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Assessment of cognition and follow-up of AAC interventions in two children with visual impairments

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Aim: Having a mean of accessing AAC aids is crucial when dependent on aided communication, but available options are severely restricted when children have no or extremely limited voluntary control over limbs, head, facial muscles, eye motor muscles and sound production. The aim is to present the assessment process and interventions for two children with such severe visual, motor and speech impairments.
Method: Two boys, now five and seven years of age, with rare genetic conditions that affect all areas of functioning were followed for two and five years. Both have very severe motor disturbances; they are not able to sit or to hold their head without support, produce meaningful sounds or use their hands for voluntary movement. The assessment and intervention processes will be described and illustrated with video clippings.
Results: They both are perceived as belonging to the expressive AAC user group and are in need of AAC, but have severe difficulties in accessing aided communication. A step-by-step program aimed at increasing eye motor control, use of vision and yes/no-response is suggested. The small, but important, improvements achieved by this program will be presented and the ensuing consequences for aided communication.
Conclusion: Assessment and development of suitable AAC interventions can be a process that takes several years when children have the most severe speech, motor and visual impairments, but it is crucial that the attempts are not abandoned too soon, as even minor improvements in physical functioning can prove vital for AAC access.


Lisbeth Seeland    
Department of Child Neurology, Oslo University Hospital

Hilde Aven Lillehaug    
Department of Child Neurology, Oslo University Hospital

Kristine Stadskleiv    
Department of Child Neurology, Oslo University Hospital


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