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AAC Clinic

AAC Clinic. Fall 2019. Population. Pediatric and adults with complex communication needs (CCN) Typical Diagnoses include individuals with: Developmental disabilities Acquired disabilities Progressive conditions Temporary needs. Typical cognitive-communicative diagnoses:. Aphasia

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AAC Clinic

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  1. AAC Clinic Fall 2019

  2. Population • Pediatric and adults with complex communication needs (CCN) • Typical Diagnoses include individuals with: • Developmental disabilities • Acquired disabilities • Progressive conditions • Temporary needs

  3. Typical cognitive-communicative diagnoses: • Aphasia • Apraxia • Dysarthria • Expressive language disorder • Mixed expressive-receptive language disorder

  4. Age range: • ~6-9 mos through lifespan

  5. Common concomitant conditions: • Mobility needs • Accessibility needs • Inadequate sensory processing • Psychosocial issues

  6. Client contexts: • In the following environments:Home, friend/relative’s home, daycare, school, medical appointments, work, community, face-to-face, telephone, 1:1, small group • With the following communication partners: Immediate family, extended family, caregivers, friends, peers, teachers, medical professionals, colleagues, individuals in community • About the following topics: ADLs, educational, medical needs, personal decision making, emergency needs/information, personal needs, personal information, feelings/opinions • For the following functions: ask questions, respond to questions, make comments, share, self-advocate, develop social interactions/closeness, fulfill social etiquette routines, resolve/prevent communication breakdowns

  7. FALL 2019 • This term, the AAC Immersion Center offers the following clinic formats: • New assessments • On-campus individual services (ped and adult) • On-campus group services (ped and adult) • ALS home visits • 4J and Springfield school visits • AAC caregiver support group

  8. Supervisors • Jeanine Geisler Brush • Lead; Supervises across lifespan • Shelley Watson • Supervises school-age population and support group • Amanda Thompson • Supervises across lifespan • Lori Hornfelt • Supervises at Willagillespie life skills classroom • Sara Starlin • Supervises at Maple Elem School • Elise Peltier • Supervises at Howard life skills classroom

  9. Group Meetings • Friday, 10/4, 12:00-2:00, in HEDCO room 230T • Monday, 10/7, 2:00-4:00, in HEDCO room 340 • Every Friday starting 10/18, 2:00-4:00, in HEDCO room 340

  10. Individual Meetings • Email your supervisor this week to set up an appointment! • Prior to the meeting, review your client chart and complete section I of CHARTR if applicable • After meeting, complete sections II and III of CHARTR if applicable • Additional 1:1 meetings available per request of student and/or supervisor

  11. Case Presentations • Twice a term • Initial 10/18 and10/25 • Final 11/22 and 12/6 • Final presentation to include 5-minute video of your choice

  12. Initial Case Presentation • Must address: • Client Age • Dx (medical and speech-language) • Date of onset • Pertinent medical hx • Social hx • Client or caregiver goals if available • If returning client, be ready to state previous tx approach used, progress towards goals, and/or perceived barriers to achieving goals

  13. Final Case Presentations • Be prepared to share a 5-minute video clip from your session • Must also address: • Client demographics • Client or caregiver goals • RATIONALE for selected tx approach(es)! • Considerations/modifications for how you adapted approach • LTGs and progress made towards goals • Any barriers? What was successful? • Anything especially unique about your client?

  14. Lesson Plans • If you have questions on LP, alert your supervisor of this via email! • Must include: • Date • Session Number • Planned activity matched to appropriate objective/goal • Plan for step up/down • Plan for data collection • Activity for home practice if applicable • Due 24 hours in advance of tx session • May email directly to supervisor (absent of any confidential info), or • Post directly to RDS

  15. Self-Reflections • Complete one reflection per session • Due same day as session • Include what went well, what could have gone better, what you need from supervisor in regards to what could have gone better, and what will be your measure of success • Video: • Use form located on infoCDS (prep and planning) • Due 11/1 • Email reflections directly to supervisor

  16. SOAP notes • Due 24 hrs after tx session • No need to email Jeanine when posted to RDS!

  17. ITPs • First draft due Monday, 11/4, by 9am • Revisions due Monday, 11/18, by 9am • Final draft due Monday, 12/2, by 9am • Will present ITP to clients following week

  18. Additional Assignments • Located on RDS under prep and planning • Client communication questionnaire • How does your client communicate? • Exploration of client devices • What content is available on your clients AAC system? • Articles, webinars, etc per your clinic assignment and/or supervisor request

  19. We’re here at clinic, your client is coming next week, now what?! • We need a road map if we have any chance of getting to where we want to go • Assess, plan, implement, have fun • It’s ok to start off being overwhelmed, scared, & freaked out • It’s not ok to remain overwhelmed, scared, freaked out

  20. Basis for Successful Outcomes • Knowledge about client • Information about devices and AAC systems • EBP Practices

  21. Participation Model • Historically, guidelines for AAC intervention were based on “candidacy” (i.e., cognitive prerequisites) • Communication Needs Model emerged • Now candidacy is based on the individual’s unmet communication needs, rather than a profile of impairments

  22. “The Participation Model…provides a systematic process for conducting AAC assessments and designing interventions based on the functional participation requirements of peers without disabilities of the same chronological age.” • Reference: Beukelman, D., & Mirenda, P. (1998). Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd ed.). Baltimore: Paul H. Brookes Publishing Co.

  23. Principles of Assessment Principle 1: Assessment is not a 1 time process. Assess to meet today’s needs, then tomorrow’s, and tomorrow’s… • Conduct initial assessment, explore changing contexts over time, follow-up for the future

  24. Principle 2: The purpose of an AAC intervention is to facilitate meaningful communication and participation in daily life activities. • Identify participation patterns and communication needs. • Identify levels of support required for success. • Assess participation patterns of peers.

  25. Principle 3: The mere provision of an AAC system is not enough. Thus, identification of actual or potential opportunity barriers is a critical component of the assessment process. • Assess opportunity barriers: policy, practice, attitude, knowledge, skill.

  26. Principle 4: Everyone can communicate. Everyone does communicate. • Assess access barriers: capabilities, attitudes, and resource limitations of individual. • Assess potential to use and/or increase natural speech. • Assess potential for environmental adaptations.

  27. Principle 5: Technology alone does not make a competent communicator any more than a piano makes a musician or a basketball and a hoop make an athlete. • Assess potential to utilize AAC systems or devices • Operational requirements • Individual and family preferences • Attitudes of other communication partners • Funding • Reference: Beukelman, D., & Mirenda, P. (1998). Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd ed.). Baltimore: Paul H. Brookes Publishing Co.

  28. First meeting • Meet and greet! • Help the client get used to the therapist and the environment. A no-pressure time to get to know the family (build rapport), look over/confirm forms in chart, obtain signed releases to communicate with other professionals (school SLP, OT, etc). • Ask interview questions • What do you want/need to know?

  29. Interview/“check in”/confirm… • Social History • Birth History • Medical History • Developmental History • Speech-Language Development and History • Swallowing, Hearing, Vision • Prior Evaluations or Therapy Services • Education or Vocation History • Other?

  30. Needs and environmental assessment • Communication partners • Communication locations • Communication modes • Message needs

  31. Also screen/assess as appropriate… • OM Function/ask about feeding and swallowing • Voice/Resonance • Speech • Fluency • Hearing/Vision/Perceptual skills • Receptive and Expressive Language • Social Communication • Play Skills or Cognition • Reading/Writing

  32. Additional AAC Tools • Social Networks • AAC Profile • Communication Matrix • Other?

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