Category Archives: Assistive Technology

What is an Augmentative and Alternative Communication Evaluation?

By: Laura Van Zandt, MS, OTR/L

Did you know October was National Augmentative and Alternative Communication (AAC) month? AAC is a specialized area of clinical services. Here at Easterseals DuPage & Fox Valley, we are very lucky to have several therapists who specialize in helping individuals find their voice through AAC. We have both Occupational Therapists (OT)  and Speech-Language Pathologists (SLPs) involved in a multidisciplinary team evaluation to determine the best strategies and/or communication systems to help a child learn to communicate.

As an OT, I first became interested in AAC when I was working with a little boy with autism who received a high tech speech output device. It was amazing to see how having his new voice provided so many new opportunities for him. It helped with his overall regulation as he now had a system to share his wants, desires, and needs.

assist-with-communicationAAC looks different from person to person and varies from low tech options, light/mid tech and high tech systems. If you think your child might benefit from AAC, our team evaluative approach may be helpful. Below is more information on what each team member does to best help your child.

  1. Many parents often have questions about whether or not a device will hinder their children’s ability to speak. This is absolutely not the case. Research demonstrates that AAC does not keep children from learning to speak.  In fact, users will make gains in language AND speech because AAC helps a child connect with others, produce successful communication, and provides consistent speech models. The child I described above, went on to learn a ton of new words after he got his device! When we begin to use AAC with toddlers, it doesn’t mean we believe they are never going to talk; instead, it often means, we believe they need a way to have a meaningful connection to others through a common language which helps serve as a bridge to spoken language.
  2.  Do try and introduce forms of AAC early. Using AAC can be very helpful for a toddler who is beginning to make gestures, eye contact or sounds to communicate messages, but isn’t yet using spoken language. Often these toddlers are frustrated they can’t communicate certain thoughts and messages. Once they start to see and learn the power of communication through signs, pictures, or more formal AAC apps/devices, they begin to feel a little less frustrated.

blog_visual3. Model, model, model. When using any type of AAC, we can never model enough. This means that everyone in a child’s life should use AAC too! As with all language learning, AAC is learned because those around the child speak the same language. If you think about it, early communication development (between birth – 12 months) is only modeling – caregivers communicating without any expectation while being connected with their baby using a common language. I love it when my clients bring their devices to therapy. If your child is already receiving therapy services, ask the therapist to use your child’s communication system during sessions to connect and engage with your child. When using AAC, continue to use verbal speech to model and help children understand the pictorial representation of language and develop the words.

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4. When you schedule an evaluation, you will see both an occupational therapist and a speech therapist trained in AAC. Both therapists are knowledgeable in a variety of access methods such as hand access, switch scanning, and eye gaze technology. The occupational therapist will specifically look at:

  • the child’s overall posture and strength to allow for upper extremity (or any other extremity) use while accessing the communication system
  • determine optimal positioning of both the child and the device to ensure the most efficient method of access
  • the child’s vision, auditory, and sensory processing needs
  • the child’s visual and/or auditory scanning ability
  • the child’s visual/auditory tolerance
  • any adaptations to engage different sensory systems, as well as monitor for sensory overload and/or assist in sensory regulation for device access.

The speech therapist is extremely knowledgeable in the vast array of AAC communication systems and AAC strategies available. They will help determine the communication system and language page best suited to bridge the gap between the child’s receptive and expressive communication skills. The evaluations are done in a play based manner to help the child feel comfortable. And play is how children learn!

DSC_1Here at Easterseals we offer a team approach for evaluating children for AAC needs. For children that could additionally benefit from AAC, we will see them for co-treats to help expand their language within play based therapy sessions.

When the child’s specific goal is to assist in overall regulation and play to support device access, then a co-treat can be extremely valuable between Occupational Therapy and Speech Therapy. OTs are trained in setting up sensory rich environments to support regulation and drive play. These activities can be very motivating for your child’s communication. There are endless opportunities to model language depending on your child’s unique development.

To learn more about Assistive Technology at Easterseals DuPage & Fox Valley, click here. 

 

Additional resources: www.speechscience.org

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The Amazon Echo as an Accessibility Support

By: Judy Gardner, MA, CCC-SLP, Speech Pathologist/Feeding Therapist

Amazon describes the Echo as a hands-free, voice-controlled device that uses Alexa (Amazon’s answer to Siri, Cortana and Google) to play music, control smart home devices, provide information, read the news, set alarms, and more.  It is exciting that people’s interactions with a computer device is much easier with no buttons to find and press.  The speech recognition still has some limitations but devices like the Echo show what the future may be around the corner.  The Echo works by constantly listening to a trigger word, by default, the trigger word is “Alexa” but you can change it in the Alexa app on your mobile device.    The communication devices we use in assistive technology allow a non-verbal child, or the child with some difficulty in oral speech to use the Echo independently.

Relationship Coordinator, Amy Liss, really enjoys this new device. “This is the most beneficial piece of technology I have ever received that can help me be completely independent.” Her favorite feature is playing daily Jeopardy trivia.

Some of these many uses:

Get quick answers for simple Web searches:  The most basic use of the Echo is to ask it questions it can answer by searching on the Web.  This ranges from simple math (Alexa what is 125 times 33?”) or spelling and definitions, etc.  The Echo is unique in that it will say the answers out loud  rather than requiring the user to read the responses.

Set alarms and timers:  So children with executive functioning is ability to self-regulate, including the ability to stay on task and manage and keep time.  For example, you can set a timer for someone to do an activity for one hour (“Alexa set a timer for one hour”) then set a second timer for each separate step that needs to be completed to accomplish the assigned task during that hour.  Just say “Alexa set a second timer for 25 minutes.  So you can have a 5 minute break.

Manage a to do list:  Just say “Alexa, add (name of to do item) to my to do list, or remind me to (name of task).”

Update your calendar:  “Alexa, add (event name) to my calendar.”  Gives the ability to stay organized.

Get your daily news fix:  (“Alexa, give me my Flash Briefing”)

Listen to Audible and Kindle books:  The Echo is a great way to listen to your books read aloud.  This can be a great way to use the Echo in the classroom setting.

wemoControl your lights:  Echo can be great way to control your home lighting using just your voice.  This can be especially helpful for those who have motor difficulties.  By installing the Hue Skill, you can get basic voice control of the lights in your home.

Control your appliances:  With a Wemo switch you can add voice control to any small appliance with an on/off switch (fans, lamps, etc.)

Listen to music and podcasts:  Echo supports a number of music services.

There are many more thing you can do with the Echo.  For more details go to www.luisperezonline.com for full details.  If you have a voice that is difficult to understand, have no fear- Alexa can use many speech generating devices to the rescue.

The Assistive Technology department at Easter Seals DuPage & Fox Valley has received a grant to install Amazon Echo in their department.  Once it is installed we hope that you all will come down and give it a try.  Learn more about our assistive technology department by clicking here.

Screen Time: What is too much?

By: Cassidy McCoy, PT

Over the past few years, computers, tablets, phones, and TV seem to have taken over. Technology has begun to change the way our children interact with each other and us. However, how much time spent on these devices is considered too much?

The American Academy of Pediatrics recently released new recommendation for children’s media use.

The recommendations include:

  • <18 months: Avoid use of screen media other than video-chatting.
  • 18 to 24 months: If you want to introduce digital media, choose high-quality programming. Also, watch it with your children to help them understand what they’re seeing.
  • 2 to 5 years: Limit your children’s screen use to 1 hour per day of high-quality programs. You should watch it with them to help them understand what they are seeing and apply it to the world around them.boy-learning-with-therapist
  • 6 and older: Place consistent limits on the time spent using media, the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.

What are the potential effects of too much screen time?

  • Obesity: Too much screen time equates to more time spent in sedentary positioning resulting in decreased physical activity and weight gain. The American Academy of Pediatrics recommend for children to get at least 60 minutes of active play daily.
  • Sleep: Devices emit a blue light that mimics daylight, which stimulates you, leading to irregular sleep schedules and shorter duration of sleep with use of a device before bedtime.
  • Behavioral problems and violence: Screen time can be an effective way to calm down, but it should not be the only way they learn to calm down. Children should learn how to identify and handle strong emotions and come up with ways to manage them (such as deep breathing or problem solving)
  • Loss of social skills: Face-to-face communication or “talk time” is critical for language development. Research has shown that it’s that “back-and-forth conversation” that improves language skills—much more so than “passive” listening or one-way interaction with a screen.

What can you to to help?

  • Set time limits and expectations
  • Create “tech free zones” such a dinner table or bedrooms
  • Use screen time to promote education and development by utilizing appropriate programming.

For more information on Easter Seals DuPage & Fox Valley visit, eastersealsdfvr.org.

One Step

Jamie Bodden Austin, M.S. CCC/SLP-L- Assistive Technology Speech and Language Pathologist
Learning a language is a journey – be it a a first language, a foreign language, a light tech symbols systems (e.g. PODD Communication Books) or a high technology voice output system (e.g. Proloquo2Go on an iPad, NOVA chat 10 or Tobii Dynavox). It begins with one step. A baby hears words for the first year said by all of their family members. The family members repeat these words, use gestures, point to things, say single words over and over words such as “Daddy”, “Up”, “Uh oh”. They focus on favorite words (e.g. “doggie” and ‘Swing”), familiar words (e.g. “bottle”, “night-night”), greetings (e.g. “Hello”) and comments (e.g. “uh oh”). After one year, the first word, a single word is spoken by the baby. When learning a foreign language, the teacher speaks single words, uses gestures and points to items. She focuses on favorite words, greetings, comments and familiar eyemaxvocabulary first.
The same is applied when learning any AAC system. It is another language. Did you know that baby hears 4,000-6,000 words per day for the first year, before they say their first word? This repetition of modeling of language is just as important through a Augmentative and Alternative communication (ACC) device. This can be formally called: Aided Language Stimulation, Partner–Augmented Input, Natural Aided Language or Aided Language Modeling. This means that all of the people in a child’s environment communicate using the AAC communication system. When we support someone to learn to use an AAC device, we talk with the device throughout the day ourselves. We can think about saying favorite words, familiar words, greetings and comments. While doing this we can use gestures, point to things and say single words with the AAC system. By having all of your family/friends involved in saying messages using the AAC system you create a language rich environment, in your child’s language. This language becomes another language in your home that you all speak.

aac The trick is that you and your family are also learning the AAC system. However, every journey begins with a single step. Like a baby learning to speak and like a person learning a foreign language, focus only on one word or one page of vocabulary at a time. The more you talk with the device with this one page or one word, the more your child will hear, see and follow your lead. You can start with a favorite activity, a greeting or with a few favorite actions. Next, find another page to focus on, such as position words, names, questions or places. You can’t learn the device in one day, but the more single words you find, you will see your own AAC vocabulary grow. Your one step is going to be the biggest step of your child’s AAC journey.

“A journey of a thousand miles begins with one step.” Lao-tzu

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.