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I chose Betty for this project.  Betty is a person with aphasia. She is an engaging client based on her case study. I aimed to find ways for her to engage more with communication partners with my device selection.

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Week 2: Appropriate Device and Application Selection

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Week 2: Appropriate Device and Application Selection

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For Betty, I decided to use the Tobii-Dynavox Indi 7 as Betty's device. Tobii-Dynavox offers Snap Core First with an Aphasia page setting. Betty has many options for communication using this device and application. She is a very positive person who seeks out communication with others, but she just needs more assistance. This device and program will help better Betty's communication with both familiar and unfamiliar partners. Information about individuals with aphasia following a stroke can be found here:  https://www.tobiidynavox.com/en-US/learn/user-conditions/aphasiastroke/

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Week 3: Appropriate Online Training for Tobii-Dynavox and Snap Core First with Aphasia Page Setting

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Week 3: Appropriate Online Training for Tobii-Dynavox and Snap Core First with Aphasia Page Setting

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1. Online webinar that focuses on how to provide effective treatment to individuals with aphasia using both low- and high-tech devices.  https://tobiidynavox-wistia.com/medias/8kp8pd12e5
2. On the Tobii-Dynavox support and training page, there was a video that looked at using Snap Scene with PWA. Even though Betty is using Snap Core First, this video discussed 8 main ideas on what to include on a device with PWA. https://www.tobiidynavox.com/support-training/videos/snap-scene/snap-scene-aphasia/
3. There is a training on the Tobii website that includes training of using Snap Core First with the Indi device. Videos on this site include unboxing, start up/access videos, and the beginning of using Snap Core First. https://www.tobiidynavox.com/support-training/indi/
4. Here is an introduction video that Betty and her family members can use to learn basic information about the device and application. https://www.youtube.com/watch?v=-5BfQ9-fmxk

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1. Series of Youtube videos from Tobii that discuss the use of Snap Core First with the Aphasia page setting. https://www.youtube.com/playlist?list=PLs_sIekvATdz6TS61jjfA-DzbKt9p28pV
2. There is a podcast from the Tobii Podcast Series that discusses aphasia in general, the different types, and the tools that can be used when working with the Snap Core First Aphasia page setting. https://tobiidynavox-wistia.com/medias/b352gks81y
3. Aphasia training cards from Tobii that can provide Betty, her family members, and clinicians with information about aphasia and how to use the Snap Core First with Aphasia page setting. http://tdvox.web-downloads.s3.amazonaws.com/Snap/Training/Aphasia%20Training%20Cards.pdf

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I chose an article that was published in May, 2020 titled, "Revisiting the Role of Augmentative and Alternative Communication in Aphasia Rehabilitation," by Aimee Dietz, Sarah Wallace, and Kristy Wiessling. The purpose of the article was to reassess the use of AAC in aphasia rehabilitation. The authors looked at specific trends in AAC use in aphasia, the LPAA model, using AAC to enhance natural abilities, and the needs for earlier introduction of AAC. Each section highlighted specific considerations that SLP's need to make note of when working with clients with aphasia who may benefit from AAC. This article helped me to understand some other considerations that I need to make for Betty. The use of the AAC device will help Betty re-acquire the independence she has lost, which is one of the main goals for use. I think that this article is strong because it helps clinicians understand all of the areas we need to consider when working with clients with aphasia!

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Week 6: Handout that Describes Alternative Access Features

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Week 6: Handout that Describes Alternative Access Features

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For my handout, I decided to incorporate some short steps with pictures for both set up and the different page settings. I think that this will provide Betty and her family with some basic information about using Snap Core First with the Aphasia Page Set. I included information from the Tobii-Dynavox Snap Core First with Aphasia Page Set Youtube Series. For this basic handout, I included information from four of the videos (Access, QuickFires, Scripts, and WhiteBoard).

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In Snap Core First, the core/fringe vocabulary is organized in Word Lists. These Word Lists are organized by category, so they are easily accessible to Betty. Examples of Word Lists in Snap Core First with the Aphasia Page Set include: names, people, places, nature, my practice words, etc. Once within a category, the options are organized in alphabetical order and in natural groupings. Since the January 2020 release, the developers have decreased the number of words and these words are organized by frequency of use. For Betty, she can use the Word Lists to practice speech and clarify a message. These Word Lists are so important to PWA, so they are displayed as the main screen on this version of Snap Core First. The Word Lists will help Betty with conversation because they are small and manageable for her communication. You can also customize the core vocabulary on the Aphasia Page Set by clicking one of the "My Word List #." Here you can include any words that may be specific for Betty's use, such as family members names. To do this, you will label the list and choose an image. You can then edit the list and add any words and pictures desirable for Betty's custom communication. Besides these options, Betty can also use Quickfires for specific time sensitive phrases, the Whiteboard and rating scales for her to offer input and for her partners to potentially draw or provide written choices, and Visual Scenes that are related to her family and interests.

Tobii Dynavox. (28 January, 2020). Aphasia Pages Word Lists [Video File]. Retrieved on 4 June, 2020 from, https://www.youtube.com/watch?v=ihumV-p61B

Tobii Dynavox. (2020).  The Story of Word Lists. Retrieved on 4 June, 2020 from, https://www.tobiidynavox.com/en-US/about/blog/snap--core-first/the-story-of-word-lists/

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Week 10: Modeling Device and Application for Telepractice

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Week 10: Modeling Device and Application for Telepractice

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This video discusses the Snap Core First with Aphasia Page Set fringe vocabulary option, also known as Word Lists, and how to frame intervention around these lists. In this video, I also discussed the use of the Quickfires and Whiteboard options for therapy as well. Examples on how to use these tools are embedded in the video. To create the video, I used screenshots from the following references:

Tobii Dynavox. (28 January, 2020). Aphasia Pages Word Lists [Video File]. Retrieved on 4 June, 2020 from, https://www.youtube.com/watch?v=ihumV-p61B

Tobii-Dynavox. (June 4, 2020). Snap Core First with Aphasia Page Set Learning Videos. Retrieved on 4 June, 2020 from https://www.youtube.com/playlist?list=PLs_sIekvATdz6TS61jjfA-DzbKt9p28pV

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Week 9: Demo Video Features of Device and Application

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Week 9: Demo Video Features of Device and Application

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The information included in this video comes from the Tobii-Dynavox Youtube series, "Snap Core First with the Aphasia Page Set Learning Videos." I discussed how to access the page set, quickfires, scripts, and the whiteboard.

Tobii-Dynavox. (June 4, 2020). Snap Core First with Aphasia Page Set Learning Videos. Retrieved from https://www.youtube.com/playlist?list=PLs_sIekvATdz6TS61jjfA-DzbKt9p28pV

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1. What makes you most apprehensive about writing a funding report?

Since I have not had any practice or instruction for writing an AAC funding report, I don't feel that I am prepared to write one for Betty. From what I understand, AAC funding reports need to be filled out in a specific way. In order for these reports to be approved, all notes written on the report need to be advocating and relevant. I fear that I would not fill out all of the requirements accurately and effectively, so I would need to have direct supervision for at least my first few reports. I need to have training and practice before I can feel confident writing an AAC funding report.

2. What resources or documentation would help you write this report? Share any links that support your findings.

To write this report, I would need to have information about Betty's background, language skills & abilities, cognitive abilities, physical abilities, hearing & visual status, and daily communication needs. This information is all provided in her chapter of the interactive casebook and will assist me with providing rationale for her AAC device. I also need more information about Betty's previous AAC uses and her experience. This will help me to provide reasoning for the new device, the Tobii-Dynavox Indi 7, based on her previous experiences. I found an example AAC evaluation template that helped me to figure out what I needed for this report at https://aacfunding.com/assets/uploads/Sample_AAC-Eval-blank.pdf .

3. Please include some resources that will help you write your funding report.

For Betty, I chose the Indi 7 through Tobii-Dynavox. The price varies between $1695-$3480. Depending on Betty's financial situation and insurance, this may not be feasible unless I can figure out different ways to cut the cost for her.  https://www.linkassistive.com/product/communication/tobii-dynavox-indi-7/#:~:text=Tobii%20Dynavox%20Indi%207%20%241695.00%E2%80%93%20%243480.00%20Indi%20is,communicating%20right%20out-of%20the-box%2C%20with%20no%20add-ons%20required.

https://efunding.tobiidynavox.com/  This is the Tobii-Dynavox funding website. I would submit Betty's request through this form. It consists of 5 steps: consultation of an SLP (myself), physician prescription, complete & submit funding report, insurance processes packet, and approval and shipping.

http://www.aacfundinghelp.com/  This website offers different options for programs that offer funding for AAC devices. The site has four different sections: Fast Facts, Programs, Report Coach, and General Resources. These options may help me to find different way to assist Betty and her family with funding.

4. What are some funding options through Medicaid/Medicare?

On the same site for Tobii-Dynavox e-funding submission, it explains at the bottom that most TD SGDs are covered by Medicare/Medicaid and private insurance. I would need to do more research to assist Betty with as many options as possible to get the cost of the device down.

https://www.asha.org/SLP/healthcare/Medicare-Speech-Generating-Devices-Information/  This site provides SLPs with information about how to submit AAC device claims to Medicare. As I am unsure of Betty's insurance, and she fits the criteria for Medicare based on her case, this may be an option for Betty's request.

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Week 11: Strengths/Weaknesses to Device and Application

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Week 11: Strengths/Weaknesses to Device and Application

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Strengths:

1.  Since Betty understands information presented with augmented input, she can use the voice feedback system of the device which will help her to listen to/understand what she is expressing to others. The case study also explained that Betty's communication benefits from photos and pictures, which is included on all words/phrases in the program.

2. There are many different types of communication options with the Snap Core First with Aphasia Page Set such as the word lists, Quickfires, Whiteboard. Word lists are a type of fringe vocabulary, which are specific to PWA and adults. The program provides these words within categories (e.g., clothing, home, etc.) so that Betty can easily choose something she wants to talk about. The clinician and the family can also help to set up word lists specific and personalized for Betty, such as the places she has traveled. Quickfires are adult-oriented words and phrases that Betty can use to greet or have a short interaction with someone. The Whiteboard option allows Betty to draw or handwrite responses to others. There are many different options with this program that will assist Betty to have many different communication options.

3. When using the Tobii-Dynavox Indi 7, which is the actual device I would suggest for Betty, a special durability kit can be bought so that there is a lesser likelihood of breaking the device. Since she has some gross and fine motor deficits following her stroke, Betty may have some difficulties with handling the device as she gets older.  This kit contains a snap-on cover for attaching a keyguard to the device and a carry strap will hep Betty carry her device across her body or over her shoulder. This is a great option for Betty to keep her device safe!

Weaknesses:

1. One important weakness is the price of the Indi 7. On the Tobii-Dynavox website, it is listed as ~$1000. Depending on Betty's insurance options and how her family's finances are, the price of the device may be too much for Betty and her family. This needs to be a key consideration when working with Betty.

2. Based on Betty's gross and fine motor limitations of her right arm following the stroke, using her left and non-dominant hand to use the device may be difficult for Betty. There may need to be additionally training for her to use her left hand to tap items on the device.

3. Betty also has worn glasses for some time before her stroke, which may make it difficult for Betty to see all icons easily and find the correct choice with eye scanning. When consulting the number of icons to be shown on Betty's screen, the clinician should take her visual skills into consideration. Showing all icons may be difficult for Betty to manage based on her visual deficits.

These are 3 strengths and 3 weaknesses for using the Tobii-Dynavox with the Snap Core First with Aphasia Page Set program. Although there are weaknesses that are specific to Betty's motor and sensory limitations and financial abilities, this device and program should work great for Betty when looking at her own goals and strengths.

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Week 13: Reflection on Tech Portfolio Assignment

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Week 13: Reflection on Tech Portfolio Assignment

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1.  What did you like most about this experience?

My favorite part of this project was being able to really understand Betty and figure out the best options for her. I was able to take all aspects of her case study into consideration, which assisted my decision-making. I knew that there were a lot of considerations when selecting a device for a client, but this assignment really helped me to fully grasp how much goes into it. I also really enjoyed learning about the device I chose. It is very enjoyable to be able to learn in-depth about a device and its features.

2. What did you like least?

I think my least favorite part was having to screenshot and snip parts of Youtube videos to make my tutorial and telehealth videos. It was extremely time consuming and I wish that the discussion board was written differently. I understand why the assignment was necessary, but it was difficult without the device in person, as well as, decent Internet photos that could assist us. In the future, I hope that there are easier options for students to acquire the materials needed.

3. What aspects of this project were the most challenging or the easiest?

Making the videos was definitely the hardest part of the project for me. I do not have any video editing skills and limited experience, so it was always extremely difficult for me to edit the videos for the assignments. I thought that the easiest parts of the project were the earlier discussion boards, like the device selection and rationale, or making the handout. These were simple, and not as tedious as other parts of the project.

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Betty Section 8: Ohio AAC Funding Report

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Betty Section 8: Ohio AAC Funding Report

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This is the completed section 8 (trial section) of the Ohio AAC Medicaid Evaluation for Betty's SGD.