Tuesday, September 25, 2012

AAC - Start-up

Emma received her long awaited ECO2 with ECOpoint made by Prentke Romich Company (PRC) last week.    There are several posts on this blog about our journey through the Augmentative and Alternative Communication (AAC) process and now that we have Emma's device I thought it would be a good idea to capture our journey of incorporating the ECO2 with ECOpoint into our lives.  For me, the journey into AAC is ridiculously overwhelming and reading posts about other children using these devices has made it a little less overwhelming.  So I've decided to do a series of posts on our journey of learning and using the ECO device.  It'll be a great way to capture Emma's progress and pace of progress and maybe others might learn a bit from our journey, read our story and make some suggestions.

First off, we've named Emma's ECO2 with ECOpoint Evie - short for Emma's voice (EV).  From now on I'll refer to her device as Evie.  Cute, right?  Next off, I'll say that we tried devices from three AAC manufacturers - in addition to the several communication apps we've been using on her iPad over the last 2 years - before we selected Evie.  I'm glad we tried all three because I was ready to select the second one and run with it until Emma's SLP insisted we should test them all.  She was right.  After all the evaluations were completed she wrote a 9 page report on why Evie was the best choice.  The report outlined Emma's testing of the following:

  • Single switches (Big Macks, Step-by-Steps)
  • Her not surprisingly unsuccessful test of units that use page overlays with digitized speech that requires the user to manipulate the overlays on their own - these are called static display LEOs from what I can tell
  • DynaVox V
  • DynaVox Maestro
  • Tobii C12 with CEye
  • ECO2 with ECOpoint
It did not include the results of her DynaVox eyegaze system trial that she had at our local hospital with a different SLP.  It was a nice system but the eyegaze system didn't work as well for Emma's movements as the Tobii and ECO2 which use the same eyegaze camera.  I was a great report and I feel like the AAC assessment was very thorough and reinforced my opinion that Emma is fortunate to be working with such a wonderful SLP in school that specialized in AAC.  The school supports and expertise in our current school district is really top notch.

When we were looking at devices I was mostly concerned about Emma's performance with the device. Unlike our decision on cochlear implant manufacturer to use, I didn't do much research into the manufacturer of the device.  This could have been a big oversight on my part but I'm happy to say that everyone I've dealt with at PRC so far has been wonderful.  They are courteous, respond promptly, and show initiative.  Funding AAC is a bit of a maze and the nice ladies at PRC never tired of my calls to check on our funding progress.  And there were many calls.  I've learned over the last 4 years that when it comes to equipment purchases they rarely go smoothly without me taking an active role in monitoring the process.  When all the approvals came through, PRC called me.  Then they called again to let me know when the unit would ship.  The day after we received Evie our local PRC Consultant called me to set up an appointment to come to our house and help us customize Evie for Emma.  He called me.  Our own PRC Consultant. I didn't know we would have that kind of service and I have to say that my stomach may have done some flip-flops because it excited me so much.  Suddenly the AAC journey seems more manageable.  I read on one of Evie's papers that PRC is employee owned and operated and it really feels that way.  Our PRC consultant will be here tomorrow morning.  I have lots of questions for him and am looking forward to his visit!

But of course I couldn't wait for him to come out to start the device set-up so I met with Emma's SLP yesterday and we discussed some options and ways to set up her device.  Then we programmed it a bit.  We decided on using the Unity 60 1-Hit core vocabulary with lots of the buttons hidden.  This basically means that the screen can have up to 60 icons on it at one time so Emma will be able to say a lot without navigating through a lot of screen.  It also means that Emma will have to learn the vocabulary and get accurate in her eye gaze selections.  For now we have most of the icons hidden.  We've left her some colors, places to go (including bathroom)!, yes/no/good/bad comments, a food selector and a play game selector.  It's a great start.  I was a bit worried that it would be too aggressive for Emma to start with a 60 vocabulary screen.  I initially thought we would start at 45 icons.  But the size difference between 45 and 60 is very minimal and her SLP really thought Emma would be good with the 60 and wanted to start her there.  I love that she believes so much in Emma.  Here is what the home screen looks like.

We also have some Pages programmed in.  One for family so she can call us.  We also plan on adding in some other pages such as books, bedtime routines, etc.  I'm going to discuss this with our consultant tomorrow.

This is a good start.  So far it's been a bit challenging for a few things and I'm glad we started on the set-up because now I have some good questions on settings and such for the PRC consultant.  I wouldn't have had them if I didn't start programming it already.  And Emma's been able to use it the last two days.  So far today she said "yes" during PT which is a big deal because she likes to look at the other kids in the room and ignore the people in her face working with her and the icons are much smaller than we were using during the trial period.  She also told me that she had to "go to the bathroom" and was thrilled when I whisked her off to the potty.  She might not have had to go but she definitely is starting to make the cause/effect connection of that icon selection path and I'm happy about that.  I look forward to seeing her progress towards adding more vocabulary.

There is a great blog post on setting up AAC devices on Adapting Creatively.  Actually, that blog has lots of good posts on many different things but the AAC post I learned a lot from is this one.  Check it out if you are on this communication journey.  It is chock full of good information I wouldn't have though of on my own.

2 Comments from readers:

Anonymous said...

This is just outstanding! I'm so thrilled for you guys and am looking forward to watching Emma's progress! Love that she told you she had to go potty! Congrats to you all on embarking on this journey!

rachellee said...

Hi there, I just found your blog today and I can't stop smiling at your Emma's spunk! My daughter is 11 and has spastic quadriplegic CP. She is non-verbal and very severely affected. I actually found your blog while googling "KidWalk" because I think that is what we are going to get, but then I saw your posts about the AAC!!! I am looking for information about communication devices, and I am so excited to read about your experience with it so far. Love your blog, and so glad you are sharing your experiences with the world!