A Gap Between EBP and Reality

In today's clinical realm, I know that it's easy (and even common!) to "miss the mark" when it comes to providing services to our clients who need AAC (augmentative alternative communication). Light and McNaughton (2012) stated there's a gap in what we know about AAC interventions and what currently happens in the everyday lives of adults and children who use AAC. They suggested increasing public awareness and decreasing attitudinal barriers as ways we can help people who use AAC. That's why I wanted to reach out to people who use AAC and family members of young AAC users to find out what we could do as clinicians and allies to better support them. 

“If you can learn a simple trick, Scout, you’ll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view, until you climb inside of his skin and walk around in it.” 
– Atticus Finch in To...

Assessments + AAC

I first learned AAC assessments my second year of graduate school. I was a part of the AAC evaluation team, which gave me many insights into how AAC assessments or evaluations are conducted. 

Over time, my knowledge and insights into AAC assessment have grown and evolved. I am sharing my most recent recommendations and insights on AAC assessment with you, so that you can also confidently select an AAC system that has a high chance of being a successful communication method for your clients with complex communication needs.

Know the History

A good way to start any AAC assessment is to get a history or background of your client. You will want to know what communication systems were used in the past and why the client or team thinks the system is not sufficient.

Note any high-tech, mid-tech, or low-tech devices, and no-tech systems used (e.g., writing, sign language, etc.).

Ask the family/caregivers about the client’s medical history, any diagnoses...

People often ask me what I do, and who I am!

Let me do a quick intro of myself. I’m Kacy Barron, a speech-language pathologist (SLP), which is our title but we are often referred to as speech therapists! We have that longer title because we actually do WAY more than just speech therapy.

Some things we do that are not just speech: expressive and receptive language, swallowing, feeding, cognitive communication, social skills, augmentative and alternative communication, voice, oral motor disorders, and more!

You can see that we have a pretty broad field! Which is why many of us SLPs specialize in an area or two. 

My specialty is in augmentative and alternative communication, or AAC.

Let me break that down for you! 

Augmentative = Supports verbal speech

Alternative = In place of verbal speech

Communication = Any form of expressing yourself

This article is written to help you understand how AAC can relate to...

I have a special treat for everyone today! I asked AAC SLP’s and AAC SLP’s-to-be their top tips for other SLP’s starting to use AAC. I can’t wait to share with you their #1 tips so you can start implementing their advice TODAY. I was so thrilled with the responses I received, and I really think these top tips can take your therapy to the next level. So, get ready to be inspired and for your AAC to-do list to grow as you read through these top tips from speech-language pathologists as they learned how to do AAC!

Get comfortable with the system outside the therapy room

Karen Fahey of @speechievibes responded with the following advice:

Take the time outside of therapy to play around and get to know whatever system you will be using. Try making a system that would work for your communicative needs! It’s fun, helps you become more comfortable navigating the program, and increases your empathy for and understanding of the experience of the user.

I love...

Many people want to know more about the differences of the LAMP Words For Life app and the Speak For Yourself (SfY) app. Both are AAC applications for iOS that are compatible with iPads. Speak For Yourself (SfY) is also compatible with the iPod/iPhone, which LAMP is not. LAMP is compatible with the Accent products from Prentke Romich Company as well as other dedicated devices (e.g., Talk to Me Technologies) and can be downloaded on their software. These apps essentially turn your iPad into a speech generating device (SGD). It does not alter the software of the iPad- but when downloading these applications you should know that this device is now used for speaking. Many of issues arise when you try to mix entertainment with speaking/communication, but more about that later.

LAMP and SfY are both based on the principals of motor planning. This makes for a strong case when introducing this app to children or adults. I often compare motor planning to how we learn how to...

Funding devices can be the most intimidating piece of the AAC process. Well, maybe not for everyone, but for me it was a huge obstacle! I see posts on Facebook all the time asking how to get a device, where to get one, how to fund one… And the truth is, it is dependent on your insurance, your location, your available resources, and maybe even your school (if the individual needing AAC is currently attending school).

Here is what I have learned from funding devices this year:

1. Devices are expensive. If you don’t know this already, the “dedicated” devices can be upward of 5k. Yes, $5,000. Some people can pay out of pocket for these. Some cannot. I don’t know many people that can say they have $5,000 lying around that they won’t miss. So, paying out of pocket for a device is usually out of the question.
2. Medicaid can be a Godsend. Medicaid will fund SGDs with the proper paperwork in many cases. What medicaid decides to fund and decides to deny is...

I'm a huge nerd when it comes to working with individuals with autism spectrum disorder, or ASD. 

You see, I wrote a graduate thesis and another paper on children with ASD and children with developmental language disorder, or DLD. 

I can't tell you how many research articles I have read on ASD. 

I also can't keep count of the number of people I have worked with who have ASD. 

It was never my intention to seek out working with individuals with autism, it just kind of happened!

And I'm so very glad it did.

I would like to mention that many people with ASD prefer the label-first name, for example, autistics or autistic person. In the academic realm, person-first language is preferred. I often use person-first language (e.g., person with ___), however I completely respect and will sometimes use label-first language out of respect for the autistic community. It is never my intention to offend or hurt a person who identifies either way, and please know that I...

So, your student, client, or child can request using augmentative alternative communication (AAC). Now What?! 

Let me give you some examples of requesting:

"I want a drink."

"Want."

"Me please."

"My turn."

"Get it."

There is SO much more than requesting that all humans should have access to. But, even if we know we want to add more communicative intent to our student/client/child's inventory, how do we facilitate that?

It's all in the modeling

It really is. We need to model (when we demonstrate and help a person use their AAC system) more types of sentences and communicative functions.

Here are the eight communicative functions listed in the Communication Intention Inventory (CII). They were considered to be representative of early intentional communication. These categories can be used to determine intervention goals (Austin, 2013):

1. Comment on action

2. Comment on object

3. Request for action

4. Request for object

5. Request for information

6. Answering a request for...