Name: Sarah Smith
Date of Birth: xx/xx/xxxx
Chronological Age: 2 years
10 month
Date of Evaluation: xx/xx/xxxx
Evaluator: XXX XXX, MEd,
CCC-SLP/TSHH
Medical Diagnosis: Hypoxic
Ischemic Encephalopathy with extensive ischemic injury.
REFERRAL:
Sarah was referred for an
Augmentative and Alternative Communication Evaluation by the Early Intervention
Speech-Language Pathologist XXX XXX.
This evaluation was undertaken to determine the most appropriate
augmentative and alternative communication system that will meet Sarah’s
current and future language and communication needs.
Sarah presents with a medical
diagnosis of Hypoxic Ischemic Encephalopathy.
She receives speech and language therapy through the New York State
Early Intervention services.
COMMUNICATION STATUS AND LIMITATIONS:
Sarah communicates primarily by
reaching, pointing and gesturing. She
also frequently uses facial expressions paired with vocalizations to
communicate her wants and needs. Sarah usually
acquires an item she wants by getting it herself as long as it is within her
reach. As reported by Sarah’s mother, Sarah
will occasionally approximate the word “no,” turn her head away and/or cry to
protest or refuse. She calls for the
attention of others by gently touching the person and/or looking at them paired
with vocalizations. Sarah’s expressive
communication is severely restricted. As reported by Sarah’s speech therapist, XXX
XXX, Sarah’s willingness to communicate far surpasses her physical ability to
do so. She has a very limited repertoire
of verbalizations and is unable to effectively communicate on a daily basis.
STATEMENT OF CANDIDACY:
During the evaluation process, Sarah
demonstrated the ability to learn and understand the usage of a low-technology voice
output communication device. Using the
voice output communication device Sarah was able to make choices, requests and participate
more easily during pretend play activities.
Sarah demonstrated the potential to continue learning how to use the
voice output communication device to enhance her communication and language
abilities in a variety of settings including, but not limited to, home and
therapies.
SPEECH, LANGUAGE AND COGNITIVE ABILITIES:
Sarah’s overall attention was
determined to be good. She demonstrates
adequate attention to people, objects and pictures in her immediate
environment. She enjoys interactive toys
and engaging in pretend play activities.
She demonstrates an inconsistent ability to follow one-step directions
and benefits from visual modeling and hand-over-hand assistance to access a
voice output communication device.
Sarah presents with delayed
speech acquisition. Although it is reported that Sarah’s speech productions are
emerging, she rarely attempted to use speech as a mode of communication during
the evaluation. Sarah demonstrates the
ability to answer “yes” and “no” by smiling or shaking her head respectively
however her reliability to answer these questions was judged to be fairly
inconsistent.
SENSORY FUNCTIONING:
Auditory: Sarah’s hearing is
reported, by her mom, to be within normal limits. She responded appropriately to conversational
level speech and the voice output communication devices trialed during the
evaluation.
Visual: Sarah’s vision is reported,
by her mom, to be within normal limits.
She does not wear glasses or known to have any visual deficits.
COMMUNICATION NEEDS OF PATIENT:
Sarah will benefit from a low-technology
voice output communication device. A low-technology
voice output communication device will provide Sarah with an effective means to
communicate her wants and needs, call attention to specific persons, share
information, and interact socially with her family and peers. It will also provide Sarah with the means to
learn and use language while participating in therapeutic and educational
activities and will allow her the ability to communicate with a variety of
partners (e.g., family, therapists and peers) in one-on-one and group settings. Therefore, Sarah needs a communication system
(i.e., low-technology voice output communication device) that will meet her
current and future speech and language needs.
She requires a device that provides her with ample vocabulary and meets
her communicative needs over a variety of setting and environments.
DURING THE EVALUATION
Mother was present for this early
intervention evaluation and stated that Sarah did not produce as many
spontaneous vocalizations as she typically does.
POSTURAL/MOBILITY STATUS:
Sarah benefits from holding the
caregiver’s hand while walking to provide her with adequate support. Sarah was seen sitting on a mat independently
throughout the evaluation.
ACCESS:
Sarah was evaluated to determine
which device features best match her access needs and abilities. Sarah demonstrated the ability to isolate
each pointer finger (on her left and right hands) and cross mid-line to access
all buttons presented. Sarah demonstrated
a preference for using her right hand, but was able to use her left hand when
necessary.
Sarah was able to access buttons ranging
in size from 2”x 2” to 3” x 3” with an overlay keyguard separating each of the
buttons by ¾”. Sarah was able to
discriminate between four, 2” x 2” and 3”x3,” real pictures and Mayer-Johnson
Boardmaker symbols. Sarah demonstrated difficulty discriminating between eight,
2” x 2,” Mayer Johnson Boardmaker symbols.
DELINIATION OF FEATURES OF COMMUNICATION SYSTEM:
The following is a list of
features of a communication device required by Sarah at this time:
1.
Voice output.
2.
Capacity to store messages for multiple communication
pages/overlays (i.e., up to 7 levels for recording per page set).
3.
Device with 4 buttons 2” x 2” or 3” x 3” in size that
activate upon direct access.
4.
Device with keyguard overlay to separate buttons and
symbols.
5. Use Boardmaker symbols beginning with nouns and verbs
in a field of 3-4. Additional parts of
speech may be introduced in smaller fields.
COMMUNICATION SYSTEM MEETING SARAH’S CURRENT NEEDS:
During the evaluation, the
7-Level Communication Builder (with overlay option and levels) was found to
meet all of the features that are needed in a communication device for Sarah at
this time. The device has four, 2” x 2”
buttons in a quadrant layout which was determined to be appropriate for Sarah’s
access and visual scanning abilities.
The overlay option on the 7-level Communication Builder enables a
communication page or overlay to be placed under a removable keyguard. This allows for pages to be easily changed
between levels and also allows Sarah the opportunity to change the overlays
independently in the future. The 7-Level
Communication Builder also enables Sarah’s language to grow in the future with
the use of the additional windows that increase the presented picture array to a
field of 8 or 16 pictures. This will
allow Sarah to expand her vocabulary (e.g., nouns and verbs), increase her
sentence length (e.g., by including additional parts of speech) and eventually
learn appropriate sentence structure.
ABILITY TO LEARN AND USE COMMUNICATION SYSTEM/COMPONENTS:
During the evaluation process, Sarah
used topical communication pages ranging from 2 to 8 Boardmaker symbols on The
Cheap Talk-4 quadrant, 7-Level Communication Builder and The Tech Talk (all
with overlay options and levels). Sarah was
able to learn and most efficiently use the 7-Level Communication Builder to
participate in activities by making choices and requesting items and actions
within an activity. She required visual
modeling and initial hand-over-hand prompting to become familiar with the
overlay pages, however after becoming accustomed to the location of familiar
symbols she was able to access the buttons and communicate her wants and needs independently. After making a selection, Sarah consistently
made eye-contact with the examiner or her mother to show her communicative
intent and to receive a response from the listener.
The Cheap Talk-4 quadrant
7-Level Communication Builder
The Tech Talk
RECOMMENDATIONS:
Based on the results of the
evaluation a low-technology voice output communication device, with overlay
options, multiple levels and additional windows, meets Sarah’s current language
and communication needs. A variety of 4
picture overlays, made with Mayer-Johnson Boardmaker symbols, are recommended
to accommodate Sarah’s communication needs across a variety of settings.
Sarah demonstrated the ability to
learn and use the 7-Level Communication Builder with moderate to minimal
difficulty. She benefited from verbal
prompting, visual modeling and hand-over-hand assistance to initially learn the
purpose of and how to use the presented device.
By the end of the evaluation Sarah was more familiar with the 7-Level
Communication Builder voice output device and was able to access it
independently to request different items and/or activities.
Sarah seems to be a good
candidate for the purchase and use of the 7-Level Communication Builder voice
output device. The 7-Level Communication
Builder will assist Sarah in communicating her wants and needs across a variety
of settings. It will also facilitate
future expansion of her vocabulary (i.e., understanding and usage), phrase
length and sentence structure by using the additional windows that increase the
presented picture array from 4 pictures to 8 or 16 pictures. The additional windows with a larger picture
array are recommended to be used when the speech-language pathologist who is
treating Sarah on a consistent basis feels it is appropriate. The purchase of Mayer-Johnson Boardmaker
computer software is also recommended for the production of the overlays that Sarah
will be using to communicate over a variety of settings. A follow-up appointment is recommended, when
the device is received, to provide education for the family and therapists on
the usage of the 7-Level Communication Builder and the production of overlays
using the Mayer-Johnson Boardmaker software.
______________________________
XXX XXX, M.Ed., CCC-SLP/TSHH
Speech-Language Pathologist
NYS License # xxxxxxxxxxx
No comments:
Post a Comment