speech that is not functional Allows people with expressive speech limitations a means of communication May increase social interaction and feelings of self-worth (ASHA, 2002)

13 13 Considerations when choosing AAC systems: Speech abilities Motor functioning skills Mobility Cognition level Visual acuity Any possible changes to the above skills AAC system should be flexible to adapt with the individual s changing needs

14 Barriers to AAC Opportunity barriers Due to other people Includes family, schools, hospitals, workplaces, rehab facilities Access Barriers Due to the client s limited abilities or potential (Beukelman & Mirenda, 2005) 14

15 Opportunity Barriers Policy Barriers Official rules in schools, hospitals, etc. Practice Barriers Unofficial procedures in schools, hospitals, etc. 15

16 Opportunity Barriers Knowledge Barriers Supporters lack of information Skill barriers Supporters difficulty applying knowledge Attitude Barriers Supporters negative or restrictive attitudes toward AAC 16

17 Access Barriers Physical/motor abilities Object manipulation and management Cognitive functions Decision making skills Expressive communication Literacy Visual/auditory impairments 17

18 Current Trends iphone apps July 2008: 400 apps January 2011: 400,000+ apps Research to support successful use of applications is needed Clinicians need to be Informed Critical Creative 18

19 Be Informed Website aring.blogspot.com/ cle/iphoneipad-apps-for-aac mon- Assets/spaw2/uploads/files/Using- Mainstream-handheld-devices-ascommunication-aids.pdf Description Blog of new technology Eric Sailer s blog on mobile learning (education) Jane Farrall has constructed a great table listing all the important features about all the known assistive/adaptive communication (AAC) applications for the iphone, ipod Touch and ipad CALL Center Scotland handout on communication applications and accessories for iphone/ipod/ipad 19

20 Be Critical Feature matching - Tech Connect: - Children s Hospital Boston: Augmentative Communication Program ite2016/mainpages2016p0.html 20

21 Be Creative Incorporating mobile technology into service delivery Data collection Speech practice Increase patient s: Understanding of language Communicative functions Communication partners 21

22 Sample Clients Varying levels of: Experience with P2G Post-incident recovery/rehabilitation Social support Treatment experience 22

23 JP Male in early 40s, independent, works as handyman 5 years post onset Snowboarding accident with subsequent stroke Word finding difficulties with severe apraxia speech Introduced to P2G in Fall

24 JP Clinical application of P2G Device competency navigation Communication repairs Increased familiarity with P2G increased his ability to repair breakdowns Asking partner focused questions Basic programming Difficulties with independent programming due to limited writing skills 24

25 PC 62 year old female, enjoys gardening and cooking Lives with husband and son 2.5 years post stroke, right hemiplgia Expressive and receptive aphasia Started using P2G in Spring

26 PC 1 st Semester Device competency Programming of individualized vocabulary Training family members 2 nd Semester Device competency Focus on auditory comprehension 3 rd Semester Operational competency symbol location Partner focused questions Auditory comprehension in relation to question/answer scenarios 26

27 PH Female in her 40s, independent and active 3 years post stroke, right hemiplegia Limited verbal output with apraxia of speech Proficient in use of P2G, is able to program messages independently 27

28 PH 1 st Semester Device competence Navigation Create novel messages 2 nd Semester Device competence Create novel pages 3 rd Semester Strategic competence When to use P2G to repair conversation breakdowns Demonstration of some clinical activities using P2G 28

29 Thank You! SJSU Adult Conversation Club Website: