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Augmentative and Alternative Communication Systems for Persons with Moderate and Severe Disabilities.

Readers will welcome the sensible approach to communication systems presented in Augmentative and Alternative Communication Systems for Persons with Moderate and Severe Disabilities. The book is upbeat and provides practical insights into the design, implementation, and assessment of communication systems. The authors draw from their own experiences in working with individuals with moderate and severe disabilities to illustrate their approach to developing an effective alternative or augmentative communication system. The book is divided into eight chapters, two of which examine assumptions and factors relevant to selecting and designing communication systems, three that address strategies involved in starting up a system, and three that describe case histories which serve to illustrate the implementation of different systems.

The authors' practical approach to communication systems is quickly established in Chapter One which describes a number of factors that are critical to the design and application of a communication system. Factors deemed to be philosophical in their orientation were chronological age, functionality, interaction, inclusion with zero exclusion, social significance, requisite skills, pluralism, natural environment, preferences, and parent-school partnerships. Selected factors dealing with practical considerations were portability, audience, expansion, maintenance, and comprehensive and integrated assessment. In general, succinct descriptions characterized the authors' writing style with only a few minor instances where a point is lost. The section on the significance of interaction as a philosophical factor is such an example; the distinction between language and communication and their relationship in interactions is not well articulated.

The authors contend that in individuals with severe disabilities, problem behavior may be a form of communication. Thus, as an alternative to traditional behavior-reduction strategies, they advocate a treatment approach that is linked to the need to communicate. Chapter Two focuses on developing treatment strategies for dealing with problem behaviors. Although brief, key issues addressed include processes in the analyses of behaviors and the development and testing of hypotheses relating to the purpose and cause of a behavior. In addition, a paradigm for understanding communicative intent and functions is described that is based on Wetherby's and Prizant's (1989) work in this area.

Chapter Three, "Getting Started," looks at the selection and use of augmentative and alternative communication systems. According to the authors, the key to an effective communication systems is to ensure that it is matched with the needs of the individual. First steps in designing, implementing, and evaluating a communication system are described within a framework that emphasizes a thorough understanding of the content, form, function, and context of existing communication signals and aims for consistency in production of signals and in the response to them.

Chapter Four looks at options beyond the initial set-up of communication systems. The options explored are: relating signals to more conventional behavior; changing symbolic forms; enlarging the number of behavioral or symbolic forms; adding new functions; expanding the range of communication partners; using a system in new contexts; and developing independence in an individual's use of a system. The authors were careful to discuss potential constraining factors that might effect efficient use of communication systems.

Chapter Five builds a case for assessing relevant skills in the use of communication systems with an emphasis on visual tracking and scanning, the determination of dominant hand, and the extent of basic receptive language abilities. Examples of assessment strategies are given as well as suggestions for incorporating assessment outcomes into a communication system. The chapter ends with a reference list pertaining to the assessment of students with moderate or severe disabilities.

Chapters Six, Seven, and Eight provide case histories of the application of alternative or augmentative communication systems for seven individuals from preschool- through adult-age groups. Many readers will find these case histories to be the most rewarding aspect of the book. Each one helps the reader conceptualize their knowledge of the principles and applications of communication systems within the context of real people in real situations. Preschool individuals are examined in Chapter Six, Chapter Seven describes the case histories of three elementary-age children, and Chapter Eight relates the case histories of one adolescent (19 years old) and one adult (37 years old). Factors salient to each of these age groups are only briefly mentioned. However, the importance of these factors are alluded to as the case histories are unraveled.

Associates to individuals who are either using communication systems or are candidates for them will find this book to be a refreshing look at the issues and options relating to the effective use of these systems. All readers, including parents, will find the authors' writing style pleasant to read with terminology and case histories that are easy to understand.

Reviewed by DAVID A. STEWART, Associate Professor, Michigan State University, East Lansing.
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Author:Stewart, David A.
Publication:Exceptional Children
Article Type:Book Review
Date:Dec 1, 1991
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