Friday, November 27, 2009

From Recipes to Rockets: AAC - Part 2

The process of funding a device, the SLP report, Medicaid applications, etc. can be daunting for some. Put on top of that, the time invested in the trials and matching an appropriate device, and you can be sure that when you see the device in a student's hands it is time for celebration.
I shared in Part 1, how we developed activities to get a middle-school boy using a Dynavox V.
We were discouraged after all our work, having Medicaid deny our claim. I have to say that all through this, the Dynavox team in Pittsburgh held our hand and the area consultant kept us in the loop as they did detective work to find what we needed to fix and re-submit our request for funding. Finally the word came back about August that we didn't do 2 things: the diagnosis for the student had a code number that had a .0 after it - we had not put it down. For example, 2145 would not be good enough. It HAD to be 2145.0! Then, for some reason, the screener of the claim wanted to not only see that there was an AT specilaist (me) overseeing the initial implementation and training, but they wanted the NAME of the AT specilaist in the description.
Past experience on everyone's part never showed that this had been necessary before - but - OK, we re-submitted and waited...
September came and went, October came and went, and then the first of November - at last! The device was approved and would be shipped out. We were ready to go down the next road, which is the set up and implementation piece.
I got a call this week from the family - they had the device and were SO excited. They wanted to know when I could come to help them get it set up. I drove over and met with them for a couple of hours and we built the student's user profile. I showed them how to edit buttons and some beginning strategies to get it up and going. Dad took a picture on his phone of his son with the device to send to the SLP that had done all the hard work of getting this boy this device (He had been transferred to new students in a new community in our region and would no longer be working with this student).
It was so exciting to leave the family with a device up and running so they could help their son express himself with his new voice for Thanksgiving break. I drove away with that great feeling that you get when you know you are in a career with some great rewards that are truly the non-financial and intangible kind. I was truly thankful.
I have another student waiting for his new device as well in another town. His didn't get denied, but we have been puzzle-piecing the funding from various sources and it has also come together in the past week or so - and he will be getting his for Christmas!
All the best to you!


Bookmark this on Delicious

Thursday, November 26, 2009

From Recipes to Rockets: Building a Fun Foundation for AAC use

One of my biggest thrills is getting to be there when students get their "voice". It is extra special when it happens over the holidays, making them ones to remember. I have been working with a speech pathologist and a family for over a year trialing devices and doing activities to develop skills with a middle school boy in order to have a speech device. We decided on the Dynavox V, and designed activities for him to use coordinating communication boards we designed.
This student had a history of short attention span, getting bored quickly with everything. I had tried working with specialists through elementary years to design a binder, picture exchange systems, use recordable symbol boards like with a Go Talk, but he would refuse an nothing could be developed.
So... last year, in a new school in a new district, we embarked on the Dynavox trials. Our first activity was building a peanut butter and jelly sandwich. Since food is the way to a middle school boy's heart, we graduated to a build a pizza activity as well. As we did these, we had a partner for the student be a helper and we set out all the ingredients. We had a folder in a snacks category that was "Build a Sandwich" or "Build a Pizza". We had all the ingredients pictured and listed with voice output and also had directive buttons labeled and pictured with a sequence of tasks to complete the activity. We went through all the items and directions with the students and checked him out on them by having him show us and "tell" us each button.
Then he used the buttons to tell the partner what to get and what to help him do to finish the recipe and then the the finished product.
We video-taped each of these and with permission from the family, showed them to the fellow-SLP's in staff meetings.
Last spring our culminating activity for the year was pretty ambitious. We bought a simple beginner level rocket kit and took digital photos of all the parts and sequences to building it. We built pages in his school/classes/science area and followed the same process of teaching him the parts identification, labeling and sequences to the finished product. We then took him out with his class to the football field to launch the rocket. We even had the countdown and lift-off ready for him to use on the device.
We saw a boy that never would use a device to communicate, begin to get the connection that this could be fun and be used to do things and work together. It went beyond the usual run-of-the-mill buttons we tend to use at school - "I'm thirsty", "I'm done", "when is recess?", "I need to use the bathroom" - with the picture of the toilet on the button - how exciting!
We began the actual funding piece with awesome support from the Dynavox team in Pittsburgh, and our area consultant. We applied to Medicaid, got the SLP report, all essential pieces in the packet and off it went.
About July, we heard back that Medicaid had denied the claim and we were back at square-one having to re-submit the claim. Summer turned to fall and still no device. There had been 9 months of school dedicated to training and trialing, we had all our ducks in a row, but still no device.
Was all our labor in vain? I received emails from the rep and the company that they were trying to find out why Medicaid denied it and we just had to sit tight until we knew what was wrong so we could correct it.
Part 2 is coming up with the end results...

All the best,