Natural Speech and AAC Intervention in Childhood Motor Speech Disorders: Not an Either/Or Situation

2014 ◽  
Vol 23 (3) ◽  
pp. 117-123 ◽  
Author(s):  
Elizabeth R. Oommen ◽  
John W. McCarthy
Keyword(s):  
Augmentative And Alternative Communication ◽  
Speech Disorders ◽  
Speech Development ◽  
Natural Speech ◽  
Alternative Communication ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Practical Applications ◽  
Speech Intervention

The future of natural speech development is uncertain for children with motor speech disorders (MSD). There is a strong desire to put plans in place as early as possible to anticipate long-term needs. Simultaneously, the knowledge that natural speech development may take time and effort and the idea that augmentative and alternative communication (AAC) can help to fill in the gap while such progress is being made makes sense on a foundational level. However, practical questions remain about the balance of natural speech intervention along with AAC use, particularly when both skills may require intervention and practice before functional benefits are realized. Although AAC stands for augmentative and alternative communication, what the acronym does not provide is an indication of how balance between augmenting natural speech and seeking more of an alternative is to be obtained. In this article, we review impairments in natural speech in children with MSDs. Through this lens, we navigate a path to understanding how, on a practical level, AAC and natural speech strategies can be implemented simultaneously and in a complementary fashion. Following an overview of literature, we move to a discussion of the dual paradigm approach. Finally, we conclude with practical applications of principles through a case study.

scholarly journals Effects of a Conversation-Based Intervention on the Linguistic Skills of Children With Motor Speech Disorders Who Use Augmentative and Alternative Communication

2017 ◽  
Vol 60 (7) ◽  
pp. 1980-1998 ◽  
Author(s):  
Gloria Soto ◽  
Michael T. Clarke
Keyword(s):  
Augmentative And Alternative Communication ◽  
Expressive Language ◽  
Speech Disorders ◽  
Expressive Vocabulary ◽  
Alternative Communication ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Grammatical Skills ◽  
Severe Motor ◽  
Expressive Language Delay

Purpose This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. Conclusion The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. Supplemental Materials https://doi.org/10.23641/asha.5150113

My Client Talks! Do I Still Need to Consider AAC in my Treatment Planning? Speech Supplementation Strategies: AAC for Clients Who Talk!

2014 ◽  
Vol 23 (3) ◽  
pp. 124-131 ◽  
Author(s):  
Elizabeth K. Hanson
Keyword(s):  
Treatment Planning ◽  
Speech Intelligibility ◽  
Speech Disorders ◽  
Natural Speech ◽  
Alternative Communication ◽  
Motor Speech Disorders ◽  
Average Gain ◽  
Word Level ◽  
Sentence Level ◽  
Communication Breakdowns

People with motor speech disorders often persist in using their natural speech to communicate despite low intelligibility and frequent communication breakdowns. Their speech may be functional in some situations, such as with familiar partners in quiet settings, but not across the variety of communication situations they face. Speech supplementation strategies, such as alphabet supplementation, allow speakers to augment their speech with additional cues. For example, alphabet supplementation, which means the speaker points to the first letter of each word while speaking, has been shown to increase speech intelligibility at the word level with an average gain of 11% and at the sentence level with an average gain of 26% (Hanson, Yorkston, & Beukelman, 2004). This form of AAC can help speakers bridge the gap between ineffective communication with natural speech and total reliance on alternative communication methods (Hanson, Yorkston, & Britton, 2011). The purpose of this article is to summarize the evidence in the area of speech supplementation, provide direction to integrate the strategies into treatment planning, and to suggest research directions for this rich area of study.

Practical Resources for Provision of Services to Culturally and Linguistically Diverse Users of AAC

2015 ◽  
Vol 22 (1) ◽  
pp. 25-39
Author(s):  
Elena Dukhovny ◽  
E. Betsy Kelly
Keyword(s):  
Best Practices ◽  
Augmentative And Alternative Communication ◽  
Linguistically Diverse ◽  
Intervention Strategies ◽  
Culturally And Linguistically Diverse ◽  
Limited Resources ◽  
Flexible Systems ◽  
Alternative Communication ◽  
Practical Applications ◽  
Provision Of Services

According to the 2010 U.S. Census, over 20% of Americans speak a language other than English in the home, with Spanish, Chinese, and French being the languages most commonly spoken, aside from English. However, few augmentative and alternative communication (AAC) systems offer multilingual support for individuals with limited functional speech. There has been much discussion in the AAC community about best practices in AAC system design and intervention strategies, but limited resources exist to help us provide robust, flexible systems for users who speak languages other than English. We must provide services that take into consideration the unique needs of culturally and linguistically diverse users of AAC and help them reach their full communication potential. This article outlines basic guidelines for best practices in AAC design and selection, and presents practical applications of these best practices to multilingual/multicultural clients.

The Labeling Problem in Aphasia

1986 ◽  
Vol 51 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Audrey L. Holland ◽  
Davida Fromm ◽  
Carol S. Swindell
Keyword(s):  
Speech Disorders ◽  
Case Description ◽  
Test Results ◽  
Apraxia Of Speech ◽  
Poor Agreement ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Communication Difficulties ◽  
Token Test ◽  
Primary Problem

Twenty-five "experts" on neurogenic motor speech disorders participated in a tutorial exercise. Each was given information on M, a patient who had communication difficulties as the result of stroke, and asked to complete a questionnaire about his problem. The information included a detailed case description, an audiotape of M's speech obtained at 4, 9, 13, and 17 days post-stroke, and test results from the Western Aphasia Battery, the Token Test, and a battery for apraxia of speech. The experts were in excellent agreement on M's primary problem, although it was called by seven different names. The experts were in poor agreement on his secondary problem(s), e.g., the presence and type of aphasia and dysarthria. The results suggest that labeling is difficult, even for "experts." Furthermore, the practicing clinician needs to be sensitive to the likelihood of more than one coexisting problem.

scholarly journals Communication Support for People with ALS

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
David Beukelman ◽  
Susan Fager ◽  
Amy Nordness
Keyword(s):  
Augmentative And Alternative Communication ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Alternative Communication ◽  
Motor Speech ◽  
Motor Speech Disorder ◽  
Speech Performance ◽  
Communication Needs ◽  
Almost All ◽  
Lateral Sclerosis

Almost all people with amyotrophic lateral sclerosis (ALS) experience a motor speech disorder, such as dysarthria, as the disease progresses. At some point, 80 to of people with ALS are unable to meet their daily communication needs using natural speech. Unfortunately, once intelligibility begins to decrease, speech performance often deteriorates so rapidly that there is little time to implement an appropriate augmentative and alternative communication (AAC) intervention; therefore, appropriate timing of referral for AAC assessment and intervention continues to be a most important clinical decision-making issue. AAC acceptance and use have increased considerably during the past decade. Many people use AAC until within a few weeks of their deaths.

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