Summary of specific EBP used during therapy as a graduate clinician. Developed own low-tech AAC device for pediatric child with cerebral palsy based on current research. The purpose of the development was to provide her with means to communicate until she receives a high-tech AAC device.

1. Brittany Janowski SPRING 2010 Evidence Based Practice

2. Client Information KH 3:8 Cerebral Palsy; motor speech disorder Little to no functional speech Status at the beginning of semester: Sign vocabulary of approx. 35 signs (mostly nouns) /jae/ & /nae/ to answer yes/no questions Guessing game No type of AAC device used

3. The need for more.... Signs/speech did not reflect her ability level She has no cognitive deficits & receptive vocabulary is at age appropriate level Vocabulary increasing, MLU should be increasing Prevention of communication breakdowns The answer....Alternative Augmentative Communication (AAC) device

4. Hesitations No previous experience with AAC devices or board maker software No in depth coursework involving AAC devices Thus, no idea where to begin.... Perfect opportunity for EBP

5. Clinical Question Population Intervention Outcome For children with little to no functional speech(P) , what is the best process of design for an AAC device(I) to facilitate communication outcomes during therapy (O)?

6. Vocabulary Selection Vocabulary selection for augmentative communication systems: A comparison of three techniques. Enhancing vocabulary selection for preschoolers who require augmentative and alternative communication (AAC).

7. Results Article #1) Vocabulary checklist was most effective in comparison with blank sheets & categorical tools, Parents provide the most vocabulary information. Article #2) Vocabulary Selection Questionnaire allows one to efficiently select appropriate, meaningful vocabulary by combining vocabulary selection methods . Parents provide most information.

8. Color Cues Article 3: The effect of color cues on typically developing preschoolers’ speed of locating a target line drawing: Implications for augmentative and alternative communication display design

9. Results Color characteristics of certain stimuli influence reaction time of locating target symbols Foreground color Background color (relevance)

10. Item Example

11. How was this information applied? Discussed AAC device with the parents (needs, benefits) Sent home the Vocabulary Selection Questionnaire Used board maker software to compile personalized boards based on VSQ Used specific color cues within design of each board

14. Next Steps Electonic AAC device Dynavox Use current design as a guide for limitations/improvements Parent Training

15. References Beukelman, D.R., Mirenda, P., Morrow, D.R., Yorkston, K.M. (1993), Vocabulary selection for augmentative communication systems: A comparison of three techniques. American Journal of Speech-Language Pathology, 2, 19- 30. Fallon, K.A., Light, J.C., Paige, T.K., (2001), Enhancing vocabulary selection for preschoolers who require augmentative and alternative communication (AAC). American Journal of Speech-Language Pathology, 10, 81-94. Thistle, J.J., Wilkinson, K. (2009). The effect of color cues on typically developing preschoolers’ speed of locating a target line drawing: Implications for augmentative and alternative communication display design. American Journal of Speech-Language Pathology, 18, 231-240. doi: 10.1044/1058-0360