Use of Power Mobility Another area where some team members may have questions about the use of AT is power mobility. While there is no clear an- swer to exactly when to begin power mobility, multiple studies have demonstrated that children less than two years of age can learn to use power mobility (Butler, Okamoto, & McKay, 1984; Jones, McEwen, & Hansen, 2003; Kangas, 1997; Zazula & Foulds, 1983). Research has not been able to identify a tool that is effective in determining readiness for power mobility. For young children who are not learning to walk at the same age as peers, power mo- bility provides many opportunities to engage in more indepen- dent exploration of their environment, as compared with focusing exclusively on remediation of mobility difficulties, which can de- lay independent exploration. When not exhausted from efforts to move about their environment, children can see, hear and touch elements around them. This is important because exploration is important for spatial searching, spatial problem solving, social and exploratory behaviors, and visual tracking (Gustafson, 1984; Yan, Thomas, & Downing, 1998). No research has substantiated a commonly held fear that chil- dren will regress in motor skills due to use of power mobility (Bot- tos, Bolcati, Sciuto, Ruggeri, & Feliciangeli, 2000; Jones, McEwen, & Hansen, 2003). Parents, who sometimes worry about loss of motor abilities if power mobility is used, have reported: increased child independence and personal control, increased child engagement in meaningful life experiences and positive effect on others’ atti- tudes toward the child when power mobility is provided (Berry, McLaurin, & Sparling, 1996; Wiart, Darrah, Cook, Hollis, & May, 2003). While there was often trepidation prior to beginning to use power mobility, Home and Ham (2003) found the majority of parents who responded to a questionnaire felt that power mobil- ity increased confidence, motivation and happiness, and reduced frustration. AT for Self-Management for Students with Intellectual Disabilities Although there is less research in other areas of AT use for stu- dents with intellectual disabilities, there is evidence that AT can be effective for self-management and self-prompting. Cullen, Alber- Morgan, and Shelia (2015) reviewed 36 studies about using tech- nology mediated self-prompting for daily living skills and found this body of research has demonstrated the positive effects of technology mediated self-prompting for adolescents and adults with disabilities across a range of daily living skills, in a wide variety of settings, and using a variety of types of technology. The most targeted activities for this research were buying, preparing and consuming food. Some focused on managing personal finances, managing a household and buying and caring for clothing. Other researchers have looked at a variety of uses of AT for self-management (Davies, Stock, and Wehmeyer, 2002a; Lancioni, O’Reilly, Seedhouse, Furniss, & Cunha, 2000; Lancioni, et.al., 1998;
of the subjects. There was no evidence of decreases in speech in any subjects. For 11% of the subjects across all studies there was no change, but for 89% of those individuals provided with AAC, their speech production increased. While this meta-analysis was done 12 years ago, it is definitive. We don’t need more research to answer this question any more than we need more research to determine if seatbelts are effective in preventing deaths in car ac- cidents. We know the answer. Don’t expect, or feel a need for, new research to address this issue. What we are beginning to see in research now is that it delves further into why AAC works and how it can be most effectively used. Romski, et.al. (2010) studied 68 toddlers with developmental disabilities. Prior to the start of the study, they had fewer than 10 spoken words each. They randomly assigned them to three groups who were provided AAC for input (receptive language), AAC for output (expressive language) or spoken language intervention only. For the first group, the adult used symbols for the child’s re- ceptive communication, pointing to them when speaking. For the second group, the adult used hand over hand to help the child use a speech-generating device for expressive communication. The toddler’s vocabulary use was checked after 18 and 24 sessions. In both augmented interventions the children made modest, but significant gains. Children receiving spoken intervention only and no AAC did not make any gains. The toddlers who received AAC for output were much more likely to produce spoken words. The toddlers who received AAC for receptive communication also made gains in their use of spoken words. This research tells us that AAC Intervention with young children with developmental delays actually facilitates the development of speech better than spoken language intervention alone. Look for more research along these lines as researchers begin to identify specific aspects of AAC use that are important. The Greatest Challenge in Teaching Children to Use AAC Several studies show that the greatest challenge to successful AAC intervention is in training communication partners. Research by Binger et al., (2010); Kent-Walsh et al., (2010) Cumley & Beukel- man, (1992); Light, Collier, & Parnes, (1985) shows that communi- cation partners tend to: • Dominate communication interactions; • Ask predominantly yes or no questions; • Take the majority of conversational turns; • Provide few opportunities for the child to initiate or respond; • Interrupt the child’s communicative attempts; and • Focus too much on the technology tool. The ImPAACT Program (Kent-Walsh & Binger, 2013) is one in- tervention program that has been documented to yield positive results for clients using AAC. https://www.researchgate.net/pub- lication/260124160_Fundamentals_of_the_ImPAACT_Program
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