Purpose
To guide the development of future trainings in the inpatient rehabilitation setting, this study aimed to expand the current understanding of (a) the experiences of speech-language pathologists (SLPs) who work in inpatient rehabilitation settings when providing augmentative and alternative communication (AAC) services to individuals with complex communication needs and (b) the challenges and facilitating factors related to AAC services within this context.
Method
An online focus group was used to explore experiences of 11 SLPs who work within the inpatient rehabilitation setting. Information was gathered about (a) the role of the inpatient SLP in AAC service delivery, (b) rehabilitation team service delivery, (c) successes and challenges to supporting individuals with complex communication needs within this setting, and (d) communication training opportunities.
Results
Themes that emerged related to (a) the complicated logistics of rehabilitation; (b) the centrality of the rehabilitation team; (c) the limited AAC tools, knowledge, and trainings for rehabilitation providers; and (d) SLPs’ attitudes. Participants reported navigating complicated logistics unique to the inpatient rehabilitation related to time constraints, limited AAC funding, the continuum of rehabilitation care, and limited AAC policies in attempting to meet patient needs. Generally, participants suggested successful team collaboration, yet limited time, expertise, tools, and training opportunities challenged attempts to support individuals with complex communication needs.
Conclusions
Increased access to AAC tools and the development of AAC trainings are recommended to equip rehabilitation professionals with skills to build interprofessional and AAC skills so patients with complex communication needs can maximally participate in the rehabilitation experience.
Supplemental Material
https://doi.org/10.23641/asha.7728710
Adolescents with autism spectrum disorder (ASD) often require support both for learning new skills and for communication. This study used a multiple baseline across activities design to evaluate the effect of videos with integrated visual scene displays (video VSDs), presented using a tablet-based app, on the percentage of steps completed independently within vocational training tasks by an adolescent with ASD and complex communication needs (CCN). Using the video VSDs, the participant met the mastery criterion for completing three tasks (including participation in communication exchanges) in a vocational setting. The results provide evidence that video VSDs may provide an effective support both for learning new skills in vocational contexts, and as a method of augmentative and alternative communication for individuals with ASD and CCN.
Children require consistent responses from partners to their presymbolic behaviors in order to increase the frequency and variety of these behaviors and eventually build symbolic language. This study served as an initial attempt to evaluate the effect of AAC training on typically-developing peers' interpretation of the behavior of three students with multiple disabilities whose communication was presymbolic and idiosyncratic in nature. The study used a pretest-posttest control group design with 12 peers in each condition (i.e., experimental and control). During the pretest, peers in both groups were inaccurate in their interpretations of the behaviors of the students with multiple disabilities. During the posttest, peers who completed the training interpreted the behaviors of the students with multiple disabilities with statistically significantly higher accuracy than participants who did not complete the training. The training may be an effective intervention approach to increase the accuracy and consistency with which communication partners interpret the idiosyncratic behaviors of children with multiple disabilities. Future research should evaluate the efficacy of using such training to increase communication partners' identification of and responsivity to idiosyncratic behaviors within the context of real-world interactions.
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