Being an Occupational Therapist in a Speech Therapist World
By Emma Emmerich
As an OT passionate about AAC, I often get asked: “Doesn’t AAC fall in the domain of the Speech Therapist?” And yes, it does make sense to think that all things related to communication would be looked after by the Speech Therapy profession. Luckily, AAC best practice recommends a team approach, where each team member contributes valuable insight into different parts making up the holistic view of the individual in need of AAC.
In my experience, OT’s are very valuable members of the AAC team. Of course individual therapists differ in their level of expertise, interest and post-graduate training. In an earlier piece, I spoke about the importance of seating and positioning for AAC access. This is one area we really make an impact. Who is better equipped to address positioning challenges than OTs with knowledge on seating and a philosophy of enabling function?
Secondly, we OTs are masters of adaptation. Like the Afrikaans saying goes “’n Boer maak ‘n plan!”, we sure know how to make something out of nothing. We use what is available and somehow make it work, at least until the more permanent solution becomes available. In AAC intervention, this is a life saving skill.
Another key principle underlying OT practice is the notion of enabling independent function and participation in activities of daily living. Assistive technology can open up new possibilities for individuals with very little functional movement. Consider things like using environmental control options to operate a TV, lights, bed controls or alarm. In rehabilitation settings, the OT would be the person responsible for adaptations to the client’s home.
Number 4 on my list of OT skills, our knowledge of vision and visual perceptual skills can and should influence the design of the AAC interface. We can make informed decisions on the actual design (grid layout or visual scene display?); number of items on the display (visual complexity); use of colour, contrast and size. Some individuals might need help with the development of visual fixation or tracking in order for them to use their AAC device effectively.
I could continue to list of skills that OTs bring to the AAC team, but I think you get the idea. The important thing to remember is that every member should be committed to the team goals. Working on your own goals in isolation will not contribute to the bigger picture, which should always be to facilitate communicative competence. Each team setup will be different, and as long as team members respect each other, anyone can be the team leader. Acknowledge your skills and weaknesses, and ask for help.
I have worked with many other professionals, and we do have to acknowledge our different backgrounds and opinions. Respect needs to be earned, so I go about my day willing to earn that trust. I don’t try to tell anybody what to do, and I commit to challenging popular opinion if it does not fit with what I know about AAC. AAC is not a last resort. AAC does not hamper the development of speech. There are no prerequisites for using AAC. Any person can communicate.
Romski, M., Sevcik, R. a., Barton-Hulsey, A., & Whitmore, A. S. (2015). Early Intervention and AAC: What a Difference 30 Years Makes. Augmentative and Alternative Communication, 4618(June), 1–22. http://doi.org/10.3109/07434618.2015.1064163
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