Abstract
This translational research study examines data collected from 179 interdisciplinary AAC evaluations for children with disabilities during a single calendar year. The study examines the complex needs of children who receive AAC evaluations and identifies OT’s distinct role in accommodating motor and sensory limitations that inhibit a child’s ability to access a device. Results indicate that children benefit from interdisciplinary AAC evaluations and describe device features OT’s can recommend.
Primary Author and Speaker: Christopher Trujillo
Additional Authors and Speakers: Tauni Malmgren, Carrie Westcott, Kellie Moritz
Contributing Authors: Brenda Del Monte, Melanie Conatser, Gina Norris
As the United States healthcare system moves towards outcome-based reimbursement models, occupational therapists (OTs) must demonstrate their distinct value in the assessment and treatment of children with multiple disabilities (MD). Historically, augmentative and alternative communication (AAC) device evaluations have been completed by speech language pathologists (SLP) as communication partners. A focus on communication alone does not address barriers to occupational performance that may impact a child’s ability to access AAC devices. Although some SLPs utilize OTs and physical therapists during AAC evaluations to determine access, this is not a universal standard.
This exploratory study is a post-hoc analysis of a convenience sample of 179 AAC evaluations conducted by one of four companies that provide AAC evaluations in the state of Arizona. In order to establish the distinct value of occupational therapy, an interdisciplinary team of OTs and SLPs collected data during the AAC evaluations they conducted during a single calendar year. The exploratory translational research study identifies the complex needs of children with MD and determined how OTs best assist the evaluation process. The study found that 28% of children who were evaluated for an AAC device had MD and significant diagnoses that impact device usage. Nearly 40% of the children evaluated for an AAC device presented with upper extremity active range of motion and/or strength challenges that required adaptations for access. Notably, the frequency of sensory processing differences that the children experienced was even higher, with 60% of the children diagnosed by an OT as having sensory processing differences during the evaluation. Over 32% of all children who were referred for an AAC evaluation due to communication deficits did not independently ambulate.
Results show that OTs can collaborate with SLPs during AAC evaluations to address challenges that may inhibit device access. While SLPs are communication partners, OTs are needed to improve occupational performance and AAC device access by addressing motor, visual, and sensory systems. OTs can provide adaptations and recommend device features that improve AAC access, which in turn increases inclusion and equitable treatment for children. Reflective practitioners can apply the results of this exploratory study to advocate for OT’s distinct value in AAC evaluations and improve the occupational performance of children with MD who have complex needs.
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American Speech-Language-Hearing Association. (2016). Scope of practice in speech-language pathology [Scope of Practice]. Retrieved from www.asha.org/policy.
Rechetnikov, R. P., & Maitra, K. (2009). Motor impairments in children associated with impairments of speech or language: A meta-analytic review of research literature. American Journal of Occupational Therapy, 63(3), 255-263.