Carol Goossens lecture

about the speaker
Carol Goossens’


Hi, I am a speech-language pathologist and special educator currently working as a consultant at the Henry Viscardi School in Albertson, New York. For the past 15 years I have worked as a consultant to several agencies in the New York City area (United Cerebral Palsy of New York City, New York City Schools, Herbert G Birch Services and The Shield Institute) and as a result have had the good fortune of working with a broad spectrum of children with special needs (children with developmental delays, multiple handicaps, cerebral palsy, autism spectrum disorders, English as a second language). I’m especially interested in the area of Augmentative and Alternative Communication and love the challenge of working with children with Complex Communication Needs. In my spare time? you ask … I enjoy making large puppets and creating art quilts that incorporate New York City graffiti (yes, I did say graffiti). Ask me about my cat’s VOCA.
taken from http://www.ncds.org/GI/ireland/bio.aspx?ID=31 on November 15, 2008


Sapphire: 10 years old 3rd grader, very motivated and eager to please
she would be a challenge because she is in a wheelchair and from clip, she displayed a lot of spastic movements
sever ballistic movement patterns-she is not able control body, always in motion
lets get into negative speech, shall we?
-cannot walk
-cannot talk
-cannot feed herself
-cannot turn book pages
-cannot write with a pencil
technology can possibly the necessity
it isn't solely about the technology, match tech with needs of indivdual
all about teamwork
lots of team support
communicates often with nonverbal head shape and yes eye-gaze, differentiated groans, used eye gaze to communicate
non-electronic communication pages
access to her communication pages? used head-pointer early on,
ACCESS: Headpointer
head pointer advantages:
-easy to make
-only means to independently access comm device
-easy to point or mark manipulatives
head pointer disadvantages
-potentially hazardous with poking other students
ergonomics, straining on her neck, fatiguing
-limited functional range
-this particular model was not stable
possible improvements? custom leather housing fro stability, angles tip to improve ease of use

a collection of techniques is usually necessary to really make headway

current access:electronic switches
using head switch and scanning selection technique to access vocabulary
highlighted vocab one by one, child hits switch to select
advantages:
-less fatiguing
disadvantages:
-slow
-requires a lot of practice to gain reliability

Diagnosis:
CP, quadraparesis with severe ballistic movement patters
functional implications of movement patterns:
impact: -task of feeding keeping hands away from food -safety to self, scratching accidentally -safety to others, involuntary harm -ability to reliably access the curriculum
potential solution:
-upper and lower extremity stabilization in order to access curriculum
?tuck arms beneath her chest harness
problems:arms slipped out of harness, worries of poor posture
potential: custom made upper extremity stabilizer
collaboration amongst multiple experts to try out different apparatus
confusion with stabilizer or restraint? how does the child feel about that? it allowed her to do more things than she could normally do, and therefore, it truely was a stabilizer
custom made worked great
-increased feeding time
BUT...perioding jaw locking...is it the result of the stabilizer or something else?
also at home, and stabilizer not at home
*need for wearing schedule
roll with the punches
she bottled up involumtaries and it manifested in another form
changes needed over time with change in weather

Access: Eye Pointing another access point
based on eye track during movement of a letter board
advantages:
-fast for spelling tests
disadvantages:
-communication through spelling is slow
-need good spelling skills (Sapphire only had beginner spelling skills)

therefore not good for communication
Access: Light pointer
light on head
advantages:
-not as fatiguing as headpointer
-more accurate
-broader range of access

they made a custom piece more comfortable and less cumbersome than the manufactured one
about the screen to point at...
-angled vs vertical
-best range of motion
tested out both with games, ended up with vertical
during this engagement, sapphire had her first apontaneous communication!!! yay
checked in the classroom
this previous was all preliminary, now onto range of motion, size of symbols
peers seemed to view her in a different light given her new ability for communication

pause at 50 minutes because this connection is not working right, causing more frustration than it is worth right now

determined range of use and then determine size of symbols
making adaptive materials accessible to all students eliminates some of the stigma involved
"disabled"
looking as locomotion...powerchair...$$$$
switches on headrest to control the movement
team approach again: team kind of talked about Sapphire like she is not therem respect for each other, but i don't like the way they are manipulating sapphire without verbally addressing her
team submitted twice for a powerchair and received in a long time 1 year 7 monthslater cost: $30,000
who paid? either the state or insurance, not parents
training from january 2005
looked into navigation issues, hallways, classroom, home, outside, independance
Access: Head Controled mouse
begins with facilitated screening
at computer used classroom suite for electronic books

art activities on the computer coloring, drawing, applying virtual makeup, stamping
e-book options of recording, go forward, go back, read again
can do recorded speech or synthetic speech(highlights words as they are read synthetically)

Sapphire does great with her new technology

link to classroom suite http://www.intellitools.com/
kid pix deluxe http://www.kent.k12.wa.us/KSD/IT/TSC/prof_dev/kidpix3/
e-books assignment she says is great for students developmentally delayed or who have autism, I think its great for all children
booby-traps embedded within the program (3 of them)
requirements: take a book, scan a minimum of 8 pages, import pages into an ebook template, must be fully functional, operates smoothly, attention to detail
create a text box to retype in the text