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Modifications for AAC
Deirdre Galvin-McLaughlin
5/14/2018 9:23 PM
Post by Deirdre McLaughlin CF-SLP and Kayley McDonald OTD candidate
As we discussed in our previous Communication Collection (CVI 101 and also 102… https://communicationmatrix.or... ), more patients with complex communication needs have been identified as having vision difficulties such as Cortical Visual Impairment (CVI). It can be difficult at times to know how to best support these visual needs in an AAC system given that so many systems incorporate the use of symbols whether that be a picture, photograph, visual scene display or written word. To make a language system as expansive as possible a number of symbols are often required to accommodate all possible communication needs and purposes, which can make displays often too complex for a child with vision difficulties.
There are several important supports and cues that may help support a client with CVI and that can be incorporated into an AAC system:
Highlighting with color preferences: Children with CVI see yellow and red better than other colors, these colors can often be an important cue (highlight outline of picture) for visual attention.
Using high contrast pictures/backgrounds/layouts: Increasing contrast of the background and pictures themselves supports vision - example of high contrast would be using a black background with bright colored object.
Reducing visual complexity: The complexity of a visual scene is often very difficult for individuals with CVI. Decreasing the complexity of the scene rather than magnification is often found to be an important support for visual attention. Ways to consider modifying the environment might be using the dark booth to get rid of visual distractions in the room and simplify AAC by using less picture symbols on the screen at one time.
Light cues for visual attention: Children with CVI attend better to light sources, which might include spotlighting picture symbols or backlighting on an iPad.
Movement cues for visual attention: Children with CVI see things better that are in motion.
This week a post will be created that outlines the ways SLPs and OTs have addressed visual access with clients with CVI using the supportive characteristic listed above. Please refer to those posts for further explanation and examples.
CVI has many different stages and levels (see post by Kayley McDonald OTD candidate, from previous collection: https://communicationmatrix.or... ) and children with CVI have very different visual skills and need very different visual supports. As always, it is important to trial these supports with your clients to determine if this is a good support for them and collaborate with the child’s Teacher for the Visually Impaired (TVI).
A link is attached with a great youtube video on CVI adaptations specific for AAC by Perkins School for the Blind is also included as a resource: https://www.youtube.com/watch?v=GE23MGY87PQ&t=7s
Visual Behavior,Speech-Language Pathologist,Parent/Family Member,Occupational Therapist,Physical Therapist,Other,Intervention Strategies,Visual impairment
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Statement A
My child doesn't seem to have real control over his body yet.
The only way I know that he wants something is because he fusses or whines when he's unhappy or uncomfortable, and he smiles, makes noises or calms down when he's happy and comfortable. Does this statement describe your child?
Statement B
My child has control over her own behaviors, but she doesn't use them to try to communicate to me.
She doesn't come to me to let me know what she wants, but it's easy for me to figure out, because she tries to do things for herself. She knows what she wants, and her behavior shows me what she wants. If she runs out of something to eat, she will just try to get more, rather than trying to get me to give her more.
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Statement C
My child clearly tries to communicate his needs to me through gestures, sounds or language.
He knows how to get me to do something for him. He uses some of the kinds of behaviors below to communicate:
- Gestures such as pointing, shaking his head, tugging at my arm or looking back and forth between me and what he wants
- Sounds such as squealing to show you he wants something or fussing when he doesn't want something
- Language or symbolic forms of communication such as speech, written words, Braille, picture symbols, 3-dimensional symbols or sign language
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How to score your child
Each question you will see is related to a certain message that your child might be able to express using a variety of behaviors. Read the question and decide whether your child is able to express the message described using any of the listed behaviors. If the answer is YES, then you must also decide whether your child has mastered the use of each behavior or whether it is still at an emerging stage. Check either the mastered or emerging box next to any behaviors your child uses to express the message. Use the following definitions to decide whether a behavior is mastered or emerging
Mastered
– Does this independently most of the time when the opportunity arises
– Does this in a number of di erent contexts, and with di erent people
Emerging
– Does this inconsistently
–
Only does this when prompted or encouraged to do so. Only does this in one or two contexts or with one person.
Tips on Communication Devices
Each question you will see is related to a certain message that your child might be able to express using a variety of behaviors. Read the question and decide whether your child is able to express the message described using any of the listed behaviors. If the answer is YES, then you must also decide whether your child has mastered the use of each behavior or whether it is still at an emerging stage. Check either the mastered or emerging box next to any behaviors your child uses to express the message. Use the following definitions to decide whether a behavior is mastered or emerging