This post is a brief review of an AAC an interactive clinical casebook by John W. McCarthy and Aimee Dietz, Speech and Language Pathologists specialising in Alternative and Augmentative Communication.
This CD-ROM presents 13 detailed case studies of people who were being supported by their speech and language therapists to use AAC systems to support their communication. The case studies include a range of acquired and developmental conditions of different ages, with some of the clients discussed also having physical, learning, sensory and/or cognitive difficulties. Further details of the chapters included can be found on this website, where the CD-ROM can be purchased:
The cases are displayed in a multimedia book (for Windows or Mac). Each case presents as an interactive story detailing in sections the assessment process and intervention plan as narrated by the speech and language therapist or clinician who was supporting the client. The sections are divided into clear headings including the following:
- Case history (birth, therapeutic, medical, unique aspects)
- Assessment (often identifying formal and informal tools)
- Communication needs (e.g. what, where, who, when)
- Barriers and supports (AAC facilitator, opportunity, public policy and practice)
- Motor speech
- Cognitive-linguistic skills (e.g. expressive, receptive, cognition,literacy, symbolic language, social skills).
- Motor, sensory and perceptual skills (e.g. fine motor, gross motor, vision, hearing)
- Arousal and response mode
- Message representation
- Alternative access (discussing a range of access methods)
- Intervention (e.g. therapy, compensatory strategies, training others)
- Communicative competence (mapping the client’s skills to Janice Light’s model)
- Motivation and attitudes (how to encourage motivation, attitude, confidence and resilience)
- Multimodal communication (exploring the multiple aided and unaided communication modes used by the client)
- Goals for today
- Patient and caregiver perspective
- Ongoing evaluation
What I liked about this CD ROM
- The cases and chapters within each case can be accessed in any order, which enabled me to find sections which I felt were most useful for my learning.
- The cases are introduced by giving a definition of the diagnosis, symptoms and other common factors.
- Many of the case studies included several videos of the clients interacting which would be a useful resource for training or presenting a case to students.
- Many of the case studies included sample assessment forms, sample notes and sample reports, which supported my understanding of the case studies.
- The benefit and often importance of speech and language therapists working with other clinicians (such as occupational therapists and physiotherapists) to support AAC assessment and implementation is emphasised.
- The clinicians refer describe informal assessment approaches and often refer to formal assessments used such as the AAC profile, the Western Aphasia Battery and the Receptive One Word Picture Vocabulary Test. This is likely to be very useful for clinicians new to AAC and for students to increase their awareness of communication assessment approaches. I found for example the informal observations described by speech and language therapists when formal language assessments were not possible to carry out valuable.
- The clinicians refer to a communication needs theoretical model and then Janice Light’s (2014) model to support decision making and assessment.
- Goals for intervention are clearly stated in each case, supporting students and clinicians further with a guide to planning intervention to meet similar objectives.
- The resource covers the implementation of a range of AAC modes (low-tech, high-tech, unaided communication), covering well how holistic AAC is and its benefits for many people with moderate-severe communication difficulties. It also covers how low-tech AAC can be used to support people with Dementia with regards to their comprehension and engagement in activities of daily living.
- Demonstrates well how information gathered during assessment can support the decision making with regards to AAC strategies and implementation (such as the prognosis of the condition, the amount of vocabulary likely required, likely literacy needs, likely access method required, positioning, portability factors and mounting).
- Discusses the role of the communication partners and the environment in the AAC journey.
- Gives examples (modelled well in videos) of strategies to support people with communication difficulties, such as supported conversation and communication passports.
- Discusses the impact of other factors, such as behavioural factors, medication supporting clinicians and students to consider the benefit of a comprehensive and holistic assessment.
- Special chapter for clients in intensive care (e.g. adapting AAC in acute care settings)
- The resource provides links to research and online resources for further information.
The CD-ROM refers to a communication needs model and several formal assessments used by the clinicians which I was not familiar with and it was assumed that these are not frequently used in the UK. This resource would therefore be a useful tool to support AAC assessment and implementation approaches however it would be recommended for students and clinicians to explore further the range of assessment models, frameworks and formal assessment tools online and in their place of work or study.
Overall, I believe that this resource would be useful for anyone who would like to broaden their understanding of AAC, AAC assessment and implementation approaches. The content on the CD-ROM would be useful for people new to AAC with sections and videos which can be specifically selected for an introduction, however the information presents as targeted for students, clinicians and professionals requiring a deeper understanding of AAC assessment and implementation strategies.
I found the resource insightful, learned of AAC strategies to support my personal development in my current role as a specialist practitioner. It was useful for me to be able to skip to specific chapters on specific conditions related to clients I was working with at the time.
I liked most of all the way that the CD-ROM looks at AAC in a holistic and multi-modal way by drawing in the benefit of combining unaided strategies with low-tech and high-tech AAC approaches. It would present as a valuable resource for students and the videos could be used in lectures and training events.