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AAC Practice in Michigan:  What Has Changed in 10 years?

The following demographic information about the AAC field was compiled by David Beukelman. Please be advised that this is a selective, rather than a complete, listing.


How Many Persons are Severely Communicatively Disordered?
 
USA 
Canada 
Australia 
United Kingdom 
2 million (8 per 1000) (Estimate) 200,000 (12 per 1000) (Estimate) 12 per 1000 (Survey) 6 per 1000 (Estimate) 

14 per 1000 (Estimate)

How Many are Severely Communicatively Disordered in U.S. Schools?

  • 3 to 5% of students certified for special education
  • 3 to 5 potential AAC users per 1000 of general population
Matas, J., Mathy-Laikko, P., Beukelman, D., & Legresley, K. (1985). Identifying the non-speaking population: A demographic study. AAC, 1, 17-31.

Who are Severely Communicatively Disordered in U.S. Schools?

Persons who are unable to meet their daily communication needs through natural modes of communication such as speech, gestures, or writing
 
Developmentally disabled 14.9%
Physically Disabled 06.1%
Mentally Retarded (MM) 18.3%
Mentally Retarded (SP) 30.6%
Severely behaviorally impaired 05.0%
Severely multiply disabled 24.0%

Matas, J., Mathy-Laikko, P., Beukelman, D., & Legresley, K. (1985). Identifying the non- speaking population: A demographic study. AAC, 1, 17-31.


What Types of Students are on USA University Campuses?
 
Cerebral palsy 82.7% of campuses
Multiple Sclerosis 67.3%
Closed Head Injury 62.2%
Muscular Dystrophy 52%
Shock/trauma/surgery 51%

Huer, M. University students using augmentative and alternative communication in the USA: A demographic study. AAC. 7, 231-239.


Who uses AAC?

  • Acquired disabilities
  • ALS (Lou Gehrigís Disease) 75%
Saunders, C., Wash, T., & Smith, M. (1981). Hospice care in the motor neuron diseases. In C. Saunders & J. Teller (Eds.), Hospice: The Living Idea, London: Edward Arnold Publishers.
  • Multiple Sclerosis 04%
Beukelman, D., Kraft, G., & Freal, J. (1985). Expressive communication disorders in persons with multiple sclerosis: A survey. Archives of Physical Medicine and Rehabilitation, 66, 675-677.

ALS & AAC Use

  • 75% use AAC Systems
  • 1/3 use AAC system less than one year
  • 2/3 use system more than two years
Sitvers, M. & Kraat, A. (1982). Augmentative communication for persons with amyotrophic lateral sclerosis (ALS), ASHA 24, 783.

Demographic Study of AAC Use in Scotland

  • Population: Cerebral Palsy
    •  
    • 61% male and 39% female
  • Recent increase in AAC use
    • 50% of users have had system less than one year
Murphy, J. et.al. (1995). AAC systems used by people with cerebral palsy in Scotland: Demographic Survey. AAC, 11, 26-36.

Type and Use of AAC System

  • More than 50% of all systems were low tech
  • 22% used systems only in formal contexts
Murphy, J. et.al. (1995). AAC systems used by people with cerebral palsy in Scotland: Demographic Survey. AAC, 11, 26-36.

Cause of Communication Disorders (Australia)
 
Unknown  38.0%
Stroke 16.0%
Cerebral Palsy 13.8%
Genetic/congenital  8.8%
Developmental Delay  5.6%
Autism 4.1%

Bloomberg, K. & Johnson, H. (1990). A statewide demographic survey of people with severe communication impairments. AAC, 6, 50-60.

Causes of Communication Disorders (Con't)
 
Progressive neurological diseases 4.1%
Trauma 3.2%
Tumor/Infectious Disease 1.7%
Elective Mutism 1.5%
Psychosis  1.4%
Surgically related 1.1%
Dysfluency 0.3%

Bloomberg, K. & Johnson, H. (1990). A statewide demographic survey of people with severe communication impairments. AAC, 6, 50-60.


Age Distribution (Australia)
 
Years
Percent
2-5 9.9
6-10 12.4
11-17 15.4
18-21 8.8
22-40 26.4
41-60 9.6
60+  17.9

Bloomberg, K. & Johnson, H. (1990). A statewide demographic survey of people with severe communication impairments. AAC, 6, 50-60.


Service Delivery

  • AAC services in 49.9% of SLP settings (ASHA)
  • 87% of SLP work with persons needing AAC services
Silverman, F.
  • 60% of SLP in Michigan serving AAC clients
Gorenflo & Gorenflo
  • 44% of SLPs in Nebraska have AAC client on school caseload at the time the survey was completed
Simpson, K., Beukelman, D., & Bird, A. (1998). Survey of school speech and language service provision to students with severe communication impairments in Nebraska. Augmentative and Alternative Communication Journal, 14, 212-221.

Service Delivery--SLPs with adults who use high tech systems on caseload
 
Number of Users Percentage of SLPs
None 76
One 12
Two 01
Three 01
Six 01
Ten 01

King, J. (In preparation). University of Nebraska, Lincoln.


Service Delivery--SLPs who monitor adults with high tech
 
Number of Users Percentage of SLPs
None 78
One 05
Two 05
Three 01
Four 01
Six 01
Ten 01

King, J. (In preparation). University of Nebraska, Lincoln.


Service Delivery--SLPs with adults who use low tech systems on caseload
  425 

King, J. (In preparation). University of Nebraska, Lincoln


Service Delivery--SLPs who monitor adults with low tech
 
Number of Users Percentage of SLPs
None 63
One 04
Two 01
Three 03
Four 01
Five 01
Ten 01
Twelve 01
Fifteen 01

King, J. (In preparation). University of Nebraska, Lincoln


Consumer Response to AAC Devices

Respondents by Diagnosis
Diagnosis Percentage
Cerebral Palsy 53
Taumatic Brain Injury 21
Neuro (Stroke, neuromuscular disease) 17
Other (spina bifida, MR) 9

Jinks, A. & Sinteff, B. (1994). Consumer response to AAC devices: Acquisition, training, use, and satisfaction, AAC, 10, 184-190.


Respondents by Age
Age Percentage
3-9 24
10-19 31
20-29 13
30-39 12
40-49 8
50-79 12

Jinks, A. & Sinteff, B. (1994). Consumer response to AAC devices: Acquisition, training, use, and satisfaction, AAC, 10, 184-190.


Amount of Training Received
 
Hours of Training Percentage
none 13
1-2 23
3-15  14
over 15  50

Jinks, A. & Sinteff, B. (1994). Consumer response to AAC devices: Acquisition, training, use, and satisfaction, AAC, 10, 184-190.


Satisfaction
 
Patient Characteristics Percentage
Cerebral Palsy 78
TBI  42
Neuro 71
Other 86

Jinks, A. & Sinteff, B. (1994). Consumer response to AAC devices: Acquisition, training, use, and satisfaction, AAC, 10, 184-190.


Satisfaction by Age & Gender
 
Children  80%
Adults (20yrs+) 44%
Female 82%
Male 57%

Jinks, A. & Sinteff, B. (1994). Consumer response to AAC devices: Acquisition, training, use, and satisfaction, AAC, 10, 184-190.


Family Perspective on AAC (Young Children)
 
Relationship to child Mother Father
Biological 87.9%   84.6%
Other (foster, adopted) 12.1% 5.4%
Age 38.4 yrs.   40.5 yrs.

Angelo, D. et.al. (1995). Family Perspectives in AAC. AAC. 11, 193-201.


Family Perspective on AAC
 
Employment Status Mother Father
Employment (Full-time) 30% 90%
Employment (Part-time) 24% 2%
Employment (Not Employed) 45.3% 8%

Angelo, D. et.al. (1995). Family Perspectives in AAC. AAC. 11, 193-201.


Family Perspective on AAC (Young Children)

  • Fatherís Priority Needs
  • Increasing AAC device knowledge
  • Planning future communication needs
  • Finding volunteers
  • Getting funding for devices and services
  • Knowing how to teach child
  • Integrating assistive devices at home
  • Develop community awareness
  • Finding advocacy groups
  • Finding trained professionals
Angelo, D. et.al. (1995). Family Perspectives in AAC. AAC. 11, 193-201.

Family Perspectives on AAC (Young Children)

  • Motherís Priority Needs
  • Integrating assistive device into community
  • Developing community awareness and support
  • Increasing knowledge of assistive devices
  • Planning for future needs
  • Getting computer aids for child
  • Finding advocacy groups
  • Coordinating therapies and services
  • Knowing how to operate an assistive device
Angelo, D. et.al. (1995). Family Perspectives in AAC. AAC. 11, 193-201.

Family Perspectives on AAC (Adolescents and Young Adults)
 
Rank Orders Mother Father 
Integrating devices into educational settings * 4
Planning for future communication 5 1
Getting computer access * 5
Social opportunities with other device users 3 *
Social opportunities with nondisabled peers 1 *

Angelo, D. et.al. (1996). Family perspectives in AAC. AAC. 12, 13-22.


Peer Attitudes Toward AAC

  • High tech not viewed more positively than low tech devices
  • Girls more positive than boys
  • Students from integrated classrooms more positive than those from segregated classrooms
Beck & Dennis (1996)

Pre-professional Preparation of Speech Language Pathologist

  • All USA speech language training programs surveyed
  • 58% responded
Ratcliff, A. & Beukelman, D. (1995). Preprofessional preparation in augmentative and alternative communication. AAC. 61-73.

Academic Course Profile

  • 15% taught more than one course
    •  
    • (Intensive Group)
  • 67% taught only one course
    •  
    • (Concentrated Group)
  • 8% infused AAC content in other courses
    •  
    • (Infused Group)
  • 11% taught no course
    •  
    • (None)
Ratcliff, A. & Beukelman, D. (1995). Preprofessional preparation in augmentative and alternative communication. AAC. 61-73.

Intensive Group

  • More AAC technical lab time
  • Require more technical competence
  • 50% of programs with multidisciplinary focus
    •  
    • 59% SLPs
    • 56% of all training grants
  • Most favorable ratings for clinical competence
Similar to voice, fluency, and adult neurogenics
Ratcliff, A. & Beukelman, D. (1995). Preprofessional preparation in augmentative and alternative communication. AAC. 61-73.

Intensive Group (con't)

  • Largest faculties (9)
  • 45% of students abtain AAC clock hours
  • 44% of theses
  • 44% of dissertations
  • 52% of SLP students prepared for AAC caseload
  • Less likely to add faculty
Ratcliff, A. & Beukelman, D. (1995). Preprofessional preparation in augmentative and alternative communication. AAC. 61-73.

Concentrated Group

  • 67% of total sample
  • 48% of SLP students able to carry AAC caseload
  • 41% of students obtain AAC clock hours
  • 22% were multidisciplinary in focus
  • 28% of theses
  • 4% of dissertations
Ratcliff, A. & Beukelman, D. (1995). Preprofessional preparation in augmentative and alternative communication. AAC. 61-73.

Infused Group

  • 10% or less class time to technical learning
  • Smallest faculty (6)
  • 13% of students obtain AAC clock hours
  • 0% of theses
  • 0% of dissertations
Ratcliff, A. & Beukelman, D. (1995). Preprofessional preparation in augmentative and alternative communication. AAC. 61-73.

Journals Used by Pre-professional programs
 
Journal Special Education SLP
AAC 34% 44%
JSHR 0% 17%
JSHD 35%  13%
SLHS in Schools 0% 11%
Seminars in Sp & Hrg 0% 5%

Koul, R. & Lloyd, L. (1994). Survey of professional preparation in augmentative and alternative communication in speech pathology and special education programs. 3, 13-22.

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