AUGMENTATIVE COMMUNICATION

SLA G304 – Spring 2005

I. INTRODUCTION TO THE COURSE AND COURSE REQUIREMENTS

Instructor:

Kimberly M. Ho, Ph.D. CCC-SLP Tel. 781-259-1615 E-mail: Office hours: by appointment

Purpose of the Course: The purpose of this seminar is to provide an overview of augmentative and alternative communication (AAC) approaches for individuals with severe communication impairments. The course is grounded in the principles of evidence-based practice. This course will introduce the clinician to basic principles of AAC, components of AAC systems; the physical, operational and cognitive-linguistic demands of AAC strategies; interaction issues; characteristics of clinical populations who use AAC; assessment principles and procedures; sample interventions; service delivery issues and strategies; and future issues in the area of AAC.  Successful participants in this class will be able to:

State a definition of augmentative and alternative communication     

Understand the basic concept of evidence-based practice (EBP) along with rationales for its importance in AAC

Describe the EBP process and apply through the writing and presentation of an evidence-based practice report

List, describe, and compare and contrast symbol types; systematically evaluate most efficacious symbol system for specific AAC user/s

Devise a communication board and practice interacting with one

Practice in-class transfers and correcting seating and positioning problems

Describe the participation model and critically analyze/compare this model to other assessment/treatment models

Complete a feature matching task by selecting an appropriate AAC system for a profiled individual with AAC needs

Develop a scripted routine for paraprofessionals on how to implement an appropriate treatment technique

Formulate goals and plan an activity that will incorporate literacy goals and include an AAC user in a classroom

These competencies correspond to the following ASHA competencies:

1. Standard III C: Knowledge of AAC Modalities (Etiology and Characteristics). Students will demonstrate knowledge of etiology and characteristics of various disorders that render use of alternate communication modalities necessary. 
2. Standard III D: Knowledge of Assessment and Intervention with AAC Modalities (Intervention and Assessment). Students will demonstrate sufficient knowledge of assessing people with communication disorders in need of AAC that they may successfully develop and implement plans of intervention.

Course Organization: About half of most classes will be devoted to the discussion of the assigned readings. For the most part, the instructor will not reiterate the content of assigned readings. Rather, this section of a class period is intended to clarify or elaborate issues and concepts related to the assigned readings. Thus, it is expected that the student engages critically with the assigned readings prior to class and arrives prepared for in-depth discussions. The remaining time will be allotted to in-class activities including simulated assessment and intervention and student presentations.

Class Times: Tuesdays, 4:00-6:30 P.M.

Required Text and Readings:

American Speech-Language-Hearing Association. (2002, April 16). Augmentative and alternative communication: Knowledge and skills for service delivery. ASHA Leader, 7 (Suppl. 22), 97-106.

Beukelman, D., & Mirenda, P. (1998). Augmentation and alternative communication: Management of severe communication disorders in children and adults. Baltimore: Paul H. Brookes.

Schlosser, R. W. (2003). The efficacy of augmentative and alternative communication: Towards evidence-based practice. New York: Academic Press.

Note: Readings listed in this outline are subject to change; additional readings may be added. All readings should be completed for the date assigned.

Class Requirements: The class requirements include (1) quizzes, (2) a feature-matching task, (3) an in-class presentation and written EBP report, and (4) class participation. Details of the project requirements and recommendations for its successful completion are included in Section III.

Evaluation Component	%	Format
1. Quizzes (5 points each)	25	Individual
2. Feature-Matching Task	25	Team
3. In-class Presentation and written EBP report	25	Team
4. Class Participation	25	Individual & Team

II. COURSE OUTLINE

Date	Content and Reading	In-Class Activities
Jan 4	Course Overview and Introduction Beukelman & Mirenda, Chapter 1 ASHA (2002) – On Reserve Now, Included in quiz 1	Simulation experience in class – 3 pts Assign context 2 simulation Due Jan 18 – 5 pts
Jan 11	Evidence-based Practice in AAC Schlosser, Chapters 12 & 16
Jan 18	Messaging, Vocabulary Beukelman & Mirenda, Chapter 2 Read the research paper at http://aacvocabulary.com/ SIMULATION - CONTEXT 2 DUE	Quiz 1 – includes ASHA (2000) Bring questions to ask Mr. Remy about his experience as an AAC user. – 2 pts Paul Remy, BA
Jan 25	AAC Symbols, Multiculturalism, Rate Enhancement Beukelman & Mirenda, Chapter 3 CLIENT PROFILE AND QUESTION FOR EBP PROJECT DUE
Feb 1	Physical Access, Seating & Positioning Beukelman & Mirenda, Chapter 4	Quiz 2 Practice in-class transfers and positioning – 2 pts.
Feb 8	AAC Assessment, Feature Matching Beukelman & Mirenda – Chapters 6, 7 Recommended reading: Blischak, D. M., & Ho, K. M. (2000). School-based augmentative and alternative communication evaluation reports. Contemporary Issues in Communication Science and Disorders, 27, 70-81.	Sample AAC report Prescription Letter
Feb 15	Beginning Communicators (Nonsymbolic) BRING TEXT TO CLASS Beukelman & Mirenda – Chapter 10	Develop a scripted routine for paraprofessionals on how to implement one of the treatment techniques described in the text. – 5 pts.
Feb 22	Transition to Symbolic Communication, Challenging Behaviors Beukelman & Mirenda, Chapter 11	Quiz 3
Mar 1	Spring Break
Mar 8	Language Learning, Literacy Beukelman & Mirenda, Chapters 12, 13 FEATURE-MATCHING TASK DUE	Using “standard” storybooks from a regular education classroom, formulate goals and plan an activity that will incorporate literacy goals and include the AAC user in class. – 3 pts
Mar 15	Inclusion, Communicative Competence, Partner Training Beukelman & Mirenda – Chapter 14	We will be combining March 8 lecture with 15^th lecture. In-class activity will be as scheduled for March 8.
Mar 22	AAC in the Intensive Care Unit (ICU), AAC in Acute Care Beukelman & Mirenda – Chapter 18	Quiz 4 (moved from March 15 due to Comps – no extra material); PPT from one group’s presentation Three EBP Group Presentations Grading sheet

Announcement: EBP report is still due as assigned (8-10 pages).

Mar 29	Acquired Physical Disease Beukelman & Mirenda – Chapter 15	Two EBP Group Presentations – will present BEFORE lecture
Apr 5	AAC and TBI Beukelman & Mirenda – Chapter 17	Quiz 5 Three EBP Group Presentations before lecture Validity lecture
Apr 12	AAC and Aphasia (ppt lecture) Aphasia handout (very large – slow download) Beukelman & Mirenda – Chapter 16	Two EBP Group Presentations Shelley Weiss, MS CCC-SLP
Apr 18-23	Final’s Week EBP report is due on April 19^th by 5 pm – Email instructor kim@kimberlyho.net	No class Paper is due as assigned. EBP Paper Grading sheet

III. DETAILS ON REQUIREMENTS

1. Quizzes (25 points)

Five in-class quizzes will be given, each worth five points. Quizzes will be based on material covered in previous lectures and required reading.  Format will include fill-in, multiple choice and short answer.

2.  Feature-Matching Task (25 points)

Each student team (3-4 students) is expected to perform a feature-matching task. The team will match appropriate AAC systems for a person with severe communication impairments. The team may base their work on a client, keeping the persons identity confidential.  If the team does not have an appropriate client, a case scenario of a person with severe communication impairments will be provided. The client profile is due on January 25. The student team will share their decision-making process in a 3-4 page paper (double-spaced, 1-inch margins) and submit the paper by March 8 in class.

3. Oral In-Class Presentation and Written EBP Report (25 points)

The topic of the Evidence-based Practice Report will be chosen by the student team (3 – 4 students) in consultation with the instructor. The EBP report will be based on a question regarding the person with severe communication impairments chosen for the Feature-Matching Task. The student team will submit a preliminary well-built question along with the client profile to the instructor by January 25. The instructor will provide feedback before the student continues with the proposed topic.

The paper will include the following sections: (a) Background: describing the motivation for this topic, the topic area, and your position and setting; (b) a well-built question using all relevant components of the CESPO framework, (c) selection of evidence sources and search strategies, (d) critical appraisal of the yielded evidence, (e) proposed application of the evidence,

(f) proposed evaluation of the application of the evidence, and (g) proposed dissemination of the findings.

Evidence-based Practice Reports will receive letter grades which may range from excellent (A+) to failure (F). Below please find adjectives describing the characteristics of a report that would yield an A+ or A-.

The topic area, described in the background section, directly relates to an identified problem/decision-making point in the field of AAC. The clinical question is indeed well-built, including all the relevant components of the CESPO framework. The evidence sources are clearly specified, based on a sound rationale, and ultimately appropriate to the clinical question. The search strategy is sufficiently is efficiently leading to the retrieval of evidence, including multiple search methods and keywords that are suitable to the clinical question. The critical appraisal is thorough based on the application of all relevant considerations pertaining internal validity, external validity, and social validity. The conclusions drawn are replicable and sound. The proposed application of the evidence communicates the findings to all relevant stakeholders in a manner that is understandable to laypersons and effectively solicits and respects the perspectives of relevant stakeholders. The proposed evaluation is adequate and reasonable given the constraints of the your position and setting. The proposed dissemination uses channels that are appropriate for the nature of an evidence-based practice report and the specific clinical question targeted. The paper is written consistently in APA style (5^th ed) and should be 8-10 pages double-spaced and submitted via E-mail as a Word document attachment. The Critically Appraised Topic Summary, to be supplied as an Appendix, contains all relevant components and is user-friendly and within 2-3 pages. The report is due on the 19^th of April (via E-mail).

The presentation of the EBP report will not be evaluated in terms of the same content criteria as the written report, but rather the clarity of communicating the main points of the report. Presentations will receive letter grades from A through F. In determining the grade, the instructor will consider peer-feedback. It is highly recommend that the presenters have at least a draft of the EBP report ready by the time of the presentation. This will ensure that the main points of the report are presented. The presenters should then incorporate feedback to the presentation into the final report. The presentation should be no longer than 20 minutes. The instructor, who will need to be respectful of other presenter’s time, will not hesitate to cut off a presentation even if it is not complete. It is the students’ responsibility to rehearse the presentation to ensure adequate completion in the given time frame. 

4. Class Participation and In-Class Activities (25 points)

Class participation is essential to the success of this course. Discussing key issues rather than regurgitating the readings will maximize class time. In addition, individual and group activities will be designed that require active participation by each student. Students are expected to read the assignment listed in the syllabus prior to each class and to be prepared for the activity.

Another opportunity for participation is presented to the students through peer evaluations of student EBP presentations. The instructor will carefully read the comments made by the students. For the students, participating in these evaluations provides an opportunity to demonstrate that they paid attention and are actively processing information in class. This presents an excellent way of participating for students who may feel less comfortable speaking in class but who nonetheless are actively processing information. In deriving a grade for participation, the instructor will examine participation patterns across these various opportunities.