Augmentative Communication Device Requests for Child

Information needed in the report includes the following information:

1. A current speech and language evaluation that includes objective date (standardized if possible) in the areas of receptive and expressive language.
2. Comparison of speech and language skills with overall cognitive skills.  Basically we need to know the individual has the cognitive skills to use the requested device.
3. 30 day trial of the device across three settings:  home, school, school, community (for child); home, work, community (for adult) with objective data collected on the usage.
4. Chronology of device selection –i.e. what other devices were trialed?  Why is this particular device necessary?
5. Ability of parents/caregivers/individual to maintain and program the device.

SAMPLE REPORT

Request for Augmentative Communication (Speech Generating Device)

Demographic Info:

Name, Address, Date of Birth, Parent, Diagnosis

Date of Report

Background Information

XXXX is a 5-year 6 mos. old male child with a diagnosis of apraxia of speech.  He has been seen for individual speech and language therapy at this facility since the age of XX.  During this time, he has demonstrated increased comprehension of language but little growth in the development of expressive speech and language skills due to the severity of his apraxia.  After extensive consideration, a request for an augmentative communication device to supplement/replace his expressive language is being requested.  We are currently recommending the following AAC device be purchased for him:  CHAT-PC.

Speech and Language Skills

Speech

Oral motor skills are well within normal limits for vegetative functions.  However, XXX was unable to elevate, lateralize and protrude his tongue upon command.  Verbal output is limited to a few isolated vowels and consonant sounds.  He is unable to sequence consonant and vowel sounds to form even simple words.  He has a diagnosis of severe apraxia of speech.  Thus, his speech is non-functional for activities of daily living.

Language

On the Receptive One Word Picture Vocabulary Test, a test of single word vocabulary, xxx earned a standard score of 85 with a corresponding age equivalent of Xxxxx, within the average range of performance.  Similarly, on the Preschool Language Scale – 4 (or Clinical Evaluation of Language Fundamentals-P), he scored within the typical range.  Concept development, as measured by the ----subtest, showed adequate comprehension of spatial relations, prepositions, as well as basic and linguistic concepts.

In contrast to the typical scores on receptive language tests, he scored in the severe to profound range on measures of expressive language due to the severity of his apraxia of speech.  He was able to sign the answers to several of the items on the Expressive One Word Picture Vocabulary Test;  however, the test could not be scored due to limited verbal ability.  He is noted to have basic expressive language abilities shown by his ability to sequence 3-4 pictures on a communication board to form simple sentences.  For example, he could communicate, “I want house book” by pointing to the appropriate icons on the communication board.

Pragmatics

Xxx is an active communication partner and readily engages in interaction with others.  He has excellent non-verbal communication skills.  For example, he will take your hand to an item he wants to play with.  He initiates communication with his current communication board or by signing the appropriate words.  Frustration is high at not being able to communicate commensurate with his intact cognitive skills.

Augmentative Communication Intervention

The following intervention/devices have been evaluated throughout the last 6-8 months.

1. Manual signs – Although he has acquired approximately 50 manual signs and can sequence them into two word sentences, most people in his environment do not sign.  Other children in his preschool are not able to understand him when he signs.
2. Communication Board – He currently uses a trifold communication board with 2” square icons.  He is able to sequence short sentences as noted above.  However, his current vocabulary exceeds the space available on the board.  In addition, he need voice output in order to get the attention of others in his environment and carryon a verbal conversation.
3. Tech/Talk 8 – this device was utilized for a short period of time but was not powerful enough to meet his needs.  His vocabulary far exceeded the capacity of the device.
4. SuperTalker – within the therapy room, he can use all 8 levels of the device with the 8-grid overlay.  However, once again his language skills surpassed the capacity of the device.
5. ChatPC – the ChatPC was selected because of its small size and versatility.  Xxx immediately acclimated to the device and was able to use it without substantial difficulty.  During a 30 day trial of the device, he evidenced the following abilities:

• An average of 79% accuracy using the ChatPC to communicate basic wants and needs at home.  50% of the errors were attributed to keystroke rather than selection as he became used to the small size of the icons. 
• An average of 85% accuracy in therapy during both structured and unstructured play in the therapy room.  He was able to sequence 4 word sentences to request comment and question.
• An average of 65% accuracy in the community.  He was able to use the ChatPC to order food in a restaurant as well as to initiate play with another child on the playground.  School trials were limited to only a few days with positive results reported by the teacher.

Family Interventions

Xxxxx’s parents and grandparents were shown how to program the device as well as to care for it appropriately.  Xxx demonstrated the ability to turn the device on and off independently.  Parents will be a good support for the use of the ChatPC.  He will continue to receive ongoing therapy services both privately and in the school setting.

Recommendations

Based on the above information it is recommended that the ChatPC be purchased for Xxx.  He will continue to receive ongoing speech and language therapy to support its use in all environments.  In addition, he will continue to receive speech and language therapy in order to increase his verbal speech.

Speech Language Pathologist

Enc:  Price Sheet

Information on the ChatPC