1 January - February 1999 March - April 1999 Volume 12 Numbers 1 and 2 Clinical News Communication partners On the Web E-mail survey For Consumers Different strokes for different folks Equipment Training materials Governmental Parallels to the deaf community The AAC-RERC Six of sixty (months) Continued on page 2 Continued on page 2 It takes two to tango. The same is true of conversation. Communica- tion is a dynamic process between at least two people. Conversations, like a dance, reflect the context, and are governed by rules of social interac- tion and discourse. They also reflect social roles, the modes of communi- cation being used and, of course, the individual styles, strategies, skills and purposes of those involved. 1 Individuals who use AAC devices and techniques–and their speaking partners–have conversations that are different from those of natural speakers. Intelligibility, rate of message exchange and a myriad of social issues (not to mention the characteristics and skills of the individuals involved) can dramati- cally change the nature of these conversations. Most people are not prepared to interact with augmented communi- cators. Natural speakers bring to a communicative exchange an ability to use conventional modes (speech, gestures) and rules for interacting, but they are not primed for what ensues. This issue focuses on the commu- nication partners of individuals who use AAC and considers how to approach their needs for training and support. The Clinical News Clinical News Clinical News Clinical News Clinical News section introduces the notion of Circles of Communication Partners (CCP). 2 Based on Marsha Forest’s Circle of Friends, 3 this paradigm offers clinicians a tool for identify- Communication partners Augmented communicators describe a “good” communication partner as patient, motivated, interested and comfortable with all methods of communication. Sadly, not all communication partners are “good” ones. In a recent survey (described on page 6), augmented communica- tors report that sometimes their partners underrate their abilities, shout at them as though they are deaf, over enunciate and/or talk to others instead of addressing them directly. After observing the interactive patterns of augmented communica- ing partners, setting goals and measuring the outcomes of training. The On the Web On the Web On the Web On the Web On the Web section shares the results of a recent ACN e-mail survey of six augmented communicators. The survey asked questions about their personal experiences with communi- cation partners. In For Consumers For Consumers For Consumers For Consumers For Consumers, the role of facilitator is considered with regard to three groups of augmented communicators. 4 The Equipment Equipment Equipment Equipment Equipment section then reviews materials designed to teach facilitators to interact more effectively with augmented communicators. In Governmental, Governmental, Governmental, Governmental, Governmental, we explore how tors and their speaking partners over many years, researchers have identified other charac- teristics as well: Speaking partners (a) dominate interactions, (b) ask predominantly yes/ no questions, (c) take a majority of conversational turns, (d) provide few opportunities for augmented communi- cators to respond, (e) often interrupt, (f) focus on the user’s technology or technique rather than the person or message and (g) do not always confirm the content of messages. Augmented communicators typically play a passive role. They use multi-modal approaches (i.e., gestures, speech, signs, language displays, electronic devices and strategies), rely on nonverbal behaviors and rarely initiate interaction. They express a limited number of speech acts and use restricted linguistic forms. They have limited opportunities to interact
Transcript
1
January - February 1999
March - April 1999
Volume 12
Numbers 1 and 2
Clinical NewsCommunication partners
On the WebE-mail survey
For ConsumersDifferent strokes for different folks
EquipmentTraining materials
GovernmentalParallels to the deaf community
The AAC-RERCSix of sixty (months)
Continued on page 2
Continued on page 2
It takes two to tango. The same istrue of conversation. Communica-tion is a dynamic process between atleast two people. Conversations, likea dance, reflect the context, and aregoverned by rules of social interac-tion and discourse. They also reflectsocial roles, the modes of communi-cation being used and, of course, theindividual styles, strategies, skillsand purposes of those involved.1
Individuals who use AAC devicesand techniques–and their speakingpartners–have conversations that aredifferent from those of naturalspeakers. Intelligibility, rate ofmessage exchange and a myriad ofsocial issues (not to mention thecharacteristics and skills of theindividuals involved) can dramati-cally change the nature of theseconversations.
Most people are not prepared tointeract with augmented communi-cators. Natural speakers bring to acommunicative exchange an abilityto use conventional modes (speech,gestures) and rules for interacting,but they are not primed for whatensues.
This issue focuses on the commu-nication partners of individuals whouse AAC and considers how toapproach their needs for trainingand support. The Clinical NewsClinical NewsClinical NewsClinical NewsClinical Newssection introduces the notion ofCircles of Communication Partners(CCP).2 Based on Marsha Forest’sCircle of Friends,3 this paradigmoffers clinicians a tool for identify-
Communicationpartners
Augmented communicators describea “good” communication partner aspatient, motivated, interested andcomfortable with all methods ofcommunication. Sadly, not allcommunication partners are “good”ones. In a recent survey (describedon page 6), augmented communica-tors report that sometimes theirpartners underrate their abilities,shout at them as though they aredeaf, over enunciate and/or talk toothers instead of addressing themdirectly.
After observing the interactivepatterns of augmented communica-
ing partners, settinggoals and measuring theoutcomes of training.The On the WebOn the WebOn the WebOn the WebOn the Web section
shares the results of arecent ACN e-mail survey of sixaugmented communicators. Thesurvey asked questions about theirpersonal experiences with communi-cation partners.
In For ConsumersFor ConsumersFor ConsumersFor ConsumersFor Consumers, the role offacilitator is considered with regardto three groups of augmentedcommunicators.4 The EquipmentEquipmentEquipmentEquipmentEquipmentsection then reviews materialsdesigned to teach facilitators tointeract more effectively withaugmented communicators. InGovernmental, Governmental, Governmental, Governmental, Governmental, we explore how
tors and their speakingpartners over manyyears, researchers haveidentified other charac-
teristics as well:
Speaking partners (a) dominateinteractions, (b) ask predominantly yes/no questions, (c) take a majority ofconversational turns, (d) provide fewopportunities for augmented communi-cators to respond, (e) often interrupt, (f)focus on the user’s technology ortechnique rather than the person ormessage and (g) do not always confirmthe content of messages.
Augmented communicators typicallyplay a passive role. They use multi-modalapproaches (i.e., gestures, speech, signs,language displays, electronic devices andstrategies), rely on nonverbal behaviorsand rarely initiate interaction. Theyexpress a limited number of speech actsand use restricted linguistic forms. Theyhave limited opportunities to interact
2
Clinical News, Continued from page 1
Upfront, Continued from page 1
policy, legislation, service deliveryand ethical issues are handled bythe deaf community and whetherthe developing AAC communitymight contemplate similar ap-proaches to quality control issues.Finally, the AAC-RERCAAC-RERCAAC-RERCAAC-RERCAAC-RERC sectionhighlights two projects: (1) ACETS,which will prepare augmentedcommunicators for employmentand (2) Tech-Watch, which willmonitor industries related to AACto encourage technology transfersthat can benefit AAC consumers.
Thanks to all who contributed tothis issue. Please see Resources andResources andResources andResources andResources andReferencesReferencesReferencesReferencesReferences. I am particularlygrateful to Rena Carney and KarenMorris, who encouraged me towrite about this topic and wereinvolved in its conception.
Now to the future. I WILL catchup with back issues of ACN thisfall (northern hemisphere) orspring (southern hemisphere). Isincerely apologize for beingbehind most of the past two years.
I appreciate your patience andunderstanding throughout mytenure as ISAAC’s president.Many say they appreciated thedouble issues from time to timebecause topics are covered in moredepth. Please let me know youropinion.
Life is good. Harvey Pressmanand I are getting married. InAugust, we will be welcoming our4th grandchild. Pretty efficient, eh?A toast to you and to your favoritecommunication partners.Sarah W. Blackstone, Ph.D.,Author
with other people.5,6,7
We know absolutely that the skillsand strategies required for successfulaugmented interactions are notintuitive and need to be taught.8,9
However, communication partnereducation and training is not neces-sarily a part of AAC interventionand, even when it is, communicationpartner training is rarely carried outsystematically.
To ignore or de-emphasizesystematic partner training severelylimits the potential outcomes foraugmented communicators. Recentresearch, in fact, suggests that easilyadministered programs can result inparents, peers and caregivers chang-
ing their behaviors in ways thatimprove the quality and quantity ofthe interactions augmented commu-nicators engage in. When trainingoccurs in natural environments,changes result after only a fewtraining sessions, and these changesare maintained over time.10,11 Theseoutcomes suggest that communica-tion partner training is a cost-effective component of AAC inter-vention.
Circles of communicationpartners
The Circles of CommunicationPartners (CCP) is a paradigmadapted from Marsha Forest’s Circleof Friends.3 While a CCP chart canbe developed for anyone, it may be
particularly useful in AAC because itidentifies the big picture, as well asspecific training needs.2 As shown inFigure 1, the augmented communica-tor is at the center. Emanatingoutward are five circles representingdifferent types of relationships.
• The inner (first) circle containsthe augmented communicator’slife partners. These relationshipsexist “no matter what” and mayinclude parents/guardians,spouse, siblings, children andgrandchildren. Often, but notalways, a person’s most signifi-cant and frequent communicationpartners are in their first circle.
• Good friends are represented inthe second circle. These arepeople that the augmentedcommunicator trusts, spends timewith and shares thoughts, feelingsand ideas with. Relationships inthe second circle are heavilydependent upon communicationand language skills.
• The third circle is comprised offavorite neighbors, colleagues andacquaintances in the community.These relationships are dependenton mobility and often reflect howactive people are outside theirhome (school, church, day pro-gram, community).
• The fourth circle includes peoplewho are paid to interact with theaugmented communicator –family doctor, dentist, neurologist,speech-language pathologist,occupational therapist, as well aspersonal attendants, instructionalassistants, teachers and others.
• The fifth or outer circle representsthe universe of unfamiliarpartners. Some augmentedcommunicators are out and aboutmuch of the time. However, manydo not interact regularly with
3
Continued on page 4
unfamiliar partners for a myriadof reasons (e.g., lack of access toAAC, age, cognitive abilities,living situation or personalpreference.)
A typical CCP for an augmentedcommunicator shows most people inthe first circle and the fourth circle,with comparably few in other circles.This reflects the impact of having asevere communication impairment,as well as the mobility problemsmany AAC users have.
By drawing up a CCP, cliniciansmay be able to more clearly identifyimportant communication partnersand better understand the impactthat the communication impairmentis having on the life and relationshipsof the augmented communicator. Asone adult AAC device user has said,“loss of the speech function is not aloss of life, but a loss of access tolife.”12
Assessment
Assessment is a first step towardimproving the functional communi-cation skills of an individual. Clini-cians can use the CCP to:
1. Identify partners. Working withaugmented communicators and those
who support them, the team gathersinformation about communicationpartners, then evaluates the data byfilling out the CCP and consideringwhether (or not) the augmentedcommunicator has a balance ofrelationships.
For example, Taylor, who isautistic, has a mother (M), grandpar-ent (G) and sibling (S) in her innercircle, a cousin (C) in her secondcircle and a few classmates (CM) anda next door neighbor (N) in her thirdcircle. Her fourth circle is packedwith teachers (T), an instructionalassistant (IA), a speech-languagepathologist (ST), a behaviorist (B), anoccupational therapist (OT), aneurologist (N) and others. Taylor’sfifth circle is mostly empty.
Looking at her CCP, it is clearthat most of Taylor’s partners arepaid professionals. Because she isnonspeaking and peers do notunderstand her attempts to commu-nicate, friendships are very difficult.Focusing on training partners in herfirst four circles is important. Herouter circle is not a priority until shehas the tools (and the inclination) tointeract with unfamiliar partners.
2. Gather information aboutpartners. The next step is for the
team to consider which communica-tion partners: (a) are most familiarwith the individual’s communicationmethods, (b) spend the most timewith the user, (c) are most available,(d) are willing to facilitate interac-tions with others, (e) have the knowl-edge, skill and opportunities to trainothers and (f) are in the best positionto assist the augmented communica-tor to develop new relationships.
Taylor’s assessment revealed thatfew of her partners are trainedinteractants. Her instructionalassistant, who is with her seven hoursa day, is not especially good atfacilitating interaction. In fact, he israther shy and withdrawn. To date, hehad not participated in any trainingprogram to increase his skills eitheras a communication partner, or asone whose job it was to facilitateTaylor’s interactions with others. Thisis a problem that begs for a solution.He is key to the success of theintervention program, and can not beexpected to “just know” how tosupport communication.
3. Identify modes of communica-tion. The third step is to find outwhich modes of communication theaugmented communicator uses witheach partner, and under whatcircumstances. For example, Tayloruses only gestures, vocalizations anda few signs, except with her speech-language pathologist during theirweekly therapy sessions. In these, sheis learning to use a simple digitizedspeech device. The team believesTaylor will make more progress if sheuses the device in more situationswith more people.
4. Identify augmentedcommunicator’s role in training. Theteam should always consider howmuch responsibility augmentedcommunicators can assume forpartner training, and what support
Aug.
Comm.
SecondFamily
Acquaintances
Unfamiliar partners
M
S
Figure 1. Circles of communication partners (CCP)(Example: Taylor, age 10 year)
CM
G
ST
N
T
Fourth
Fifth
Third
First
Paid workers
Friends
C
N
B
T
IA
OT
CM
4
Clinical News, Continued from page 3
they will need, both initially and forthe long term.
Note: The ultimate responsibility forteaching people to interact with anaugmented communicator should belongto the augmented communicator. AACprofessionals, friends and familymembers should not take this responsi-bility away. Even individuals who, likeTaylor, are young or have significantcognitive limitations, can learn to dothings that modify a partner’s behavior.Examples include: pointing to anexplanation about how they communi-cate on a display or communicationdevice, giving a picture to someone as arequest (PECS system), vocalizing toattract attention, pointing to a pictureand looking at a partner to requestsomething, using a device to tell apartner “please hang on a minute, I havesomething to say,” and looking at aspeaking friend to request that she actas an interpreter during the interaction.13
Setting goals
After the CCP assessment processis complete, the team uses data fromthis process to help determineintervention goals. For example, goalsfor Taylor might include: (a) trainingher mother and instructional assis-tant as facilitators, so they canincrease her opportunities to commu-nicate and support her participationin these interactions, (b) increasingthe number of partners she has in hersecond and third circles, (c) teachingpeers to “wait” at least ten secondsto give her a chance to greet them,initiate interaction and respond and(d) expanding her use of graphicsymbols and the AAC device.
When developing a treatmentplan, the team needs to decide: (a)who will train which partners, (b)who will be trained first, second,third, (c) what each partner will betaught and (d) what training ap-proaches will be used. [See theEquipmentEquipmentEquipmentEquipmentEquipment section for materials thatsupport partner training.]
Reality check
It is important to keep in mindthat people have lots of interests andresponsibilities to juggle. If partnersdo not have the time, the resources orthe desire to change their behaviors,they won’t. Thus, whenever yousense resistance, ask about it, andthen listen very, very carefully towhat you are being told.
Because communication partnersmust learn to alter well-establishedpatterns of interaction, successfultraining requires understanding andguided practice. Not everyone is agood candidate for training; and noteveryone will succeed. Becauseresources are limited, it is advisableto invest time in educating andtraining those who are likely to: (1)improve their interaction skills and(2) learn how to facilitate the develop-ment of independent communicationskills in the augmented communica-tor.
Importance of AAC
The CCP can also bring out theimportance of augmentative andalternative communication (AAC).Just ask familiar partners to imaginewhat their lives would be like if theonly people they were able to com-municate with were family membersand folks like their gynecologist,dentist, doctor and pharmacist.
Training unfamiliar partners
Unfamiliar partners are people inthe augmented communicator’s fifthcircle. They become partners inciden-tally, or because the individual istrying to accomplish some task (e.g.,order food in a restaurant, call ataxi). Because unfamiliar partnersare almost never prepared to interactwith someone who uses AAC tech-niques, it is crucial for augmentedcommunicators to provide a shortexplanation (either using a speech
output device or pointing to a writtennote) about the communicationmethods they use. It is also impor-tant to provide information topartners about what they should do.If the user can not or does not chooseto provide an explanation, a facilita-tor must be available, or interactionsuccess is unlikely.
Temple University’s Institute onDisabilities in Philadelphia hasconducted workshops and run manycourses for medical, dental and lawschool students, as well as profession-als working in the judicial system,law enforcement agencies and victimservice area. The courses are de-signed to raise awareness, provideinformation and teach AAC strate-gies. All are co-taught by consumersand professionals. Reported outcomesare very positive. For example, 600fourth year medical students, resi-dents, and attending physicians at theTemple University Medical Schoolhave been trained. Prior to training,only thirty-one percent said theyknew how to communicate withpatients who had a significant speechdisability. Only eight percent saidthey felt comfortable about interact-ing with them. After a 2 1/2 hourtraining program, all reportedknowing more about AAC strategiesand techniques. Eighty-five percentsaid they felt more comfortableinteracting with augmented commu-nicators.14
Familiar partner training
Familiar partners are people whoare a regular part of an augmentedcommunicator’s life (Circles one,two, three and four). These partnershave a range of skills and abilities,but most benefit from learning somebasic rules and strategies to optimizetheir interactions. One example ofhow to increase awareness is provid-ing written information, as illus-
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Continued on page 6
trated in Table I.15 Remember,however, that just reading somethingusually won’t work. Modeling andguided practice are needed to changebehaviors. Strategies are suggestedthroughout this issue.
Training facilitators
A facilitator is “one who makesthings easier.” People who facilitatecommunication are familiar partnerswho do things that enable interactionto occur (e.g., positioning, remindingpeers to do or not to do something,instructing interactants to providemore pause time, preparing vocabu-lary, and so on.) An AAC facilitatorprovides assistance to both users andpartners. Ideally, however, thefacilitator is not an active participantin the interaction.
According to researchers, some ofthe most important strategies facilita-tors need to learn are:
• Structure the environment to supportcommunication (e.g., ensure properpositioning, access to devices, tech-niques and strategies).
• Provide varied and meaningfulopportunities for communication.
• Provide for involvement in motivatingactivities.
• Prompt only when required.
• Model the appropriate use of AACtechniques and strategies.
• Help communication partners (a)respond to users’ communicativeattempts, (b) give individuals enoughtime to communicate. (c) confirm theirintended message, (d) share their focusof attention, (e) provide appropriatelanguage input and (f) expect communi-cation at an appropriate level.16
Fried-Oken and her colleaguessuggest approaching training byteaching facilitators certain linguis-tic, strategic, social and operational
competencies. [See Table II.]Linguistic competence. Asappropriate, provide opportunitiesto convey both simple and com-plex messages. Model use oflanguage forms the augmentedcommunicator uses.
Strategic competence. Provideopportunities for augmentedcommunicators to initiate com-munication (by focusing attentionon the individual, pausing for tenseconds). Reinforce all attempts tocommunicate and confirm themessage.
Social competence. Acknowledgea message by doing somethingthat relates to it. Greet the aug-mented communicator and expectinteraction. Learn to establish eyecontact at the same level. Act in apatient manner during momentsof silence. Learn to wait.
Operational competence. Encour-age and validate the use of theAAC system (by using the samesystem, if appropriate, or model-ing an answer if the individualdoes not respond). Be responsiveto changing needs by checking tosee if the system needs updating.Ask about updating vocabularyand so on.17
Table I. Ten quick and easythings to do when you meet an
augmented communicator15
Table II. Communicative competencies for the facilitators of augmented communicators(adapted f from Fried-Oken, Sharp, Femmer, Staehely, 1999)17
6
E-mail survey
I asked seven augmented communi-cators about their conversationalexperiences. They reported (notsurprisingly) that they prefer commu-nicating with people in their firstCircle (parents, siblings, adultchildren) and second Circle (friends).Only one said a paid care providerwas a preferred partner. Characteris-tics of their favorite partners are:
* They have real conversations with me.* They have a genuine interest in what I say.* They have an ease to their communication.* They understand my speech.* They are patient when I use my device.
One respondent pointed out that,independent of preferences, the livingsituation you are in will largelydetermine whom you talk with.
Consumers said that naturalspeakers do a number of things thatmake them “good” partners. Theseinclude being patient, interested andcomfortable with all methods ofcommunication, as well as trying tounderstand impaired speech, makingan effort to interpret signs/gestures,being comfortable with moments ofsilence, repeating and confirmingmessages and admitting when theydon’t understand what is said.
Characteristics of partners thatrespondents said were not desirableinclude:
Finishing my thoughts (withoutpermission). Doing other things while Iam keying in a response or question.Making me use an AAC device as a firstmode of communication.
Most, but not everyone, agreedthat being a good communicationpartner is a skill that can be taught.They suggested the best ways tolearn these skills are to be around
After developing these competen-cies, facilitators also need to learnhow to support both augmentedcommunicators and their communi-cation partners during different kindsof interactions.
Outcomes measurement
The CCP chart can help cliniciansmonitor progress and measureoutcomes. Over time, the CCP willdocument increases in the number oftrained partners and types of rela-tionships maintained. These data arelikely to directly reflect the quality ofa person’s life and the functionalchanges they are making toward thedevelopment of communicativecompetence.
Final thoughts
Communication partner trainingis a cost-effective investment in thefuture independence, joy, satisfactionand fulfillment of an augmentedcommunicator’s life. ApproachingAAC intervention from a frameworkthat enables clinicians to supportpartners, as well as to focus on theindividual’s language and communi-cation issues, reflects best clinicalpractice.
people who use AAC.Other strategies theyfeel might work areengaging in activities
that involve reversingroles, and role-playing.
Familiar partners
In response to the question,“What type of AAC system do youprefer when talking face-to-face withfamiliar partners,” most participantssaid “speech,” referring to bothnatural speech and synthesizedspeech. One person preferred using alow-tech device and/or signs andgestures.
Respondents said they relied ontheir natural speech with familiarpartners “some of the time,” but noone could rely on it “all of the time”because environmental conditions(e.g., noise) and internal statesreduce their intelligibility.
When I feel tense, it’s easier and lessstressful to use AAC techniques than tostrain and struggle to get out a word.
Unfamiliar partners
Most said they prefer having afamiliar person around to supporttheir interactions. All respondentssaid they prefer using speech outputdevices when communicating withstrangers, because:
I am in control of the device and don’thave any limits on what I can say. I amable to produce intelligible utteranceswith the device. I can talk aboutsomething specific.
Reportedly, some unfamiliarpartners do things that positivelyaffect the communication process,such as repeating message compo-nents, asking for confirmation,showing an interest and beingpatient. Behaviors of unfamiliarpartners that can interfere withsuccessful communication include:(1) asking too many questions atonce, (2) making negative assump-
Clinical News, Cont. from page 5
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Continued on page 8
Different strokes fordifferent folks
Pat Dowden, a respected AACclinician and researcher, recentlyidentified three groups of augmentedcommunicators based not on theirreceptive language, but solely ontheir current expressive communica-tion skills.18
1. Emerging communicators.Individuals with emerging expressivecommunication skills have no reliablemethod of symbolic communication.They communicate using gestures,facial expressions, vocalizations, etc.These non-linguistic and oftenidiosyncratic forms significantly limitthe range of messages they canconvey.
Emerging augmented communi-cators may be very young, older withsignificant developmental delays, oradults with severe acquired disabili-ties, including language impair-ments. Emerging communicatorsmay not have had access to AAC
tions about disabled people and (3)being unable/unwilling to “read”messages constructed with low-techdisplays, signs or their naturalspeech.
Facilitators
In response to a question aboutthe role of facilitators, these individu-als said they expect communicationfacilitators to:* Get my AAC device ready (e.g., make sure it is
fully charged).
* Understand my speech, facial expressions andgestures.
* Be very patient with me.
* Know when to predict what I am saying andwhen to “hear me out.”
* Show empathy (match my mood when speaking).
They also want facilitators to helpthem talk to other people by:* Telling my partner how AAC works.
* Rephrasing or suggesting I slow down if I’mwithout my device.
* Interpreting and “translating” my speech.
* Encouraging partners to admit they are lost, so Ican go back and try to rephrase.
* Telling partners to be patient because it takes mea while to respond to their questions.
End note
Respondents said they did notenjoy interacting with familiar orunfamiliar people who are:
Rude, impatient. Look at me like Ihaven’t got a brain. Make me wait untilall others are waited on. Talk down tome. Insist on only talking when I use adevice. Interrupt me. Show a lack of
interest. Shout at me when they know Ican hear. Treat me as though I amstupid. Don’t have time. Use the powerof their speech to overpower my roboticvoice. Use the power of their spokenlanguage to control the interaction.
This litany of behaviors furtherconfirms the need for communica-tion partner training and the respon-sibility we in the field hold forimproving such appalling conditions.
intervention, or may havehad inappropriate AACintervention. Theseindividuals dependheavily upon familiar
partners to facilitate their interac-tions.
The focus of AAC intervention forthis group is to identify a reliablemethod of intelligible communicationand to provide sufficient partnersupport so that individuals haveopportunities to express themselveseffectively throughout the day.Successful outcomes will reflectwhether (or not) a reliable method ofcommunication is being used.
2. Dependent communicators.Individuals with dependent expres-sive skills communicate reliablyusing both symbolic and nonsymbolicmodes. While they can express arange of communicative functions,they often remain dependent onfamiliar partners, because the modesof communication they use (e.g.,partner-assisted scanning, eye-coding or severely dysarthric speech)are not easily understood by theirpartners.
Individuals may also be dependent
communicators because they havehad little or no AAC intervention, donot have adequate or appropriatevocabulary and/or are unable toproduce novel messages.
Goals for AAC services are toincrease their access to vocabularyand develop their literacy skills.Other goals are to decrease theirdependence, expand their communi-cation partners and increase thenumber of topics they can converseabout. Progressing from a dependentto an independent communicatoroften takes many years. Dowdensuggests intervention should be verysystematic and well documented.
3. Independent communicators.Individuals with independent expres-sive communication skills caninteract with both familiar andunfamiliar partners about any topic.These individuals may or may notuse equipment, and may or may nothave receptive and cognitive skillsthat are considered normal or age-appropriate. Independent communi-cators may choose to depend on afamiliar partner or a facilitator toprovide support from time to time.
8
Goals often focus on increasingthe speed of communication andrefining social interaction skills.Independent communicators definetheir own desired outcomes andreasons for intervention. Children cando this at an age-appropriate level.Professionals assist independentcommunicators by teaching newstrategies, recommending newequipment and/or modifying existingAAC technologies and techniques.
Role of facilitators
Using Dowden’s groups, it seemspossible to set forth some moreexplicit expectations about the rolescommunication facilitators mightplay in addressing the widely diverseneeds of augmented communicatorsand their communication partners.The thoughts below and those inTable III represent only a “first cut”at a more conceptual basis forapproaching communication partnertraining. Please let us know what youthink.
• Emerging communicatorsEmerging communicatorsEmerging communicatorsEmerging communicatorsEmerging communicatorsneed maximal support from askilled facilitator. The facilitatormust be able to encourage interac-tion, understand and interpretidiosyncratic behaviors andsupport both augmented commu-nicators and their partners duringan interaction. In addition, afacilitator must encourage theemerging communicator to use
more conventional expressiveforms. Facilitators provide com-munication opportunities andmodel the use of targeted AACtechniques. In addition, facilita-tors often use augmented input,which may include gestures, signs,graphic symbols, text, spoken ortactile prompts. While facilitatorsencourage the use of symbols andconventional modes of communi-cation, they also understand thatcommunication is not only ameans to an end, but also an endin itself. AAC techniques are notwhat communication is about. It’sthe message that matters.
Facilitators of emerging commu-nicators make every effort tosupport all communicationpartners, but their real job is tostay out of interactions andencourage direct communicationbetween augmented communica-tors and their familiar partners.
Although emerging communica-tors tend not to interact withpeople they don’t know, whenthey do, both partners requireconsiderable support.
• Dependent communicatorsDependent communicatorsDependent communicatorsDependent communicatorsDependent communicators useconventional linguistic andnonlinguistic forms. Even so, theyoften need a facilitator to assistthem. The facilitator’s major rolesare to provide access to thevocabulary that the user needsand to act as an interpreter or
translator when communicationpartners are unable to understandthe message. For example, partnerassisted scanning, eye gazesystems, alphabet boards and evena person’s dysarthric speech willrequire that partners are familiarwith the technique and howmessages are constructed. Thisrequires training and practice.Ideally, the facilitator can explainand demonstrate how a techniqueworks and then stand back in caseof communication breakdowns.
Other important things facilitatorsmay do to support a dependentaugmented communicatorinclude: (1) set up a device forcommunication, (2) make sure itis fully charged, (3) make phonecalls and (4) program new vo-cabulary. Over time, the aug-mented communicator may learnto direct these tasks.
When the individual who usesAAC is conversing with familiarpartners, facilitators may (or maynot) need to provide support toboth interactants. Ideally, thefacilitator would wait until theaugmented communicatorrequests help to interpret, help torepair a breakdown, reinstruct thepartner in the technique beingused, and so on.
However, when dependentcommunicators interact withunfamiliar partners, a facilitator
For Consumers, Continued from page 7
Table III. The role of facilitators with emerging, dependent and independent communicators(adapted in part from Dowden, 1999)18
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Continued on page 10
Training materials
Training someone to facilitateinteraction is not a one shot deal.Offering off-the-cuff suggestions(e.g., “pause for ten seconds and lookexpectant”), conducting an inserviceor workshop, providing a check list, aspecial training package, a newchapter on communication partnersor a written report with trainingsuggestions may all help, but nosingle one of these approaches willsuffice to change communicationbehaviors.
A prerequisite to helping adultpartners learn is to understand howthey learn. Adults learn by doing, byseeing and by being coached. Thematerials reviewed below take intoaccount these (and other) basiclearning principles.
Communicating matters
Communicating matters: A trainingguide for personal attendantsworking with consumers who haveenhanced communication needs, (inpress) by Barbara Collier. This videoand manual focus on training adultattendants to communicate effec-tively with augmented communica-tors. The materials target “dependentcommunicators” and the needs ofpersonal assistants.
The video provides excellentexamples of competent augmentedcommunicators using a range of low-tech and no-tech strategies to makechoices, express opinions and man-age their own affairs. Personalassistants learn how to communicateeffectively by asking open-endedquestions, getting familiar withcommunication boards, giving object
choices, and muchmore. In addition, thevideo demonstratesways a personal
To be available from Paul H. Brookes PublishingCo., POB 10624, Baltimore, MD 21285. http://www.pbrookes.com
Making connections
Making connections: A practicalguide for bringing the world ofvoice output communication tostudents with severe disabilities,(1999) by Peggy Locke and JackieLevin. This 78-page guide focuses onhelping communication partnersintroduce voice output communica-tion devices to emerging and depen-dent communicators. While only afew pages directly relate to partnertraining, the guide provides a useful,easy-to-follow approach that familymembers (first Circle) and peoplepaid to support augmented commu-nicators (fourth Circle) can refer towhen introducing simple voice outputtechnology.
Available from AbleNet, Inc., 1081 10th Avenue,SE, Minneapolis, MN 55414. http://www.ablenetinc.com
Communicating effectivelywith persons who use AAC
Communicating effectively withpersons who use AAC, (1996) byYvonne Gillette. This 30-minutevideo and guide is designed forstudents (speech-language patholo-gists) in preservice programs. Theprogram provides strategies for threetypes of augmented communicators.
Early augmented communicators (thosewho do not regularly send or respond tomessages).
Novice augmented communicators(those who understand and sendmessages but require more advancedmethods to fully participate).
is nearly always required. Facilita-tors often act as interpreters ortranslators of the message. Inaddition, they may help by writingletters, preparing presentationsand doing other business for thedependent communicators,because of the difficulty manyhave expressing novel thoughtswith a limited vocabulary.
• Independent communicatorsIndependent communicatorsIndependent communicatorsIndependent communicatorsIndependent communicators needa communication facilitator onlyon rare occasions. Because theyare literate and have access toAAC techniques that others findeasy to understand, thefacilitator’s role tends to bedirected toward setting up andmaintaining equipment. However,facilitators also carry out requeststo translate dysarthric speech,make phone calls or program adevice.
Summary
Dowden’s paradigm, describingthree groups of augmented commu-nicators based soley on their currentexpressive communication skills, canhelp clarify and further define thedifferent role communication facilita-tors need to play when supportingaugmented communicators withfamiliar and/or unfamiliar partners.Her groupings may also help makemore explicit our expectations ofcommunication facilitators undervarying circumstances.
10
Equipment, Continued from page 9
Advanced augmented communicators(those who can understand and sendmessages but need to enhance theirparticipation skills).
The video begins with three“what’s wrong with these interac-tions” scenarios. Then, an on-camera instructor talks abouteffective strategies, which are subse-quently demonstrated. Despite theclinical, didactic feel to the video, theconcepts and strategies depicted areimportant ones:
1. Establish a partnership by followingthe augmented communicator’s lead,initiating routines and sharing the lead.
2. Develop routines together by (a)balancing turns in play and conversa-tion, (b) waiting, signaling andexpecting the augmented communicatorto take a turn and (c) communicatingresponsively to shift the power to theaugmented communicator.
3. Share emotionality and enjoyment bytalking about your own feelings andshowing emotion in your voice and face.
4. Exchange messages by (a) communi-cating briefly, then pausing to providespace for the user’s messages, (b) usingmessages similar to those that theindividual uses and (c) using commentsmore than questions or commands.
Available from Innocomp, 26210 Emery Road,Suite 301, Warrensville Heights, OH [email protected]
AAC skill development
Augmentative and alternativecommunication skill developmentpackage, (1997) by Marsha Lester-Cribb. This comprehensive programis intended to be used by an aug-mented communicator and a naturalspeaker to improve their interactionskills. The package contains fourtopic-based booklets and an accom-panying resource video. Topics are:
1. Individuality and control in relation-ships, which covers assumptions peoplemake, conversational control and itseffects and other communicationbehaviors.
2. Time, which addresses ways aug-mented communicators and naturalspeakers use time during interactions. Italso deals with silence and rate issues.
3. Eye gaze and facial expression, whichdepicts ways eye gaze and facialexpressions are used in communication.
4. Misunderstandings, which discussesmisunderstandings and ways to preventthem, as well as how to deal with themwhen they occur.
Developed as part of a researchproject conducted at the University ofStirling in Scotland, the package isdesigned to give AAC users as muchcontrol over the communicationprocess as possible. Suggestedprocedures are for partners tovideotape themselves having a chatand then decide which strategies towork on. The videotape (PAL-format)is didactic and integral to the trainingmanuals. Many good points aremade throughout the program.
Available from AAC Research Team, Departmentof Psychology, University of Stirling, StirlingFK9 4LA Scotland.
Building communicativecompetence
Building communicative compe-tence with individuals who useaugmentative and alternativecommunication, (1998) by JaniceLight & Cathy Binger. This 250+page book is a step-by-step, wellresearched guide for teaching aug-mented communicators three specificskills to enhance communicativecompetence. The skills are anintroduction strategy, turn takingand partner-focused questions.
In addition to a focus on theaugmented communicator’s skilldevelopment, the book is a marvelousinstructional guide for teachingcommunication partners/facilitatorsthe skills they need to support anaugmented communicator’s develop-ment of communicative competence.For example, the authors identify thefollowing procedures for teaching
facilitators:1. The clinician meets with facilitatorsone-to-one, or in a small group.
2. The facilitator(s) and clinician reviewthe goal and discuss its importance.
3. The clinician and facilitator(s) discussstrategies currently being used tosupport the individual’s communicationand to encourage faciliator(s) tocontinue using these strategies
4. The clinician explains the targetfacilitator strategy.
5. The clinician demonstrates the targetstrategy and discusses the impact ofusing it versus not using it.
6. Facilitators practice using the strategywith the augmented communicator.
7. The clinician provides feedback to thefacilitator(s) to improve performance.
8. The clinician evaluates whether (ornot) the instruction is effective.
9. The clinician checks with thefacilitator(s) and the individual who usesAAC, as appropriate, to insure theirsatisfaction with the instruction.
10. The facilitator(s) practice using thetarget strategy in a wide range of dailyinteractions with the augmentedcommunicator.
11. After instruction is completed, theclinician monitors the facilitators’continuing use of the strategy.19
The instructional program hasundergone systematic field testing toensure its effectiveness and can beadapted to meet a range of AACneeds.
Available from Paul H. Brookes Publishing Co.,POB 10624, Baltimore, MD 21285. http://www.pbrookes.com
Other highly recommendedresources
Space precludes an adequatedescription of all the resources Iuncovered. Thus, I’ve listed someother very good references on page 11.Please take a look for yourself.
Attitudes and strategies towards AAC:A training package for AAC users andcarers, (1995), by Joan Murphy & JanetScott. Video and manual. Available fromAAC Research Team, Department of
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Continued on page 12
Parallels to the deafcommunity
Two quite different groups of peoplewho experience severe communica-tion difficulties include those who aredeaf/severely hearing impaired andthose who are unable to speakbecause of severe speech and lan-guage impairments. In both cases,they require accommodations andappropriate assistive technologies tointeract with people at home and intheir communities. Without thesetools and techniques, people withsevere communication impairmentsare categorically denied access tolanguage, to their social milieu, tothe political process, to education,employment and self determination.Obviously both people who are deafand those who are unable to speakfor other reasons find this unaccept-able. This article seeks to comparehow each community is dealing withthe quality of services it receives.20
Some history
People who are deaf learn acommon languge/means of expres-sion and are able to communicatewith one another across distances,using TTDs and other technologies.As a result, the deaf community hasdeveloped a strong political agendaand, after years of advocacy, theynow have well-established require-ments and standards for interpretingservices, a code of ethics for theprovision of clinical and supportservices, and regulations for thehearing aid industry. Our small,more diverse AAC community doesnot.
Individuals who use AAC, while
understanding thelanguage spokenaround them, rarelyhave opportunities to
interact with each other.In fact, it has only been in
the past five to ten years that aug-mented communicators had themeans even to begin to form acommunity. Intelligible voice outputcommunication devices, low-costcomputers with fast modems and theInternet are providing the necessarytools. Organizations like ACOLUG,the Pittsburgh Employment Confer-ence (PEC) and regular consumer-attended conferences sponsored bysome (but not all) of ISAAC’schapters and associated groups, arebeginning to provide the means.These venues are enabling aug-mented communicators to take thetime they need to discuss the issuesthey feel are most important, sharestories they want to share andperhaps, over time, begin to plan apolitical agenda that they wantenacted. What has the deaf commu-nity done with regard to insuringquality of the interpreting servicesthey require? Might the AAC com-munity want to follow a similar path?Does the AAC community feel thatcredentialing and certification willresult in a higher quality of facilita-tor/interpreter services over time?These are just some of the parallelsto consider.
Interpreters & teachers
The deaf community has deafinterpreter services and certificationrequirements at the local, state/provincial and national levels. Forexample, the National Registry ofInterpreters (RID) works to providewhat they refer to as the three Q’s ofinterpreting: Quantity, qualificationand quality. Their mission is to
Psychology, University of Stirling,Stirling FK9 4LA Scotland.
The Augmented Chronicles: Essays byaugmented speakers about theirexperiences with augmentativecommunication and personal assistants,(in press) edited by Melanie Fried-Okenand Hank Bersani. Book ( based on atraining publication.) To be availablefrom Paul H. Brookes Publishing Co.,POB 10624, Baltimore, MD 21285.
Don’t hang up: A training package tohelp people with communicationdifficulties use the telephone moreeffectively, (in press) by Joan Murphy &Janet Scott. Video and manual. Availablefrom AAC Research Team, Departmentof Psychology, University of Stirling,Stirling FK9 4LA Scotland.
Picture It: Partners in CommunicationTraining: Using real environmentsthrough interactive teaching, (1996) andThe Triple C - Checklist of Communica-tion Competencies (Video and Assess-ment Package), by Karen Bloomberg &D. West. Both are available from SCIOP/Spastic Society of Victoria, PO Box 381,St Kilda, Victoria, 3182 Australia.
prAACtically speaking FunctionalCommunication Strategies, (1996) byKaren Bloomberg. Video and manual.Available from Functional Communica-tion Outreach Service (FCOS) 705Geelong Rd., Brooklyn Victoria, 3025,Australia.
See what we say: Vocabulary and tipsfor adults who use augmentative andalternative communication, (in press) byBarbara Collier. Manual. To be availablefrom Paul H. Brookes Publishing Co.,POB 10624, Baltimore, MD 21285.
Talking to people with severe communi-cation difficulties: An introductorytraining video, by Joan Murphy & JanetScott. Video and leaflet. Available fromAAC Research Team, Department ofPsychology, University of Stirling,Stirling FK9 4LA Scotland.
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promote excellence in the delivery ofinterpretation and transliterationservices among those who are deaf/hard-of-hearing and people who arehearing, to ensure effective commu-nication. They offer: (a) training fornew and professional interpretersthrough the professional developmentcommittee (PDC), (b) a certificationmaintenance program (CMP), (c)continued certification throughRID’S national testing system (NTS)and (d) self-regulation through anational ethical practices system(EPS).21
Teachers of the deaf and interpret-ers for the deaf must be certified.According to RID,
Sign Language/spoken Englishinterpreters are highly skilled profession-als. They must be able to listen toanother person’s words, inflections andintent and simultaneously render theminto the visual language of signs usingthe mode of communication preferred bythe deaf consumer. The interpreter mustalso be able to comprehend the signs,inflections and intent of the deafconsumer and simultaneously speakthem in articulate, appropriate English.They must understand the cultures inwhich they work and apply thatknowledge to promote effective cross-cultural communications.21
The Americans with DisabilitiesAct requires the provision of “quali-fied” interpreters in a variety ofsettings. The Act states that to satisfythis requirement, the interpretermust have “ . . the proven ability toeffectively communicate.”
One important measure of aninterpreter’s proven ability is a profes-sional credential. Credentials areobtained by taking and passing anassessment of skills. The NationalRegistry of Interpreters for the Deaf(RID) provides testing for nationalcertification. Assessments by theNational Association for the Deaf (NAD)and other state agencies may also beaccepted by employers.21
The Registry of Interpreters forthe Deaf, Inc. has set forth principlesof ethical behavior to protect andguide interpreters and transliterators,and the hearing and deaf consumersthey serve. This Code of Ethics,which is shown in Table IV, applies toall members of the Registry and toall certified non-members.21 [Seehttp://www.rid.org]
AAC facilitators
There are no national, regional,state/provincial or local programsthat I am aware of that teach (orcertify) individuals who act ascommunication facilitators for peoplewith severely impaired speech who
use AAC techniques and require acommunication facilitator.
[Note: One possible exception is the Speech-to-Speech, a telephone relay system for persons withspeech impairments. Operators are beingtrained.]22
There are no certification require-ments either. Currently, the job ofcommunication partner/facilitator isassumed by an aide, personal assis-tant, speech-language pathologist,teacher or family member who may(or may not) have had any training inhow to act as an interpreter and tofacilitate communication betweenindividuals who use AAC and theirvarious communication partners.
While rights granted under theI.D.E.A. and A.D.A. in the UnitedStates cover people who are deaf andthose who are severely speechimpaired for other reasons, the AACcommunity does not have certifica-tion requirements for facilitatorsrelated to either the quality or theethics of these services or regulationsfor AAC technologies. There doesexist a Communication Bill ofRights; and ASHA is taking underconsideration the issue of recogniz-ing speech-language pathologistswho specialize in the area of AAC.23
Governmental, Cont. from page 11
Table IV. Code of ethics for interpreter services21
13
Continued on page 14
Six of sixty (months)
The AAC-RERC just completed sixmonths of a five-year project fundedby the National Institute for Disabil-ity and Rehabilitation Research. Thisissue highlights the ACETS and Tech-Watch projects, which are bothamong the AAC-RERC partnerprojects.
ACETS: Employmentresearch
ACETS (pronounced assets) is theAugmentative CommunicationEmployment Training and Supportprogram located at the Institute onDisabilities/UAP within TempleUniversity in Philadelphia. The goalof this five-year project is to developand implement a curriculum to trainat least 25 augmented communica-tors to significantly increase theirvocabulary, knowledge and skillsrelated to employment, especially infields that rely on the Internet.Augmented communicators whograduate will have in-depth work-related skills and experiences en-abling them to be employed or self-employed. Staff will disseminate thecurriculum through the AAC-RERC,the Institute on Disabilities and othercollaborating AAC-RERC partners,at the end of the project.
Key staff are Diane Nelson Bryen,principle investigator, Kevin Cohenand Leonard Kasday. All are fromthe Institute on Disabilities. Inaddition, Lou Heite, a graduatestudent (Temple University) and fouraugmented communicators (DavidChapple, Gus Estrella, Leigh AnnLightholder and Solomon Rakhman )will be working on the project.Augmented communicators are
providing direction,training and input to allaspects of ACETS.The first ACETStraining program will
begin in October 1999.Recruitment for the initial cohort ofaugmented communicators isunderway. At present, there are fiveapplicants for the six possible spaces.To participate, individuals must havesignificant speech disabilities, bebetween 18 and 64 years old, use acommunication device for face-to-face communication, be able tointerface their communication devicewith a computer, be familiar with theInternet, and have a strong desire towork.
The ACETS curriculum includes aone-week program and may encom-pass up to a year of an internship orfocused training with an ACETSbusiness affiliate or mentor. ACETSstaff have conducted focus groups(both face-to-face and through e-mail) in an initial effort to determinewhat topics to include in the training.Staff are also recruiting businessaffiliates (e.g., UNISYS, TempleUniversity’s Small Business Develop-ment Center, The Census Bureau andothers) and asking them to share: (a)descriptions and requirements of jobsin their company, (b) informationabout the company’s “work” cultureand (c) feedback about experiencesthey have had with people who havedisabilities. Businesses may partici-pate in the training program andprovide mentorships and/or intern-ships. In exchange, ACETS is offeringto help companies become betterprepared for a diverse workforce,accommodate employees who useAAC approaches, establishmentorship programs to maximizethe contribution of employees withsignificant disabilities and establishinternship programs for employees
with significant speech disabilitieswho use assistive technology tocommunicate.
The training program is designedto answer the following researchquestions:• What skills do competent AACusers have prior to enrolling inACETS, and what do they need?
• What are the outcomes forgraduates of ACETS on: (a) increas-ing their computer/telecommunica-tion skills, (b) employment-relatedvocabulary and communication, (c)small business planning skills, (d)job-seeking skills and (e) jobreadiness skills?
• What is the impact for ACETS?Do its graduates increase their full-time and part-time employment(including income, benefits, etc.) inthe extant private sector or theirown businesses?
• Employer-related questions are: (a)what issues do businesses need toaddress prior to hiring AAC users,(b) what accommodations dobusinesses need to make and (c)what accommodations are mostdifficult to make, and why.
ACETS staff are collaboratingwith AAC-RERC staff at Penn State,who are also conducting an employ-ment-related project. [See volume 11,#6 of ACN.] The AAC-RERC’sattention to employment issuespromises the field information andstrategies that will enhance thelikelihood of more augmentedcommunicators becoming success-fully employed.
For more information, contact Diane NelsonBryen or Kevin Cohen, Institute on Disabilities/UAP, Temple University, 1301 Cecil B. MooreAvenue, 423 Ritter Annex, Philadelphia, PA 19122.215-204-2247 (voice); 800-750-7428 (TTY); 215-204-6336 (FAX). [email protected][email protected] Check out twoWebsites: http://www.aac-rerc.com and http://www.temple.edu/inst_disabilities
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Tech Watch Project
The Communication Enhance-ment Technology Watch project isbeginning to monitor and seek outtechnological developments–in boththe commercial market and inlaboratories around the world–thathave products with potential applica-tions for AAC in the pre-releasestages of development. The desiredoutcome of the Tech-Watch project isto facilitate the transfer of state-of-the art technologies into AACproducts. If successful, AAC con-sumers, manufacturers, developers,service providers and others inter-ested in the efficiency and effective-ness of AAC technologies willbenefit.
A number of technology catego-ries are being monitored in search ofdevelopments that could result inimproved portability, durability,speech, access, displays and more.Kevin Caves, principle investigator(soon to be at Duke University),Frank DeRuyter (Duke University)and Howard Shane (The Children’sHospital, Boston) are working on thisproject.
The current focus is on establish-ing the monitoring protocols andcollection formats for the project.Areas that the AAC-RERC is begin-ning to monitor are:
Battery lifeBattery lifeBattery lifeBattery lifeBattery life - Typically, AAC devicebatteries are standard NiCd or NiMHrechargeable batteries that require an ACtransformer to recharge. Recharge timesare 8-10 hours. Different devices usedifferent style batteries (from AA toblock batteries weighing 2-3 pounds).New battery technology is desired thatwould be smaller, lighter, longer lasting,cost effective and require shorterrecharge time.
Computer technologyComputer technologyComputer technologyComputer technologyComputer technology - Dedicated AACdevices use a variety of computertechnologies including microprocessors,RAM, PC Card technology, speakers,storage devices, integration, IRtechnology and keyboard development,among others. New computer technology
is desired that would take advantage ofhigher speed processors and increaseddurability and portability.
Display technologiesDisplay technologiesDisplay technologiesDisplay technologiesDisplay technologies - Touch screen anddynamic display communication systemsuse computer displays that presentinformation in color and whose layoutcan change based on what the user iscurrently communicating. For example,a user could start a dynamic displaydevice with a page containing thealphabet for spelling out messages, thenchange to a page of custom messagesthat can be retrieved with a singlekeystroke. Display technology is desiredthat would have high resolution in brightlights, scratch/water resistance, lowpower consumption and touch screentechnology.
User interface strategiesUser interface strategiesUser interface strategiesUser interface strategiesUser interface strategies – A variety ofaccess methods are employed by users ofAAC technology. New user interfacestrategies (e.g. control by eye, sound,mind, etc.) or improvements to existinguser interface strategies (keyboard,touch screen, encoded input, switchscanning, etc.) are desired that wouldimprove the user’s performance andsimplify setup of the device for the useror caregiver.
Vocabulary retrieval/encoding softwareVocabulary retrieval/encoding softwareVocabulary retrieval/encoding softwareVocabulary retrieval/encoding softwareVocabulary retrieval/encoding software– Strategies or programs that could beused to increase the rate at which a useris able to generate unique messages arerequired.
Keystroke rate enhancement softwareKeystroke rate enhancement softwareKeystroke rate enhancement softwareKeystroke rate enhancement softwareKeystroke rate enhancement software –Strategies or programs that could beused to increase the rate at which a useris able to generate keystrokes are needed.
Authoring environments softwareAuthoring environments softwareAuthoring environments softwareAuthoring environments softwareAuthoring environments software –Software that will allow parents,teachers and therapists to customizecommunication and educationalmaterials is sought.
Therapy toolsTherapy toolsTherapy toolsTherapy toolsTherapy tools– There is a need forsoftware solutions that will developskills in AAC, as well as maximizespeaking potential.
Synthesized speech outputSynthesized speech outputSynthesized speech outputSynthesized speech outputSynthesized speech output – AACtechnologies are currently standardizedon DECTalk, recognized as the highestquality synthesized speech outputcurrently available. Synthesized speechoutput technology is desired that is morenatural, intelligible and emotive.
Digitized speech outputDigitized speech outputDigitized speech outputDigitized speech outputDigitized speech output – AACtechnologies also employ digitized(recorded) speech. Digitized speechoutput and compression technology aredesired that have improved quality and
clarity, fast recording and play backperformance and reduced storagerequirements.
Speech filtering technologiesSpeech filtering technologiesSpeech filtering technologiesSpeech filtering technologiesSpeech filtering technologies – Severaldevices on the market attempt to clarifyspeech. Technologies are needed thatfilter or clarify an individual’s speech sothat a communication partner canunderstand it.
Voice recognition softwareVoice recognition softwareVoice recognition softwareVoice recognition softwareVoice recognition software – Severalvoice recognition systems for personalcomputers are on the market that, onceproperly trained, do a reasonable job ofconverting speech to text. Technologiesare needed that enable individuals withspeech impairments to convert impairedspeech to text for communication orwriting.
Information is currently beingcollected from a growing variety ofresources, including the SoutheastRegion for the Federal LaboratoryConsortium (FLC), which promotesand facilitates the rapid movement ofresearch results and technologies intothe mainstream of the U.S. economy.Project staff are monitoring industryalerts and the Internet for relatedtechnologies as well. They sincerelywelcome input from the field.
For additional information, contactKevin Caves, AAC-RERCAAC-RERCAAC-RERCAAC-RERCAAC-RERC, Box 3888,Duke University Medical Center,Durham, NC 27710. Phone: (919) 681-9983; FAX: (919) 681-9984; Email:[email protected]
Visit the AAC-RERC Website at: http://www.aac-rerc.com
[The AAC-RERC section is partiallyfunded by the National Institute onDisability and Rehabilitation Research ofthe Department of Education undergrant number H133E9 0026. Theopinions are those of the grantee and donot necessarily reflect those of the U.S.Department of Education. This articlewas published June, 1999.]
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Augmentative Communication NewsAugmentative Communication NewsAugmentative Communication NewsAugmentative Communication NewsAugmentative Communication News(ISSN #0897-9278) is published bi-monthly. Copyright 1999 by Augmen-tative Communication, Inc. 1 SurfWay, Suite 237, Monterey, CA 93940.Reproduce only with written consent.Author: Sarah W. BlackstoneTechnical Editor: Carole KrezmanManaging Editor: Harvey PressmanOne Year Subscription: Personalcheck U.S. & Canada = $50 U.S.;Overseas = $62 U.S.Institutions, libraries, schools,hospitals, etc.: U.S. & Canada=$75U.S.; Overseas = $88 U.S. Single rate for this issue = $20.Special rates for consumers and full-time students. Periodicals Postagerate paid at Monterey, CA. POST-MASTER send address changes toAugmentative Communication, Inc.Augmentative Communication, Inc.Augmentative Communication, Inc.Augmentative Communication, Inc.Augmentative Communication, Inc.1 Surf Way, Suite 237, Monterey, CA93940. Telephone: (831) 649-3050.FAX: (831) 646-5428.e-mail: [email protected]
References1 Kraat, A. (1985). Communication interaction
between aided and natural speakers: A state ofthe art report. Toronto, Ontario, Canda:Canadian Rehabilitation Council for the Disabled.
2 Blackstone, S. (1991). Interaction with thepartner’s of AAC consumers: Part I – Interaction.Augmentative Communication News. 4:2, 1-3.
3 Forest, M. & Snow, J. May’s map. With a littlehelp from my friends. A videotape. ExpectationsUnlimited. POB 655, Niwot, CO 80544.
4 Patricia Dowden (May, June 1999) Personalcommunications.
5 Light, J., Collier, B., & Parnes, P. (1985).Communication interaction between youngnonspeaking physically disabled children andtheir primary caregivers: Parts I, Discoursepatterns; Part II, Communicative functions; PartIII, Modes of communication. (AAC) Augmen-tative and Alternative Communication, 1, 74-133.
6 Culp, D. & Carlisle, M. (1988). Partners inaugmentative communication training. Tucson,AZ: Communication Skill Builders.
7 Harris, D. (1982). Communication interactionprocesses involving nonvocal physicallyhandicapped children. Topics in LanguageDisorders. 2:2, 21-37.
8. Calculator, S. (l988). Promoting the acquisitionand generalization of conversational skills byindividuals with severe disabilities. AAC. 4:94-103.
9 McNaughton, D. & Light, J. (1989). Teachingfacilitators to support the communication skillsof an adult with severe cognitive disabilities: Acase study. AAC, 5: 35-41.
10 Light, J., Binger, C., Agate, T. & Ramsay, K.(1999). Teaching partner-focused questions toindividuals who use augmentative and alternativecommunication to enhance their communicativecompetence. Journal of Speech, Language andHearing Research (JSLHR). 24:1, 241-255.
11 Light, J., Seligson, L. & Lund, S. Teachingnondisabled peers to interact with children whouse AAC. Paper presented at the ISAAC BiennialConferece, Dublin, Ireland, August, 1998.
12 Beukelman, D. & Garrett, K. (1988). Augmenta-tive and alternative communication for adultswith acquired severe communication disorders.AAC, 3:104
13 Blackstone, S. (1991). Op. Cit. p. 1.14 Diane Bryen (June 1999). Personal communica-
tion.15 Blackstone, S. (1991). Beyond public awareness:
The road to involvement. AugmentativeCommunication News, 4:2, 6.
16 Light, J. & Binger, C. (1998). Building communi-cative competence with individuals who useaugmentative and alternative communication.Baltimore, MD: Paul H. Brookes Publishing Co.
17 Melanie Fried-Oken (June 1999). Personalcommunication. [Competency rules are from ahandout by Melanie Fried-Oken, Joan Sharp, LisaRemmer, Jan Staehely]
18 Dowden, P. (1999). Lesson 2C: The Impact of
Current Communication Skills on Intervention.In Dowden, P. & Yorkston, K (1999). SPHSC 453:Communication Augmentation for Non-SpeakingIndividuals. Seattle, WA: University ofWashington Educational Outreach.
19 Light, J. & Binger. C. Op. Cit. p. 16.20 Rena Carney (May 1999). Personal communica-
tion.21 The National Registry of Interpreters Website.
http://www.rid.org22 Bob Segalman (June 1999). Personal communica-
tion.23 National Joint Committee for the Communicative
Needs of Persons with Severe Disabilities. (1992).Guidelines for meeting the communication needsof persons with severe disabilities. Asha, 34(Suppl. 7), 2-3.
Cynthia Cress, University of Nebraska-Lincoln,202D Barkley Center, Lincoln, NE 68583. Phone402-572-4431 ccress1unl.edu
Patricia Dowden, Children’s Hospital & MedicalCenter, Mailstop CH-89, 4800 Sand Point, Way,NE, Seattle, WA 98105. Phone [email protected]
Gus Estrella, United Cerebral Palsy Assoc., 1660 L.Street NW, Suite 700, Washington, D.C. [email protected]
Melanie Fried-Oken, Oregon health SciencesUniversity, Child Development and RehabilitationCenter, POB 574, Portland, OR 97201. Phone 503-494-4632. [email protected]
ISAAC’s Board of Directors an-nounces a project to publish a bookcomprised of the creative expres-sions of augmented communicators.Please help make this happen!
Work must be submitted by October 15, Work must be submitted by October 15, Work must be submitted by October 15, Work must be submitted by October 15, Work must be submitted by October 15,1999. A letter of intent to submit is 1999. A letter of intent to submit is 1999. A letter of intent to submit is 1999. A letter of intent to submit is 1999. A letter of intent to submit isrequested by September 1, 1999. requested by September 1, 1999. requested by September 1, 1999. requested by September 1, 1999. requested by September 1, 1999.
Augmented communicators may submit“any creative writing, drawing, painting,dramatic work, musical score, photo-graph or other creative art which can berepresented on paper in black andwhite.”
Contact the ISAAC Secretariat, 49 Donway West,Suite 308, Toronto, Ontario M3C 3M9 Canada.www.isaac_online.org
The Ninth Symposium on The Ninth Symposium on The Ninth Symposium on The Ninth Symposium on The Ninth Symposium onLiteracy & Disabilities Literacy & Disabilities Literacy & Disabilities Literacy & Disabilities Literacy & Disabilities
Embassy Suites, Research Triangle
Park NC, February 3-5, 2000.Concurrent session will include seven broadprogram areas (strands): (1) inclusion; (2)augmentative and alternative communication andother assistive technologies; (3) individuals withsevere profound disabilities; (4) preschool-agedchildren with disabilities; (5) elementary school-aged children with disabilities; and (6) adoles-cents and adults with disabilities.
For more information please contact Janet Sturmat (919-966-1009) or David Yoder (919-966-9040or dyoder @css.unc.edu) at the University ofNorth Carolina.
