TechnoTalk
Newsletter
VOLUME 20 - ISSUE 4 - JULY 2011
From the editor’s desk
As we all know the world of AT can change
very quickly which is also reflected in some
recent changes to staff and AT services
within Technology Services at Cerebral Palsy
Alliance.
At the end of May we farewelled Liza
MacLean our senior occupational therapist
and acting Team Leader at TASC. As you
would know Liza was respected by her
colleagues and the AT community for her
knowledge and passion to provide high
quality outcomes for our clients. We wish
her every success in her new job.
The 30 June 2011 saw the closure of
Technability, the assistive technology sales
division of Cerebral Palsy Alliance. After
almost 20 years of supplying products and
services we are in a position where we were
no longer able to continue operating the
business. We farewelled Adam Lynn on
17 June and wish him every success as he
moves into a new business venture. We will
continue to be able to provide you with
advice on alternate suppliers of products.
Finally, if you are interested in all things
communication you should not miss our
comprehensive article on trialling and
implementing devices.
DATE for your diary…….
ARATA 2012 Conference
“Bridging the AT GAP”
This conference will provide an opportunity
for all stakeholders, including clinicians,
consumers, educators, inventors, suppliers,
funders and policy makers to meet in Sydney,
to share knowledge, experience and expertise
to help bridge the AT gap.
Where: Sydney Masonic Centre
www.smcfc.com.au
When: Wednesday 22 – Friday 24th August 2012
How to find out more information:
www.arata.org.au
Until next time, happy reading.
ARATA 2012 Conference .............................................1
Jo Ford
Trialling and Implementing SGD .................................2
New App .......................................................................5
We welcome any feedback, good or bad, that you may have on our service. Please feel free to contact us
by phone on 02 9975 8469, email [email protected] or by writing to Cerebral Palsy Alliance PO Box 184 Brookvale NSW 2100
TechnoTalk Newsletter is free and available from www.cerebralpalsy.org.au/tasc
TechnoTalk
Trialling and Implementing Speech Generating Devices (SGD)
by
Anna Bech, Alana Bain and Diana Limbrey
So you’ve identified the device that you / your
child / your client needs? Now the hard work
begins! It’s not enough to get the device and
expect it to be trialled or used successfully.
Successful implementation of a device relies on
a number of factors.
Hodge (2007) identified that in order “for the
potential of communication aids to be realised a
coordinated support system is needed,
providing both technical assistance in setting up
and maintaining equipment and support in
using it”. Therefore it is essential that device
trials are well thought out and planned.
So what are the factors that can influence the
success of a device trial? What do we need to
think about before the device arrives on your
doorstep?
1. The Support Team
It is important to know who will be supporting
the device and what each person’s
responsibilities are during the trial. The team
may include family, school staff, peers and
therapy staff. Work out who will be doing the
programming
and
supporting
the
implementation.
2. Timing of the Trial
Liaise with the team to ensure where possible
that the trial is arranged for a mutually
convenient time for all relevant parties. Consider
time commitments of all involved and general
time of year; busy periods such as holidays may
mean a shift from normal routine or alternatively
may provide extra timing for support from
family. Extra time should be allocated to
programming as soon as the device is available
for trial so that it can be implemented promptly.
them and it is not an ideal time for the trial to
begin, it’s ok to request that they send it to the
next person on the list and have your trial next.
3. Goals and Outcome Measures
Goals are a great way of ensuring the device is
being used in a motivating, meaningful and
functional manner. Goals help to keep the team
on track as they provide a focus for the trial,
identifying aims and progress during a trial.
When detailing goals, the SMART framework
can be applied:
• Specific: Goals should detail the exact
behaviour, when and where the behaviour
will be targeted, and how often.
• Measurable:
The desired behaviour
should be observable so it can be
quantified.
• Attainable: Goals should be realistically
possible and a considered baseline be set
with the team.
• Relevant: Goals should be non-artificial
and should be implemented in the client’s
real environment to meet real needs.
• Timed:
The length of the period of
intervention should be detailed as well as
time/s for review.
At TASC, we routinely use outcome measures to
measure progress. Prior to commencement of
the trial, it is helpful to discuss and set the goals
for the trial.
•
Try to keep close contact with the supplier and request that they provide at least 2-4 weeks notice prior to the trial. If you are contacted by The Goal Attainment Scale (GAS) is an
individualised criterion-referenced measure
which uses a 5-point scale of predicted
performance. It is useful to measure
progress towards an expected outcome for
identified goal/s. When writing a GAS goal,
consider what variable you are focusing on
– such as level of prompting, sentence
structures used, mean length of utterance,
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Example goal: For the device user to make a request at a cafe independently
Score
Attainment Levels
+2
The client uses the device to produce
more than one phrase “I want + noun” to
ask for something to eat / drink
independently.
+1
The client uses the device to produce a
phrase “I want + noun” to ask for
something to eat / drink independently
(no prompts).
0
The client uses the device to produce a
phrase “I want + noun” to ask for
something to eat / drink with verbal or
visual prompts.
-1
The client uses the device using a single
word, to ask for something to eat / drink
with verbal or visual prompts.
-2
The client points to items in the
immediate environment, or gets help
from a friend to request an order.
•
The Individually Prioritised Problem
Assessment (IPPA) is a client centred
measure, designed to assess change over
time and helps to identify if the provision of
assistive technology is effective in reducing
problems identified by the individual. In
order to establish this, the IPPA is readministered once technology has been
provided. The problems are rated for their
level of importance to the individual and
also for the level of difficulty which is
experienced in performing the activity
(rated on a 5-point scale, with 5 being the
most important and most difficult).
Baseline
2 weeks
4 weeks
be programmed in order to target the goals.
Although many devices come with preprogrammed page sets, it is important to
individualise the device for the user. Vocabulary
selection should be discussed and completed
prior to the trial.
When thinking about vocabulary for the device
keep the following in mind:
- What do they need and want to
communicate?
The vocabulary must reflect what the user wants
or needs to communicate. The device will be the
person’s voice and should incorporate messages
that are relevant and motivating to him/her.
Think about what messages they are having
4. Vocabulary Selection
difficulty communicating at the moment. How
Physically programming could these be represented on the device?
a device can be the easy
part. The challenge is - The vocabulary should be functional.
understanding what is Providing a page of nouns (such as table, chair,
appropriate and useful dog) as part of the vocabulary may not be as
to program. Hopefully functional as providing phrases or comments,
goals and outcome measures have been set, as such as “I’m finished”, “that one”, “help me”, “I
these will provide a guide around what needs to like”. It is important to consider communication
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• Behaviour: Consider the desired behaviour
when a cell is pressed. Examples for
communication include speaking the
message instantly or in contrast, inserting
the message into the message window
where it will be stored ready to be spoken
once the message window is activated. The
latter option may be more suitable for
sentence construction as many words can
- What are their peers saying?
be stored in sequence and then spoken
The vocabulary must be age appropriate. together.
Listening to people of the same age and gender
as the device user can help. What words and
topics are they using? Try to incorporate similar 6. Implementation
words or phrases for the device.
McMillian (2008) reported that in order to
integrate the technology into the environment,
“opportunities for learning and using skills must
5. Programming the Device
Once you have made a list be provided”. Some ideas to consider with
of the vocabulary (and of implementation include:
functions. Comments such as “that is fun” and
questions such as “how are you” are just as
important as requests.
- In what environments do they need to
communicate?
That is, who to and where are they needing to
communicate and what vocabulary do they need
in those situations.
course the device has
arrived), it is time to
program. It is important to
strive
for
consistency
throughout a user’s SGD.
•
• Ensure that the device is readily available
to the device user at all times.
•
Layout: Consider locating navigational cells in the same locations. For example, locate ‘go back’ in the top left corner and ‘clear’ in the bottom left.
Encourage and expect the device user to
use the device each day and in a variety of
settings. For example, greetings and small
talk when arriving at day service, purchasing
a bus ticket, indicating preferences at
home. Try to build the use of the device
into routine activities.
•
Design: Use the cell design to visually add meaning. Cells which speak a message are usually represented by a cell with straight edges however cells which navigate to another page are usually represented with •
folders.
Colour coding: Colour can be used to represent different word classes. The Fitzgerald Key is commonly used in various overlays in SGDs such the Minspeak/Unity overlays and Gateway. The colour codes are Modelling - show the device user how they
can use the device to communicate, e.g.
borrow their device at a café and ask for a
cup of coffee using the device. If the user
responds via other means (such as verbally
or with sign language), acknowledge this
but then type the response on the device.
• Decide on the desired number of cells per
page and try to keep this consistent.
•
•
as follows:
People (yellow)
Actions/verbs (green)
Nouns (orange)
Adjectives/ describing
words (blue)
Social (pink)
Other words classes (black)
•
Expand their language. You can use
modelling to show them how they could
structure their sentence and expand their
language. For example if they say
“bubbles” you could model “I want
bubbles” or “more bubbles”.
Create communication temptations by
sabotaging the environment - give the
person part of an activity (e.g. a paint brush
with no paper or their dinner with no
cutlery) - encourage the device user to use
their device in order to repair the situation,
e.g. “fork please”.
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Respond immediately and consistently to
all communication attempts. Provide praise
and positive reinforcement for all
communication attempts on the device.
•
Practise using the device and what you
might say before putting the device user in
a situation. E.g. if you are going out for
coffee, pre-program in what he/she may
like to order and support them to access
the vocabulary in role play before you enter
the situation.
•
Give them time to prepare their message/s
and response. Show them that you expect
a response. E.g. use an expectant facial
expression or pause.
McMillan, J. (2008). Teachers make it happen: From
Ask open-ended questions rather than professional development to integration of augmentative
and alternative communication technologies in the
closed ‘yes/no’ questions. E.g. rather than classroom. Australasian Journal of Special Education,
saying “Did you have a good day?” you 32(2), 199-211.
could say “What did you do today?”.
•
•
References
Hodge, S. (2007). Why is the potential of augmentative
and alternative communication not being realised?
Exploring the experiences of people who use
communication aids. Disability & Society, 22(5), 457-471.
Have you seen this App?
Verbally is a FREE text-to-speech app for the iPad. It suits people with literacy who can access the
iPad through direct touch.
Verbally has three keyboard layouts that may suit a range of needs. Another feature includes word
prediction. There are four possible options presented and the app can learn the most commonly used
words.
It also has a list of core vocabulary (containing 50 of the most commonly used core words) and a phrase
bank, containing twelve commonly used phrases such as “Could you please help me?”
As this is a free App, there are some limitations. Such as, the inability to customise the size of the cells
or to customise your own phrases.
For more information go to:
http://verballyapp.com/index.html
Cerebral Palsy Alliance
321 Mona Vale Road Terrey Hills NSW 2084
T: 02 9479 7200 F: 02 9479 7233
E: [email protected]
W: www.cerebralpalsy.org.au
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