Augmentative and Alternative Forms of Communication

Dysarthria is an umbrella term for a group of related motor-speech disorders caused by damage to the cerebellum, cortex, brainstem or peripheral nervous system that results in impaired control of motor movement needed for speech.

Treatment for this disorder primarily focuses on advancing intelligibility and improving speech-motor control. However, for patients with a severe form of this impairment, developing functional communication through augmentative or alternative means of communication may be priority of intervention (Roth et al., 2021). 

Augmentative and Alternative Communication (AAC) is an example of an evidence based support for people with motor speech disorders such as AOS (Hanson & Fager 2017).  

While AAC comes in many forms (no tech, low tech, high tech) and is offered through a multitude of companies and devices, a quick and simple example of a high tech communication modality is the application AlphaTopics AAC by Tactus Therapy. 

Evidence Based Practice

The AlphaTopics AAC app incorporates both alphabet and topic cues which have been shown to improve speech intelligibility for individuals with dysarthria (Hustad, 2005). This app is designed with the idea in mind that the AAC user can touch the first letter or first few letters of a word they want to say and the listener can detect what word the user is attempting to convey by listening or seeing. This idea is known as alphabet supplementation and has been shown to increase speech intelligibility at the word level by 11% and at the sentence level by 26% (Hanson et al., 2004). 

Example Client Profile

This communication modality works best for someone with a severe form of dysarthria whose language skills are virtually unimpaired and simply need help providing extra clues to their listener in order to be understood. 

Example Goal

Tom will participate in conversation using his AlphaTopics AAC app at 80% intelligibility given frequent maximal verbal cues in order to communicate thoughts, feelings, and needs as recorded by clinician and family data. 

Materials needed

• iPhone, iPad, android 

• AlphaTopicsAAC app available for download for $2.99

Example of data sheet for tracking client's progress towards goal above:

References

Hanson, E. K., & Fager, S. K. (2017). Communication supports for people with motor speech disorders. Topics in Language Disorders, 37(4), 375–388. https://doi.org/10.1097/tld.0000000000000137

Hanson, E. K., Yorkston, K. M., & Beukelman, D. R. (2004). Speech supplementation techniques for dysarthria: A systematic review. Journal of Medical Speech-Language Pathology, 12(2), IX-XXIX.

Hustad, K. C. (2005). Effects of speech supplementation strategies on intelligibility and listener attitudes for a speaker with Mild Dysarthria. Augmentative and Alternative Communication, 21(4), 256–263. https://doi.org/10.1080/07434610500194854 

Roth, Froma P., and Colleen K. Worthington. Treatment Resource Manual for Speech-Language Pathology. Plural Publishing Inc., 2021.