Comments on Augmentative and Alternative Communication Evaluation and System Selection: A Response to Woltosz

Joe E Reichle, Theresa Mustonen, Jeff Sigafoos, Linda Hinderscheit, Gloria Wiemann, Peggy Locke

Research output: Contribution to journalArticlepeer-review

5 Scopus citations
Original languageEnglish (US)
Pages (from-to)204-207
Number of pages4
JournalAugmentative and Alternative Communication
Volume5
Issue number3
DOIs
StatePublished - Jan 1 1989

Bibliographical note

Funding Information:
used to reimburse any other provider of in-serviceservice would most likely come from the same sourcestions, the value of a particular electronic aid can only training or technical assistance. be evaluated after a trial period. Some public sector A longer range alternative to the training needs iden-funding sources such as Medical Assistance of Minne- tified involves the within-agency efforts to design andsota offer funded trial periods when there is a merito- implement in-service and technical assistance modelsporting the request was not available. Some manufac-rious request for which an objective data base sup- in the area of augmentative and alternative communication. This type of effort is exemplified by a projectturers place severe restrictions on the length of the initiated in the St. Paul, Minnesota, public school sys-rental period while other manufacturers offer no lease tem. In an attempt to increase its within-district exper-devices at all. There is a critical need to have lease tise in providing AAC services to students with severedevices at reasonable remuneration to manufacturers.policies that permit access to all commercially available handicaps, the school district is cooperating with the University of Minnesota Department of CommunicationClearly, such policies will require careful negotiation Disorders to develop a district-wide inset-vice and tech-among funding sources and manufacturers. nical assistance model. The project, which is funded by a U.S. Department Summary of Education grant, consists of three working taskThe goal of Woltosz’s proposal is important and forces with widely divergent responsibilities and a tewcho-rthwhile. A systematic method that promotes the nical assistance team consisting of highly skilled distcriocltlaboration between those who directly serve the professionals in special education, communication dliesa-rner and those who manufacture electronic com-orders, and occupational/physical therapy. The tamskunication devices is welcomed. This type of cooper-forces have created materials which are used by tahteion would probably result in manufacturers becoming technical assistance team to train district professionmalosre aware of the needs of potential electronic com-to make referrals and to provide ongoing AAC assesms-unication aid users, and might also result in substan-ment and intervention to individual learners. The tetciahl-improvements in equipment. However, we are not nical assistance team provides on-site consultation ovceornvinced that the system that Woltosz proposes an extended period of time to help the learner’s intsehro-uld be the highest priority for development. It is our disciplinary team to decide on the type of electronicb eolrief that four priority activities would have far more immediate impact on the delivery of AAC servicehsa.s been completed. If such a specification cannot be These include: (a) the development of inservice awndritten at the end of the evaluation, then the effective-technical assistance both from within the service denlievs-s of the evaluation must be questioned. ery system and from outside providers; (b) that manuT-he model is further designed to eliminate the prac-facturers assist in the promotion of the independteicnet of “fitting people to devices” rather than adapting representatives who can work with a variety of codme-vices to meet the needs of people. Too often clini-panies to keep local service providers abreast of currceinatns who are familiar with only a small number of electronic aid developments; (c) that manufacturdeersvices recommend those devices over and over, forc-develop more objective criteria that focus on the fienag-their clients to adapt to the limitations of the devices tures of their products; and (d) that public and privraatteher than asking manufacturers to meet the clients’ sector funding agencies work with manufacturersr etoal needs. By developing a generic system specifica-create flexible lease arrangements so that comparatbiloen, the clinical team challenges manufacturers and devices can be objectively explored by the candidathteeir representatives to fit the device to the person, for the device. rather than the other way around. Of course, manufac-turers with little flexibility in their products will shy away Joe Reichle, Theresa Mustonen, Jeff Sigafoos,from this approach, while those who can readily modify Linda Hinderscheit, Gloria Wiemann, and systems to meet new requirements will welcome it. Peggy Locke I strongly disagree with the authors’ contention that Center for Rehabilitation and Community In-“manufacturers would be well advised to hire only tegration speech-language pathologists…” (Bruno & Romich, Department of Educational Psychology 1989, p. 203). There is simply no reason for speech-University of Minnesota language pathology to be the only professional back-Minneapolis, MN 55455 USA ground for manufacturers’ representatives and, in fact, there are strong arguments against this approach. Aug-mentative and alternative communication (AAC) is a multidisciplinary field. Many of the technological ad-vances in the field have come from outside of speech Tetlie, R., Mustonen, T., York, J., Hinderscheit, L., & Reichle, J.pathology. Occupational therapists, physical therapists, (1988).A survey of professionals serving augmentative/alternatpsychologists, rehabilitation engineers, special educa-ive communication userUs.n published manuscript, University of Min-nesota, Minneapolis. tors, and others have all made significant contributions Woltosz, W. S. (1988). A proposed model for augmentative andto AAC. mentative and Alternative Communicatio2n3,3 4-2, 35.alternative communication evaluation and system selAeucgti-on. Of all of these, the training received by occupational therapists (OTs) and rehabilitation engineers is most oriented toward skills needed by manufacturers’ rep-resentatives. Both OTs and rehab engineers are trained to problem-solve, and to take a systems approach to developing a solution. Engineers and OTs are generally “equipment-oriented,” while most speech-language pa-I am delighted to have received the comments on tthheologists receive little or no training in equipment-Forum article and am pleased to offer the followionrgiented disciplines. The functions of the manufactur-replies. Because the two sets of comments are signeifri-’s representative are strongly directed toward provid-cantly different, I will address each separately. ing assistance to the clinical team after a selection is made-with such items as mounting, coordinating Bruno and Romich wheelchair and communication system controls, and The authors correctly note that “the selection of apnroviding troubleshooting help in the event of a break-appropriate communication system requires the expdeorw-n. The primary training of the speech-language tise of many individuals” (Bruno & Romich, 1989, pp.athologist is oriented toward oral dysfunction and 203); however, they seem to have missed the point oflanguage. While these areas are undeniably important, the proposal. they are the functions of the local clinical team, and It is one of the functions of the clinical team to gathhearve little to do with the day-to-day functions of a and organize information from various sources andm toanufacturer’s representative. There are, of course, a assemble an overall description of the client’s neednsu,mber of outstanding manufacturer’s representatives skills, and environmental factors so that an appropriawtheo are speech-language pathologists; however, there recommendation can be made. The proposed modies lcertainly no justification for making this field a prereq-merely formalizes this process in a manner that pruois-ite to become a manufacturer’s representative. vides a specification for an ideal device. It does nSootme of the best representatives do not have college contend that device characteristics are an end undteogrees at all, but are technicians experienced in pro-themselves, but does suggest that a set of devicveiding and supporting durable medical equipment, are characteristics can be generated to describe what kinsowledgeable about computers (an increasingly im-needed for a given individual once a proper evaluatipoonrtant aspect of AAC), and provide valuable assist-

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