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Effect of late-onset AAC/PODD Intervention in a 17 year old student with Cerebral Palsy

Effect of late-onset AAC/PODD Intervention in a 17 year old student with Cerebral Palsy. Isphana Al Khatib, Premila Chandrasekaran, Tanuka Gupta and Deepika Gopalarao Al Noor Training Centre for Children with Special Needs Dubai. Augmentative and Alternative Communication.

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Effect of late-onset AAC/PODD Intervention in a 17 year old student with Cerebral Palsy

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  1. Effect of late-onset AAC/PODD Intervention in a 17 year old student with Cerebral Palsy Isphana Al Khatib, Premila Chandrasekaran, Tanuka Gupta and Deepika Gopalarao Al Noor Training Centre for Children with Special Needs Dubai Rehab 2010, Dubai

  2. Augmentative and Alternative Communication Augmentative and Alternative Communication (AAC) is an area of clinical practice that attempts to compensate for the severe impairments in communication that non-verbal individuals have in meeting their daily communication needs. Rehab 2010, Dubai

  3. AAC and UNCRPD Article 2 “Communication” includes languages, display of text, Braille, tactile communication, large print, accessible multimedia as well as written, audio, plain-language, human-reader and augmentative and alternative modes, means and formats of communication, including accessible information and communication technology Rehab 2010, Dubai

  4. Rehab 2010, Dubai

  5. Partner-Assisted Communication Communication is a two-way process “Smart” partners Rehab 2010, Dubai

  6. Pragmatic Organization Dynamic Display (PODD) as Partner-Assisted Communication PODD is a multi-level communication book Rehab 2010, Dubai

  7. Rehab 2010, Dubai

  8. PODD- Key organizational features • Vocabulary organization • Pragmatic branch starters • Taxonomic, topic and anecdote organizations • Incorporating individual requirements Rehab 2010, Dubai

  9. PODD-Key partner-related features • One single response • Have limited physical control • Flexibility in the pace and responsiveness • To predict and use the system more efficiently. Rehab 2010, Dubai

  10. Aim of our Case Study To study the effectiveness of use of late-onset AAC/PODD intervention on the range of communication functions and social interactions on a 17 year old student with Cerebral Palsy Rehab 2010, Dubai

  11. Case History • VK, a 17-year old adolescent with a diagnosis of Spastic Quadriplegia • Physical condition • Hand function: severely restricted Rehab 2010, Dubai

  12. Case History • VK’s hearing and vision are within the normal range of functioning. • Visually responsive and this sensory modality is one of his strengths. • Keen observer and responds well to people. • Able to communicate yes/no Rehab 2010, Dubai

  13. Rationale for selection of PODD The selection of PODD was determined by • Severity of his physical challenges • Pre requisite conditions of use of eye gaze • Yes/no responses • Sight words to access PODD • Pragmatic organization of the tool i.e. PODD • Social responsiveness • Lack of funding required to procure the eye gaze equipment aided the decision of the selection of PODD. Rehab 2010, Dubai

  14. Methodology Rehab 2010, Dubai

  15. Preparation • Consent letter to secure parental approval • Multiple sources of data collection • Trans-disciplinary assessment • Eye pointing is the main modality for communication. • Advanced receptive language • An orientation on the use of AAC strategies to parents Rehab 2010, Dubai

  16. Methodology-Baseline Assessment Rehab 2010, Dubai

  17. Baseline assessment- Physical Status Seating: customized wheelchair which can be reclined and has firm hip straps to maintain appropriate seating posture Rehab 2010, Dubai

  18. Influences on PODD creation Rehab 2010, Dubai

  19. Creation of PODD • Use of Boardmaker • Scaffolding of PODD • Different versions Rehab 2010, Dubai

  20. PODD Rehab 2010, Dubai

  21. PODD Rehab 2010, Dubai

  22. Steps in Training • Duration of Training: 22weeks • Familiarization process: 2 weeks • Routines • Different communication partners Rehab 2010, Dubai

  23. Training record Rehab 2010, Dubai

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  26. Pragmatic Profile: Communication Functions Rehab 2010, Dubai

  27. Social Networks Inventory: Social Interaction Additionally there has been a significant increase in the frequency, effectiveness and efficiency in the use of the non-electronic communication board/PODD Rehab 2010, Dubai

  28. Circles of Communication Partners Pre-Training Post-Training Rehab 2010, Dubai

  29. Observations Observations indicate an enhancement in • Frequency and quality of communication • Communication repertoire • Initiation of communication with adults • Frequency of requesting, describing and commenting • Emotional maturity Rehab 2010, Dubai

  30. Conclusion These observations indicate that despite late-onset intervention, improvements in functional communication and social interaction can be brought about by the use of partner-assisted communication strategies such as PODD. Rehab 2010, Dubai

  31. Implications for further research • Use of PODD on different clinical populations • Longitudinal studies on larger number of cases to study the effectiveness of PODD • Examining the effectiveness of PODD on specific aspects of communication and literacy Rehab 2010, Dubai

  32. References • Allaire, J.H., Gressard, R. P., Blackman, J. A., &Hostler, S. L.(1991). Children with severe speech impairments: Caregiver survey of AAC use. Augmentative and Alternative Communication, 7, 248 – 255. • Blackstone, S. (1995). AAC outcomes. Augmentative Communication News, 8(1). • Calculator, S. N. (1988). Evaluating the effectiveness of AAC programs for persons with severe handicaps. Augmentative and Alternative Communication, 4, 177 – 179. • Culp, D. M., Ambrosi, D. M., Berniger, T. M., & Mitchell, J. O. (1986). Augmentative communication aide use – A follow-up study. Augmentative and Alternative Communication, 2, 19 – 24. • Goossens’, C. (1989). Aided communication intervention before assessment: A case study of a child with cerebral palsy. Augmentative and Alternative Communication, 5, 14 – 26. • Kraat, A., & Brune, P. (1997, November). Getting from here to there: Lessons from ‘Miles’. Paper presented at the American Speech Language Hearing Association, Boston, MA.  Rehab 2010, Dubai

  33. References • Porter, G. and Kirkland, J. (1995) Integrating Augmentative and Alternative Communication into Group Programs: Utilising the Principles of Conductive Education. Melb: Spastic Society of Victoria • Porter, G., Kirkland, J. & Dunne, L. (1996) Developing Functional use of AAC within holistic group programs. Paper presented at the ISAAC conference: Vancouver, Canada. • Porter, G. (1997) Observational assessment forms (printed in, Department of Education. (2001). Students with physical impairment: Augmentative and alternative communication. Brisbane, QLD: Author • Porter, G., Kirkland, J. & Dunne, L. (1998) Multi-level communication books. Poster presented at the ISAAC conference: Dublin, Ireland. • Porter, G. (2000) Low-Tech Dynamic Displays: User friendly Multi-level communication books. Paper presented at the ISAAC conference: Washington, USA. • Porter, G. (2000) Ideas for the design of low- tech dynamic displays: User friendly, multi-level communication books. (Printed in Department of Education (2001) Students with physical impairment: Augmentative and alternative communication. Brisbane, QLD: Author.) Rehab 2010, Dubai

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