1 The Critical Need fr Knwledge and Usage f AT and AAC Amng Speech-Language Pathlgists Survey White Paper Published by: Assistive Technlgy Industry Assciatin ATIA 401 N. Michigan Ave., Chicag, IL 60611, U.S.A.
2 Cntents Intrductin... 2 Survey Methdlgy... 2 Executive Summary... 3 Detailed Findings... 4 A Wrthwhile Skill, but a Lack f Knwledge f AT and AAC amng SLPs... 4 Obstacles t Prviding Mre Clients with AT and AAC supprt... 7 Lack f Curses... 7 Mentring... 9 Wrklad Little Access t Cntinuing Educatin Funding Issues Service Delivery Issues Challenges and Opprtunities in Emerging Technlgies Differences in SLPs/Child vs. SLPs/Adult in Desire fr Mre Training Cnclusins Recmmendatins Appendix Survey Questins P a g e A T I A
3 Intrductin In late 2011, the Assistive Technlgy Industry Assciatin (ATIA) cnducted a survey f speech-language pathlgists (SLPs) t gauge attitudes abut and usage f assistive technlgy (AT) and its cmmunicatin subset, knwn as augmentative and alternative cmmunicatin (AAC) within the SLP prfessin. Ultimately, the findings f the study presented herein are meant t cntribute t dialgues ccurring within the SLP prfessin cncerning the use f technlgy in treatment. The stakehlders invlved in implementing this study understand that the SLP prfessin has an verall gal f helping SLPs achieve cmpetency in treatment that uses all apprpriate tls, including technlgy, in the treatment f speech and language disrders. The study is based n Aided AAC, where a cmmercially available device r ther technlgy aids the client in cmmunicating. This is in cntrast t Unaided AAC, which is exemplified by American Sign Language (ASL). The ATIA s hpe and expectatin is that the findings frm this study will be helpful t the SLP prfessin in assessing its use f AT and AAC in treatment and pltting a strategy fr imprving the varius related cmpetencies within the prfessin. The issue f AT and AAC cmpetency in SLP practice has relevance tday. Research cnducted ten years ag by the American Speech-Language Hearing Assciatin (ASHA) fund that identificatin f AT and AAC specialists was nt a pressing prblem at the time. Mst cnsumers and family members fund the small number f available AT and AAC specialists via infrmal netwrks (i.e., wrd f muth ). Mre recently, hwever, ASHA s updated Scpe f Practice in Speech-Language Pathlgy makes AT and AAC knw-hw the respnsibility f all SLPs. Technlgical change has als made it easier fr SLPs t access infrmatin frm experts (via webcasts, nline curses, blgs, etc.) As a result, accrding t ASHA subject matter experts, it appears that significantly mre SLPs are invlved in AT and AAC delivery. Hwever, as the findings f this current survey will reveal, all f this evlutin in training, practice Year f Graduate Degree and awareness has nt necessarily resulted in the level f cmpetency that the prfessin requires. Pre % Figure 1 - Year f graduate degree Caselad by client age grup (n=549) SLPs/Child (Wrk with children) 78% 1990 t Present 57% Figure 2 Caselad by client age grup SLPs/Adult (Wrk with adults) 6% SLPs/Mixed (Wrk with mixed age clients) 16% Survey Methdlgy The ATIA surveyed 549 speech-language pathlgists (SLPs) in the United States. The respndents were drawn frm the membership f tw American Speech-Language-Hearing Assciatin (ASHA) special interest grups (SIGs): One whse missin addresses AT and AAC and the ther, Schl-Based Issues. Respndents represent a range f practice settings, area f fcus/expertise, and length f time in practice. Data was cllected thrugh a quantitative survey via the Internet in Octber, In additin, several in-depth interviews were cnducted with SLP stakehlders wh are familiar with the issues invlved in implementing AT and AAC in the therapeutic cntext. Their cmments infrm sme f the analysis cntained herein. Respndents received n incentives neither mnetary nr inkind in exchange fr their participatin. Tw caveats must be nted: 1) Participatin in survey was self-selected (randm sampling was nt emplyed). 2) Participants were aware that ASHA special interest grups had referred them fr participatin. NOTE - In this paper, we categrize SLPs by client age grup using the fllwing terms: SLPs/Child, SLPs/Adult and SLPs/Mixed (See Figure 2.) 2 P a g e A T I A
4 Executive Summary The majrity f SLPs surveyed admit lacking knwledge, direct experience, and cmpetency in Assistive Technlgy and Augmentative and Alternative Cmmunicatin. Basic cnfusin als exists amng sme SLPs regarding the nature and uses f AT and AAC, and what rle they play in the cntext f language and literacy, and treatment regimens. And, there is a perceptin amng SLPs surveyed that many f their prfessinal peers wh prvide AT and AAC services are unqualified t d s. At the same time, there is a sense that AT and AAC are an interesting and wrthwhile field f knwledge that many SLPs hpe t expand in their practices. Highlights f the survey results include the fllwing: SLPs are interested in AT and AAC: 86% f respndents wuld like t knw mre abut the range f AT and AAC devices and services that can help the learning and cmmunicatins cmpetencies f clients in their caselads. Attitudes abut AT and AAC are nt unifrm. Sme SLPs are excited abut AT and AAC and see it as an pprtunity fr their practices, while thers lack interest, nt perceiving it t be relevant. There are nt enugh AT and AAC-cmpetent SLPs: Only 10% f respndents believe that there are sufficient ranks f SLPs with AT and AAC knwledge t meet the needs f cnsumers. SLPs d nt receive adequate educatin in AT and AAC: 74% f respndents feel that they lack adequate preparatin in AT and AAC in schl. 78% f respndents feel that they had inadequate preparatin in AT, excluding AAC, in their undergraduate and/r graduate prgrams. SLPs pint ut a lack f cnsistency in SLP delivery f AT and AAC services: Mre than a third f respndents feel that their SLP clleagues wh emply AT and AAC interventin strategies and technlgy are nt knwledgeable in AT and AAC. SLPs desire mre knwledge abut AT and AAC, especially in the realm f new technlgies such as tablet cmputers. Mre than 90% f respndents want mre infrmatin abut tablets, and their ptential rle in AT and AAC treatment. In terms f remediating AT and AAC knwledge gaps in the prfessin, SLPs favr a mix f preservice curriculum mdificatins, mre cntinuing educatin pprtunities, and increased mentrship. 3 P a g e A T I A
5 Detailed Findings The survey results reveal a prnunced belief amngst SLPs that knwledge within the prfessin is deficient with regard t AT and AAC. Beneath this clear finding, hwever, many nuances and differences f pinin pervade. This is t be expected in such a large and diverse prfessin. Cmplicating the picture are pragmatic factrs such as diverse needs f the varius client age grups served, funding, and in the schl setting specialized service rles, sme f which preclude direct invlvement in AT and AAC treatment by SLPs. A Wrthwhile Skill, but a Lack f Knwledge f AT and AAC amng SLPs The survey shws a belief that AT and AAC are wrthwhile skills fr an SLP as evidenced by 86% f respndents stating they wuld like t knw mre abut the range f devices and services that can help the learning and cmmunicatins cmpetencies f clients in their caselads. On the tpic f Autistic Spectrum Disrders (ASD), 76% f SLPs/Child feel that AT and AAC are pririties fr them given that it can meet the needs f students with ASD. Despite the clear pinin that AT and AAC are imprtant and relevant t SLP practice, the survey shws strng cnsensus that the prfessin is deficient in its ability t prvide fr the AT and AAC needs f its clientele. As Figure 3 shws, nly 9% f SLPs/Adult and 12% f SLPs/Child think that there are enugh AT and AAC- cmpetent SLPs wrking tday. There are enugh SLP s with AAC knwledge t meet the needs f cnsumers. SLPs/Adult SLPs/Child 86% 85% 9% 12% Agree - Strngly r Smewhat Disagree - Strngly r Smewhat Figure 3 Q5. "There are enugh SLPs with AT and AAC knwledge t meet the needs f cnsumers." Accrding t caselad by age. When SLPs talk abut their wn preparatin t ffer AT and AAC technlgy and interventins, they reflect a similar lack f cnfidence. As Figures 4 and 5 shw, three quarters f SLPs d nt think they had adequate preparatin in AT and AAC in their undergraduate r graduate prgram. SLPs wh earned their graduate degrees befre 1990 feel as if they received less preparatin in AT and AAC than their clleagues wh graduated mre recently. Furthermre, while 3 ut f 4 respndents state that they are familiar with the IDEA 2004 definitin f assistive devices and services, nly 21% felt that they were adequately prepared in AT and AAC by their pre-service training. 4 P a g e A T I A
6 AT and AAC training is ptentially part f the Cmmunicatin Mdalities part f the SLP curriculum, which is required fr ASHA certificatin. Hwever, AT and AAC are nt mandatry. An SLP can attain ASHA Certificatin by taking a curse in ther Cmmunicatin Mdalities such as sign language. In that case, the SLP wuld graduate and receive ASHA certificatin withut taking any cursewrk n AT and AAC. I had adequate preparatin in AAC in my undergraduate and/r graduate prgram. SLPs/Child SLPs/Adult "I had adequate preparatin in AAC in my undergraduate and/r graduate prgram." 1990 t Present Pre % 75% 77% 65% 24% 23% 34% 13% Agree smewhat r Disagree smewhat strngly r strngly Agree smewhat r strngly Disagree smewhat r strngly Figure 4 - "I had adequate preparatin in AAC in my undergraduate and/r graduate prgram." Accrding t caselad by age. Figure 5 - "I had adequate preparatin in AAC in my undergraduate and/r graduate prgram." - By year f graduate degree. This research als sheds light n a crisis f cnfidence that SLPs have regarding their clleagues wh implement AT and AAC. Mre than a third f respndents disagree with the statement, "SLPs wh include AT and AAC in their practices are very knwledgeable abut AT and AAC interventin strategies, including but nt limited t AT and AAC technlgies." Ging beneath the surface, hwever, it becmes apparent that SLPs d nt share a cmmn definitin f AT and AAC r a unifrm sense f where it fits int the brader cntext f treating language and literacy deficits. Evidently, AT and AAC are many things t many peple. On ne level, this cnfusin is understandable cnsidering the multiple diagnses, client age grups, practice settings, and technlgies that exist. And, differences in training explain sme f the cnfusin. Given that 74% f respndents d nt agree with the statement that they received adequate AT and AAC training in schl, it fllws that they wuld nt necessarily all share the same definitin f AT and AAC. 5 P a g e A T I A
7 Dissnance regarding the definitin f AT and AAC falls int fur brad categries: - It s all abut the technlgy Sme respndents have a very narrw perceptin f what AT and AAC are, which includes nly the use f technlgical services and devices t augment cmmunicatin. Fr these SLPs, knwing which cmmunicatin tls, including devices t use and hw t use them summarizes the use f AT and AAC. I have seen several SLPs wh fcus n AT and AAC wh tend t autmatically use the highest tech device pssible, even befre attempting lw tech r fr kids wh d nt have a cnsistent yes/n respnse at all. I think that AT and AAC knwledge is cntingent n the practical use f the device in the setting that yu wrk in. - It s a treatment prcess which may (r may nt) utilize technlgy Sme respndents feel that AT and AAC are simply single parts f a brader language and literacy treatment prcess. [There is an] incrrect perspective by practicing SLPs that they dn t d AT and AAC. Everyne des AT and AAC. It is just a cmmunicatin supprt that shuld be part f all speech and language treatment. In mst cases, AT and AAC are part f every single thing I d as an SLP, even with kids that peple dn t think f as AT and AAC users. I think it is time that AT and AAC and traditinal SLP camps be less divided. - Aren t AT and AT and AAC the same? Sme respndents fail t distinguish between AT (which invlves a vast array f technlgies/devices t help any type f disabled persn functin) and AT and AAC(which is mre narrwly targeted at helping peple with cmmunicatin disrders t cmmunicate). These types f respndents tend t use the acrnyms interchangeably. My district has an AT and AAC team t access and determine best AT. (emphasis added) - It s ver my head Many respndents express a belief that they are s ut f date that they effectively dn t understand the tpic f AT and AAC, r perhaps never did. This may r may nt be the case in reality, but it is a sentiment that infrms respndents pint f view. The technlgy changes s fast, yu need t update a few times a year!!! I had excellent training in AT and AAC in the early 1980s, but I have nt kept up with the latest technlgy as my caselad desn t warrant it. I require training fr each new kind f device I use. A recurring sentiment revlves arund a sense that SLPs wh use AT and AAC tend t be verly reliant n a specific technlgy r device. One schl-based SLP stated, As a lead SLP fr ur [schl] district, I find that SLPs tend t becme familiar with ne way f prviding AT and AAC. Out f 13 emplyees, I have 4 that regularly prvide AT and AAC t students, but each ne has their wn idea f what s best, and are all very different. 6 P a g e A T I A
8 This reflects a gap in understanding abut where AT and AAC fits int the verall treatment prtcl. Accrding t subject matter experts, an AT and AAC interventin shuld fit the client s individual level f language prficiency. Fr example, if a child des nt yet have a firm understanding f language itself (i.e. Yes means I want smething and N means I dn t want smething ) then an augmentative cmmunicatin technlgy, such as a speech generating device, will have limited therapeutic value. Sme SLPs d nt believe that their prfessinal peers are cmpletely aware f whm AT and AAC technlgy can serve and hw including thse wh specialize in AT and AAC. One respndent nted, It seems that SLPs take the same apprach t AT and AAC n matter the diagnsis Autism Spectrum Disrder (ASD) teaching f AT and AAC are very different frm CP and even different than dyspraxia. Anther revealing cmment: I am currently wrking with a 3 rd grader wh is unintelligible. The student is f average ability and is able t express ideas, just nt s he can be understd every SLP I knw that has experience with AT and AAC has n idea what t d fr a student at this by s level. Obstacles t Prviding Mre Clients with AT and AAC supprt There exist a hst f bstacles t the gal f prviding mre clients with AT and AAC supprt. Many factrs are t blame fr the current situatin, thugh the survey results highlights deficiencies in preservice educatin, a lack f mentring, little access t cntinuing educatin pprtunities, verwhelming caselads, and funding prblems. Lack f Curses On educatin, the respndents describe several interlcking prblems with AT and AAC training. On a basic level, there is simply nt enugh time in the curriculum fr dedicated AT and AAC curses. Figure 7 shws the tp 4 barriers t better preparatin in AT and AAC. The issue f n time in the prgram is the mst serius barrier identified. Furthermre, respndents share that attentin devted t AT and AAC at the graduate level is minimal, and that AT and AAC cursewrk is ften elective-nly. Nt surprisingly, nly 21% f respndents feel that they were adequately prepared in AT by their pre-service training. 7 P a g e A T I A
9 Tp 4 Barriers t Increased Preparatin in AAC Lack f AAC cntent integrated in ther curses Lack f AAC clinical pprtunities in the University clinic Lack f faculty wh are well-versed in AAC N time in the prgram fr a required, dedicated curse in AAC Figure 6 Q9 Tp fur ranked barriers t better preparatin in AT and AAC (mean scres). The lack f cursewrk is nly ne aspect f the prblem, hwever. As Figure 6 shws, a lack f AT and AAC cntent integrated int ther curses, a shrtage f faculty wh are well versed in AT and AAC, and few clinical pprtunities in AT and AAC are als cnsiderable barriers. Hence, the status f AT and AAC training in SLP educatin emerges as ne that is a secndary need, ne where faculty themselves may nt have the backgrund t teach it effectively. The desire fr integratin f AT and AAC int ther cursewrk hints that SLPs want t understand AT and AAC ptins and perspectives in a brader treatment cntext. Figure 7 displays bstacles t greater AT and AAC that were identified by asking, What are the mst imprtant factrs in pre-service educatin that wuld result in mre graduating students practicing AT and AAC effectively? Tw factrs emerge as significant: - Mre required curses 67% f SLPs/Child and 78% f SLPs/Adult ranked this as imprtant. - Mentring by experienced AT and AAC prfessinals 73% f SLPs/Child and 63% f SLPs/Adult ranked this as imprtant. 8 P a g e A T I A
10 "What are the mst imprtant factrs in pre-service educatin that wuld result in mre graduating students practicing AAC effectively? (Sum f 1st, 2nd r 3rd rank)" SLPs/Child SLPs/Adult 78% 67% 73% 63% 50% 45% 43% 40% 35% 32% 28% 42% Mre required curses/credits in AAC. Mentring by experienced AAC prfessinals. Internship requirement in AAC. Mre elective curses/credits in AAC. Internship elective in AAC. Schlarships in AAC specialty. Figure 7 Q7 What are the mst imprtant factrs in pre-service educatin that wuld result in mre graduating students practicing AT and AAC effectively? (Sum f 1st, 2nd r 3rd rank) Mentring Interest in mentring as a slutin fr imprving AT and AAC knwledge demnstrates that a lack f mentring is a factr inhibiting knwledge tday. SLPs/Adult view mentring by experienced AT and AAC prfessinals as the single mst imprtant way t becme prficient in AT and AAC technlgies and interventins; whereas SLPs/Child cnsider n-the-jb cntinuing educatin t be just abut as imprtant as mentring in achieving AT and AAC cmpetence. SLPs/Mixed (wh treat clients age birth t ver 65 years f age) have a much greater interest in becming mentrs (76%) than thse wh treat nly children (43%). This greater interest frm SLPs/Mixed may be due t a cmfrt level that they have achieved frm prviding a greater range f services. SLPs/Child are much mre interested in being mentred (80%) than SLPs/Adult (50%). Regardless f their treatment ppulatin, thse SLPs/Adult wh received their master s degree after 1990 are als very interested in being mentred (81%). (Nte, hwever, that Questin 10, which asked respndents if they want t be mentred and wanted t be a mentr des nt specifically refer t mentring in AT and AAC.) Imprtance f Pre-Service vs. In-Service Mentrship n Develping AAC Knwledge and Skills 90% SLPs/Adult 74% 63% 73% SLPs/Child In-Service Mentring Pre-Service Mentring Figure 8 Imprtance f Pre-Service vs. In-Service Mentrship n Develping AT and AAC Knwledge and Skills Accrding t caselad by age. Figure 8 cmpare views n mentring acrss the Adult and SLPs/Child. SLPs/Child seem t be mre interested in mentring as a pre-service pprtunity while SLPs/Adult seem t favr mentring while in 9 P a g e A T I A
11 practice. This makes sense given that many SLPs/Child mve directly frm degree prgrams t schl settings where they are plunged int AT and AAC treatment issues right away and may feel the need fr earlier mentring n the tpic mre urgently. Wrklad Sme respndents, particularly schl-based SLPs, cite a lack f time in their schedules t becme mre versed in AT and AAC. D nt put mre n us. We barely functin in the schl setting when we have students n a caselad. Experts affirm that lack f time and heavy wrklads prevent many SLPs frm learning mre abut AT and AAC. An interesting finding is that there is a perceived lw frequency f actual need fr AT and AAC, and this fact als makes learning AT and AAC less f a pririty fr sme SLPs. It is perhaps unrealistic t expect SLPs t have cmpetency in cnducting AT and AAC evaluatins r have familiarity with a range f devices given all f their ther prfessinal respnsibilities. Experts cncur that a diversity f pinin exists abut the actual need fr AT and AAC. While sme f the respndents eched the sentiment that nly a small percentage f clients need AT and AAC, research dne by ASHA [need citatin] fund that SLPs believe that mre than half f their clientele culd benefit frm sme frm f AT and AAC. This split hints at a self-perpetuating cycle, where AT and AAC-challenged SLPs are reluctant t prvide the service and their clleagues are unlikely t refer t AT and AAC specialists in whm they lack cnfidence. As a result, AT and AAC are nly pursued in a small selectin f cases. Little Access t Cntinuing Educatin Asked What factrs wuld increase the availability f SLPs with AT and AAC skills?, respndents in aggregate and SLPs/Adult as a sub-grup rank Mre pprtunities in cntinuing educatin in AT and AAC as number ne. But SLPs/Child cntend that the best way t enlarge the field f AT and AACskilled SLPs is t clearly demnstrate that AT and AAC are evidence-based practices. Bth Adult (67%) and SLPs/Child (52%) agree that added AT and AAC pre-service requirements wuld als lead t a swelling f the ranks f SLPs/Adult wh are practicing AT and AAC. And SLPs/Child feel that mre knwledge abut AT and AAC prducts wuld drive a prliferatin f AT and AAC-skilled SLPs, as well. 10 P a g e A T I A
12 "What factrs wuld increase the availability f SLPs with AAC skills?" (Mean rankings) Better Reimbursement fr AAC assessment and therapy Awareness f the pprtunity fr practice grwth, based n the ptential size f ppulatin needing services in AAC. Mre knwledge abut available AAC prducts. Mre AAC preservice requirements. Mre infrmatin regarding evidencebased interventin practices in AAC. Mre pprtunities fr cntinuing educatin in AAC. Figure 9 Q6 What factrs wuld increase the availability f SLPs with AT and AAC skills? (Mean rankings) Funding Issues There exists a hefty set f impediments t accessing the pprtunities fr cntinuing educatin. [We need] mre affrdable cntinuing educatin pprtunities/reimbursement - unfrtunately a lt f settings that use/implement AT and AAC d nt have the budgets t educate staff/send them t wrkshps r pay t bring peple in, and SLPs seem less willing t spend their wn mney during these fiscally cnscius times. The issue f better reimbursement fr AT and AAC assessment and therapy was ranked rather lw as a driving factr that wuld increase the availability f SLPs with AT and AAC skills. But pen-ended cmments by respndents and discussins with experts in the field indicate that funding is in fact a majr bstacle t getting mre SLPs wrking with AT and AAC. SLPs are cncerned that equipment is nt always cvered by insurance and that related services are nt cnsistently cvered either. Service Delivery Issues I wrk with a significant number f students with autism and have fund AT t be ne f the mst imprtant aspects f treatment the challenge has been btaining funds fr technlgy via insurance reimbursement as well as having the time and talent t prgram the high tech devices and create lw tech systems. High tech devices are s expensive and it is becming mre and mre difficult t btain apprval fr devices thrugh private insurance cmpanies. I am finding that even when apprval is given families have a difficult time paying their c-payment prtin. Many schl-based SLPs view the AT and AAC knwledge questin frm an institutinal distance. While SLPs may have clients n their caselads wh are in need f AT and AAC, depending upn the rganizatin structure f the schl, AT and AAC may be implemented by ther prfessinals. Sme 11 P a g e A T I A
13 schl districts have AT and AAC handled by departments ther than Speech and Language, with little if any crdinatin with SLPs. Many smaller districts d nt have that ptin in place. They may have never had it r it is currently unavailable due t budget cuts. In sme cases, they may have previusly used utside cnsultants r fee-fr-service AT resurces centers and s frth. Yet, schl-based SLPs are invariably required t serve all students that cme int their caselads. The SLP is respnsible fr prviding the best treatment ptins but is frequently unable t influence hw AT and AAC will actually be delivered. The result is frustratin and stress abut hw t best prvide AT and AAC fr clients wh need it. It is impssible fr the average SLP in the schls t stay knwledgeable abut all AT and AAC technlgies. An AT and AAC/AT specialist is needed t d that. Our district des nt use SLPs fr AT and AAC evaluatins r training. Challenges and Opprtunities in Emerging Technlgies Technlgy presents bth an pprtunity and a challenge. SLPs mentined technlgical advances with bth psitive and negative cnntatins. Fr sme lnger-practicing SLPs, technlgy is viewed as a frustrating bstacle. Fr example, It is hard t keep up with all f it [AT and AAC technlgy] when yu are wrking with the children and dealing with the day t day needs and requirements and Technlgy is changing s fast that the lessns I received in schl n lnger exist. At the same time, many respndents express a view that technlgy, especially new tablet cmputers, hlds prmise fr making high quality AT and AAC available at relatively lw cst. Tablets with AT and AAC sftware are apparently far less expensive than custm made AT and AAC technlgies. If a tablet is cmparable t the dedicated speech utput device, they culd be purchased fr less than families wuld have t pay fr a c-pay n dedicated devices. "I need t learn mre abut hw t use tablets (ipad, etc.) and applicatins in my clinical practice." SLPs/Child SLPs/Adult 55% 42% 33% 26% 21% 6% 6% 11% Strngly agree Agree smewhat Disagree smewhat Strngly disagree Figure 10 Q13 Level f agreement with I need t learn mre abut hw t use tablets (ipad, etc.) and apps in my clinical practice. - Accrding t caselad by age. 12 P a g e A T I A
14 As Figure 10 demnstrates, 85% f respndents verall perceive that they need t learn mre abut hw t use tablets and applicatins in their clinical practices, cmpared t nly 65% f SLPs/Adult. This split suggests that tablets, which are easily acquired, easy t use, and cmparatively inexpensive, are seen as a real bn t schl age clients. Hwever, the same cautins abut the ver-reliance n technlgy discussed earlier shuld still be factred int the discussin abut the ptential f tablets. Sme respndents express cncern that tablet cmputers are being hailed as a magic cure-all. They warn that, as with any AT and AAC treatment technlgy, such as tablet devices must fit int the cmplete diagnstic and treatment scheme. I have becme increasingly frustrated with the pervasive general attitude that an ipad is the answer t meeting a student's AT and AAC needs. As smene wh wrks clsely with teams thrugh a cllabrative evaluatin and decisin-making prcess, it is ften nt the best AT and AAC tl. Differences in SLPs/Child vs. SLPs/Adult in Desire fr Mre Training Asked abut a set f tpics in which respndents wuld be interested in mre infrmatin and/r training, psitive respnse was quite high. The lwest ranked ptin, Hw t write an effective evaluatin reprt was favred by 75% f respndents. Tablets and assessment tls received 91% agreement. SLPs/Child, hwever, express a higher level f agreement with the desire t learn than d SLPs/Adult. In sme cases, the tpics are schl-related, s the lack f interest amng SLPs/Adult is understandable. Hwever, interest n the part f the SLPs/Adult lags behind that f SLPs/Child in every single case. This suggests that SLPs/Child are under mre pressure t be prficient in AT and AAC than their cunterparts with adult-nly caselads. The table blw summarizes the results and highlights the difference between Child and SLPs/Adult. Respnses t: I wuld be interested in mre infrmatin and/r training n the fllwing tpics: SLPs/Child "Strngly r Smewhat Agree " SLPs/Adult "Strngly r Smewhat Agree " Hw t select the right tls fr each client 91% 84% Hw t keep up with changing technlgy 95% <85%> Overview f AT relevant t speech-language pathlgy (beynd AT and AAC) 89% <75%> Available assessment tls - what available and hw t use them 93% <79%> Cmparisn f AT and AAC dedicated cmmunicatin devices 88% <72%> Resurces and strategies fr funding (including grants) this includes funding fr mbile & tablet devices 90% <74%> Hw t write an effective evaluatin reprt 78% <61%> AT fr persns with Autism 91% <64%> Mbile & tablet devices (such as iphnes, ipads, etc.) as instructinal tls and student supprts - hw they wrk with the IEP Gals 95% <52%> Cllabrative teaming fr AT in the schls 87% <27%> Table Q14 Shws cmbined Agree smewhat and Agree strngly respnses fr I wuld be interested in infrmatin and/r training n the fllwing tpics. < > = difference is statistically significant at a 90% cnfidence level. 13 P a g e A T I A
15 Cnclusins The SLP prfessin has recgnized the challenges that are raised in this study n an anecdtal basis fr many years. Nw, hwever, it is pssible t quantify ur understanding f knwledge f AT and AAC and suggest ways that everyne invlved in speech-language pathlgy can mve the issue frward. Given the gal f helping SLPs achieve cmpetency in speech-language pathlgy treatment that uses all apprpriate tls, including technlgy, the present research reveals that the state f prviding AT and AAC apparatus and services is prblematic n numerus levels. Underpinning this is a strng sense that the skill set f AT and AAC amng SLPs needs t be imprved, and that clients culd benefit frm additinal numbers f SLPs with increased AT and AAC cmpetencies. There are nt enugh AT and AAC cmpetent SLPs: SLPs cnsider neither themselves nr their peers t be truly capable f delivering AT and AAC t clients. The prfessin des nt seem t have a standard definitin f what AT and AAC are, as well as an understanding f hw AT and AAC can prvide slutins t their clients. Mst SLPs didn t learn AT and AAC in schl and cntinuing educatin is difficult t get: Educatinal apprach t AT and AAC deficient and flawed Mentrs wanted but nt easy t find Schl districts are decreasing r eliminating budgets fr SLPs wh prvide AT and AAC and/r cntinuing educatin fr thse wh are suppsed t be prviding thse services Prfessinal cnditins are nt always hspitable t AT and AAC: Lack f funding fr adequate evaluatins, AT and AAC device ptins, and/r treatment. Organizatinal (schl district) structure frequently makes SLP respnsible fr AT and AAC but des nt permit them t implement it. The circumstances f treatment delivery are nt always ptimal. T much narrw fcus n specific devices and techniques. Lack f integratin with brader speech/language treatment apprach 14 P a g e A T I A
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