Demands Associated With an Augmentative and Alternative Communication System in Relation to Alternative Forms of Access for Individuals With Motor Impairments

PURPOSE

Successful adoption and use of aided augmentative and alternative communication (AAC) must address how to promote fluid, efficient, and organized execution of the motor behavior needed to access the AAC system. A substantial number of people who use AAC have significant motor impairments and require "alternative" access options, such as eye gaze or switch use. Such individuals may be particularly vulnerable to interference from a poorly designed system. However, the inherent demands of alternative access methods have received little direct study. The goal of this tutorial is to offer a clinically and theoretically guided framework for considerations concerning AAC access, with the hope of spurring further discussion and empirical research.

METHOD

A framework that draws upon dynamic systems theory was used to illustrate the interactions between the various elements of importance to AAC access. Information and research from the fields of motor learning, developmental dynamic systems theory, AAC, and assistive technology was integrated into this tutorial to examine their applications for alternative AAC access methods.

RESULTS

The framework illustrated that AAC access involves a complex coordination between individual skills, the demands of the communication environment, the activity being undertaken, and the supports and demands inherent in the AAC system itself.

CONCLUSIONS

Awareness of the many demands that alternative forms of access place on the person who uses them can guide clinicians during assessment and intervention decision making regarding access options for individuals with significant motor impairments. Specific directions for future research are considered.

Influences on students' assistive technology use at school: the views of classroom teachers, allied health professionals, students with cerebral palsy and their parents

PURPOSE

This study explored how classroom teachers, allied health professionals, students with cerebral palsy, and their parents view high-tech assistive technology service delivery in the classroom.

METHODS

Semi-structured interviews with six classroom teachers and six parents and their children were conducted. Additionally, two focus groups comprising 10 occupational therapists and six speech pathologists were carried out. Ethical and confidentiality considerations meant that the groups were not matched.

RESULTS

Results revealed that it is often untrained staff member who determine students' educational needs. The participants' experiences suggested that, particularly in mainstream settings, there is a need for support and guidance from a professional with knowledge of assistive technology who can also take a lead and guide classroom teachers in how to meet students' needs. Students' motivation to use the technology was also found to be critical for its successful uptake.

CONCLUSIONS

The study points to the need for classroom teachers to be given sufficient time and skill development opportunities to enable them to work effectively with assistive technology in the classroom. The participants' experiences suggest that such opportunities are not generally forthcoming. Only in this way can it be ensured that students with disabilities receive the education that is their right. Implications for Rehabilitation Classroom teachers, allied health professionals, students, parents need ongoing support and opportunities to practise operational, strategic and linguistic skills with the assistive technology equipment. System barriers to the uptake of assistive technology need to be addressed. To address the lack of time available for training, programing and other support activities around assistive technology, dedicated administrative support is crucial. Professional development around the use of the quality low cost ICF-CY checklist is recommended for both school and allied health staff.

Evaluation of methods for teaching electronic visual scanning to children with cerebral palsy: two series of case studies

PURPOSE

To evaluate the effectiveness of two instructional techniques in teaching electronic row-column scanning to children with cerebral palsy.

METHOD

Two case series involving four participants each. Eight children, four boys and four girls (ages 3-13 years), were assigned to one of two intervention groups and completed three baseline and five intervention sessions. One intervention (n = 4) consisted of computer-based activities alone, while the other intervention (n = 4) consisted of a sequential approach starting with paper-based activities and then shifting to computer-based activities.

RESULTS

Participants within both groups demonstrated varying degrees of skill mastery (80% accuracy or better) of linear and, for some, electronic row-column scanning within the training phases of the intervention sessions. However, there was no clinically important change in test scores between baseline and outcome measures for either group.

CONCLUSIONS

Significant challenges exist when studying the effectiveness of instructional techniques for teaching electronic row-column scanning to children with cerebral palsy. These case series provide information regarding the importance of selecting the most appropriate scanning technique to ensure reliable switch activation, carefully structuring the teaching environment to optimize learning, and being cognizant of the impact of fatigue and motivation on performance. [Box: see text].