Pros and Cons Augmentative and Alternative Communication Systems

Describe the different communicative needs of person with disabilities

 Communication is one of the most important aspects of social life. Since man is a social animal, communication becomes one of his intrinsic needs. People with Learning disabilities can use signs and symbols to assist in their communication process. They can be taught to make gestures with their hands, face and body to support their spoken words. This would enable them to convey their thoughts to the other person. The Americans with Disabilities Act, other laws and the efforts of many disability organizations have made strides in improving accessibility in buildings, increasing access to education, opening employment opportunities and developing realistic portrayals of persons with disabilities in television programming and motion pictures. Where progress is still needed is in communication and interaction with people with disabilities. Individuals are sometimes concerned that they will say the wrong thing, so they say nothing at all—thus further segregating people with disabilities. Listed here are some suggestions on how to relate to and communicate with and about people with disabilities.

Discuss the basic approaches to meeting these differing needs

Abraham Maslow developed a theory based on the idea that all humans share common needs and that these needs can be arranged in a hierarchy, of ladder format, in order of priority. Lower level needs have the highest priority. According to Maslow, lower-level needs must be satisfied before higher-level needs become sources of motivation. For example, a person's need for food, water, and shelter (physiological needs) take priority over social and self-esteem needs. Only when one's basic needs are met, can one focus on higher-level needs. Once a lower-level need is satisfied, the next higher-level need becomes the most important to the person. If a lower-level need suddenly becomes unsatisfied, it can take priority over a higher-level need. For example, suppose a person who is primarily motivated by the need for promotion (accomplishment) suddenly becomes stranded at sea in a lifeboat. The need for food, water, and to keep the lifeboat afloat (survival needs) take priority over the need for social acceptance or recognition. Need is satisfied, the next higher-level need becomes the most important. The person’s behavior then changes in response to the higher-level need. If a lower level need suddenly becomes unsatisfied, it can take priority over a higher-level need. Therefore, each level of need determines a person’s behavior.

Recognize the needs that individuals have for conversation and for graphical output such as writing, mathematics and drawing

A Specific Learning Disability (usually abbreviated to LD) means a disorder in one of more of the basic psychological processes involved in understanding or in using language (spoken or written), which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations. It also includes directional confusion, sequencing difficulties, and short-term memory retention problems. These problems are NOT primarily due to visual, hearing or motor handicaps, NOR due to mental retardation, emotional disturbance, or because of environmental, cultural, or economic disadvantage. The individual is considered to have a LD if achievement is not commensurate with age and ability levels in one or more of the above specific areas when provided with learning experiences appropriate for age and ability levels.

Describe the major characteristics of alternative and augmentative communication devices

Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write. People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth. AAC users should not stop using speech if they are able to do so. The AAC aids and devices are used to enhance their communication.

Describe current approaches to speech output in assistive technologies

The American Speech and Hearing Association's (ASHA) definition of an augmentative and alternative communication (AAC) system as "an integrated group of components, including the symbols, aids, strategies and techniques used by individuals to enhance communication". This article addresses some frequently asked questions regarding AAC. A SGD or communication device is used by an individual to enable him or her to communicate more effectively with others. A device assists an individual in communicating through printed words, speech or voice output, pictures, or any combination of these. Devices range from having basic components and performing fundamental language functions to having the ability to perform computer-like functions and control household appliances. SGDs are designed to be used as either a primary method of communication or a supplementary mode of communication to augment existing communication strategies and can be configured or customized to address most communication needs. Individuals who cannot speak, are difficult to understand, or have language retrieval issues might use a SGD. Communication devices are used by people of all ages with a variety of disabilities. An individual with a communication impairment may have difficulty with expressive (what he or she can express) and/or receptive (what he or she understands) communication

List and describe the major approaches to rate enhancement and vocabulary expansion

Augmentative and alternative communication is typically much slower than speech, with users generally producing 8–10 words per minute. Rate enhancement strategies can increase the user's rate of output to around 12–15 words per minute, and as a result enhance the efficiency of communication. There are two main options for increasing the rate of communication: encoding and prediction.

• Encoding is a technique permitting an AAC user to produce an entire word, sentence or phrase using only one or two activations of their AAC system. In numeric, alpha-numeric, and letter encoding (also known as abbreviation-expansion), words and sentences are coded as sequences of letters and numbers. For example, typing "HH" may retrieve "Hello, how are you?" In iconic encoding strategies, such as Semantic compaction, icons (picture symbols) are combined in a sequence to produce words or phrases.
• Prediction is a rate enhancement strategy in which the device attempts to predict the letter, word or phrase being written by the user. The user can then select the correct prediction without needing to write the full word. Word prediction software may determine the words predicted based on their frequency in language, association with other words, past choices of the user, or grammatical suitability

Describe the major assessment questions that must be asked and answered in determining the most appropriate augmentative and alternative communication device for an individual user

There are a variety of communication devices available. Devices can have a single message or multiple messages. Medicare categorizes devices based on the following features.

• Speech Output - Digitized (recorded human speech) or synthesized (electronic conversion of text into speech).
• Message Type - Prerecorded (messages that are stored) or Message Formulation (can spontaneously create novel messages).
• Recording Time - less than or equal to 8 minutes, greater than 8 minutes, or based on the memory size of the device in general (e.g., 16 MB).
• Access Method - Direct Physical Contact with Device or Multiple Access Methods (e.g., switch, mouse, joystick, etc.).
• Message Formulation Technique - Spelling only or Spelling and Other Methods.

Additionally, devices have different selection sets (dynamic, static or both). Dynamic sets are similar to a computer monitor. The selection set or level changes automatically on a dynamic screen as the user makes choices. Some dynamic sets can be activated by touch or through a pointing tool (e.g., stylus). Dynamic sets can be color or black and white. Typically, the information on these screens is difficult to see in places with bright lighting. These screens can also be damaged by misuse or accidental impact.

Static sets have fixed symbol choices or levels that can be manually changed. Most static sets are easier to see in brightly-lit situations, depending on the quality of the information you are displaying (e.g., photographs, text, etc.). Static sets usually have a group of letters, pictures and/or words on an overlay that is inserted or attached to the device. Spelling or keyboarding devices generally have static sets.

Discuss the major goals for and the significance of training in augmentative and alternative communication device use and communicative competence

AAC refers to an area of research as well as a set of clinical and educational practices (ASHA, in press). The knowledge and skills that are viewed as minimal and necessary requisites for competent practice in this area have been published separately. This technical report includes a review of the scientific foundation for the knowledge and skills. Speech-language pathologists are encouraged to implement evidence-based practices, that is, to integrate best and current research evidence with relevant stakeholder perspectives and clinical or educational expertise.

• AAC involves attempts to study and, when necessary, temporarily or permanently compensate for the impairments, activity limitations, and participation restrictions of individuals with severe disorders of speech-language production and/or comprehension. These may include spoken and written modes of communication.
• Speech, Communication, and Language. It is important to distinguish between the terms speech, communication, and language if we are to understand the concept of augmentative and alternative communication. Speech refers to a method of communication that relies on vocal production and auditory comprehension. It relies on effective use and coordination of five primary subsystems: phonation, articulation, resonance, respiration, and prosody. Like speech, AAC systems constitute methods of communication in that they involve the transmission of meaningful information from one person to another. Messages are often conveyed through the use of one or more different types of symbols that represent ideas, entities and events in the world. The selection and combination of symbols are governed by a set of rules, or, language. Rules correspond to three dimensions of language: form, content, and use. Form refers primarily to phonologic, morphologic, and syntactic rules. It is thus concerned with the sequencing of sounds, or traditional orthography to create words and the sequencing of words to create phrases and sentences. Content refers to the use of language to convey meaning. Use corresponds to the pragmatic aspects of language and relates to the functional uses of language in context.

Delineate the steps and procedures involved in implementing an augmentative and alternative communication device use

This technical report, together with the associated position statement and knowledge and skills document, is intended to complete a family of documents that provide background information, including a scientific foundation, for service delivery related to augmentative and alternative communication. AAC is an area of practice that has undergone significant and rapid growth over the past 10 years. In all likelihood this pattern will continue as new technologies and instructional practices emerge. Speech-language pathologists who are practitioners in this area are encouraged to rely on evidence-based practices when making clinical decisions. They are also encouraged to contribute to the knowledge base in AAC by forging collaborations with the research community. Universities are encouraged to take a leadership role in both pre-service and in-service instruction about AAC. Those that do not already require one or more AAC courses should consider doing so, given the prevalence of individuals who rely on these methods of communication and the growing body of literature related to this topic.