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Yogi Berra It seemed rather incongruous that in a society of super sophisticated communication, we often suffer from a shortage of listeners. Notice the wavy lines in the middle of Figure 3 that indicate interference. Following are the roles, knowledge base, and skills deemed necessary for SLPs to provide a continuum of services to individuals with limited natural speech and/or writing. 1.0 Role: Assessment of individuals whose impairments preclude their use of natural speech and/or writing as a primary means of communication, as well as their communication partners and the various environments in which communication occurs. 1.1 Identifying and coordinating (when necessary) the participation of other team members throughout the assessment process; recognizing the importance of collaborating with specialists, family members, and other parties as needed. 1.2 Determining the purpose(s) of AAC assessment, such as natural speech facilitation, temporary means of expression, alternative to natural speech, and replacement of challenging or problem behaviors with more conventional and socially acceptable forms of communication. 1.3 Conducting a comprehensive needs assessment and/or a discrepancy analysis to identify why an individual's level of participation in a particular activity might be restricted due to his/her lack of access to an effective means of communication. 1.4 Using authentic assessment procedures to assess and determine individuals' communication skills and needs in relation to the communication skills of other persons the same age, in everyday situations: background history, including cultural environment and expectations, past and present speech-language and AAC interventions, auditory and visual functioning, and physical skills as well as symbol knowledge and literacy skills. results of a thorough oral peripheral examination of structures and their corresponding adequacy of functioning for natural speech, short and long term. production of messages through vocalizations, natural speech, manual signs, graphic symbols, and other forms of communication. potential to use and/or increase natural speech. comprehension of messages conveyed by natural speech and language, gestures, graphic symbols, and other forms of communication. opportunities for communication with different people in different settings. strategies used by listeners that optimize interactions with individuals who use AAC. federal, regional, state, and local policies and procedures that foster or impede the use of AAC. attitudes of others toward AAC and the individuals who use these systems of communication. additional information about cognitive, motor, sensory, and perceptual abilities, as well as academic achievement and work performance. optimal techniques for accessing items, including means of selection and size, number, spacing, and arrangement of symbols on aided devices. 1.5 Identifying the need for, and then referring to, professionals from other disciplines in order to conduct a comprehensive and integrated assessment. 1.6 Involving consumers (e.g., clients and their families) in all decision making to the greatest extent possible throughout the assessment process. 1.a Knowledge of typical speech-language development and ability to apply this information to individuals who rely on AAC. 1.b Knowledge of the anatomy and physiology underlying speech and language skills. 1.c Knowledge of oral-motor function and its relationship to natural speech production. 1.d Knowledge and skills necessary to conduct and interpret the results of a comprehensive oral peripheral examination, including assessments of the primary subsystems of speech (i.e., respiration, phonation, articulation, and resonance). 1.e Knowledge of the various purposes and intents underlying communication. 1.f Knowledge of cognitive-communication disorders. 1.g Knowledge of neurologic conditions and motor speech disorders in children and adults. 1.h Knowledge of the characteristics of syndromes and progression of symptoms in individuals with little or no natural speech and/or writing. 1.i Knowledge of prognostic indicators for functional natural speech and language performance in spoken and written modes. 1.j Skill in obtaining a thorough case history, including skills soliciting and providing information through interviewing. 1.k Skill participating in different models of service delivery. 1.l Skill interpreting and applying assessment results from other team members. 1.m Knowledge about and skill in administering (with and without accommodations), and interpreting results of standardized, nonstandardized, and criterion-referenced assessment procedures while maintaining reliability and validity. 1.n Knowledge of cultural and linguistic differences and their implications for changes in administration methods, content, and interpretation of assessment results. 1.o Knowledge and skill necessary to conduct unbiased, valid assessments that consider sensory, cognitive, and motor disabilities as well as cultural and linguistic differences. 1.p Skill assessing individuals' current and future communication needs and desires. 1.q Knowledge about and skill in assessing natural speech production, intelligibility, and comprehensibility. 1.r Knowledge about and skill in assessing spoken and written language comprehension and expression. 1.s Knowledge of methods and skills to obtain and analyze communication and/or language samples. 1.t Knowledge about reading, writing, and spelling development and disorders, and related methods of assessment. 1.u Knowledge and skill to assess symbol knowledge (i.e., recognition and use), and literacy/proto-literacy in reading and writing. 1.v Ability to assess pragmatic skills (e.g., communication intent/function, success and effectiveness of communication, discourse skills) of individuals who use AAC and persons with whom they interact. 1.w Ability to assess AAC users' language skills, both production and comprehension, including form (different modes of communication and their relative effectiveness, alone and in combination with one another; phonology; and syntax), content (semantics), and use (pragmatics). 1.x Skill in conveying assessment information and implications (e.g., recommendations, goals, and intervention suggestions), orally and in writing, to individuals who use AAC, parents and other family members, co-workers and friends, employers, and other professionals. 1.y Knowledge of the roles of other professionals and skill in making referrals to appropriate professionals, agencies, and services. 1.z Knowledge and skill in identifying and measuring desired outcomes in collaboration with individuals who use AAC, their families, and significant others. 1.aa Knowledge of sensory, movement, and other systems that influence communication as well as speech and language development. 1.bb Skill in identifying individuals who would benefit from AAC, while appreciating the significance of a zero-exclusion criterion when applied to candidacy for AAC systems. 1.cc Knowledge and skill providing individuals with ample content with which to express themselves through their AAC systems. 1.dd Knowledge of how language is generated on AAC systems during communication. 2.0 Role: Assessment and documentation of AAC methods, components, and strategies to maximize functional communication by individuals. 2.1 Understanding the corresponding sensory (particularly vision and hearing), motor, cognitive, linguistic, and social abilities that are needed to use different unaided and aided modes of communication. 2.2 Matching features of AAC systems to capabilities of individuals being considered for those same systems. 2.3 Assessing and documenting functional communication needs in environments that are relevant to an individual, including home, school, work, leisure and recreation, and elsewhere in the community. 2.4 Assessing current and potential resources (e.g., other SLPs, physical therapists, occupational therapists, rehabilitative engineers, family, friends, peers, teachers, co-workers, and employers) and levels of support. 2.5 Assessing individuals' and their communication partners' motivations to use, and attitudes toward, AAC. 2.6 Customizing AAC systems to meet individuals' needs and skills. 2.7 Modifying AAC systems as individuals' communication abilities and needs change and new technologies arise. 2.8 Determining the most appropriate AAC system components relative to: needs, abilities, and preferences of individuals who use AAC, and their communication partners. co-existing uses of other types of assistive technology. 2.9 Implementing AAC systems that incorporate and integrate multiple modes of communication. 2.10 Teaching other professionals, family members, employers, and others how to support individuals' effective uses of their AAC systems. 2.a Knowledge of typical human development and disorders relative to cognitive, physical, behavioral, linguistic, sensory (particularly vision and hearing), motor, perceptual, proto-literacy and literacy skills, and corresponding implications for the selection of AAC systems. 2.b Knowledge of the hierarchy of evidence (e.g., empirical research, experimental single-subject designs, case studies, clinical impressions, and anecdotal experiences) that can be used to make informed decisions about the capabilities and communication needs of individuals who use AAC. 2.c Knowledge of cultural and linguistic patterns and what is considered to be competent communication from a particular cultural perspective. 2.d Knowledge of the general purposes and applications of AAC systems. 2.e Knowledge about, and skills in, evaluating individuals' symbolic skills, including levels of abstraction (e.g., actual objects, photographs, pictures, line drawings, and words), and complexity of symbols they can use and understand. (Note: no hierarchy has yet been demonstrated with respect to symbol abstraction in relation to ease of learning.) 2.f Knowledge of various aspects of aided and unaided AAC systems that include, but are not limited to: design of nonelectronic communication books and communication boards. number, size, spacing, and arrangement of items on an aided device. amplifiers and artificial phonation devices. 2.g Knowledge of the broad array of dedicated devices that are designed specifically for AAC purposes, and their respective features (e.g., methods of access, durability, types of symbols, organization of items, auditory and visual features, modes of output [spoken and printed], flexibility, portability, and cost). 2.h Knowledge of the performance differences of the broad array of nondedicated devices (e.g., different forms of computer hardware and software, as well as adaptations such as touch screens and expanded keyboards that are intended for purposes that include but are not limited to communication) and their respective features.
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