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Use of AAC to Enhance CommunicationResearch Paper

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Augmentative and Alternative Therapy

Calculator, S.N. (2014). Parents' Perceptions of Communication Patterns and Effectiveness of Use of Augmentative and Alternative Communication Systems by Their Children with Angelman Syndrome. American Journal of Speech-Language Pathology, 23(4), 562-573. Doi: 10.1044/2014

Description:

Angelman syndrome (AS) is a neurogenetic syndrome that emanates from deficient manifestation of the UBE3A gene; as a result, there are different anomalies of Chromosome 15. Among its symptoms, including potentially major facial alterations, those detected in all individuals consist of severe cerebral disability, movement or balance conditions akin to those perceived in ataxia, behavioral distinctiveness, and very minimal functional speech. The problems with speaking are compounded by severe expressive and receptive language interruptions.

Design

The initial aim of this study was to collect information, with reference to current methods, concerning the manner in which individuals with Angelman Syndrome communicate. The research focus included 'regularity of use' for devices as well as exploring parents' opinions concerning the comparative significance of each method of communication for their children. This encompassed an evaluation of electronic Augmentative and Alternative Therapy devices. Further questions modeled in this study were directed precisely at individuals' usages of electronic AAC devices. This included a record and/or list of the devices their children were presently using; as well, parents were asked which AAC device they considered to be the child's most unconventional devices. Further information was pursued concerning their evaluation of their child's usage of their most unconventional devices. This incorporated examinations of the significance comparative to other forms of communication, practicality, accomplishment, level of device approval or refusal, and practical results correlated with usage of these devices.

3) Method

The main tool used in this study was a survey that parents administered on their own over the internet by use of Qualtrics software. Several aspects included in this survey were related to a number of procedures that were considered the best by an expert in providing AAC services to the wider population of students with severe disabilities. These practices, which stemmed from a comprehensive examination of the matching literature, were successively established to reveal the predilections of a group of 32 parents of individuals with Angelman Syndrome. Different from previous studies, this particular one placed its focus on the definite significance of each method to the children, as observed by their parents. Per se, it may be considered as experimental at this point in time. In this case, the parents are the ones who administered the survey and this method has inspired truthful replies.

4) Results

The study, which began with 209 parents, had 174 parents who replied to the question of methods of communication and corresponding importance. These parents had a tendency to allocate the highest ratings to 3 non-symbolic methods of communication. The subsequent highest average rating was allocated to electronic Augmentative and Alternative Therapy (AAT) devices. This preference included both AAT devices with speech output and also those that did not have. Eight-four parents (48% of the initial population), referred to the AAC method as one of the most important. The other method that ranked well with sixty-six parents (38% of initial population) was natural gestures.

5) Clinical Implication

This research study has recognized several variables that may establish intervention targets. These may well be apprehended in the form of purposes for personalized educational programs and other scheduling documents. Clinicians and instructors may improve and advance aims and objectives that encourage individuals' achievement. This includes not only having requirements and wishes met, but also empowering them to communicate an assortment of messages in a clear manner and to more people with less effort used. AAC programs might be assessed to some extent by individuals' intensities of acceptance of their devices (preferences) with respect to other constituents of AAC systems. General influence of devices might be inspected with regard to comprehensive measures of quality of life. At the end of the day, AAC systems will only become practicable to the degree that they allow individuals to accumulate valued outcomes.

Conclusion

The use of Augmentative and Alternative communication (AAC) systems significantly improves functional and social communication when compared with no therapy in individuals with neurological disorders. However, acceptance of AAC programs by patients might be influenced to a degree by the individuals' level and/or extent of acceptance of their devices, and with other constituents of AAC systems. Further research might fruitfully examine the general influence of the Augmentative and Alternative communication devices with regard to comprehensive measures of quality of life.

CASM: Critical Appraisal of Systematic Review or Meta-Analysis

Evaluator:

Date: 26th May 2015

Evidence Source: American Journal of Speech-Language Pathology

Foreground question addressed by the evidence:

For Angelman syndrome (AS) (Patient/problem)

Is use of Augmentative and Alternative communication (AAC) systems (Treatment/condition)

Associated increased communication (Outcome)

As compared with severe lack of communication (Contrasting treatment/condition)

Appraisal Points:

1. Was there a comprehensive and clearly described search for relevant studies? yes

2. Were clear and adequate criteria used to include and exclude studies from analysis? yes

3. Were individual studies rated independently? Yes

4. Were individual studies rated with blinding? No

5. Was inter-rate agreement adequate? Yes

6. Was an average effect size (treatment) or accuracy metric (diagnosis) presented? Yes

7. Were results weighted by sample size? Yes

8. Was the confidence interval adequately precise? Yes

9. Did a forest plot suggest reasonable homogeneity of findings across individual studies? No

10. If not, was a heterogeneity or moderator analysis conducted? No

11. Were the results sufficiently relevant to my patient and practice? Yes

Validity: Compelling X Suggestive Equivocal:

Importance: Compelling X Suggestive Equivocal:

Clinical Bottom Line: The use of Augmentative and Alternative communication (AAC) systems significantly improves functional and social communication as compared to no therapy in individuals with neurological disorders.

Article Two: Hagan, L., & Thompson, H. (2014). It's good to talk: developing the communication skills of an adult with an intellectual disability through augmentative and alternative communication. British Journal of Learning Disabilities, 42(1), 66-73. doi:10.1111/bld.12041

1) Description

Augmentative and alternative communication (AAC) systems have been repeatedly recognized as a way of enhancing an individual's communication capabilities and their ability to take part in interactions. Nevertheless, current literature shows that active display speech generating devices (SGDs) are not frequently presented for adults with temperate intellectual disabilities (ID). This case study gives an account of the influence of using an SGD on the communication capabilities of a nonverbal individual with moderate intellectual disabilities. Clinical evaluation and therapy result measures consist of semi-structured interviews with personnel and communication dyad studies. These measures were undertaken prior and subsequent to cooperative intervention from communication and language psychoanalysis and behavior support. The study describes a 40-year-old woman, Ann who has attention deficit hyperactivity disorder (ADHD), a moderate ID of unknown aetiology and is nonverbal.

2) Design

Active display speech generating devices are not frequently presented for adults with temperate intellectual disabilities. This case study gives an account of the influence of using an SGD on the communication capabilities of a nonverbal individual with moderate intellectual disabilities.

3) Method

The researchers considered the question of whether introducing a speech generating device could have an impact on the participant's communication abilities. The methods used in the study included used a semi-structured interview and analysis of a communication dyad to determine and/or ascertain if there was any variation in the participant's communication abilities. These procedures were steered prior to the intervention, in the evaluation stage, and were then reiterated after the intervention to assess the result of therapy.

4) Results

The main results reported included:

1. Verbal expressions. It was reported that the device gave the participant a voice and that the participant's verbal expression was enhanced after using the device. The researchers also gave their perception that increase in frequency of using the device would enable sustained progress in verbal expression. In addition, the researchers insisted that the device helped the participant to have discussions that were more effective and practical.

2. Verbal comprehension: The researchers reported that there was no change in the participant's verbal comprehension subsequent to the intervention.

3. Barriers to Communication: The researchers reported that the formerly recognized barriers to communication were successfully overcome when the participant used the device.

4. Social interaction: The researchers noted changes in the participant's social interaction, mentioning that the device helped the participant to start discussions and sustain them. It was reported that by making use of the device, the participant improved on repairing conversation breakdown.

5) Clinical Implication

There are positive implications for introducing and initiating AAC devices with younger individuals with communication problems and complex needs. These have shown the benefits of introducing SGDs to enhance the quality of interactions and also their frequency, and improved repair in communication breakdown.

Conclusion

The use of Augmentative and Alternative communication (AAC) systems significantly improves functional and social communication than no therapy in individuals with neurological disorder.

CASM: Critical Appraisal of Systematic Review or Meta-Analysis

Evaluator:

Date: 26th May 2015

Evidence Source: British Journal of Learning Disabilities

Foreground question addressed by the evidence:

For attention deficit… [END OF PREVIEW]

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