1 AugCommEvalsSimplified (ACES) Tools & Resources Using your toolkit.

11

Aug Aug

CommComm

EvalsEvals

SimplifiedSimplified

(ACES) Tools & Resources(ACES) Tools & Resources

Using your toolkitUsing your toolkit

22

GoalGoal

Learn the ACES module to assist in Learn the ACES module to assist in your evaluation processyour evaluation process

To define and finish your toolkit listTo define and finish your toolkit list To learn more web-based resourcesTo learn more web-based resources Your local reps and the ways they Your local reps and the ways they

assistassist To leave with “next steps” for the To leave with “next steps” for the

cases you came withcases you came with

33

AgendaAgenda

Evaluation Examples: 3 types of Evaluation Examples: 3 types of communicatorscommunicators

Work through your individuals with Work through your individuals with complex communication needs (CCN)complex communication needs (CCN)– Use the ACES module and Evaluation Use the ACES module and Evaluation

ToolkitToolkit– Feature matchingFeature matching

AAC equipmentAAC equipment– Communication evaluation toolsCommunication evaluation tools– Website resourcesWebsite resources– Meet your vendorsMeet your vendors

44

Your turnYour turn

Do case histories – Do case histories – Yours & in groupYours & in group

– ACES moduleACES module Tools usedTools used Communicator skillsCommunicator skills Device featuresDevice features Next steps . . . Next steps . . .

Lunchtime – trial toolkits Lunchtime – trial toolkits

55

What was one idea yesterday that What was one idea yesterday that you will implement? you will implement?

66

Evaluation softwareEvaluation software Tobii CommunicatorTobii Communicator HomepageHomepage Choose 1 from each categoryChoose 1 from each category

Try spellingTry spelling

77

Evaluation ExamplesEvaluation Examples

3 types of communicators –who is 3 types of communicators –who is yours?yours?

– EmergingEmerging

– Context – dependent / situation dependentContext – dependent / situation dependent

– IndependentIndependent

88

What you will need:What you will need:

99

EmergingEmerging

No No RELIABLERELIABLE means of means of EXPRESSIVEEXPRESSIVE communication through communication through SYMBOLICSYMBOLIC language language

Have some functional non-verbal Have some functional non-verbal communication (gestures, vocalizations, communication (gestures, vocalizations, other nonsymbolic communication)other nonsymbolic communication)

Able to attend, even briefly, to individuals, Able to attend, even briefly, to individuals, conversations, pictures, or symbolsconversations, pictures, or symbols

Yes/no (acceptance/rejection) depicted with Yes/no (acceptance/rejection) depicted with body language; i.e. no reliable yes/no for body language; i.e. no reliable yes/no for more complex communicationmore complex communication

1010

Case history for LM; Case history for LM; Pertinent backgroundPertinent background

Age: 4 years oldAge: 4 years old Diagnosis: Seizure disorderDiagnosis: Seizure disorder

Communication Diagnosis: DysarthriaCommunication Diagnosis: Dysarthria School setting: Attends university School setting: Attends university

preschoolpreschool Previous evaluation by AT team / Previous evaluation by AT team /

schoolschool– Did not address communication Did not address communication

components; recommendations for AT components; recommendations for AT good – other info wanted to expand on:good – other info wanted to expand on:

What doing? How doing it? What doing? How doing it?

1111

LM continuedLM continued

Mother very involved – attend Mother very involved – attend workshop w/ team workshop w/ team

Previous program set up for school; Previous program set up for school; several things tried at homeseveral things tried at home

Reason for evaluation: mother Reason for evaluation: mother wants support for home program – wants support for home program – and wants to coordinate with school.and wants to coordinate with school.

1212

Observations:Observations:

Limited interestsLimited interests Short attention span for most Short attention span for most

activitiesactivities Very active – did not sit for longVery active – did not sit for long Needed constant attention for Needed constant attention for

safety due to balancesafety due to balance Mother felt she was a distraction - Mother felt she was a distraction -

not wanting to be therenot wanting to be there

1313

Toys mother brought (books with sound, IPOD)

Objects – monkey; ball, bubbles, etc.

Switch - Switch interface – toy

Single Message communicator

Computer (with touchscreen) w/ RJ Cooper Software

1414

Level: Emerging

Vision: not sure

Hearing: normal

Current communication: facial, body language, vocalizations, some eye contact, sign more / all done (approximations)

Fine motor: gross imitations of signs

Gross motor: poor balance, constantly moving

Switch access: best with no wires

1515

ObservationsObservations

Use of objects recommended:Use of objects recommended: Starting to use; tried “monkey” for songStarting to use; tried “monkey” for song Cause – effect with toys: (magic frog / bubble Cause – effect with toys: (magic frog / bubble

machine)machine)– Played with switch cables – needed to cover up (wireless Played with switch cables – needed to cover up (wireless

would be better and attach switch to table)would be better and attach switch to table)– Reached for toy – needed to keep toy out of reachReached for toy – needed to keep toy out of reach– Not much attention Not much attention

Voice output – single message communicator – no Voice output – single message communicator – no interestinterest

Computer program / using CE software with Computer program / using CE software with touchwindowtouchwindow– Limited attentionLimited attention

1616

Chart – not appropriate

Instead use Communication Matrix –

Likes / Dislikes checklist

1717

1818

Communication MatrixCommunication Matrix

1919

2020

University of University of WashingtonWashington likes_and_dislikes_checklist.doclikes_and_dislikes_checklist.doc

A checklist can be helpful when A checklist can be helpful when searching for initial likes and searching for initial likes and dislikes for an individual with dislikes for an individual with "emerging" communication skills. "emerging" communication skills.

Searches auditory, visual, Searches auditory, visual, kinesthetic, tactile, tastes, kinesthetic, tactile, tastes, textures, smells, etc. textures, smells, etc.

Copyright (2002) Patricia Dowden, Ph.D., CCC-Sp; UW Speech & Copyright (2002) Patricia Dowden, Ph.D., CCC-Sp; UW Speech & Hearing SciencesHearing Sciences

2121

Goals: Goals: Communication Communication FunctionsFunctions Make request – use objectsMake request – use objects Make choices – touch; choice of 2Make choices – touch; choice of 2 Continue – more; touch objectContinue – more; touch object Stop – all doneStop – all done Protest/reject – push away; head shakeProtest/reject – push away; head shake Help – approach person; hand Help – approach person; hand

something to personsomething to person

2222

Questions? ? ? Questions? ? ?

2323

Case Study #2 - DZCase Study #2 - DZ

Age 7Age 7

Diagnosis: Down’s Syndrome: AutisticDiagnosis: Down’s Syndrome: Autistic Communication Diagnosis: DyspraxiaCommunication Diagnosis: Dyspraxia

Reason for referral: Mother and SLP felt like Reason for referral: Mother and SLP felt like he could benefit from use of voice output; he could benefit from use of voice output; felt he was “ready” due to new interest in felt he was “ready” due to new interest in computercomputer

2424

Context- or Partner-Context- or Partner-DependentDependentHas Has SYMBOLICSYMBOLIC communication that is communication that is RELIABLERELIABLE

but limited to particular but limited to particular CONTEXTSCONTEXTS or or PARTNERSPARTNERS

Rely on partners to provide limited response Rely on partners to provide limited response setset

Need frequent instruction and cueingNeed frequent instruction and cueing Difficulty with initiationDifficulty with initiation May only be functional in particular settingsMay only be functional in particular settings Wide range with regard to # of partners and Wide range with regard to # of partners and

# of settings# of settings

2525

Pertinent Background Pertinent Background Info:Info: Home schooledHome schooled Receiving private speech therapyReceiving private speech therapy Previously tried verbal, gestures, Previously tried verbal, gestures,

signs, PECS – not successfulsigns, PECS – not successful Interest in computer; was using Interest in computer; was using

computer and had started computer and had started accessing it with a mouse.accessing it with a mouse.

2626

Observations:Observations:

Limited interestsLimited interests Short attention span for most Short attention span for most

activitiesactivities Had cloth he carried much of the timeHad cloth he carried much of the time Brought items to session (his CD) Brought items to session (his CD) Limited communication functionsLimited communication functions

(currently completing Communication (currently completing Communication Matrix & Likes / Dislikes form)Matrix & Likes / Dislikes form)

2727

Tools usedTools used

Single Switch – Switch Latch Timer – Battery operated toy (bubbles)Single message communicatorGo Talk 4+ - 9+ - 20+Computer with his software, RJ Cooper software, and communication software (navigating pages)

2828

ObservationsObservations

Demonstrated ability to operate switch Demonstrated ability to operate switch (bubble machine). Used with switch (bubble machine). Used with switch latch timerlatch timer

Tried voice output devices (Go Talks)Tried voice output devices (Go Talks) Computer program / access: Moved Computer program / access: Moved

mouse to drag object from bottom of mouse to drag object from bottom of screen to picture above it (example screen to picture above it (example bone up to dog)bone up to dog)

Enjoyed voice output – when paired Enjoyed voice output – when paired with high interest activitywith high interest activity

Was very purposeful and accurate Was very purposeful and accurate almost immediatelyalmost immediately

2929

Video - DZVideo - DZ

3030

Level: Context-dependent

Vision: glasses

Hearing: normal

Current communication: facial, body language, vocalizations, reach , some eye contact

Fine motor: use single finger; tap

Gross motor: very ambulatory

3131

3232

SymbolsSymbols

Used 2 symbols: ball and computer on Used 2 symbols: ball and computer on 4 pictures device (Go Talk) 4 pictures device (Go Talk)

2” size (color with background colored)2” size (color with background colored) Progressed to 1” pictures on Progressed to 1” pictures on

20+ Go Talk20+ Go Talk 1” size (color with white background)1” size (color with white background) Concrete (ball) and abstract (more)Concrete (ball) and abstract (more)

3333

Language Language representationrepresentation Single meaning picturesSingle meaning pictures

3434

Navigation page Navigation page changeschanges One page per situationOne page per situation

Facilitator changeFacilitator change

3535

Keyboard – Keyboard – not at this not at this timetime

Voice / speech – Voice / speech – digitized; high digitized; high interest – easier to understandinterest – easier to understand

Type of device – Type of device – digitized static digitized static display; (Ruled out dynamic display; (Ruled out dynamic display: lack of vocabulary display: lack of vocabulary needs; durability)needs; durability)

Device functions - Device functions - NA NA

3636

Rate enhancementRate enhancement - - NANA

Message formulation – Message formulation – single single message – or combine words into message – or combine words into routine phraseroutine phrase

Message display - Message display - NANA

3737

Device types triedDevice types tried

Static display (Go Talks)Static display (Go Talks)– 9+ (2 inch); 20+ (1 inch)9+ (2 inch); 20+ (1 inch)

Dynamic display Dynamic display – Not as easy to see; short visual Not as easy to see; short visual

attentionattention– Knocked on the floorKnocked on the floor– Too sensitive; touched multiple Too sensitive; touched multiple

places at one timeplaces at one time– Could be used as Could be used as

3838

Symbols: Pictures; digital photos – people

Language representation: single meaning pics;

Navigation: facilitator change; few pages needed for vocabulary interest – up to 10 pgs

Keyboard: NA

Voice/speech: digitized

Type of device: digitized

Device functions: NA

Rate enhancement: NA

Message formulation: single key messages

Message display: NA

3939

Other FactorsOther Factors

4040

Functions – WHY are Functions – WHY are they communicating?they communicating? X Attend to environment/othersX Attend to environment/others X Express wants/needsX Express wants/needs X Make requests / choicesX Make requests / choices X Continue/stopX Continue/stop X Request attention / helpX Request attention / help X ProtestX Protest X GreetX Greet Answer / ask questionsAnswer / ask questions Direct actions of othersDirect actions of others Initiate – maintain – end conversationInitiate – maintain – end conversation Make commentsMake comments Relate personal experiences/eventsRelate personal experiences/events Repair communication breakdownsRepair communication breakdowns Express novel thoughts / ideasExpress novel thoughts / ideas

4141

Places – where are Places – where are they communicating?they communicating? HomeHome

4242

Communication Communication partners – who are partners – who are theythey MomMom Dad (occasionally)Dad (occasionally) Speech therapistSpeech therapist SiblingsSiblings

4343

Researching devicesResearching devices

aacTechConnect.comaacTechConnect.com Free resourcesFree resources

– Simpler digitizedSimpler digitized– DigitizedDigitized

4444

aacTechConnect.com – possibilitiesaacTechConnect.com – possibilitiessimpler digitized devicessimpler digitized devices

4545

Digitized devices to considerDigitized devices to consider

4646

Device Assistant Search-Device Assistant Search-pick the symbols to usepick the symbols to use

4747

Helps you decide on type of Helps you decide on type of devicedevice

4848

Answer the questions about Answer the questions about featuresfeatures

4949

5050

5151

5252

www.aacTechConnect.cwww.aacTechConnect.comom

* Review simpler digitized devices* Review simpler digitized devices

5353

Decision-makingDecision-making

FundingFunding

Devices to consider Devices to consider

Trialing devicesTrialing devices

RecommendationsRecommendations

5454

Accessories sheet (on Accessories sheet (on CD)CD)

5555

Report template (on Report template (on CD)CD)the Communicatorthe Communicator

5656

The Communicator – The Communicator – Other FactorsOther Factors

5757

Decision-making Decision-making

5858

Device decision-Device decision-makingmaking

5959

SDT video SDTSDT video SDT

6060

Other examples YGOther examples YG

Used to promote verbal speech Used to promote verbal speech – Severely apraxic 9 year old, bilinguqal Severely apraxic 9 year old, bilinguqal

girlgirl– Very little verbal speech – choose not to Very little verbal speech – choose not to

speakspeak– Teach to imitate words as she selects Teach to imitate words as she selects

them- including sentences (highlighting)them- including sentences (highlighting)– Helps to facilitate syntaxHelps to facilitate syntax– Used to clarify speechUsed to clarify speech– Increases confidence and use of verbal Increases confidence and use of verbal

speechspeech

6161

YG videoYG video

6262

Independent Independent (Generative)(Generative)Can communicate Can communicate ANYTHINGANYTHING on on ANY ANY

TOPICTOPIC to to ANYONEANYONE in in ANY CONTEXTANY CONTEXT

Locate, select, and convey messages Locate, select, and convey messages on their ownon their own

Can interact with familiar / unfamiliar Can interact with familiar / unfamiliar partners equally wellpartners equally well

Can sequence symbols or letters to Can sequence symbols or letters to generate novel messagesgenerate novel messages

6363

Case Study #3 - MSCase Study #3 - MS

Independent communicatorIndependent communicator ALSALS Computer literateComputer literate Current conditionCurrent condition Verbal speech minimally adequate in a Verbal speech minimally adequate in a

few situations; changing quicklyfew situations; changing quickly Physical access – severely limited- in Physical access – severely limited- in

wheelchair – and unable to use hands on wheelchair – and unable to use hands on keyboard / mousekeyboard / mouse

Very computer literate – used to Very computer literate – used to communicate by email communicate by email

6464

ToolkitToolkit

AccessAccess– Headpointing - fatiguesHeadpointing - fatigues– Eye gaze – good Eye gaze – good – Scanning – single / double switch – could do- Scanning – single / double switch – could do-

much slowermuch slower

Language Representation methodLanguage Representation method– Spelling Spelling – Word-based Word-based – Pre-stored messagesPre-stored messages– Conversation facilitationConversation facilitation

6565

Free software (no voice)Free software (no voice)– Point-N-ClickPoint-N-Click– Click-N-TypeClick-N-Type– EtriloquistEtriloquist

Word +Word +– EZ keys – rental (with voice)EZ keys – rental (with voice)

6666

OutcomeOutcome

Trialed various systems – decided on Trialed various systems – decided on Tobii ATI (recommended by other Tobii ATI (recommended by other therapist)therapist)

Not used for whileNot used for while Not working – problems and no local Not working – problems and no local

supportsupport Insurance provided first systemInsurance provided first system Added Medicaid – should pick it upAdded Medicaid – should pick it up Continued use of computer for written Continued use of computer for written

communication (offered)communication (offered) MDA fundingMDA funding

6767

22ndnd evaluation evaluation requestedrequested Called vendorsCalled vendors

– 3 in area3 in area– Patient request for 1Patient request for 1– Short timeline too provide trials for all Short timeline too provide trials for all – EyeMax worked immediatelyEyeMax worked immediately– Company agreed to provide loaner during Company agreed to provide loaner during

funding processfunding process– Waiting – using device independently with Waiting – using device independently with

grammar based text-boardsgrammar based text-boards

6868

TMTM

27 year old autistic boy27 year old autistic boy Very good on internet browsing (Google Very good on internet browsing (Google

King)King) Need device for communityNeed device for community Previous evaluation-recommendationsPrevious evaluation-recommendations Use of several communication systems (low Use of several communication systems (low

& high tech)& high tech)– WordPower – home use – slow down words – pace WordPower – home use – slow down words – pace

himselfhimself– Calendar – for allCalendar – for all– Device – for additional Device – for additional

spelling/conversation/community interactionsspelling/conversation/community interactions– Spelling system – character prediction – use of Spelling system – character prediction – use of

word predictionword prediction

6969

TM - continuedTM - continued

Program own device- Say It Sam Program own device- Say It Sam Communicator by Words +Communicator by Words +– I will repeat the steps AFTER he does I will repeat the steps AFTER he does

them (100% proficient)them (100% proficient)– Select his own vocabularySelect his own vocabulary– Where he wants to program itWhere he wants to program it– Chooses picturesChooses pictures– Do not give him access all of the timeDo not give him access all of the time

7070

TM videoTM video

7171

SRSR

First met – device down – with First met – device down – with keyguardkeyguard

Increase access by putting device upIncrease access by putting device up improve access by 50%improve access by 50% Found software to replace keyguardFound software to replace keyguard Highlights as she moves over it – Highlights as she moves over it –

used to use screen to stabilize – now used to use screen to stabilize – now access has improvedaccess has improved

7272

SR videoSR video

7373

Questions? ? ? Questions? ? ?

7474

Your turnYour turn

Decide on groupsDecide on groups- - Emerging communicatorsEmerging communicators– Context – depending communicatorContext – depending communicator– Independent communicatorIndependent communicator

Decide on 1 person the group will Decide on 1 person the group will focus onfocus on

Get out your worksheets: Get out your worksheets: Communicator / Device / ToolkitCommunicator / Device / Toolkit

7575

Pertinent Background Pertinent Background InfoInfo

Age: Age: DiagnosisDiagnosis Medical concernsMedical concerns Educational /residential setting: Educational /residential setting: Behavioral (attention, continue/end Behavioral (attention, continue/end

situation/activity; help, express situation/activity; help, express desires/ needs, etc.)desires/ needs, etc.)

OtherOtherReason for evaluation: Reason for evaluation:

7676

CommunicatorCommunicator

7777

DeviceDevice

7878

Other factorsOther factors

7979

Functions – WHY are Functions – WHY are they communicating?they communicating? Attend to environment/othersAttend to environment/others Express wants/needsExpress wants/needs Make requests / choicesMake requests / choices Continue/stopContinue/stop Request attention / helpRequest attention / help ProtestProtest GreetGreet Answer / ask questionsAnswer / ask questions Direct actions of othersDirect actions of others Initiate – maintain – end conversationInitiate – maintain – end conversation Make commentsMake comments Relate personal experiences/eventsRelate personal experiences/events Repair communication breakdownsRepair communication breakdowns Express novel thoughts / ideasExpress novel thoughts / ideas

8080

Other factorsOther factors

WhereWhere

With whom?With whom?

8181

Device Selection Device Selection OptionsOptions CataloguesCatalogues

– AAC TechConnect – contact AAC TechConnect – contact manufacturersmanufacturers

Manufacturer websitesManufacturer websites– Go to individual ones – AAC TechConnect Go to individual ones – AAC TechConnect

has listhas list AAC TechConnect – free resourcesAAC TechConnect – free resources

– Pictures (thumbnails of 85+ devices)Pictures (thumbnails of 85+ devices)– Free flyersFree flyers

8282

8383

Lite Tech Low Cost Lite Tech Low Cost ChartChart

8484

Trialing equipmentTrialing equipment

Vendors – local resourcesVendors – local resources ManufacturersManufacturers Loan equipmentLoan equipment Rental optionsRental options

8585

Manufacturers RepsManufacturers Reps

Companies:Companies:– DynaVox Mayer-JohnsonDynaVox Mayer-Johnson– PRCPRC– Tobii ATITobii ATI– Saltillo Saltillo – TellusTellus– Words +Words +– ZygoZygo

8686

FundingFunding www.aacfundinghelp.comwww.aacfundinghelp.com 33rdrd party medical funding party medical funding

(Medicaid, Medicare, Private (Medicaid, Medicare, Private Insurance)Insurance)

Medicaid AvailableMedicaid Available Educational or VocationalEducational or Vocational

or Independent livingor Independent living Private pay or donationsPrivate pay or donations

(Used equipment)(Used equipment) Work with your local device Work with your local device

representativesrepresentatives

8787

www.aacfundinghelp.cwww.aacfundinghelp.com om

8888

Explore programming Explore programming of the deviceof the device Try the actual programming – see Try the actual programming – see

how it feelshow it feels Communication partners need to Communication partners need to

feel comfortable with the feel comfortable with the programmingprogramming

Sales representatives can assistSales representatives can assist Ask what support options includeAsk what support options include

8989

Accessories (list on Accessories (list on CD)CD) Carry bagsCarry bags KeyguardsKeyguards Access hardware (switches/head controlled Access hardware (switches/head controlled

device, joystick, etc.)device, joystick, etc.) Mounting systems/componantsMounting systems/componants Extra power (if required)Extra power (if required) Internet/computer access Internet/computer access

(hardware/software)(hardware/software) Environmental controlsEnvironmental controls Software to make overlays (for digitized Software to make overlays (for digitized

devices)devices) Others?Others?

9090

Completing the Completing the paperwork (on CD)paperwork (on CD) Gather – Case History Gather – Case History Summarize – Assessment Summarize – Assessment

SummarySummary Write report - ReportWrite report - Report Get quote / info from manufacturerGet quote / info from manufacturer Complete funding paperwork Complete funding paperwork

(packets from each company)(packets from each company)

9191

Free templatesFree templates

CDCD www.aac-rerc.orgwww.aac-rerc.org Report Coach: aacfundinghelp.comReport Coach: aacfundinghelp.com Dynavox – Funding ManagerDynavox – Funding Manager Prentke-Romich: Funding Submission Prentke-Romich: Funding Submission

AssistantAssistant Templates on www.aactechconnect.comTemplates on www.aactechconnect.com

9292

Questions? ? ? Questions? ? ?

FeaturesFeatures

Access methodsAccess methods

Hands-onHands-on

ProgrammingProgramming

FundingFunding

SupportSupport

9393

Do you . . . Do you . . .

Have some new Have some new strategies to try?strategies to try?

Have some things in your Have some things in your closet you will dig out closet you will dig out for use?for use?

9494

Our goals were . . . Our goals were . . . Explain the process of obtaining an AAC tool/deviceExplain the process of obtaining an AAC tool/device

Describe tools/techniques used to determine the Describe tools/techniques used to determine the AAC candidate’s skillsAAC candidate’s skills

Complete many of the components with templates Complete many of the components with templates provided for gathering, compiling and reporting the provided for gathering, compiling and reporting the results.results.

Identify components on AAC devices such as Identify components on AAC devices such as common features and categories of devices (i.e. common features and categories of devices (i.e. dynamic display, digitized, integrated, etc.)dynamic display, digitized, integrated, etc.)

Identify local resources and consultants for trials, Identify local resources and consultants for trials, support, and funding assistance for AAC devices.support, and funding assistance for AAC devices.

9595

Review your goalsReview your goals

How did we do? How did we do? Place a check mark by the ones you Place a check mark by the ones you

accomplished.accomplished.

What else to include next time? ? ? What else to include next time? ? ? Please complete survey – we make Please complete survey – we make

changes based on your inputchanges based on your input Testimonials – greatly appreciated and Testimonials – greatly appreciated and

will be posted on websitewill be posted on website

9696

9797

9898

THANK YOUTHANK YOU

for helping othersfor helping others

get their voiceget their voice

9999

[email protected]@aacTechConnect.com

www.aacTechConnect.comwww.aacTechConnect.com866.4U.AAC.RX ( 866.482.2279)866.4U.AAC.RX ( 866.482.2279)

www.aacTechConnect.comwww.aacTechConnect.com