The project is being implemented with the support of UNICEF Ukraine and with financial support from the Government of Norway.
Implemented by: Partner:
Area Clinica di Neuroscienze
Neuroriabilitazione Santa Marinella
Luigi Marotta
luigi.marotta@opbg.net
Topic 1 (30 minutes)
Verbal and non-verbal communication. Language and communication deficits after other injuries.
Topic 2 (30 minutes)
Evaluation procedures and assestment tools. Receptive abilities.
Topic 3 (30 minutes)
Evaluation procedures and assestment tools. Expressive abilities.
Topic 4 (30 minutes)
Guidelines and care needs. Augmentative Alternative Communication strategies.
Topic 1 (30 minutes)
Verbal and non-verbal communication. Language and communication deficits after other injuries.
Topic 2 (30 minutes)
Evaluation procedures and assestment tools. Receptive abilities.
Topic 3 (30 minutes)
Evaluation procedures and assestment tools. Expressive abilities.
Topic 4 (30 minutes)
Guidelines and care needs. Augmentative Alternative Communication strategies.
AAC can encompass a wide range of tools and techniques, from simple gestures and picture boards to sophisticated speech-generating devices.
AAC refers to all methods of communication that supplement or replace speech.
These methods can be used by individuals with a variety of communication needs, including those with speech or language impairments.
Supporting and enhancing the natural abilities present
Modifying and adapting the environment
Introducing A.A.C. modalities: strategies, systems, aids
Improving communication skills for individuals who need support beyond natural speech.
Increasing communicative autonomy.
Elevating communicative competence and meeting functional communication needs in various contexts.
• AAC means all of the ways that someone communicates besides talking.
• People of all ages can use AAC if they have trouble with speech or language skills.
• Augmentative means to add to someone’s speech.
• Alternative means to be used instead of speech.
• Some people use AAC throughout their life.
• Others may use AAC only for a short time, like when they have surgery and can’t talk.
sign languages
text visualizations
Braille
tactile communication
large print
Communication includes accessible multimedia sources: written, audio, plain language, the human reader, alternative and augmentative communication modes, media and formats, including accessible communication and information technologies
AAC It is an augmentative and not just an alternative approach because it does not replace, but enhances, implements and supports the natural communicative abilities of the person with communication disabilities.
General strategy: creating concrete foundations that enable the development of communication skills and then offering the tools to do so.
Individual strategies to be worked out and not of a standard approach that might get excellent results on one person and of little value on another.
The development of communication skills aims primarily at the emergence of communication opportunities, which must take place on the basis of the individual's personal situation and interests.
The purpose of
C.A.A.
should not be to teach alternative methods of verbal language to replace conventional ones, but to work alongside them to enhance their language.
AAC allows people to express their needs and desires independently, which can boost their self-esteem and sense of self-determination.
AAC can help improve people's social relationships as others are better able to understand what they are trying to communicate.
Limitations and disadvantages the risk of “loss of communicative identity” on the part of the person who has to adapt to a predefined set of images and words, losing the communicative nuances that characterise the individual.
AAC is not intended to replace verbal language, but, on the contrary, precisely because it is “augmentative”, involves the simultaneous intervention of an alternative medium or tool alongside standard verbal language, accompanying the symbol through reinforcement by the communicative partner speaking aloud.
To take the correct approach to CAA, it is necessary to identify the most suitable communication system for the individual.
We must start from their current abilities to develop strategies and tools, taking all contextual elements into account.
We can schematise this process in the following way:
Simple to understand systems
Practical to use without complex functions
Easy to transport and use in different contexts
Easily accepted by the patient!
Highly complex communication aids
Systems requiring training
High-tech systems with user-environment interface
Self-learning and adaptive systems
Not always acceptable to the patient!
There are many Assistive Technologies, integrated with Artificial Intelligence systems, ChatBots, Communication Bots and SocialBots that are part of the tools that can be used for AAC
Adaptability
Adaptivity
Adaptability is the automatic adaptation of the interface according to user interactions.
Adaptivity refers to the ability of the clinician to modify the characteristics of the program to make it more appropriate to the individual user.
This technologies make the programme dynamic, creating an individualised therapeutic pathway for each patient through collaboration with other healthcare professionals, caregivers or teachers.
1. customisation of content: according to the needs and interests of the individual patient, modifying audio and video elements, using users' favourite characters and settings
2. customisation of layout: It helps to make incoming information easier to understand It helps to maintain attention for longer periods
Adaptation by the clinician can be of different types:
3. customisation according to different pathologies: tools that facilitate the task and record the patient's performance and transmit it to the clinician, as well as providing feedback to the patient via the application.
Objective: support the development of communication skills.
Our patient may be in one of these conditions
• Pre-intentional forms
• Non-symbolic intentional forms
• Symbolic expressive forms
• Evolved communicative functions
Objective: support the development of communication skills.
may have one or more of these characteristics • initial communicators
dependent context communicators • independent communicators
They lack good symbolic expressive skills and use:
Gesture
Vocalisations
Look
Facial expressions
Body language
They need to be interpreted by others
These modes can be:
Use indicators such as persistence, joint attention, and variable alternative modes to assess communication difficulties.
Focused on the communication partner's ability to give meaning to a behavior, stable and unstable, often preintentional and bring it to awareness (even just cause and effect)
• The communication partner must always respond to every attempt at communication.
• Interactive style with adequate pauses and waiting times
• Welcoming emerging styles and interests
• Offering communication opportunities
They have symbolic communication but are able to use it with specific partners and contexts: Objectives
• Increase in vocabulary
• Increase in AAC strategies
• Decrease in dependence on context/partner
• Development in reading and writing
They can interact with partners and in different contexts, on multiple topics
They generally know how to write and/or use communicators of varying technological complexity independently
• Expansion of operational skills with AAC • Expansion in the choice and use of aids • Increase in participation in community activities
Aids can / must be used by adapting them to different levels of complexity
The value of the aid is not attributed based on its complexity, but on its effectiveness within the chosen communication strategy
Strategies
Communication opportunities
Self-determination
Relational skills
Ability to
modify one's environment
Possibility of participation in community life
Fuselli, A., Fineschi, A., Guida, L., Scarane, A., & Addati, E. (2024). L’uso del comunicatore come strumento per abbattere le barriere alla partecipazione: Presentazione di un caso clinico. Logopedia e Comunicazione, 20(1).
Griffiths, T., Clarke, M., & Price, K. (2022). Augmentative and alternative communication for children with speech, language and communication needs. Paediatrics and Child Health, 32(8), 277-281.
Burnham, S. P., Finak, P., Henderson, J. T., Gaurav, N., Batorowicz, B., Pinder, S. D., & Davies, T. C. (2024).
Models and frameworks for guiding assessment for aided Augmentative and Alternative communication (AAC): a scoping review. Disability and Rehabilitation: Assistive Technology, 19(4), 17581772.
Razak, N. S. R. A., Peter, D. R., & Min, L. H. (2022). Augmentative and Alternative Communication (AAC): The Need for Teacher Guidelines. Journal of Social Sciences and Business, 1(1), 33-41.
Il presente documento Ë stato elaborato in n.xx slide da Ospedale Pediatrico Bambino Ges˘ il xxxxxx.
I contenuti sono strettamente riservati; Ë vietata la riproduzione e la divulgazione, anche solo parziale, senza il benestare scritto di Ospedale Pediatrico Bambino Ges˘.