Fundamentals of AAC

Dr. Nerissa Hall is co-founder of Commūnicāre, LLC and codirector of the Speech, Language, and Literacy Center at Tate Behavioral, Inc. Her work concentrates on augmentative and alternative communication, assistive technology, and tele-AAC, and she works primarily with school-aged individuals, providing specialized, evidence-based intervention, assessment, and consultation services. Dr. Hall received her masters and doctorate degrees from the University of Massachusetts- Amherst, focusing on AAC skill advancement and implementation as well as tele-AAC. She has presented nationally regarding these and other related topics. Dr. Hall has served as a LEND Fellow and as adjunct faculty at Elms College, Cambridge College, and the Uni-versity of Massachusetts-Amherst. She is part of the team that edited Tele-AAC: Augmentative and Alternative Communication Through Telepractice and is passionate about advancing the fields of AAC and AT to ensure meaningful outcomes for individuals using AAC and AT and the teams that support them.Dr. Jenifer Juengling-Sudkamp is a speech-language pathologist who provides augmentative and alternative communication consultations, assessments, and interventions across multiple medical settings to adults with complex communication needs that are often a result of acquired neurodegenerative disorders and/or traumatic brain injury. She has a passion to improve people’s access to AAC consultative, evaluation, and/or interventions and joined a team of talented editors and authors to contribute to the resourceful clinical book, Tele-AAC: Augmentative and Alternative Communication Through Telepractice. Dr. Juengling-Sudkamp is a clinical instructor in the Department of Orthopaedics at Tulane University School of Medicine, where she teaches combined undergraduate and graduate courses in applied neuroscience that are specific to the clinical management of athletes with sport-related brain injuries. She also served as the program manager and a consultant for the Sport Concussion Clinic, the NFL Players Association’s Trust Brain and Body, and the Milestone Wellness Assessment programs at Tulane University. She has coauthored publications and copresented nationally and internationally on topics including AAC, tele-AAC, and the management of cognitive-communication deficit and dysphagia among adolescents and adults with acquired neurological disorders.Dr. Michelle L. Gutmann is a clinical professor at Purdue University Department of Speech, Language, and Hearing Sciences, where she teaches a variety of graduate courses including AAC, counseling in communication disorders, and motor speech disorders. After completing her doctoral studies and prior to coming to Purdue, she served as a clinical assistant professor and the speech-language pathologist for the ALS Clinic at Vanderbilt University Medical Center. Prior to returning to doctoral studies, she worked clinically for approximately a decade with both children and adults who needed AAC. She is part of the team that edited Tele-AAC: Augmentative and Alternative Communication Through Telepractice and is passionate about working with adults with acquired and/or neurodegenerative communication disorders who need AAC. Dr. Gutmann has served as the professional development manager for ASHA’s SIG 12 (AAC) since 2017. She is also active in both research and clinical endeavors related to the application and implementation of AAC for adults with acquired neurological disorders. Her interests include telepractice, interprofessional education, clinical education in speech-language pathology, implementation science, and health literacy. She has published and presented nationally and internationally.Dr. Ellen R. Cohn is an adjunct faculty member in the Department of Communication and Rhetoric in the Dietrich School of Arts and Sciences and the College of General Studies at the University of Pittsburgh and is an adjunct professor at the University of Maryland Global Campus, where she teaches distance education health communication and a variety of other applied communication courses. She has held secondary appointments in Pitt’s School of Dental Medicine and in the Clinical and Translational Science Institute and as a Faculty Fellow, University Honors College, and an affiliated faculty member of Pitt’s University Center for International Studies. Dr. Cohn has coauthored books on the topics of videofluoroscopy/cleft palate; communication as culture; diversity across the curriculum in higher education; telerehabilitation; a casebook in communication science and disorders; tele-AAC; and two programs at the University of Pittsburgh’s School of Law: Certificate Program in Disability Law, and the first MSL with a concentration in disability law. Dr. Cohn is a past investigator for the U.S. Department of Education National Institute on Disability and Rehabilitation Research, Rehabilitation Engineering Research Center on Telerehabilitation. She served as professor in the Department of Communication Science and Disorders School of Health and Rehabilitation Sciences, University of Pittsburgh, associate dean for Instructional Development (2007–2015), assistant dean for Instructional Development (2002–2007), and director of Instructional Development (1999–2002), School of Health and Rehabilitation Sciences, University of Pittsburgh. Dr. Cohn was designated a Diversity Champion, American Speech-Language-Hearing Association (2009), and was a Provost’s Office, Diversity Seminar Fellow (2005). Her interests span the areas of telerehabilitation/telehealth/telemedicine; interprofessional education; cleft palate, dentofacial, and craniofacial disorders; clinical training in speech-language pathology; and health-care communication. She is the founding editor (2008–present) of the International Journal of Telerehabilitation (a PubMed indexed electronic journal). In 2013, Dr. Cohn was named a fellow of the American Speech-Language-Hearing Association. In 2006 she received the honors of the Southwestern Pennsylvania Speech-Language and Hearing Association. In 2020, she and coauthor Dr. Jana Cason received the American Speech-Language-Hearing Association’s Editor’s Award for Ethical Considerations for Client-Centered Telepractice, Perspectives of the Special Interest Groups.

• Table of ContentsPrefaceAcknowledgmentsAbout the EditorsContributorsReviewersSection I. AAC System FundamentalsChapter 1. A Co-Constructed Description of AACNerissa Hall, Hillary K. Jellison, Maria Burke, William Burke, Craig Burke, and Julia SerraIntroductionFundamentalsA Change in FocusA Co-Constructed Understanding of AACIn ConclusionCase Study: WBClinical Profile and Communication NeedsThe AAC SystemNext StepsReferencesChapter 2. No-Tech AACAmal M. MaghazilFundamentalsUnaided AACAided AACIn ConclusionCase Study: PGClinical Profile and Communication NeedsNext StepsReferencesChapter 3. Mid- and High-Tech AACElena M. FaderFundamentalsMid-Tech AACHigh-Tech AACCommunicative PurposeIn ConclusionCase Study: RAClinical Profile and Communication NeedsNext StepsReferencesChapter 4. Mobile AACOliver WendtFundamentalsIntroduction: What Are Mobile Technologies?The Mobile Technology Revolution in AACPrinciples in Mobile Technology Application DesignResearch Evidence and Funding Issues Related to Mobile TechnologyCase Study: LMClinical Profile and Communication NeedsAAC ConsiderationsThe AAC System or ServiceNext StepsReferencesChapter 5. Physical Access Features of AACKathryn D’Agostino RussoFundamentalsWhat Is Alternate Access and Who Is It for?Types of Alternate AccessAssessment for Alternate AccessMultimodal and Low-Tech Access for CommunicationConsidering Multiple Methods of AccessAccess and Mobile TabletsLearning Language and Access SkillsIn ConclusionCase Study: JBClinical Profile and Communication NeedsAAC ConsiderationsThe AAC System or ServiceNext StepsReferencesSection II. AAC Language FundamentalsChapter 6. Cultural and Linguistic Responsivity in AACGloria Soto and Marika KingFundamentalsConsequences of Subtractive Bilingual Environments for AAC UsersBuilding Additive Bilingual Environments for AAC UsersCulturally and Linguistically Responsive AssessmentCulturally and Linguistically Responsive InterventionCase Study: JRClinical Profile and Communication NeedsNext StepsReferencesChapter 7. Language and Vocabulary Features of AACBrittney Cooper, MariaTeresa “Teri” H. Muñoz, and Gloria SotoFundamentalsGeneral ConsiderationsVocabulary Selection FrameworksTypes of VocabularyVocabulary Selection ToolsIn ConclusionCase Study: ANClinical Profile and Communication NeedsNext StepsReferencesChapter 8. Literacy Instruction and Intervention for Complex Communicators Who Use AACAmanda SoperFundamentalsRobust AAC: A Critical Accommodation for Literacy InterventionBarriers to Literacy Instruction for Students with CCNsScience of ReadingLiteracy Intervention for Language ComprehensionLiteracy Intervention for Word RecognitionAccommodationsIn ConclusionCase Study: VWClinical Profile and Communication NeedsLiteracy Instruction ConsiderationsNext StepsReferencesSection III. AAC Assessment, Intervention, and Implementation for Toddlers, Preschoolers, and School-Aged IndividualsChapter 9. Assessing Toddlers and PreschoolersMeher BanajeeFundamentalsGeneral Principles of Assessment of Toddlers and PreschoolersPreparation for the AssessmentAssessmentCase Study: RCClinical Profile and Communication NeedsRationale for Clinical Decision-MakingNext StepsReferencesChapter 10. Intervention and Implementation for Toddlers and Preschoolers Using AACBarbara WeberFundamentalsCase Study: IBClinical Profile and Communication NeedsThe AAC SystemRationale for Clinical Decision-MakingNext StepsReferencesChapter 11. Assessing School-Aged IndividualsSarah GregoryFundamentalsCase Study: RJClinical Profile and Communication NeedsThe AAC System or Service ConsiderationsAAC ConsiderationsNext StepsReferencesChapter 12. Intervention and Implementation for School-Aged Individuals Using AACAmanda SoperFundamentalsIntervention Across the Five Domains of LanguageIntervention Across AAC CompetenciesInnovation/Modifications to Existing Language Therapy ToolsDescriptive Teaching MethodSupport and Teaching StrategiesCase Study: JVClinical Profile and Communication NeedsOngoing AssessmentIntervention Strategies and Implementation SupportsNext StepsReferencesChapter 13. Data Collection and Goal Writing in AACKate Grandbois and Amy WonkkaFundamentalsGoal WritingCase Study: SBClinical Profile and Communication NeedsThe Data Collection SystemThe Rationale for Clinical Decision-MakingNext StepsReferencesChapter 14. AAC for the Child in End-of-Life CareRachel SantiagoFundamentalsThe Care Team at End-of-LifeCommunication PlanningCommon Needs and Symptoms Children May Experience at End-of-LifeAAC Considerations at End-of-LifeIn ConclusionCase Study: GMClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesSection IV. AAC Assessment, Intervention, and Implementation for AdultsChapter 15. Services for Young Adults Using AAC Transitioning to AdulthoodDiane Nelson BryenFundamentalsPrologueNew and Emerging Communication TechnologiesAAC and the Importance of TransitionCase Study: CKClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 16. Assessing AdultsJeffrey K. Riley, Lois Turner, and Stacey HarpellFundamentalsCommunication Assessment and Action PlanFinal ReportCase Study: GBClinical Profile and Communication NeedsThe AssessmentNext StepsReferencesChapter 17. Intervention and Implementation for Adults With Neurodegenerative Disorders Using AACCatherine Kanter, Emily Kornman, and Annette M. StoneFundamentalsEducation and CounselingPreservationAugmentationAdaptationIn ConclusionCase Study: SHClinical Profile and Communication NeedsAAC System or Service ConsiderationsNext StepsReferencesChapter 18. AAC for the Individual in the Intensive Care UnitRichard R. Hurtig and Tami AltschulerFundamentalsIntroduction: Communication Risks and Barriers Including Health Disparities, Diversity and InclusionSpecial Considerations for the Intensive Care UnitPatient Care StandardsCommunication Partner Training and Interprofessional PracticeLife-Sustaining Decision-Making and End-of-Life CommunicationBest Practices ModelsIn ConclusionCase Study: EGClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 19. AAC for Adults in End-of-Life CareAmanda SteadFundamentalsCommunication Difficulties at End-of-LifeHow AAC Can Support Communication, Socialization, and Decision-MakingCase Study: KMClinical Profile and Communication NeedsAAC ConsiderationsThe AAC System or ServiceNext StepsReferencesSection V. AAC for Persons With Developmental DisabilitiesChapter 20. AAC for Persons With Developmental DisabilitiesJeeva JohnThe FundamentalsChallenging Behaviors and the Role of Speech-Language PathologistsAAC Evolves Across Their Life SpanEstablish “Buy-in” and Prepare for the Communication JourneyAssessment and Tool SelectionInvestigative InterventionDesigning a Meaningful Communication SystemConsultation ServicesCase Study: KCClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 21. AAC for Persons With Autism Spectrum DisorderTanushree Saxena-Chandhok, Deborah Xinyi Yong, and Sarah Miriam Yong Oi TsunFundamentalsSETT FrameworkCommunicative CompetenceAAC Intervention StrategiesThe Role of the Caregiver in AAC InterventionCase Study: ELClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 22. AAC for Persons With Cerebral PalsyKatya HillFundamentalsAAC Strategies and TechnologyAAC AssessmentInterventionCase Study: PLClinical Profile and Communication NeedsAAC System and Service ConsiderationsNext StepsReferencesChapter 23. AAC for Persons With Specific Sensory ImpairmentsLesley Quinn and Hillary K. JellisonFundamentalsDual Sensory ImpairmentCortical Visual ImpairmentAAC and Sensory ImpairmentsCase Study: HSClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 24. AAC for Individuals With Sensory Integration ChallengesSarah Gregory and Elisa WernFundamentalsCompetencies Versus Sensory Integration AreasConsiderations for the Trial ProcessInstructional StrategiesCase Study: ESClinical Profile and Communication NeedsAAC ConsiderationsThe AAC System or ServiceNext StepsReferencesChapter 25. AAC for Persons With Complex TraumaLesley QuinnFundamentalsCase Study: PWClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesSection VI. AAC for Persons With Acquired DisabilitiesChapter 26. AAC for Persons With Traumatic Brain InjuryLindsay R. James Riegler and Laura P. KlugFundamentalsReview of Cognitive-Communication Deficits in Traumatic Brain InjuryAAC Versus Assistive Technology Versus Information and Communication TechnologiesAugmentative and Alternative CommunicationAssistive TechnologyInformation and Communication TechnologiesSpecial ConsiderationsCase Study: THClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 27. AAC for Persons With Motor Speech DisordersMary AndrianopoulosFundamentalsDysarthriaCase Study: RLClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 28. AAC for Persons With Amyotrophic Lateral SclerosisTelina CaudillFundamentalsCommunication SymptomsDysarthriaVoice DisorderCognitive-CommunicationDysphagiaCommunication NeedsIntervention PhasesPhase 1: Monitor, Prepare, and SupportPhase 2: Assess, Recommend, and ImplementPhase 3: Adapt and AccommodateCase Study: RPClinical Profile and Communication NeedsAAC System or Service ConsiderationsThe Rationale for Clinical Decision-MakingNext StepsReferencesChapter 29. AAC for Persons With AphasiaKimberly A. EichhornFundamentalsCase Study: WPClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 30. AAC for Persons With DementiaVanessa L. Burshnic-NealFundamentalsSetting the Stage for AAC Use in DementiaStrengths and Deficits in DementiaMemoryCommunicationStrengths and Deficits in Dementia: Clinical ImplicationsGuidelines for Developing AAC for People With DementiaExamples of AAC for People With DementiaSupported Preference AssessmentMemory BooksOrientation AidsReminder CardsActivities of Daily Living SupportSupporting Care PartnersIn ConclusionCase Study: AMClinical Profile and Communication NeedsAAC ConsiderationsThe Rationale for Clinical Decision-MakingNext StepsReferencesChapter 31. AAC for Persons Who Are Medically ComplexAbygail E. Marx and Sarah MarshallFundamentalsIntroductionParticipation FrameworkCase Study: LGClinical Profile and Communication NeedsAAC System or Service ConsiderationsNext StepsReferencesSection VII. AAC Services for StakeholdersChapter 32. AAC ConsultationErin S. SheldonIntroductionTerminologyThe Fundamentals of AAC ConsultationLimits of the Traditional AAC Consultation ProcessCollaborative ConsultationThe Collaborative Consultation ProcessSpeech-Language Pathologists as LearnersSpeech-Language Pathologists as TeachersDeveloping Consensus on the ProblemSharing Decision-MakingBuilding Capacity for AAC ImplementationCase Study: JEClinical Profile and Communication NeedsNext StepsReferencesChapter 33. Communication Partner Training for FamiliesTabitha Jones-WohleberFundamentalsPerson-Centered PlanningFamily-Centered SupportFamily CharacteristicsAAC in Everyday LifeSpiraling Learning Experiences for AAC Communication Partners: Four Key ElementsCase Study: PHClinical Profile and Communication NeedsAAC Service ConsiderationsNext StepsReferencesChapter 34. Communication Partner Training for CliniciansTabitha Jones-WohleberFundamentalsCommunication Partner TrainingResponsive and Engaging Communication PartnersSupporting Adult Learners to Teach AACModels of SupportDesigning Effective Learning Opportunities for Communication PartnersBarriers to AAC ImplementationOpportunity Barriers Include Attitude, Knowledge, Skill, Practice, and Policy BarriersCase Study: JTClinical Profile and Communication NeedsAAC Considerations for TrainingNext StepsReferencesChapter 35. Communication Partner Training for StaffJill E. Senner and Matthew R. BaudFundamentalsCase Study: BTClinical Profile and Communication NeedsAAC ConsiderationsNext StepsReferencesChapter 36. Tele-AACMichelle BoisvertFundamentalsMethods of Tele-AAC Service Delivery and Setup ConsiderationsAssessment, Intervention, and Consultation Services Delivered via Tele-AACCase Study: JSClinical Profile and Communication NeedsTele-AAC Setup for Optimal Visual AccessNext StepsReferencesSection VIII. Perspectives of Stakeholders: A Collection of EssaysEssay 1. Ethical Considerations and AAC: A Framework for Ethical Communication and PracticePaula LeslieReferencesEssay 2. Ethical Considerations and AAC: A Framework for Neuro-Affirming PracticeNerissa Hall and Ellen R. CohnNeuro-Affirming PracticeAAC Solutions for Neurodivergent PersonsIn ConclusionReferencesEssay 3. Ethical Considerations and AAC: A Consumer’s PerspectiveChris Klein and Katya HillEssay 4. Ethical Considerations and AAC: A Parent’s PerspectiveDanielle A. WagonerLanguageIncludeSupportTeamEncourageNormalizeAlways L.I.S.T.E.N.ReferenceEssay 5. Ethical Considerations and AAC: Critical Health Situations, Informed Consent, and the Importance of Appropriate AACPaula LeslieReferencesEssay 6. Cultural Considerations and AAC: Introduction to Models of CultureEllen R. Cohn and John W. GareisEdward T. Hall’s Cultural Iceberg ModelPurnell’s Model for Cultural CompetenceHofstede’s Cultural Dimensions ModelConclusionReferencesEssay 7. Cultural Considerations and AAC: Introduction to African American Culture—Cultural Values and Communicating RespectPaula K. DavisReferencesEssay 8. Cultural Considerations and AAC: Introduction to Hispanic Culture—Cultural Values and Communicating RespectGlen M. TellisCultural Values and Communicating RespectRespect for AuthorityCultural Values and Other AspectsReferencesEssay 9. Cultural Considerations and AAC: LGBTQIA+ Affirmative Practice: Empowering Our Queer Clients and FamiliesGazit Chaya NkosiVocabulary and DefinitionsReferencesEssay 10. Cultural Considerations and AAC: Culture and Social and Economic Determinants of Health and the Use of AACEllen R. Cohn and Mario C. BrowneWhat Are Social Determinants of Health?Scenario 1: A Family Suffering From Societal and Economic StressorsScenario 2: A Family With Superior ResourcesDigital Resources and Social Determinants of HealthReferencesEssay 11. Cultural Considerations and AAC: Self-Evaluation of Cultural CompetenceDorian Lee-Wilkerson and Shelly ChabonReferencesEssay 12. Cultural Considerations and AAC: Religious ConsiderationsJohn W. GareisDietPrescription MedicationMedical ProceduresConclusionReferencesEssay 13. Cultural Considerations and AAC: Essential Faith-Based Vocabulary for Protestant Christian Users of AACJohn W. GareisEssay 14. Cultural Considerations and AAC: Essential Vocabulary for Jewish Users of AACKaren J. Golding-KushnerGuidance on Use of This VocabularyReferenceEssay 15. Cultural Considerations and AAC: Essential Vocabulary for Muslim Users of AACAmal M. MaghazilGuidance on Use of This VocabularyReferencesEssay 16. Cultural Considerations and AAC: Avoiding “Cheugy” Vocabulary SelectionEllen R. CohnGenerational LabelsASHA Practitioner Age DemographicsImplication for Vocabulary Selection for AAC SystemsReferencesEssay 17. Clinical Considerations and AAC: Building My AAC VillageTannalynn NeufeldEssay 18. Clinical Considerations and AAC: The Other A for “Augmentative”Rebecca M. LavelleEssay 19. Clinical Considerations and AAC: AAC, Language, and Literacy—It’s About ConnectionLesley QuinnReferencesEssay 20. Clinical Considerations and AAC: Visual Supports and AACAmy Wonkka and Kate GrandboisEssay 21. Clinical Considerations and AAC: AAC Report Writing and Leveraging Automation as a Tool for CliniciansMichelle Boisvert and Nerissa HallIntroductionThe Complexity of AAC EvaluationsData Interpretation and Report WritingAutomation Is the Tool for AAC Report WritingIn ConclusionEssay 22. Clinical Considerations and AAC: Ethical Vendor RelationshipsKatya HillReferencesEssay 23. Clinical Considerations and AAC: Building the Evidence Base for Evidence-Based Practice Tim DeLucaIntroductionBuilding the Evidence BaseImplementation ScienceResearch-Practice PartnershipsDiffusion and DisseminationDiffusion and Dissemination in ResearchDiffusion and Dissemination in Clinical PracticeConclusionReferencesImplementation Science Resources Essay 24. Clinical Considerations and AAC: The Future of AACMai Ling ChanReferences