Biomedical Engineering Reference
In-Depth Information
fluency. However, the following three questions summarize value-based questions that
were asked by all team members:
1. Is the client's communication rate as fast as others of similar profile?
2. Is the client's use of alphabet-based approaches the most effective language repre-
sentation method possible?
3. Is the client's use of a touch-screen, page-based display the most effective technol-
ogy solution?
14.2.3 Step 2: Collecting Clinical and Personal evidence
Traditional methods of observation and LAM tools were used for this process (Hill and
Romich 2001). The PeRT software was used to analyze language samples and generate a
performance report. Although traditional methods of observation allowed for the collec-
tion of the multimodal aspects of communication, only LAM tools provided the accuracy
needed to monitor change or make comparisons among interventions. In addition, the
measurement of communication and selection rate requires a time stamp for calculating
standardized units of measure (Romich and Hill 1999).
On the basis of the formulated EBP questions, the following performance measures
were critical to obtain: (1) average and peak communication rate, (2) communication rate
of language representation methods, (3) selection rate, (4) mean length of utterance, and (5)
frequency of complete utterances.
14.2.4 Step 3: Locating and reviewing research evidence
The electronic search for evidence resulted in eight studies that were used to provide exter-
nal evidence to guide decisions. These studies were summarized by the SLPs and shared
with the team. An electronic database managed by the author was mined to find perfor-
mance data of individuals with similar profiles (Hill et al. 2000). The results provided infor-
mation on the performance achieved by others using AT systems under consideration. In
addition, the client joined an online discussion group to seek user input on satisfaction with
various AAC/AT options. He shared responses to his queries from the discussion group
with the team as well as content on related topics that he felt pertained to his situation.
14.2.5 Step 4: Using the evidence
This step involved using the external, clinical, and personal evidence for the MPT process.
The primary, secondary, and tertiary features were discussed and demonstrated to the
client with trials. The client requested the following three trial periods before making a
decision about AAC and/or AT: (1) his current AAC device with modifications and current
computer arrangement, (2) an upgraded touch-screen AAC system to emulate with the
computer, and (3) a hybrid AAC system to emulate with the computer.
The primary components became the major features for the client to select. Identifying
the various language representation methods (LRMs) used to generate communication
for spoken or written language would influence performance. Becoming aware of how
core and extended vocabulary could be stored and retrieved was a feature that he had not
previously considered. Because the client preferred not to use pre-stored messages, but
wanted SNUG to be his primary means of communicating, customizing a bank of prepro-
grammed sentences was not considered.
