I don’t even know where to start.

20 Feb

It has been a really, really long time. SO LONG. MONTHS. I wish I had a valid excuse but basically it is cold and I’m sleepy and I’m busy and I don’t wanna go to the library to blog. I’ve had so many things to share, and I can’t even begin to pick a topic. I think the last thing I blogged about was CFs and swallowing therapy and how I suck at dealing with behaviors. I still suck at dealing with behaviors. I’m working on it OKAY?!

But I’ve been doing so many new things and meeting so many people and I learn something new every day. I think my most challenging area since my last blog has been AAC! Oh yeah my friends. Can I just tell you – in grad school and undergrad I was all, “UGGGGH AAC.” Now I eat-sleep-breathe AAC. And I enjoy it! It still scares me and confuses me and and overwhelms me and I’m still learning an INCREDIBLE amount. It seems so daunting! AAC is changing every day and that stresses me out – how am I supposed to stay on top of it? How can I make sure my clients have the best system for them when I might discharge them and find out about a new system the next day? I DON’T LIKE THAT.

So currently, my caseload is right around 30 plus evals. Which feels kinda crazy-pants some weeks, so I feel really bad for people in schools and hospitals who have more than that. Don’t forget, my friends: ASHA says no more than 40 but I know you all are doing way more than 40. Average is 50ish. Max is 110ish. SCARY.

Anyway, so about half my caseload is adults. I see two adults with acquired disabilities, and the rest have developmental disabilities. I’m not seeing anyone for swallowing currently, and I see one adult for cognitive-communicative tx, and the REST are AAC. So I’m seeing like 12 adults for AAC. It is a LOT of work. My adult clients require way more planning than my kiddos. The kids are challenging, but in a very different way. I’m doing some AAC with a couple of my kiddos but it isn’t the ONLY thing we’re working on. Basically my desk looks like the birthplace of AAC on most days:

DESK EXPLOSION

DESK EXPLOSION

So what am I doing with these clients? Some I’m working on developing low-tech communication books and wallets. So far I’ve successfully created two functional and effective communication books for clients who use ASL, but have difficulty communicating with hearing individuals (specifically group home staff and workshop employees.) I’m learning a lot about interacting with the Deaf community, and I’m taking a sign language course right now. It’s…interesting. We’ll get there one day once I catch up on this blogging business.

A couple of clients I’m helping to obtain high-tech speech generating devices for. One client my goal is a Dynavox Maestro, the other a NovaChat7. I’m also trialing a Springboard Lite with a client.

Some clients I’m going more mid-tech with – Go Talk 20, 7 Level Communicator, Three Message Platform Communicator etc.

Some devices I’ve trialed include: Dynavox Xpress, Dynavox V+, Dynavox DV4, NovaChat7, Springboard Lite, Alt Chat, Tobii C12, ProxTalker, Go Talk 4, Go Talk 20, 7 Level Communicator, One Message Communicator, Three Message Platform, Four Message Communicator. The DV4 isn’t made anymore, but we have one in a cabinet and I like using it during evaluations because it has a large screen and “exploratory” pages that assist in evaluating category skills, access skills, identification skills etc. Someone today referred to it as a dinosaur, but I think this ol’ dinosaur still has a place.

Also of course, I’ve been working with the iPad and apps. I don’t LOVE the iPad the way everyone else does. Don’t get me wrong: it is awesome and there’s so many things that can be done with it in therapy and in terms of using it for a communication device. My main beef with it is that damn 60 minutes piece that focused on its use with people with autism. I think just about every person I see for AAC has asked if they can get an iPad. I’m like:

WELL, you certainly CAN but I can’t promise that insurance will pay for it or any apps on it (probably not). And I also can’t promise that using it will be successful or that it will be appropriate for the person using it. The iPad IS NOT a be all end all.

I’ve also been downloading free AAC apps for my Android phone and there are SO MANY. I think I want to start reviewing them and sharing what I think here on my blog. So get excited for that. I think it is a great idea especially for home-health therapists to be able to just pull out their phone and try an AAC app with a client.

You may be wondering how I get my hands on all this good stuff.  First of all, my workplace has an AWESOME Resource Center that has SO MANY AAC and AT products. It’s great. I just be-bop down there about a million times a week and borrow devices. Also, I utilize DATI a LOT.  In fact I’m on their wait list right now to borrow a Dynavox Maestro. DATI is a life-saver! They’re so incredibly knowledgeable and helpful. LOVE. And of course, if I need to I can always contact companies directly and ask them if they know of a device I can borrow in the area (I tweeted at Saltillo and they were so helpful in my hunt for a NovaChat. Thanks Cara at Saltillo!) I think I’m pretty in what is available to me.

I think one of the more frustrating things about AAC is actually GETTING a device. The process is so long. I wrote up an explanation for families for the steps it will take to get a device. I found that families were coming to the evaluation and expecting that their loved one would have a device by the next time I saw them. And while I don’t want to discourage anyone from coming to therapy to get a device, I also don’t want them to be surprised if it takes a long long lonnnnng time.

My letter to families and caregivers

My letter to families and caregivers

I think overall, the learning curve for AAC is a little intense, but I’m getting there. I tell people that I’m learning just like they are and that it is definitely a trial-and-error process. If you have any questions, ideas, suggestions, stories – WHATEVER – about AAC, please share!

PS – I’m obsessed with the NovaChat7. OBSESSED.

2 Responses to “I don’t even know where to start.”

  1. Tara Miller February 25, 2013 at 7:31 pm #

    My new favorite AAC iPad app is the GoTalk app! There is a free version and the full version is only like $80. It is pretty user friendly and there is a huge 80 page tutorial on the attainment website.

  2. eL May 27, 2013 at 6:10 pm #

    Love your blog. I’m finishing up my CFY and enjoy reading your blog. AAC can be daunting and I really appreciate you saying the iPad isn’t a ‘cure all’ like so many parents/families think!! I thought I was the only crazy speech path that hates that 60 Minutes video!

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