Biomedical Engineering Reference
In-Depth Information
to another location. Finally, more SLPs are offering telerehabilitation services to support
training and intervention for clients using AT.
The MPT process is client-centered and requires that the individual, including family or
significant others, participate in the selection of AT options. The SLP may have the role of
explaining the full range of AT solutions along the continuum of no technology to high-
performance technology. In addition, the SLP may explain and demonstrate the various
AT components related to speech and oral and written language and communication. This
instructional and demonstration time ensures that the client and family are fully informed
of all of the options and are actively involved in the selection of the AT interventions con-
sidered for trial.
Individuals and/or family members may enter the MPT process with preconceived
notions about the type of AT they want. By providing an overview of the range of AT
options and descriptions of AT in terms of primary, secondary, and tertiary components,
the person and family gain an appreciation of the complex nature of the MPT process (Hill
and Scherer 2008). Although off-the-shelf products may be a final solution, the selected
AT more frequently includes features that provide more flexibility and customization for
the person's unique capabilities than products not designed for specific populations with
disabilities. With limited knowledge, an individual may have high satisfaction with an AT
solution, but once they are fully informed about the performance differences that exist
among the available solutions their initial satisfaction vanishes. Consequently, the exter-
nal, internal, and personal evidence gathered by the SLP is used to support the details for
the feature match.
14.1.5 evaluation of the effectiveness and Usefulness of the AT
The trial portion of the MPT process requires collecting quantitative and qualitative data to
evaluate the effectiveness and usefulness of the AT intervention. It is typical in the United
States for third-party payers to require that the AT team provide documentation for at least
three trials on similar solutions before making a selection. Although three trials may be
documented, the AT team must have reviewed the range of solutions and a detailed com-
parison among the possible AT options. Because no research evidence exists regarding
the length required for an AT trial, the professional opinion of the AT team along with the
choice of the individual and family makes the decision about the trial lengths.
Baseline data on any current AT that were collected at the start of the assessment can be
compared with data collected during the AT trials. Automated performance monitoring
provides quantitative data that are based on units of measurement to use at the trial stage
(Hill and Romich 2001). The built-in data logging feature of several AT systems, integrated
software, or external tools offer effective and efficient methods for monitoring gains in
performance or for comparing AT solutions under consideration. The SLP's role includes
identifying the most reliable and valid measures to monitor performance and recommend-
ing the methods to collect oral and written language samples.
The collection and analysis of language samples is the most authentic procedure for iden-
tifying communication competence (Light and Binger 1998; Paul 2007; Hill 2009). The param-
eters used to measure communication competence are the same across cohorts and the life
span. The parameters used to determine the severity of a communication disorder are also
valid for AT speakers and writers. The SLP selects those measurements that will provide
the most reliable and valid data for decision-making and monitoring progress. Typical data
related to the subsystems of language (semantics, morphology, and syntax) include the mea-
sures of vocabulary, syntactic diversity, and the length and complexity of utterances.
