Augmentative and Alternative Communication最新文献

This survey study examined augmentative and alternative communication (AAC) practices reported by early intervention speech-language pathologists (SLPs) across the United States (N = 376). The study examined (a) types of AAC that SLPs reported using (i.e., sign language, photographs, pictures, symbols, talking switches, and iPad apps or dedicated speech-generating devices); (b) SLPs' perspectives on the influence of child spoken language ability on AAC recommendations; (c) factors that influenced AAC decision-making within early intervention; and (d) perceived barriers associated with AAC implementation. SLPs reported that they were significantly more likely to introduce all types of AAC to children without spoken language abilities compared to children in later stages of language development. On average, they were most likely to report using or recommending sign language and photographs, and least likely to report using or recommending talking switches or speech-generating devices. Of the options provided, child expressive and receptive language abilities were rated as the most important factors to consider when determining AAC use, followed by cognitive ability, diagnosis, and chronological age. SLPs identified caregiver buy-in and carryover across providers as the most significant barriers to AAC implementation. Recommendations for future research and current AAC practices within early intervention are discussed.

Significant advances have been made in interventions to maintain communication and personhood for individuals with neurodegenerative conditions. One innovation is Message Banking, a clinical approach first developed at Boston Children's Hospital (BCH). This paper outlines the Message Banking process as implemented at BCH, which includes the option of "Double Dipping," where banked messages are mined to develop personalized synthesized voices. More than a decade of experience has led to the evolution of six core principles underpinning the BCH process, resulting in a structured introduction of the associated concepts and practices with people with amyotrophic lateral sclerosis (ALS) and their families. These principles highlight the importance of assigning ownership and control of the process to individuals with ALS and their families, ensuring that as a tool it is empowering and offers hope. Changes have been driven by feedback from individuals who have participated in the BCH process over many years. The success of the process has recently been extended through partnerships that allow the recorded messages to be used to develop individual personalized synthetic voices to complement banked messages. While the process of banking messages is technically relatively simple, the full value of the process should be underpinned by the values and principles outlined in this tutorial.

Families are the most significant communication partners for an individual with complex communication needs. Even though family-centered approaches are recommended to support augmentative and alternative communication (AAC) services for an individual, it is difficult to establish a successful plan that fits each individual's family. A framework for practitioners is proposed to effectively obtain and understand information about a family's unique dynamics as part of service delivery to positively impact AAC device uptake and long-term use. The goal of using this model is to minimize the disruption to the family while maximizing the integration of the AAC system. This paper proposes and illustrates a framework to enrich AAC services through the integration of several theoretical models of family systems theory, family paradigms, and a procedure called the self-created genogram. This paper begins by reviewing ecological family systems theory and family systems to guide and provide a framework to support effective AAC implementation. The process of self-creating genograms is then introduced as a means to obtain a rich perspective on family characteristics and dynamics that is informed by the individual who uses AAC. All of this information allows professionals to provide relevant information and tailor options for the family. As a result, the family is able to make informed decisions about AAC intervention in a manner most consistent with how they typically operate. Finally, we apply this framework to a hypothetical case of a child with autism and complex communication needs across three timepoints (preschool, late elementary/early middle school, and high school/post-secondary transition) to demonstrate how this framework can be used in clinical practice.