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COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER, 2000 idan "ar={=Xere) nal=M [ale( =)e l-tate(-1a)m@r-lale mate) mCio m Blom hw g PETER LINDSAY, SHIRLEY ter access, telephone arrangements, independent person 1s “not subject McNAUGHTON, ANN RUNNING, etc. In contrast, we also discussed to the authority of another’. When MIRIAM RUNNING the concept with Bob Gibbons, the we asked Annette Lindsay, wife of father of a 24-year-old verbal Peter Lindsay, and Bob Gibbons for This time we decided to combine women with autism. Elizabeth is their definitions, interestingly they our editorial with the feature. In able to look after all her personal both gave the same one “being able fact, we decided to write the fea- needs, walks, talks, sings, accesses to make one’s own decisions and ture ourselves with the help of books and TV as she desires, and act on them’. Annette and Bob others so that we could explore the volunteers in the community daily stressed that being able to act on full implications of the topic of with a support worker. Bob is one’s own decisions 1s as important independence. We were delighted currently facing the question of as making them. But does the action at the contribution of the other what independence means to his have to be undertaken solely by the associate editors to this issue and daughter. How much “independ- person without any assistance from feel particularly fortunate that ence” will be possible for her? How others, for the individual to be truly Nola Millin had been asked to do a can he maximize her opportunities “independent”? Ann and Miriam presentation on the topic and was to achieve as much independence Running talked about similar issues willing to share it with us. We were as her abilities allow? and used terms like “self determin- also pleased to find so many other In the writing of this feature, we ing” and “free” to describe inde- “contributions” by AAC users in were also assisted by the thoughts pendence. They also insisted that previous issues of Communicating of many persons who have shared whatever independence is, it is Together. their life experiences in the pages of important that one strives for it. ast spring, when the Communicating Together through According to both dictionaries and associate editors agreed the years. Finally we thought about people then, independence seems to enthusiastically upon the what independence means to us be about being free to make choices theme, “Why become independent personally. Is it really any different in one’s life. We seem to feel that it and how to do it?” we all took for for those of us who (currently) have is very important for mature adults granted that we knew what “inde- no major disability and those who to be able to make their own choices pendence” was. As the time for have different types and degrees of and to manage their own affairs. producing this issue approached, disability? Is anyone really “inde- As we discussed the issue more however, we began to realize that pendent”? What do we mean by deeply, the question kept surfacing “independence” wasn’t as straight- independence, anyway? Why try to of whether anyone, speaker or AAC forward as we had thought! For our become independent? If we decide user, non-disabled or able-bodied, feature article, we decided to involve to try, how do we go about it? And was really independent. Is anyone a number of persons in order to perhaps, the most important ques- really totally free to make whatever examine several facets of independ- tion, “What kind of independent choices they want? What about the ence and their implications for person would we like to be?” constraints of their social obliga- persons with disabilities. As is our tions, their responsibilities? What What is Independence? custom, we are giving our attention about the constraints of family, The dictionary is always a good to AAC users in particular. We finances, and conscience? Maybe starting point for a discussion such began by having a conversation with the only differences in independ- as this. According to the Oxford Ann Running, an AAC user with ence for persons who have a disabil- cerebral palsy in her thirties, and her American Dictionary (1998), ity or who use AAC and persons independence can be defined as mother Miriam. We asked them what who are able-bodied are in the kinds “not dependent or controlled by they thought about the concept of of constraints they face and the another person or thing”, “self independence and the role it played areas of their lives in which they governing”. The Funk & Wagnalls in both of their lives. Ann lives in a face them. In the end, we even Standard College Dictionary (1968) group home and requires total questioned whether total independ- adds such synonyms as “autono- support for her personal care, feed- ence would be, in fact, a positive mous” and “self-determining”. The ing, wheelchair movement, compu- 2 COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER 2000 thing! Maybe, as the song says, I. Independence in Daily Living course, freedom of choice in this freedom is “just another word for Activities area is critical. Selecting what TV nothing left to lose”. And maybe, a In talking with Ann Running, we program one watches, what CD one life divorced from the interdepend- learned of the many choices that she listens to, what movie one goes to ence of one’s family and commu- feels are important with regard to see can make all the difference in nity members would not be so dressing, eating, grooming. For an one’s feeling of “independence”’! great! Finally, before we leave the AAC user such as Ann, who is When it comes right down to it, thought of “interdependence”, let’s severely limited physically, we independence in daily living activi- remember the strong programs know independence can be greatly ties may simply require care-givers based on the work of interdiscipli- enhanced through her having taking the time to listen, and under- nary teams within AAC clinics. Too choices as to what she wears, what lying this, recognizing and respect- much “independence” within these and when she eats, when she gets ing the AAC user’s rights and settings can be a liability! up and goes to bed, when she has a wishes! bath, etc. We recognize the need for Perhaps most important in Independence for AAC Users schedules within group homes and relating to independence in daily In what follows, we examine we know the time it takes for staff to living activities is the opportunity to areas in the lives of AAC users in “listen” to an AAC user. We know, choose where one lives. In Ontario which they seem to have varying however, of group homes in which at the present time, supported opportunities for choice and inde- time is allotted in the schedule for housing for AAC users is in very pendent action. We explore three the AAC user to specify her/his short supply due to a freeze on areas in particular. The first is the wishes regarding dressing, eating government-supported housing area of day-to-day personal care and grooming. In group homes initiatives. Most of the AAC users and activities. This 1s the area where where this does not occur, we have we know feel they are lucky to have the physical limitations of many to assume that it is either a matter of a place to live. Some are satisfied AAC users would seem, on the habit or convenience, not a matter with their living arrangements. surface at least, to have the most of inherent constraints. Many others would like to make a dramatic impact on their opportuni- Within the area of daily activities, change, but that option is not avail- ties for independent action. The we cannot forget recreation and able to them. For some, the need to second area 1s that of socializing entertainment. Technology can play move is urgent due to the poor and interpersonal relationships. a vital role in this area. As with other health of family members who now Making friends and having satisfy- activities of daily living however, care for them. But no residential ing social relationships is fundamen- the understanding and support of openings are available to them. In tal to being human. We have often care-givers is essential. Environ- situations such as this, independ- been told by AAC users that this is mental controls can provide the ence is impossible. The feelings of an area that is extremely important capability for opening the door to AAC users in these situations are to them, and that it is one of the guests, turning on the television or those of being totally dependent most difficult areas for them to deal CD player, and computers offer upon the decisions of others. In this with. opportunities for games, art, music, case, the dependency arises from The final area we discuss 1s “travel”, reading and writing. Care- government policy that disregards independence of mind. This is an givers must ensure that the technol- the needs of individuals who are area where, hopefully, AAC users ogy is kept in good working order, unable to finance their own living have the greatest potential for however, and be available to assist arrangements. Their dependence is independence, freedom and choice. when problems arise. How many of the most formidable kind; it is We examine the kinds of constraints AAC users do you know who have inherent within the societal struc- that seem to operate in these differ- equipment that is nonfunctional ture. ent areas and the extent to which because of inadequate care given to Second in importance to an these constraints are a matter of it by the individual’s care-givers? overall sense of independence for convenience and habit or are, in Independence for AAC users in many AAC users, is the ability to fact, inherent in the situation. recreation and entertainment relies select and direct their care-givers. as well upon some physical assist- Pilot programs in Ontario are ance from time to time. And of giving the authority to manage COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER, 2000 3 their care-giver staff to a small weddings, visits to former school- tronic medium. For those who are number of individuals with dis- mates’ residences, social gatherings print literate and who have comput- abilities. Funding for this purpose is with other AAC users, are all be- ers, this is already beginning to directed to the individual, who in coming more rare, as the mechanics happen. A wonderful example turn is responsible for hiring, train- of getting to locations in other appeared in the March, 1998 issue ing, or discontinuing the services of districts and personally paying for of Communicating Together in the a team of care-givers. This begin- care-givers make all but occasional feature article by Anne Abbott, Sex ning of economic “independence” outings impossible. and the Woman with Disabilities is a very positive step. It can only be A revealing indication of the (pp. 4-6). hoped, it will become available to range of friends that are possible for Ann Running is making the many more persons with disabilities an AAC user can be seen by listing opportunities to socialize more and who are prepared to assume the those who are considered friends to enlarge her circle of friends. She, responsibilities involved in order to and examining how often they are along with her mother and the gain this type of independence. It is seen. All too frequently the second author of this article, are an important “how to” when it “friends” are close relatives, profes- initiating a “Friends” music group in comes to independence in one’s sionals who are currently or have in Toronto. The Ontario Federation for daily living. the past worked with the AAC user, Cerebral Palsy is providing the relatives of these professionals, and funding for a pilot program, and ll. Independence in Socializing volunteers. Few are able-bodied letters of invitation are in the mail as and Interpersonal Relationships. peers. Few friends with whom the we write this piece. Ann was 1m- The area of friends and social AAC user has regular contact are pressed with the Friends music relations is another very important other AAC users. Often fellow group of Kitchener-Waterloo, both one for many AAC users we know. students or fellow residents from in hearing them and in reading In far too many instances they have many years past are considered about them in the Winter 1998 issue very limited opportunities to make friends, even though there has been of Communicating Together. She friends with peers, be they able- no contact possible since leaving the decided she wanted to belong to bodied or physically disabled. For school or residence. The opportuni- such a supportive group of friends those living at home with their ties to see any friends are rare and in Toronto and took the action family, the circumstances that made visits with other AAC users are needed to make it happen. Ann also it difficult for them as children to often only yearly or biennially. The takes action on Thursday mornings have a wide range of experiences opportunity to make a date inde- when she becomes a “greeter” at the (difficulty of transporting a wheel- pendently or to see a friend inde- Bloorview-Macmillan Centre. chair in a family car, inaccessible pendently rarely if ever exists for There, she and her mother meet homes of friends, limited public many of the AAC users we know. parents who want to talk about their transportation, energy and time of Even “talking” with a friend children’s problems and have family members) become intensified independently can be next to impos- discussions in which Ann’s and as parents grow older and siblings sible. This has been one of the Miriam’s experiences can be shared. have increased responsibilities with strong motivating forces behind the We know of another AAC user who their own families. Opportunities for work by the first two authors to volunteered in a hospital as a guide independent socializing are practi- develop BlissInternet. Other soft- during his summer community cally nonexistent for many AAC ware for Blissymbol communication college vacations. users living at home. Even when via the Internet is being developed These types of opportunities social events are attended without in The Netherlands and Sweden. offer a little bit of independent family members, it is usually in the The goal with this software is to socializing. Even so, for the person company of a paid care-giver. ensure that socialization is not who is not physically independent, For those living in residential dependent upon physical access or these outings still require a compan- settings, staff shortages and reduced upon print literacy. In time, as more ion, be it a family member, a volun- transportation services are limiting AAC users gain access to the teer or paid staff. One need hardly the kinds of personal outings that internet, it is hoped that their inde- ask the question, “Why become used to be possible before the pendence in socialization will be independent?” in this context. Who funding cuts in Ontario. Family increased, at least within the elec- 4 COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER 2000 among us does not cherish the As we thought about social- adults. Knowing the independent intimate moments we have one-on- ization independence, we also spirit of many of her students, one with friends? “How to do it?” thought about sexual independence Sherri’s greatest contribution is in for AAC users with severe physical and the many challenges faced by providing the environment in which impairments has to be responded to AAC users in this area. The article independence of mind can develop by “finding the right technology”! referenced above by Anne Abbott and flourish! Group discussions Whether it be light tech. (a spelling, and other articles in the March 1998 about the local and international picture or Bliss communication issue of Communicating Together news, advocacy issues in the To- board) or high tech. (computer, focus on this topic. This issue of our ronto area, and the challenges of VOCA), independence can only be magazine was particularly insight- independent living, ensure that this gained by an AAC system that ful. For current subscribers who do educational program relates directly matches the individual’s capabili- not have this back issue, we would to issues in the lives of Ann and her ties, and is “friendly” to friends! be pleased to mail it upon request. classmates. Instruction relating to Often, the level of technology Independence in this area begins in literacy, communication and each that is preferred will depend on the having knowledge and in being able individual’s technology is individu- situation. For one-on-one conversa- to communicate one’s feelings. The alized, but much attention is given tions with friends, frequently the personal sharing offered by the to group activities and socializing. quiet private communication board contributors to the March 1998 Throughout the years, we have is preferred. When socializing in a issue of Communicating Together seen many examples of independ- group situation on the other hand, make a valuable contribution in the ence of mind expressed in the the VOCA may be much more area of sexual independence for articles written by and about AAC appropriate. Independence relies on AAC users. Their ideas relate very users! We thought we would select being versatile and proficient in the well to the last area of independence a few from past issues of Communi- technology that is used. To quote we are considering here. cating Together to illustrate the Ann, “I count on my Freestyle variety and depth of their thinking lll. Independence of mind computer to write my own ideas and on this topic: The body may be constrained say what I think and feel. I want to but the mind can be free. We had to plan my social life and what I do. In Ruth Sienkiewiecz-Mercer begin this way, for it is in this area restaurants, I love to place my own (1991) of independence that AAC users order from the menu using my From her book co-authored with can have an equal playing field to computer!” Steven B. Kaplan, / Raise My Eyes that of able-bodied persons, if we As we discussed peers as friends, to Say Yes, p. 224-225 but ensure that their communication we wondered how the situations of system is adequate to meet their “Now I am getting an education. AAC users who attended integrated potential. Ann and Miriam Running I go grocery shopping for versus segregated schools during gave us many examples of the myself, and my personal care their formative years, differed by the intellectual independence that is attendants ask me what I want time these individuals were in their fostered in the Adult Education to do and when I want to do thirties. We welcome any thoughts program at Seneca College, which it......All of the people still in this area from our readers. For all Ann attends four days a week. How living at the State School of us, how many of our school critical to this independence are should be moved out, and all friends remain with us throughout ongoing educational opportunities of the money now being spent the years? What is the situation for and ongoing upgrading of commu- at the institution should be those attending segregated schools nication and literacy abilities. Here, directed at the handicapped or classes? What is the situation for technology plays a vital role, but so living in the community. The those integrated through their school does the enlightened instructor! For State School should be torn years? For many of our AAC users Ann, this person is Sherri Parkins. down brick by brick.” in Ontario, integration was not an Sherri Parkins is a very gifted option during their early school teacher and caring human being. years, SO Comparisons were not She gives much more than literacy possible. instruction in her program for AAC COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER, 2000 5 Andrew Murphy (1992) Nola Millin (1993) Because of my Blissymbolics Associate Editor, Communicating “What does the future hold? Together. and Touch Talker, I was able Everyone thinks about the to have an active part in future. We all hope and try to “If you are a child, adult, parent, Mom’s funeral. I met and plan for a better life. What that teacher, clinician, able-bodied, communicated with people means to each of us will vary. I non-verbal, regardless of who who came to support us in am no different and spend a lot you are or what condition you love... . My experience of time thinking about my might have, you will experience showed me that being able to future. Thinking about finish- change. Isn’t it wonderful? communicate helped me to ing my education so I can get a Everybody is equal when it feel independent and more in job. Thinking about developing comes to the experience of control at this very hard the skills so I can live on my change. As I already mentioned, tines own, with help of course, what we differ so drastically in Susan Foster Odell (1995) thinking about making new is our ability to cope, or in some In memory of Susan Odell, Carol friends and staying in touch cases not to cope, with change. Lynn Katsios wrote: with my old friends, thinking It seems like our society 1s about seeing more of the world facing a greater amount of “Sue was born with cerebral and how I can make it a better serious changes than ever palsy. She couldn’t walk. place.” before and from what ['m She couldn’t talk. In fact, seeing, a lot of people are Sue couldn’t do the things Kari Harrington (1993) having difficulties in knowing that most people take for A frequent contributor to Commu- how to’cope:. 4. . I’m going to granted every day. When nicating Together. look at the negative side of Sue awoke to begin her day, “The most hurtful thing to me change and discuss positive she waited to be washed, personally was when I was ways that either I have coped, or dressed, then lifted into her first staying here and asked that I have seen others cope, electric wheelchair. When one of the attendants to be with change. I’m not a profes- hungry, she waited for careful of my equipment. I sional counsellor but I do feel someone to feed her. Every have devices and gadgets that that I have witnessed enough moment of Sue’s life echoed need special care when loss in my life, or in the lives of the same theme — wait. handling them. She seemed to others, to be able to share some When Sue went out, people be treating them roughly. She of my experiences.” stared at her. As she drove called me a ‘fuss budget’. Rev. Lee Mehrlich (1994) her wheelchair, her arms and When I printed out on my legs had involuntary muscle Epson how easily these things “Tt is difficult to know that spasms, and sometimes can be broken, how hard it 1s someone you love is very flailed wildly. And Sue to get them fixed sometimes sick. What seems to be drooled. and how I didn’t want to have helpful is to hope he or she But inside that body that to do without them, she just will get well and to remem- didn’t work was a quick laughed at me and walked ber that person for who they intelligence, a keen percep- away. It really hurt my feel- are, for their strengths, their tion and an indomitable ings. I know I was especially smiles, and the many ways spirit. Sue packed more sensitive at that time, how- that they urge Us'On Sa. =. living into her short years ever, I think a person who Mother’s death is a very big than many people do in relies on devices has the right sadness for us. There is so much longer lives. Even with to expect that their equipment much in her that we do not her physical limitations, she will be treated with the same want to let go of her. All my had a job with a community respect as they are.” life she has been an advocate awareness program. Even for me. Because I could not though she couldn’t talk, Sue speak, she was my mouth... was a trained public pre- COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER 2000 SeliChee. tee Sue never individual’s physical disabili- every opportunity available to questioned her lot in life. She ties to his or her total capacity make choices about his or her life. never asked for concessions for learning and development And when the opportunities are because of her disability. She in a decision which was not not there, they make them happen. lived her life in quiet dignity, only a legal landmark but the Why become independent? In asking only of others that seal on a triumph of the order to be fulfilled as a person, to they treat her as an equal.” human spirit. When asked, realize our unique capabilities and ‘Who will make decisions for make our unique contribution in Treena Guy (1995) you, Justin?’, he responded, our world. How do we do it? oe Interestingly, it is through an “Sometimes when I am out interdependence with others! For it with friends, strangers ask the Paul Marshall (1998) is only through interacting with people that are with me if I Associate Editor, Communicating others that our potential is realized. want something. It really Together. Many AAC users teach this to frustrates me as it is as if I those who interact with them. I[sn’t was not there sitting beside “As I look back over my life, I it wonderful that as we relate with them. I know that they are always had an inner drive to each other, both partners can be afraid to talk to me because be as independent as I could. I contributing to the independence they think that if they don’t am not sure where we get our of the other? And in this regard, understand what I say, I will inner drive to do or not to do there is no difference between get upset. No way would I be things. In my case, it is not an those with a disability and who use upset if at first they didn’t ego trip or “I will show them” AAC, and those who are able- understand. It makes me (well, maybe a little!) frame of bodied! We share much more happy when strangers try to mind. It is just that I enjoy sameness’ than difference. talk to me.” doing things for myself even if I have to struggle and put Justin Clark (1996) more energy into a task.” We want to remind you again Described by Shirley McNaughton And there are many more as we did in the last issue that this “At the age of eighteen (legal examples that space limitations is our last year of publishing age of adulthood) a Rideau prevent us from sharing! Communicating Together. There Centre psychiatrist certified will be four more issues published Conclusions that Justin Clark was able to after this one. It has been a won- So, why become independent? make his own decisions about derful and satisfying experience Perhaps, rather than respond to our matters affecting his life. for all of us. We particularly enjoy original question, we should first Justin’s father, Ron Clark of the lively and invigourating an- change it slightly to “Why become Ottawa, concerned for his nual editors’ meeting where we an independent person?” For it is son’s future, filed court action argue and debate what are the the full person that counts, not one [1983] to have him declared most important issues in AAC that facet of the individual that may or mentally incompetent under should be covered in Communi- may not be “independent”. In fact, the Ontario Mental Incompe- cating Together in the upcoming the writing of this article has lead tence Act. In the ensuing year. We are going to try to make us to consider what we should highly publicized week-long this last year our best! We hope have been thinking about all along case, Justin told the court, you will continue to subscribe for “What is an independent person?” through his Blissymbol board, one more year. There are many examples that he believed he was capa- In the next issue, the theme ts above and in the pages of Com- ble of making choices for “Dreaming — everyone has the municating Together since our himself. right to dream!” first issue in 1983. An independent At the end of the trial, person is one who is confident in Judge Matheson challenged who he or she is and who takes Oe) Canadians to look beyond an COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER, 2000 7 AS COMMUNICATION CHANGES Smelling the Flowers chronic care hospital she lives in. me connect to others, for example Audrey uses a wheelchair and call Wheeltrans to arrange a pick- ALDA STEPRANS relies on caregivers for all her up time, but I am happy that I can needs. Although Audrey cannot direct those who help me. I am speak, she can spell to make her independently minded enough to needs known. communicate what it is I need or want. t’s important for me to be as Because I have an electric independent as I possibly wheelchair and know how to use it can be. I like to do as much safely, I can go to the corner store, as I can for myself. For some out to the hairdresser’s or down to things I am very dependent on the park on my own. I even went others. I need to be washed, to the hardware store around the dressed, helped out of bed and corner to buy some hooks. My listened to. But, I can feed myself, wheelchair has opened up my paint, make my own decisions and world so that I’m not having to be communicate using my letter in the same place all the time. I get board or Light Writer. Alda Steprans to see new places and experience If I wasn’t as independent as | new things. I enjoy that. It is much Those of you who read Com- now am, I could not get to the oil more exciting than being in the municating Together regularly painting classes I attend at the Pat hospital I live in all of the time. I know that Audrey McGee is a Arato Aphasia Centre. I love going love to see the flowers and trees in regular contributor. She suffered a there! It was only because I was the gardens of my neighbourhood. stroke some years ago. Because independent enough to use she is slow to learn she did not do Wheeltrans that I even got the AUDREY McGEE well in a rehabilitation setting, but chance to go. Because I cannot § continues to enjoy learning at the speak, other people have to help READERS WRITE We did not have space fora There is a huge difference between access graphics easily and voice Using Technology section in using a computer system or a very output has been the best means to this issue. We did however sophisticated voice output device and open up communication opportunities receive an interesting comment some introductory voice output device for them. I imagine that you are from a highly experienced AAC with a young child. Also, use of a worried about devices being used clinician and one of our readers, voice output device does not preclude exclusively. I don’t think that the Shelly Deegan. It is interesting to the use of non-technical means of approach should be to shy away from note how compatible Shelley's communication. What ever happened technology — technology is here to remarks are with Tracy to the philosophy of ‘total communi- stay. We should focus on how best to Shepherd's (see page 9-10). cation’? It was widely acknowledged use technology, how to make it work that the use of signing and graphic the best for our young clients to help would like to make the follow communication worked well together teach language, communication, ing comments. There were to enhance overall communication. social skills. Let’s make technology requent negative comments re Why shouldn’t technology be part of work for us, rather than fearing how it the use of technology with young the mix? There is no better way to is impacting on the field of AAC and children in the Summer 1999 issue of teach initiation and interjection skills to AAC users. Communicating Together. I feel that children than through voice output. I Shelley Deegan this needs some clarification. I often have very young nonspeaking visu- Chedoke-McMaster wonder what people mean when they ally impaired students who cannot Technology Access Centre lump everything under ‘technology’. Hamilton, Ontario 8 COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER 2000 CLINICALLY SPEAKING Baby Steps Toward Independence to make more of their own choices the pressures of time removed this and gain their independence more must take a tremendous strain off TRACY SHEPHERD quickly. It is interesting to see the AAC users and help to make transition. communication exchanges more Clinically speaking there are so relaxed. many wonderful devices and Low technology is really computers out there for our clients. amazing in providing independ- Many of these options promote ence with promoting more intimate our clients to be independent and conversations and speed. Most of open up opportunities for them. the AAC users I know are faster Let’s talk about computer technol- and more comfortable when ogy. Everybody and their brother having a one-on-one conversation is making devices that can do using their low-tech systems. And anything from calling to order a let’s be honest - they don’t break pizza to doing the dishes when down. One user I know has a you are finished eating it. The Blissymbol board and communi- devices and computers are becom- cates mostly with her mother at ing very sophisticated. Devices home. The board must have Tracy Shepherd literally will open doors for indi- hundreds of Blissymbols on it but viduals with communication they are so well used that the difficulties and allow them access symbols are actually worn out. to the world outside which they They haven’t bothered to replace didn’t have previously. The the symbols since they both know he goal of independence Internet alone has been remark- what the symbols are from is an overriding for able. Individuals with disabilities memory. Needing to use low-tech, our clients. There are so who for a long time needed assist- you might say, does not promote many ways to explore options for ance to do their banking and independence. To the contrary, independence and each individual shopping and communicating can one must always have a communi- defines their independence differ- now go on line with adapted cation partner to have a conversa- ently. It is quite exciting to see access and do these functions tion so there is always the need for clients able to do something themselves without a facilitator. another person to “assist”. independently with or without In more recent past, adapted Voice output certainly has its technology that they were previ- access to the Internet has im- place. There are times when folks ously not able to do. This becomes proved making the process a bit need to give a speech or use the the highlight of clinical visits when easier for individuals with physical telephone and these occasions we can train a skill and come back access issues. It certainly opens up lend themselves well to the use of the next time to see the skill per- new worlds for them! E-mail is a VOCA. These seem to be more fected and the client asking us for another avenue that allows access “out in public” kinds of uses more information, “How do you and communication. As we know where projection 1s a concern. do. .5. “Lnis Keeps US on Our AAC users are typically a bit slow Multi-modal communication is the toes. For children the steps toward in their communication exchanges. most effective way to achieve the independence are slow and small Using e-mail nullifies the difficulty highest level of communication but as individuals enter adoles- in having to wait for a reply. When possible. I am lucky enough to cence and adulthood they are able using e-mail you get to the re- have some friends and colleagues sponse when you get to it. With who demonstrate the epitome of COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER, 2000 9 these skills. Given the many example of independence. Of modes and systems for AAC there course, AAC users need to be COMMUNICATION MATTERS are many options for independ- intimately involved in the choice of ence available to individuals. It vocabulary available to them. We is an affiliated publication seems to be getting the right really need to make a big effort to of the combination for each user and include them in this process and, International Society identifying the best mode for each damn it, we need to give them the for Augmentative & Alternative situation that promotes the most opportunities to swear if they want Communication (ISAAC) independent communication to. I have a hunch that they are possible. probably swearing at us if we don’t Editors: Sally Millar & Patrick Poon Edinburgh, Scotland I would like to speak to the include them in the process. selection of vocabulary that goes Other issues around independ- Published in the UK into the voice output devices and ence and vocabulary selection 3 times per year communication displays. There is include the need for the younger a real struggle on the part of those child who is not yet literate to have Special Rate to ISAAC Members: trying to gather this information. a facilitator program all the vocabu- $44. US In a lot of cases the non-verbal lary for the child. This really takes $68. Cdn individuals don’t have the input the independence away for the child they should about what goes onto and vocabulary often doesn’t get Case studies their communication displays. I updated and refined often enough. Clinical/educational practice newly developed AAC systems was once involved in a discussion Vocabulary needs to be constantly book reviews with a colleague who was opposed reviewed and updated with as much recent or in-progress AAC research to there being swear words on a involvement of the child as possible informal and easy to read low tech display of a high school in order for children to have appro- multidisciplinary perspective student. Their rational was that it priate opportunities to communicate. articles by teachers, therapists, engineers, researchers was not appropriate for that stu- This issue is eliminated when those dent to use those words in the high who have acquired literacy skills Subscribe through ISAAC school environment. Well don’t get can program their own vocabulary. or directly through: me started! I certainly feel that any So there are some natural barriers vocabulary available to any other requiring attention regarding the Communication Matters high school kid should be avail- selection and programming of Fax: 0131-651 6234 Email: sally.millar@ ed.ac.uk able to any kid who happens to vocabulary. use augmentative and alternative I once had a teacher ask me communication. The thought of about a child who had a this individual is that those words Touchtalker, “How many times a should not even appear on the day do you want Susie to use this display. This really makes my thing?” Somehow the idea of com- blood boil. I strongly feel that munication and independence ISAAC Israel Journal while kids probably should not be seems to get lost in the glitz of the an affiliated ISAAC publication using foul language, the truth of technology. My answer to her was the matter 1s that they do! of course “six and the rest of the Published annually in the spring in We need to allow kids using class can only make six attempts at Hebrew with English abstracts. AAC the opportunities to find out communication throughout the day Subscribe through ISAAC when it is appropriate to use that as well!” language and when it is not. Let We have come so far with help- Rate to ISAAC members: them experience the natural social ing individuals communicate and Regular mail: $20.00 US consequences of using foul lan- with bridging a few gaps to inde- Airmail: $25.00 US guage at inappropriate times. Live pendence. There will always be and learn! After all, that is how all barriers but together we can help to other kids learn when they can use resolve them one issue at a time. that language. Here is a prime 10 COMMUNICATING TOGETHER VOL. 16, NO. 4/WINTER 2000

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