JCPSLP November 2017

Supporting social, emotional and mental health and well-being: Roles of speech-language pathologists

Partner assisted scanning Enable the unexpected Helen Bayldon and Sally Clendon

Partner assisted scanning (PAS) is a strategy used with people who have complex physical, cognitive, and sensory needs (CPCSN) to enable expressive communication and facilitate language learning. This paper describes how and why PAS may work for individuals with CPCSN. It outlines some of the barriers to augmentative and alternative communication (AAC) intervention for individuals with CPCSN who may use PAS. Finally, the paper presents factors to consider when implementing AAC with PAS, including considerations for the design of AAC systems with reference to research findings and advice from clinical experts. I n the past few years, partner assisted scanning has become more widely used as an access method, however, it is still not well understood by speech- language pathologists, or others, who support individuals with complex physical, cognitive, and sensory needs (CPCSN) (Nevers, 2016). There is very little literature that describes PAS as an intervention strategy, and thus, limited discussion of its efficacy. However, several clinical experts (e.g., Burkhart, 2016; Farrall, 2015; Porter, 2012; and Zangari, 2016) have suggested that when combined with a robust augmentative and alternative communication (AAC) system, PAS is a strategy that supports language learning and communication in children with complex communication needs and multiple challenges. The number of individuals with CPCSN is relatively small in New Zealand. In 2015, approximately 1.1% of the total school population received Ongoing Resource Scheme (ORS) funding, which provides the very highest level of support for students needing special education. Of those 8,525 students, nearly a quarter (2005, or 23%) received very high ORS. These are the students with the most complex physical, vision, hearing, language or learning needs (Education Counts, 2016), and for whom PAS may be a useful strategy to access communication. In this paper, the authors describe the key aspects of PAS and the rationale for using this strategy. Some of the barriers that inhibit AAC intervention with individuals with CPCSN, and how PAS may offer a solution, are also

discussed. Clinical implications for those working with individuals with CPCSN, including considerations for the design of the vocabulary set, the choice of selection method, and training for communication partners in how to provide an environment that supports aided language development, are presented. What is partner assisted scanning? Communication is a complex process that involves four observable components. People take turns being receivers (listeners) and senders (speakers) of information (the message) via a means of communication (e.g., speech, writing, gesture, sign, accessing a communication device) (Beukelman & Mirenda, 2013; Burkhart & Porter, 2006; Light, Beukelman & Reichle, 2003). The information component starts with the sender’s intent, and requires the coordination of attention and a sophisticated set of motor movements to access the means of communication and thereby relay the intent to the receiver. When individuals with developmental or acquired disabilities cannot use typical motor movements to speak, write, gesture or sign, they may use aided language strategies as a means of communication to relay their messages. Aided language includes the use of pictures, objects, photos, written words or braille to represent words, phrases or concepts. The bank of symbols that are available is called the vocabulary set and this may be organised into an AAC system such as a communication book or device, or taken from the context or environment and offered as a list (Burkhart, 2016). The items selected for a particular individual need to reflect his or her communication needs, which are dependent on age, cultural background and environment (Light & McNaughton, 2014). Individuals who use AAC indicate their choice via direct selection or indirect selection through scanning. Direct selection involves touching or pointing (for example, with a finger, head tracker, eye pointing [including eye gaze technologies], or optical pointer) at the desired item and is the simplest and most “direct” method for making a selection (Treviranus & Roberts, 2003). Direct selection is often the first choice for access to an AAC system, as it is operationally simple and more efficient. However, for some people with significant motor impairments that inhibit or compromise direct selection, indirect selection via scanning (switch or partner assisted) is a viable option (Dropik &

KEYWORDS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION

COMPLEX PHYSICAL,

COGNITIVE, AND SENSORY NEEDS

PARTNER ASSISTED SCANNING

THIS ARTICLE HAS BEEN PEER- REVIEWED

Helen Bayldon (top) and Sally Clendon

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JCPSLP Volume 19, Number 3 2017

Journal of Clinical Practice in Speech-Language Pathology