Biomedical Engineering Reference
In-Depth Information
The secondary components offered a wide range of options to consider and manipulate.
The SLPs on the team and the AT consultant were more involved in discussing, demon-
strating, and comparing the various language software with pre-stored vocabulary con-
figurations, different numbers of display locations, symbol types, color display options,
sizes of touch screens, etc. In addition, given the client's significantly reduced selection
rate on his current systems, the team suggested evaluating alternative access methods as
a means to increase communication rate. The client indicated that he wanted the option
to switch between direct keyboard selection and optical head pointing, depending on his
physical status during the day. Other features that were considered desirable by the client
included infrared control for computer access and environmental control and data logging.
In comparing the various AAC systems under consideration, the client found value in the
following secondary features: core and activity row configuration to access vocabulary,
icon prediction, icon tutor, and easy access to display status and tool box customization.
The central tertiary component important to the client was being able to use the AAC
system with a computer. Setting up the peripherals in the dorm was needed for this to hap-
pen. In addition, mounting solutions and fabrication of other peripherals were needed and
performed by the rehabilitation engineer. The client also took into consideration services
offered by the manufacturer.
Step 4 involved a clinical summary at the end of three months. The summary was
written to describe the result of the assessment and trial process and culminated in
submitting a funding request for a new AAC system and updates to computer access.
Training and intervention on the new communication technology included a 1-hour
therapy session once a week for three months. The built-in LAM feature provided an
efficient method for monitoring progress by both the client and the SLPs and prompted
discussion about treatment outcomes. Within three months of treatment, the client had
learned his new language application program and was selecting words using semantic
compaction 90% of the time. His average communication rate was 6.7 words per minute
and peak communication of 21 words per minute with direct keyboard selection. For
this case, the use of semantic compaction was 16 times faster than spelling. By the end
of the academic year, performance and outcomes data indicated significant gains, that
overall spoken and written communication were more effective and efficient, and that
user satisfaction was high.
Table 14.2 compares the client's performance on his original system with his performance
on his new system at the end of the first month. Using PeRT allowed for precise and accu-
rate reporting of performance measures during the assessment and intervention processes.
The performance reports provided an ongoing, reliable record of progress for treatment
outcomes. In addition to improvements in his communication performance in various
social environments, his communication in classes was also considered to be improving.
With an improvement in his grades, withdrawal was no longer considered necessary. Two
years later, the client graduated from the university with a four-year degree. He has met his
long-term goals by being gainfully-employed and living independently.
14.3 Conclusions
Our case adheres to the precepts of a client-driven process to reach an AT solution that
allows the individual to reach their highest potential within the ICF framework. The
