Jonathan is 71⁄2 years old and attends a regular education second-grade classroom with an aide and special education support. He has normal intelligence and spastic cerebral palsy. Jonathan is very social but does not communicate verbally well because of his dysarthric speech patterns. He is intellectually able to keep up with second-grade classwork, but is unable to do the written work assigned to the class. He has been seen by OTs, PTs, and speech-language pathologists (SLPs) since birth and has made fewer gains in motor control over the past two years. At this time, Jonathan spends most of his school day in his wheelchair, and he is unable to produce any written output. Jonathan is unable to isolate a pointer finger to do computer or blackboard tasks. He has a full-time aide to assist him with writing, mobility, and other physical tasks within the school. Jonathan needs moderate assistance on individual tasks and does not function well in groups. He works well independently and communicates when assistance is needed. One of the teacher’s hopes forJonathan is that he will gain skill in negotiating and compromising, because he has mostly used his augmentative and alternative communication (AAC) device to give directions or answer direct questions to date.Jonathan has extensive rehabilitation needs, including communication needs. As readers learn more about the nature of communication, the interrelationship between communication and other rehabilitation needs will become clear.Jonathan has been using a specialized assistive technology device called an augmentative/alternative communication (AAC) device that allows him to touch a point on a screen to make the device speak preprogrammed words or phrases. The device he has been using is the one he was given as a 2-year-old. Now, this device cannot meet his communication needs. For Jonathan to function effectively in both the school and the community, he must be able to produce language as complex as that of his age peers. His SLP has just upgraded him to a device that allows him to compose grammatical phrases, rather than just using preprogrammed requests. A simple touch screen will not allow him the scope of control options that he needs for this new system. Jonathan is learning to scan and select using a simple switch to build his language. The SLP is involved in programming the device and assuring that he has the vocabulary he needs. However, to use this device functionally, Jonathan must have a way to access it while he is seated in his wheelchair. Placement of the switch, supportive positioning for Jonathan, the mounting of the device on the wheelchair, or the placement of the device on the class desk are all issues that both the OT and PT will need to address. This will involve the assessment of his movement patterns, his energy (and fatigue) levels, as well as an assessment of the environments he usually interacts with. For Jonathan, the new device can enhance his life in many ways, it can allow him to advance academically, it can allow him to communicate at an age-appropriate level with peers, and it can offer him options to continue to develop his language skills. Although the SLP is central to the identification of the best device for Jonathan, the ability for him to have the device when and where he needs it and have a reliable means of accessing it are the domain of both PT and OT practitioners. Without interprofessional communication and collaboration, Jonathan is unlikely to have a communication system that meets his needs.Some questions to consider:1. Why would the OT and PT be involved in helping Jonathan use his new device? Shouldn’t this be the exclusive role of the speech therapist?2. Because many AAC devices are expensive, some school districts do not want to let students take the devices home. How might this impact Jonathan if he is only able to use the device at school?3. Many digital technologies, including smartphones, can read out text typed into them. Would this type of technology be useful for Jonathan? Why or why not?
Jonathan is 71⁄2 years old and attends a regular education second-grade classroom with an aide and special education support. He has normal intelligence and spastic cerebral palsy. Jonathan is very social but does not communicate verbally well because of his dysarthric speech patterns. He is intellectually able to keep up with second-grade classwork, but is unable to do the written work assigned to the class. He has been seen by OTs, PTs, and speech-language pathologists (SLPs) since birth and has made fewer gains in motor control over the past two years. At this time, Jonathan spends most of his school day in his wheelchair, and he is unable to produce any written output. Jonathan is unable to isolate a pointer finger to do computer or blackboard tasks. He has a full-time aide to assist him with writing, mobility, and other physical tasks within the school. Jonathan needs moderate assistance on individual tasks and does not function well in groups. He works well independently and communicates when assistance is needed. One of the teacher’s hopes for
Jonathan is that he will gain skill in negotiating and compromising, because he has mostly used his augmentative and alternative communication (AAC) device to give directions or answer direct questions to date.
Jonathan has extensive rehabilitation needs, including communication needs. As readers learn more about the nature of communication, the interrelationship between communication and other rehabilitation needs will become clear.
Jonathan has been using a specialized assistive technology device called an augmentative/alternative communication (AAC) device that allows him to touch a point on a screen to make the device speak preprogrammed words or phrases. The device he has been using is the one he was given as a 2-year-old. Now, this device cannot meet his communication needs. For Jonathan to function effectively in both the school and the community, he must be able to produce language as complex as that of his age peers. His SLP has just upgraded him to a device that allows him to compose grammatical phrases, rather than just using preprogrammed requests. A simple touch screen will not allow him the scope of control options that he needs for this new system. Jonathan is learning to scan and select using a simple switch to build his language. The SLP is involved in programming the device and assuring that he has the vocabulary he needs. However, to use this device functionally, Jonathan must have a way to access it while he is seated in his wheelchair. Placement of the switch, supportive positioning for Jonathan, the mounting of the device on the wheelchair, or the placement of the device on the class desk are all issues that both the OT and PT will need to address. This will involve the assessment of his movement patterns, his energy (and fatigue) levels, as well as an assessment of the environments he usually interacts with. For Jonathan, the new device can enhance his life in many ways, it can allow him to advance academically, it can allow him to communicate at an age-appropriate level with peers, and it can offer him options to continue to develop his language skills. Although the SLP is central to the identification of the best device for Jonathan, the ability for him to have the device when and where he needs it and have a reliable means of accessing it are the domain of both PT and OT practitioners. Without interprofessional communication and collaboration, Jonathan is unlikely to have a communication system that meets his needs.
Some questions to consider:
1. Why would the OT and PT be involved in helping Jonathan use his new device? Shouldn’t this be the exclusive role of the speech therapist?
2. Because many AAC devices are expensive, some school districts do not want to let students take the devices home. How might this impact Jonathan if he is only able to use the device at school?
3. Many digital technologies, including smartphones, can read out text typed into them. Would this type of technology be useful for Jonathan? Why or why not?
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