Guest Author: Marisa Bierenfeld
What is considered a “good” outcome? Many factors contribute when trying to measure positive outcomes for individuals that use AAC devices. Professionals must work together with the individual using the AAC and their families to generate measurable goals while including the individual’s personal expectations. Communication impacts all aspects of the individual’s life, therefore, acts as the foundation for participation in all environments with all types of communication partners.
Remember to Explore the Evidence
Lund and Light, 2006 conducted a descriptive study that measured various domains of communication in adults that ranged from 19-23 years old. This long-term study included participants that have been using AAC devices for at least 15 years. Researchers measured receptive language, reading comprehension, interactions skills, linguistic complexity, functional communication, educational and vocational success, self-motivation and quality of life. All participants had cerebral palsy, however had different AAC systems and means of communication.
Results indicated that various factors influence “good” long-term outcomes of AAC intervention. Personality characteristics influence positive outcomes for individuals who use AAC in areas such as motivation and self-determination. The individuals environment also contributes to the quality of life and AAC outcomes. Parental and family support and educational placement were other factors that play a role in AAC outcomes. All the factors stated above are not necessarily divided, as in they influence each other.
The WHO ICF (World Health Organization’s International Classification of Functioning, Disability, and Health) created a framework for the structure of measuring outcomes. It includes measuring the individual’s health condition, body function/structures, participation, environmental factors and personal factors, and activities. These aspects of the individual’s life play a role in communication.
Communication interaction relates to the function and linguistic complexity of intentions by the individual using AAC. In Lund and Light, 2007, researchers measure turn-taking, function, and linguistic complexity. The same participants were used as in Lund and Light, 2006. Results showed that as participants engaged in more turn-taking with peers than caregivers and unfamiliar partners. Individuals improved in pragmatic, semantic, and syntactic skills in addition to improving access to AAC, which contributed to conveying more opportunities to convey communication functions. Preschoolers and adults using AAC utilized functions such as confirmations/denials and provisions during conversation. Communication partners engage in functions such as requests for information, requests for confirmation, and clarification. Factors such as role of the communication partner and context of information must be considered when assessing functionally communication in individuals using AAC.
Linguistic complexity developed from preschool to adulthood in using more than one concept during turn-taking. Complex sentences take more time to construct, therefore, individuals that use AAC may utilize telegraphic (shortened) messages to increase the rate of communication. To write linguistically complex messages, individuals using AAC must be educated in syntax and grammatical structures to have success in conveying information, wants/ needs.
The key to a positive outcome is to recognize the personal goals that the individual using AAC have for themselves, not only with the specific AAC device (competence), but in all aspects of their lives (home, school/work, community.) What may appear a “good” outcome to most professionals, may not be for the individual using AAC due to the individual’s expectations. In conclusion, there is not one definition for a “good” outcome; the patients, families, and professionals must construct specific goals tailored to the needs and priorities of the AAC user.
- Measuring positive outcomes includes not only goals related to AAC performance and competence, but other factors such as peer/family relationships, work/school environment, and quality of life.
- Communication interaction and linguistic complexity are main components when measuring long-term outcomes for individuals who use AAC.
- “Good” outcomes are tailored to the specific individual using the AAC device.
Lund, S. K., & Light, J. (2006). Long-Term Outcomes for Individuals Who Use Augmentative and Alternative Communication: Part I–What is a ‘Good’ Outcome?. AAC: Augmentative And Alternative Communication, 22(4), 284-299. doi:10.1080/07434610600718693
Lund, S., & Light, J. (2007). Long-term outcomes for individuals who use augmentative and alternative communication: Part II – communicative interaction. AAC: Augmentative & Alternative Communication, 23(1), 1-15.