Sunday, September 30, 2012

AAC Week 1 Recap

We've had Evie up an running with Emma for less than a week.  Less than a week.  I have to keep telling myself that because she is doing so well with it.

Overall, Emma is still very excited when we set it up for her to use and we're trying to give her opportunities throughout the day to use it in various circumstances.  I've tried using the eye gaze and it's hard (!) so we want to give her more frequent but shorter duration sessions with it so she doesn't get frustrated.  I'm actually surprised and happy to say that Emma is much better at it than I am - probably because she many of the nuances figured out from using it so much.  She is doing really well when it's just me and her, but is not as interested in using it when Daddy or lots of other people are around which is what we expected.

When the consultant came to the house he was surprised at how far along on the set-up we were.  We were especially happy when he asked Emma what her favorite color was and she said "colors" "pink".  That was a proud Mommy moment ;-)  His visit helped me understand the device more in depth since I was already familiar with  many of the screens.  Two things he did I hadn't known about - there are six numbered buttons on the top of the device that come pre-set with function.  A couple didn't apply to us so he reset the #4 button to toggle on/off the eye gaze tracking.  This means with the touch of an always accessible button we can quickly look to see if the device is positioned correctly to track her eyes.  Right now it is our most used button!  He also reset the #5 button to toggle between pause/active with the eye gaze.  If we are looking at the screen to modify it and the eye gaze is active than it picks up our eyes and moves all about.  This is not desirable and so now we have an easy way to pause and resume the eye gaze for device set-up.

The consultant also showed me how to link some pages - for example there is a great page made up for reading the story Brown Bear and we now linked that to the icon for reading the book Brown Bear - and made really good suggestions on how to incorporate more of the "core" vocabulary instead of programming in so much "fringe" vocabulary.  For meals we are now having Emma say Eat, Drink and Stop in the core vocabulary and the fringe vocabulary has items such as applesauce, cracker, pudding, smoothie, milk, etc.  Previously we were directing Emma to use Eat and the fringe vocabulary of Eat, Drink, and All done under that and it was not idea.  Switching to the core vocabulary coupled with the fringe vocabulary of the cracker, milk, etc. with the Stop core button to mean all done has been good.  I taught this to Emma at snack time on Friday and she told me multiple times that she wanted to eat pudding, cracker no, pudding yes, cracker no.  I kept offering her the cracker even though I knew she wanted her pudding to really reinforce the power of communication for her.  I have to admit that I didn't think she would pick this up so quickly.  Especially since saying "cracker no" requires her to select two icons - the cracker and the no icons.  I thinks he told me 15 things during that one snack and when it was over she clearly said to me that she wanted to "go" "shopping".  Again, requiring her to string together two items.  It was nice to hear she wanted to go shopping and let us have a little *conversation* that I'd love to go shopping with her but we had to stay and clean the house.  This is really fun!  The fact that she is stringing together two words already instead of only one word at a time is really encouraging to me.  I'm looking forward to seeing where Emma goes with AAC and how quickly she gets there.

The eye gaze really opens up her world but it is also limiting.  It has to be placed at a distance of 20-24" from her eyes and in direct line of her vision so we can't just have it sit on her tray table to use it.  We did get a mount for her wheelchair with the device and tried to have it installed the other day but it wouldn't fit with the configuration of her wheelchair.  She has an appointment in two weeks to have her wheelchair changed to the large wheels in the back and smaller wheels in the front so Evie's mount can be installed.  We had the configuration of the wheels in front to give Emma the opportunity to move her chair around a bit with her hands but her arms really aren't that good at moving and so we decided it is much more important to give her consistent access to her talker rather than keep the wheelchair as is with the hope that she might decide to move it.  It will be nice to have a mount for many things, but I'm really looking forward to using it to reinforce communication in public.  I programmed the Greetings line on the talker to say her name, her age, her pets, etc.  Basically, when we are out and people stop to talk with Emma - and trust me, going out with Emma is like going out with a celebrity and everyone stops to talk to her! - she could look at any of that string of icons and say something appropriate.  We do have her OT goals set up so we are working towards a future where Emma might be able to use her hands instead of her eyes to communicate with Evie, but that will likely take some time.  For now we're happy to have the eye gaze option and feel blessed that it is opening up so many opportunities for us to help Emma learn and grow.

Here is a short video of Emma deciding what family member to say "hi" to - notice that she says hi to everyone but Mommy.  She was teasing me which is not surprising at all.  My girl has a silly sense of humor!

Week 1 with Evie was so much better than I thought possible.  I'm starting to see how moving to this system will impact Emma's access to school learning and curriculum in addition to communicating her wants/needs with family and friends.  I'm still praying that she actually starts to talk with her voice instead of AAC but in the meantime we continue to move forward.  

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