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28 Cards in this Set

  • Front
  • Back
Developmental/Congenital Disabilities

* differs from acquired in that...
* differs from acquired disabilites in that the individual has the disability as language is being acquired
* Does AAC impede language development?
* children learn language through using language...its an active process --> AAC allows the developmentally delayed child to practice using language functionally
* evidence indicates that AAC has NO advers affects on dvp of speech skills
* it suggests that after being introduced to AAC, children show increased vocalizations 90% of the time
Some developmental/congenital disabilities... (6)
- autism
- CP
- devp apraxia of speech
- intellectual/cog delay
- specific language impairment
- various genetic abnormalities and syndromes

* in some cases, like Down's syndrome and CP and some genetic disorders, the impairment is aparent shortly after birth and interventions can start early
* in other cases, like autism and devp apraxia of speech, the delay isn't apparent until closer to child's 2nd bday after lang dealy is established
AAC and Autism...

* what strategies/systems are used
* AAC rep in this area damaged by facilitated communication
* visual strategies
* low tech systems
* Lite tech systems
* high tech systems
3 visual strategies for used for autism
* schedules
* first, then boards
* chioce boards

for early communication and behavior
Light-tec systems for autism (4)
* single messaging systems for cause and effect, turn-taking, signalling and early social interaction skills
* cheap talk-devices,
* tech speak,
* Macaw, ...
for developing communication, especially for kids who do well with auditory feedback
High-tec systems for autism (3)
high tech systems such as dynamyte, mini merc, palmtop, etc for more advanced language and literacy skills (small systems)
AAC and CP
AAC and other technologcial interventions are key tools in the prevention of the development of learned helplessness
* switch adapted toys can be used before the child's first bday to promote the concept of cause and effect
* single and sequential messaging systems should be in place early for cause and effect, turntaking signalling and early social interaction skills
* adapted systems like eye-gaze boards can be used during early lang-devp to promote choices and basic communication skills
* light tec scanning systems such as the macaw can be used during emerging language development
* high tec systems such as the dynavox, Mercury, Vanguard, etc (big) for more advanced language, literacy skills and environmental control
AAC and Developmental Apraxia of Speech (DAS)
* expressive language skills may be quite advanced and speech output may be prolific, but intelligibility is an issue

* strategies aimed at this group tend to be clarification strategies as speech often remains their primary means of communicative
'clarification strategies'
- often involve establishing the context thru the use of topic boards or remnant books
- often involve monitoring stratgies to help client recognize when others aren't understanding
- often involves techniques such as letter boards to indicate the initial sound of the word
9 acquired disabilities
1) amyotrophic lateral sclerosis (ALS)
2) multiple sclerosis (MS)
3) Guillain-Barre syndrome
4) Parkinson's
5) Huntingtons'
6) Cancer
7) TBI
8) Stroke
9) Spinal cord injury
Sudden vs Gradual acquired disabilities
Sudden onset...
*Spinal cord injury

* MS
* Parkinsons

* with gradual onset, clien can prepare and play active role in design of AAC system
* many of the gradual onset causes of lang impairment are progressive while often the sudden onset causes improve over time
* the improvement seen after an injury to the brain is known as spontaneous recovery
What is ALS?

(Amyotrophic Lateral Sclerosis)
- 'lou gehrig's disease'
- progressive degenerative disease of unknown cause involving the motor neurons of the brain and spinal cord
- need extensive AAC as 75% not able to speak at time of death
What are the 5 Communication Stages of ALS?
1) No Detectable Speech Disorder
- consultation/education begins...instruction on what AAC is and means
2) Obvious Speech Disorder with Intelligible Speech
- arrange envir to reduce interference
- discussion of and intro to clarification strategies
- voice amplificatin systems considered
3)Reducion in Speech Intelligibility
- continue w/ clarification strategies
- use of unaided techniques
4) Residual Natural Speech and AAC
- AAC becomes primary communication system
- devices w/ strong literacy component such as a lightwriter or handheld communicator are popular
5) Loss of useful speech
- must rely on AAC
- yes/no strategies introduced
- eyegaze scanning introduced
- systems like morse code are taught
Guillaine-Barre Syndrome
GBS results from the progressive destruction and regeneration of the myelin shath of the peripheral nerve axons
- paralysis starts from the periphery and moves towards the centre, peaking in about 3 weeks
- impairment can last several months and has an 85% full recovery
5 communication stages of GBS
1) deterioration stage
2) loss of speech
3) prolonged speechlesness
4) spontaneous recovery of speech
5) long term residual motor speech disorder
What AAC systems are used with GBS?
- patients with GBS are typically provided with low-tech strategies such as learning to indicate a clear yes/no and the use of basic communication boards
- in some cases of prolonged speechlesness, high tec systems may be considered
- about 15% have residual on-going weakenss and may need to be provided with clarification strategies
- it is difficult to test AAC users for phonology
- typically can discriminate and manipulate phonologic info successfully in structured (routine) decontextualized (out of context) tasks
- skills don't generalize
- AAC users at high risk for phonology and phonological awareness delays

- 4 potential reasons for morphological delays
- both receptive and expressive morphological delays are seen in ind who use AAC

1) symbols needed to indicate morphology aren't present on device
2) faster and more efficient to leave off morphology
3) AAC user has never been explicityly taught morphology
4) lack of practice and early feedback
7 potential problems with syntax
1) predominance of both one or 2 word utterances in both structured and spontaneous settings
2) difficulty with both expressive and receptive word order tasks
3) longer composed sentences often contain syntactic structures not common to the individual's spoken language
4) omission of connector words, articles and auxiliary verbs are common - even when words are available
5) simple clauses predominate
6) primarily used for greetings and requests with limited use of questions, commands, negatives and comments
7) extensive use of multimodal combinations such as gesture and symbol, or vocalization and symbol and gesture
4 potential problems with Semantics

As a result of these problems, we see...
1) can't select their own vocabulary
2) not provided with sufficient vocabulary
3) generally don't recieve symbolic feedback when errors are made
4) communication display may not reflect developmental level

As a result of these problems we see...
- frequent overextensions (ex: horse to mean cow) and other linguistic strategies to compensate for lack of appropriate vocal (ex: bird and water for duck)
- general delays in vocab dvp
5 potential difficulties in the area of pragmatics
1) entering into a conversation
2) interupting other speakers appropriately
3) paralinguistics (ex: sarcasm, increasing volume to make a point, etc)
4) proxemics due to physical barriers
5) changing or maintaining topics
Assistive Devices Program
The Ontario Ministry of Health and Long Term Care runs the ADP program to help ppl who have longterm physical disabilities get needed equipment and supplies
- in some cases ADP pays 75% of the cost of items likecomm devices, wheelchairs, breathing aids, etc
What are some examples of the categories of equipment ADP covers?
- communication devices
- hearing aids
- home oxygen
- orthotic devices
- prosthetic devices (breast, limb, ocular, maxilofacial)
- visual aids
- wheelchairs, positioning and ambulation aid
3 levels of authorization service in ADP
1) individual authorizer (IA)
2) general level clinic
3) expanded level clinic
Communication Devices in ADP
- adaptive peripherals
- electrolarynges
- communication boards
- mounting systems
- signalling aids
- voice amplifiers
- teletypewriters for the speech impaired
- voice output devices
- voice prosthesis
- writing aids
6 Hearing Aids in ADP
- bone-anchored hearing aid
- replacement sound processors
- cochlear implant processors
- hearing aids
- personal FM systems
- teletypewriters
Items NOT covered by ADP
- regular or adaptive telephones
- environmental control units/devices
- used equipment (for purchase, not lease)
- items purchased outside ontario
- communication devices which are used for only 1 pupose such as school, work, sports, rec or social activitites